Four cases illustrative of difficulties in the diagnosis of aneurysm of the aorta / by Geo. S. Middleton, M.A., M.D., F.F.P.S., Physician to the Royal Infirmary and to the Royal Hospital for Sick Children.

  • Middleton, George S.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Four cases illustrative of difficulties in the diagnosis of aneurysm of the aorta / by Geo. S. Middleton, M.A., M.D., F.F.P.S., Physician to the Royal Infirmary and to the Royal Hospital for Sick Children. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    face it was evident that there was a great bulging of the left side, extending from the 9th dorsal vertebra to the sacrum, the centre of greatest prominence being at the level of the 11 tli dorsal vertebra, 2d inches from the middle line. Dulness commenced at the level of the 7th dorsal spine, extended downwards to the crest of the ilium, and was Fig. 1.—Percussion dulness, 5th November. St. indicates stomach note. Fig. 2.—Percussion dulness, 5th Nov. The deeper shading indicates greatest bulging. continuous with that described in front. Over the greatest o bulging, i.e. over 10th, 11th, and 12th ribs behind, there was marked pulsation, but not excentric (Fig. 2). A systolic murmur was audible on both sides of the spine over a wide area. There was no apparent difference in the femoral arteries. There was no tenderness on percussion of the vertebrae and no sign of any interference with the spinal cord. There were no tumours on any of the bones. The decubitus was on the left side tending towards the prone position, with the right thigh flexed and the left extended.