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September 21, 1912


Author Affiliations

Birmingham, Ala.

JAMA. 1912;LIX(12):941. doi:10.1001/jama.1912.04270090185012

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Patient.  —R. W., a boiler-maker, aged 38, was admitted to St. Vincent's Hospital March 12. 1912. He was pulseless and in extreme shock from loss of blood consequent on a stab wound just beneath the middle of the left clavicle, inflicted a few minutes before. By packing the wound and applying pressure over it, hemorrhage was checked. The shock was combated by intravenous infusion and other routine measures. Four days later, signs of aneurysm were first discovered on auscultating near the stab wound, which region was perceptibly bulging. Expansile pulsation and a thrill were evident to palpation. The left radial pulse was slighly weaker than that of the right side. He was kept in bed with rest and suitable diet for three weeks. During this time, he complained of considerable pain over the tumor and shooting down the arm. Beginning on the eighth day, powerful compression was applied over and