An inaugural dissertation on the congenital malformations of the heart ... / [John Paget].

  • Paget, John, 1808-1892.
Date:
[1831]
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Licence: Public Domain Mark

Credit: An inaugural dissertation on the congenital malformations of the heart ... / [John Paget]. Source: Wellcome Collection.

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    the abdominal aorta, the basilar artery, and other single arterial trunks, are all occasionally found double ; while in those vessels naturally symmetrical, as the carotids, phrenics, renals, and spermatics, there is a great disposition to unite into a single trunk.* To understand the malformations of excess in the aorta, we must call to mind the state of that vessel in early fcetal life. It must be recollected that it never unites beyond the middle of the dorsal region, but presents at one period almost exactly the structure of this part in the turtle, (viz. an arch passing down on either side, with a ductus arteriosus opening into it from each pulmonary artery,) and that the principal change which it afterwards undergoes, is the obliteration of this arch on the right side. In the magnificent plates of the arteries by Tiedemann -f* * §, there is a case quoted from Malacarne J, which beautifully illustrates this formation. The aorta, immediately after leaving the left ventricle, divides into two branches, which passing up¬ wards, each give off, as in the turtle, the vessels to the head and upper extremities on each side, when they again unite to form the aorta descendens. It is true that the relative position of the parts in this instance has suffered considerable change, but that is of little importance, in comparison with the striking ana¬ logies they present in other respects. It is probable that ano¬ ther of the cases represented by Tiedemann, § from Horn el¬ fins, || may be traced to the same cause. In this, 44 Aorta sub arcus initium divisa et ad finem ejusdem sursus unita conspici- tur. Per banc quasi insulam, transeunt trachea et (esophagus.11 The arrangement of the vessels, as represented by Dr Allen Thomson in the chick about the 12th day, bear a sufficient¬ ly strong resemblance to this malformation, to enable us to trace an analogy. Serres** also refers to a case, though he has not entered into any details concerning it, in which he says, * Dr Green on the Varieties in the Arterial System of the Human Body, Dublin, 1830, p. 20. t Tabulae Alter. Corp. Human. Tab. iv. Fig. 7. Osservazioni in Chirurgia, Torino, 1784, P. 2, p. 119, Fig. 1, 2. § Tabula? Arter. Corp. Human, Tab. iv. Fig. 6. |j Commercium Litter. Norimberg, 1737. Hebdomas, xxi. p. 101, Tab. ii. Fig. 1, 2. 5[ Eilin. New Phil. Journal, Jan. 1831, Plate iii, Fig. 31, ** Annales dcs Sciences Nat. T. xxi. p. 20.