Cases of aneurism of the aorta, treated by the iodide of potassium / by Byrom Bramwell.

  • Bramwell, Byrom, Sir, 1847-1931.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Cases of aneurism of the aorta, treated by the iodide of potassium / by Byrom Bramwell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    tumour. Tlie facts which led me to diagnose an aneurism were— 1. The rapid growth of the intra-thoracit3 tumour. (Tlie symptoms only dated back five months.) 2. The general appearance and good condition of the patient. 3. The accentuation of the aortic second sound. 4. The pulsation in the supra-sternal notch. 5. The absence of oedema, in spite of the large size of tlie tumour, the obliteration of the right radial pulse, and the engorge- ment of the left braohio-cephalic and external jugular veins. The diagnosis Avas fully justified by the subsequent history. All the cases of intra-thoracic tumour (non-aneurismal) with which I am acquainted have gone on steadily from bad to worse, and have soon been attended with marked constitutional disturb- ance, emaciation, etc. Nor is this to be wondered at, when it is remembered that the forms of morbid growth occurring in this situation are rapidly growing sarcomata and carcinomata. (Fibro- mata and lipomata being so very rare that practically they may be ignored.) Since this paper was read I have met with a remark- able case, in which a cyst the size of an egg was in close contact with the aortic arch at the junction of the ascending and trans- verse portions. The physical signs were^in many respects, identical with those of aneurism. Case V.—Large Aneurism of the Loiver Part of the Thoracic and Upper Part of the Abdominal Aorta. Extreme Emaciation, Pain, and Sleeplessness. Greatly relieved hy Large Doses of Iodide of Potassium. Death after Discharge from Hos'pital from Pupture of the Sac into the Left Pleural Cavity. P. M'C, £et, 41, married, a marine stoi'e dealer, formerly a sailor, was admitted on 20th October 1875, complaining of agonizing pain in the small of the back, sleeplessness, debflity and constipation. Previous History.—His present illness commenced three years ago with pain in the small of the back. Previous to that date he was very healtliy. Eighteen years ago he had sy])hilis For the last SIX months the pain has been terrible. He has been almost constantly under the infiuence of morphia. He has been under many medical men, but has got no benefit. Family History.—Very good. State on Admission.—IIq is a perfect skeleton, and wears an expression of great suffering. He is very pale and anaemic, though naturally ruddy. His hair is red. The left thi^h is shghtly fiexed on the abdomen. He can only sleep in one posi- tion-on hi.g right side, with the thigh well flexed on the ab( omen, and the head and chest propped up by pillows ihere is a marked feeling of fulness, hardness, and resistance