The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . ed, and uponAvhich they may be distinctly solid, they are usually irregular andnodulated on the surface, and can fre-quently be detached by the fingersbeing passed underneath them andraising them from the subjacent is much danger of mistaking aconsolidated aneurism which is under-going or has undergone spontaneouscure, and in which there is conse-quently no pulsation, for a solid tumorof some kind. I have known oneinstance in which the thigh was ampu-tated for a very painful
The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . ed, and uponAvhich they may be distinctly solid, they are usually irregular andnodulated on the surface, and can fre-quently be detached by the fingersbeing passed underneath them andraising them from the subjacent is much danger of mistaking aconsolidated aneurism which is under-going or has undergone spontaneouscure, and in which there is conse-quently no pulsation, for a solid tumorof some kind. I have known oneinstance in which the thigh was ampu-tated for a very painful solid tumorof the popliteal space, which proved on dissection to be a consolidated aneurism pressing upon the posteriortibial nerve (Fig. 356). Aneurisms, more particularly those that are diflused, have not unfre-quently been mistaken for abscesses; and it is no very uncommon thingfor a Surgeon to be called to an aneurism which, under this supposition,has been diligently poulticed, or painted with iodine. I have twice liga-tured the external iliac for aneurisms of the groin that had been mis-. Fig. 356.—Section of Aneurism of Calf, un-dergoing spontaneous cure, mistaken forTumor. Limb amputated, (a) Black re-cent Coagulum lying in centre of Lami-nated Fibrine. {b) Posterior Tibial Nervestretched. 44 ANEURISM. taken for abscesses. Occasionally, the more fatal error has beencommitted of puncturing the tumor with the view of letting out pus,when none appeared, and, either immediately or after a lapse of a fewhours, profuse arterial hfemorihage ensued. That this accident mayarise from the intrinsic difflculties of the diagnosis, is evident from thefact that it has happened to such Surgeons as Desault, Pelletan, Dupuy-tren, Pirogoff, and many others. I have once seen this accident occurto a Surgeon of considerable experience, who mistaking a diffused popli-teal aneurism for an abscess, opened it with a bistoury, but finding nopus, applied a poultice; alarming htemorihage ensued i
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