I have very generally, if not always, found the heart quite healthy, when an aneurism arose from the aorta at its origin ; and do not remember to have seen it remarked.
1782. Arch of the aorta, showing a defined, false aneurism
about as large as a hen's egg. 1862.
1783. A portion of the aorta, showing two aneurisms about two inches and a half beyond the left subclavian artery. One is about the size of an English walnut, the other about half as large again, and they are upon the same level, and about an inch apart. Apparently of the mixed variety. The smaller sac had burst into the left pleural cavity, in which last was a large quantity of serum, and nearly a washbowl full of coagulated blood ; the opening being a ragged slit, and not much more than a line in length. The larger one, as seen in the preparation, encroached upon the O3sophagus, the inner surface of which was discolored. An additional portion of the aorta shows a third sac just above the valves, one-third of an inch or more in diameter, and of the true variety. The vessel itself is considerably dis- eased.
From a gentleman, set. twenty-nine. Cough for seven or eight months, and urgent for the last three or four ; not much expectoration. Some dyspnoea ; and about a month before his death spoke of pain in the region of the heart. He was considered, however, as a healthy man. Went to his room to smoke a cigar ; and about two hours afterward was found dead. 1866. Dr. H. J. Bigelow.
1784. A portion of the aorta, showing a defined, rounded aneu-
rism, 7 in. in length, and just above the diaphragm ; ori- fices very defined. The sac seems to be formed, mainly, by a dilatation of the artery ; the inner surface of which is much diseased, but not ossified. The aorta, otherwise, is moderately diseased, but of the natural size.
From a man, about fifty years of age, who had had for more than two years pain in the lumbar region, became much emaciated, and died from a rupture of the sac into the left pleural cavity ; this last containing about six quarts of blood. The bodies of three of the vertebrae were extensively absorbed ; and the head of the ninth rib was detached. 1861. Mr. J. E. Cobb, med. student.
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