Studies in cardiac pathology . he right side of the heart, whereas calcification seems to bemuch more common (Crawford).^ Inasmuch as the congenital variety of tricuspid stenosis is, sofar as we can judge, generally the result of a fetal endocarditis,it is not surprising that the pathologic appearance presents noespecial features distinguishing it from the post-natal form. Itmay, however, be due to true malformation and be associatedwith other anomalies, such as a persistent ductus arteriosus, im-perforate ventricular septum, patulous foramen ovale, etc. Before closing this section, attention
Studies in cardiac pathology . he right side of the heart, whereas calcification seems to bemuch more common (Crawford).^ Inasmuch as the congenital variety of tricuspid stenosis is, sofar as we can judge, generally the result of a fetal endocarditis,it is not surprising that the pathologic appearance presents noespecial features distinguishing it from the post-natal form. Itmay, however, be due to true malformation and be associatedwith other anomalies, such as a persistent ductus arteriosus, im-perforate ventricular septum, patulous foramen ovale, etc. Before closing this section, attention should be called to thefact that, owing to the almost constant association of tricuspidand mitral stenosis, it is often very difficult to determine howmuch or how little effect the latter has had in bringing aboutthe secondary changes in the heart. (Figs. 15, 20b, 23, and 24 were from cases of combined lesions;in the first, at least, there was a definite history of rheumatic fever R. Crawford: Practitioner, 1907, Ixxviii, Fk;. 27.—Chronic Mitral Endocarditis. Female, white, aged forty-three years. (Pennsylvania Hospital. Autopsy No. : Dr. Longcope.) Clinical Notes: Past history negative. For the last six weeks has had abdominalswelling, post-prandial discomfort, slight loss of weight, and some edema of the feet. A systolic murmur is heard at the aortic area which is transmitted down the is also a systolic thrill. Ascites is present. Paracentesis abdominalis was twice per-formed. Death occurred gradually, with the symptoms of peritonitis. Pathologic Diagnosis: Carcinomatosis of the peritoneum, etc. Chronic mitral endo-carditis. Fatty degeneration of the heart, etc. : Contains 100 of clear fluid. It shows no abnormalities. Heart; Is not increased in size; it weighs 240 gra., and contains fluid blood and a fewpostmortem clots. The epicardium contains much fat; it is smooth and glistening and are not especially prom
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