. Transactions of the Southern Surgical and Gynecological Association. increase the blood pressure in the sac and thereby hasten itsfurther dilatation unless prompt coagulation should occur. In January, 1910, a colored man, aged thirty years, wasadmitted to the hospital; family history negative; claimedto have been well, except chills and fever at the age of nine-teen. Subsequently stated, however, that he had occasionalpain in the chest since August, 1908. The latter statementwas not elicited until after operative interference was had any specific disease. In August, 1909, he was i
. Transactions of the Southern Surgical and Gynecological Association. increase the blood pressure in the sac and thereby hasten itsfurther dilatation unless prompt coagulation should occur. In January, 1910, a colored man, aged thirty years, wasadmitted to the hospital; family history negative; claimedto have been well, except chills and fever at the age of nine-teen. Subsequently stated, however, that he had occasionalpain in the chest since August, 1908. The latter statementwas not elicited until after operative interference was had any specific disease. In August, 1909, he was injured in the subclavian regionof the left side by a wagon crank; followed within one monthby a swelling in the same region, which remained a fewweeks and became smaller; to be followed in a short time byanother enlargement in the same region, which also remainedabout a month and became smaller. The present tumorbegan to enlarge about December 15,1909, and had graduallyincreased in size. The patient worked until Thursday Fig. 1.—Aneurysm of left subclavian J. GARLAND SHERRILL 193 before Christmas, at which time he discontinued, owing to thefact that he could not obtain work, suffering no discomfortfrom the tumor but remaining in the house since that present he complains of pain and tenderness in the leftshoulder, also suffers tenderness just above the spine of theleft scapula and in the left axilla. When I first saw him, about January 1, 1910, he had apulsating tumor about the size of a small melon situated atthe upper part of the thorax, extending from near the medianline and just above the level of the clavicle downward andoutward almost to the margin of the pectoralis major tumor pulsated synchronously with the heart and wasdistinctly expansile in character No distinct bruit couldbe heard over the tumor, but an accentuated second soundof the heart was easily detected. The patient had an almostimperceptible pulse in the left radial, and it was d
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