Studies in cardiac pathology . ) Obhteration of thepericardial cavity with marked increase of mediastinal connective tissue, withor without caseation, (b) Obliteration of the pericardium with extensive ad-hesions to the surrounding structures, without much increase of mediastinaltissue, (c) Mediastinitis without pericardial involvement. The most important adhesions are those which occur betweenthe external surface of the sac and the surrounding structures,since it is in these cases that the heart is to the greatest extenthampered and restricted in its action. When in addition to the pericardiu
Studies in cardiac pathology . ) Obhteration of thepericardial cavity with marked increase of mediastinal connective tissue, withor without caseation, (b) Obliteration of the pericardium with extensive ad-hesions to the surrounding structures, without much increase of mediastinaltissue, (c) Mediastinitis without pericardial involvement. The most important adhesions are those which occur betweenthe external surface of the sac and the surrounding structures,since it is in these cases that the heart is to the greatest extenthampered and restricted in its action. When in addition to the pericardium, the mediastinum, pleurae,liver, and omentum are also involved, we have what has been de-scribed as pericardial pseudo-cirrhosis of the liver (Picks disease).Both the heart and the liver are covered with a thick white laj^er ofinflammatory product, so that they have the appearance of beingcoated with icing, hence the German name Zuckerguss Leber Sicard: New York Med. Jour., 1907, p. Harris: Medical Chronicle, IK -AcTTE Fibrinous Pericarditis. A specimen from the University of Pennsylvania Museum showing the typical corvillosum, or shaggy heart. (The entire heart could not be better reproduced owing to thedifficulty of photographing through the convex surface of the hermetically sealed jar in whichthe specimen was preserved.) 126 STUDIES IN CARDIAC PATHOLOGY und Herz.^ This condition is generally a part of an extensivemultiple serositis, often tuberculous in origin, and is associatedwith ascites and signs of portal stasis. Head collected 55 cases ofthis kind, and added 4. He found that one-third of the casesoccurred in persons under twenty years of age. The commonestcausal factor was rheumatic fever, although tuberculosis, pneu-monia, nephritis, and chorea were also accountable. Pericardialpseudo-cirrhosis has been approximately reproduced experimentally,by the injection of iodin into the pericardium. The inflammatoryreaction which followed, by constricting th
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