Cases of aneurism of the aorta, treated by the iodide of potassium / by Byrom Bramwell.

  • Bramwell, Byrom, Sir, 1847-1931.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Cases of aneurism of the aorta, treated by the iodide of potassium / by Byrom Bramwell. 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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    directly from tlie aorta, the second and third commnnicated with tlie external tumour through the openings above described. The contents of the internal aneurisms were chiefly recent clots and fluid blood. The walls of the internal aneurism were very thin. In the dried preparation they are transparent. The two surfaces of the pericardium were firmly adherent. The aortic valves were incompetent, the edges of tlie segments being firmly joined to- gether. The aorta was slightly atheromatous. Case III.—Aneurism of Ascending TJwracic Aorta. Great relief from large doses of Iodide of Potassium. H. P., set. 42, married, a labourer, was admitted to the Newcastle- on-Tyne Infirmary on 4th February 1875,suffering from an aneurism of the ascending part of the aortic arch. Previous History.—He had smallpox three years ago, but, with this exception, has been very healthy. His present illness com- menced six months ago with pain in the chest. Fifteen weeks ago he gave up work. There was then a slight prominence in the upper part of the right chest. He has never had syphilis nor rheumatism, and knows no cause for his illness. Family History.—Good. Present Condition.—He is a stout muscular man, 5 feet 9| inches in height, ruddy complexion, anxious expression, hair brown. He complains of a constant gnawing pain and a sensation of heat in the chest. At times the pain shoots up to the right shoulder, and down the right arm as far as the elbow. He is short of breath on exertion. A prominence, the size of a lien's egg, is visible between the first and third right costal cartilages. A strong single impulse is felt over the tumour, which is soft and yielding. There is absolute dulness on percussion over the prominence; impaired percussion over an area measuring five inches transversely and four vertically. (See Plate I. Fig. 3.) On Auscultation, a strong impulse is communicated to the ear, and a double murmur is heard. The systolic portion of the murmur is soft, the diastolic almost musical. The mm-mur is heard very ■distinctly posteriorly in the right supra-scapular region, and all down the right side of the spinal column. Two inches to the right of the 6th dorsal vertebra it is more distinct than else- where. At this spot the murmur is of a cooing character. The respiratory murmur and vocal resonance are absent over the ab- solutely dull area anteriorly. Kespiration is weaker in the right than in the left lung. The size of the heart is normal. A soft systolic murmur, distinct from tliat over the aneurism, and propagated upwards towards the left axilla, is audible at the apex. The pidmonary sounds are not accentuated. Over the sternum, at the level of the 4th costal