Maryland medical journal . es presenting as MARYLAND MEDICAL JOURNAL. 20I a general thing few and indefinite symp-toms. Literature.—In reviewing the litera-ture of spontaneous rupture of the aortawe have found that previous to the year1800 there were but two contributions,one in 1761, by Nicholls and publishedin the Philosophical Transactions, Vol-ume 35, page 443, and the other in 1798by Lynn, published in The MedicalRecords and Researches of a PrivateMedical Association, London. Thelatter contribution is of especial interest denly taken with a second paroxysm inthe same location and died ins
Maryland medical journal . es presenting as MARYLAND MEDICAL JOURNAL. 20I a general thing few and indefinite symp-toms. Literature.—In reviewing the litera-ture of spontaneous rupture of the aortawe have found that previous to the year1800 there were but two contributions,one in 1761, by Nicholls and publishedin the Philosophical Transactions, Vol-ume 35, page 443, and the other in 1798by Lynn, published in The MedicalRecords and Researches of a PrivateMedical Association, London. Thelatter contribution is of especial interest denly taken with a second paroxysm inthe same location and died the autopsy a condition was foundthat accounted for the pain so suddenlyexperienced at two different was a ruptured aorta, the tear inthe two inner coats not exactly corres-ponding with that in the outer. Lynnattributes the primary tear in the intimaand media to the strain of labor, thesudden paroxysm of pain in the regionof the heart occurring while this was atits height. Blood escaped through this. for a number of reasons aside from theearly date of its publication. The pa-tient was a young woman eight and ahalf months pregnant. During laborthat came on about two weeks too soon,she was suddenly seized with agonizingpain in the region of the heart and laborabruptly ceased. Forceps delivery wassuccessfully resorted to and the patientmade a good recovery from the labor,suffering only with occasional distressabout the heart. Thirteen days fromthe time of the first pain she was sud- rent and accumulated between the ex-ternal and middle coats at the upper endof the inner tear and when the arterycould no longer stand the force of thecirculation plus the strain produced bythe accumulation of blood it burst withexcruciating pain and instant death. Up to the end of the first half of thiscentury we have found references to 39cases in all, of spontaneous majority of contributions to thesubject consist simply of reports ofcases, little attempt being mad
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