The question of damage to the heart as a result of an extreme nonpenetrating injury is not only of interest but of great practical importance. Especially in medicolegal cases does this problem come up. The present scholarly study should be especially valuable to physicians since all the literature on the subject, with detailed case reports, is assembled. Many of the cases are not entirely clear, since autopsies were not always done, but the author has assembled the best information available. It seems clear that severe damage to the heart and pericardium may often result from external trauma.