Organic Diseases of the Heart

TEI3RE is perhaps no group of internal structural diseases, which are more accurately distinguished by their physical signs than those of the heart.The modes of determining the condition and action of the muscular substance of the organ, made known by Corvisart, Avenbrugger, Laennec, and their successors, and the method of interpreting the val- vular murmurs, which I first proposed in 1835, have rendered the Diagno- sis of the more common ORoANlc DIs8Ass OF TH,E HEART comparatively easy and accurate.But the general knowledge of the PROGNOsts and TREATMENT has not advanced in an equal degree; and mistakes are often occurring, in consequence of the misapplication of the long prevalent notions respecting the prospects and treatment of heart disease to cases which, although correctly diagnosticated as such, are not of the gave nature which is apprehended.It is a satisfactory result of extended experience on this subject, that organic lesions of the heart, even of considerable amount and complexity, are not incompatible with prolonged life, and, under favourable circumstances, with a moderate sare ofhelth and comfort.For example: About fifteen yean ago, I was oonsulted by a medical man of middle age, who presented formidable signs and symptoms of obstructive and regurgitant disease of the aortic orifice, with greatly enlarged heart, and dilatation of the ascending aorta The symptoms, at that time, were not only those of inordinate action of the heart, but the functions of the brain were occasionally impaired; exer- tion or emotior sometimes causing confusion of thought and indistinct articulation.Yet this gentleman has been engaged in a pretty extensive country prctice ever since; and within the past year, when I last heard of him, he had not abandoned his professional duties.And when at length death does occur in such cases, I have been often urpsed at the enormous amount of disease that had gradually accumI Ited, yet sometimes without causing those alarming and distressing sufrings, which occur in other institnoes, where the lesions ar much ls consi- VOL.