all the others the pericardium adhered to the heart. The left ventricle, in all the cases, was most enlarged in size, but not in thickness, and in most of them the heart was found of an unusually pale color, and very soft and tender in its texture.

In one case, the examination of which was made by Mr. Chilver, in the presence of Sir Walter Farquhar, Dr. Baillie, Dr. Saunders, Dr. Gillan, and myself, Dr. Baillie thus describes the appearance of the heart. "The pericardium was found closely adhering in every part to the surface of the heart. The heart itself had increased wonderfully in size; it was at least three times the size of a healthy heart. The muscular structure was, however, not increased in thickness beyond what it commonly is, so that its powers of action were not augmented proportionably to its bulk. As the quantity of blood in this heart was much larger than is natural, (for instead of a few ounces it contained almost a quart of blood) its powers of propelling this blood to the different parts of the body must have been much diminished below the common standard."

Mr. Thomas, of Leicester-square, gives the following account of the examination of the body of a young gentleman (who died of this disease,) at which I was prevented from being present. "The heart was somewhat larger than common, and the enlargement was confined principally to the left side. It was of a pale color, extremely soft and tender in its texture, and its cavities were filled with coagulated blood, having but a slight cohesion of its component parts. Nothing remarkable presented itself in the right auricle and ventricle; but upon opening the left ventricle was found an irregular excrescence of the nature of Polypus, attached to, and nearly occupying the whole of one of the valvula mitrales."

I have an account of a case so far back as the year 1770, in which all the appearances correspond almost exactly with those in the case described by Dr. Baillie. The heart is mentioned to have been three times its usual size; the pericardium adhered to the left ventricle, which was inflamed, and was thinner than the right. Where the pericardium did not adhere, a small quantity of water was found in it.

I examined lately, the body of a young lady who died of this disease, in presence of Mr. Nixon and Mr. Jones, sur

geons, at Hampton, and found the heart of an unusual size, and the pericardium adhering closely in every part to it. The substance of the heart was of a pale color, and the texture of it was so tender, that the finger could with great ease be pushed through it. It was chiefly enlarged on the left side, but its muscular structure was not increased in thickness. The valvula mitrales were edged with a substance of a spongy appearance, perhaps coagulable lymph.

I have an account of an incipient attack of this disease, judiciously and successfully treated by Dr. Pemberton. His account of the case is so very distinct, and in many respects corresponds so exactly with the disease I have described, that I will take the liberty to give it in the doctor's own words.

"Mr. had been in his youth, and indeed even to the time he was taken ill, (aged 36) subject to the acute rheumatism. He had been particularly troubled with this complaint during the whole of the winter immediately preceding the affection of the heart, which took place in March. He was seized with a considerable pain at the heart, and a difficulty of respiration, great palpitation and great anxiety. He conceived that the smallest motion of the body would have instantly destroyed him, and this dread seemed to have totally bereft him of the power of utterance. He sat for six or eight hours without being able to articulate a sound, though he was conscious of what was going on about him. He had frequent rigors, and almost constant profuse sweats. Cordials of various sorts were given him, till he appeared in a slight degree more composed, when a small quantity of blood was taken from the arm. This did not appear buffy. In about three days he ventured to move from the chair where he had remained from the first attack, but upon the slightest exertion the palpitation and anxiety were renewed. When he remained perfectly at rest the palpitation was hardly observable.

"In about a fortnight all his apprehensions of death seemed removed; but still on the most trifling exertion he was reminded of his former sufferings, so that for a month he scarcely moved at all.

By placing the hand upon the heart, there appeared a very VOL. I.

2 Q

great throbbing, which beat up the carotids so much as to occasion a most unpleasant noise in the head.

"On considering the circumstances of this case, I was inclined to suspect that a small portion of the surface of the heart had been affected with inflammation, and that in consequence, a partial adhesion had taken place between it and the pericardium. The plan recommended, was a seton in the region of the heart, and a pill composed of three grains of the succus spissatus cicuta, and half a grain of the powder of digitalis, three times a day, abstinence from all fermented liquors, and a moderate quantity of animal food.

"The irregular action of the heart continued at intervals for eight months, when it gradually lessened, so that in about a year there remained no symptoms of the former complaint, and Mr. is now (at the distance of four years) equal to undergo any exertion or fatigue without producing any irregularity of the heart's action."

The knowledge that this disease is always the consequence of, or is connected with, rheumatic affection, points out the necessity of attending to the translation of rheumatism to the chest; and shows the importance of employing very vigorous measures to remove it as soon as possible; but whenever it has made any considerable progress, I fear it will baffle every effort.

November 20th, 1806.

Since writing the above I have been favoured by Dr. Marcet with an account of two cases of translation of rheumatism from the extremities to the chest, producing several of the symptoms I have noticed; but not in so marked a degree ás in the cases I have seen. Both these patients died, and were opened, and in both of them the heart was found to be much enlarged. I also last year attended a person aged 29, who had twice had the acute rheumatism; but having been wet through last September, was seized with shiverings, succeeded by a pain across the chest, great difficulty of breathing, which was increased by the slightest motion, a very strong palpitation of the heart, and violent action of the carotid arteries, accompanied with a sense

of great debility, and an apprehension she was just going to expire.

She had been in this state for a fortnight, before I saw her. She had not been able to go to bed for many nights; her legs and thighs were much swollen, and her pulse, which was very weak, was so quick, that it could not be counted. She had no cough. She submitted to have a blister applied to the region of the heart, but would not allow an issue to be made. By the use of the digitalis her pulse became less frequent; but as it disordered her head and stomach she was obliged to relinquish it. The action of the heart now was tremendous; she daily became weaker, although her appetite continued good to the last, and she died at the end of two months.

She was opened in the presence of Mr. Taylor, of Kingston. The lungs on the left side had very little space to act in, the heart, which was enlarged to a most extraordinary size, occupying the greater part of the left side of the thorax. The lungs were found on both sides, to have strong adhesions to the pleura; and above a pint of water was found in the cavity of the thorax. A considerable quantity of water was contained in the abdomen. All the abdominal viscera were sound, except the spleen, which was of a much paler color and softer texture than usual.

The Case of a Man who died in consequence of the Bite of a Rattle Snake, with an Account of the Effects produced by the Poison.

By EVERHARD HOME, Esq. F. R. S.

WITH PRELIMINARY OBSERVATIONS.

From the London Medical and Physical Journal, for 1810.

THE public sensation which was occasioned by a man having been bitten by a rattle snake, kept at a menagerie in Piccadilly, was extended as far as a knowledge of the fact had spread. Curiosity, with respect to the symptoms and fate of the wounded man, was highly excited; but many months elapsed before this curiosity was satisfied. A minute detail of the case has now been published, and we embrace this opportunity of laying it before our readers.

The genus to which the serpent that wounded the subject of the following case, belongs, is peculiar to America, and has the expressive appellation, CROTALUS, given to it by Linnæus. It contains five species, according to the Systema Natura Linn.

To which the Count La Capede has added a sixth, the Fisher, (le Piscivoire) described by Catesby, (Natural History of Carolina,) and by him only, and two varieties, Gronian durissus. (Crotalophorus tertius. Gron. Mus. 11. 70. n. 45,) and the fasciated durissus. (Crotalus faciatus. Vosmaer. monagr. anno 1767.) The whole of the species of this genus are furnished with poisonous fangs, but have the character of seldom biting, unless irritated, or for the purpose of securing their prey.

The species by which this person was bitten, is the crotalus horridus, the most terrific and formidable of the genus. Many names have been given to it, either expressive of its mechanism or its qualities; it is the caudisona terrifica of Laurentius; the vipera caudisona, and anguis crotalophorus of our countryman, Ray; the regina serpentum of Hernandez; the boiquira of Piso, and the Encyclop. Method. From the quickness of its motions, the Mexicans call it ecacoatle, for it darts on its prey, wounds, and retires with the swiftness of the wind.

The crotalus horridus is found along the American continent, from the Streights of Magellan, to Lake Champlain, in Canada. For a long time after the discovery of the new world, this regina serpentum, reigned without control over its vast wilds and impassable forests. Few, possibly none, of the native animals preyed upon it; and it was secured from the destroying hand of man, by superstitious terrors that influenced, un

The pacific disposition of the rattle snake is asserted by Batram. This word, expressive of velocity, is sometimes written Hoatcoatl. Savage nations often employ a highly figurative language. The Mexicans denominate the rattle snake Tuetlatacauqui, the king of snakes.