On the extent of the pleura above the clavicle / by C.E. Isaacs.

  • Charles Edward Isaacs
Date:
1857
Catalogue details

Licence: Public Domain Mark

Credit: On the extent of the pleura above the clavicle / by C.E. Isaacs. Source: Wellcome Collection.

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    muscle, and the subclavian artery. It usually extends some¬ what higher on the right side than on the left.”—Allen's Dis¬ sector, p. 296. Wilson remarks that “ the pleura covers the thoracic surface of the vessels, at the root of the neck, extending for somewhat more than an inch above the margin of the first rib.”— Wilson's Dissector, p. 306. I have consulted the Encyclopedia of Anatomy, Bourgery and Jacob, Sibson’s Medical Anatomy, the works of Meckel, Hiische, Theile, Velpeau, Blandin, Malgaigne, and many others, without finding any more information upon the subject. Hot the slightest mention is made of the extent of the pleura above the clavicle. Having been aware, for some years past, of the great height to which the pleura sometimes extends above the clavicle, and of the practical bearing of this fact, I consulted at that time many of the works already quoted, but to my surprise met with the result already stated. As I continued occasionally to observe this arrangement of the pleura in the neck, it seemed to me that this point was of sufficient importance to demand investigation, and I shall here give the result of examination of one hundred subjects, in which I have endeavored to use all possible care and precaution, so as to ensure accuracy in every observation. The following method was adopted: The subject being placed upon the back upon a firm table, the thorax was opened in the usual manner, by cutting through the cartilages of the ribs, and either sawing or breaking through the sternum, near its junction with the second rib. The next step was to ascertain that the body was squarely and evenly placed upon the table, the arms lying easily and evenly by the sides, and the head, neck, and upper extremities put into as natural position as possible. Care was also taken, in measur¬ ing the extent of the pleura, not to disturb the parts any more than could be avoided. One hand was then introduced into the thorax, and into the superior part of the pleural cavity, above the clavicle, and this was carefully examined. By the other hand, applied upon the skin, the opposite fingers of the hand first introduced could easily be felt through the inter-