144 EXTRACTS FROM ENGLISH PAPERS. 
tremity, or of extreme anterior portion of anterior vena cava. 
Continued fomentations to neck and chest, and gentle 
hand-rubbing from above downward. Seen again at 4.30 P.M., 
the oedema was less intense in facial, maxillary and laryngeal, 
but much increased in pectoral and axillary regions. The 
area of emphysema on the right side had greatly extended. 
The pony had eaten a small bran mash during an interval for 
lowering the head, which was suspended to avoid the oedema 
becoming intense in region of larynx. She received amyl 
nitrite inhalations every three hours, but the effusion became 
more intense during the night, extending to the knees and 
over the whole area traversed by the external thoracic veins, 
especially on right ribs. 
Death occurred at 9 A.M. on 10th, and post-mortem was 
made at 3 p.m. The connective tissue in the whole of affected 
area was engorged with very dark blood, the effusion being 
about three inches thick, excepting in the area of the blocked 
veins, the connective tissue was normal. The thorax was 
opened laterally and the external aspect of heart and peri¬ 
cardium was normal, the vena cava was soft, and the coats 
not discolored. Outside the first rib the thrombosis evidently 
commenced, and extended upward, this part being coal black, 
and so dense that it was impossible to discern the vessels or 
where the rupture had taken place, but it was evidently be¬ 
tween the point indicated by the external injury and the first 
rib. Mucous membrane of mouth, etc., pale. The endocar¬ 
dium in left ventricle was abnormally thick, and* there was a 
small lymph-deposit on the bicuspid valves. No ecchymoses 
present, nor in the right ventricle, where the tricuspid valves 
were in a similar condition to the bicuspid ; there was an ex¬ 
travasation about three-quarters of an inch in diameter on the 
outside of right auricle. Mucous membrane of trachea pale; 
hypostatic congestion of left lung. Blood from axillary and 
jugular veins, spleen and pectoral connective tissue examined 
microscopically—contained no micro-organisms. The cause 
of death was evidently venous hemorrhage in the subcuta¬ 
neous connective tissue. I have seen death similarly caused 
in a few hours from an injury to the left carotid artery.— Ibid . 
