Collection of facts illustrative of the morbid conditions of the pulmonary artery / by Norman Chevers, M.D.
- Norman Chevers
- Date:
- 1851
Licence: Public Domain Mark
Credit: Collection of facts illustrative of the morbid conditions of the pulmonary artery / by Norman Chevers, M.D. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![that the mfants have survived for more than a few days, but I shall hereafter have occa- sion to quote a case (by Dr. Mauran) in which, although there was merely a single auricle and ventricle, and the pulmonary artery was impervious at its origin, the child lived ten mouths and a half. A single ventricle giving off a single ai'tery (aorta), ivhich distributes ttvo branches to the lungs. A malformation of this kind was observed by Dr. Farre*, in a male infant, which died seventy-nine hours after birth, having suf- fered for thirty hours from dyspnoea, and some coldness and livor of the surface. The heart was found distended to the utmost with blood : it consisted of an auricle and a ventricle. From the ventricle one artery— the aorta, furnished with semilunar valves— arose; its first two branches were pulmo- nary, very large, and situated close to each other.f Otto describes that when there is a single arteri;il trunk from the heart, the pulmonary branch or branches are usually given off low down. Occasionally, however, higher up in the ascending portion of the aorta, as de- scribed by J. F. Meckel (Descriptio Mon- strorum Nonnullor, p. 11). Heart consisting of two auricles and two ventricles, giving off' a single artery, which distributes pulmonary branches. M. F. Tiedemann observed the following singular malformation in the heart of a male child, which died 9 days after its birth. The superior and inferior vena cava, and the coronary vein, opened into the right auricle. From the arterial part of the heart arose a single but very large trunk. After giving off the coronary arteries, there arose from the right side of this great trunk a large artery, which ascending gave off the left and right carotid, and the right subclavian. From the posterior part of the great arterial trunk the left and right pulmotiary arteries originated ; these were sub-divided and dis- tributed in the usual manner. A little higher up the main trunk bec.ime very much contracted, but immediately after- wards resumed nearly its former caHbre, and represented the descending aorta. From the arch of the aorta (beyond the contrac- tion) the left subclavian artery aro^e. The foramen ovale was pervious. The right * Pathological Researches, Essay 1, on Mal- formations of the Human Heart, p. 2. t M. T. Weber (Observatio Anatomico Path, ue Lorde Lniveiitriculari e quo unus tantum truricus arteriosus surpit. Bonna; : 1832) de- scribes and figures a similar malformation which he found in the heart of a calf. There were however, two auricles in this case, and alarffc a8c'^,uIig'„„X''' '^•■^ auricle communicated with the right ven- tricle, and the left auricle with the left ven- tricle. The ventricular septum was perfo- rated at its upper part, so as to allow a communication between these two cavities. The great arterial trunk took its origin chiefly from the right ventricle, but there was a small communication of its orifice with the left ventricle also. The child [when born] appeared well nourished, but wasted until the time of its death. It took the breast feebly; the warmth of the body was very sensibly less than that of other children of the same age. Its breathing was always short, but there was not any blueness of the surface. Death was preceded by convulsive attacks, and appears to have been due to inflammation of the spinal chord, and congestion of the meningeal vessels of the brain*. Dr. Arrowsmith, who translated the above case, and appended some interesting physio- logical remarks, justly observes that it appears to be quite unique. The ventricular septum was in great measure formed, al- though the ventricular arterial trunk re- mained still undivided at its origin ; in fact, nearly in its primitive state. It appears probable that, in all the cases where the cavities of the heart remain single, there exists, from a very early period of intra- uterine life, a certain amount of impediment to the pulmonary circulation, owing either to narrowness of the pulmonary vessels or mechanical obstructions of various other kindsf. The figure which accompanies this case, in the original paper, shows that here the afferent vessels of the lungs were of considerable, though apparently not of full, size; hence, probably, the more advanced formation of the septa. The heart consisting either of a single auricle and ventricle, or of two auricles and one ventricle, the -pulmonary artery and aorta arising by separate orifias from the ventricle. There is another class of cases where, the cavities of the heart remaining single, the pulmonary artery is found to have be- come completely developed. The instance already quoted from the Ephemerides be- longs to this class. The following is a nearly parallel example :— In a case published in Hufeland's Jour- nalj, a man, set. 24, who from his infancy had been subject to violent beating of the heart, suffered after an attack of pneumonia from great increase of palpitation and fre- quent paroxysms of suffocation, in which he found no relief, except by pressing the chest * Zeitschrift fur Physiologic, B. iv. H. ii • and London Mkd. Gaz. vol. xiv. p. 704. '' t See Cyclop, of Pract. Med. vol. iii. p 66 T Quoted in the Lancet, 1828-9, p. 137.](https://iiif.wellcomecollection.org/image/b21475350_0011.jp2/full/800%2C/0/default.jpg)
