Case of a small aneurysm of the first part of the arch of the aorta, opening into the pulmonary artery and conus arteriosus of the right ventricle : with remarks on the general subject / by Sir William T. Gairdner, M.D., K.C.B., F.R.S., Physician to the Western Infirmary, Glasgow.

  • Gairdner, W. T. (William Tennant), Sir, 1824-1907.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Case of a small aneurysm of the first part of the arch of the aorta, opening into the pulmonary artery and conus arteriosus of the right ventricle : with remarks on the general subject / by Sir William T. Gairdner, M.D., K.C.B., F.R.S., Physician to the Western Infirmary, Glasgow. 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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    true, an equally remarkable tendency to muttering delirium, without fever or any other apparent cerebral complication, but suggestive of danger had it tended (as was regarded probable) either in the direction of coma or of exhaustion. During nearly ten weeks of observation, however, his state in this respect remained the same, noisy and apparently very restless, especially at night, but yet always able to pull himself together, as it were, when addressed, and even up to within an hour or two of his death responding to questions, as if he felt “better” or “ very well,” as the case might be. His pulse was always unduly rapid (98 to 116, but always regular, increasing in rapidity latterly to 138), and his respiration appeared more or less laboured, but without any marked orthopnoea, or any considerable lividity until near the end. The treatment was mainly on a diuretic plan (salines, digi- talis, diuretin, spartein, caffein, etc.), and was, up to a certain point, successful, the diuretin in particular taking great effect on the quantity of the urine, and for a time on the dropsical condition. It was found impossible, however, by any com- bination of these remedies, to prevent recurrence of the dropsy, and ultimately drainage by Southey’s tubes and by incisions had to be employed—again for a time, with apparently good results—showing a very remarkable vital resistance to what seemed, all along, a most dangerous combination of symptoms. It is not desirable, however, here to go into more details of these fluctuations in the general state of this patient. The following extracts from the reports will bear chiefly on the objective cardiac changes, and particularly the murmurs. Owing to the question of an aneurysm being throughout present to the mind, particular attention was given to the percussion of the manubrial and extra-cardiac area, but no definitely dull space such as would indicate a sacculated or general dilatation of the arch, could at any time be detected, the cardiac dulness, on the other hand, was manifestly ex- tended laterally, and quite as much towards the right as towards the left. A distinct systolic thrill was felt over the right ventricle, and epigastric pulsation was distinctly present.