The successful treatment of internal aneurism : illustrated by cases in hospital and private practice / by Jolliffe Tufnell.

  • Tufnell, Jolliffe.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: The successful treatment of internal aneurism : illustrated by cases in hospital and private practice / by Jolliffe Tufnell. Source: Wellcome Collection.

    13/46 (page 7)
    sac. There was a double pulsation sound when the ear was laid u[)on the tumor, but neither hndt de sovfflct nor murmer of any kind. Tlie aneurism evidently sprung from the anterior aspect of the right side of the ascending portion of the arch of the aorta, and was approaching rapidly towards the surface, absorbing all before it in its progress. The nature of the case was explained to him, and the treatment hereafter to be recommended was commenced upon the 19th of September, and continued steadily until the middle of November. At first he felt the loss of food consider- ably, and used to look anxiously at the other patients eating their meals, but he had the sense to restrain his appetite, and took nothing whatever but the regimen allowed. He suffered more from thirst than hunger, and complained a good deal of dryness of the throat and fauces at night, which, however, was somewhat relieved by keeping a pebble in his mouth. These annoyances soon became less and less, and upon the 25th of September the pulse had become reduced to 70, and was soft, whilst the pulsation and pain in the tumor had greatly diminished. Upon the night of the 26th, however, an untoward circumstance occurred, another patient, in a fit of maniacal delirium having rushed into the ward, and made for his bed, producing intense agitation and alarm. Port wine and opium were given to hhn, and confidence after a while was restored; but his heart's action became tumultuous, and remained so for some time, not regaining its steadiness of beat until the 28th. Ice was at the commencement applied to the tumor, but after a little while a thin piece of linen rag moistened with water was kept on as an evaporating medium instead. The tumor now began to be less prominent, and was described by the patient as feeling more condensed. The double thump gradually disappeared in the tumor, and a single beat only could be felt, corresponding to the natural sound of the heart, but slightly louder. U])on the 2nd of October the pulse had fallen to 02. He could now lie flat upon his back for two hours at a time, Avhicli he could not upon first admission, being then obliged to rest more or less ])ropped up. The tumor gradually became firmer and firmer, and flattened in the centre. Towards the middle of November his general health was excellent, and his bulk and weight had but very little declined. His diet was now slightly increased. He lefc the hospital upon the 13lh of Dccend)cr fjr his home, where he pro- •^'''ed to remain at rest for some fi '