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

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APPENDIX. Deripuit, chirurgum vero dolori, qui honestum virum non potest non premere, quotie aegro, cui subvenire Conatus est, potius nocuit Dissecuimus sub noctem, Irgente OCCaSione, partes aegras Cuti remota continuo tumor ipse succeSsit, membraneus, CellulOSUS, SpongiOSus, cuti adhaerens, pugno duplo major Eum denique longo labore ita mundavimus, ut Carotidem esse, et a subclavia adusque divisionem duorum ramorum carotidis extendi adpareret. Induruerat membrana carotidis, et Crassior facta erat, et amplior, ut minus deceat mirari eos, qui uterum graVidum CraS-siorem reddi vident. In ipso sacco aperto multum rumorum sanguineorum fuit, quorum exterior pars et membranae arteriosae sinitima, in spongiam

cellulosam abierat. Fluidi sanguinis parum

inerat.

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72 APPENDIX.

Ea emplum e Londini Obserrationibus et Invratigationibus Medicis .RICHAR TRIGG, age forty-eight years, o an athletic habit of Ody, and who adbeen accustome totarii labour, his occupation ein that os a porter, ad likewisedi an very Deely, and lived therwise illi great irregularity. Heiad been assected witha dissiculi os breathinisor a monili past, O-gether illi a light cough, and at intervalsii expectoratei mucu preti deepi tingetlwith lood he had likewise, at the fame time, perceived an increasin tumor i thenech, siluated on the lest fide of the trachea, and the superior par of the tumor extendingbefore it This tumor as abolit the fige of a mali hen' egg. These complainis ad graduali increased unti this time, the 29th

London Medicat Observations and Inquiries, Ol. i. p. 23.

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APPENDIX. 73

of October 776, when he was admitted a patient into the Leicester Infirmary. With the mos able medicat assistance, thedificult of reathin and haemopto Verysoon est him, an in about a Ceeli' time hebecam si e frona his complainis, except the tumorin his necti, hichaein supposed obe an neuriSm, medicat assistance, on thalaCCOunt, a thought to eis no avail hewas heres ore discliarge the hospital, apparently et in ther respectS. The this November he had a return of his forme complainis for hich he was re- admittet in to the hospital These ilis ereagain imos totali remove iri ut on the 26th of November e again spi up lood, though in a very mali quantity, and without an materiat inconvenience On the 27th, his pittin of lood a ruther increa sed, but Was et inconsiderable He ad been, through the day, ver cheerful, nil inihimself greatly relieved frona his complainis, andeXpected a speed recovery he had alien

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74 APPENDIX.

his Dod illi a good appetite, and in the evening, after Cheerfuit catin his supperwith the other patienis, e retired totis bellii the ighest spiriis. Immediatel aster-Ward he was seiged illi a sit of coughing, which was occasionedias he himself expressed it by a bit os read going the wrong

self, o into ed. oon after his he was again attacked by the ough he called out for heip he was supportet ove the fide of the ed by two assistants, and Spit ut sonae more bl ood When suddenlyae brought upabout eight unces O blood and mucus, and instanti eXpired. The cause of his sudden death not eingso clearly understood a naight be Wished, we ad recolii se to an examination of the part after death, in orde the more fullyrio investigate it the appearances of Whicli, Sthe were hewn by dissection, I ill egleave to relate.

The est carotid artern vas found dilate lto the fige of a mali hen' egg, abolit an

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incli and hal above the orta, the aneuriSanal fac lying obliquet upon ille inferior parto the PD3αr, and the upper end of the trachea This eniat genaent of the arter Wassilied with a preti sit in coagulima. The est subclavian arter Went ira amuch greater distanc froni the carotid than usual bein siluated more than an incli distant to the lenis it There id not appeart be any more neurisius in the large arteries, hicli,ere caretally Xamine l.

This patientia linjoyed the greatest share of health ill withino vo monilis besere his death; hen helegan to sinit sonae dissiculty

in breathing, and perceived ille aneurisin fili carotid arterni increase . emplum primun a Scarpa prolati l ALCUNI anni a lao e luto, e Mesaminato io pure uia Aneurisma delia Carotide destra in

Quae in hoc casu nullo modo neurismati carotidispertinent Omittuntur.' Scarpa, Suli Aneurisma,Me.

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76 APPENDIX. un Militare, ii quale precipitato col cavallodalle mura dimant ova ostii una validissima torsione e Stiraturamel collo I tumore Occupava il lato destro, tetro 'angolo dellamascella e porgeva in suor Comem pugno, e pulsaVa con grande eemenga. op Seimes ebbi contegZa, che quest infelice aveva perduio a vita fra te mani 'un ignorante Ciarlatano, che gli aveva aperto it tumore

IN ut altro caso 'Aneurisma delia Carotide, i Dottore ΡIcc IN ELLI, primo chirurgo dello pedale di Bergamo, e mi respellabile amico, mi ha procurato ropportunita d'esaminare ne cadavere te parti Laratoria ella malatii h come egue Lucregia ossettid'anni 44 entro nello pedale di Bergamo ilgiorno 16. Febbr o 1803. a motivo 'un tumore pulSante della grossegeta di due vovi digallina che essa da tremes portava ne lato

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APPENDIX. 77sinistro dei collo e che fu giudicat unaneu-riSma Nero, OSSia Saccato. Non fu possibiled'iscoprire te agioni di questo Aneurisma. La malata non Seppe di altro, Se non cheerano trascors soliant tre est, da cheessa 'era accorta lavere questo tumore net collo it quale iungi 'aver edulo atrusod'interni ed esterni remedj, andava angi ognigiorno pii visibilinente Crescendo. Essa aveva pero da due mes un'ulcera venere sultabbro sinistro delia vulva, quantunque SeΠ-ga ingrossamento deli Oiandole inguinali, esenga segni manifesti di ue. 'inserina siti Ovava olire modo Stenuata quando entronello pedale. Non pertant si ovettero replicare per intervalli elle icciole missionidi sangue, Siccome era quest Punico eZZodi diminuit e la dolorosa distensione de tumore, e di procurare qualch sollieuo alla infelice malata Malgrado ioci tumore 'accrebbe, ei occupo loratio che .vi fra laclavicola, e angol della mascella inferiore. Illi orno 2 d'Aprile dello stesso anno la cute

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73 AI'PENDIX. de lato sinistro et collo eccessivamente distes screpolo, e die te uogo ad un ulcera rotonda, a quale intaco it sacco Aneurismatico e miSe alio Scoperto, i primo strato Coten-noso deli Aneurisma senZa che cio fosse SuSSeguito da emorragia. It torno 13 dello stessomes incominci a rona persi, edis ulcerarsi anco a cute che coprivaria sommitti dei sacco Aneurismatico e la corrosione and tanto pro-sondamente, chesii torno'. di aggio alte 4. pomeridiane penetro ne cava deli Aneurisma, di ove scerono improvvisamente dodicione di sangue. Queste astarono perchesia donna gia estentiata Cadesse in deliquio; ia- vutas dat quale e opo Ver preS UI POCO di vino, verso lamegga noti spiro. Aperto ii cadavere si trovo cheaAneurisma era esset-tivamente delia Carotide sinistra, origine delia quale arteria in questo Soggetto deviava lalla comune manter in Cio, he nascevadali arteria Innominata che quanto diret Innominata ava origine alte due Carotidi, ed alia Sottoclaveare destra. salter, mala-

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APPENDIX. 79 carne avevan gia in altra Occasione osservata, e delineata questa arieta Larco della Aorta, ed i cuore eratio in stato sano Parteria pulmonare Un poco piu grossa de consueto. a Carotide sinistra, alia quale eraderivato Ancurisma, e levasi appertuito de naturale suo calibro I sacco Aneurismatico erasi fati aderente alla hiandola Tireoidea. Aperto it sacco Aneurismatico dalla Sua Ommita, ossi dat luogo della secondasCrepolatura in asso, e uotatici grum di Sangue, Omparve et fondo di detio sacco laCarotide sinistra crepata damn lato pel ratiodi se linee, C. C. Ememplum a Domino Ioa=rne Bel editum . ELIZABETI WALLACE, a lesti cadie, a

had ted a very dissolute and abandone lase:

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bout that period she sirst observe theriump, Whicli, heia he ought an asylum in the hospital, as et o bigger than a Walnut. She had n other complain beside cough and dissiculi os breathing, ut the Cough was attimes O violent, and accompante With suchstraining that the nurse ho Walched her,

pillei her. At his period the dissiculi of