Treatment of Aneurism hy injecting into the sac a concentrated solu-
tion of the Perchloride of Iron.—At a meeting of the London Medical
Society, in the early part of April, Mr. G-ay read the account of a case
(of which the following is an abstract) lately communicated to the Societe
de Chirurgie, by M. Larrey, and forwarded to this country by Dr. Cos-
tello. In the month of January, Dr. Pravaz of Lyons, made known to
the Academie des Sciences a new method of effecting the coagulation of
blood, by mixing with it a cencentrated solution of the per-chloride of
iron; and, at the same time, suggested the employment of this agent for
the cure of aneurism. M. Delongchamps, an army surgeon in the same
town, followed up the suggestion, and with the happiest results, as the
following narrative will show :—
A blacksmith of Le Maus, set. 26, met with a blow over the left eye-
brow. This was followed by an aneurism of the supra-orbitai branch of
the ophthalmic artery, which gradually increased in size, until it had
attained that of a pigeon’s egg. Continuous pressure was made over the
tumor, by means of a pad and spring, for twenty-five days and nights,
but without any benefit j and as the patient was unwilling to submit to
the process of electro-puncture, and other remedies did not appear to be
suitable to the case, M. Delongchamps decided on trying the proposal of
Dr. Pravaz.
On the 4th February, an oblique puncture was accordingly made
through the walls of the sac, and whilst compression was made on the
artery above and below, a few drops of the solution were injected into it,
by means of a small glass syringe with a fine point. A few drops of
florid blood followed the withdrawal of the syringe, but without jet; a
few more drops of the solution were then injected, and it became at once
evident that these had produced the desired effect; for the blood in that
portion of the sac into which the nozzle of the syringe had been introduced
became rapidly firm, and pulsation ceased. In the remaining portion of
the sac, however, no such change took place, which arose from the fact,
that a firm plug of coagulum had formed in the orifice of the syringe
during the operation, which no force on the piston could dislodge, and
prevented the escape of a quantity of the solution sufficient to coagulate
the whole of the blood within the sac. The patient suffered no pain, nor
did he desist from his ordinary work. On the 6th of February, as the
success of former operations had only been partial, ten or twelve drops
more were injected, the nozzel of the syringe having been previously well
greased, in order to prevent the formation of a plug, as on the former
occasion. A sharp burning pain followed, and the contents of the sac
could distinctly be felt to be undergoing a process of solidification. Not
a drop of blood escaped this time on the withdrawal of the syringe, and
pulsation ceased entirely. On the 7th, the patient suffered some throb-
bing pain and restlessness, and the tumor became swollen and hot. These
symptoms, however, subsided quickly under the use of evaporating lotions,
etc.; so that, on the 8th, the patient could resume his work. A slight
oozing of pus through the last puncture took place a few days afterwards,
and with this a subsidence of the tumor. By the 15th of March, the
cure was so far advanced, that its situation could scarcely be recognized.
Mr. Gay expressed his opinion, that the treatment of aneurism by the
method referred to was deserving of every attention; but that at present
its employment should be confined to smaller aneurisms. The affinity
of the perchloride of iron for fibrin is so strong, that its coagulation com-
mences as soon as they come into mutual contact; and so firm is the
clot that ensues, that no fear need be entertained of any shreds being
washed away by the circulating current. As a styptic, this and other
experiments that have been made, prove that it is invaluable.—Edinburg
Monthly Journal.