hours. In
another case the patient lived twenty-six hours after reception of the
injury, the conical pistol-ball passing through the anterior margin of
the right lobe of the lung into the pericardium, through the right
auricle, and again entered the right pleural cavity, passing through
the posterior margin of the lower lobe of the right lung; at the
autopsy it was found in the right pleural cavity. The left lung and
cavity were perfectly normal. The right lung was engorged and somewhat
compressed by the blood in the pleural cavity. The pericardium was much
distended and contained from six to eight ounces of partially
coagulated blood. There was a fibrinous clot in the left ventricle.

Nonfatal Cardiac Injuries.--Wounds of the heart are not necessarily
fatal. Of 401 cases of cardiac injury collected by Fischer there were
as many as 50 recoveries, the diagnosis being confirmed in 33 instances
by an autopsy in which there were found distinct signs of the cardiac
injury. By a peculiar arrangement of the fibers of the heart, a wound
transverse to one layer of fibers is in the direction of another layer,
and to a certain extent, therefore, valvular in function; it is
probably from this fact that punctured wounds of the heart are often
attended with little or no bleeding.

Among the older writers, several instances of nonfatal injuries to the
heart are recorded. Before the present century scientists had observed
game-animals that had been wounded in the heart in the course of their
lives, and after their ultimate death such direct evidence as the
presence of a bullet or an arrow in their hearts was found. Rodericus a
Veiga tells the story of a deer that was killed in hunting, and in
whose heart was fixed a piece of arrow that appeared to have been there
some time. Glandorp experimentally produced a nonfatal wound in the
heart of a rabbit. Wounds of the heart, not lethal, have been reported
by Benivenius, Marcellus Donatus, Schott, Stalpart van der Wiel, and
Wolff. Ollenrot reports an additional instance of recovery from
heart-injury, but in his case the wound was only superficial.

There is a recent case of a boy of fourteen, who was wounded in the
heart by a pen-knife stab. The boy was discharged cured from the
Middlesex Hospital, but three months after the reception of the injury
he was taken ill and died. A postmortem examination showed that the
right ventricle had been penetrated in a slanting direction; the cause
of