20 THE TONER LECTURES. 



improvement followed under aconite given with gentian, Lnt 

 not a cure. 



R K. (Case-book, p. 96, April, 1814), age 14, had been play- 

 ing ball for four j-ears. Two years ago began to notice palpi- 

 tation after running ; and, for a short time previously, short- 

 ness of breath on active exercise or on going up stairs. The 

 impulse of the heart was found to be very extended ; the first 

 sound dull and heavy ; the percussion dulness measured trans- 

 versely 3|, perpendicularly 3|, obliquely 5j inches. 



Now these cases of dilated hypertrophy were undoubtedly 

 duo to the constant exertion, and, as with rowing, anj^ one 

 having a tendency to palpitation, or finding it induced, ought 

 to stop playing, or play very seldom. Instances like those 

 quoted would thus become still rarer than they are. Under 

 all circumstances, in the not too steady addiction to the game, 

 in the intervals of rest, lies the secret which makes the violent 

 exercise beneficial and not baneful. To study further the 

 eflfects of the game, I have carefully examined a club of pro- 

 fessional base ball players, who, of course, only play at cer- 

 tain seasons, and even then not incessantly, and I found their 

 cardiac condition, as well as their general health, excellent. 

 This is the record : — 



A. J. R., age 34; height 5 feet G inches; weight 148 pounds. 

 Has been an active base ball player for seventeen 3'ears ; a 

 professional player for ten. He chiefly plays second base, 

 or acts as a fielder. His general health is excellent. After 

 severe exertion he has at times a sharp twitch la the region 

 of heart, but he never suffers from palpitation or shortness of 

 breath. He has a wide chest ; the respirations are 22 in the 

 minute ; the pulse is Y2, firm, and strong. The impulse of the 

 heart is rather forcible, and is felt in two intercostal spaces. 

 The first sound is weighty, but on percussion the diameters 

 of the heart are found to be normal. 



John E. C, age 23; height 5 feet *r^ inches; weight 110 



