ase. On the left shoulder were small,
hard, and prominent livid spots.
The cellular membrane, both on the outside and inside of the thorax,
was quite bloody, which is not usually the case in dead bodies. The
cartilages of the ribs were slightly ossified, and, upon their
removal, it appeared that the pericardium and its contents occupied an
extraordinary space, for the lungs were quite concealed by them. These
organs being drawn forward, appeared sound and free from adhesions;
their colour, anteriorly, was rather dark; posteriorly, still darker;
their consistence firm. Their vessels were so crowded with blood, as
to cause an uniform dark colour in the substance of the lungs,
especially in some particular spots, where the blood appeared to be
accumulated; but whether this accumulation was confined to the blood
vessels, or extended to the bronchial vesicles, could not be
satisfactorily determined. No one can doubt that blood may be
frequently forced through the thin membrane of the air vesicles, who
considers, that in these cases the heart often acts with uncommon
violence, that, when it is enlarged, it attempts to send toward the
lungs more blood than their vessels can contain, and that there is
commonly some obstruction to the return of blood from the lungs into
the heart, from derangement either in the mitral or aortal valves, or
in the aorta. The consequent accumulation of blood in the lungs seems
to me to be the probable cause of the dyspnoea, which so much
distresses those affected with diseases of the heart; for if there be
an inordinate quantity of blood, there must be a deficiency of air.
This accumulation of blood in the lungs has, by some writers, been
considered as an appearance belonging to idiopathic hydrothorax.
Whether it ever exists in that complaint seems to me uncertain. The
pressure of water upon the lungs, may possibly interrupt the free
circulation of blood through their vessels, yet probably the same
pressure would prevent the entrance of blood into the vessels, unless
there be some other cause to overcome it, such as increased action of
the heart, which attends only the first stage of hydrothorax. It has
beside been proved by the experiments of Bichat, that the collapsion
of the lungs does not obstruct the circulation of blood through the
pulmonary vessels. It seems probable, therefore, that those who have
thought this collection of blood an appearance belonging to idiopathic
hydrothorax, have m
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