Sudden death / by Herbert French.

  • French, Herbert Stanley, 1875-1951.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Sudden death / by Herbert French. 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.

    17/34 (page 15)
    site for a small aneurysm of this kind is in the first part of the aorta immediately above the . aortic valves. You will remember that the I pericardium extends along the aorta for an inch or so above the level of the aortic valves. You will therefore realise that there is ample room for a bulge the size of a small walnut, or even larger, to develop upon that part of the aorta 1 that lies within the pericardium, as in this (Specimen, and for it to rupture into the peri- (cardium. The case could not then be diagnosed I from ruptui'e of the heart itself, except upon ] post-mortem examination. Death occurs abruptly, because the blood (effused into the pericardium, outside the auricles, iis under such pressure that the latter are unable Ito go on working. Every year cases of this kind lare brought into the front surgery dead. Here is a (specimen of rupture of a small aortic aneurysm; (there were no symptoms until sudden death (occurred. You may ask in what sort of patient (this aneurysm is most liable to occur. It is (Commonest in strong labouring men who perform ihard intermittent work, who drink hard, and Nwho have had syphilis. The importance of this ffrom the point of view of the Employers’ Liability . Act is obvious. Aneurysm may, of course, occur \without there being either history or evidence cof syphilis, but in any case of aortic aneurysm (the chan<3es are as much in favour of syphilis Has they are in cases of locomotor ataxy. tSyphilis weakens the wall by the production of aatheroma, identical in nature with the weakening cof the valves that gives rise to syphilitic aortic rregurgitation. Alcoholism accentuates this (!change, and intermittent hard manual work (uauses intermittent increases in blood pressure.