Howrah Hospital Report for 1846. 521 



of the heart at last became smothered. On examination there was 

 found hydrops pericardii, dilatation of both ventricles, endocarditis 

 in the shape of leathery thickened mitral and tricuspid valves, in- 

 flammation of the aorta at the root of the semilunar valves, with 

 ulceration and perforation of the aorta at the part ; inflammation of 

 the lining membrane of the pulmonary artery also. 



Case 4th. — Death from dysentery and hepatic abscess. He com- 

 plains of difficult breathing at times, and of pain across the chest, and 

 of tenderness on pressing under the margin of ribs on left side : 

 heart's impulse not increased ; he has felt the same morbid sensations 

 for a short time many years since : the heart disease of old standing. 

 By auscultation a strong bruit is heard attendant upon the systole all 

 over the heart. Upon examination there was found the closest adhe- 

 sion of the pericardium to the heart, without any apparent alteration 

 of structure, so that the bag of the pericardium at first sight appeared 

 to be wanting; the pericardium was separable from the heart by 

 careful dissection ; the heart, with its closely attached pericardium, 

 was attached to the diaphragm, instead of having the bag of the 

 pericardium to move in. 



Delirium tremens. — Ten cases of the disease have, occurred in 

 the year, some of them slight ; there have been three deaths, 

 one of them in a man a few hours after admission in a dying 

 state. The post mortem appearances of two habitual drinkers 

 exhibited considerable vascular fulness and congestion, as 

 well of the scalp as of the feeding veins of the longitudinal 

 sinus on the superior surface of the brain ; considerable effu- 

 sion of serum within the sac of the arachnoid superiorly, and 

 at the base of the brain, and within the ventricles of the 

 brain, and beneath the arachnoid, found also within the spi- 

 nal canal ; milkiness of the arachnoid, and adhesion of the two 

 surfaces along the line of the longitudinal sinus; a highly 

 injected state of the pia mater, and appearance of bloody 

 points upon slicing the brain. In one case an apoplectic cell 

 of the size of a nut, filled with coagula, was found at the 

 inferior part of the anterior lobe of the right hemisphere. 



3 Y 



