Concerning aneurysms : the Gordon Bell memorial lecture / by Oskar Klotz.

  • Oskar Klotz
Date:
1926
Catalogue details

Licence: In copyright

Credit: Concerning aneurysms : the Gordon Bell memorial lecture / by Oskar Klotz. Source: Wellcome Collection.

    19/80 (page 17)
    bulge at the site of injury. In his researches he was able to find only two or three specimens in which the wall of the aneurysmal sac consisted of the annular muscular fibres, and this he believed was the only criterion whereby true aneurysm could be distinguished. In 1749 Haller made the remark that “aneurysms of the aorta near the heart are no longer of rare occurrence”. The cases which he reported appear to have been of a luetic kind. At about this time aneurysms appear to have been fairly common in England, for William Hunter (1757) reported his observations upon a number of them. He recognized three types of aneurysm: (1) true, by dilatation; (2) false, by rupture; (3) mixed, that is, partly by dilatation and partly by rupture. He gave as his opinion that aneurysm of the aorta was incurable. Though he recognized clearly the association of syphilis with aneurysm, he did not think that this was the only cause of the aortic disease. Hunter appears to have been the first to recognize clearly the development of the arteriovenous aneurysm produced through blood-letting. During the operation of venu-punc- ture, the knife is by accident driven through the vein walls into the underlying artery. This, he found, led to the permanent establishment of a communication between the artery and vein. Hunter also described the varicose aneu¬ rysm in which the dilated artery assumes a very tortuous course. It is not clear that this type of arterial change should merit a distinct name, since the majority of his cases appear to be nothing else than the irregular dilatations and sinuous course of sclerotic arteries. He spoke of the serpen¬ tine appearance of the thoracic aorta of a woman, as well as of similar characters in the peripheral arteries of the extremities. A very interesting series of aneurysms was observed by D. Monro in 1760. Some of the lesions he recognized as arising in association with injury, while the internal thoracic type he believed of spontaneous origin. His observations upon these aneurysms, each of which was carefully dissected