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Updated: June 14, 2025
The finger being introduced into the wound, penetrated between the fourth and fifth rib on the left side. "Having arrived at the pleuritic sac," says the Professor, "I gently tapped the surface of the lung, in order to assure myself that it was not injured; my finger penetrated into the pericardium, and the point of the heart beat against it."
*The Pleura.*—The pleura is a thin, smooth, elastic, and tough membrane which covers the outside of the lungs and lines the inside of the chest walls. The covering of each lung is continuous with the lining of the chest wall on its respective side and forms with it a closed sac by which the lung is surrounded, the arrangement being similar to that of the pericardium.
When the mother stops to sharpen her tool, the little woman always sharpens hers also. Perhaps there is water to be fetched in bags made from the dried pericardium of an animal; the girl brings some in a smaller water-bag. When her mother goes for wood she carries one or two sticks on her back. She pitches her play teepee to form an exact copy of her mother's.
Sometimes the surfaces of the pericardium are not closely adherent to each other, but bands of adhesion stretch from one surface to the other. After adhesions have taken place between the two layers of the pericardium, the action of the heart is impaired, serious interference with the cardiac action may develop, and sudden death may occur.
It has been thought that gentle movements and possibly exercise, sooner than theoretically justified, might cause the heart to beat a little more actively and possibly prevent the formation of tight adhesions between the two layers of the pericardium. Whether such activity of the heart will prevent adhesions is something that has not been determined.
No pretense, however, was made that any unhealthy condition was found about the heart, except in the attending physician's assertion, that, on puncturing the pericardium; a little gas, as he thought, whizzed out, and that he recollected of having read in two medical works, of cases where such a gas collection had proved fatal.
It might be added that the shock to the cardiac action might be sufficient to check it, and at present we would have no sure means of starting pulsation if once stopped. In heart-injuries, paracentesis, followed, if necessary, by incision of the pericardium, is advised by some surgeons.
Is not this owing to the time necessary for the fluid in the cells of the lungs to change its place, so as the least to incommode respiration in the new attitude? In the dropsy of the pericardium does not the patient bear the horizontal or perpendicular attitude with equal ease? Does this circumstance distinguish the dropsy of the pericardium from that of the lungs and of the thorax?
From the watery condition of the blood there resulted various serous effusions into the pericardium, into the ventricles of the brain, and into the abdominal cavity. In almost all cases which I examined after death, even in the most emaciated, there was more or less serous effusion into the abdominal cavity.
The lungs, the organs of respiration, are two pinkish gray structures of a light, spongy appearance, that fill the chest cavity, except the space taken up by the heart and large vessels. Between the lungs are situated the large bronchi, the oesophagus, the heart in its pericardium, and the great blood-vessels.
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