A case of pulmonary embolism, with notes bearing generally on the subject of emboli / by Wm. Robert Smith.

  • Smith, William Robert.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: A case of pulmonary embolism, with notes bearing generally on the subject of emboli / by Wm. Robert Smith. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    16/18 (page 14)
    Uterus firm, five inches in length, and seven-eighths of an inch in thickness ; no signs of inflammation present. The emholon in this case I helieve to have been detached from the uterine sinuses at the time my patient walked from one bed to the other. If this hypothesis is correct, the embolus was probably detained in the heart by the relaxed tendinous cords which are bo abundant in the right ventricle, and thus gave rise to the high temperature, and quick, jerky pulse. At any rate, I think it is clear that, if this were the case, treat- ment, to be of service, should then have been adopted, but unfortunately at this stage there is a marked absence of sym- ptoms sufficiently reliable to insure a satisfactory diagnosis. I believe the rigors which my patient had were owing to the sudden appearance of a'clot in her circulation, and not, as I then believed, to the swelling and tenderness of the breasts: yet why should this not have been the cause? or how is it possible to diagnose with certainty a condition of so much danger to the patient ? The only symptoms I could not explain were the continned high temperature and quick pidse after the mammary trouble had subsided. I know some will urge that the embolus might have been separated directly at the time of death, but I think the absence of all inflammation of the veins and uterus goes far to negative this idea. It is with the view of learning something as to the treatment and diagnosis of such cases, from those who have had far more experience than myself, that I have ventured to trouble you, at, I fear, some length, with this subject to-night. rar lon * Son, Printer*, Paternoster So* London.