Hydatid disease of the lungs / by J. Davies Thomas.

  • Thomas, J. Davies (John Davies), 1844-1893.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Hydatid disease of the lungs / by J. Davies Thomas. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    At present I call your attention to the considerable amount of support that it must give to the blood-vessels that still remain permeable to blood, on the wall of the fibrous capsule. When this is suddenly removed by the rupture of the cyst, it is almost unavoidable that some of the vessels should burst and cause haemorrhage. The haemoptysis that takes place at a greater or less distance of time after the occurrence of rupture is of very great importance, inasmuch as it is often very copious and occasionally fatal. Haemorrhages of this class are closely allied to those that occur in the third stage of phthisis, and are probably induced in the same manner. In considering the haemoptysis seen in the third stage of phthisis, it should, of course, be borne in mind, that it does not always happen, when blood-spitting occurs in a patient who has a cavity in his lungs, that the blood expectorated comes from the cavity itself, or indeed from the lung containing the vomica, for it may be derived from another part of the same lung or from the opposite one ; in fact, it may be a haemorrhage of an early stage of phthisis in a portion of lung remote from the cavity. The true vomica haemorrhages are usually very profuse, and are often immediately fatal. They depend upon one of two local causes. 1st. Erosion of a branch of the pulmonary artery or vein on the walls of a vomica ; or 2nd. Bupture of a pulmonary aneurysm, or of a varicose dilatation of the pulmonary vein in the interior of the excavation. In the cavities sometimes left after the expulsion of hydatid cysts from the lungs, somewhat similar conditions prevail, for the vessels may lie as it were dissected on their walls, or may be found to traverse the cavity itself from one wall to the opposite one. Thus Bouvier* records the case of a woman, aged 65, who died of meningitis. In the lower lobe of the left lung was a large hydatid, the fibrous capsule of which was formed by a cellular membrane, along which projected the vascular branches denuded, and as it were dissected in a part of their course.” Occasionally vessels may entirely traverse cavities, and yet retain their lumen unobliterated, thus Schrotterj relates. A case where there was found post mortem, in the upper lobe of the left lung, a cavity of the size of a walnut filled with a puriform fluid; this was crossed transversely by an unobliterated artery of the thickness of a thread. In such cases it is only natural to expect that rupture should easily take place ; an instance of this occurred in a case of Professor Waldeyer’s recorded by Wolff4 * Hydatides du Poumon. Bull, Acad. Eoyal de Med. de Paris, 1842-43. f Mediz Jahrbucher, Wien, vol. xiv. Cited by Hearn and Carriere. J Vier Fable von Echinococcus hominis, nebst Bemerkungen fiber das Yorkommen der Echinokokken in Breslan. Inaugural-Dissertation, 1869.