Demonstration of Preparations and Lantern Slides from the Pathological Laboratory of the London Asylums, at Claybury

Abstract

The preparations I am about to exhibit are taken from cases that have occurred during the past three months at Claybury. The first three are, I am afraid, of no neurological interest, but they are somewhat rare. The first is a case of aneurysm of the thoracic aorta. The patient died suddenly from hæmorrhage. Her age was forty, and she had had three attacks of hæmorrhage previously to the fatal one. She was a chronic drunkard and had had fits. The shape of the clot is rather curious. It is more or less cylindrical, and seems to have burrowed down into the chest, pushing the lower lobe of the left lung forward as its sac. The next specimen is one of rupture of the first part of the arch of the aorta. This patient was an old woman of eighty, who had been resident for about a year, and then developed an attack of bronchitis. In the course of two or three days she got rather worse, and one evening told the nurse she thought she was going to die the following morning. She did die, and the interesting point about it is, that the only other case of rupture of the aorta I remember seeing occurred in a man of about forty-five, and he, also, the day before he died, said he thought he was going to die. The blood had ruptured the aorta in a T-shaped manner about an inch above the coronary arteries, and passed down between the pericardium and over the wall of the aorta and ruptured into the former. The next specimen is an exceedingly rare one. The man was about seventy-seven years of age, and he had symptoms of sensory asphasia. He was quite unable to remember even his own name, or any other name, but if a name was mentioned to him he at once recognised it. In the same way, he could not write a single word, but he at once recognised a word which was mentioned to him, and he was able to write it. The aphasia was associated with symmetrical lesions of the angular gyri. The man died quite suddenly one evening while talking to another patient, and the cause of death was heart failure due to aneurysm of the left ventricle. I do not remember ever before seeing, except in a museum, an aneurysm of the left ventricle. The true wall of the ventricle is about two to three millimetres in thickness, the pericardium is generally universally adherent, and the anterior part of the left ventricle is about an inch in thickness, owing to the existence of this aneurysmal clot.