a very decided increase of the heart-sound over the tumor, while the ear of a second observer is kept upon the thorax, and the sound is still heard over the normal position of the heart. We observe similar phenomena, simply reversed, when he attempts to throw the heart upon the right side. These are the facts. Our inferences from them are, perhaps, of no more value than would be those of any one else. It is possible that, by the drawing downward of the diaphragm, the pericardium may be so elongated and narrowed, as actually to compress the heart from the sides. It may also be supposed that, besides this mechanical action, there is an element of will acting in some peculiar way upon the heart through the nervous system. With regard to the act of "throwing the heart" into the abdomen, as is claimed, that claim is by no means admitted. We have stated to you the fact, however, that there is an increase of the sound over the tumor; and this seems to us to be developed as a result of the extraordinary muscular tension. It is easy to understand, I think, that the compression of the abdomen, under this strain of its muscles, would have the effect of bringing the abdominal walls, the spleen, and the heart into very close relation with each other, and of increasing greatly the facility of transmitting sound. We are disposed to think this the true explanation, since the heart is still to be heard at its normal position at the same time that its sounds are so distinct below. As to the peculiar action of "rolling the belly," it seems to me the result of prolonged training, commenced in early life. This has enormously developed the recti muscles, so that when relaxed they feel like a great mass of dough under the fingers, and has given them a power of vermicular motion precisely like that of a snake or an eel. Indeed, I am not sure but this case may throw a little light upon some speculations of the transcendental anatomists. One of these, as you know, is that the lineæ transverse of the recti are the rudimentary homologues in man of the abdominal ribs of some lower animals-all we have left of them. Now these give an opportunity for each of the short muscles between them to act by itself; and by bringing them successively into action, the vermicular motion is produced. One word more. There is no motion of the chest in breathing, or scarcely any. You tell the boy to take a long inspiration, and he immediately expands the abdomen into a great tumor, while the thorax remains perfectly quiet. This shows the wonderful action. of his diaphragm-even more wonderful than the power of, and control over, the other muscles of the abdomen. Dr. HAUGHTON asked whether the sound in the abdomen might not be due to the pulsations of the abdominal aorta. Dr. MOORE. We thought of that, and it is possibly so. Dr. Hoy had examined Mr. Grew, the man without a sternum; and he could suspend the heart's action for a short time by his will. Dr. Moore's report was adopted, and he was requested to reduce its points to writing for the Committee of Publication. At seven o'clock the Section adjourned, and referred its Minutes to the Association. |