died, in
March, 1809.

DISSECTION.

The right cavity of the thorax was filled with water; the left
contained none. The lungs were sound, but very dense, full of dark
coloured blood, and, on the right side, pressed into the upper part of
the thorax. The heart was one half larger than natural; its substance
firm, and its anterior part, especially near the apex, covered with
coagulated lymph. The right auricle and ventricle were large, and
their parietes thin. The parietes of the left auricle and ventricle,
particularly of the latter, were much thickened, and their cavities
were filled with black coagulum.

The liver was contracted; its coat wrinkled, and marked with
appearances of recent inflammation.

CASE VII.

To JOHN C. WARREN, M. D.

MY DEAR SIR,

Your important communication to our society, which is about to be
published, will lay before the American public much more knowledge
respecting the diseases of the heart, and large vessels, than has
hitherto been presented to them. A case has lately fallen under my
observation, having so much similarity to those of organic diseases of
the heart, which have occurred to you, as to mark its affinity, yet
with some differences, which characterize it as a variety. If the
statement of it will add any value to your collection of cases, you
are at liberty to publish it.

A. S. twenty-eight years of age, and of middle stature, was attacked,
after a debauch, with pain in the region of the heart, which subsided,
but returned a year after on a similar occasion. He then became
affected with palpitations of the heart for six months, great
difficulty of breathing, which was augmented by ascending an eminence,
severe cough, dizziness, and violent head-ache, attended by a
disposition to bend the body forward, and sudden startings from sleep.
His pulse was always regular, and never remarkably hard. His
countenance, till within a few weeks of death, presented the
appearance of blooming health. His feet and legs did not swell at any
period of the disease. He suffered exceedingly from flatulence, to
which he was disposed to attribute all his complaints. This symptom
might have been aggravated by his habits of free living, and
occasional intoxication, which he acknowledged, and to which he traced
the origin of his disease.

After death, water was discovered in the thorax; but the lungs had not
t