File:Maryland medical journal (1902) (14596231768).jpg

Identifier: marylandmedicalj4519medi (find matches)
Title: Maryland medical journal
Year: 1902 (1900s)
Authors: Medical and Chirurgical Faculty of the State of Maryland
Subjects: Medicine
Publisher: Baltimore : Manning and Ashby
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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tacks of dyspnea and apeculiar cough. Dr. Shriver, who subsequently attended him,states that for the last two months the patients condition was simi-lar to that which we found upon his admission to the hospital. Thepatient was a man about six feet in height, thin, muscular, some-what stooped. He was very pale, and there was a slight bluishtinge to his skin. He had a characteristic brassy cough, slightexpectoration, and had lost about fifty pounds. There was somesuggestion of laryngeal tuberculosis, but laryngoscopic examina-tion by Drs. Goldsborough and Reik failed to show any disease inthat organ. An examination of sputum by Dr. Stokes also gavenegative results. The patient had a very pecuUar way of sittingup in bed doubled over, and, as a rule, when in any other positionterrific attacks of dyspnea would follow. He would becomecyanotic, and in each attack death seemed imminent. Careful ex-amination of the chest failed to reveal any cardiac lesion, and no AORTIC ANEURISM—GoRTER. 353
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Fig. I.—Akeurism of the Aorta Occupying the TraxsverseAXD Descending Arch. The thoracic contents have been removed en masse, and are viewed frombehind. Occupying almost the entire space between the apices of lungs, is tlieaneurismal sac. This is filled with partially organized blood clots. The posteriorwall of the aorta is entirely wanting and the clots rested directly on the upper dorsalvertebrae which were much eroded thereby. Between the sac and the upper portionsof the lungs are a few adhesions. A small portion of the esophagus is recognized at O. 354 MARYLAND I^IEDICAL JOURNAL august, 1902 bruit could be anywhere detected, notwithstanding the fact thatthe brassy cough persisted. There was no difficulty in swallowingeither liquid or solid food. On his admission to the hospital thedyspnea was so marked that surgical interference was clearly indi-cated. The condition was so critical that an anesthetic could notbe given, so I did tracheotomy under cocaine, the patient sitting-bold

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