. The principles and practice of modern surgery . an unnatural pulsation felt by the patient, and de-tectable by the stethoscope ;—together with symptoms of disordered cir-culation and respiration. In the abdomen, an aneurismal tumour may befelt through the parietes. Diagnosis.—Tumours situated over arteries, and receiving pulsationfrom them, may be distinguished from aneurism by noticing, 1st, thatthey do not pulsate at first, when they are small;—whereas aneurisms doso from their earliest formation. 2dly, that a tumour may often be liftedup from the artery, and that then it will cease to pul
. The principles and practice of modern surgery . an unnatural pulsation felt by the patient, and de-tectable by the stethoscope ;—together with symptoms of disordered cir-culation and respiration. In the abdomen, an aneurismal tumour may befelt through the parietes. Diagnosis.—Tumours situated over arteries, and receiving pulsationfrom them, may be distinguished from aneurism by noticing, 1st, thatthey do not pulsate at first, when they are small;—whereas aneurisms doso from their earliest formation. 2dly, that a tumour may often be liftedup from the artery, and that then it will cease to pulsate. 3dly, That aneu-risms are generally soft at first, and become hard subsequently;—tumours * Scarpa on Aneurism, by Wishart, Edin. 1808, p. 113. t This drawing exhibits an aneurism of the common femoral artery, for which theexternal iliac w^as tied by Sir B. Brodie. The ligature is seen, imbedded in lymph;the coagulum in the artery above and below it; and the laminated coagula in theaneurism. From the museum of St. Georges 300 ANEURISM. are generally the reverse. 4thly, That tumours cannot be emptied by pres-sure;—and that no alteration is made in their consistence by compressingthe artery above, othly, Enlarged lobes of the thyroid gland may be dis-tinguished from aneurism of the carotid by their slipping up out of thefingers, along with the lar}nx, in the act of deglutition. 6thly, Psoasabscess may be known from aneurism by the precursory pain and weak-ness in the back; and by its disappearance when the patient lies , Pulsating tumours, composed o( erectile or of malignant growths—especially those connected with bone—are sometimes mistaken for aneu-risms ; from which, in fact, it is hardly possible to distinguish them duringlife, since they have the same kind of pulsation, attended with the samewhizzing noise, and checked like that of aneurism, by pressure on theartery above. The mistake, however, is of no very serious consequence,becaus
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