of the sigmoid valves; that the second sound accompanying the dilatation of the ventricles, is caused by the spreading out or expansion of the same valves, by the retrograde column of blood."

I have somewhat abridged by leaving out such remarks as I did not deem important for present purposes, the description of the motions and sounds of the heart, as observed and recorded by M. Cruveilhier.

By comparing our synopsis of the three cases here given, with each other, it will be observed that there is a striking similarity in some important particulars. In all three of the cases the observers attribute an active dilating power to the heart, and describe the action to be sudden and energetic. I believe all agree that there is no interval of time or state of rest between the action of the auricle and ventricle.

Case. Mrs. H-, wife of Mr. B. C. H., was married in the year 1842, and on the 27th of June, 1845, was delivered of her second child, the peculiarity of which has given rise to our communication. Mrs. H. is small, has always been slender, although not sickly, and is of a nervous temperament. Since her confinement with the anomalous child of 1845, she has had three well developed and healthy children, two of whom are now living. The first, or that born previous to 1845, was normal and well formed in all its parts, but died in infancy,

The husband of Mrs H. is a large man, as much above as she is below mediocrity, as to size. Mrs. H. does not attempt to assign any cause for the strange development of her infant. She states that she was very nervous during most of the period of her pregnancy; that she felt strangely, and a constant uneasiness, and was unable to lie down during the two or three months preceding her confinement.

On mentioning these symptoms to my colleague, Prof. Townsend, he suggested that they might have been caused by the incessant pulsation of the naked foetal heart against the wall of the

uterus.

In every respect, except the position and situation of the heart, the child was perfectly organized, and of large size, weighing ten pounds; cried at birth, vigorously, and manifested all the symptoms of health and of active life.

The attending physician, the late Dr. Wing, informed me that the action of the heart was strong when the child was born, and that it gradually became more feeble in its action until it ceased to pulsate, in about an hour or an hour and a half after its birth.

He also informed me that when he took hold of the heart with his hand, soon after birth, it seemed to squirm, twist and struggle like a bird, or some small animal held in the hand.

I hardly know where to begin, or how to describe this curious and interesting specimen, rather imperfectly represented by the accompanying photographs. We could only obtain permission to take, for preservation of the montrosity, what is here exhibited-the sternum, cartilages of the ribs, heart, portion of the umbilical cord, and surrounding skin anteriorly; and posteriorly or internally, the aorta, and its thoracic branches, the lungs and trachea.

It will be observed that the opening through which the heart escaped from the cavity of the chest is situated at the junction of the ensiform cartilage, with the lower end of the sternum proper; that it is oval or egg-shaped; about an inch and a half or two inches long, and in the center an inch broad, as it is surrounded by the true skin; and that deeper seated the opening is much smaller, being situated in what appears to be a firm, dense membrane, like the pericardium. This opening permits the aorta and pulmonary vessels to pass freely.

The position of the heart, which is the greatest peculiarity of the specimen, is next to be described. It will be observed that it stands out nearly in a horizontal. position from the surface of the body, with one face looking upwards and the other downwards, one ventricle turned to the right and the other to the left, and with the two auricles to correspond in their positions with the ventricles. The heart appears to maintain this position from being suspended, as it were, across the inferior margin of the membraneous opening, by the blood vessels, and counterbalanced by the lungs situated within.

The true skin is defective from the lower border of the cardiac opening to near the stump of the umbilical cord, which has been divided more than an inch from the body, and a ligature cast around it.

Posteriorly we observe the top of the sternum, and at its angles the articulating surfaces from which the clavicles were removed; and laterally and below, the divided cartilages of the ribs.

The lungs have fallen down, so as to leave the upper and anterior wall of the chest unoccupied, either by heart or lungs.

Between the lungs and at their roots, the thoracic aorta may be seen, with the stumps of the branches given off from its arch, and a little below the divided trachea.

I have recently been furnished with the following brief notes of

a nearly parallel case:

A physician of this city attended a lady in labor, Dec. 29th, 1851, who was delivered of a male child nearly at the full period of gestation.

"The labor was natural, and the child lived about two hours, breathing irregularly.

"The heart of the infant was situated on the outside of the sternum, and seemed connected with the internal parts through an aperture about an inch and a half in diameter.

"It was without a pericardium, and the pulsations were distinct for a time, but gradually became irregular, and finally ceased, but could be excited to action by irritation, for nearly an hour after the breathing ceased."

It is to be regretted that the physicians who were eye witnesses of these cases, from the birth of the infants to their death, did not note and record the motions of the heart, as were particularly observed, and minutely and faithfully recorded in detail, in the case' published by M. Cruveilhier.

Accurate observations made of a few such cases, would, I think, shed some light upon what appears to be a mooted question in relation to the location and structure of the parts, to which the pulsations have been referred by so many different individuals, in the case of M. Groux.