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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    A well-marked case of this kind has been recorded by Allen.* A woman, aged 50, was admitted into the Melbourne Hospital, on February 19, 1877. “ The left chest was distended and motionless, its measurements larger than those of the right side; the intercostal spaces were slightly tumid; there was absolute dulness all over the left side, . with absence of respiratory murmur, and of vocal resonance and fremitus. The right chest was moderately resonant, the breath sounds were roughened, and attended with rather coarse crepitation. “ The heart’s beat could be felt, and its sounds heard, a little to the right of the sternum, a distinct thrill was very perceptible to the right of the sternum, over the upper two intercostal spaces; a loud systolic bruit was heard in the same situation, and could be easily differentiated from the heart’s sounds. The superficial veins of the right side of the chest were distended.” The patient died, and at the autopsy. “ The pericardium and its contents were seen to be displaced to the right but unequally ; there was almost universal firm adhesion between the parietal and visceral layers of the pericardium; the heart’s apex was retained nearly in its usual position, while the base and great vessels were pushed over to the left (right P); the walls of the heart were very flabby ; its cavities were not sensibly dilated; the valves were normal, and there was no aneurysm nor dilatation, nor any trace of atheroma of the aorta or any of its branches. The left pleura was distended by a huge hydatid cyst, which was covered above by the collapsed, almost airless slate-coloured remains of the left lung. The cyst cavity extended downwards to the diaphragm, displacing the liver downwards and to the right.” In this case, the symptoms to some extent, simulated aortic aneurysm, but the well-marked dulness and absence of respiration all over the left side of the chest were indicative of something more than or different from aortic aneurysm. It is unusual for pulmonary hydatids to cause erosion of bones. I have already alluded to a case where the vertebra} were found eroded, and the vertebral canal invaded by hydatid disease, but I have raised doubt whether this should be regarded as a case of invasion by a hydatid originally of intra-thoracic origin. Landauf has recorded a case of hydatid of the right side of the chest where the cyst protruded under the breast, and had eroded the ribs in the parasternal line, causing over an area of about three centimeters square, a defect in the chest wall, with complete destruction of the ribs and inter- costal muscles of the part. THE PHYSICAL SIGNS OF THE RUPTURED CYST. In some cases the cyst may be ruptured, and part of its contents be evacuated, and yet it may refill, and the parasite probably still retain its vitality. * Aust. Med. Jour., March, 1881, p. 104. f Archiv. fur Gymckologie viii.. Heft. 2.