In these cases graduated exercise, baths, and the Schott method, with a Case of aneurism of the aorta treated by mineral baths and graduated walking exercise, with a liberal nitrogenous di etary and free ingestion of fluids to eliminate uric acid, etc. After six weeks the patient could walk with comfort during three hours a day. A sciagraph showed that there was no increase in the size of the aneurism in spite of the exercise. Recurrence of the symptoms promptly yielded to the same treatment. Bezly Thorne (Brit. Med. Jour., Mar. 6, '97).
In this form of aneurism favorable results are sometimes obtained by the introduction of foreign bodies.
Fifteen cases of aortic aneurism in which, when practicable, introduction of silk-worm gut was resorted to. In one case the gut-fibres were absorbed after the desired effect had been produced. Von Schrhtter (Inter. klin. Rund., Nov. 26, '93 In 1S95 Dastre demonstrated that the injection of a solution of gelatin into the veins of a dog rendered the blood more coagulable. This discovery has recently been utilized in the treatment of aneu rism of the first portion of the arch of the aorta.
Case of a man, aged 40 years, who had a large aneurism undoubtedly due to a malarial aortitis, which had eroded the second, third, and fourth right cartilages, the extremities of the corresponding ribs, and a large portion of the sternum. On the surface of the tumor there were patches of ecchymosis which were soft and depressible, and in the neighborhood of which the blood was directly in con tact with the very thin skin. On Janu ary 20th 13 drachms of a 1-per-cent. sterilized solution of gelatin in a 0.1-per cent. solution of sodium chloride was injected into the subcutaneous tissue of the left buttock. The solution was in jected at a temperature of 98.4° F. There was a slight reaction following this injection. During the following days the tumor became somewhat dimin ished in volume and the pains completely disappeared; but soon the tumor re turned to its former dimensions, the walls again became soft, and the inter costal pains returned. On February 10th a second injection of 5 ounces of a solu tion similar to that first employed was given. This solution was followed by results similar to those which followed the first injection, except that there was no reaction. Since that time twelve in
jections similar to the second have been made at intervals of from two to five days. The tumor diminished in volume (one inch in the vertical and one-half inch in the transverse diameter). It is very firm, and, although on palpation a pulsation can be felt. that pulsation is not expansile, but is transmitted from the aorta. The pain entirely disappeared. Lancereaux (Gaz. des Hap., June 24, '97).
Case of sortie aneurism in which the tumor extended over the sternum, the sternal portions of the clavicles, and the whole anterior surface of the neck. its diameter being seven and one-half inches. Injections in the vicinity of the tumor of 75 minims of gelatin, suspended in 10 drachms of sterilized normal saline solu tion, were given every four days. Under this treatment its size has decreased, the hoarseness has disappeared, and the general condition is improved. Carl Beck (N. Y. Med. Jour., Apr. 15, '99).
Gelatin injections in aortic aneurism. The first indication is to eradicate, if pos sible, the cause. By increasing the co agulability of the blood the sac may now be obliterated. This is most efficiently accomplished by gelatin. Gelatin injec tions (15 grains of gelatin in drachms of sodium-chloride solution once a week) may then be resorted to. Re markable results on personal case in which five weeks of this treatment prac tically freed the patient from symptoms both subjective and objective. In this case the iodides had produced no effect. N. Kalendern (Klin. therap. Woch,, Jan. 2S, 1900).
Case of very large aneurism of the ascending aorta, treated by gelatin and electrolysis. Coagulation of most of the contained blood occurred. The opera tion was comparatively painless except at the beginning. A few weeks later the patient had an attack of intermittent fever. Several large blebs formed near the sternal margin of the aneurism, which finally ulcerated and revealed ne crosed fragments. The patient died suddenly from haemorrhage, the blood pouring from the point of successful puncture. Autopsy showed evidences of recent coagulation. W. W. Johnston (Amer. Medicine, May 11. 1901).
Carotid Aneurism (in the cervical region).