Some account of cardiac aneurysms : being the Bradshawe [sic] lecture, read before the Royal College of Physicians of London on August 18, 1883 / by J. Wickham Legg.

  • Legg, J. Wickham (John Wickham), 1843-1921.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Some account of cardiac aneurysms : being the Bradshawe [sic] lecture, read before the Royal College of Physicians of London on August 18, 1883 / by J. Wickham Legg. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    age. In this early atheroma was found. In the heart from a girl of 19 a branch of the left coronary artery passed over the tumour, and, as might be looked for, was there plugged by a thrombus. No source of emboli save the aneurysms themselves could be found in the hearts. In the published cases in which the coronary arteries were reported to be healthy, the patient was young, 25 in Craigie's case, 30 in Dr. Hilton Fagge's, 39 in Leyden's, or even 44 in Lancereaux' ; while in the cases in which the arteries were diseased the age was in nearly every instance over 50. In Dr. Cholmeley's case, the man was 48; but even here the arteries, though thick walled and rigid, were permeable. In Dr. Thos. Barlow's the man was 42, and the right coronary artery had only one patch of atheroma on it. It seems more likely that the athe- roma follows the age of the patient and is independent of the fibrous scarring, rather than that the atheroma causes the fibrous degeneration of the- heart. It is very likely that blocking of the coronary arteries of the heart causes sudden death; but it seems doubtful if it cause in all cases chronic myocarditis. Take Dr. Greenfield's case. A woman 27 years old died suddenly ; the orifices of the coronary arteries were completely con- cealed by the swelling of the coat of the aorta, and were indicated only by small vertical puckerings on the surface. It was found impossible to pass a bristle into either directly from the aorta, but by following them backwards from their branches small bristles were with difficulty passed through the orifices into the aorta. The mus- cular tissue showed no sign of fatty degeneration to the naked eye; and when examined with the microscope many hours after death slight but widely distributed molecular fatty change was found in the centre of many of the fibres. No disease beyond the endoarteritis defor- mans of the root of the aorta was found in the body. There were small patches of atheroma in the coronary arteries.^ ' W. S. Greenfield, Transactions of the Pathological Society of London, 1875. Vol. xxvi, p. 55.