. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. e arch which have attained considerablesize and are sufficiently free from coagula to constitute pulsating those still Mithin the chest and those which have perforated the chestwall and form external masses belong to this group; also those aneurisms ANEURISM. 673 of the dosccMidiiiij; aorta \vlii<-h coiiiijrcss the left lung or erode the vertebrae,tiiid in paiiiciilar those which erode the lihs and appear us external tumorsat the l)aek. The connective-tissue overj^row
. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. e arch which have attained considerablesize and are sufficiently free from coagula to constitute pulsating those still Mithin the chest and those which have perforated the chestwall and form external masses belong to this group; also those aneurisms ANEURISM. 673 of the dosccMidiiiij; aorta \vlii<-h coiiiijrcss the left lung or erode the vertebrae,tiiid in paiiiciilar those which erode the lihs and appear us external tumorsat the l)aek. The connective-tissue overj^rowth in the infhunniatory capsule involvesand compresses the nerve-trunks with which the tumor comes into con-tact. To this fact is to be attributed the pain so characteristic of growinganeurismal tumors, the palsies of tiie recurrent laryngeals and pneumo-gastric, and derangements of the S3mpathetic. When neighboring blood-vessels are implicated in the growth, towhich the venous trunks and the pulmonary artery are particularly liable,they are narrowed and tiie veins may be completely compressed, or per- .1 D. Fig. 355a.—.?Vneurism of the arch of theaorta protruding tlirough tlie sternum.—Ger-man Hospital. Fig. 355S.—.Aneurism of the arch of the aortaprotruding through the sternum. The samepatient one year later. Death occurred suddenlyfrom external rupture through the skin. foration into the superior vena cava may take place. In a similar mannerthe trachea, a main bronchus, or the cesophagus may be involved andcompressed, or the sac may rupture into these organs. The sternum, costal cartilages, ribs, and the bodies of the vertebraeundergo more or less extensive erosion under the pressure of the distendingsac. In rare instances portions of the bony wall of the chest are enclosedin the advancing sac. and a fragment of a rib or the end of a partly erodedclavicle is found within its capsule. Hemorrhage.—The adventitia, even when reinforced by encapsulatingconnective tissue,
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectmedicine, bookyear192
