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tioii better, and, by the 24th, she was again well, except that the palpitation returned at times, when it could be distinctly seen to move her dress as she lay upon the sofa. She was merely ordered to take the tincture of digitalis, which seemed to lessen the violence of the heart's action, leaving no other symptom of disease about her. In my note book, I perceive I have remarked that this case was a strong instance of palpitation of the heart being often connected with rheumatism, as was, I believe, first noticed by Mr. (afterwards Sir David) Dundas, of Richmond, and since more particularly by the late Dr. Pemberton, and Dr. Marcet. Soon after this, Mr. N. and his family left Liverpool, to reside in or near Dublin, and I heard nothing of my little patient until the year 1821, July 29th, a period of more than eight years, during which time, I was informed, she had enjoyed uninterrupted good health, with the exception of the palpitation, and even that had now entirely left her; nor had it at all prevented her pursuing her duties or pleasures like her other sisters, although it was now ten years from my first being consulted on her case.
On Friday, the 27th inst. she crossed the water from Dublin to Liverpool, having, within the previous day or two arrived at the former place by a canal conveyance; she was, during her passage to the latter place, seized with most violent vomiting, which, at first, was thought to be nothing more than ordinary sea-sickness, but which continued all the following day (Saturday) though on shore, and on Sunday 1 was called to her assistance, to meet Mr. Hensman, a respectable general practitioner of this town. 1
