436 OBSERVATIONS ON SOME DISEASES OF THE HEART. 
“8///. — The tumefaction has nearly subsided. 
“ 9 tli . — Considerable diarrhoea and general debility, so that she 
cannot stand. The pulse no longer to be felt. At night she died 
in the posture which for some time she had scarcely changed, 
the head lying on the extended fore-legs. 
“ Autopsy . — The cellular tissue of the trachelian surface of the 
neck was infiltrated, and the infiltration extended under the pec- 
toral muscles. The abdomen contained nothing remarkable ex- 
cept the infiltration reaching to the sub-lumbar muscles. 
“ On opening the chest, we found that the pericardium had ac- 
quired an extraordinary size. I disengaged it by cutting the 
ligaments, or, rather, the car no-ligamentous adherences, by which 
it was attached to the surrounding parts. The whole of its ex- 
terior surface presented a strange irregularity. One part of it 
was of a lardaceous or fatty character — another was glandular — 
and another carcinomatous. On cutting through the mem- 
brane, three gallons of a brown serous fluid — exceedingly fetid, 
and resembling both in its colour and odour human excrement 
dissolved — escaped. Yellow, albuminous flocculi of the weight 
of three or four ounces were floating on this fluid. The inner 
surface of the membrane, which was of a pale yellow colour, ex- 
hibited no alteration except two little ecchymoses, — one about 
the middle, and the other at the bottom of it. The thickness of 
the pericardium, which varied from three to four lines, gave to 
the whole a weight of eight pounds. 
“ The Heart . — The whole surface of this viscus was very irregu- 
lar, and covered by vegetations of different colours, black in 
some places, and in others yellow or brown. They were easily 
detached by means of a scalpel at certain points, but they formed 
very intimate adhesions with the depressed portions of this viscus. 
At the base of the left ventricle there existed a deep red spongy 
production, covered by a delicate membrane from which a mul- 
titude of small vessels proceeded. At certain places in the inte- 
rior of this tissue portions of concrete matter, — in others, a mul- 
titude of small points in actual suppuration, and in others, gra- 
nulse, which had not yet assumed the lardaceous character. 
“The heart, disengaged from all the accidental productions 
which covered its exterior, presented spots of different colours 
impressed more or less deeply in the tissue of the organ, accord- 
ing to their extent, and position. They all formed a portion of 
a lardaceous tissue, into which the whole of the heart seemed to 
be changed, except at the point of the left ventricle, and the 
traces of which extended to the internal membrane of the heart. 
These spots, generally brown, were surrounded with black and 
green circular lines, and were faintly marked as they approached 
the centre, giving the idea of the singular clouding of some kinds 
