Continued observations on haemoptysis / by Vald. Rasmussen ; translated from the Hospitals-Tidende by William Daniel Moore.

  • Rasmussen, Valdemar.
Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: Continued observations on haemoptysis / by Vald. Rasmussen ; translated from the Hospitals-Tidende by William Daniel Moore. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    situated close to the opening, and is found to be a small aneurisraa- tic dilatation on a branch of the pulmonary artery accompanying a bronchus, which dilatation, when slit up, measures three millimetres. This aneurism burst with a small slit-like fissure; from the open- ing a large, firm, decolorized coagulum projects, and the inside of the aneurism itself is invested with a thin layer of firm, light, red fibrin. All the bronchi to the lower lobe are filled with coherent coagula of blood, and likewise throughout the pulmonary tissue small light-red hjEmorrhagic infiltrations are seen. The bronchial glands are greatly swollen, of a light-gray colour, firm, here and there pigmented. In the pleura and its adhesions is no perceptible miliary de- position. In the left lung are similar smaller cavities not filled with blood ; they are circumstanced in all respects essentially like those on the right side. In the large bronchial trunks on both sides a large amount of blood is met with ; it is found in smaller quantity in the trachea. In this, as well as in the larynx, nothing else abnormal is dis- coverable. The spleen is somewhat enlarged, firm, with numerous and large follicles. The kidneys are cyanotic, without any miliary deposition. The liver also is cyanotic. The mesenteric glands are only slightly swollen; they are pale. In the small intestine, some follicular swelling is met with, espe- cially about the ileo-cgscal valves. In the large intestine, several irregular, sinuous, large ulcers are found, partly smooth, partly with distinct miliary deposition ; several seem on the point of healing. This case is one of no slight interest. In the first place, as to the clinical course of the hasmoptysis, we see such occur, and for the first time, in a patient with pulmonary phthisis already far ad- vanced, in the beginning only as a few spots of blood, and ten days later tolerably violently; it ceases, while the hectic condition is still further developed, though without signs of secondary pneu- monic infiltrations, and not until a month later does the fatal haemo- ptysis come on, not profusely, as we are accustomed most frequently to see it, but even very sparingly, only a tablespoonful of blood being brought up, while death nevertheless takes place very rapidly and sufi'ocatively by obstruction of the bronchi in the hitherto sufficient parts of the lungs. This condition is, however, according to my former observations, not so striking; for, in such advanced phthisis, death may occur without even so much as a drop of blood reaching the mouth, as my sixth case shows. This case presents greater interest, however, in an anatomical point of view ; I shall therefore examine the results of the post- mortem examination more closely. We found in the apex of the