before death. A similar plastering-up, as he would call it, is shown by Curveilhier. (Anat. Path. liv. xxvin. pi. 3.) From the lower part of the sac the cceliac artery arises ; but at its very origin there is a linear obliteration, and so complete that no trace of it was seen upon the inner sur- face of the sac. A portion of the vessel is preserved, and shows that it was smaller than usual. The sup. mesenteric artery also arises just within the sac, and is very much contracted at its origin, as if undergoing obliteration. Directly by the side of this aneurism was another, as large or larger than the two fists, and that burst into the left pleura! cavity.
The patient, a negro, set. thirty-three years, and a strong laboring man, entered the hospital (275, 118), with obscure pains over the abdomen, that he had had for two weeks ; having, previously, been quite well. A few days afterward there came on an effusion into the left pleural cavity, the result of a very moderate amount of inflamma- tion ; and about three weeks after admission he died almost instantly. There had been pulsation in the left epigastric region, and his chief complaint was of the left hypochon- drium ; but aneurism had not been suspected. A large amount of blood was, of course, found in the chest. 1868.
Dr. J. Homans, Jr.
A complete and linear obliteration of a large artery, where it arises from an aneurismal sac, I have met with three times (Med. Jour. Vol. LVI. p. 174) ; and think it cannot have been generally noticed that the obliteration may be confined to the orifice and leave the vessel itself free. (See Rokitanski and Hasse.) See also the next case. 1789. The aorta, from the arch downward, showing a defined aneurism, of the size of a hen's egg, and situated just at the origin of the upper mesenteric artery, which last is entirely obliterated where it arises from the sac, but be- comes of full size immediately afterward. The vessel is cut open behind, and is generally nearly healthy.
From a man, set. thirty-three, who had complained for three months of epigastric pain and costiveness ; and died, in fifteen hours, after a rupture of the sac into the general cellular tissue.
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