Some account of cardiac aneurysms : being the Bradshawe lecture, read before the Royal College of Physicians of London on August 18, 1883 / by J. Wickham Legg.

  • John Wickham Legg
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Some account of cardiac aneurysms : being the Bradshawe lecture, read before the Royal College of Physicians of London on August 18, 1883 / by J. Wickham Legg. Source: Wellcome Collection.

    50/92 (page 38)
    ♦ the internal membrane of the ventricle. At the bottom of it were four pouches (one of which had burst) pro¬ truding into the right cavities of the heart. One of these pouches projected into that portion of the right ventricle from which the pulmonary artery springs, and to which some anatomists apply the name of infundibulum or in- fundibuliform cavity. The pouch was connected with the anterior or larger fold of the tricuspid valve ; being adhe¬ rent to the surface of the fold which faces the pulmonary artery. A second pouch formed a very slight bulging into the right auriculo-ventricular opening at the tendinous margin or ring. The third pouch was situated a little below the second one, and involved the base of the ante¬ rior or larger fold of the tricuspid valve. The fourth pouch, that which had burst, had made its way through this fold, and will be described presently. (( Of the three divisions or folds of the tricuspid valve, two (viz. the right or posterior fold, or “ curtain ” and the left or internal fold or “ fixed curtain ”) were quite healthy. The anterior and larger fold or “ curtain,” that which prevents the escape of blood into the pulmonary artery during the diastole of the ventricle, was, however, in a morbid state. Nearly the whole of its auricular surface was covered with firm lymph, [? what we should now call thrombus] and a portion of the fold, about the size of a sixpence, was pouched or dilated, and protruded like a truncated cone. In the centre of the pouch or truncated portion was the aneurismal aperture, the diameter of which was about equal to that of a large quill. Part of the fold (viz. the portion immediately around the pouch, as well as a portion of the free or floating margin) was adherent to the wall of the ventricle; so that a part only of the fold could act as a valve during the systole of the ventricle.” Opposite to the mouth of the aneurysm in the left ventricle there was a patch of “ lymph ” on the aortic face of the mitral valve. I have lately come across a very interesting case,, taken from a patient of Dr. Dickinson’s, by whose courtesy I am