Volume 3

A descriptive catalogue of the Anatomical and Pathological Museum of St. Bartholomew's Hospital / published by order of the governors.

  • St. Bartholomew's Hospital Museum (London)
Date:
1882-84
Catalogue details

Licence: Public Domain Mark

Credit: A descriptive catalogue of the Anatomical and Pathological Museum of St. Bartholomew's Hospital / published by order of the governors. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    90/394
    aneurysm extends from the transverse part of the arch downwards and forwards to tlie tliorax, where it opens by a large aperture through the sternum and right costal cartihiges on a level with the iifth costal interspace. The skin for some distance round the actual point of rupture is thickened and discoloured. The aneurysmal sac is large and free from clot ; its walls are thickened to a considerable extent. 1887 From a married woman, aged 42, who first noticed a swelling at the right side of the sternum eleven months before her death. On raising the right arm she had aphonia. The tumour, which measured during life two and a half inches in diameter, had well-marked expansile pulsation. The patient suffered much from dyspnoea and cough. A cast of the case is preserved in Series Ivi., No. 98a, and a drawing in Series Ivii., No. 186, See Elizaheth Ward Book for 1884, No. 245. 1487b. The Heart and Aorta, with a portion of the Thoracic Wall, showing the seat of an aneurysm, and the manner in which it has ruptured through the chest wall. The heart is healthy, but the aorta is greatly dilated, and is very atheromatous. The aneurysm extends from the transverse part of the arch downwards and forwards to the thorax, where it opens by an irregularly oval aperture through the sternum on a level with the third intercostal space. The aneurysmal sac is very large, and tracks downwards. It contains a large amount of clot. 1888 From a man, aged 38, who had syphilis fifteen years before his death. On admission to the Hospital, he had a prominent swelling extending from the sternal end of the clavicle to the cartilage of the fourth rib, with the left border of the sternum as an axis. In the swell- ing was well-marked expansile pulsation. The pulse was equal in both wrists ; the pupils were equal. The aneurysm gradually pointed, the first drop of blood oozing out four weeks before his death. A series of casts of the thorax, made by the patient himself, and showing the gradual increase in the size of the aneurysm, are preserved in Series Ivi., No. 98b. See John Ward Book for 1887, Case xi. 1497a. A Heart with the Arch of the Aorta. An aneurysm of the extra-pericardial portion of the aortic arch has ruptured into the pericardium. The aneurysm is fusiform, with two large saccules, one occupying the greater portion of the arch, and involving the great vessels, whilst the second smaller saccule is deeply ulcerated, and is separated from the left bronchus by the thickened walls and matted surround- ing tissues. The larger, saccule is partly obliterated by a fibrinous clot. An ulcerated track leads from the smaller saccule by a perforation large enough to admit the little finger into the pericardium, immediately anterior to the pulmonary artery. A black rod has been passed along this track. The pericardium showed no signs of recent inflammation, except in the vicinity of the perforation. The cavity was dis- tended with a pint and a half of dark fluid blood without clots. 1889 From a man, aged 34, who presented during life the signs of a small aneurysmal tumour pulsating in the second left intercostal space. He was suddenly seized with faintness and symptoms of collapse. When seen on the same evening, he was apparently dying, being pulseless, with cold extremities and clammy skin. No effusion was apparent into any of the cavities. On the next day the patient had rallied ; but on this and the succeeding day effu- sion into the pericardium gradually manifested itself, and was accompanied by a paroxysmal cough, with intense pain, presenting in some respects the character of angina pectoris. His highest temperature was 101° F. He lived fifty-six hours after the rupture had commenced. Six months before his death he had been treated by Tufnell's method, and it appears probable that the coagulum in the larger saccule was laid down during this period. See Transactions of the Pathological Society, vol. xl., p. 62. Presented by S. H. Habershon, M.D. ANEURYSM OF THE ARCH OF THE AORTA, TREATED FOR NINE MONTHS BY TUFNELL'S METHOD. 1503a. An extensive Aneurysmal Dilatation of the Aortic Arch. The aneurysm extends from a point immediately above the semilunar valves to the origin of the left subclavian artery. On the cardiac side of the innominate artery the wall of the