Since the communication above referred to was presented to the Royal Society, I have made a very minute dissection in alcohol of the whole nervous system of the young heifer’s heart. The distribution of the ganglia and nerves over the entire surface of the heart, and the relations of these structures to the blood-vessels and muscular substance, are far more fully displayed in these preparations than in any of my former dissections. On the anterior surface, there are distinctly visible to the naked eye ninety ganglia or ganglionic enlargements on the nerves, which pass obliquely across the arteries and the muscular fibres of the ventricles from their base to the apex. These ganglionic enlargements are observed on the nerves, not only where they are crossing the arteries, but where they are ramifying on the muscular substance without the blood-vessels. On the posterior surface, the principal branches of the coronary arteries plunge into the muscular substance of the heart near the base, and many nerves with ganglia accompany them throughout the walls to the lining membrane and columnse carneæ. From the sudden disappearance of the chief branches of the coronary arteries on the posterior surface, the nervous structure distributed over a consider able portion of the left ventricle is completely isolated from the blood-vessels, and on these, numerous ganglionic enlargements are likewise observed, but smaller in size than the chains of ganglia formed over the blood-vessels on the anterior surface of the heart. In the accompanying beautiful drawings, Mr. West has depicted with the greatest accuracy and minuteness the whole nervous structures demonstrable in these preparations on the surface of the heart. But the ganglia and nerves represented in these drawings constitute only a small portion of the nervous system of the heart, numerous ganglia being formed in the walls of the heart which no artist can represent. It can be clearly demonstrated that every artery distributed throughout the walls of the Uterus and Heart, and every muscular fasciculus of these organs, is supplied with nerves upon which ganglia are formed.
Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris
