. Diseases of the heart and arterial system; Designed to be a practical presentation of the subject for the use of students and practitioners of medicine. sof the transverse arch of the type now considered. If the t\d)e isbut slightly constricted, the lung becomes retracted only sufficientlyto occasion immobility of the side, tympanitic resonance and di-minished respiratory sounds. When the bronchus is greatly nar-rowed the side becomes perceptibly snuiller than its fellow, thepercussion note is dull, and respiratory sounds are may be retention of the secretions with rales, bro
. Diseases of the heart and arterial system; Designed to be a practical presentation of the subject for the use of students and practitioners of medicine. sof the transverse arch of the type now considered. If the t\d)e isbut slightly constricted, the lung becomes retracted only sufficientlyto occasion immobility of the side, tympanitic resonance and di-minished respiratory sounds. When the bronchus is greatly nar-rowed the side becomes perceptibly snuiller than its fellow, thepercussion note is dull, and respiratory sounds are may be retention of the secretions with rales, bronchorrhoca,:ind bronchiectasis—symptoms which, in the Montreal GenerallIos])ital, are characterized as aneurysmal phthisis (Osier). Aneurysms of this portion of the arch sometimes occasion pres-sure on the thoracic duct. If they develop in such a direction asto involve the innominate or carotid artery, the condition is apt ANEURYSM OP THE THORACIC AORTA 797 to be shown by a symmetry or delay of the pulses on that on the sympathetic is another manifestation of tumoursin this situation, and is shown by dilatation and immobility of the. Fig. 116.—Trachea from Case of Euptuked Aneurysm, showing Point of Rupture. pupil when the nerve is irritated, and by contraction when thesympathetic is paralyzed. Tracheal tugging is another result ofaneurysm of the transverse arch, as was first shown by Oliver. Tt 798 DISEASES OF THE HEART is due to the downward traction of the sac on the trachea at itsbifurcation. This si^n will be spoken of ai;ain at greater lengthunder Palpation. Aneurysms in this situation nia} rupture intothe trachea (Figs. 11(>, 117). (3) Aneurysms of the descending portion of fhe arch growlaterally and posteriorly in the majority of instances, and yet it is
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