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Updated: May 14, 2025
When a fluid exudate into the pericardium has occurred from inflammation that is, when it is not an exudate from disturbed kidneys or circulation it will continue to increase to some extent in spite of any treatment.
This consists of a closed membranous sac so arranged as to form a double covering around the heart. The inner layer of the pericardium is closely attached to the heart muscle, forming for it an outside covering. The outer layer hangs loosely around the heart and is continuous with the inner layer at the top.
At the postmortem, which was secured with some difficulty on account of the authorities ordering the bodies to be burned, the pericardium was found single, covering both hearts. The digestive organs were double and separate as far as the lower third of the ilium, and the cecum was on the left side and single, in common with the lower bowel. The livers were fused and the uterus was double.
The following singular case of a wound penetrating into the chest and pericardium of a dog, is recorded by Professor Delafond: A mastiff dog fighting with another was stabbed in the chest by the master of his antagonist. Five hours after the accident, the Professor was sent for.
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.
On the following day there was pain in the epigastrium, and by the fourth day the pain extended to the vertebrae, with vomiting, delirium, and death on the fifth day. At the autopsy it was found that a foreign body, seven cm. long had perforated the pericardium, causing a suppurative pericarditis.
From no section does one get a better idea of the character and scope of the work than from that relating to the heart and arteries affections of the pericardium, diseases of the valves, ulceration, rupture, dilation and hypertrophy and affections of the aorta are very fully described. The section on aneurysm of the aorta remains one of the best ever written.
The sac is completely closed, so that no communication exists between the serous cavity and the parts in its neighborhood. The various serous membranes are the pleura which envelops the lungs; the pericardium which surrounds the heart; the peritoneum which invests the viscera of the abdomen, and the arachnoid in the spinal canal and cranial cavity.
Leeches may be used over the region of the pericardium, and cups are sometimes used. Dry cupping is more frequently used. These measures sometimes seem to reduce the inflammation, and certainly often relieve pain, but the most valuable local treatment is cold, which may be applied either in the form of an ice bag or by a small coil through which ice water is caused to flow by siphonage.
Notwithstanding the confinement of the pericardium, the heart, when under circumstances of unusual excitation, beats violently against the ribs, and, were it not thus tied down, would often bruise and injure itself, and cause inflammation in the neighbouring parts.
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