Indurative mediastino-pericarditis / by Thomas Harris.

  • Harris, Thomas.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Indurative mediastino-pericarditis / by Thomas Harris. Source: Wellcome Collection.

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    Pericardium: Immensely enlarged, as indicated by the above measurements; but its cavity obliterated by old adhesions. The external or fibrous coat was closely adherent anteriorly to the back of the sternum and to the anterior portion of the costal cartilages. Laterally it was closely adherent to the pericardial layers of the pleura. The Heart, Lungs, and the structures in the Mediastinum, together with certain of the abdomina viscera, were removed en masse, and a single vertical incision was made, through the heart and mediastinum from front to back so as to ascertain the condi- tion of the mediastinal tissue and the structures therein contained. Mediastinum : There was no enlargement of the lymphatic glands of the mediastinum, with the exception of one gland situated immediately below the bifurcation of the trachea between the two bronchi. This gland was slightly enlarged, measuring fin. in length by Jin. in thickness, and was the seat of the caseo-calcareous change. There was possibly a slight increase of the fibrous tissue in the mediastinum surrounding the arteries, veins, and adjacent structures ; but this was not marked, and the chief evidence of mediastinitis was alForded by the firm adhesion of the external surface of the pericardium to the pleura and to the sternum and costal cartilages. As previously stated, the anterior part of the mediastinum was adherent to the posterior aspect of the sternum. Heart: The interior of certain of the cavities of the heart was exposed by the above described median incision through the mediastinum. The cavities contained dark-red recent blood clot. The cavities were dilated, but the valves, as far as could be ascertained from the incision made, appeared normal. As the specimen was required for museum purposes, the heart was not further dissected. Lungs: At the apex of the right organ there was slight puckering and a small area of fibroid induration, apparently indicative of old apicial pulmonary tubercle. Both lungs congested and much compressed by the extensive chronic pleurisy. The fibrous tissue forming the thickened pleura not only completely surrounded them both, but in places extended slightly inwards into the pulmonary tissue. Although increased in consistency, there was no complete consolidation anywhere, and no indication of any recent tubercular focus. The only sign of tubercle in the lungs being the old obsolescent aflfection of the apex of the right organ. Vertical measurement from base to apex of the right organ 4Jin., of the left 4-|in. Abdomen: Peritoneal cavity contained 35oz. of turbid yellow fluid. The parietal layer was generally thickened; it was smooth and had a white porcelain-like appearance. The visceral layer was also densely thickened, and over the liver and spleen the opaque white porcelain-like appearance was very pronounced. The peritoneum forming the serous