A case of axillary aneurysm : ligature of subclavian artery, recovery, development of acute mania, subsequent death from pulmonary haemorrhage / by Henry Rundle.
- Rundle, Henry, 1845-1924.
- Date:
- [1890]
Licence: Public Domain Mark
Credit: A case of axillary aneurysm : ligature of subclavian artery, recovery, development of acute mania, subsequent death from pulmonary haemorrhage / by Henry Rundle. 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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![external jugular being tied in two places and divided between. After the ligacure, 'bic'a was of carbolised catgut, had been ap- plied, no pulsation could b-) ielt either in the aneurysm or in the radial. The edg-s of r.iie wound were sutured, and the arm and right side of the cbest wrapped in cottonwool and flannel bandage. April 29r.b. He elept well during the night. Temperature 102.2°, left pulse lOi, light not percnptit)le; respirations 28. Much less pain in forearm, but complains of numbness. Circumference of upper arm, llf inches; elbow, 11| iccties; wrist, 8| inches. April 30th. Good night. Temprrature 100°, respirations 26, left pulse, 98. In good spirits, no pain. May 1st. Wound dretsed; a few drops of pus; temperature 99.4°; slight pulse felt at the right wrist. No perceptible pulsa- tion in the tumour; the skin over it less angry looking. May 5r.h. Going on well; wound nearly healed. Swelling of arm reduced; upper arm, lOJ inches; elbow, II inches; wrist, 7^ inches. No pain of any k'nd, but unable to raise his arm. Tumour harder and size reduced. May 12th.—Sat up in ward ; wound healed. Has more move- ment in right arm, and no pain in it. May 24th. Has been restless at night, at times noisy, capricious regarding his food, and suspicious of those around him. Ordered potass, hromid., gr. xx ; chloral hydrat., gr. x; ter die May 26Ch. More sleep, but very noisy and difiScult to manage; egotistical, and has delusions as to wealth and on religious matters. May 31st. In a state of simple mania, raving and shouting, and resisting all efforts to quiet him. He was therefore removed to the PoI•t^ml1uth Borough Asylum. June 7th. Has been noisy and difficult to manage since his admission; pulls off the bandage from his arm; became so violent that he was prescribed gr. s'o of hyoscyamine hypodermically. Slept afterwards. June 13r,h. Had a severe, sudden bsemorrhage to-day from a small opening in the centre of the wound. ]31ood spurted out (arterial), and evidently from some large vessel. Controlled by pressure on the second part of the subclavian. On Jane 14i;h, 16th, 17th, 20th, and on July Srd, there were hsemorrhagea from the wound, generally occurring after attacks of violence. On some occasions they were alarming in character, but in each instance were controlled by pressure. June 18th. Has tenderness over a point at the right sterno- clavicular articulation, which presents a small rounded swelling, with a sense of deep fluctuation. There is slight discharge of sanguineo-purulent fluid from the wound. July Gth. Very noisy and excitable, cannot be kept in bed; the swelling over the sternum is now red; takes nourishment; de- lusions continue. July 10th. Had a noisy and restless night, quite beyond control. Swelling incised; the tissues were bo^gy and a small quantity of pus escaped—drained and dressed. The aneury*.mal sac has con- tracted considerably, and the swelling in the arm and hand has di-appeared. July 11th. After spending a restless night, he was suddenly seized with violent haemoptysis, bringing up about a pint of poarlet blood intermixed with frothy mucus. When seen at 6 30 A.M., he was dead, and presented all the appearances of death from syncope. Poot-mortem Eriminaf ion made Nine Hours after Death.—Rigor mortis commencing; cadaver»c liyidity absent; body well](https://iiif.wellcomecollection.org/image/b2227716x_0006.jp2/full/800%2C/0/default.jpg)
