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Updated: May 14, 2025
Outer layer of pericardium. C. Covering of lung. D. Diaphragm. *Cavities of the Heart.*—The heart is a hollow, muscular organ which has its interior divided by partitions into four distinct cavities. The main partition extends from top to bottom and divides the heart into two similar portions, named from their positions the right side and the left side.
Several jagged fragments were removed; a portion of the pleura, two by four inches, had been torn away, exposing the pericardium and the left lung, and showing the former to have been penetrated and the latter torn. The lung collapsed completely, and for three or four months no air seemed to enter it, but respiration gradually returned.
Both the pericardium and left pleura were distended with fresh blood and large clots. Church reports a case of gunshot wound of the heart in a man of sixty-seven who survived three hours. The postmortem examination showed that the ball had pierced the sternum just above the xiphoid cartilage, and had entered the pericardium to the right and at the lower part.
Affections of the heart-valves and of the pericardium are commonly present. On recovery from the acute illness, it may be found that the joints have entirely recovered, but in a small proportion of cases certain of them remain stiff and pass into the crippled condition described under chronic rheumatism. There is no call for operative interference.
As stated above, if pericarditis develops during the progress of chronic disease, such as interstitial nephritis, or during sepsis, or from abscesses or growths in the region of the pericardium, the prognosis is bad. In acute pericarditis, absolute mental as well as physical rest is essential.
He then read some observations which he had made on the appearances of his body after he was dead; that his back and the parts he lay on were livid; the fat on the muscles of his belly was loose in texture and, approached fluidity; the muscles of the belly were pale and flaccid; the cawl yellower than natural; the side next the stomach and intestines brownish; the heart variegated with purple spots; there was no water in the pericardium; the lungs resembled bladders filled with air, blotted with black, like ink; the liver and spleen were discoloured, and the former looked as if it had been boiled; a stone was found in the gall-bladder; the bile was very fluid and of a dirty yellow colour inclining to red; the kidneys were stained with livid spots; the stomach and bowels were inflated, and looked liked they had been pinched, and blood stagnated in the membranes; they contained slimy, bloody froth; their coats were thin, smooth, and flabby; the inside of the stomach was quite smooth, and, about the orifices, inflamed, and appeared stabbed and wounded, like the white of an eye just brushed by the beards of barley; that there was no appearance of any natural decay at all in him, and therefore he has no doubt of his dying by poison; and believes that poison to have been white arsenic; that the deceased never gave him any reason why he took the same sort of gruel a second time, nor did he ask him.
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.
Now, “death by lightning may be the result of, 1st, a syncope by fright, or in consequence of a direct or reflex influence of lightning on the par vagum; 2d, hemorrhage in or around the brain, or in the lungs, the pericardium, etc.; 3d, concussion, or some other alteration in the brain;” none of which phenomena have any known property capable of accounting for the suppression, or almost suppression, of the cadaveric rigidity.
It is said that in the presence of Leucatel and several theologians, Francois Botta opened the body of a man who died after an extended illness and found the pericardium putrefied and a great portion of the heart destroyed, but the remaining portion still slightly palpitating.
Harris gives an instance of a man who was injured by a bar of iron falling on his shoulder, producing a compound fracture of the ribs as low as the 7th, and laying the heart and lungs bare without seriously injuring the pericardium. Rupture of the heart from contusion of the chest is not always instantly fatal.
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