. A practical treatise on medical diagnosis for students and physicians . I Wi t Tumor of the Anterior Mediastinum. PHYSICAL SIGNS OF ANEURISM. 967 Hemorrhage The hemorrhage may be gradual when there is slighteakage into the trachea at the point of compression. The amount ofblood lost is small. It may take place externally. (See S39)Profuse hemorrhages, causing sudden death, occur from rupture into thetrachea or bronchus and from perforation into the lung. * With regardto difficulty of deglutition, it maybe said that the oesophageal somdshould never be passed in suspected cases of aneurism, on
. A practical treatise on medical diagnosis for students and physicians . I Wi t Tumor of the Anterior Mediastinum. PHYSICAL SIGNS OF ANEURISM. 967 Hemorrhage The hemorrhage may be gradual when there is slighteakage into the trachea at the point of compression. The amount ofblood lost is small. It may take place externally. (See S39)Profuse hemorrhages, causing sudden death, occur from rupture into thetrachea or bronchus and from perforation into the lung. * With regardto difficulty of deglutition, it maybe said that the oesophageal somdshould never be passed in suspected cases of aneurism, on account fthe danger of rupturing the sac. Clubbed Fingers In intrathoracic aneurism clubbing of the fingersand incurvation of the nails of one hand are sometimes! although com-paratively rarely, seen. to Fig. Suspected aneurism. General endarteritis and valvulitis. (Original) |-Thrill and impulse. += Murmur. Outline area of dulness. TR. = In first interspace thrill and murmur. Compression and pressure on the sympathetic system of nerves have beenterrecl to It the pressure is moderate, sufficient only to irritate ormulate the vasodilator fibres, dilatation of the pupil, usually associatedth unilateral pallor of the face, results. If the pressure is sufficient toralyze or destroy the vasodilator fibres, the pupil becomes contracted,id one side of the face hyperaemic and usually the seat of increased per-oration Associated with the contraction of the pupil, narrowing of thellpebral fissure and exophthalmos may be observed ; the latter occursmiy, and is attributed in some cases to venous engorgementPhysical Signs (Plate XXXVII., Fig. 1.) Inspection. In healthI position o± the aorta can not be recognized. Pulsation may be seen 968 DISEASES OF THE HEART, BLOODVESSELS, AND MEDIASTINUM. at the ep
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