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A thin membrane, standing vertically in the middle plane, the mesocardium, connects the ventral wall of the head-gut with the lower head-wall. These cavities afterwards join and form the simple pericardial cavity, and are therefore called by Kolliker the "primitive pericardial cavities."
An incision eight inches long was made over the 4th rib, six inches of the rib were resected, the bleeding intercostal artery was ligated, the blood was turned out of the pericardial cavity, this cavity being irrigated with hot water. The wound in the pericardium, which was two inches long, was sutured and the external wound was closed. Recovery followed.
The body temperature is higher than normal, and the pulse rapid and irregular. On auscultation, friction sounds that correspond to the tumultuous beats of the heart are heard. When fluid collects within the pericardial sack, the heart beats become feeble and the pulse weak. Labored breathing and bluish discoloration of the lips follow. The disease usually runs a very acute course.
Vite mentions an example of remarkable tenacity of life after reception of a cardiac wound, the subject living four days after a knife-wound penetrating the chest into the pericardial sac and passing through the left ventricle of the heart into the opposite wall. Boone speaks of a gunshot wound in which death was postponed until the thirteenth day.
These adhesions between the two surfaces of the pericardium may be general throughout the entire pericardial sac, or they may be limited to some one or more parts of the pericardium. Perhaps one of the most frequent points of adhesion is the anterior part of the pericardium, while the apex is the part most likely to be free, even when other parts of the pericardium have grown together.
The inner or serous layer covers the external surface of the heart, and is reflected back upon itself in order to form, like all membranes of this kind, a sac without an opening. The heart is thus covered by the pericardial sac, but is not contained inside its cavity. The space between the two membranes is filled with serous fluid.
When the pericardial sac was incised, a teaspoonful of turbid fluid oozed out, and the needle was felt in an oblique position in the right ventricle. By pressure of a finger passed under the heart, the eye of the needle was pressed through the anterior wall and fixed on the operator's finger-nail.
Zillner attributed this circumstance to the small size of the wound, atheroma and degeneration of the aorta and slight retraction of the inner coat, together with a possible plugging of the pericardial opening.
Smooth, round objects do no appreciable harm unless they block the opening into the third compartment of the stomach. This frequently occurs in wool-eating lambs. Sharp-pointed objects may penetrate the surrounding tissues or such organs as the spleen, diaphragm, and pericardial sack. If these organs are injured by the foreign body serious symptoms develop.
It treats of the pericardium and of the pericardial fluid and perhaps of the musculi papillares, and contrasts the thickness of the walls of right and left ventricles. The author considers that the left ventricle is empty of blood as indeed it is after death and is the source of the innate heat and of the absolute intelligence.
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