236 Epidemics. 



perhaps, ten to one than they were formerly, because 

 formerly they were known by their remote effects, especially 

 upon the pulse and by dropsy ; but now, long before a 

 patient can have the most remote idea of any ailment at the 

 heart, hardening and thickening of the valves, and old 

 adhesions of the pericardium, can be detected by the mere 

 motion and impulse of the heart ; regurgitation and un- 

 rhythmical action, when only slight, can be frequently 

 detected long before the pulse gives a faithful index, unless 

 it be by the symphograph ; much more pericarditis, 

 effusion, endocarditis, and many other affections of a 

 grosser or more apparent character can be made amenable 

 to the several indications which careful auscultation, and, 

 with regard to site and size, percussion supply. Hence, 

 from the mere fact of increased diagnostic powers, 

 occasional diseases of a very fatal character in a specific 

 organ are remoulded into a great number of slight, and, in 

 many instances, very manageable diseases, and into a few 

 that are very serious, and often necessarily fatal diseases of 

 the heart. 



But what is here maintained is, that we have no direct 

 proof of the greater tendency to disease of an organic 

 character in the heart ; but that, taken upon the whole, the 

 heart, as a central organ of the body, has less power to 

 propel the blood throughout the body than formerly; that 

 the hard wiry pulse, so often found in brain affections and 

 serous inflammations, is now scarcely ever known or felt ; 

 likewise the hard, wiry, and almost incompressible pulse is 

 to the present, or rather rising generation, a perfect myth. 

 The frequency of serous and congestive apoplexy is now 

 common, and not the exceptional apoplexy; whilst apoplexy 

 from extravasation is not so frequent as formerly. The 

 firm, organizable, and tough or friable lymph in serous 

 inflammations is now rarely seen ; it is altogether more 



