ON THE MOTIONS AND SOUNDS OF THE HEART. 167 
became slow and strong, with superficial loud grating or rough 
sound; and becoming gradually weaker, soon ceased. One 
ounce of serum in left pleura. Two to three ounces in pericar- 
dium. External pericardium exhibited several striated patches 
of minute vessels. The cellular tissue was infiltrated with se- 
rum, and the serous membrane was easily detached. No lymph 
on the inner surface of the pericardium, but the heart was 
completely coated with thin membraniform soft lymph, thick- 
est at the septum, and near the base. On the anterior and po- 
sterior surfaces numerous minute depressions or lacunz were 
seen in the lymph. The lymph was easily removed. On the left 
ventricle near the apex was an oval space of an inch by an inch 
and a half, of bright red patches, seeming partly vascular, 
partly ecchymotic, about the middle of which was a punctured 
wound and aclot in the muscular tissue beneath, and some 
ecchymoses under the corresponding endocardium. The in- 
terior of the heart healthy. The serum from the pericardium 
after standing separated into crassamentum and liquid. 
OssERVATION IV. 
June 23rd.—Subject, a stout Ass two months old. Pulse 
60-70 ; strong, with sounds very loud. 
Quarter to 4p.m. A needle was introduced at the upper 
edge of the fourth rib, three inches from the sternum, and one 
inch deep. The heart’s action was accelerated, with obscure 
blowing with the systole. 
The needle being withdrawn, the heart’s action was slower, 
with double creaking or leather sound, reported by two obser- 
vers as accompanying both sounds, which became stronger after 
a few minutes. Heart’s action varying in regularity. 
Quarter of an hour after. Leather sound at the site of the 
puncture, not at all at the apex. Natural sounds there quite 
distinct. 
June 25th, 7 a.m. Both cardiac sounds loud, with sounds of 
friction at the basis cordis. 
June 26th, 7 a.m. Normal cardiac and friction sounds as 
before. A long needle three times introduced in different di- 
rections between the third and fourth ribs, and three to four 
inches from the sternum, without any marked effect, except 
sometimes on strongly depressing the handle towards the ster- 
num, a blowing with first sound was heard, the second sounds 
being normal (rubbing rather than blowing sound, Cg.). 
On first introducing the needle a scratching noise was some- 
times heard with the systole, as if from the point hitching 
against the heart’s surfaces. 
