A dictionary of practical surgery: comprehending all the most interesting improvements, from the earliest times down to the present period : an account of the instruments, remedies and applications employed in surgery : the etymology and signification of the principal terms : ... forming together a "catalogue raisonné" of surgical literature (Volume 1).

Samuel Cooper

Date:: 1823

Credit: A dictionary of practical surgery: comprehending all the most interesting improvements, from the earliest times down to the present period : an account of the instruments, remedies and applications employed in surgery : the etymology and signification of the principal terms : ... forming together a "catalogue raisonné" of surgical literature (Volume 1). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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$Emaciation, weakness, distress of counte- nance, anorexia, constipation succeeded. At length, a large pulsating tumour was dis- covered in the epigastric region. The case was now pronounced aneurism of the abdo- minal aorta. There was no nausea, nor vomiting, except that some days before death, a quantity of fetid, blackish fluid was twice or thrice voided. JYo fever. The swelling caused a sense of constriction ra therthan pain, and the tbrobbings became more perceptible. The pulse was feeble, but slow and regular. After death, the stomach was found adhering to the liver, pancreas, and abdomen ; and a cancerous I amour occu- pying its internal surface from the duodenum to the insertion of the (Esophagus, the coats of the stomach being an inch thick. The surface of the pancreas was also diseased, and the pylorus, situated in the midst of the cancerous mass, was contracted by the thickening of the parietes of the stomach, and obstructed by numerous fungi. The liver was large, but apparently sound ; the spleen small. The aorla, the cozliac trunk, and its branches were quite natural. (See Journ. de Med. per Leroux, Oct. 1815, and Medico-Chir. Journ. Vol. I. p. 289.) Morgagni describes the case of a woman, 44 years of age, who, after a suppression of the menses for some months, was attacked with palpitations in the epigastrium. Mor- gagni, on applying his hand to the part, felt a large hard body moving forcibly. At first, it was regarded as an aneurism in the ab- domen ; but, as there were no similar throb- bings in the chest, and there was nothing extraordinary in the pulse at the wrists, Morgagni concluded, that the movements in question could not depend upon the heart. Neither did he take the disease for an aneu- rism, because the throbbings did not cor- respond to the pulse. As for the large in- durated mass, it appeared to him more easy to say what it was not, than what it was: it could not be merely a globus hystericus, which never beats like an aneurism. Mor- gagni considered the case as an hysterical spasmodic complaint, ordered the patient to be bled, and the following day the pulsa- tions ceased. (Morgagni, de Sedibus et Coxi- tis Morborurn, T.I, Epist.39, 18.) Aaskow relates a case, in which, after the subsidence of a hard painful swelling un- der the upper false ribs of the right side, a ;iliar throbbing movement presented it- iu the same part. The phenomenon led to the diaphragm : '' et in loco ngularis motuspalpitationis instar, enim con»piciebatur,quasi muscu- i is se constringendo partes vi- ce t et extrorsum protrude- ocictatis Medico: Havniensis. ■1. \,p.20S, 3-e.) en of these abdominal mes occurring in hypo- al and chlorotic patients ;, and as de, without leaving any ■in down as ner- ■ailtdes Mat driacal patient, affected with pulsations in the abdomen; which, with other complaints, were dispelled by means of brisk opening medicines. (Heilung's Methode Uberstizt von Plattner, Leips. 1782. 2. B. S. 29.) Thilenius observed a flatulence of the stomach, which he represents as having been epidemic, and attended, in some pa- tients, with pulsations at the scrobiculus cordis. (Med. Chir. Bemerk. Frankf. 1789. S. 211,-217.) My friend, Mr. Hodgson, also, in speak- ing of pulsations in the epigastrium which are not the consequence of organic disease, and occur in irritable hypochondriac sub- jects, states his opinion, that, in some in- stances such pulsations were a consequence of distention of the stomach with air, which was thrown against the abdominal muscles by the pulsation of the great bloodvessels; and in these cases, the throbbing was di- minished by the eructations. (Onthe Dis- eases of Arteries and Veins, p. 96.) These abdominal pulsations are also de- scribed by Zuliani, as a symptom of hypo- chondriasis and hysteria (De /Ipoplexia, Li]>s. 1790 p. 79.) They also happen in cer- tain febrile diseases. (Vcrmchnberden Pem- phygus und das Bins'nfieber von C. G. C. Bra- une, Leips. 1795, S. 2H ; und Dr. R. Jackson on the Fevers of Jamaica, 8vo. Lond. 1191.) In a dissertation on cramp in the stomach, Haii remarks. Quin immo, ubi diutius vexavit gastrodynia, continuos aegrotans persentit spasmos, ut et baud raro pulsatio- nem quandam plane singularem. in cardia et ventriculo, pulsuiautem cordis minimesyn- chrone. (Diss, de Gastrodynia, Upsal. 1797.) In the same essay is also given an account of a man, who had violent palpi- tations in the epigastric region, apparently first excited by the larva ot the musca pen- dula, many of which were vomited up. Pinel is another writer who describes these abdominal pulsations, as an occasional symptom of hypochondriasis. Palpita- tions du cceur et quelquefois une sorte de pulsation irreguliere, dans quelque partie de l'abdomen. (Kosographie Philosophique. T. 2, p. 25, Paris, an. 6.) Dr. Albers details some cases which fell under his own notice. A young woman, whose menses were upon her, and who had been for some days constipated, was seized with frequent fainting fits and febrile symp- toms, occasionally voiding from the bowels a quantity of dark matter, each evacuation of which was followed by a swoon. One morning at five o'clock Dr. Albers was sent for, as it was feared the patient was about to die. She was extremely exhausted, and the fainting fits followed each other, with hardly any intervals. She could just say, I feel a throbbing in the belly; and, when Dr. Albers applied his hand to the he felt a violent pulsation, extending from the ensiform cartilage down to about the bifurcation of the aorta. The action of the heart was weaker than natural; the pulse at the wrist very small, but not quicker Oian it had been on the preceding day, and$

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