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.

    31/50 (page 31)
    (See Plate vii. Figs. 3 and 4.) (Tliis is a point of some iiuportaiice, for a good-sized aneurism of the innominate was found after deatli. The case does not, however, disprove Dr Mahomed's observations as to the diagnosis of innominate aneurism by means of the sphygmo- graph, for the sac of the aneurism was so filled with coagulum that the normal diameter of the blood channel was accurately preserved.) On 8th March the patient Avas worse ; the oedema had returned. At the time of my visit he was seized with a severe rigor, during which the temperature rose to 105°'2 F. On 9th March he spat up some muco-purulent matter mixed with blood. The base of the neck was very hard and brawny, and the skin had a red, erythematous appearance. On lOih March he died. The post-mortem was made twenty-seven hours after death. The base of the neck was much swollen and infiltrated with serum containing leucocytes. The aorta, from its origin to the termination of the transverse portion of the aortic arch, was very much dilated and atheromatous. (Specimen exhibited at May meeting of Edinburgh Medico-Chirur- gical Society.) A sacculated aneurism, the size of a small cherry, projected from the anterior surface of the aortic arch. This small aneurism, to the outer surface of which the lung was firmly adherent, was completely filled with firm decolorised clot. The base of the clot was level with the internal surface of the aortic arch. The innominate artery was irregularly dilated to the size of a bantam's egg. The vessel, at its origin and at its termina- tion, was of normal calibre. The sac of the aneiirism pressed upon and was adherent to the trachea. The left common carotid artery, immediately after arising from the aortic arch, was uniformly dilated to the size of a damson. The right common carotid, immediately above its origin from the innominate, was dilated to the size of a small cheny. The left subclavian, immediately above its origin from the aorta, was slightly dilated. Firm coagula channelled in their centres filled the aneurisms of the innominate, left common carotid, right common carotid, and left subclavian arteries. The canals in the coagula exactly corresponded in their calibre to the normal size of these vessels. The superior vena cava was pressed upon and greatly obstructed by the dilated arch. The heart was normal, its weight 10 oz. The other arteries throughout the body were natural. Both lungs were adherent at their apices. The upper lobe of the left lung M'as in places consolidated owing to the deposit of small masses of black pigment. The trachea and bronchi were inflamed. The other organs were normal. The cause of the aneurismal dilatation of the arch and its branches was not ascertained.