On Two Cases of Rapidly Developed Unilateral Ataxy

D. Drummond
1881 BMJ (Clinical Research Edition)  
a branch of the pulmonary artery into the aneurysm; probe B into the phthisical cavity into which the aneurysm had burst. :~~-; %"' -. L~P ost Mfortem Examination.-In the apex of the left lung was a cavity of the size of a hen's egg; near the root of the same lung was an aneurysm of the size of a walnut, communicating with a branch of the pulmonary artery, the sixth division of that vessel; it contained blood. Its sac had a smooth interior, and its wall, which was a quarter of a line thick, was
more » ... f a line thick, was separable from the surrounding tissue. It projected into, and nearly filled, a phthisical cavity, into which it had ruptured, and which also contained blood. The mouth of the aneurysm, which was smooth, was a quarter of a line in diameter. Both lungs were studded with caseous masses of lobular pneumonia, most of which were encapsuled by condensed tissue; many had undergone softening, and in some the broken-down material had been removed and cavities left. The trachea and bronchial tubes contained blood. The heart, aorta, and abdominal viscera were sound. REMARKS.-Pulmonary aneurysm occurs chiefly in chronic phthisis, arising from chronic catarrhal lobular pneumonia, or scrofulous pneumonia, where the lungs are the seat of cheesy masses. It is, I believe, most frequently found towards the root of the lung. Its mechanism of production is uncertain; it may be due to ulceration of the vessel, or more probably, to loss of support of the vessel from softening, and removal of the caseous matter around it. In F.'s case, in the centre of each cheesy mass were seen by the naked eye an arteriole and a bronchiole; and, where the central part of these caseous masses had broken down and been removed, the vessels in the centre were seen to be unsupported. Blood had found its way into the trachea from the phthisical cavity, into which the aneurysm had burst, by means of a bronchial tube, which communicated between the cavity and the trachea. Hcemoptysis in such cases is usually sudden, profuse, and repeated at short intervals. It is a question whether, in the case recorded, the aneurysm was the source of blood in each attack of haemoptysis. No other aneurysm, nor evidence of previous hemorrhage, being found else-
doi:10.1136/bmj.2.1074.156 fatcat:pil3ijpy65ao3hhdm7duc4bgl4