These murmurs are due to pressure upon the aorta, and must be distinguished from the sound produced in aneurism of this vessel.
In the case above mentioned of fatal haematemesis from miliary aneurismover an hour of continuous searching was required to find the pinhole perforation in the mucous membrane in the bottom of which lay the small aneurism.
In one such case I found that the fatal hemorrhage was due to the bursting of a miliary aneurism of a small artery in the submucous coat.
The tumor produced by aneurism is generally smoother and rounder than that caused by cancer.
Cancer may invade the portal vein, tumors of adjacent parts other than those of the liver, or an aneurism may compress it and cause dropsy.
In my case of obliterating endarteritis just referred to there was a small aneurism in the floor of the ulcer.
Footnote 94: In a case of pulsating pyloric cancer observed by Bierner the symptoms were much more in favor of aneurism than of cancer.
The pulsation of an aneurism is expansile, but the impulse of a tumor resting upon an artery is lifting and generally without lateral expansion.
Should aneurism be detected, passage of the tube would be hazardous.
The propriety of performing Mr. Wardrop's or indeed the common operation for aneurism about the neck might depend on the information {205} thus obtained of the state of the aortic valves.
These cases led me into an error; for, meeting the signs of permanent patency of the aortic orifice in conjunction with aneurism, I erroneously attributed to the aneurism the signs which arose from the permanent patency.
This idea contains the germ of the Tufnell treatment, which has been the most successful therapeutic measure for the treatment of aneurism in the nineteenth century.
Aneurism of the aorta of itself does not produce the signs arising from permanent patency of the mouth of the aorta.
The proofs we possess as to the frequency of abdominal, especially mesenteric, aneurism from this source are overwhelming.
In the walls of the verminous aneurism one not unfrequently finds all the pathological changes exhibited by atheroma in man.
The favorite seat of the worm-aneurism is the trunk of the anterior mesenteric artery, directly at its origin from the abdominal aorta.
Like the worm-aneurism itself, atheroma of the abdominal arteries arises from a circumscribed acute and subacute endo-arteritis.
The dangerous symptoms of the worm-aneurism are exclusively due to embolism and thrombosis of the affected artery, arising from the parietal clot.
Friedberger has published some valuable lectures, in which, amongst other points, he incidentally remarks upon the comparative freedom of military horses from aneurism as compared with ordinary laboring horses.
This holds good for all the visceral arteries, with the exception of the abdominal aorta, in which an aneurism may arise from local increase of pressure.
This change in the media points to the fact that in the development of aneurism in man the early disturbance of the nutritive process in the tunica media is not a less essential factor than the degeneration of the tunica intima.
In consequence of its position the worm-aneurism of horses is not open to physical examination, and on that account cannot be diagnosed by physical signs; moreover, it offers no characteristic symptoms.
Diffused aneurism from wounds, and the other species of the disease, will be afterwards treated of.
The lower limbs being chiefly subject to such exertions, aneurism in them is most frequent;[16] and for the same reason it is said to be common in those who ride much on horseback.
If the aneurism compress a plexus of nerves, or the spinal chord itself, the anterior part of the vertebræ having been previously absorbed, paralysis is produced.
When blood has been extensively injected into the limb, when the aperture in the vessel has remained pervious, and when a large diffused aneurism exists, bandaging is worse than useless.
Aneurism of the branches of the internal iliac, whether spontaneous or the result of wound, is rare.
The carotid has also been tied for the cure of aneurism at the root of the neck, when it was impossible to place a ligature betwixt the tumour and the heart.
Illustration] An aneurism of the descending aorta, in a great measure one from dilatation, is here represented: the patient also laboured under popliteal aneurism of one limb, and inguinal of the other.
The cause, or causes, of aneurism by anastomosis are also unknown.
For aneurism at the angle of the jaw, the point of deligation must in a great measure depend on the size of the tumour.
The rage now, more especially on the other side of the Atlantic, is all for curious aneurism needles and tonsil shavers.
This form of aneurism is supposed to consist of a dilatation of the internal and muscular coats of the artery; the external cellular having been destroyed.
Such are the facts, from which the Reporter infers, that the aneurism consisted of a protrusion of the internal and middle coats of the artery.
Aneurism from a Wound, cured by Valsalva's method.
Aneurism from a Wound, cured by Valsaiva's method.
It is a sight extremely interesting, to observe the gradual return of heat, strength and colour, to an arm on which the operation for the aneurism has been performed.
I do not know that this operation was ever performed in the thigh, the artery being so guarded in this part, that an aneurism rarely forms here.
He dressed them every day, but the bandage for the aneurism he renewed only every other day, although two of the openings lay under it.
He had suffered for some years, though he did not know it, from an aneurism of the aorta, and the bursting of the aneurism into the larynx was the cause of death.
The patient upon whom he performed his now celebrated operation was afflicted with a popliteal aneurism--that is, the aneurism was located on the large popliteal artery just behind the knee-joint.
If by any means the blood can be allowed to remain quiet for even a few hours in this aneurism it will form a clot, contract, and finally be absorbed and disappear without any evil results.
An aneurism was palpable at the inner part of the top of the popliteal space, about the size of a pigeon's egg; a strong thrill was to be felt, especially when the knee was flexed, and with this expansile pulsation and a loud machinery murmur.
For either femoral or popliteal arterio-venous aneurisms ligature of the artery above and below the aneurismis the best and safest treatment.
On the right side of the neck a large aneurism fills the carotid triangle, extending from the mid-line backwards to the margin of the trapezius, and from the level of the top of the larynx upwards to the margin of the mandible.
How far this condition may prove permanent there has been little opportunity of judging; nor as to the possible ultimate weakening of the vessel wall and the development of a secondary aneurism has time allowed the acquisition of experience.
Fulness but no pulsation was noted at end of three weeks; seven days later pulsation was evident, and an aneurism the size of a pigeon's egg, with firm walls, became localised and palpable.
These observations raise the interesting question whether the irritable circulation which has been classically considered one of the predisposing causes of spontaneous aneurism should not rather be regarded as a result of the condition.
In another case ligature of the femoral artery for popliteal hæmorrhage was followed by the development of a traumatic aneurism in the ham.
It is worthy of remark that no case of gangrene due to aneurism came under my notice, except subsequently to operation.
Such positive evidence as was afforded by operation as to the exact condition of the vessels in two cases of femoral arterio-venous aneurism was, that in either case a clean perforation existed.
On arrival at Woolwich the patient was found to have a varicose aneurism at the upper end of Hunter's canal.
A case of arterio-venous aneurism of the femoral artery quoted in the Lancet[17] will illustrate the difficulty which may be met with in determining the actual bleeding point in the irregular cavity laid open.
The aneurism was cured by ligation of the vein above and below the communication and proximal ligature of the popliteal artery.
A portion of the fibrin-like lining of the aneurism may flake off and drift along in the blood stream, until finally a vessel that is too small for the floating particle or embolus to pass through is reached.
The patient with the suspected predisposition to aneurism kept fairly well for a week or two, and then took a sudden turn for the worse, presenting at times most unwonted symptoms.
Besides, as the aneurism progresses there will come a steady, boring pain and increased shortness of breath, which will themselves help to keep him quiet.
If an aneurism affect the upper end of the external iliac artery, it is proposed to tie the common iliac; but this is an operation of so serious a nature, that it can in this respect be exceeded only by tying the aorta itself.
The aneurism of the arch of the aorta may cause suffocation in two ways--viz.
When an aneurism arises from the aortic arch it implicates those important organs which are gathered together in contact with itself.
Aortic aneurism and its effects on neighbouring organs.
In the same way an aneurismof the aorta, Q, by pressing upon the inferior vena cava, T, may cause oedema of the lower limbs.
If an aneurism attack any part of this subclavian arch, it must be in close connexion with some one of these branches.
Hemorrhage from the lungs, from rupture of an aneurism or from injury of the mouth or throat, may make its way into the air-passages and cause suffocation.
Wounds of an artery or vein, or both, may result in an aneurism or an arterio-venous aneurism.
Thus an aneurism following an injury might be mistaken for an abscess and opened with skill but with a fatal result.
Having passed the hand over the arch of the aorta and noticed whether there is any evidence of aneurism or dilatation, we grasp the heart firmly by the apex, raising and drawing it forward.
The aneurism has grown so alarmingly, that I became desperate, and having no one to aid us, I reluctantly obeyed my mother's requirement that I should come here.
In fact, whatever parts the aneurism may reach or subject to its pressure, may have their functions suspended or disturbed.
The sacculated, or circumscribed, aneurism consists either in a dilatation of the entire circumference of an artery over a short portion of its length, or in a dilatation of only a small portion of one side of the wall.
In all cases of animals which are habitually subject to colicky attacks, parasitic aneurism of the anterior mesenteric artery may be suspected.
Death is produced usually by the pressure and interference of the aneurism with adjoining organs or by rupture.
In worm aneurism we usually find large thrombi within the aneurismal dilatation of the artery, which sometimes plug the whole vessel or extend into the aorta.
The aneurism gives rise to colic, which appears periodically in a very violent and often persistent type.
True aneurism is a dilatation of the coats of an artery over a larger or smaller part of its course.
The aneurism may rupture, since it constitutes a weak place in the wall of the blood vessel, and the horse die of the resulting hemorrhage.
Aneurism of the anterior aorta may be situated very closely to the heart or in the arch, and it is very seldom that we can distinguish it from disease of the heart.
Aneurism may become very large; as it increases in size it presses upon and causes the destruction of neighboring tissues.
The wall of the aneurism is atheromatous, or calcified; the middle coat may be atrophied.
False aneurism is formed after a puncture of an artery by a dilatation of the adhesive lymph by which the puncture was united.
When the aneurism occurs in the posterior aorta no diagnostic symptoms are appreciable; when it occurs in the internal iliac arteries an examination per rectum will reveal it.
There is one form of aneurism which is not infrequently overlooked, affecting the anterior mesenteric artery, primarily induced by a worm--Strongylus vulgaris.
If the aneurism is seated along the neck or a limb it appears as a tumor in the course of an artery and pulsating with it.
And so, my dear lady, that assassin called Aneurism lies in wait for the hearts that abuse their own force of emotion; sparing hearts that, less vital, are thrifty in waste and supply.
These remind us of our aneurism needles, and it is interesting to note that Galen (ut supra) speaks of an 'eyed hook'.
Bonaparte looked at him, and said: "My dear Roland, your aneurism looks to me very much like a pretext for remaining single.
I intended to put him in college without mentioning it, and when he was old enough to tell you about him--always supposing that my aneurism had not carried me off in the meantime.
For all my seeming good health, I am suffering from a horrible aneurism that causes me spasms of weakness and faintness so frequent as to shame even a woman.
It is true that since I have been subject to this aneurism I rush where the lightning flashes and the thunder growls.
Even before I was suffering with this aneurism it has happened to me a dozen times, when I have seen the flash of sabres and heard the thunder of cannon around me.
This result will be more directly brought about when the aneurism happens to press on the ganglion of a posterior root.
There are sundry special cases to be considered, however: thus, Benedikt himself remarks that the pain set up by the pressure of a pulsating aneurism is, from the nature of things, lancinating from moment to moment.
The above list will hopefully give you a few useful examples demonstrating the appropriate usage of "aneurism" in a variety of sentences. We hope that you will now be able to make sentences using this word.
