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.

    29/50 (page 29)
    come across any case in wliich the direct^ physical signs of an aortic aneurism were so closely simulated. The pulsation and limited dulness at the seat of election of aortic aneurisms resulted, of course, from the presence of the tumour and from the way in which it was related to the aortic arch. The accentuated second sound was due, chiefly, I think, to the increased arterial tension which resulted from the kidney disease, partly, to the dilated condition of the aortic arch. The systolic murmur and thrill were evidently caused by the passage of the blood over the thickened and roughened aortic valve. Case of Aneurism of the Aorta, Innominate, Left Common Carotid, Right Common Carotid, and Left Subclavian Arteries, simulating Solid Intra-tlwracic T%imour. M. F., £et 64, a striker, was admitted to the ISTewcastle-on-Tyne Infirmary under my care on 18th February 1878, suffering from oedema of the face, neck, and upper extremities, and complaining of shortness of breath on the least exertion. Previotis History.—The patient, who had been under my care for some days as an out-patient, stated that he had been through life an unusually strong healthy man. He had neither suffered from rheumatism nor syphilis. His present illness commenced some six weeks previous to admission with shortness of breath on exertion. This was followed by swelling of the face and hands. He had of late occasionally experienced a slight pain under the manubrium sterni and in each shoulder. He had lost flesh, his voice had become thicker than it used to be, and there had been some dysphagia. Condition on Admission.—The patient was extremely dirty, the skm being of a deep brown colour; this was so marked that the case was sent to me as one of Addison's disease. The nipples, genitals, and axillae, were not specially pigmented. The patient was fairly nourished, though he stated that he had lost flesh. The base of the neck was very much swollen and hard. The face, upper extremities, and upper part of the thoracic wall were cedematous. The superficial veins of the thorax and abdomen were engorged and prominent. (The veins of the head, neck, and upper extremities were also engorged, but were in oreat part hidden by the oedema.) There was well-marked pra3Cordial vascularity. The lips were swollen and blue. The slightest exertion, such as getting out of bed to urinate caused great shortness of breatli. When at rest the breathino- was natural. Food seemed to stick at a point correspondinf^ to the manubrium sterni. There was some cough and frothy expectoration. • I.e., the physical sigias at the seat of the aneurism, in contra-distinction to tlie HKiirect or pre.ssure signs.