Transactions of the Association of American Physicians (Volume 5) (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1890. Excerpt: ... VARICOSE ANEURISMS OF THE AORTA AND SUPERIOR VENA CAVA. By WILLIAM PEPPER, M.D., PROYOST OF AND PROFESSOR OF MEDICINE IN THE UNIVERSITY OF PENNSYLVANIA; AND J. P. CROZER GRIFFITH, M.D., PHYSICIAN TO ST. AGNES' AND THE HOWARD HOSPITALS, AND ASSISTANT PHYSICIAN TO THE HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA. There is, perhaps, no pathological condition whose symptoms are usually more characteristic than are those of obstruction to the normal flow of blood in the superior vena cava. Such a condition may be brought about by compression by tumors or aneurisms, by inflammation and consequent thrombosis of the vein itself, by rupture of an aneurism of the aorta into the vena cava, by penetration of a malignant growth into the vessel, or by bands of inflammatory tissue constricting it from without. The characteristic symptoms consist in intense oedema and cyanosis coming on rapidly or slowly, and limited to the upper half of the body; together with such secondary symptoms as would naturally follow these conditions. It is difficult to conceive of any cause suddenly operating to bring about obstruction, yet failing to produce these effects. Only when the cause operates very slowly does it seem possible that the symptoms may be slight, or even absent, the collateral circulation having become established. Rupture of an aneurism of the arch of the aorta into the superior vena cava, one of the causes referred to, is so rare an occurrence that we have been interested in looking into the history of the affection, in connection with a case occurring under our own observation, with the hope of determining whether there exist any symptoms which would permit of a diagnosis during life. The following history of the case is imperfect in some points, owing to the patient's s...