Note 28 — PART I.

I once observed a similar condition in a young woman in St. George's Hospital. Each pulsation of the heart could be heard with great distinctness at a distance of two or three yards from the patient; during the paroxysms, there was the greatest difficulty of breathing; the countenance became anxious and livid, and a distinct thrill was communicated to all the arteries. After death, the countenance and upper part of the body were found livid from venous congestion. The lungs did not readily collapse when the chest was opened. The auricles of the heart were greatly distended with black blood; the inner surface of the left ventricle presented a white patch, of about two square inches in extent; the lining membrane of the aorta, for several inches, was of a bright red colour; this extended round one-third only of the circumference of the vessel. No other structural change could be found in the heart or vessels, which would account for the symptoms observed during life.