Notes on cases of tumour in the mediastinum / by E. Symes Thompson.

  • Symes-Thompson, Edmund, 1837-1906.
Date:
[1865]
Catalogue details

Licence: Public Domain Mark

Credit: Notes on cases of tumour in the mediastinum / by E. Symes Thompson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    acute attack. The disease did not yield to treatment, and the patient, who had been throughout in a miserable state of debility, died from asthenia. At the post-mortem the right pleura was found full of clear serum; the lung, compressed and hobnailed, about the size of a pine-apple, occupying the pre-vertebral groove. The whole front of the chest was lined by a mass of solid tissue, varying from half an inch to two inches in thickness, covering the pericardium and extending laterally on either side of the sternum. A somewhat similar case has been recorded by Dr. Barker (“Transactions of Pathological Society,” vol. vii., p. 47), in which, besides a lobulated growth in the upper part of the mediastinum, a second flattened mass was attached to the whole anterior surface of the pericardium. In this case also the right lung was collapsed and nodulated, the pleura being full of turbid fluid. Cases of this kind make an impression on one’s memory, and greatly lessen the difficulty of diagnosis in analogous cases that may fall under observation. In the “ Dublin Medical Press ” for October 12th, 1864, a case is detailed in which the heart was displaced to the left in con- sequence of effusion into the right pleura. A loud systolic murmur occurred at the apex, which disappeared on the removal of the fluid by paracentesis. In this case a trace of thickening in the mitral valve, insufficient to account for the murmur, was observed. In the case I have fully detailed the roughening of the valve was veiy slight; but as the murmur was persistent and not influenced by the withdrawal of the pleuritic fluid, we must infer that the roughening was the cause of the murmur, especially as murmurs at the mitral valve, caused by displace- ment, are very rare. Dr. Benson, of Dublin, considers his case unique. In both these instances the right lung was greatly com- pressed, not so much, however, as in the case of a patient at the Brompton Hospital, whose post-mortem I recently attended, in which the lung was not larger than the forefinger, and could scarcely be detected as it lay covered with condensed pleural tissue in the pre-vertebral groove. In this case the heart was pulled over to the right side and pulsated beneath the right nipple. The whole left side in the precordial region was resonant on percussion, and the anterior edge of the left lung extended beneath the right clavicle and occupied the space i vacated by the upper lobe of the right lung. A case occurred at King’s College Hospital, recorded in the “ Pathological Transactions,” vol. x., p. 62, in which a cancerous | tumour, occupying the interval between the oesophagus and trachea, projected into the latter so as to narrow the canal, and