CIHM 
 Microfiche 
 Series 
 (IVIonographs) 
 
 ICIVIH 
 
 Collection de 
 microfiches 
 (monographles) 
 
 m 
 
 Canadian rnstitnta for Historical Microraprodu :tions / InstituI Canadian da microraproductions historiques 
 
Technical and Bibliographic Notes / Notes technique et bibliographiques 
 
 The Instiiute has attempted to obtain ttie best original 
 copy available lor filming. Features of this copy which 
 may be bibliographically unique, which may alter any of 
 the images in the reproduction, or which may 
 significantly change the usual method of filming are 
 checked below. 
 
 D 
 
 D 
 D 
 
 D 
 
 Coloured covers / 
 Couverture de couleur 
 
 I I Covers damaged / 
 — ' Couverture endommagee 
 
 I 1 Covers restored and/or laminated / 
 — ' Couverture restauree et'ou pelliculee 
 
 I I Cover title missing / Le litre de couverture manque 
 
 j j Coloured maps / Cartes geographiques ej . couleur 
 
 I j Coloured ink (i.e. other than blue or black) / 
 
 Encre de couleur (i.e. autre que bleue ou noire) 
 
 I I Coloured plates and/or illustrations / 
 Planches et/ou illustrations en couleur 
 
 r^ Bound with other ma:erial / 
 ' — ' Relie avec d'autres documents 
 
 Only edition available / 
 Seule edition disponible 
 
 Tight binding may cause shadows or distortion 
 along interior margin / La reliure serree peut 
 causer de I'ombre ou de la distorsion le long de 
 la marge interieure. 
 
 Blank leaves added during restorations may appear 
 within the text. Whenever possible, these have 
 been omitted from filming / II se peut que ceitaines 
 pages blanches ajoutees lors d'une restauration 
 apparaissent dans le texte, mais, lorsque cela etait 
 possible, ces pages n'ont pas ete filmees. 
 
 L'Institut a mi^rofilme ie meilleur examplaire qu'il lui a 
 ete possible de se procurer. Les details de cet exem- 
 plaire qui sont peut-etre uniques du point de vue bibli- 
 ographique, qui peuvent modifier une image reproduite, 
 ou qui peuvent exiger une modifications dans la meth- 
 ode normale de filmage sont indiques ci-dessous. 
 
 I j Coloured pages / Page^ de couleur 
 
 I 1 Pag'!s damaged / Pages e idommagees 
 
 I I Pages restored and/or Ip.minated / 
 '- — ^ Pages restaurees el/ou pelliculees 
 
 
 
 Pages discoloured, stained or foxed / 
 Pages decolorees, tachetees ou piquees 
 
 I j Pages detached / Pages detachees 
 
 r^ Showthrough / Transparence 
 
 I 1 Quality of print varies / 
 
 ' — ' Qualite inegale de I'impression 
 
 I I Includes supplementary material / 
 
 Comprend du materiel supplementaire 
 
 1 I Pages wholly or partially obscured by errata 
 slips, tissues, etc., have been refilmed to 
 ensure the best possible image / Les pages 
 totalement ou parliellement obscurcies par un 
 feuille; d'errata, une pelure, etc.. ont ete filmees 
 a nouveau de fa?on a obtenir la meilleure 
 image possible. 
 
 I I Opposing pages with varying colouration or 
 discolourations are filmed twice to ensure the 
 best possible image / Les pages s'opposant 
 ayant des colorations variables ou des decol- 
 orations sont filmees deux fois afin d'obtenir la 
 meilleur image possible. 
 
 n 
 
 Additional comments / 
 Commentaires supplementaires: 
 
 This Item rs filmed at the reduction ratio checked below/ 
 Ce document est filme au taux de reduction tndique et-dessous 
 IDX 1«X 18X 
 
 22X 
 
 U 
 
Th* copy filmed h«r* has b«an r«produc*d thinks 
 to th« ganarosity of: 
 
 Osier Library, 
 
 McGill Univenity, 
 
 Montreal 
 
 Tha imagat appaaring hara ara ttia bast quality 
 possible considering tha condition and legibility 
 of the original copy and in keeping with the 
 filming contrect specifications. 
 
 L'axemplaira fllmt fut reproduit grlca i la 
 ginArositt da: 
 
 Oiler Library, 
 
 McGill University, 
 
 Montreal 
 
 Las images sulventes ont M reproduites avec la 
 plus grand soin, compta tenu de la condition at 
 da la nattart de rexemplaira filmi. et an 
 conformlt* avec lea conditions du contrat de 
 fllmage. 
 
 Original copies in printed paper cavers are filmed 
 beginning with the front cover and ending on 
 the last page with a printed or illustrated imprae- 
 sion, or the beck cover when sppropriatt. All 
 other original copiae ara filmed beginning on the 
 first page with a printed or Illustrated Impres- 
 sio I. and ending on the laat page with a printed 
 or iliuatrated Impreeaion. 
 
 Lee exempleires originaux dont la couverture an 
 pepier est imprimte sont fllmis an commancant 
 par la premier plat at en terminent soit par la 
 dernlAre page qui comporte une emprainta 
 d'imprassion ou d'illustration, soit par la second 
 plat, aalon le cas. Tous las autres exemplairas 
 originaux sont fllmAs en commenpant par la 
 premltre pege qui comporte une empreinte 
 d'impreasion ou d'illustration et en tarminant par 
 la darnlAra page qui comporte une telle 
 empreinte. 
 
 The last recorded frame on each microfiche 
 shall contain tha symbol —^ Imeening "CON- 
 TINUED"), or the symbol ▼ (meaning "END"), 
 whichever epplies. 
 
 Un dee symboies suivants apparaitra sur la 
 darnlAre image de cheque microfiche, salon la 
 cas: la symbols -^ signifie "A SUIVRE". is 
 symbola ▼ signifie "FIN". 
 
 Meps. pletes. charts, etc.. may be filmed at 
 different reduction ratios. Those too large to be 
 entirely included in one exposure are filmed 
 beginning in the upper left hand corner, left to 
 right and top to bottom, aa many frames aa 
 required. The following diagrama illustrate the 
 method: 
 
 Lea cartaa. planchaa. tableaux, etc.. peuvant itra 
 filmto i dea ttux de reduction diffArents. 
 Lorsque le document est trop grand pour iue 
 reproduit en un seui cliche, il est filmi i partir 
 de Tangle supArieur gauche, de gauche i droits, 
 et de haut en baa, an prenant la nombra 
 d'imagea ntcessaire. Les disgrammas suivants 
 lllustrent la mithode. 
 
 1 
 
 2 
 
 3 
 
 1 
 
 2 
 
 3 
 
 4 
 
 5 
 
 6 
 
MlCaOCOPV KtSOiUTION TIST CHART 
 
 ANSI iir.d ISO ItST (HART No 3 
 
 J.0 !'^i- IK 
 
 '"" iiy 
 
 ;- lii 11,2 
 
 1.8 
 
 11:25 il 1.4 
 
 1.6 
 
 ^ .TIPPLED irVMGE In, 
 

 M'S|.;c.M XOTKs 
 
 MAl-I.Kl.: AHH,,TT K.A.. M..,., A-i.n,„t ,■„„ 
 
 H.„r,„i„, ,r.a„ ,/„ J,„,„„„ „,^,^„, j_,,^_.^__^^ ^^^^^ ^ 
 
 if. 
 
I 
 
MUSIMM NoTKs. 
 
 .-r ;i,„| .,|„.,. Wurk ili.iK- 
 M I'ill I'lii.rr.lU I 
 
 ^'^'I'l !■■■■ I'l I M.A.. M II,, A.-,.i;,ii, ii,|,,„,„, 
 
 I 
 IMUlKI-,vs|.:,i|T.IV,iKMT,u. MAI.IdlrWAiiov,,,,- |,||. |||,u,,.. 
 
 ''■'Z:::\!':n'T'':'''" ':'";'/■''' ^ '■■-" '-» "■■"■' >■"'■■"'■ ^ '■■"■'■' 
 
 aZ'»Z ' ' ' '■ "■"''' '"■"■' ' '■■"'" ^ ""'"■■ 
 
 Fr.m, „ !■„„. Il,.|„„,,.,l 1,, X, K, MmI,,,,.,. ,m,|i,, ,m, „„„,,,, , ,, ,,,„„. , , ,, 
 
 lVa,,.„rf,„»,„,r»„,i;„/,-,.„,v,„.„, „„„/,.,„ „,,,,,,,■.«■„)„„„,,■, I-:,. 
 Tins fpreinion wliicli presents a coiuliliun of -ivjl iMtiiMl,„nViil 
 ranl.v im well a» <,f clinical .'i-niliciii.c. ,- ul- ,„..,, i,it,.r,-i„i" i, 
 .Monlmil.i-s ,Mi,I to tlio-o M M,(l,ll fro,,, ,, l„,torir,! oo ,„ „r ^„.,, 
 Kor tliu natiu- of It,-, .\„,lrf.,v I |oli,„.s ,,, «u.|l-l,,io«„ to i„„.i of ,„ ,„ ,|', „' 
 at one of the four ninli.ul ni,-.n who, in Is-.M, inilinld eo,ir<i- of l,.,.i,m-s 
 
 for .m..l,,..ll .l,i,h,,ls ill thi, ('„,.. which, in IKVS, „„„. incor,,onuea 
 
 a> tho ModiKil Kacihv of Jlcfiill |-„iv,.,-silv, Th- i,,,.,,-, ,r„lion „( H.c 
 
 '■''™'>" '■"">■ "'^moi-.l M„,|i,„| school i„.i„. |„ ,|,„ ,,,|| ,|,„ i„„ 
 
 'IIK--I of ii6 I'.o.nder* 
 
 Or, |[ Imc. vv„. Ml-o r, f tho |,io,„.,.r ! „|,.,., „,■ ,|„, M„„,,,„,] 
 
 <;encr,i! Hospital i„i,l «n. co.ii,,.,,, ,1 „,tl, ,l„| ,,„|i|,„i„„ f,,,,,,, ],i , 
 
 ;""' >■'"'■ "" -'1'^"!' ■" i-'i". II.- "ill, ,.,■- f,„„„i,„i ,i,„ s ,,,; 
 
 lli.lorv So.ioiy of Mo„l,v„l. .,,,,1 „„. i|. |i,,,| p,.,„i,le,„. 
 
 •Mfiv.l S:,ll,ll,;,n,, wviliii^r „r ||,„ |I„|„„,.- |.„|,| j|,,|,,| I,, I,.., ^ ^^^,^^ 
 
 ii> f.illous:— "The nieilal »iis f,ni,i,l,.,| !„■ i|„ ]■•.,. '.y „; S|.,,||,,,,„. ,„ 
 IKill in honor of |h,. hito ncnn. PmlWsnr llol,,,,-, i,,;,,, „|„„„ j, „, n, 
 he ."aiil, that no man .n, r liv,rl mon^ ,o„,,„'ntion^lv ai„I r,.„ h',,,, ,]'„:,] 
 mop. holovd. It i,, ^ „,„,., ,,o,„.rvinK ,nul ).T«tof„l trihi,,,. to i!„. 
 ni|.m..ry „f ,lcpart«l worth, a.sociat,.,! as it i< with tl„. „„„ f ,„„ 
 
 V.h.. ll;,s the roiin.hr ..f Iho |i,M n.,.,lir;,l -,.hoo| i„ T, „;,!,, „„i „|„ 
 
 for nearly forty y.a,- r.-main,.,! in ,o„n,.,Ho„ th-nwilh" 
 
 llr, II, lines is saiil lo h;n,. heen a ,l,.tail...| an. I ...i,.,i,„i 
 Ih.m I, rilliant h.etiiri.|' an.l I,., w.,, „„ in,l.f.itio,l,l,. -m.l 
 
 ■ Tl... ,».q,i,.,„ „f ll..n,,l,lM„.s M.IhII „;,.,„, ,, „i„,,„,,,, , ,, 
 
 ..1..,..I,I1... ,.r,.r,,,l wi,1,i„„„, ,v ...., ,.„,„.„,„,„,. •„• 
 
 "',"'■'•"•'"'■""■ l""|."-."'f. ..I...'"! ,■....! ll,..a.h„ , ■|,.a,.„|,„,|„ 
 
 "Ml, ,,■,,.,„„,,,,,„, ,„,„,„-,.,„.,„,,„•,,„„,, , ,,,„,,,„,, I,, ^ 
 
 ..lltTliiftI HI..I anefiil for ,!,<> |,.o-,.,is,. j„,i',„|,.a ■■ 
 
 . rath, r 
 ■I'll.- 
 
Ull.'!-.' 
 
 
 I I,,. J 
 
 ■■■1 I ■- ' 
 
 irii^i!> -I Ih 
 
 .„>■] .1 «|.|r-|.nM<l 
 
 (.-in., «liH l^'fl I 
 
 nlii. Ii :-hll r.iriii 
 Naliinil \\\tlar\ 
 f.innr.l |«irl ..fill. 
 
 ..r 
 
 (lilt 
 
 I III. 
 
 nil' 
 
 I li.iu lii'in 
 ' iIm-: llii 
 
 I.I' lil^l. 
 ri'lli.ll-. 
 
 lllllil 
 
 lll.r.-l .Al.'llilll/ f.ir li.l I llii' -lil.Jiil nil nil! 
 
 II.. M.ltll^ 1.. Ill 
 
 iiiiirk |.|i.." Ill- ' 
 ,.,ll,.r|.,r. \.il- II lii.Miii-l. "I ■i.|Ml...:,'i«l 111 
 
 iiilii.il.li- li,|-l.,iniiiii iiliil mil. I'll. .11- 
 
 ilii!i..ltiilil |..irls i.l' III.' Il..ll.;illl Mil'.-ll 
 l.i.icly Cilli'.'! 1.111.1. Ill till' Ui'il|.lllll M 
 flrrtl iiii.li.iH 111' ivh il i- ii.-w 111... ..1 lIli" 
 I'liivir.ilv I liiiil II lif'lc ''.V 111.' I'll.' >ii- William l)iiwa..ii. 
 il lsi;-i, as t. 
 
 II.. »ii. 
 il K,'.,l.,;;i-I. 
 ..r iiiiiii r.iU 
 11, illl.l 111" 
 i'l'lllll 111.".' 
 
 Ik'sI piiru 
 
 new Muscim omtoiiu" n t'oneral fivlli'otion nf Znolnin', a (traonil 
 ,'..ll,.ili„ii or li.'..l..i,T iin.l l"iilii'c.nl..l"u'y. llii' //..(ui.V ('•.llr,-li;ii ■•< 
 a.niii CatmUan S- Foni'jn minniih. tlir llnhnia' lltrhannm. cmlninituj 
 s,mimn<s of lunrly all Ihr. flanls indi.inioiit !■' L««'r Canniln: the 
 I.n^.an .'..lli'.'lii.n "f I'Ml rliaratttri-titi riiinili.ni fossils an.l tli.' Tooiier 
 oolli'ction of 'i.iOO rnnadian insects." 
 
 In tilt' Didpnth Miismim liis miniralopical oollection is not presorvod 
 a» a wliolo, lull Iho spocimma iin. si-attorr.t.ilassifiod nmnnj; othors for 
 li-ailiin.r piirpi.si'S. All nrr n,ini.'l liovvcvcr "ILilm.-s' follootion" and 
 rarrj- llii' Ticinnl lalii'l. a small yollow paper L.^nriiiL' tin' cataloRlie 
 nimilior Dr. Holmes ^r„v.. tlieiii. wrilten tiy liim-.lf. .\ii eitremely 
 inten-stinj; catiilopmi for these speeimens lan In- seen in tlie Miisenm. 
 It is entirely in hia own writinir. It shows liis wide knowUvIpo of 
 iiiin.'nilof.'v ii'nil .lal.s the source iinil .late al wliiih Iho specimens were 
 ohtained. 
 
 The herli.iii-un here is almost iiior.. intero-tinj; to ns. for, from a 
 cAtnlopie eilitetl hy Professor .TamM Hnmst.in in 18.'>t, hut made out 
 hy Professor Holmes himself, fh<> specimens "'1 are seen to Ik- from the 
 immediate vicinity of Montreal, collect.'d ft. .ii 1R91 to IRS.- and reprc- 
 sinting in over .'lOn specimens almost the .ntire Horn of this district 
 This collection is not seattered ani'.njr .ithers hi,, is preserved intact as 
 111.. 7f.i/i,o'.s' llnhir'nim. 
 
 Pr. ITcdmes ^'radiiatcil from the TTnivrrsity of Kdinhurirh, in ISIO 
 and the tti'e hefore us was reported hetore the K.linhurBli JTcdico- 
 fliinirfticnl Society in 1S23, wlion he was a yonn? man of 5(1 and 
 hefore he could have hcen four years in practice. Knowinjj his fiituri. 
 it is verv' interestinp to read this, which was prohahly his first paper 
 nf im|i..rtance. On this ground I tnist that the aliove apparent 
 
UifrHwiun from tlu' |»i(h,.l,inkiil -imhuu'H r.iniiiii); l u- .iil,j,, i „t tli,. 
 |>u|Kr. will l„. luriiu.n.l. 
 
 Tliia - iiii-ii liad .1mi«1 ii|i„ii il„. »hi-Ki'« ,.r lli.^ IV,li,.l,.„-i, ,il Mii- 
 M'lwu 1,1, ,iij- j,.ar, xiiliuut ii n-fi'iviic' an,i il. nil.T,-iiM-- lii-iuij 
 
 M,-rii,il 1,, i.avf |,a,,..,l l,,v„.,il 1 ,• k. ii „f ll,„ , •■,■ i «,,aniM..i.. |lr. 
 
 llsl.T, li.mi-viT, in reply I., an iimiumv ..n lliv «!.'■ «liilv.| tlial lie 
 
 roiiHiiilKTi'd il |uin-,tly, Imviiii- •■ u II il.'iii.iii.irali'il il, iitiil diuc 1..I iiiu 
 
 I" till' Kilinburgli Jlu.l.ial .l..i|.,iai |,| „1|„.|, |„. ,„|,| ,, |„„| i,^,,,,, 
 
 jv|i,irli.a liy Ur. Ilolmt's. 
 
 I laku 111 lilivrlj ..I iv|iiilili,l,ii,(; III-, ll,,li,n.,- urllrlr ill l„t,., I.ntll 
 li'x.111,1. Ill Itself it i,ri.-.-iiil» iiiuny |iomiI- -.r mlir.M l„ ii. .,i in,.,l,rii 
 lilii-s Mini lie. aiw It IS .1, cla.-r-inlUj urilti'li llial .<arrvK a u.ir.l i-aii 1„- 
 I'liiillr.l «illi,,ut Icjss. 
 
 CASK OF MAI.I'OUM.VrillN (IK •j|IK IIKAIM'.* 
 
 V. I'-. il..i.aK>. M.ll., M.irilni.l. K.inm i riii.jula. 
 
 ''^ mii'al.-l II. i; ■ .Mf.li.on.lniitfi.al s...i.'ij ,,r K.liiiljuiKli. Iij lli. Alimjii. 
 
 -Miiriti .'nil. Ifiat. 
 Tliu lolluviiug cast of .•ualluruialion ..f llic Uearl, is, 1 btlitvc uuiiiue, 
 IK fur as llif ainijaruiRfs fxlfinl, tlwujjli snural, in wliitli similar 
 I'lrects on the uiiTulutlon must liavf kin iiroiiuocd, aro to lio limini 
 rreorik'J. Jlanj of llio casis uolloili.l liy Dr. Karri' in liis K.saj- on 
 Malformations of llif lluirt, rusomljk. iliis m u,k. „r i„„iv |„„iii.,ilars, 
 liut no „no i.vadly. Tlioujfli, from llii' ixislinoc of all tlio parts llial 
 arc found in tin- notural stiito, il niiniit lie elassid anionj; eases of iin- 
 perfeet doiilile lieurl, yet it may perhaps Se mure torreelly eonsiil. red 
 intermediate Ijetween them and lliose ol sinj;! ' heart, as from the rela- 
 tions and small ea|i.ieity of the right ventricle, i' eali be looked upon 
 only as the comnieneement of the pulmon.iry irtery. The elVeets on 
 the eonsliliition of the hlood wonld endeiitlv be 111,' siime as if only 
 one aiiriile and ventricle existed. 
 
 Isaac .\., al. ■.";. of a clc-licalc habit, had been aireelcd from infancy 
 Willi ,1 p.iipitalion nt llic heart, atteiiilcd by a peculiar bliu-ncss of the 
 diccl.s and lips, more rminrkalile al one time than another, The 
 palpilalioii vas inneh incrc:. ■', hy ,|uick motion. ,iii,l sniijcci to .iL'-ra- 
 i.iCon after any irrej;nlarity. which a turn for dissipation frcniciilly 
 liicsenlid. Ai these times the ilillicully of respiration was L'l-eat. and 
 altcichd by pain in the region of the heart. Kor a few years past he 
 had ha d a more sever e attack every winter, apparently origiiialiiif! in 
 Itepuliiislmd from tliB Tiaiis. .Medieo.fhlr. SiR-iety of KilliiiiiirKli, 1K». 
 
,„,,„,„., .-Hi I ,.ii.l«...|.li.i. lil'i I 
 
 i.un... ,,„h, ..-I .nil. I- '■'- '"■■■•'- ■; ;' 
 
 ,v(, i..,ii>,ii I" -" '■'•' ' "' ;' 
 
 ,, ^,. rilMl »l.l, mil. I IH- .<.■!..: ■■ .■.1.1,1. M,,. I .■.. II..' 
 
 I III, „| .1,, V l.v >..|., I,,./. V.I llli""."' I"l- "•'■"h -I '"""■. 
 
 ..iv.ilU „„.,.l>'..i..l ..|.|.r.-...>. .."'I M..1'"' I ' "'""" II'" I"'"'"-'!'"- 
 
 M,. „:,. , Mr I., I,.. ,A..Tl I" I"'-""'"- "" '"• ^' '"'■'"""- '" 
 
 ll„. I,.|| -i.l... Ariv .ilt,.|..|.l 1.. 1 1.1- n-l'l •"!■■ "''" '""""'I ''> '' 
 
 .,,,...,,1 |,,„ii.iM.! '.iir...,,i...M, .>i.i.ii ..i.i.^..i i.'iii i.i'i -'■ '"- I'"-'""'- 
 
 I'nI. umI.iI.u ... Mi.,iinii.- ..1. li..> n--l.l -I'l'' "■'- [•>■-"< .■>'" '" ^'' ■•■'*'■ 
 .,,,.1 if. I.v ,1.'. 1.1. Ml. !..■ Iiini.'.l .li.riii^ .I.. |.. !.•■ »i- .".il-. "'"I l'.> " "'■■ 
 
 |..ii". 
 
 T,. r h,,,. 111., m-.ii.i ..f III.' -,Mii|.M 
 l|„. 1 nil. On 111.- r.lli ,111.1 If-'li 11 I'll- 
 
 «,i, iil.-liu.-i.-.l 
 
 ■'I'l'l 
 
 In n.M. ;li.' 
 
 ,l„,l 1,. 111.' .4,. -I .111.1 
 
 „l, „,.,.., 11, ,.,1, .1.111.111.1.1 ».lll ■■ -."1.1 lllll-l'.'-l' '-• «.l.-.-l..l.l->..i 
 
 „illi I. Ill irilliiic I'.'li.'l. ■!■ ii^'"" 1'."'^ '' '■'"■'■"' ■""' ■"" ■ 
 
 ,:i,luii,., »..n ,i-..,l, Tli.M. 1- .11.- ".'I.' •■•"" I llir.ii::l>..i" ll- 
 
 .li-.U-l'. 
 
 I'liriM' il- ...iiliiiii.iii.'.- 11 iii.'i.' I'l'iii '""" "I'l" 
 
 ,,.,h..iil t.ui"^' "I'l"''!'- '''•'■!'■ •""' '""'- "'"■ "■'"" I'""' ""■' "'" 
 
 p,ll|.iljl,nll 1..-, ami..vill-. Tl:.. I.'i.sm' '•■""«•■ "•'">■ '■"! ■'-'■"" '■""■' 
 l,.»,ii-,i- ill.- .1..-.; V.II..VM1..-,- ..( ll... .-v.- .i".i "l^iii. .'".I l">-'l' '■"!"'■'■'' 
 HI, I,,.. „,.|,. 11... I.. ..r I.- |.,v-,iil ,l„ni,- llii. |,i..(.-n- ..1 ll... .-iMiliiiiil 
 
 S..TII,! |,„i.. I...I..I-. 1.1- il.mli. Ihi' I'.'.t lii'^'iiii 1" '»-,.|l. II .i.11,.1 111- 
 
 ,r.«»i..l ;..r,i.l.MlK. 1111. 1 » 1- -...." full. .mil liv tlmUM'i"" i" H"' .i'"' "■ 
 
 ,111,1 ,lVi-i..ii 111' 111.. ..:...-'. 'I'll.' |.r.',-,'ii.'.. "< III". I '" til" |.. ri.'.inliiiiii 
 
 „,i. ..ii.!.,.,'l,'.l ri,.|.i (1... |..in..i.l l.,.,i.:-- ...i-y .V «li'l" 111. luii'i^ l'..i«.inl. 
 
 ., ,i,„| „ ulii.-h ..„i'..i ;i l.'W .l.iv- I..!'.)'.. .I.'iilli. I.iil l'..'."ii" 1— 
 
 |,|...M,i,„„l .,li,r»,ii.U. Al 111.. - ,' tiiii.' .1 |..'. uli.ir s..iiii.i »',i- ...',',1- 
 
 -hliiillv lu'iH'l. |„irli,',il.,llv «l,.'li 111.' i.ir iv„- I, 111. I,, t., ;i|.|il....l.li lii- 
 l.r.',iH.'HM.iliir I., li.i.t |.n..hi.'..,l l.y l.iiM.I.'S ..f iiir ..iili-niij; ii I...I1I. full 
 
 .,!■ Mi.l,.|' ,ml li,'.|,i.'lil iii,'lili.,li..ii I., -.vii. '.:..'. ..Ill lily ill. I I l.y 
 
 ,111. iii| !- |i, 11...V., -ii|.,.rv..ii,.,l. 
 
 •I'll,, ;,,i|,, |„.,,l,,,l„liiy ..r I.. Ill- ..f -..nii'i'. .'.Hiliii.'.l Ih.. l.rai'lii.i. ill 
 
 ll;,. lull,,,. ;,;i,.I ..I' ll... tr,.,, 1,11, 111 I., -lilllliLillN 1111,1 ,1111. Kil..-, ,.X,.,'|i! 
 ll,.,l. ill ,„|,H,|,;, 111',. ..f .'iiliir^,'lll,.|,t ,.f 111. In.i- lii'lU'-' p. i'.'..i>'.'.l. -"!.- 
 
 iiiiriiil,, „f r, iiv uiis , .nj,.iii...l N" ,-|..',Ui.' .■ll'...! f..ll..«..l il- 
 
 ..vliil.ilii.ll. i.ill il ii|i|...iin..l ii-.'l'ill l.y ii.'li"^' ..11 111.. l...»-.'l-, 'I'll!" 
 
 .1,1V. |.i'i.vi..lls I.. Ill,' liTui iiiiti.'li i.r 111., .'ll-,'- ,..i'-li i-iiii "- iill.'ii.l."! 
 
 I.v'i.\|.,','li.rnti..ii ,.f 11111,11*. ;,l li,'-l i„iv.'l »illi l.l."'.l- 
 
 liii ih,. sti, ,.f |.',.l,ni,ii.v. ll, »,i- ,vi,l,.iilly siiiliiiL'; lli.' ]i,il|iiliili..ii 
 ,,|,.l,,, I. ,,.uiil..i,.,iii,. i.'.y .iini.,11- ,111.1 iiiiiul il,.l,r,.s-„.,l, iiiiu'li "Mlir.'- 
 
f-|iiMn..ii -liMii, 
 
 Mm. I,.. I .,,.!> 1,1^1 i„. 
 
 ■I'llr |,.||., IIm.MIkI,., 
 
 I ^ ttil.iniillin^. (i 
 
 liii'llMti ,>i 111, -irt. n. 
 
 .,.|Mi,t, ..I 1 
 ml;,' 
 
 lll.l.l-. 
 
 lull .IK. I l> 
 "lIlT - 
 
 IIIU III. IllU.ll. h. 
 
 J. riuMlli ..11 I 
 
 I.IlM^. f..l|..». '. 
 «.l- I.".||lir I. Ill 
 
 ll,.' II I. iM'i 
 
 ::ill.ll. - 
 
 mill.... 
 
 :lll \l III. 
 
 " Il.l.lll.i... ..Ill 
 
 ll «,i. .,l....u..l. 
 -Wl.lll I- ..nil 
 
 .ll l.lll.. - III III.. 
 
 U-k-lliliillj; III III.. .Ii.,,ii|, r III,. ,,i,|., „„, ,1 ih, „,.,, 
 ...-lllllli.il .11. Ulll, I,, III ,.M, „.., I.,, .,....|-.l| .1,1. 
 
 lli.il ilii' .in. mil .lil.il.in..i., ..,.,, ... ,.i.i..ii.i' II. 
 ll iiiiii.li.iii ..I III.. 1 1. Ill, l.iii, |. I, .1.11 , ., 
 
 IMIl'l-Mll "I lIl.iM. ..f til,. .l|.t,.|J .Mill. .1.1 uiy l..lll,lllU, 
 
 \ ri'iiiiirkulil,. I iniiiiihl III,,, ml, ii.lin;; ih,. ,,|.,. ..,,, il,,. ,,|,] 
 
 imiMll,.',-, II,.,-. I'll 111,. ;(|,t ,\,.|-y >\ iii|,l..iii ..,,- i-..'!;!., i|. ,|. r,. ,.|rii- 
 .-i..ii t'liiiiiiii.' ).T,iiini|.uii,l lli.i iiiin.il lull,. |.i..l.,il.ilii. .,| III, -1,...,. 
 
 in^- iiijiiy lioiir*. T.i ..iii- ,.iir|.n-,.. Ii,iii,.\,r. h,- lir-i h,. .. i. ,.,ii- 
 
 ■ i.l.i ilil.v ].,.|i,.vi,l. iiiiij ...||t|||||,.|| l.i i|ii|.r..i,; 111. „..i, 1,1,1 iiiiii ..i.lliii.,, 
 ..[ III.. iil..li.ir 11 liciiiii,. .1.111, .11, in, nil, I r..| ilii,.,. ,ir r,,iir .l,i.. ili.r,. 
 .iliprarcil 11 |.r.i.|i..il „t 111, r.i.i\,T,v, Tlii< |,n,\,.il r.illin i.,ih; ih. iiriii,. 
 iH-aiiiR. .-i.nnl\ iiml tiijili i.„|„r,.,|; il,,, i|,i(;li», imii., ,in,I li'lt nim ,i..||.|iiii. 
 tiiin mill iiis iili,li,iii|.n Larp.r, 11,. -iilTi.rul I,.- li.,wi.\,r. tli.m ul ih,. 
 I'limimncfmeiit. 
 
 Til.. Iii.ily » xiiiiiinnl ill 111,. |ir,..,.ii,.,. .,f ,i ,\i.|i,,Mi. ril.liv. II, 
 
 .mil l(iil,|.|-t.,iii. III., im, fi,n,i,.r ,,f „|„,,ii iii|,.,i,|,,,| ,]„. ,,;i„, ..nl, m,. 
 
 Skitiii imumih-:- In ,.M,„ii,iiii^. ||i,, |„„|v ,Al,.rii;illi. ili,. I...i..r 
 rvln-iiiilii... p.irl, i.| p.ni.nili„n, .mil li.n,|. |.,iii .,f ih,. :,lii|.,i,i..|i .,■,. 
 
 .iiiisiiiirnlilv .w,.||,.il fri.Tii ,.irii..i,.ii im., th,. nlliilnr iiniiilii.; , In 
 
 .iliminn III,, iihilniiiiniil iiivily Ihiiil .,1' an onin^-,. c.il.ir win cill . il. 
 .iiiiiiiilililij; ti. n,.|irly u ,|iiarl. Tlii. liviT |iri.wnl,.il ilM.|f mlarciil ami 
 lianK'ni'il. 'I'lir liar,lni..» una ^r,.Tit.ral. anil ,.\l,.nil,',l llir..ii-li i|. .iil,- 
 .tanri'. ivliirli, wlun iilt int... .i|,|.|.ari.<l iii..llli.il nilli v,l|.,.vi.|i ;|.i.. I,. 
 'rilo |iyl,irii. ONlri'liiity ..f lii.. .Miiiai li ..a- Imv. r lliaii ii.iial .\ l.-w 
 ■if llii- j:lanili. at tli,. nmt „r lit,. iiii..|.|il,.ry |.tiliir);,.|l ami l,,if.l; u|.. -Itii. - 
 liiiillli.v. Until ..iil,.s of till, tlinrav i-iinlaiii,il lliiiil, Imt ti.it t.. a lir.... 
 Hit. .mil. Till. liiTiianiilllii ,.|.|ii|,i,.,l aliiui.t iiilinli- llii. I, I'l ..iiily. lhi. 
 liiiiL- 111. ill;; |.r....i.,l ml, I th.. i,,,,,,.,- ami I, i, k |,,iil^; ih,..- i.-, r.. I,, alil.y 
 . vri.|il 111 i..,ntaiiiiiiL' tliii'l . irii-nl 111 ihiir .iil,.|aiii ... r|.,.ii -lilliii..- ii|, 
 ihi- iiiTiuirilluiii. ulii.li ...iilaimil fr.i.ii :i L. I niiiii... ..f -,.riini. Hi. 
 Iiiart ,ani,. intn vi...-. L-rmTally , iilai-L-. .1. [.afii, iila ly l!i,. ndit aiiri.l... 
 III., .iiii' iif iiliiili was iiiiria.,.,1 t.i Hi,. ra|ia,.ily ..i ;■ pint. 
 
 H'lii.n ,.|ii.ni.il anil |.|i.ar,.|l i,f tli,. I.I..1.1I wiHi wi.i.li il w.i. filli.l tlir 
 inii.,.|ilii. piTtinatir appoaml ri'iiiarkatily .tnniL:, Tli.. iiil,ri..r n.ii-h 
 ..ml h.iril. appanntly fnnii larlliy ilcpiwitinn. ami ..■iviiiu a iTilly f. il 
 ..Inn 111,, kiiil'i. was passed over it. The foramen .ivalu was pi.iviniis, 
 
 I 
 
I 
 
 ,„ ,,„„ ,,,„ilv ll,. liiuH f .r^ill"'! ■>' 111'' liltN' liii;-"'-. 'I'll" 
 
 !„.,„i «;." lliciw.lfiHil. ami 111'' '"1""" ."iitnnii'il .l"»ii ml" Hir \ni- 
 ;,i,.|c. In ."Ills l"iv ■""! II" i'^' »'■"' ■iiiii'l^'''l "■''!' y'l"" "I"'!'- ''"' 
 ,„r|iUMulii M"^^•;lpIl■ .iiul 1«" "f Hui mtiriiluiiai- valve- w.mv iv.l ami 
 iiurvas.'.l ill -i'". 'I'll'' piifii'tM of the luft vmtrii'l.- iv.Ti- lliiiin.-r lliiin 
 ii-iial. ana llii' lavil.v inii'li larpT than naUii'al, I'a-'iii;; Ih" li«S'-' 
 into uhal a|i|..aiT,l ll; "pi-liiu); U-Hve.-ii this vulilrii'h- aii.l Ih" Ivl'l 
 :ii,rul,.. it |«i-.i,l hy a laiV" "|i"iiiiif.- int" th" rif-'I't aurii'lr; aii.l it «as 
 ihcii l.iiiiiil that Ihrrc was no i-"nimiiiiirali(in hi'lvvoi-n tli" ri,s;lil aiin.l" 
 :,m\ Irfl vHilru'l". Th" rip-lit vciilri.-l" was niiuli h-s than natural. 
 'I'lif |HiliM"iiaiy artery, "f its natural size, jiassi'il rrom its iippcr oinl ; 
 ih,. hhinil ha.l f"iiiul inprc'ss into this vontridi- fnnn tl"' l"ft vcnlrii'l" 
 thr.iiiph an op.aiinj.' with tiTOliinms margins, just Ik.Iow the semilunar 
 vah.r.if 111 a"rta. Its size aliout half an inch liy Ihree-f.iiirlhs of an 
 inch. The |>rael,.niatiiral orifice l»tvvecn the right aiiriele ami lefl 
 velitriele was larpe. and fiirnishcil with valves similar tn the trieiispicl. 
 Part of these were thiekoned and of a eartilaginmis hardness. At the 
 hase o( one of the division?, there was a tumour of the size of a bean. 
 Cintainin;: a tlii. ki-h yidlow matter. The left auricle wa.s partly conceal, d 
 l.v the eoliininie eamea-. and their tendinous terminations affixed to tie 
 valves just mentiooed, and was a little enlarced hut natural, as were 
 the veiiip flowing into it. 
 
 The cniirse of the I'irciilation in this eurimis ca.=o must have heen as 
 follnws:— The hhiod entering the right auricle liy the two eavie, jias.sed 
 almost entirely into the left ventriele, a small portion proliahly finding 
 its way into the left auricle, A ,«irt of the hlood would pass during 
 the diastole of the ventricles from the left into the right ventricle, and 
 lie propdled through the lungs, to lie returned into the left auricle. 
 The hhiod it-self would constantly remain in a state very little oxygen- 
 ated, as the portii.n returning from the lungs would he mixed with .he 
 rcturred venous part, hcforo heing propelled into the aorta. 
 
 'i'he accompanying sketch (I'late 1) may serve to explain the appi'ar- 
 anccs: — 
 
 (it) The rier'Ciinlium held up hy pins, 
 
 [h) I'art "f internal surface of aorta ivitli orilice of one of the coro. 
 
 nary arteries . 
 I, 1 The left auricle. 
 (,/) The left ventricle. cros.=ed hy a prohe placed under the eoliimna' 
 
 carneiv and eonlje tendineie. 
 (c) ,\ part of the right ventricle, with the sides separated liy a pice 
 of »lialehonc. 
 
(/') 'I'll.- roiiiuiniiif; |iiirl .if lli,' nf;lit viiiin.l... -I',, thi, |„i,.|„,„ ||„, 
 
 I'lil" 'iij ai-ln-y iviiiamcj lUlutlifd. 
 
 (y) A |in.l„. |,,,,-s,,i i|,n,Mf.-l, ll„: „val u|.,.i,„ik U-U;vn il„. iw., 
 
 vi'iurii'lcp, 
 I//1 'i'hi' iBisNint I'nijii ilii- \,-<i viiilritic iiilci lluj ri-lil auricle wliidi 
 
 lias as larjir as ll,,. 1,11 aiin.ular i.rili.c. 
 It) 'I'lu' pani-li,, uf lli,^ Ufl vi'iuricK-. 
 
 nlaliv,.|y 
 
 ' [latit'iils 
 
 I'lUricu- 
 
 Iii llie cliiiHal hi.Morv givtn iiitiTi-liii;; |minls aro,— lli, 
 
 'liglil ivaiiciHs lliat s,.,.,MS to liiiv,. cxisto.!;. il is s|mlicll uf , „ 
 
 lii'.-iiliar l.]iR.ru-ss of tlic c-liooks an.l li|,s, moru rcnarkal.!,- al ..'u,. liiiiu 
 liiaii aimlli,.,;- ami llii. fact that tlif iwUcrit attained tli« uj;i. of a2 
 
 viNirs 111 fairly j: 1 In-alih and witli aiiparfntl.v activL' lialiits. I tind 
 
 liowcviT a fair nuiiditT of casfs rufonlud ,if cor triloculari' wli, 
 liave lived lo a fairly advanced a"e. 
 
 Professor Kwaid -f li.rlin' gives a case of cor Iriloeiilarc l.i 
 lare where tlie [laticnt died at the age of 48 years. 
 
 Max Mann= frfves a case of cor triloculare liialnnlum dvinj; at a8 
 years from a glioma of the brain, a qnilc independent alTeclion. 
 
 In tills report it is also very interesting to compare the keen ol.serva- 
 tion ivhieh Dr. Ifolmes liroiight t,> licar on nil the det.lils of his ca.sc 
 (noting fhict nation, signs, of cflusion. pnlse, hnhbling in the chest, etc.), 
 his chwc connotation of the .se()nenee of events, his skill,,,! p„s| miirleiii 
 l.vhni,|iie, with an entire absence of those melbods of physical examina- 
 tion which it would seem to ns in the light of our pr.'sent'day knowh-dg., 
 almost must suggest themselves lo one who was studying bis ease so 
 'los.ly. Hut in matters even of the purest observation snggestion 
 sci'ms mvded to leail the way. In this cimneetion Dr. Holmes' ,iwn 
 words, spoken some 2,i years later, in his VaMirhn, aihhr., h Ihi- 
 ■<l«,hul> of lU medical faniHij of MrCill Unherxih, in inr,\. are very 
 striking. He says:— It is rnther humiliating to look hack into the 
 history of m, . Heine and to see the neglect ,if great discoveries and fre- 
 quently the opposition to the intrclnetion of great improvements. The 
 ease of Tnoculntion and more recently of Vaccination, mav serve to show 
 the one and the long neglect of Peren,ssi,in as a means of diagiui-is of 
 diseases of (he heart, the other. It was about Ih,' niiihlle of last ,-,,ii- 
 turv (hat ,\uenbnigger published his ini|iortan( disi-overy ami .it was not 
 till it was ri-comniended by CorvLsart many vears ;ifli,r tli,, pri'senl had 
 commenced (in Liins) that its value hecanie gencrallv known 
 
 .T 4,a 
 
 ' (tlTl ('till. \V,„ll. i>ntn 
 /ioKl. neUvaK. t',(. V[., 
 
 nly finally allii,!,, („ (be , 
 
 xxxv. c, \im. 
 
 ast improviuieni inlr,iduci-d 
 
'!r!'rr".>-n'l"'lhc Firml. A,a,lr,M> ^iinl ,1 i- miiuIi I.- -i.i.- I"- 
 |,„,,l,, nf ..n-ulK.!,,.,, l„.,.;nM. ,v„rnM, l.,k. ■. ""I'l-^'" ' " 
 
 ,|:.,|,,„.„„.,l I „, ,„.!> ..K-..,ck. .- , whul. „.-h.,v-«.,h.,nnlh;'. 
 
 „|,J.l „. |,.,r.u„, ,1.,- 1..I.".' ..—0 '-■ -I'"-- '■ ""'-" '" ■'" 
 
 ■rill' imnl .!> it ..|.|«-ii'> l< 
 
 ,1, i„-,la.v ..- .1 l].l.-r..i.. .-|«(ili..'.i 1. .'.*.■. .1- 
 
 An ...iul. h>..H-t ..( i..." H.,v !..■ l..t tl.e I...-. .,i,.l ...,,.,..1., . 
 
 ,h,.,-„.r ll..,J. ...rniial 1T...U the ,uiri<.ul.,r-v.„l.-ic-„l,u- ki-oovv ,l.,«-,»vanL 
 'l-l,,. ,,,,x .. M„nt ;....l ruumk-l: llu' auri<:l.'S h.iv. I»ii opoi.e.! n, tl,. 
 „.„„| „av an.l sl„.sv „„ an-mali.. of th.. .Mt.rin,- voin- li. n.H, 
 al.ri.k. i; larplv .lil.ttnl and ...m.wl.al l,v,.cr.n.|.l.u..l a„.l tl,.;iv .- .. 
 slit-liko op™.ug ..!• the f..ran...t ovale. Tl..- ve„lr.e.,h.r ,....• u^.n hu- 
 !«.„ ,,,ene,l l.v an ...ei,.o„ ..., .is a.il.r.nr -u.'r.tee .l.n.u;.* he ....... 
 
 , '"rl ; . ..,v,.,|. .( I .I-.'., in. II. IV eiivitv eee.lj.vl.l;; the wle.le 
 
 1.) the apex. Ihi? iv\eal. ,l ...;.. '"""•> . .'■..,,, ,., 
 
 ,„f,rior ..art ..t the l.eai-l a.1.1 .. .^i.iall tnaL^.h..' eav.ty ..t....te,l al th. 
 
 ,.i..h. er a.iel,. ,.r .h,. lai-er .■avi.v an.l in front ..I the .....la. 
 
 Tl...h,W--..v,»h.,.h....an,.,lhv,..-.ir..l,..e.-theh.^v,...ne:e 
 
 has font. o,..mn,-. 1 1 1 .h.^ in. ..-l-l- .--..';".--;"^ »''•'';' ','f;' 
 a,„.i,.|,, pm,*,i l.v ,l.,...-.....-|.i.l valve ,an,l,h.-,.n.e.M. P I1..1.. - 
 
 a..,,u.pre,,.™....'al...-..u.h..w.e.,.l...|.f. v.n.nel. an.l,-.j..l. ,.n..el... 
 
 ,„r„ishe,l.i.hvalv..-.ie..hu-,.. ll.el,u.,-,,..l. , II 1 he n..,ral .:..,- 
 ,„„„i,.a,in, uilh .1..- l.'ll .H.riele .,.,.1 f><^nM hy the n.itral valve. ,., 
 The „..rta «l...l. li-'. h.^hin.! an.l p..sleri..rly m Ih" ...e.l..... ...,•. It 
 
 i.. „ern..,l in .li.ve.i.... .,n.l p..-i.ie.. h..! ■'< 'lis-'l'<l.v .l..n..>is"v. ...Lhre. 
 
 ,„ A.lia,.e.n,l.hape,lor.Hi...'»i.l. ..n.l.n...,- e.l,. s. ,...1 valv..h,,' .n 
 
 ,,,,,„,„.,.. j,,., I,el..v> ..n.l ... ih.' rij-'i.t '.I' ll." ■■'"'"■■ '•>l>'- '/''""■' 
 
 ,|„. ln.„spi.l. ul.i.h h.eU i..... ll..' H...I1.'.' ..■i.....^'.ll..f e.tv.ly s.l....l.>.l 
 
 a, ,l,e n.l.l upp.T a.... n...- ..",le ..f He' h.^i.-t. 
 
 ■PI,, ,.nK -i.-n in th.. la,',.',' .■l......l.e.- ..f .... .nl..n.i,l n.'.ila.' s.^pl...... 
 
 -,.pa^.,in;.h,^.■n..... 1. the ...■..■.•i..l h.-'L - " s,„.n .,n,.r,,l.,r 
 
 nl,.i ;- // .."■■■ "/./"'• ;-"■' "/■ "- /'•'■'"■'"'■ 7'" :'"';'' '"■"■';"'' 
 
 r„rwar.l l.^>. th;." I...lf .." i.'eh l..>.«.vn .1.,' tii.nsp..l a.,.1 nnlral .alv.- 
 u-hi.'h lie .... .ilhi-l- si.le "f it. 
 
 ■phi' walls ..r thi- v,.|...-iel,- ar.' .ih"... h.ilf m. ."'■'. I''"'' 
 papillarv n,...el..s a.vv, y .tn.n.. ,.sp..e.allv ..n th.- \.U s..l,.. 
 
 !pl,„ „„a||„.i..n,..l...- eav.ty ,.,..a„'.l..l...vea...l I.. lh..-.,h,.s,..,ll..l 
 
 1.1 th 
 
i) 
 
 l.y \h-. il(jlnii'.s -ilu' n^iil wiiliifir :' it \v.i. uv,, o[irT!Mi;:>; (I) it ^iv.'s 
 I'll llir |iiiliiii'iiiir;v .ifiii'v, (■.'! an>l u i-niiiriiiiiinaU'' wii' ihc 1,11 v,ii 
 
 ini-l, l.V ihr i1liI1|..ii,| ,liil|,t,l uj,,' g Wlli.'ll llil. l,r,.|| ,l,-,' I 1 1 ., ,| ;, l,n, ,.. 
 
 'I 111' tun .,i\ili[s iiiv -ciLirauil 111,111 ,a,li ,,ili,r Ijv ;i iiiUMiilar m'iiiiimi 
 .,\i-r a ,iaarur ,,f an null llink. ulia'li i- li,ar„iMl,M l,y 111,' ,liuiii,,ii.l- 
 .-!lill„al ,,[„aiill;; a! 11,^ llllui- fll,l. 
 
 'I'll,' imhuuinn-if adn-'j ,,< ,</ ^"„-/ .sec aii.l .-^lii^lilly larL'.T lliaii tli' 
 aiiila in tr,,iil ,,1 \ilii,li it rr,i^-i- rmtii fi,i;lii I,. 1,>1| ; it .«/,„„. ,i„ .siy/i 
 './■ Jlsmse. 
 
 At lii-sL ,^igiu tills jiiiiillor cavity apjioars like a i„iui;li iu llit' wall ol' 
 111,- uiiiaiLlf, -ir Ur' CUUU.S ai-uri,,sii.-, i,f lliu jmliiiuiiary arUTy cut ,<ll 
 in, 111 111,; right Mi: ui tlic main liinK ,>( llw o,jijmiuii vuutriclL'. Ami 
 I hi' am.malv In-iuii- ii, nufjlu l,i. r,,ii.-iikT.d 1,1 !«■ lw„-lul,l: - |li a l,itiil 
 ,1, 'It'll ,,l ih,, iiitt'r\,nli'l,iilai' .-t'jiliiiii j,i',,iliR'ilij., a cT iiialriiiiii nil, ,,11- 
 lan', a I'ail'ly cumiuuii ,',,iig,'i:iial ainmiaJy. ^■.') A siii„i'tiuiii,'raiy v,ii- 
 lii.li'. |,n„lili',',l 1,_\ thi' , iitliiii; ,,11 ,,l 111,' c.liii- iiiU'ti,,-ll- ,,]■ til,' |,lll|ii,,- 
 ii,iiy artL-ry l,y an .iii,,iiiiili,ii'i .-i'|)iiiiii siicli as wa-, d,'>cril)i,'tl i»y l>r. 
 .''^li^jilR'U .Macki'uzit; in sjjLMkim; <il a h,.'ai'l witli llirtie voiuriclcs as 
 ■■'\ii i'.\ag{;i'nili,,u ,,1' lliu f,,|,!s ,,( tln' mus.iulaf eiiluiiiiis l,i wliii'li iIr' 
 Iruusjiid Villvus are atlatlied."* 
 
 (■|,ii.-i,l,'i'iiig the iiiall.r, huui'H'i', h',,111 au i'mlji'y,jl,j,;i,'al slaii,l|„.im 
 a siuiiilir cvplanaliun ol tliu fuels --,'em- 1,, siiii the ease lietlei'. It 
 is ,111,' uhieli seems 10 liaie su^-gesU'd il-ilf l,. llr. ll„liiies als.i, Jinlgiiig 
 l,y his iH.meiielalure. I'or lie tails the large' eiiamlier re," ving v,-m,iis 
 
 ,iiid arterial IjltMjil I'rniii l),>lli aiirieh's. the /,■/'/ tan, I ,n„l .1 e 111,111 
 
 1,'iilriele) ajid tile small chaiiilier, giving ult ih,' luiliiimiary ami iiaviiig 
 
 I'" ' lllllieatieli Willi tile ami, 1,'s. the ri.jlil (aii,l m,i a Slip,'l1iliiiier- 
 
 ary) \,'iiirieh'. 
 
 The interventrieular s,'|,iiini it will lie r,'iii,'iiilK'n',l is .1,'v,I,,|k',I in 
 ,arly heial life fniiii llir,',- .lin, li„iis. Ill,' sry,(,„i, iufrrlitx. wliieii grews 
 iiji Inmi the i>,>sti'ri,ir wail near tlie apex; the «■/,(„», inlermnlium, 
 wiiii'ii is a iirohmgatiim downward anil I'erwunl ,if the inhrnurinilar 
 '■■/■linn; and the sriilum .yiijirrhis. a e,,iitinnali,,ii dewiiwanl ,,f tlie 
 a,,rti,' septum, wliieh ferming within ih,' a,,nie hull, has ,livi,l,',l lit,, 
 luirla fnim the pulnnraary artery. The septa lliiis ,l,,ri\,',l friaii hnhiw. 
 ai.ev,' and piisteriorly. unite tn f,,rm tlie itilei'v,'nn'inilar sepliim net 
 far frnm its upper h..i-,l, r. The |„,int ,,f ,ini„n n-niiiiii- tlie w,.ak, st 
 I'art of this se|itnm thronglioiit life and is hnorni in tlu' a, lull luiirt 
 as tile /ifiri virrnhnimifcii or 'Utmlefeiukil Sfi/iri'." 
 
 Tn ,Hir speeimi'n Ih.' <ier/iV .ir/./inii lia.s fully ,1evi.l,,i>i.,l. the aorta an,l 
 ■ Trans. I'litli, .s,„'> . „( I,,,,,,],,,,. V„l. :tl. 
 
urmiil rc'liilitHi,-. ami [HTl't'Llly 
 
 Im'd. Tilt 
 ' iiuhiu'iiar 
 
 .iiilu Is UKirix 
 
 (T sliul ull Infill til 
 
 ■y ii) II luily deVL'lnpLi 
 
 kIiiiiii is iililKilx'liU; 
 iLiiii,' liTwaril iiilo 
 
 ii|ir 
 
 .till I'll li\' liii 
 
 111! 
 
 <MI pi- 
 
 utririi' iiL-Lwciii tliii luitrul liiiil Lriiiis|>id 
 
 Ia'I 11^ su;iiiusL' 
 
 that ; 
 
 •O' 
 
 early pcriuil ul' iiijtal iitV* tiw ii</rli<' 
 
 ,.■.■;./;(,/, liiul liein cuuiimiull .i.i«liwai-ds I'llillT to lUl-^l tiiu .irlilllm illfe 
 niix. .if, ' lat bi-iiis, dfleclivi-, to lufit tia-.oi)iK«iiti- voiilriuulur wiili, 
 iviiilti tlie nvplum uiltrmediurit lulled to cloiie iu uud uoiupk-tu tilt- divi- 
 siiin of lliu eavity. Tiii-rt' would liave tlitls resuiU'd a tihaniWr giving 
 oir tiie iiulmonar)' partially rut oir Irum ii diaiubiT giviiij; olt tliu aorta 
 and also riuciving Ijluod from Ijolli the aurii-lus. 'riiis laltor cliaiulxT, 
 wliii-ii may Ix' cousidurod (iu llr. lloliuts' o»ii words|, lliu left vuiitriulu, 
 liiuiiii; tints a great oxcvjw of worii to do, would liavc grown iiiui-h morn 
 rapidly tliau tiiu otlior. .\lid tiit wall eulliiig olt tliu siuali cavity eon- 
 taiuiug till- pulniotiary ailcry would, iu tliu Bulisi'iiucut growtli ot liii- 
 Imirt, liavc iK^on -arried round to tlie side of tliu greatly enlarged left 
 vi-ntrielc and out of all relation to the aeptuiu intermedium between 
 Ike mitral and tricuspid valvea. And exactly tlie appearances aeeu 
 lure would liai ' en produced. 
 
 TlirLe plalea accompany this paper: 
 
 I'late 1. is a reproduction of a line copper-plate engraving published 
 Ijy Dr. Holmes witii his papu in the Trims, of Iht tJiliiiburgh iltd. Ckir. 
 >'..(■., J.v>.i. and apiiarcntly tal^cu from a drawing made at tlie time. 
 The letlrring is Ills own and is explained at the end of his te.\t. 
 
 riate I la and IMate lib represent two photographs kindly taken by 
 Ur. I'atrii k of the heart as a niuseum specimen and show the interior of 
 the two ventricles and the large arteries, (ilass tubes projett through 
 tlie mitral and trieuspij oriUtes uud through the diamond shaped open- 
 ing between the ventricles. 
 
 I'late 111. is a lUagrammatie sketch of the heart to show tlie mixe.l 
 courso ot the blood and the relation of its cavities. It will 1 si..i, 
 that no cliamber contains pure arterial Wood, that entering l, lefi 
 
 auricle from the lungs iiieeiing with a stream of veiioiis bl I llinnml 
 
 llie foramen ovale. Kor this .ketcli I have to thank Ur. li. Taii 
 Maikenzie. 
 
 List of Ur. lloliiies- writings aeeessible in the Millili Medical l.il- 
 rari-: Tho.se pajH-rs which have seemed to me especially valuable 1 ha\. 
 underlined. 
 
 I 
 
 U- 
 
II 
 
 I. Cmu :>! .Malfiiniialicin cif thu Heart. Triuis. iif I lie Meii. (lur Sm' 
 • if l-Minl.uigh, In; I. 
 
 ■-', l)n FMiij Ti,i,i„un „f ll,r I Imia will, M,.m,s „f Oiari,,,,, Itup. 
 !tin ,i,„l /■■,il,ll I'nil.iHilis. liiili-li Am.Tiran .I..1U-U., lol.-j, Vol. :l .p. s;. 
 
 .•1. III. (iiiii.^li.,1 Wniiii,! (>!■ III,. ll,,,rt Willi I'nlumti,,,! ,if il„. IVn 
 raniiuni. Ilii'. .Nimr. ,l,iiini, Ism, Vul. 1, |i. i;;, 
 
 -I. On (ll.slni.'lini, ,,r il„. ,\|,j,o,„|,x Ntninroniiis ami o". I'u-i .Mi.rlrTn 
 .\li]i<'aninces in r'i-i[iiiiili>. liiil. .\iiiir, Jmirn.. \'i.l. ;;, i., -.'s.-,. 
 
 "i. linniLrks iiii llr. .NrLicm's ('..iiiniuiiicalicin iv llie C'liaiii|j[aii I'asi^ 
 "f I'crilcnili^. .MoMlival Jli'iliial (iazillii. lull, p. IDU. 
 
 li. On llif Kiii|iliiviiii-nl «f rhl.inil'.inn. Mril. .\mor. .Iciuni,. I.Sir-lS. 
 (lii'liorting a case wliuro lit' .-laini.-i i-lilm-„li,riii was uscil for tliu lirii 
 lime in tliisi Province.) 
 
 ". Viiledietory Ad.lros.^ Ui llie Students of .Mcllill .Medical Faculij, 
 ISiM. Brit. Anier. .lonni., \'ol. li, p. .'il, 
 
 R. yalr,lirl„ry Ail.lrrss Id Unuhinln in ilnlirbie, ibid., 18,-il, ji. 1. 
 
 !l. ("iu«o of Heart Discafu. M.mtreal Mini. L'liron., 18.'i.j, Vol. -J. 
 10. Fatal Jaundin. ibid., Vol. 3, p. aSl, 
 
la 
 
i '! 
 
 jU 
 
!l 
 
THE MONTREAL 
 MEDICAL JOURNAL 
 
 A MONTHLY RtCORD OF 
 THE PBOGRESS OF 
 
 Medical and Surgical Science 
 
 OFFICIAL lOURHAL OF 
 THE McGlLU MEDICAL 
 UNDERGRADUATES 
 SOCIETY 
 
 Subscription price, $3 00 per annum. 
 
 ADDRESS : 
 
 P. O. Box 2T3 
 
 it. 
 
 K