Case of aneurism of the arch of the aorta, pressing upon the left bronchus, and annihilating the ordinary physical indications of pneumonia / [Robert Spittal].

  • Spittal, Robert, 1804-1852.
Date:
[1842]
Catalogue details

Licence: Public Domain Mark

Credit: Case of aneurism of the arch of the aorta, pressing upon the left bronchus, and annihilating the ordinary physical indications of pneumonia / [Robert Spittal]. Source: Wellcome Collection.

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    On pressing abdomen, an indurated, undefined swelling is felt beneath integuments immediately to the left and below the umbili¬ cus. On pressure over the induration, the flow of matter, is acce¬ lerated. About half an ounce of thick good matter discharged this .morning. No tenderness ; but feels slight pain on pressing deep. November 1, 11 a. m. Has been doing well. At present feels easy ; pulse 106, soft ; tongue clean ; respirations 26 ; on cough or expectoration. About two teaspoonfuls of good pus sponged from wound. 4-J p. m. About 1 o'clock, feeling excessively hungry, she took half a teacupful of arrow root, a small piece of roast beef, half a pint of strong soup, and a small piece of bread, without the nurse being aware of it. Immediately afterwards she experienced se¬ vere griping pains over the whole abdomen, followed by vomiting of the matters taken. She was seen by Mr Crabbe, who adminis¬ tered a few drops of the 01. menth. pip., which produced some re¬ lief, and ordered warm fomentations to the abdomen. After vo¬ miting the pulse sunk to 80. At present the griping pains occur frequently with loud borborvgmi. Abdomen somewhat distended, and generally tympanitic above the umbilicus. A curve of intes¬ tine is very prominent, and clear on percussion. Continued firm pressure on abdomen gives relief. Frequent vomiting of a green¬ ish fluid. Pulse 100, soft. Cries for relief. Dr Spittal, who was sent for at this time, administered five grains of opium, in the form of suppository. 2d, 12 m. Pain in abdomen only occasional. Had a good night. Still occasional sickness, bringing up a few mouthfuls of mucus. Tongue clean. An injection was given at 10 a. m,, which has not yet come away. Pulse 98, soft. Injection to be repeated, with a little salt in it. To have beef-tea and toast for dinner. 8 p. m. There has been no stool since 6 p. m. on the 31st. During the day there has been frequent retching, with discharge of mouthfuls of mucus. The coil of intestine noticed in the re¬ port of yesterday still prominent in abdomen, and tympanitic. Marked difference between fulness and distension above umbili¬ cus, and flatness and collapse of abdomen below it. Pressure with points of fingers causes pain ; but she is very irritable. Has had. two injections, which have been for the most part retained, but no evacuation has been produced. Had nothing to eat; drank only a little coffee. Pulse 108; no shivering. Fomentations to ab¬ domen. I£. Calomel. gr. viij.; Gum. Opii gr. ij. ; Con. q. s. Ft. pil. ij. Sumat una stat. sumend. Four pounds of warm water to be injected slowly. If no motion by 12 o'clock to have a tobacco enema ; six ounces of boiling wa¬ ter to fifteen grains of tobacco. lip. m. Injection of water was given about a-quarter of an hour
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