290 BRITISH PHYSICIANS. of the heart. II. That the tendency to this dis- order arises from mal-organization in the heart itself ; which mal-organization seems to be chiefly induration of the coronary arteries. III. That this mal-organization acts by diminishing the energy of the heart. IV. That the chief symptoms of the dis- ease are the effects of blood retarded and accumu- lated in the cavities of the heart and neighbouring large vessels. V. That the causes exciting the paroxysms are those which produce this accumu- lation ; (1) by mechanical pressure, (2) by stimu- lating, in an excessive degree, the circulating system. VI. That, after a certain approach towards quiescence, the heart may recover its irritability, so as again to carry on the circulation in a more or less perfect degree, from the operation of the usual stimuli ; but, VII. That death may at length ensue from a remediless degree of inirritability in the heart. In the year 1809, Dr. Parry published, in the Edinburgh Medical and Surgical Journal, " Ob- servations on the Utility of Venesection in Pur- pura," which he considered to be " of the nature of what are called active haemorrhages ; since it matters not, in a pathological view, whether febrile extravasation of blood takes place from the rup- ture or gaping of an artery, in the cellular mem- brane, in the skin, or on the surface of the epithelion in the nose, fauces, or bronchia." The cases adduced " strengthened an opinion which he, more than twenty years before, maintained, and which a large subsequent experience had tended to confirm, that in various diseases, among which may be reckoned inflammations, profluvia, haemor-
