Indurative mediastino-pericarditis / by Thomas Harris.

  • Thomas Harris
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Indurative mediastino-pericarditis / by Thomas Harris. Source: Wellcome Collection.

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    healthy appearance, he became more and more livid. He recovered, however, from the pulmonary attack, and was able to return home for a short time, but he had to come again and again for the ascitic fluid to be removed. He was admitted for the last time on February 5th, 1894, when he was in a more serious condition than on any previous occasion. The abdomen was, as usual, distended, and the boy was very livid. He had a troublesome cough, and there were numerous rales and rhonchi audible over the chest. The precordial dulness was similar to that above recorded when he first came under observation. The elbow-joint and the enlarged axillary glands showed no appreciable change. The jugular veins were very much distended ; the cheeks, lips, and ears became more and more cyanotic. The extremities became cold, the boy passed into a drowsy semi-conscious condition, and died on February 22nd, 1894. The post-mortem examination was made on February 23rd, 1894, by Dr. Kelynack, the Pathological Registrar to the Infirmary. Permission was not obtained for the examination, which consequently was not so complete as it otherwise would have been. Adherent pericardium ; adhesion of the exterior of the pericarditim to surrounding parts; dilatation of the heart; nutmeg liver; chronic 2Jeritonitis and ascites ; slight anasarca of the lower extremities. External.—The body was that of a spare boy. The abdomen was prominent, aud evidently had been distended with fluid. Very slight anasarca of both feet, none of any other part of the body. Lips aud cheeks blue. Rigor mortis well marked in both upper aud lower extremities. Cutaneous hypostasis dorsal. Eyeballs prominent, but the eyelids just met over the eyeballs. Right elbow presented a fusiform swelling, with sinuses on the outer and inner sides of the olecranon, and a little thin pus oozing therefrom. A small cicatrix existed over the front of the elbow. The joint was ankylosed. An enlarged gland could be felt in the right axilla. On opening the abdomen 35oz. of turbid yellow fluid was removed. Internal.—Thorax : On removing the operculum the lungs aud the pericardium were seen to be closely adherent to the posterior surface of the operculum by old inflammatory matting. The pericardial and mediastinal area at the level of the second costal cartilage measured 2in. across; at the level of the third costal cartilage it measured 2|in. across; at the fourth, S^in. ; at the fifth, 3Jin. ; at the lower border of the sixth, 4in. Pleura3: Firm fibrous adhesions on both sides, almost completely obliterating the pleural cavities; a small space, however, existed at the upper portion of the right cavity, which contained a small quantity of straw-coloured serous efi'usion, and another small space also remained at the lower part of the same cavity. The pleuritic adhesions were e\'idently of old standing. They could not be separated by the fingers, but had to be detached with the aid of the knife. The pleura) were also closely adherent to the pericardium and to the diaphragm,
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