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found her pulse very weak and intermitting; thirst; parched tongue, and great debility; bowels natural, but the palpitation, she thinks, is now more violent than ever she felt it before; and, indeed, it is quite as distinct to the eye as to the touch. Some infusion of calumbo, with laudanum, was given in the state of effervescence, for the purpose of allaying the vomiting, which it soon effected; but, at our evening visit, we found a great change for the worse, the patient labouring under orthopnoea, with feeble fluttering pulse; restlessness; cold extremities, and a most bounding palpitation of the heart. Madeira wine, with brandy, relieved the difficult breathing, and she felt comparatively easy; twelve leeches were applied to the chest, and a blister, which enabled her to resume the horizontal position, but, about three o'clock on the following morning, she died very suddenly.
Post mortem examination. — The good sense of her mother willingly granted us permission to examine the thoracic viscera, and at three o'clock of the same day, Mr. Hensman and myself gladly availed ourselves of the opportunity. There was some effusion of bloody serum in the cavity of the chest, the exact quantity of which I have only noted as not considerable. The heart was greatly enlarged, and the pericardium so closely and strongly adhering to it, that it formed one solid mass throughout the whole surface, and was, with difficulty, separated, by dissection, with the scalpel, although no other organic derangement was observed, except a slight blush upon the right ventricle, indicative of some inflammation having existed. The left lung adhered strongly to the pleura costalis, but the right was quite free.
