death takes place in such cases, there is no doubt that many persons so dying, have been erroneously included in the list of apoplectic deaths. In certain diseased states of the valves, the extremities of the body become gangrenous, as if the heart were unable to propel its blood to the extreme parts: the author well remembers two females who were admitted into the Westminster hospital, with a disease of this kind, in which the gangrene gradually extended upwards, and that, after death, the valves of the heart were found ossified. The coronary arteries are occasionally ossified, a circumstance which often accompanies a diseased state of the valves of the heart, and that of the aorta; a change which has been regarded as giving rise to the disease, termed angina pectoris, but which would seem to be symptomatic of any morbid state of the heart. In some cases the heart itself has been found ruptured; we have already offered some observations upon this event, under the history of syncope, p. 27. Dr. Baillie has seen only one case, and in that, the blood escaped into the pericardium, and the person instantly expired.
Examination of the abdomen.—In proceeding to the examination of this cavity, and its contents, the first appearance to be noticed, is that of the peritoneum, in which we have to observe whether any marks of inflammation exist, as displayed by a crowd of very small vessels, injected with florid blood, and a change in the texture of the membrane, by which it appears to be thickened, more pulpy, and less transparent. The existence and character of any fluid in the abdominal cavity should be noted, for its nature will be found to be immediately connected with the nature and extent of the disease by which it has been produced; if the liver be schirrous, the fluid will be
