Case of aneurism of the ascending aorta opening into the right auricle : fatty degeneration of the muscular substance of the heart / by Thomas Bevill Peacock.

  • Peacock, Thomas B. (Thomas Bevill), 1812-1882.
Date:
[1844]
Catalogue details

Licence: Public Domain Mark

Credit: Case of aneurism of the ascending aorta opening into the right auricle : fatty degeneration of the muscular substance of the heart / by Thomas Bevill Peacock. 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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    CASE OF ANEURISM OF THE ASCENDING AOBTA. Though communications between the sacs of aneurisms of the aorta and the right cavities of the heart, have been for some time known occasionally to occur, and the memoir of Mr Thurnam, has rendered pathologists familiar with the general features of these cases, it is conceived that the following instance, presenting, as it does, several points of interest, is worthy of record. On the 24th of November 1840, I was called to see James Monk, aged 48. I found him in a state of great prostration, the pulse being imperceptible at the wrist, and his extremities cold; he complained of constant vomiting, and pain in the feet and an- kles, his face was sallow and puffy, and the abdomen swollen. With these symptoms he had been suddenly seized while engaged in his occupation of a horse-keeper; he was removed to the Chester Infirmary, but though appropriate treatment was had recourse to, he continued to sink, and died about eighteen hours after the com- mencement of his attack. No history of his previous state of health was obtained. He had continued his occupation regularly till his seizure, and was of very intemperate habits. The body was examined thirty hours after death. The abdominal cavity contained a large quantity of yellow-co- loured serum. The mucous membrane of the stomach displayed no unusual vascularity. The valve of the pyloris was so firm and con- tracted as only to admit the forefinger to be passed through it with force; The cavity of the stomach was larger than ordinary. The mucous membrane of the small and large intestines was healthy, there being only slight congestion of the dependant portions of the ileum and of the ccecum. The large intestine was free from fecal matter, and contracted. The liver displayed a very marked de- gree of hepatic venous congestion. The gall-bladder contained dark and viscid bile; but the ducts readily gave passage to this fluid into the duodenum. The spleen was healthy. The kidneys were lobulated and congested, but not apparently granular. The chest was unusually broad and expanded; both pleural sacs contained serum in considerable quantity. The lungs were emphys- ematous. The pericardium was universally adherent to the heart by a thick layer of condensed cellular membrane. The heart was of very large size. The right ventricle greatly dilated, and its walls 1 On Aneurisms, and especially Spontaneous Varicose Aneurisms of the Ascending Aorta and Sinuses of Valsalva.—Medico-Chir. Trans., vol. xxiii. 1840.