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Eques erat ornatissimus, annos natus quinque et sexaginta, sed robustis membris et proba humorum temperie, nisi quod ante annos aliquot diuturnis et contumacibus crurum ulceribus laboraverat : quae pertaesus remediis qua internis qua externis tandem persanaverat. Is novissime rheumaticis doloribus subinde obnoxius, sed levibus adeo ut qui domo exire non prohiberent, quod et pridie fecerat quam moreretur, iis acerbius prehensus est V. Nonas Junias ad sternum quidem et brachia, non sine capitis perturbatione. Quibus per ea quae sunt visa magis idonea cum occursum esset, jam circa meridiem magna ex parte relevatus, quamvis infirmo pulsu, alacriter se gerebat. A prandio cum quievisset, expergefactus, eosdem quos mane dolores sensit. Quapropter inambulare in conclavi coepit ; sic enim illos facilius ferebat. Sed postquam satis id fecerat, cum lectum repetiisset, querebatur de fumis ad caput ascendentibus, et de pectoris angustiis, inquietusque sese huc illucque vertebat. Quod cum spatio temporis non brevi fecisset, repente se mori sensit, simulque pallens et se agitans illico interiit. Abdomine diducto, inventa sunt omnia secundum naturam. Pectore autem aperto, et pulmonibus, qui antrorsum compulsi erant, dimotis, pericardium deprehensum est nigro, concretoque sanguine distentum. Is e sinistro cordis ventriculo exierat per scissuram longam unciae dimidium et secundum illius longitudinem ductam, circa quam cordis fibrae non recenti corrosione exesae conspiciebantur.
There was a very distinguished knight, sixty-five years old, but with sturdy limbs and a sound balance of the humoral fluids, except that some years earlier he had suffered from long-lasting, obstinate ulcers of the legs. Weary of these, he had at last completely healed them by remedies both internal and external. More recently he had occasionally been subject to rheumatic pains, but pains so slight that they did not prevent him from leaving home, as he had indeed done on the day before his death. On 1 June these seized him more severely, at the sternum and in the arms, accompanied by disturbance of the head. After they had been treated with the measures judged most suitable, he was already largely relieved by about midday and behaved cheerfully, although his pulse was weak.
After resting following dinner, he awoke and felt the same pains as in the morning. He therefore began walking about his room, for in this way he bore them more easily. But after doing this sufficiently, he returned to bed and complained of vapours rising to his head and of tightness in his chest; in his restlessness he turned this way and that. After doing so for a considerable time, he suddenly felt that he was dying and, at the same moment, grew pale, struggled, and died immediately.
When the abdomen was opened, everything was found in its natural condition. But when the chest was opened and the lungs, which had been pushed forwards, were moved aside, the pericardium was found distended with dark, clotted blood. This had escaped from the left cardiac ventricle through a tear half an inch long, running in the direction of its length. Around it the fibres of the heart were visibly eaten away by an erosion that was not recent.
The anatomical finding is rupture of the left ventricular wall into the pericardium. This is Morgagni's account in The Seats and Causes of Diseases Investigated by Anatomy by Giovanni Battista Morgagni, Book II, Letter XXVII, article 8. The language of balanced humoral fluids, rheumatic pain, rising vapours and erosion belongs to the account's historical descriptive framework. It does not establish a modern rheumatological diagnosis or a microscopic cause of rupture. The Roman date is the fifth day before the Nones of June, counted inclusively: 1 June. The translation retains the historical half-inch measure without assigning an unjustified modern measurement to the specimen. [ref]
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