168 REPORT—1840. 
A fine curved tenaculum about two inches in the curve, was 
passed two to three inches from the sternum, hehind the third 
rib, with the point toward the spine ; and when at the greatest 
depth, the handle was depressed toward the sternum, so as 
to move the hook outwards toward the ribs; a loud blowing 
then attended the first sound, which was distinct; the second 
sound was wanting, when the handle was most depressed, and 
obscure when the handle was somewhat raised, and restored to 
full force when the hook was withdrawn. 
Half an hour after. The first sound was accompanied with 
blowing between the first and third ribs, while a friction sound 
accompanied the second sound (the Reporter called it alto- 
gether friction sound, with both systole and diastole, but vary- 
ing in hoarseness or roughness) ; it was faintly audible in the 
carotids. 
Half-past 3 p.m. Still slight friction and blowing (roughness 
only of friction, Reporter) increased after the animal struggled. 
The tenaculum was again introduced and manipulated as before ; 
and again the second sound was stopped by drawing at the 
root of the arteries, and restored on releasing the hold; the first 
sound being accompanied by a loud whizzing, and the hoarse 
or rubbing sound being indistinct if not absent. 
On withdrawing the hook, a transitory crackling was heard ; 
on the introduction of the hook, the heart’s action became tu- 
multuous and irregular, and on withdrawing it, very rapid. 
Pulse 112. Half-an-hour after, the pulse still 112, and the first 
sound accompanied by murmur. ' 
June 27th, quarter-past 7 a.m. Sounds as before; rough mur- 
mur as of friction, with first sound especially. The animal then 
pithed, and artificial breathing established and chest opened. 
Heart was acting vigorously, with the sounds distinct and 
normal. 
First Experiment. 
On introducing a finger into the right auri-ventricular ori- 
fice, first sound was accompanied with a whizz, and wanted its 
flap at the beginning ; the whizz was accompanied by a thrill 
sensible to the finger introduced ; the whizz ceased and the 
systolic flap returned on removing the finger. 
This expcriment was repeated several times with the like 
results. 
Second Experiment. 
The hook was introduced through the auricle with a view to 
hook up the tendons of the mitral valves, when the flap seemed 
impaired not suppressed, and the whizz was uncertain. 
