Principles of pathology and practice of physic (Volume 2).

  • Mackintosh, John, -1837.
Date:
1837
Catalogue details

Licence: Public Domain Mark

Credit: Principles of pathology and practice of physic (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    72/558
    portion of the lungs, and even the spine itself, has formed a part of the aneurismal tumour. Aneurisms of the aorta produce various effects on the neighbour- ing parts, according to their size and situation. Lacnnec assures us, that simple dilatation, when in a moderate degree, hardly pro- duces any effect; but that the most inconsiderable false aneurisms may give rise to very serious disorder. The first and most common of these effects is compression of the heart and lungs, by impeding the circulation and respiration. When the aneurism is in contact with the lungs, it most commonly merely compresses them; some- times, however, the substance of these organs gives way, and the aneurism, when it bursts, pours its blood directly into the air-cells; three remarkable cases of which I have already related when treat- ing of haemoptysis. Frequently the aneurism compresses the trachea, or one of the bronchial trunks, which it flattens and event- ually destroys, and death ensues by a species of haemoptysis from the rupture of the tumour. The same occasionally, but not so frequently happens to the oesophagus. Sometimes the aneurism bursts into the pericardium; two cases of this are also quoted, (page 50.) Laennec states, that he never met with an example of it. The left cavity of the pleura, however, is stated to be by far the most frequent situation into which the rupture takes place. Laennec quotes a case recorded in the Bulletin de la Faculte de ]Medicine, in which an aneurism of the aorta burst into the pulmo- nary artery. He mentions a case where the thoracic duct was compressed and destroyed; and Corvisart notices a fatal instance from compression of the superior vena cava. I have seen a pre- paration of aneurism of the abdominal aorta, which communicated freely with the vena cava. A preparation is in my museum, in which the splanchnic nerve is involved in the aneurismal tumour. This might account for the violent epigastric pain, nausea, and want of appetite, experienced for a series of years by the unfortu- nate man. Aneurisms often destroy a large portion of the vertebral column, and there can be no doubt that this destruction is the effect of interstitial absorption, not of caries. On the side next the verte- brae the sac is occasionally completely destroyed, and to use the words of Laennec— the circulating blood is bounded by the naked bone: several instances of which have occurred in my practice. Aneurisms of the ascending aorta and arch, sometimes destroy portions of the sternum by their pressure, so as to be at length covered only by the integuments. Aneurisms of the arch of the