Notes on the surgical treatment of aortic aneurism : being in part a reprint of some papers in the Lancet on the same subject published in the years 1869 and 1872 / by John Cockle.

Date:: 1877

Credit: Notes on the surgical treatment of aortic aneurism : being in part a reprint of some papers in the Lancet on the same subject published in the years 1869 and 1872 / by John Cockle. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$benefit should be first clearly defined ; next, that the facts suggesting and justifying its adoption should be as clearly set forth. For all the reasoning will partake of an a i^osteHori character. It may be stated at the outset, that the method proposed for the treatment of aneurism involving the upper portion and arch of the aorta with cervical ex- tension, stands last on the list of therapeutic means so far as regards mere chronological sequence, since it neither interferes with, nor displaces any present means. Its adoption is only urged when these means, fairly and sufficiently tried, are powerless to control the fatally tending progress of the affection. In conclusion, let me add that I have no theory to propound as to the “ how”, i.e., the proximate cause of the formation of laminated clot in the aneurismal sac consequent on obturation of the left carotid artery—whether from “ diversion ” of the blood-current—from an influence transmitted to the living membrane of the sac—or from an extension of the clot from the end of the tied vessel {sic Holmes). These are still to be regarded as postulata. My more immediate concern is with the evidence tending to support the view of a causal relation between such obturation and the actual occur- rence of laminated clot; and by this latter agency the attainment, if not of radical cure of the aneurism (for that, probably, must be the exception rather than the$