Abhandlungen und Notizen über E.A. Groux's Fissura sterni congenita / von den berühmtesten Ärzten Europa's.

Date:
[1857]
Catalogue details

Licence: Public Domain Mark

Credit: Abhandlungen und Notizen über E.A. Groux's Fissura sterni congenita / von den berühmtesten Ärzten Europa's. 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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    Let us now turn oiir attention to what we can learn from an examination of the person with fissured sternum. In running through the principal features of interest in his case, when I come to speak of a pulsatile swelling corresponding to the right auricle, you will noticethat the phenomena here observiible most minutely correspond with what we have been looking at upon the heart of the dog. CONGENITAL FISSURE OF THE STERNUM. E. A. Groux, the subject of this defect, is a native of Hamburg, 2-5 years of ags, below the aveiage height, and ahhough a little thin and pale, yet appears in the enjoyment of pretty good health. I will first sketch you an outline of his history, which I am sure you will consider not altogether de- void of interest. He tells me that he just remembers, when about four or five years old, being taken by his family doctor to a Medical Society at Hamburg; but for what purpose he scarcely then understood, nor did tlie interest of his case fully occur to liim until, wiihin cumparatively a recent period. He was aware that his chest was not exactly like other people's, but be did not know that there was any special interest connected with this maltormation. About 1850 he was over in London, residing with a relative moving in a comfortab'e sphere of life, and was attacked with cholera. His recovery was protracted, he was for some time under medical attendance, and then it was that his defect was made known to the profession. He was taken about as a curiosity toour leading physicians, anioiigst whom was Dr. Babing- ton, who brought him down to Guy's, and had a couple of models made of him by Mr. Town, wliich are preserved in our Museum. I took him across to Mr. Towne's room the other day, and we compared his present condition with these models, to see if any change had taken place We noticed that the clavicles and the lateral margins of the sternum had slightly appi oxiniated, so as to render the groove narrower than it formerly was, during a quiescent condition ot the chest. To proceed with our sketch. He alterwards returned to Hamburgh, and being seized with an attack of haemoptysis he was recom- mended to leave the situation he held in a house of business which kept him confined all day, and to go into the coiuitry for a time. It now occurred to him to put in practice the suggestion, which, he says, had often been made to him, viz.:—to travel, and show himselt to the medical celebrities of the different countries, titarting for Hanover in 1851, he found his ex])ectations realized ; and since then he has been visiting all the principal places on the Continent, including France, Germany. lielgium, Holland, Spain and Russia, and to judge from his appearance, one would certainly conclude that he made it thoroughly answer his purpose. He was in London for a short time, about two years ago, and after a short stay now. he intends to proceed to the pro- vincial towi.i where medical schools are attached, and then to Scotland and Ireland. He canies with him an album, in which he gets one to insert one's opinion of his case and to sign one's name. So that, having been to nearly all the most distinguished men of our ;ige, his album presents a most interest- ing collection of autographs, and at the same time testifies the interest his case has elicited. On getting him to expose his chest, we notice in the medium line a longi- tudinal groove, which is rej)resented in this drawing that I requested our artist to make of him. The groove of course correspoJids to the absent por- tion of the sternum. It is bounded on either side by a continuous hard ridge, which constitutes the lateral margin of the bone, and articulates with the costal cartilages. The skin passes naturally over the chest from one side- to the other, but we see it raised on one ])art of the gr.-ove by a i)ulsatile swelling Ca in the sketch), which occupies the position of the right auricle. The c'avicles and the two margins of the sternum above have no connexion whatever with each other; but below, the latter are joined by a hardish substance which h..hls the situatioti of the ensiform cartilege, and forms the lower boundary of the groove. The substance, however, must essentially differ in Btructure from cartilage,for it possess such elasticityas to allow him