Captain Job Jackson, forty-five years of age, a man of vigorous
constitution, after an indisposition of some years continuance, was
seized with palpitations of the heart and dyspnoea, occurring by
variable paroxysms, especially on ascending an eminence, and attended
by hardness, irregularity, and intermission of the pulse. To these
symptoms were superadded dizziness and severe head-ache, a disposition
to bend the body forward, sudden starting from sleep, with dread of
suffocation, violent cough with copious expectoration, which for
fifteen days before death consisted of black blood, distressing pain
across the chest, especially on the left side, great oedema of the
lower extremities, and paucity of urine.
He died painfully in January, 1809, after violent struggles for
breath. The day before death the pulse became regular. He rested his
head upon an attendant, and made no attempts to lie down for some
days previous[6].
[Footnote 6: The symptoms of this case were related to me by
Dr. Rand, sen.]
DISSECTION,
SIXTEEN HOURS AFTER DEATH.
The skin was of a yellow colour. The inferior extremities, quite to
the groins, were oedematous.
The left cavity of the thorax was filled with water; the right
contained only a small quantity. The pleura costalis, on the left side
opposite to the heart, was thickened and covered with a very thick
flocculent coat of coagulated lymph, and the pericardium opposite to
it had the same marks of inflammation. The lungs on that side were
pushed up into a narrow space. They were dense and dark coloured.
The pericardium contained little more than the usual quantity of
water. The heart, which exhibited marks of some inflammation on its
surface, was astonishingly large, and firm in proportion. Its cavities
were principally filled with coagulum. The semilunar valves of the
pulmonary artery had their bases slightly ossified, and the remaining
part thickened. There were only two valves of the aorta, and these
were disorganized by the deposition of ossific matter about their
bases, and a fleshlike thickening of the other part[7]. The parietes
of the heart, especially of the left ventricle, were greatly
thickened, and somewhat ossified near the origin of the aorta.
[Footnote 7: See plate first.]
The liver had the same appearance as in case second.