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CASE OF OSSIFICATION OF THE PE- RICARDIUM, AND OF THE HEART, WITH ENLARGEMENT OF THE LAT- TER. (From the London Medical Repository.) Marsh, aged 43, was admitted (Kent Hos- pital) July 30,1824, with general dropsy. He had laboured under palpitation of the heart for upwards of twenty years, and had, in the course of the few last years, been frequently under me. dical care. What seemed to have afforded him the most marked relief was bleeding. Upon his admission into the hospital, his countenance be- trayed the utmost anxiety his complexion was M a yellow dusky hue; his lips purple. He breathed with extreme difficulty in every position, and the. recumbent posture could not be borne.— There was strong and irregular throbbing at the heart; and the pulse at the wrist was weak and unequal, often almostimpeicepuble fora moment. His abdomen and lower extremities were consi- derably swollen. His tongue was white. Under the use of digitalis and colchicum, aided by two bleedings, he became so much better that, on the 25th of august, he requested to be made an out- patient. Scarcely, however, had he reached home, when all the symptoms became worse; and on the 23d of September he was again admitted in a most deplorable state. The extreme distress he experienced in breathing had, during his absence, been relieved for the moment by bleed- ing, but it quickly returned; and whenhearrived in Canterbury, he was forced to kneel with his elbows on a chair, and even in that posture he could scarcely respire. Medicines, similar to those formerly prescribed, were resorted to in vain. It was found absolutely necessary to bleed him agam; but the relief was very trifling, and in a day or two the arm assumed a gangrenous aspect. The patient died October the 8th; and the following were the appearances, upon dis- section, thirteen hours after death:- The face and neck were of a livid hue. Upon opening the chest, we found a considerable quantity of fluid effused in it. The lungs 011 both sides adhered firmly to the pleura costalis they were of much paler hue than usual, but other- wise healthy. The great disease, as was to be expected, was of the heart, and the membrane investing it. The latter was much thickened, and it every where adhered firmly to the heart.— Upon dissecting it away, various portions of it were found converted into bone. The heart it- self was more than double the natural size, and its surface presented many points of ossification there was bony matter also in the left velltricle; but the substances of the organ were in general, exceedingly tender, and the left auricle was so thin that, in all probability, had the patient sur- vived a little longer, it would have given way. Neither the semilunar valves, nor the auriculo- ventricular valves, were in the least degree os- sified. The abdominal viscera were, in general healthy, only the liver was paler, and perhaps somewhat harder thannatural. The gall-bladder contained several black polished gall stones. In this case it required no extraordinary acu- men to recognise the existence of organic disease of the heart. The patient himself was satisfied that he laboured under such disease, and stated that nearly twenty years ago he experienced ex- actly the same sensations, and seemed to have precisely the same symptoms with a yonng man who was in the same ward, and who appeared evidently to be labouring under enlargement of the heart. The case just recorded is an interesting one, both on account of the very long period during which the patient struggled with the di- sease, and tho rarity of examples of ossified pe- ricardium.



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