152 
REPORTS OF CASES. 
tract particular attention until the morning of March 17, when 
she refused food, lying around and moaning. She was due to 
calve in ten days. I found patient lying in natural position but 
moaning. When made to stand moaning continued, general 
appearance unfavorable, and would indicate otherwise than the 
latter stage of pregnancy. Examination proved left lung to be 
normal, but could discover no murmur over postero-inferior por¬ 
tion of right. Pulse 104, temperature 103 2-5. A peculiarity 
of the pulse was its regularity and distinctness, considered along 
with the rate ; venous pulse distinct; no cardiac sounds on left 
side , and but faintly on right. 
To save explanations, I pronounced it u heart trouble,” and 
explained the advent of a foreign body as an occasional cause ; 
pronounced the case fatal, prescribing, however, stating a wish 
to hold post-mortem when death occurred. 
Post-mortem .—Opened right thorax, and in so doing opened 
the pericardial cavity, which was enormously enlarged, forcing 
its way under right lung, and becoming attached to the wall of 
right thorax by an inflammatory exudate. Pericardium greatly 
thickened and filled with an exudate of a milky consistence and 
of a quantity which would seem inconsistent with truthfulness 
were I to state it. Posterior surface of heart adherent to peri¬ 
cardium, and the latter to diaphragm. Carefully breaking 
down the adhesion between the heart and diaphragm, I found a 
common darning needle fixed in the posterior surface of the 
right ventricle. 
Some of our authorities speak of making a positive diagno¬ 
sis in these cases, but in this case the symptoms were so much 
at variance with those laid down in our works, that I should 
feel some hesitancy in making such. We are told that the 
heart beats are short, angry and hard. In this case it was just 
the reverse, the pulse being rapid, but remarkably regular and 
distinct. No splashing or gurgling; cardiac murmur very 
faint, distinguished on the right side only, probably explained 
by the adhesion of pericardium to right thorax, which also ac¬ 
counts for the absence of murmur at this point. Nor was I 
able to trace the course of the needle from the reticulum to the 
heart. No adhesion between reticulum and diaphragm. The 
offender being small and sharp pointed, probably produced but 
a small amount of irritation during its passage. During the 
whole period of unthriftiness the owner had noticed no special 
digestive disturbance, excepting the last three or four days,, when 
she refused all food and water. 
