Case of thoracic aneurism - death - autopsy : remarks on the treatment of internal aneurism / by Henry I. Bowditch, M.D.

  • Henry Ingersoll Bowditch
Date:
[1866], [©1866]
Catalogue details

Licence: Public Domain Mark

Credit: Case of thoracic aneurism - death - autopsy : remarks on the treatment of internal aneurism / by Henry I. Bowditch, 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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    followed by Valsalva, and distinctly pressed upon our notice by Dr. TuffDell,.biit :t.i'fcer all not really'so much relied upon as it ought to have been by him or by his predecessors. On the contrary, he evi- dently considers the very restricted diet as a very important part of the treatD' .at, and he carries this to so great an extent as may here- after pr.:- ent, as it has already prevented, many from submitting to it. This brings me to the final sugge&iious I wish to make upon this subject. Why not, without giving up t ither of the principles laid down b, Valsalva, use ali of them rationally and neither of them heroicQui^ ujiless the very qi et rest of t] c body be considered he- roic? Let me touch again upon each one. 1st Venesection. I should have no hesitation, in using venesec- tion, t a moderate amount, in any case where the pulse was full and strong, and there was much pain and throbbing in an aneurismal tumor. I would use it once, perhaps twice, at i)itervals of days, to a moderate amount—to ten or possibly twelve ounces at one time. Leeches might certainly be used where there was much local pain or swelling. 2d. Diet. I would simply reduce it lo tha v >;t that would just satisfy without overloading the stomach. It shou. > consist of the usual simple meats and vegetables. I should certainly use eggs and meat and albuminous substances generally, in preference to others. I should think the food might be reduced one half. 3d. I would rigidly enjoin absolute rest horizontally. The patient i should not once rise for two or three months. He should have, as | Dr. T. suggests, a room as perfectly agreeable as possible, and at- j tendants to aid and amuse him. 1 would have a bed made for his convenience, and an apparatus by crank, pulleys, &c., to raise him twice daily, still in a horizontal posture, so that the back could be bathed and the bed made anew. 4th. Various medicines might be used, according to the peculiari- ties of the case—among others, digitalis, veratrum viride, &c., tend- ing to lessen the frequency of the pulse. So tonics, laxatives or opi- ates might be required. Cold might be placed and pressure might be made over the aneurism. By these means we may hope, I think, to check, if not permanently cure, many cases of internal aneurism, even of the most serious cha- racter. I sincerely hope that, if any member of the Society has a case of internal aneurism, he will think of the plan and faithfully report to us the result. 1/