When the heart is subjected to a direct injury, as a bullet wound, or knife wound, hemorrhage into the pericardial sac may result. Other causes are rupture of the heart from a blow, or from disease of its walls, or from perforation of the sac from the rupture of an aneurism of the aorta, or from rupture of the coronary arteries. The result of this hemorrhage is usually death, but death is not caused by the quantity of blood lost, which is not large, but by compression of the surface of the heart and of the larger veins.

Prognosis:—When the condition occurs from direct injury the chest wall has been opened in a number of cases, the blood clots removed and the injury successfully repaired. When due to the progress of chronic disease it is necessarily fatal.

Symptomatology:—The symptoms are those of heart oppression, difficult respiration, a rapidly failing pulse, progressive cardiac weakness, with other signs of imminent dissolution.

The Eclectic Practice of Medicine with especial reference to The Treatment of Disease, 1910, was written by Finley Ellingwood, M.D.