The heart participates in the general wasting, and consequently appears after death to he remarkably small. According to our statistics its average weight in the male cases was 8.2 oz. and in the female 7.5 oz.; and since the normal average in the two sexes is 11 oz. and 9 oz. respectively, it would seem that the organ usually loses about one quarter of its initial weight during the course of the complaint. The smallest heart (3 1/2oz.) recorded in our series was taken from a young man who died from pyloric stenosis, and Habershon met with one of similar weight in a woman forty years of age. An increase of size almost always indicates the existence of old endocarditis. As a rule the walls of the organ are flaccid, and its cavities contain decolorised as well as recent clot. The muscular tissue is usually flabby, friable, and either pale or dark brown in colour, and on microscopical examination the fibres are often found to be remarkably attenuated, and not infrequently to present signs of fatty degeneration. An excess of fluid in the pericardium was only met with in 4 per cent, of our cases, and acute pericarditis was present in only two instances (-7 per cent.), in both of which it was secondary to suppurative pleurisy on the left side.
Chronic endocarditis existed in 4.6 per cent., acute ulcerative endocarditis in 2.3 per cent., while small recent vegetations upon the mitral or aortic cusps were observed in nearly 4 per cent. In every case of recent endocarditis the growth in the stomach was extensively ulcerated. Secondary deposits in the heart or its serous covering occurred in 2.3 per cent. Some degree of atheroma of the aorta was present in 31 per cent., but in only 7 per cent, was it extensive ; and an aneurysm was only noted in two cases (.7 per cent.).