CHRONIC AFFECTION OF THE HEART. 
331 
ed into the rectum. Some Singularly hardened pieces of mucus 
and faeces were returned. Horn with gruel ; ball of digitalis. 
21 st -—Apparently better; the difficulty of staling, and the 
painful aud ineffectual attempts to dung have ceased. The pulse 
is 96, low, but not irregular. The pony has drank at least 
three gallons of gruel, at different times: the mouth, however, is 
'very hot, and all solid food is refused. Give no medicine. To¬ 
wards evening he seemed a little better still, and had again 
drunk gruel ; but he died early on the following morning. 
22 d .—The animal was opened at noon, and while it was warm. 
The lining membrane of the trachea was slightly injected ; the 
pulmonary pleura inflamed, but not intensely, but there were 
one or two small patches or thickening of the membrane, and 
deposition of coagulating lymph; no congestion in the substance 
of the lungs. The mucous coat of the intestines, thro gh its 
whole extent, was slightly vascular, of a deeper colour, and with 
more appearance of inflammation in the colon. The principal 
disease, however, was in the heart, where an intelligent pupil of 
mine said, some days before, that it would be found. The peri¬ 
cardiac bag contained a quart of yellow serous fluid. The portion 
of the membrane covering the heart seemed, in various parts, to 
be easily detached from the substance beneath, and the duplica- 
ture lining* the bag was not in the slightest degree affected. 
The substance of the heart was pale, softened, and had a mace¬ 
rated appearance. It would seem as if the finger could he 
easily thrust through the parietes of the ventricles. The mem¬ 
brane lining the ventricles, and particularly the left ventricle, 
presented numerous spots of ecchymosis. The whole of the 
cornea columna on the septum was blackened. The duplna¬ 
tures of membrane constituting the mitral and semilunar valves, 
the last particularly, presented a very singular appearance from 
their degree of injection, and the lining membrane of the aorta 
was of a yellowish red. 
I offer this case almost without comment, although it affords 
matter for much serious reflection. Did the langour and depres¬ 
sion so marked, even at the commencement of the disease, de¬ 
signate that low and insidious fever which so often runs its 
course unsuspected, and which no skill can arrest, and the rava¬ 
ges of which are at length to be found in every important viscus ? 
or was it from the beginning an affection of the heart, which 
no symptoms sufficiently characterized, but which, at length, be¬ 
came connected with or produced the general irritation which 
was so manifest ? Could the depletion have been carried to 
a greater extent ? Could other remedial means have been 
adopted ? 
* 
