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his arms, and which leaves very little doubt, in my mind, of there being- some organic affection of the heart; but whether the disease was enlargement of its cavities, thickening of its walls, or derangement of its valves, I could not, at this stage of the complaint, satisfactorily ascertain. I, however, put him upon a plan of such remedial means as I thought calculated to reduce the action of the heart and arteries, namely, antimony and digitalis, and by the 17th he was under the influence of the latter, (which the pulse, at 74, evinced,) and was more feeble. Still he has head-ache, with pains of his shoulders, back, and arms, and also of his legs, after walking. To the antimony and digitalis was added a sedative saline mixture. 18th. Pulse again 80, and vibrating; palpitation equally strong, and also thrilling, which extends into his arms; the pains of his head, back, and legs, have all returned, much increased by walking fast, or up stairs; tongue, skin, and bowels all natural. Returns to London. To take two grains of the oxyd of zinc, in the form of pill, twice a day, increasing the dose gradually. To have a seton inserted in his left side, as soon as convenient, after his return home.
Being fully aware that my idea of the nature of his disease had not previously been suspected, and as the slightest intimation of his heart being the seat of it, caused great anxiety and alarm to his mother, I was very solicitous that she should consult any other physician in London, in order to investigate the symptoms, and watch the progress of the complaint, furnishing her, at the same time, with my written opinion of its seat and nature. This advice.
