Aneurisms of the arteria innominata : their history and differential diagnosis from aneurisms of the arch of the aorta / by T.S. Holland.

  • Holland, Thomas S.
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: Aneurisms of the arteria innominata : their history and differential diagnosis from aneurisms of the arch of the aorta / by T.S. Holland. 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.

    29/64 (page 27)
    was completely obliterated on a level with the superior part of the ilaruyx; the subclavian was pervious, except where the ligature had Ibeen applied. The innominata was an inch and three-quarters in I diameter, and the walls of the part that formed the sac were much 1 thickened. The upper part of the sternum, first rib, and clavicle, ' were eroded from the pressure of the sac. No. 36. Sir D. Dickson’s Case^ Revue Medicale^ vol. ii., for 1837, }p. 111.—A sailor, aged 40, admitted to the Marine Hospital, Ply- 1 mouth, in April, 1835, for continual cough, with viscid, sometimes imuco-purulent expectoration, and a feeling of constriction, more than fpain, at the upper part of the sternum. Pulse irregular, respiration llaborious, Avith niucous and sonorous rales over the chest; he suf- ffered from paroxysms of dyspncea, of an asthmatic character. Chronic ibronchitis, Avith hypertrophy of the heart, was diagnosed; and at a Hater period there was thought to be a tumour compressing the ttrachea. Pie died asphyxiated, June, 1836. Post mortem—An aneurism, the size of an orange, engaging the centire of the innominata, had obliterated the left siibclavian vein, aand the blood could but Avith difficulty pass through the right sub- cclavian vein, hence the distention of the vessels of the head and rneck; the trachea was compressed, and adhered to the tumour; there Twas also general dilatation of the thoracic aorta. [I have searched i:in vain for any notice of this case in the English medical journals.] No. 37. M. Ddbrueil’s Case^ Sur les Anevrysmes de la Portion As- ccendanteet dela Crosse de VAorte^ p. 90—A man, aged 37, admitted to Ithe Hopital St. Eloi de Montpellier, the symptoms being, pain, in- t tense and continued in the upper part of the chest, low down in the week and right shoulder ; respiration sibilant; frequent cough ; r/oice Aveak and cavernous ; right pulse scarcely to be felt; right numeral artery pulsating very feebly. A pulsating tumour existed iAbove the right sterno-clavicular articulation, and extended across ffie neck to the sternal attachment of the left sterno-mastoid ; a se- cond tumour rose above that just described, as high as the fifth cer- rdcal vertebra; a bruit de rape was heard over it; while an obscure nruit de soufflet was heard over the chest, there being no difficulty in distinguishing the pulsations of the tumour from those of the heart. Aneurism of the arch of the aorta and innominata was diagnosed. Ifhe tumour, as it increased in size, dislocated the clavicle, pushed the sternum forwards, rendered the dyspnoea more and more in- tense; blood was discharged by the mouth, and he died soon after. Post mortem.—Eem ark able flattening of the tumours; an aneurism ir.rose from the superior and posterior of the transverse part of the i:,rch, inclining to the right, resting on the trachea, into which it had ) »urst. Theinnominata was dilated to double its normal size, its caliber was almost entirely obstructed by a mass of solid fibrine of a very an- ;ient date, which scarcely alloAved any blood to pass through it. No. 38. M. Dubrueil’s Case, Sur les Anevrysmes de la Portion As- '< endante et de la Crosse de VAorte, p. 122.—A captain of artillery, aged :4, was attacked with pain in the upper part of the chest, for which ‘le took warm baths; hemoptysis appeared, and continued at in- tervals; attacks of dyspnoea becamp so urgent as to oblige him to E