364 MORBID ANATOMY.
the 15th the tumor appeared smaller, became so from that time, and on the 20th of March no vestige of it could be felt. A loud, continuous bruit, however, was still heard ; and a vibratory thrill along the internal jugular vein, which Mr. B. thought may have been wounded simultaneously with the artery.
1795. A second cast taken March 20th. 1857.
Dr. J. M. Warren.
1796. Cast in plaster, by Mr. G., showing the tumor in a case of subclavian aneurism.
The patient was a man, set. twenty-eight, who, four months before entrance into the hospital, on the 15th of August (264, 134), fell down a hatchway. Ten weeks be- fore entrance a tumor appeared behind the right clavicle. After lifting a heavy weight pain came on ; and this, with the tumor, increased from that time. On admission, the tumor was of the size of a goose-egg, and pulsating ; with a marked systolic souffle and a distinct aneurismal thrill. Pain pretty constant, quite severe, and extending down the arm, and into the chest. Arm somewhat swollen, and radial pulse very faint. On the 26th the tumor was gently kneaded, with a view of breaking up the contents ; pres- sure was afterward applied, and the patient was kept upon the lowest diet. Under this treatment the tumor di- minished somewhat in size ; but on the 15th of Sept. two ulcers had formed under the apparatus that had been ap- plied. On the 17th a small slough appeared, and on the 20th he left the hospital. The whole limb subsequently gangrened, and he died within a few weeks after his dis- charge. The cast was taken by Mr. J. O. Green, one of the house-pupils. 1866. Dr. H. J. Bigelow.
1797. Aneurism of the left subclavian artery.
From a woman, set. thirty-five. (Hospital, 75, 118.) There had been some numbness of the extremity for eleven months ; and a tumor, which was 3 in. in diameter, had ex- isted for seven months. Operation by Dr. B. The ai-tery was dilated just outside the scalenus ; and, to get at the sound part, one-third or more of this muscle was divided, and one-half of the mastoid. Instead of tying the ligature, a string of beads was run down upon it, so that the pressure
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