380 STRONG AND CROWELL. 



dilated, circular; corneae and conjunctivae clear. Ears, nose, and mouth 

 normal. Superficial lymphatic glands not enlarged. Thorax broad and 

 short; abdomen tense, but not distended. Rigor mortis not present. No 

 post-mortem hypostases. 



On section the rather abundant and yellow subcutaneous adipose is very 

 moist, a clear fluid exuding from all cut surfaces. The skeletal muscles 

 are pale, soft, friable, and moist. The abdominal cavity contains only a 

 small amount of clear fluid in the fossge, the peritoneum being everywhere 

 smooth and glistening, without adhesions. The intestines are somewhat 

 distended, their serosa pale. Liver reaches 2 centimeters below the right 

 costal margin and 6 centimeters below the xyphoid. The dome of the 

 diaphragm .stands at the upper margin of the 5th rib on the right and 

 the lower border of the 6th on the left. 



Thorax. — On removal of the sternum the tissues of the anterior media- 

 stinum are found to be somewhat oedematous. Both lungs are retracted 

 beyond the cut costal margin, exposing a very large pi*3ecordial area. Each 

 pleural sac contains about 200 cubic centimeters of clear yellowish fluid. 

 The thymic pad is moist and fatty without recognizable glandular remnant. 



Heart. — The praecordial area is large and the pericardium very tense. 

 Before opening the pericardium, the apex is felt impinging upon the parietal 

 pleura in the midaxillary line at the 6th rib, and the right border of the 

 pericardium is 2.5 centimeters to the right of the sternal margin. On 

 opening the pericardium, its inner wall is found smooth, and not more than 

 about 30 cubic centimeters of clear fluid is found in its sac, the heart filling 

 up and distending the sac. Both ventricles present anteriorly, the right 

 a little more than the left, and the distension of the right heart (both 

 auricle and ventricle) is the more marked. The right edge of the heart is 

 very much rounded. In the right auriculo-ventricular groove anteriorly are 

 a few small punctate epicardial ecchymoses. The apex is formed by both 

 ventricles with a groove between them. Epicardial fat is not over abundant 

 and the coronary vessels are not prominent. On section of the heart, 

 abundant dark fluid blood escapes from both sides and the heart collapses, 

 diminishing greatly in size. Both right auricle and ventricle are, however, 

 evidently dilated after opening the heart in the usual way, and the calumnas 

 carneae and papillary muscles are somewhat flattened. The tricuspid ring 

 admits three and one-half fingers, the tricuspid leaflets being large, thin, 

 and pliable with rather long and slender chordae tendineas. The entire 

 endocardium of the right heart is smooth and pale except for the presence 

 of small punctate haemorrhages on the outer wall of the ventricle just 

 beneath the mural flap of the tricuspid valve. The muscle of the right 

 ventricle is thin, pale brown, and rather friable. The pulmonary orifice 

 and valves are normal. The left side of the heart is less dilated, and its 

 endocardium is intact, the mitral ring admitting 2 fingers with ease. 

 The aortic ring and leaflets are normal. Muscle of the left ventricle 

 measures about 12 millimeters at mitral insertion and is firmer than that 

 of the right ventricle; its cut surface is smooth, rather more of a yellowish 

 tinge than normal, although not flecked, and has a glassy appearance. No 

 haemorrhages are found in the left heart. 



Lungs. — Both lungs are diminished in volume and are free from pleural 

 adhesions. The pleura is smooth and moist, and the pigmented lines of the 

 interlobular septa are readily visible. Elasticity of the lungs is diminished, 



