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.

    18/46 (page 10)
    sal 1 that lie had so dreaded to touch it that he had not examined it at all, but he thought that from the pain which he suffered it must be increasing in size. When laid upon his back with the legs well drawn up, and the abdominal parieties relaxed, a loud bellows murmur was audible by t])e stethoscope and ear. The pulsation was single. In the erect position the bruil could still be heard, but much less loudly than when recumbent. The bowels were confined, for he had been afraid to go to stool lest the beating should burst, and in spite of the advice of the surgeon to keep the bowels lax, he had avoided encourao-inff their action. The feature of interest Avhich struck me particularly in this case Avas the existence of an aneurism of this size in a person so fat, arguing that its dimensions must have very recently expanded, and that, if its existence Avas a consequence of the accident at the diggings, its presence could have caused a mere rheumatic aching, and not in any Avay have interrupted digestion or the general health. The tissues forming the walls of the sac were circumscribed and perfect. I explained to this gentleman the nature of the case, and the rest and regimen tliat he must maintain. There was no reason, however, for enforcing obedience, as he was willing to undergo anything that would hold out a hope of averting death. I need not specify treatment, but say that within three Aveeksthe outline of the tumor covdd be felt, with a pulsation icilhin, marking the fact that there had already formed a solid lining to the sac. This deposit gra- dually increased, and in five weeks,or a little more,had become dense. The recumbent position, however, was maintained for thirteen weeks. The bellows murmur became gradually more and more soft, and the pulsations less distinct. At the end of the period named, this gentleman sat up in bed, and then gradually moved about, but for a long time he would not trust himself to do more than creep across the room. By degrees, however, he gained confidence in his pow- ers, but fearing a relapse, remained for some time in England, and afterwards sailed for Melbourne, and when I last heard of him Avas perfectly well, that is to say, free from pain and in the enjoyment of life. The next case that I shall detail is one of abdominal aneurism, occurring in a gentleman thirty years of age, Avhose history is as (o'lows:—Captain first consulted Mr. Solly on the 16th of