Case of aneurism of the innominata, treated by ligature of the right carotid artery; with observations / [Sir William Fergusson].

  • Fergusson, William, Sir, 1808-1877
Date:
1841]
Catalogue details

Licence: Public Domain Mark

Credit: Case of aneurism of the innominata, treated by ligature of the right carotid artery; with observations / [Sir William Fergusson]. Source: Wellcome Collection.

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    afforded, were I not to express my conviction, that in this case,, in so far as the aneurismal sac was concerned, the changes con¬ sidered favourable for a permanent cure, had gone on in a most satisfactory manner. The sac had diminished in size, and after death, was found filled by clots of fibrin, which I am satisfied were only formed after the operation. The symptoms after the operation were in some respects pecu¬ liar; as, for example, the difficulty of swallowing, and also an¬ other which is not referred to in the report, viz. an inability to modulate the tone of the voice, which, when he spoke, resembled that of a boy at the age of puberty. The former of these, and perhaps also the latter, may be attributed to the inflammation and suppuration in the textures between the wound and the side of the larynx. The same condition of the parts may account for the increased fulness observed in the left side of the neck; the parts covering the larynx and trachea perhaps yielding more readily to pressure from swelling, than the textures on the right side, already condensed by inflammation. It will be remarked, in the report, that the pulse gradually rose from the second day after the operation; a circumstance which made me more uneasy than I might otherwise have been : I must confess, however, that, though convinced of the existence of bronchitis, I had no suspi¬ cion that there was such an extent of inflammation in the left lung, as appearances on dissection evinced; and it is remarkable that the patient should have made no particular complaint of pain in this region. The softness of the pulse, the cool and moist state of the skin, and the absence of all those symptoms usually denoting serious inflammation in the chest, seemed to me suffi¬ cient to lull all suspicion of wrong. I have often wondered since, whether the action of the tartarized antimonv on the heart and m/ on the skin, could have given rise to deception ? and also, what might have been the effect of abstraction of blood at an earlier period in the treatment ? The latter question I deem one of great practical importance, in reference to the treatment of aneurismal cases after operations; but ifca discussion would lead me beyond the scope of this paper, which, I fear, has already extended be¬ yond all reasonable limits. BALFOUR AND JACK, PRINTERS.