444 PRACTICE OF PHYSIC. 



self, or of the great vessels immediately connected with it. The 

 second is, of those consisting in or depending upon certain af- 

 fections subsisting and acting in other parts of the body, and 

 acting either by the force of the cause, or in consequence of the 

 mobility of the heart. 



" Every practitioner knows, that palpitation, syncope, and 

 other irregular motions of the heart, commonly depend upon an 

 organic affection of the heart, or of the great vessels immediate- 

 ly connected with it, as aneurysm, polypus, or ossifications, 

 which are commonly considered as incurable diseases. Dissec- 

 tions have indeed so commonly discovered such causes, that 

 practitioners are very ready to despair of curing such diseases, 

 and desert all attempts towards it ; but I think it may be for 

 the instruction of practitioners to give the following case : 



" A gentleman, pretty well advanced in life, was frequently 

 attacked with palpitations of his heart, which by degrees in- 

 creased, both in frequency and violence ; and this continued for 

 two or three years. As the patient was a man of the profession, 

 he was visited by many physicians, who were unanimously of 

 opinion, that the disease depended upon an organic affection of 

 the heart, as we have just now said, and considered it as abso- 

 lutely incurable. The disease, however, after some years, gra- 

 dually abated, both in its frequency and violence, and at length 

 ceased altogether ; and since that time, for the space of seven 

 or eight years, the gentleman has remained in perfect health 

 without the slightest symptom of his former complaint. 



" Besides this, I have had some other instances of palpita- 

 tions, both violent and lasting, for some length of time ; and 

 these especially, with the instance above-mentioned, persuade 

 me, that spasmodic affections, though sometimes both violent 

 and durable, are not always depending upon organic and incur- 

 able affections of particular parts, but may very often depend 

 entirely on an affection of the brain alone. M.M. 



MCCCLXIII. With respect to the cases depending upon 

 the first set of causes, I must repeat here what I said with res- 

 pect to the like cases of syncope, that I do not know any means 

 of curing them. They, indeed, admit of some palliation, first, 

 by avoiding every circumstance that may hurry the circulation 

 of the blood ; and secondly, by every means of avoiding a pie- 



