Disputatio pathologica de arteriae carotidis aneurismate quam ... eruditorum examini subjicit Jacobus Vose ..

발행: 1809년

분량: 143페이지

출처: archive.org

분류: 미분류

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Sunda ν, ου. 7.-LWas uel disappotntexto indier laboui in unde aiigh degreeo constitutiona irritation the tumor Wasalso increased an very fore pori preSSures the ound was a large as immediately after the operation, an disCharged a Santous Serum; he Complained os a great dissiculi in SWallo ving, and of a mos distressing cough after the sit of which sh hooped violently;her pulse 96 and herclest arm again eakerthan themther.-Mondo, Nov. 18. he had passed a resties night complain os patii inher head, and the fige of the tumor has in-Creased there is reat oreneas pon theneck, hen it is pressessi the pulse is quick,

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tincture os optum the tumor is stili more increased, and the si in verriti atro unishre colour.-IVe e3day, Nov. 20. he hadsiept threelour last night her pulse is 108, and mali; he is nable o wallo evenlier saliva, hicli constanti dribbles Domiter outh, and ever attemptini deglutition

found inflamed, and around the clo of blood whicli it contained there a a considerable quantity fius. The inflammation extende on the oulside of the ac long the par Vagum, early to the basis of the liuit Theglottis as linos closed, and the internalsursace of the trache wa inflamed coagula-

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sa APPENDIX. ting lympii adhering to iis muCOus membrane. The sudden increas Whicli the paris had undergone frona inflammation, addet totae sige of the tumor previolis to the operation, ad occasione so much pressure,ponthe pharynx that it ouldio easit admita bougie of the fige of a goos quill ThenerVes, a may be Seen, sustainedio injury, the ligatur havin passe belween the recurrent and the arter o the ne hand, and the par vagum n the other. The cause of her death then, as the inflammation O the aneurisma fac and the paris adjacent, by hicli the fige of the tumor hecam increased so a to res o thepharyncani prevent deglittition, and uponthe laryn X, O as to excite violent sits of coughing, and ultimatelnto impede respiration. A simila event, however, a be in future revented by performin the operation hen the tumor is mali, and pressure has no been made by it pon important paris, o i ii is o considerable si2e, as in

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APPENDIX. 95iliis case, by pening the tumor ani dis-chargin the coagulum, as Oon a inflammation appears.

Ases could no obtain permission to penthe ead the cause of the paralysis remainsunt nown It id not immediatet succeed the operation, ut Was observet sit stin theeighth da after it. It came on hilst helaboured unde great constitutionat irritation, tessene Das it decreased, and returne. Whenthe irritation ecam greater butis it appeared that the irritation hich sh sussere lWas Win to the operation ein to longiles erred, it illiso prevent in performingit in an case in hicli the diseas is ome-

lange of bleedin a the time the ligatures separate, inCe, although the were discliar. ged frona the wound on the welfth day, and the were certaini separated frona the arteryon the leventu the ulcerate extremit of

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96 APPENDIX. the esset ad been losed by the adhesive proces anili a clodio blood whicli adheredstrongi to iis coats Hence e ma conclude, heresere, that the carotid arter maybe, in this respect a Sasely ted as an other arter in theiody.

EXPLANATION O PLATE FIRST. A. Aneurismal umor. B. Trachea. C. Right Subclavian Arte . D. Arteria Innominata. E. Clot continue within the Arteria Innominata. FF. Pars Vaga. G. Caroli Artery, missi a portionis it remove to hewthe clo withincit. H. Recurrent eme.

I. Laryn inflamed an ulcerated. The ulcerate Artery, here the ligatur ha been applied. I. Jugula Vein. O. Clot exposed in the arter above the tumor.

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APPENDIX. 97 emplum ear propriis not/3 Auctoris editum . HUMPHRIDIUS HUMPHREY quiliquaginta annos natus, Vir robusti habitus et athletici, in noso omium Guy advectus est, Domino Asile Cooper curante die XXiid Junii anno MDCCCVIII, anetirismate iniStrae Carotidis laborans haec autem est historia mali. Multos annos geruli ossicio functus Londini, et prospera Valetudine usu erat, usque ad se vel septem abhinc menses quum primum notavit exiguum tumorem, mole fere juglandem aequantem, pulsatilem, in parte sinistra colli positum, sub maxillae inferioris angulo, et deorsum usque ad os hyoideum pertinentem. Abhinc quinque mensibus, dolor immanis sinistri lateris capitis, Cum magno motu pulsatilis sensu ad idem latus cerebri, amplifiCationem tumoris comitabatur; loquela tumore impediebatur, et paulatim minus clara fiebat;

Hoc exemplum nuper prolatum eS A DOm A. COOper. Vide Medico-Chirurgical Transactions Vol. i. 1809. N

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s APPENDIX. circa superiorem partem laryngis irritamentum sensit, quod rauca tussis subinde oriens sublevavit; at progressu morbi non respirationem impediebat tussis e tumore laryngem premente penitus oriri videbatur; appetitus cibi abnormis tres aut quatuor dies satis bene cibos sumebat, deinde per multos eos fastidiebat; et subinde nausea laboravit inter edendum, Sed nunquam ad vomitum. Illi

frigoris sensus apud aurem sinistram Saepe erat, Calore Succedente oculi sinistri ut

ii mira fuit, qui palpebris contractis imminutus esse videbatur. Tribus dehinc mensibus, Dr Hamilton vesicatorium praecepit, quod dolorem capitis levabat; et duobus postea mensibus alterum admovebat, et paucos dies retinebat simili fructu aeger operari usque ad diem, quo in nosocomium reCeptu CSt, perstitit. Operationis die XXiid Junii nempe Septimo mense ab origine morbi, arteris carotidis amplificatio proxime infra maXillae angulum erat; et uXta angulum acutum, qui divisione

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