VOL. HI.] PHILOSOPHICAL TKANSACTIONS, 585 



LIF. The Case of a Man, whose Heart was found Enlarged to a very Uncommon 

 Size. By Mr. Richard Pulteney. p. 344. 



Thomas C. aged about 32 or 33 years, had the rickets in his infancy, and 

 continued very weakly for several years after. In the winter of the year iT^g^ 

 on taking cold, he was afflicted with peripneumonic and pleuritic symptoms; 

 which had scarcely left him, when he was seized in the summer of the year 

 1760, after great exercise in walking, with a fever, and very violent rheumatism: 

 this, after affecting most of his joints, remained the longest and most trouble- 

 some in his knees. When he was somewhat better of his rheumatism, but 

 before the pain and stiffness of his joints had left him, he u^as advised to go into 

 the cold bath: he did so; but on coming out again, instantly felt such an in- 

 creased load, fainting, and anxiety about the praecordia, that he thought he should 

 scarcely have recovered the shock it gave him ; yet he ventured in again a day or 2 

 after; but experienced the former symptoms in an aggravated degree: and from 

 this time he dated the disorder which terminated his life. A palpitation of the 

 heart, to which he had been subject for some years before, became now much 

 stronger, and gradually increased with his other complaints, to a very great de- 

 gree. His rheumatism continued to affect his breast, and all his joints, parti- 

 cularly his knees ; especially on taking cold, or any irregularity in the non- 

 naturals, he became weaker, breathed shorter, especially on walking a little, or 

 talking rather more or higher than usual, any of which exertions put him out of 

 breath presently. 



When he first applied to Mr. P., in the beginning of March 1761, he found 

 him labouring under the above-mentioned complaints; and on examining his 

 pulse, found it soft, and extremely quick : it commonly went at the rate of J 10 

 in the morning, and in the evening 120 pulsations in a minute, as he repeatedly 

 observed. The palpitation of the heart struck Mr. P. instantly, as it shook his 

 whole body at every stroke. He could never observe any inequality of the in- 

 termittent kind in the pulse, under any the most accelerated motion of it, or in 

 whatever situation the body was placed. At this time the chylopoietic organs 

 were all tolerably good. Stimulating food, or fermented liquors, had for some 

 time always increased his anxiety and load on his breast, and this experience had 

 induced him to refrain from them. He had slept very ill for several months^ 

 sometimes not more than an hour or two during the whole course of the night 

 He could not sleep on the left side at all, and was always easiest in an erect 

 posture. He was commonly awaked with a sense of suffocation from the vast 

 load and oppression on his breast, and from the strength of the palpitation. 



From his first application to Mr. P. he had no hopes of doing him any real 

 service, as he thought it evident from his complaints, and particularly from the 



VOL. XI. 4F 



