transverse portion of the arch, including the arteria innoftn-
nata ; with fusiform dilatation of the aorta leading to it. The
sac is filled with solid coagula: the remaining part of the
dilatation held fluid blood. The most projecting part of the
tumor rested against the upper bone of the sternum, and at
this spot, a large, circular piece of the sac had been so far
absorbed, as to allow of the: coagulum coming into immediate
contact with the osseous texture. The valves of the aorta,
notwithstanding their close proximity to so much disease, are
unchanged from the condition of health; and the heart, itself,
is natural, both as to structure and size. The preparation Was
found in a middle-aged, male subject, procured for anatomical
purposes.—J. Shekleton, Esq.
B. c. 254. Enormous aneurism of the ascending aorta, protruding
through the sternum. The sac is formed by a gradual
dilatation of the coats of the artery, commencing above the
semiluhar valves, and terminating below the orifices of the
great vessels, which are included in it. The skin covering the
protruding part of the tumor is preserved: it exhibits a circular
aperture, caused by the detachment of a slough, and plugged
Up by a fibrinous coagulum. The hemorrhage Which took place
through this opening, put an end to the patient’s existence.
The aortic valves are sound, and the heart small and free
from any appearances of disease. The remainder of the thoracic
aorta appears healthy. From a middle-aged woman,--—
T. Roney, Esq.
B. c. 255. Aneurism of the aorta springing from the top of
the arch, near the origin of the innominata, and protruding
through the superior, and right margin of the sternum, at its
junction with the clavicle. A portion of the tumor rises above
these bones ; and, during life, could be felt at the-root of the
neck. Its cavity is half filled with coagula. The orifices of
the three great branches are much diminished in size. The
aortic valves are perfectly sound, and the left ventricle is free
from any abnormal alterations.
P a t i e n t a black man , a servant, aged thirty-five. For a
length of time previous to death,, his upper extremities were
anasarcoiis, and the pulse could hardly fye felt at the wrist.
He was carried off, rather suddenly, by serous eflhsion into the
cavity of the chest.—J. W. Cusack, Esq.
B, c. 256. Dried preparation, showing a large aneurism of
the aorta, at the junction of the ascending and transverse
portions of the arch. Parts of the sternum, clavicle, and extremities
of the superior ribs have been absorbed ; the corresponding
piece of the sac has also disappeared; and, during
life, the coagulum which it contained, was in contact with the
inner surface of the skin.—Professor Todd,
B. c. 257. Large aneurism of the ascending part of the arch.
Its cavity would probably contain three pints of fluid. It communicates
with the anterior part of the artery, close to its
origin, by a circular opening, about the size of a half-crown
piece, and marked by a smooth, and rounded margin. The
three Coats appear to be continued into -the sac. The tumor
had made its way forwards and downwards, so as to press
against the lower part of the sternum and left costal cartilages.:
the iatter are pushed forwards, but not eroded. Posteriorly,
it rested against the pericardium: and, laterally, it closely
adhered to the lungs. The aortic valves are diseased: the
heart, generally, but more particularly the left ventricle, hypertrophied
: the pericardium, universally adherent,
The patient was. a robust, middle-aged man, who died- sud-
denly, but not from rupture of the sac, which, as, shown in the
preparation, is firm throughout, and filled with a laminated
coagulum.
B. c. 258. Great coagulum from the preceding aneurismal
tumor, marked B. c. 257. A small part of the centre is hollow.
B, c. 259. Large aneurism of the arch of the aorta, involving-
the orifice of the arteria innominata. The opening into the
sac is circular, smooth, and comparatively small. Nearly the