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

  • William Fergusson
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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    Nine p.m. Pulse 110, soft and compressible; skin moist; no thirst; bowels have been opened once. 2^th. One a. m. Has slept during the greater part of the night, and muttered a little; pulse 110, soft; skin and tongue moist; bowels open; still complains of pain in swallowing. Stitches removed from wound,, which has united throughout its entire extent, excepting where the ligature is placed. The tu¬ mour is decidedly smaller, and the throbbing is less distinct. 25th. Slept well during the night; pulse 110, soft and com¬ pressible; rather stronger in the left wrist than in the right; the clavicle and sternum now much more distinct than before the operation; expresses himself and looks much better to-day. 26th. Still continues to do well. 27th. One p. m. Has been much troubled during the night with cough, attended with difficult expectoration, but has slept tolerably well during the morning; pulse 100; stream of blood through the right radial artery giving the impression of a smaller current than in the opposite arm. Ten p. m. Pulse 110; skin cool and moist; cough trouble¬ some. He is much annoyed by mucus collecting in the larynx; bowels confined; to have a purge of calomel and jalap. To-day the bronchial tubes seem partially filled with an excess of mucus, and he has occasionally, though with seeming reluctance, com¬ plained of slight pain in the chest whilst coughing. 28th. One p. m. Has slept tolerably during the night, though much troubled by cough and difficult expectoration; pulse 110, and much the same in both wrists; breathing somewhat hurried; countenance anxious, and in his manner there is an appearance of distress, for which it is difficult to ascribe a direct cause. There is evidently slight bronchitis, but this does not seem suffi¬ cient to account for his present condition. Bowels being still confined, I ordered an enema, and Sxii. of blood to be taken from the left arm. Ten p.m. Cough more troublesome; respiration hurried and more difficult; blood drawn in the morning, cupped and buffed; pulse 120. The wound in the vein reopened, and blood allowed to flow to the extent of gxxviii, when the patient became pallid and faint, the pulse at the wrist being nearly imperceptible. At this period, the tumour decreased in size, and its pulsations were much weakened. Bowels opened by the enema; the small doses of tart, of antimony, which have been continued throughout the treatment, ordered to be omitted; three grs. of calomel, one of opium, and one of extract of hyosciamus to be taken imme¬ diately. 29th. Blood drawn last night of an inflammatory character. Cough and expectoration have ceased since the bleeding; great
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