extreme jeopardy, a rupture may be induced, and thus prove instantly fatal, or the action of the heart may be suddenly arrested, and a fatal syncope be the result; and from the suddenness with which death takes place in such cases, there is no doubt that many persons so dying, have been erroneously included in the list of apoplectic deaths. In certain diseased states of the valves, the extremities of the body become gangrenous, as if the heart were unable to propel its blood to the extreme parts: the author well remembers two females who were admitted into the Westminster hospital, with a disease of this kind, in which the gangrene gradually extended upwards, and that, after death, the valves of the heart were found ossified. The coronary arteries are occasionally ossified, a circumstance which often accompanies a diseased state of the valves of the heart, and that of the aorta; a change which has been regarded as giving rise to the disease, termed _angina pectoris_, but which would seem to be symptomatic of any morbid state of the heart. In some cases the heart itself has been found ruptured; we have already offered some observations upon this event, under the history of syncope, p. 27. _Dr. Baillie_ has seen only one case, and in that, the blood escaped into the pericardium, and the person instantly expired. _Examination of the abdomen._—In proceeding to the examination of this cavity, and its contents, the first appearance to be noticed, is that of the _peritoneum_, in which we have to observe whether any marks of inflammation exist, as displayed by a crowd of very small vessels, injected with florid blood, and a change in the texture of the membrane, by which it appears to be thickened, more pulpy, and less transparent. The existence and character of any fluid in the abdominal cavity should be noted, for its nature will be found to be immediately connected with the nature and extent of the disease by which it has been produced; if the liver be schirrous, the fluid will be tinged with bile, and of a yellowish colour; if extreme debility accompany the disease, it will often be of a chocolate colour, from the admixture of blood; should no disease exist in any of the viscera, it will resemble that of the serum of the blood. Previous to the removal of the viscera for more minute examination, it will be proper to observe their general situation and appearance, and to notice particularly whether the calibre of the visceral tube be natural, distended, or contracted; in some instances its diameter is sensibly diminished, as in cases of poisoning by lead. It sometimes occurs that the intestines are glued together with extravasated lymph; and, at others, that the abdominal viscera are more or less joined together by adhesions, which are the effects of former inflammation; these adhesions become gradually so elongated as to produce little or no inconvenience. If upon opening the cavity of the