On Some Cases of Idiopathic Neuritis

J. M'crea
1873 BMJ (Clinical Research Edition)  
May 24, i873.] THE BRITISH MEDICAL JOURNAL. the adductors, and vastus externus muscles, in a partially disorganised state. The integument showed no symptoms of thinning in any part. The anterior crural nerve was found deeply imbedded in the clot, and was the only recognisable structure in the tumour. An incision was made from the middle of Poupart's ligament to the umbilicus, and thence to the sternum. The kidneys were in a healthy condition; the liver was enlarged, and showed appearances of
more » ... d appearances of waxy degeneration. On cutting across the aorta, and dissecting the external iliac artery downwards, it was found that an aneurism existed on the right superficial femoral artery. The femoral artery was then dissected upwards from the popliteal, as well as possible, to the tumour, and the mass removed for preservation. It consisted of a quantity of laminated fibrine, situated in Scarpa's triangle, where it appears to have burst, and this, I believe, took place before the patient applied for medical relief, at which time the tumour was localised, and about the size of two fists. The epigastric and circumflex ilii arteries were considerablv enlarged. The upper part of the femoral artery leading into the tumour was pervious; that immediately below it and leading from it was impervious. This case of diffused aneurism is, I think, worthy of record, on account of the close resemblance of its symptoms to those of malignant disease. If the nature of the tumour had been discovered during its early stage, an effort to cure it might perhaps have been made. This case clearly shows that cachexia, rapid growth, and severe pain must not be accepted as sufficient evidences of cancer. In reviewing the history of this case, there are some points which should have suggested its non-malignant character; namely, the absence of lymphatic enlargements, or symptoms of secondary deposit, and of any tendency to ulceration of the skin over the tumour; the favourable family history; and the fact that the tumour was definitely bounded superiorly by Poupart's ligament.
doi:10.1136/bmj.1.647.585 fatcat:c7yslh5mifgppdwhgre3roxwxi