Editorials and Medical Intelligence

1844 Boston Medical and Surgical Journal  
These reasons were met as follows:-1. The occupations of the man were merely presumptive evidence of the probability of aneurism. *• The pulsation of the tumor might have been (as is frequently the case) the result of the artery beating under the indurated mass. 3. The diminution on pressure and subsequent enlargement might be attributed to the lessening or increase in size consequent on the compressed or dilated state of the arteries and veins that surrounded the tumor. 4. With ¡'espect to the
more » ... bruit, although not audible to all of us, it was so to the majority of those present ; Mr. Myers and myself could not hear it ; but it imports little whether it existed or not, as its existence refers little to the case. 5, The flow of blood on the introduction of ihe exploring needle did not conclude anything further, as it might have arisen from distended cutaneous vessels, or dilated arteries and veins in the tumor. But no "oubt was entertained by any one that the tumor must be removed in order to save the man from suffocation, nor did any question exist that the removal of it could be effected unless the carotid artery were previously tied. This, therefore, was done, on the 23d September, by Mr. tecles, in the usual short space of time, although he was somewhat impeded by disarrangement of pans, consequent on the existence of so large n swelling. In order to test the accuracy of the diagnosis, it was deermined to delay, for a time, the extraction of the tumor. The day after lle application of the ligature slight cerebral disturbance came on, which Was subdued by moderate bleeding, but on the fourth day the patient Was seized with paralysis of the left side (the side opposite to the ligau,e) ; the usual remedies restored him to sensation, and, partly, to mo-'on. I" November, however, he wished to return home, and then, in aiiuary, four months after the operation, he was unfortunately attacked VV|th bronchitis, of which he died. Un making a post-mortem examination the carotid artery was found , he completely obliterated by the operation. A glandular tumor em-. aced and intersected all the deep-seated muscles, vessels and nerves of , e neck ; it was covered by the skin, platysma-myoides, sterno-cleidostoideus muscles, and the two layers of fascia, »
doi:10.1056/nejm184410090311005 fatcat:epvsur4nhjhnjmidghcjoa2e4y