A case of pulmonary embolism, with notes bearing generally on the subject of emboli / by Wm. Robert Smith.

  • Smith, William Robert.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: A case of pulmonary embolism, with notes bearing generally on the subject of emboli / by Wm. Robert Smith. 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.

    15/18 (page 13)
    patient's countenance was anxious, and she expressed herself as feeling very ill and depressed. Milk diet was ordered, a gentle aperient given, a simple effervescing draught ordered three times a day, and hot flannels were applied to the breasts. March 2.—Has slept well, and feels better this morning ; tongue less furred; bowels moved freely twice ; has taken her nourishment better. Temperature 102-4°; pulse 120, irregular and rather jerky. 3rd. —Much better; slept well; tongue clean; is more cheerful; temperature 102 ; pulse 120, still distinctly irregular. At 5 p.m. I was summoned to see the patient at once, as she was much worse; upon visiting her two hours afterwards, when the message reached me, I found her dead. As far as I could learn from the husband, who was present, it appears she had raised herself in bed to use the bed-pan, and felt suddenly so ill that she laid down again, and died within a quarter of an hour with all the signs of asphyxia. The face was pale, the eyes were open, pupils widely dilated, the muscular system rigid, and hands firmly clenched. Autopsy, twenty-four hours after Death.—Rigid mortis present; body well nourished. Upon opening the chest, the left lung was found collapsed, although the right was by no means over- distended. Heart: Pericardium contained a small quantity of serum; right cavities and largo veins distended with dark fluid blood; left chambers empty. Trachea congested, and the left bronchus contained a little frothy fluid. Lungs: Right normal; hypostatic congestion at base. Left—upon tracing the branches of the pulmonary artery into its substance, at the site of the bifurcation of one of the main branches, an embo- lism, composed of clot, was found firmly wedged ; it was about three-quarters of an inch in length, and rather larger round than a piece of slate-pencil. The lung-tissue was congested about the site of the embolus, but there was no distinct infarct.