He complained of pain and dyspnea; in twenty-four hours his symptoms increased to such an extent that operation was deemed advisable on account of collapse.

The 5th rib was resected and the pleural cavity opened.

When the pericardial sac was incised, a teaspoonful of turbid fluid oozed out, and the needle was felt in an oblique position in the right ventricle.

By pressure of a finger passed under the heart, the eye of the needle was pressed through the anterior wall and fixed on the operator's finger-nail.

An attempt to remove by the forceps failed, as the violent movements of the heart drew the needle back into the cavity.