percussion of enlargement of the heart. The lividity was extreme before death. On dissection, the right cavities were found much hypertrophied, but the left were healthy, as were also the valves. The whole heart is preserved. 1860. Dr. Henry I. Bowditch.
369. A direct inter-auricular opening, more than in. in di- ameter, and just above the valves, which are somewhat imperfectly developed. Three or four small direct open- ings also, in fossa ovalis. Right ventricle rather thick, and the ductus arteriosus would have allowed the passage of the head of a pin. Organ otherwise well ; and a part only is shown. From a child that died of pneumonia, at the age of five months. Stunted in its growth ; paroxysms of dyspnoea from birth, and often livid ; pulse rapid, small, and irregular. See Amer. Jour, of Med. Sc. ; April, 1850. 1852. Dr. M. S. Perry.
370. Interventricular opening, from a mulatto child, four years
old. Dyspnoea, lividity, and paroxysms of distress, almost from birth. Action of heart regular, but with a loud bellows sound. The opening is, as usual, free, and at the upper part of the septum. Right ventricle much thickened, as usual, and the left rather thin. The pulm. artery was small, arose rather indirectly from the ventricle, and had two valves, which differed much in size, but were other- wise normal. Aorta enlarged, and the valves well. 1861.
Dr. J. B. S. Jackson.
371. Interventricular opening, from a delicate little girl, six
years old. She always had hurried breathing, with rapid and violent action of heart, but was never livid. CEdema the last four months ; with ascites, for which she was tapped several times. Dr. C. found the sternum promi- nent, and the heart evidently " distended " ; the first sound " rushing," and the second clear. The opening was four lines in diameter, between the ventricles ; these last being thickened, and the left perhaps a little the most so. Valves of the pulm. artery thickened, and two of them fused. Pericarditis. Liver ecchymosed ; showing the tendency to
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