[ 35 ° ] 
previous gradual dilatation of the fame, and that, pro- 
bably, to a very confiderahle degree. 
In cafes of this kind, commonly one of the ven- 
tricles is found diftended to a monftrous fize, while 
the reft of the heart remains nearly in its natural ftate. 
It is but rare, perhaps, that the heart is feen fo equally 
and univerlally enlarged, as in the cafe under conh- 
deration. 
This man, I have obferved, had the rickets, when 
a child : in this diforder, the whole fyftem is found 
to be in a very lax debilitated ftate •, and the heart is 
faid to be fo in particular. The conftitutions ot rickety 
children frequently amend as they grow up, and particu- 
larly about the age of puberty- But, in this cafe, I think 
we may fafely conclude, that this man s heart never 
recovered its due tone, after he grew up. It is fcarcely 
to be fuppofed, that the heart could fuflfer fo great an 
enlargement during the laft year or two of his life 
only : the more fo, as I remember to have heard him 
fay, that, for many years before his death, a very little 
exercife put him out of breath. Doubtlefs it was in- 
crealed greatly during the latter years of his life, by 
his buftnefs, which obliged him to exercife much, 
particularly in walking ; fo that before he got his 
rheumatifm, he came home to weak, and lo much 
fatigued with his ufual day’s exercile, that he has been 
almoft unable to ftir for a day or two. We may add 
to this, the increafed force that the heart fuftained 
during the time he laboured under his inflammatory 
diforders, both before and after his rheumatifm feized 
him. . . 
The great increafe of his diforder, upon going into 
the cold bath, is not furprizing. Thethock ot the 
cold 
