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

  • Oskar Klotz
Date:
1926
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Licence: In copyright

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

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    in its minutest part, are very instructive in indicating the care with which pathologicai processes were studied with the crude instruments then available. Each layer of tissue was unfolded with patience to observe its relation to the surrounding structures. In this way the descriptions of the walls of aneurysms are almost as clear as those available to us to-day where the microscope is used to reveal the intricacies of tissue architecture. Monro, by such careful dissections, was able to show that true aneurysms may exist with the dilatation of all the coats of the arteries, or that the aneurysm may possess in its covering only portions of each layer. He stated: “That all the coats of arteries are sometimes dilated is plain to ocular demonstration from the dissection of the aneurysmal sacs in the case of John Parker. It may seem surprising that I should quote so particularly this case for a fact now so generally looked upon as common. The reason of it is that, although we have many histories of cases of true aneurysms related, yet I have not found one of all those I have examined where the different coats of the arteries have been traced by dissection, continued over the whole circumference of the aneurysmal sacs. Haller is the only good anatomist who says he ob¬ served all the arterious coats, particularly the muscular, in an aneurysm. But then he gives no figures of these coats, nor is he particular in the history of their dissection.” Monro could offer no common cause for the majority of true aneurysms. “Strainings of the body, an increased momentum of the blood, and a stop put to its free circulation through some of the large vessels, has been alleged to give rise to several.” He found, however, that “sometimes a scorbutic or venereal taint, or some other acrimony in the blood has been accused”, and he himself felt that “there must either be a particular disposition of the blood, which renders it capable of softening or relaxing the arterial fibres, or some disorder in the fibres or vessels affected, before an aneurysm can be produced.” He found, however, that there was nothing very definite to which the cause of aneurysm might be ascribed.