On the diagnosis and treatment of thoracic aneurism / by William Moore, M.D.

  • Moore, William, M.D.
Date:
[cbetween 1800 and 1899?]
Catalogue details

Licence: Public Domain Mark

Credit: On the diagnosis and treatment of thoracic aneurism / by William Moore, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    signs of this lesion, but none of nwe value than those dependent on pressure on the cervical sympathetic, on the nerves of the upper region of the spinal cord, and those traversing the thorax generally. This is specially evidenced by arrest of respiration, variations in the voice, difficulty of swallowing, and neuralgic seizures; whilst the objective effects seem to be specially exemplified in altered con- ditions of the eye and its appendages, in variations in the muscles of expression, by increased temperature, and, lastly, in pustular and herpetic eruptions on the skin. It is to illustrate these phenomena I adduce the following cases:— Case I.—John C, aged fifty-seven years, was admitted into Mercer's Hospital, on the 7th of November last. About three weeks before his admission he felt a pain in his right breast, which radiated over the sternum, towards the opposite side, and was aggravated by his lying in any position except the supine. It was intermittent in character, but, during its exacerbation, was very severe. He had been a hard drinker, and suffered from acute rheumatism about ten years ago. In appearance the patient is healthy; and, on stripping the chest, his muscular development is above the average. He com- plains of pain between the shoulders and down both arms, of having occasional sensations of fainting, and pain about the precordial region. He has a slight cough; and, since his admission into hospital, he observed his expectoration to be mixed with blood of a dark red hue. On examination, appreciable dulness can be elicited, on percus- sion, in the right subclavicular region, close to the sternum; and, on applying the hand over the part, distinct pulsation can be felt. The heart's sounds are normal; but about the junction of the cartilage of the third rib, on the right side, with the sternum, both sounds are louder and more marked than over the precordial region; and over this same space a systolic bruit can be heard, prolonged into both subclavian arteries, but especially into the right. Kespi- ration is natural, and there is no perceptible difference between the radial pulses. He does not complain of dysphagia. Now, in this case we have many subjective symptoms, and physical signs of thoracic aneurism. Among the former I may mention the neuralgic pains, modified attacks of angina; whilst among the latter, dulness on percussion, distinct pulsation, with systolic bruit and hemoptysis, are the most prominent. Now, as to
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