A CASE OF ENDOCARDITIS. 
263 
successively appeared during the course of the disease would 
seem to indicate ; or, rather, did the aneurismal state of the heart 
predispose it to take on this inflammatory character ? 
These questions are so much involved in obscurity, that I 
scarcely dare to offer an opinion respecting them. 
One circumstance in this singular and valuable case of M. 
Mercier deserves particular attention ; — it is the coincidence of 
the inflammation of the lining membrane of one of the cavities of 
the heart, with the painful affections and sad lamenesses to which 
this animal was subject. 
This is particularly important, connected with another fact, first 
observed by M. Bouley, jun., — the development of sessamoideal 
rheumatic synovitis at the close of pleurisy. 
By the side of these, and having considerable analogy with 
them, is a curious fact. When an irritating fluid is injected into 
the pericardiac sac, by means of a puncture between the carti- 
lages of the sixth and seventh rib, painful disease in the joints is 
manifested in one or more of the limbs, at the very time that 
inflammation is developed in the serous membrane of the heart. 
These pains are sometimes so intense, that the animal can scarcely 
walk. I am now instituting experiments on this subject, the result 
of which, at some future time, shall be given. 
H. B. 
[I am far from being assured of the connexion of this disease 
of the heart, with any rheumatic affection ; but every practi- 
tioner of considerable experience will recollect states of the 
heart very similar to that described by M. Mercier. Small 
vegetations — a species of polypus — have adhered to the lining 
membrane of the heart ; they have assumed the character of 
real organization, and have ultimately become united with 
the membrane, which they at first only mechanically covered. 
There has been a true vascular communication between the 
membrane and the polypus. This union being once esta- 
blished, the polypus rapidly grows ; it distends the neigh- 
bouring vessels — it produces aneurism of the cavity which it 
occupies — and, connected with this, a state of inflammation 
soon arises, w T hich causes extreme disturbance and pain in 
the heart, or the vessels which communicate with it, and de- 
stroy the animal. 
What are the causes of these abnormal concretions ? Is 
there any peculiarity in the contraction of the heart ? a want 
