Cases of aneurism of the aorta, treated by 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 iodide of potassium / by Byrom Bramwell. Source: Wellcome Collection.

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    interspace above to a point an inch below the xiphoid cartilage, a distance of six inches. Transversely, its widest diameter was five inches. (See Plate III.) The external tumour contained a large quantity of firm laminated clot. The lower end of the sternum was eroded. A circular opening, larger than a five-shilling piece, communicated between the ex¬ ternal and internal tumours. Below the lower end of the ster¬ num, in the position of the xiphoid, there was another opening, triangular in shape, and almost as large as the circular one already described. The edges of the circular aperture were in places beautifully smooth, evidently blood-worn. The internal tumour was of large size and sacculated. It sprang from the very base of the aorta on its right side, and was firmly adherent to the exterior of the right cavities of the heart. The internal portion of the tumour con¬ sisted of three sacs; the first was the size of an orange, the second somewhat larger, and the third the size of a hen's egg. All three sacs freely communicated one with the other. The first sprang directly from the aorta, the second and third communicated with the 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 the segments being firmly joined to¬ gether. The aorta was slightly atheromatous. Case III.—Aneurism of Ascending Thoracic Aorta. Great relief from large doses of Iodide of Potassium. H. P., set. 42, married, a labourer, was admitted to the Hewcastle- 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 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 hen’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