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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    cartilage, a loud systolic and faint diastolic murmur are audible. At the ensiform cartilage the second sound can be faintly heard. (It was particularly noted that the diastolic murmur was much less loud at the base of the heart and down the sternum than over the tumour itself.) In the vessels of the neck, especially on the right side, a loud systolic murmur is heard. The radial pulse is 66, regular, equal in the two wrists, and just visible. The pupils are equal and dilated. He sleeps badly because of pain in the chest. The other systems and organs are normal. Treatment.—He was told to remain in bed, and half a drachm of the iodide three times daily was prescribed. Siibseqicent Progress of the Case.—He made rapid and continuous improvement, and in a few days was much easier. On Uh and 5th March the pain returned, and he spat a little blood. On 9 th March the iodide had to be discontinued owing to dyspepsia. On 12th March he complained of numbness in the right arm, and of cramp in the left thigh and leg. The iodide was repeated. On 4:th April he discharged himself, saying he felt quite well. The prominence was very much less. There had been no pain since 5th March. He promised faithfully to continue the medicine. Remarks.—In this case the beneficial effects of the medicine are undoubted. When admitted the patient was suffering from severe pain, and was totally unable to undertake the least exertion. The aneurism, too, was increasing very rapidly. After his discharge he returned, in spite of advice, to heavy work (lifting timber). He continued to work for nineteen months without pain or inconvenience. In November 1876 the tumour again began to increase in size. He presented himself for examination on 14th December 1876. His general condition was good. The aneurism was larger than at the time of his discharge from hospital (April 1875). The heart was now considerably hypertrophied. The other physical signs were the same. He was advised to discon- tinue work, and to take the iodide as before. I have not heard of him since. A point of gTeat interest was the fact that the diastolic murmur was much louder OA'^er the aneurismal sac than over the position of the aortic valves and the lower end of the sternum. The question arises whether this was one of those rare cases in which a diastolic murmur is generated in the sac itself. Case TV.—Anetorism of the Transverse Portion of the Aortic Arch. J. R, £et. 55, a labourer, was admitted on 1st June 1875 complaining of pain in the chest, shortness of breath, and difficidty in swallowing. Prcviov.s History.—His present complaints commenced five