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Show '18 or ANEURISM. raIeKING or run NERVE. palpitation and breathlessness. These feelings came upon him before he had time to think what might have happened. CHAPTER II. In some instances, a shooting pain has struck up the arm to the head ; and 011 the following day a thrilling sensation has been felt towards the fingers. OF ANEURISM. In general it is some little time (perhaps three days) after the operation before any convulsive motions in the muscles of the arm side of the neck and back are felt. The convulsive attacks and the clenching of the jaws increase in violence, and seem to bear no relation to the state of inflammation in the '40.)va mum‘ ill of the coats of the artery, the blood may be so contained by denly roused and stiffened with convulsion. It is these har- the cellular membrane as to form a circumscribed tumour, or rassing attacks when he is dropping asleep, and the short disturbed slumbers, with frightful dreams, which exhaust and subdue the patient's strength and spirits. The disease, as I conceive it, soon ceases to be a local affec- it may only be retained by the general fascia, and of course be more generally difi‘used: and thus we have the distinction \ .5 amwweuavn Of this, at least, we are certain, that if the patient re- ceives the slightest scratch or abrasion of the skin, the disease, though previously much abated, recurs with the utmost v10. lence. In the violence of the paroxysms, large doses of opium, with cold air, or the dashing of cold water will, I believe, give re- lief. As to the wound, I should do nothing; yet I would pre- fer to incisions the burning of it with caustic. The general health and strength must be supported by generous diet and wine. But on this subject. I speak with diiiidenee, because in tetanus from other causes I have often seen those fail, on whose abilities I place the greatest reliance. if the' nerve is to be cut, we recur to anatomy: mark the place of the orifice, calculate upon the distribution of the . -I...--' '___‘~._.......:_. -..‘~L. """"‘ " _ . ed in the condensed cellular membrane, or under the fascia. In this case it has been called a false mzcurism. Though out wound. They are even greatly aggravated after the healing of the wound. Their accession is chiefly when the patient is exhausted by watching, and when just falling asleep he is sud- tion. .5. r. ANEURISM is a pulsating tumour, formed of arterial blood. It is colourless, and little painful on pressure. The blood may be contained in the dilated artery, in which case it has been called the TRUE ANEURISM ; or it may be contam< nerves, and, plaéing a tourniquet on the arm, dissect and cut the nerve. It will, however.,at once occur to the surgeon, that a teazinzr ozieratiem serl emf: out iCl‘VCS in this irritab le (4.4.. of the.. panenfg Wm, . nay _. , ml. .. be,nuiikzltlct l \\ ith an aggravation of the diecuse. of the true, the false, the circumscribed, and the diffused aneurism. I believe there is no distinction of aneurism arising from the puncture of the external coats of the artery only. When the tumour of an aneurism is first formed, the blood being fluid, it is compressible, and its pulsation ispowerful; but when the blood coagulates, and is formed Into a firm coat, the tumour does not vanish on pressure. Aneurism follows from obliquely penetrating wounds, which have pricked the artery-from a fractured bone tearing the artery-from a twist or injury of tire artery when m a diseas~ ed state~-from a scale of ossification in the artery, tearing or causing an ulceration of its coats-from the artery losing its elasticity, and gradually yielding to the impetus of the blood. The most distinguishing character of an aneurism is its pulsation; but when the blood has coagulated in any considerable quantity within it, the pulsation often becomes very obscure. On the other hand, if a tumour lies in contact with a large artery, or includes a considerable artery in its substance, it receives the pulsation from the artery: and may be mistaken for an aneurism. VOL. 1. ?l |
