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ANEURYSM AND ITS TREATMENT
How to Deal with Weakened Arteries
While the condition is always grave, sufferers from aneurysm will derive some consolation from the following account of the nature and causes of the disease and the wonderful methods by which modern surgery deals with it.
An aneurysm may be termed a dilatation or bulging of the wall of an artery. The pressure of blood in the arteries is very high. These vessels carry the blood directly from the heart to the organs and members of the body, and so have to bear the full force of its powerful beating. They must be uniformly tough and elastic, or else they will tend to atrain and then to bulge. If one part, however small, has any weakness, there will be a tendency to bulging at that part-in other words, an aneurysm will begin to form.
 
Anything which weakens the wall of an artery anywhere may cause an aneurysm. The two commonest causes are injury and disease. The Great War furnished a very large number of injury aneurysms of various kinds. If a bullet or piece of shell grazed the wall of a blood vessel, the wall was weakened. After a time there was apt to be a bulging at this place. Thus, aneurysms were found by military surgeons in the arms and legs, the neck, the chest, the body- wherever, in fact, an artery runs and a bullet strikes.
 
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Speaking generally, such aneurysms are not likely to prove fatal unless they occur in some very inaccessible place; for nature has gifted us richly in the matter of blood vessels. If one vessel goes out of action other smaller vessels open up and grow wider, and so carry on the circulation; a process known as anastomosis (q.v.).
The treatment of aneurysms of the limbs is, as a rule, to shut the blood vessels on which they are situated -a simple surgical operation. But this treatment cannot be employed when the aneurysm is situated in the greatest of all blood vessels, the aorta, which is the main trunk leading right out of the heart. There is no "other way round" in the case of this huge vessel, which is wide enough to take two or even three fingers.
So far as ordinary civilian life is concerned, aneurysms of the aorta amount to about 90 per cent. of all aneurysms. They are much more frequent in men than in women. The great majority of cases are due to disease of the blood vessel wall and to repeated muscular strain. Thus they are common in hard manual workers.
Apart from this treatment, the usual way to deal with aneurysms of the aorta is to ensure that the patient leads a quiet life as free as possible from stress of all aorta. Complete rest in bed for some months on a very restricted diet is sometimes successful in delaying the progress of the trouble. In all cases the diet should be very light and moderate, and alcohol forbidden. All muscular strain must be avoided.
Pain, which is often very severe, is due to the pressure of the bulging blood vessels on the nerves in its neighhourhood. Other common symptoms of aneurysms of the aorta, also due to preasure on nerves, are a metallio tone of the voice and a cough resembling the sound made by a gander. When the case is very advanced the swollen vessel may be felt beating against the wall of the chest. X-ray photographs give valuable information.
There is no doubt that the majority of aortic aneuryems are due to syphilis affecting the small blood vessels which supply the wall of the aorta, leading to its degeneration. Treatment of the syphilitic infection will sometimes cause marked improvement in the aneurysm.
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ANEURYSMS: HOW THEY OCCUR
Left, aneurysmal dilatation shared by all the coats of an attery. Centre, localised dilatation at a weak spot in the artery. Right, aneurysm in the abdotninal aorta containing several layers of clot due to successive deposits, like geological strata.
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