I herewith report the clinical history and autopsy findings of a man who died as the result of a congenital deficiency in the central tendon of the diaphragm, which opening connected directly with the pericardial cavity, the heart at autopsy being surrounded by the entire transverse colon and the great omentum:
—The patient was 70 years of age, and was admitted to the Newark City Hospital in December, suffering from intense dyspnea, which he had had for one week. His family and personal history, except for the fact that he was never confined to his bed on account of sickness, throws no light on the condition to be described.
—On admission to the hospital the patient presented the clinical picture of an acute right heart dilatation, being markedly cyanotic and dyspneic, with a rapid, irregular and feeble pulse. Aside from these symptoms there was little in his physical