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cules of organized substances contain an average of about 50 of the more elementary atoms, we may assume that the smallest organized particle visible under the microscope, contains about two million molecules of organic matter. At least half of every organism consists of water, so that the smallest living being visible under the microscope, does not contain more than about a million organic molecules.*

From the elaborate investigations of Sir Wm. Thomp son it has been demonstrated that the diameter of the gaseous molecule can not be less than 50,000 of a centimeter, nor the number of molecules in a cubic centimeter of gas greater than six thousand million, million million.

Thompson says, whatever may be the result of future experiment, it cannot invalidate the conclusion, that a stratum of 500,000 of a centimeter thick, cannot contain in its thickness many, if so much as one, molecular constituent of the mass, and if a quantity of water were extended to this thickness, it would have more energy than the same mass of water in ordinary conditions by about 1,100 times as much as suffices to warm it by 1° Cent. This is more than enough to drive the liquid into vapor. Hence, if a film of 0.00006 of a centrimetre thick can exist as liquid at all, it is perfectly certain that there cannot be many molecules in its thick

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The size then of the various molecules according to different observers would range between 5,000,000 to ,,,ʊʊ of an inch. As Sir Wm. Thompson says to form some conception of the degree of coarse-grainedness indicated by these conclusions, imagine a rain-drop, or a globe of glass as large as a pea, to be magnified to the size of the earth, each constituent molecule being magnified in the same proportion. The magnified structure would be coarser-grained than a heap of small shot, but probably less coarse-grained than a heap of cricket balls."

Now for a practical application of these facts to the subject we are considering-it will be necessary though, first to examine the method by which the potencies are obtained such as the first, second, third, fourth--the one hundredth the one hundred thousandth and the millioneth, and to calculate how many molecules of the medicine are present-if any at all. According to the centesimal scale, as introduced by Hahnemann, the first potency must contain part of the strength of the remedy, the following each ro of the preceding one.

Take for example Belladonna the medicinal strength of the mother tincture being, it will be necessary in preparing the 1st potency to use 98 drops of Alcohol and two drops of the mother tincture of Belladonna. One drop of this solution is then added to 99 drops of Alcohol to produce the second potency-and one drop of the second must be added to 99 drops of Alcohol to produce the third and so on indefinitely for higher potencies. So that the several potencies will contain the following fraction of the original drop:

1st Potency-will contain the th part of a drop.

1-10,000th part of a drop. 1-1,000,000th part of a drop. "Billionth part of a drop. Trillionth part of a drop. Quadrillionth part of a drop. Quintillionth part of a drop. none at all.

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2nd.

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was supposed to contain the septillionth part of

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* But contains none at all.

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* See Am. Jour. Sci. and Art, Vol. L, p. 38 and 258.

Maxwell "Atom" Ency. Brit.

44

To form some conception of such large figures as even one billion, it is only necessary to state that one billion exceeds all the seconds of time in 32 years.

So that if a patient were given one half a teaspoonful of the potency (6 cent.,) which contains the one billionth of a drop of Belladonna, every second for one year, he would in the course of that time have swallowed what would be equivalent to one drop of Belladonna; and further, if it were possible to prepare a one hundreth-thousandeth potency, as some claim to have done, which could contain its share of the drop of Belladonna, it would take 22,222 years by taking a half teaspoonful every second of time, to swallow one drop of the medicine. In swallowing one drop of the medicine which contains the one billionth of a drop-if it were made with water the patient would swallow 15,448 gallons in the course of a year.

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In the annual address (1873) delivered by Dr. T. F. Allen, of New York, before the State Medical Society, which has just come to my notice, I quote the following: In making our dilutions, one drop of the drug is each time added to 99 of pure water. If the whole could possibly be preserved we should have at the fif teenth dilution our original drop of the tincture diluted with an amount of water the size of this globe; the sixteenth would dilute with 99 other globes, and so on. Now, at the fifteenth each drop would contain one sin. gle atom of the original drug. In the sixteenth only one drop in a hundred would contain an atom, and in taking one drop of this (at random) to make our seventeenth, the chances are much against our getting that one drop containing the atom, and in the next few potencies, the chances amount to a certainty that none of the drug can be present." This paragraph has embodied in it exactly what I wished to communicate, viz:--That after a medicine had been diluted and diluted, a time would come when some portions of the liquid added would contain one molecule of the medicine, while another portion would contain none at all-just as the soap bubble bursts when the film has been expanded to such an extent that its thickness becomes the diameter of the molecule of water, to expand it more as a film it would be necessary to expand the molecule, and this would produce a decomposition and new bodies would be found having properties entirely different from water. Just as the molecules of the soap bubble burst and go here and there through the air, so will a drop of medicine burst when diluted beyond a certain point, and its molecules will go here and there, one portion of the liquid containing one molecule and another none at all. Is it possible then that physicians are justified in using such high potencies as even the twentieth, the thir tieth, &c., when science completely demonstrates that there is not even a molecule of the medicine present? Dr. Allen states, "We' (?) believe, with reasonunbiased and unprejudiced, that a dilution of a drug far exceeding all probable or even possible limits of sub-division of matter is yet active, and active too in a measure identical with the crude material;" and he believes that the peculiar molecular activities or forces which endow matter with its properties can be transferred to indifferent fluids or other molecules. which shall receive and perpetuate these forces, and in time become active as was the original matter."

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This is a very pretty theory, but I doubt if there are many scientific men who will be willing to admit that any medicine which possesses properties peculiar to a certain drug, can possess such properties when not even a molecule of the drug is present. Let us look and see what would be the consequence of such a theory-the result would be that every glass of croton water we drink would be medicated water; for in preparing the high powers, as a rule of the drug is thrown away, 100 this would convert all the waters of the earth into the fifteenth potency. But as there are several thousand potencies made at present, all containing a peculiar drug, and of the drug is thrown away--it is difficult

for me to see why the water is not at present all medicated water. And if such is possible, where do the Homœopaths (who believe in high potencies), obtain sufficient pure water of an " indifferent" nature to enable them to make their various potencies.

I can see the advantage of giving medicine in as small quantities as possible, when the system is in an abnornal condition, but I cannot see the advantage of giving a medicine so diluted, that it has not sufficient forcepower to demonstrate its presence by any well known chemical reaction, and if this is my opinion, how much less would I think of a medicine which has not even one molecule of the original drug present. I can not conder the force-power of a drug as something independent of the drug-I can only consider the force-power of the drug as the drug itself--and as the only means by which the drug becomes known to our senses, consequently where we have evidences of the force-power peculiar to a drug, there we have evidences of the material presence of the drug, and since there can not be one molecule of the drug present in the 20th potency, therefore there can be no force-power other than from the menstrum in which the medicine is given.

What effect could a few drops of the 30th potency have in a glass of water to a person who is traveling. I can understand that after awhile the organic and inorganic constituents normally present in water, would have little if any influence on the human system, provided a person resided in one place and drank the same water; but to a person who travels, the impurities fluctuate in composition and have a powerful action on the system as is well known; is it possible then the theoretical forcepower present in the 30th potency could have any action on the system, when it had to battle with such powerful competitors. Such an idea is not even reasonable and should not be encouraged.

Let sufficient medicine be given to accomplish the object in view,-and only sufficient-but let us deal with realities instead of theoretical quantities.

Because good nursing, food and fresh air has restored sick persons to health is no justification for using what are called medicines, which do not contain a trace of a drug; the time has often come when these three factors have been overpowered and death has been the result, because physicians have dealt with theories instead of facts.

In a future paper I will say something with respect to insoluble substances. I quote the following remarkable passage from the Homœopathic Pharmacopoeia: We avail ourselves of a fact, unknown to chemistry, that all medicaments brought by tritutration to the third potency aresoluble in water and alcohol. "I will also say a few words as regards the wonderful force-power sugar of milk must acquire when placed in the moon's light, or under the influence of the colored lights of the spectrum, as also when treated with melted ice or snow water; and perhaps refer to the remarkable property milk sugar acquires when placed at the pole of a magnet, which then enables it to cure the tendency of ingrowing toe nails.

reconsider in every phase, all the various items which have any bearing upon the health and lives of children, in the hope that little by little we may gain knowledge which will keep us on in the grand work of preserving human life, and improving human stock. It is very probable that any decrease in the present high rate of infant mortality will be brought about more by preventive medicine and strict hygiene, than by any treatment of disease once begun, no matter how skilfully treatment may be applied.

The point in Infantile Hygiene to which I wish to direct attention has never to my knowledge, been brought to the notice of the profession through the press; and though it probably has little or no bearing upon the mortality of children, yet in its remote effects it may have an important relation to the vitality and consequent longevity of individuals. It may seem at first view a trivial matter, and one unworthy of consideration. It is simply concerning the manner in which children are habitually laid hold of when about to be raised to a person's arms--the way in which children are commonly lifted.

It is to be observed this is universally done by placing one hand under each of the child's arms, overcoming their weight by holding the thorax firmly grasped in the hands, thus subjecting the child's chest to a very considerable pressure. This pressure is necessary if chil dren are to be lifted in this manner, for the articulation at the shoulder is not. yet firm enough to allow the child's weight to be overcome by an upward tension alone, without danger of straining that joint.

We see then, that when we lift a child in this manner our arms are strongly adducted, and our fingers quite forcibly flexed upon the yielding walls of the child's thorax, and the resulting pressure is brought to bear upon those ribs extending from the fourth to the ninth, and is most concentrated in the mammary regions,slightly below and exterior to the nipple. If this compression were only in occasional operation it would not merit any attention, but when we remember that during the first 3 years of childhood this abnormal pressure is applied many times daily, it becomes more worthy of our consideration.

If we find that this method of handling children may be a possible near or remote source of departure from health, we are to note the fact that those children who belong to the better classes of society, and have there. fore the most constant and solicitous care bestowed upon them, are more subjected to whatever deleterious influence this mode of lifting them may exert, than are the children of poverty who have much less attention. The especial point to be considered in relation to this subject is this: What will be the effect which the frequent, daily repetition of the pressure above described will have upon the soft and rapidly growing thoracic walls of children? Will it not have a tendency to de crease the normal lateral diameter, and the antero posterior diameters of the chest, in the mammary region, where the pressure is greatest, and thus diminish its capacity? If it do this in even a slight degree, then its detrimental influence must at once be acknowledged.

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A STUDY IN INFANTILE HYGIENE. May we not here find a solution of the cause of that deformity known as pigeon breast, the origin of which BY J. N. TILDEN, M.D., PEEKSKILL. has not, heretofore, had any satisfactory explanation. The many causes which lead to the production of Dr. Alexander Shaw, author of the article on "Surgical disease in children have been very carefully noted and Diseases of Childhood," in Holmes Surgery, in speaking classified by the various authors who have written con- of this deformity, states that it is not inconsistent cerning the affections of children. Diet, air, exercise, with symmetry in other parts of the chest, and the frame clothing, cleanliness, &c., have all been considered in generally. The deformity is more frequently observed their various relations so thoroughly that the subject of in the young, which leads to the inference that patients "Infantile Hygiene" would seem to be well nigh ex- commonly outgrow it." His theory of its causation is hausted. When we consider the large human mortality that it is produced by want of free entrance of air into which exists under the age of five years we must admit the lungs to fully distend them, and he says that "when the vast importance of this subject, and if we would the chest, as in childhood, is highly flexible, any cause perform our duty as conscientious physicians, we must that obstructs the entrance of the air into the lungs give it our repeated and almost constant attention. We may lead to changes in its figure resembling pigeon must persistently trace and retrace, and consider and breast deformity." It will be shown quite conclusive

ly a little further on, that this deformity is much more three years of age, the plane of the chest in the mam likely to take its origin from the abnormal external mary region is flattened,

pressure which is so frequently applied during childhood, than from the hyper-action of the muscles of inspiration, induced by dyspnoea. According to Dr. Shaw, the deformity in question is caused by the external pressure of the atmosphere, acting upon the flexible walls of the chest when the lungs are not freely inflated. The thorax acted upon by the respiratory muscles to enlarge its capacity, but as air does not fully fill the lungs there is suficient overbalance of external atmospheric pressure to indent the chest along the line of least resistance, which is the junction of rib and costal cartilages, and this indentation leads to protuberance of the sternum.

It is much to be doubted if dyspnoea could in this way produce so marked a deviation from the normal shape of the chest. If so, then we should expect to find it existed in every case of habitual asthma. Not only is this not the case, but it is quite common to find cases of pigeon breast where we can elicit no history of previous dispnoea.

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Another point in this connection which is simply speculative; because we have no rigid normal standard by which to judge is concerning the obliquity of the ribs. It will be borne in mind that the first three ribs are nearly horizontal in their direction from behind, forward. From the fourth their direction becomes oblique, pointing downward more and more to the ninth, when the obliquity decreases until the eleventh and twelfth are again nearly horizontal. Is it possible that the daily, often repeated compression and depression of the ribs between the fourth and ninth, which we have noted as occurring during the first three years of childhood, is in any degree responsible for this obliquity? It is well known that lacing very quickly, and materially increases the obliquity of those lower ribs which form the base of the thorax, and similarly if a like cause were in operation early in life, bringing under its influence all those ribs which have an oblique direction, might it not be the cause of this obliquity? Is this obliquity strictly normal or has it become through repetition an hereditary deviation from a better standard, which would give increased thoracic capacity, increased vitality and larger immunity from phthisical disease? If all the ribs were more nearly horizontal, the phenomena respiratory action would be somewhat modified from its present mode. This point is alluded to, as it might be supposed that the obliquity of the ribs is necessary for the suitable accomplishment of respiration. In examining the thoraces of children from two to four years of age, we shall almost invariably find that the full rounded curve which laterally bounds the thoraces of infants of a few months of age, has given place to a sharper or shorter curve in the subaxillary region, and the plane of the chest in the mammary region is abnormally flattened. This degree of flattening varies considerably in different children, being modified not only by constitution but by the wide variations in which they are subjected to the cause. It is also dependent upon the size and weight of the child. The chest of a large, heavy child becomes modified in shape earlier than in the case of a more delicate infant. This fact is illustrated in lines No 6, in the diagrams. In these diagrams are represented in one plate the lateral curve of the chest, extending from the spinal column around to the sternum, and in the other the outline of the anterior aspect of the thorax extending from each subaxillary space, across on a line with the nipples. These lines are reduced one-fifth from actual measurement taken from seventeen consecutive cases of children varying in age from two weeks up to three and a-half years. These diagrams will fairly illustrate the average as we would find it in a hundred cases. We see from these diagrams that there is a considerable variation in the outline; demonstrating beyond doubt that in children of

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various types, and varies in different individuals. This is granted, but notice that in infants under the age of six months, and even one year, the outlines (so far as my observation has extended, comprising nearly 300 cases), have been constant, after one type, as shown in No. 4, aged seventeen days. No. 10, aged four months; No. 14, six months, and No. 2, a small but healthy child aged fifteen months.

The nearest approach to the same outlines in older children is found in Nos. 13 and 17, aged respectively 3 years and 2 years. In both these cases very little care or attention was bestowed upon them after they were one year old. These two children were then left to the care of older children too young to carry them, and therefore they were very seldom lifted in the habitual manner. In contrast to these chest lines, observe Nos. 1, æt. 3 years; 3, æt. 16 mos; 6 æt. 31 years; 7, æt 64, and 8, æt. 51. Notice in No. 1 a near approach to pigeon breast deformity. This child was a great favorite; had a nurse in constant attendance, and was subjected to the mode of lifting under consideration oftener than any other case which has been found. No. 3 gives early evidence of the influence of thoracic compression, for the reason that he is a large, heavy child, who had unremitting attention. Nos. 3 and 4 are brother and sister, and we cannot, therefore, account for the marked difference in outline by ascribing it to variety in natural type, and the same is true of Nos. 8 and 10. We see, then, beyond doubt, that the thoracic outlines of children certainly change, as previously pointed out, and vary markedly accordingly as the children are subjected to the method of lifting already described.

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Combe, in his work on infancy, says that in lifting young children the nurse should be very careful never to lay hold of them by the arms, as is sometimes thoughtlessly done, but always to place the hands one on each side of the chest immediately below the arm pits." This caution is well so far as it prevents nurses from raising children by the arms, and in small, light children is safe, but in large children, weighing within the first year from 15 to 25 pounds, the amount of compression required to raise such children to the nurse's arms is sufficient to distort the anterior aspect of the chest from its normal shape. We need not be reminded that these pliant thoracic walls serve to protect those organs most concerned in our vitality and strength. No. 3 illustrates this point: It is the outline from a child who weighed over twenty pounds before he reached the age of one year. Compare it with No. 4, the outline of his infant sister, aged two weeks.

It is possible, inasmuch as children after three years of age are seldom lifted by thoracic compression, that the energetic vitality of childhood soon suffices to correct in a great measure and in the large majority of cases, any deficiency of thoracic capacity or other deviation from normal growth which the cause under consideration may have produced. If, however, this compression of the chest become recognized as even an occasional source of departure from a normal condition; if ever a case of pigeon breast deformity be traced to this cause; if by diminishing thoracic capacity in the slightest degree it thus impairs vitality, then, indeed, does it demand the attention of our profession! In the progress of our science we more and more recognize our duty to lie rather in the prevention of disease than in its cure. is our paramount duty to use every means at our command to develop and improve the physical condition of our race, for through physical advancement will come also intellectual and moral progress.

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In the consideration of this question, it will be well for us to look a moment at what is accomplished by simple manipulation in the treatment of diseases. It is not necessary here to go into details, for it is well established that in many surgical diseases treatment by manipulation in its various forms is of the greatest importance. Take, for instance, the daily use of suspension

in spinal curvatures, extension and rubbing in partial anchylosis, massage in sprains and contractures, &c. Now, if in these rigid structures manipulation applied once or twice daily has the effect of changing materially the condition of the parts operated upon, how much more will the frequent, daily repetition of firm pressure always applied in nearly the same manner upon the rapidly growing, easily yielding and pliant walls of a child's thorax have the effect of changing and distorting their normal growth.

The question now arises how may this danger be avoided? How shall we instruct mothers and nurses to lift and carry their children in any better manner than the one so universally in use? How shall this prevailing method be improved upon? The answer is very plain and simple. Nature has admirably adapted the pelvis for supporting the weight of our bodies at all ages, It is therefore to be advised that a child should always be raised by placing one hand under the gluteal region, while the other hand may either in front or behind the thorax assist in supporting the weight and at the same time steady the child in a comfortable position. This is easily done when the chid is either lying or standing. When in a sitting position, one hand may be passed across the chest either in front or behind and by a slight hold of the opposite arm the child's body may be tilted to one side, or backward or forward as may be most convenient, when the disengaged hand may be easily placed under the gluteal region, and, as before, the child's weight will thus be admirably supported by both hands, one protecting and sustaining the thorax and the other the pelvis, thus supporting the child's weight equally, easily, and without possible danger of harm. The accompanying illustrations show the two positions above described and this method of lifting children will be found equally as convenient as the mode commonly in use, while its superiority consists in the entire absence of those possible dangers which have been pointed out as liable to arise from compression of the chest.

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prove these articles to be innocuous, The capacity of the human mechanism to accommodate itself to extremes in its various processes and surroundings is one of the most wonderful features of our existence. We find variations in all degrees in diet, exercise, clothing, cleanliness &c. We frequently see all the laws of hygiene set at utter defiance and yet find robust and vigorous health when we would only expect to find disease. And again under the most favorable auspices of careful hygiene, where every condition would seen to promise health we often find sickness and death.

The wisest theories of the physiologist and therapeutist are often set at naught by the actualities of practice. These contradictory problems are not to discourage us. We are not to yield because our science refuses to become exact. Slowly and little by little does our knowledge of the human body, its diseases and their treatment come. Let us therefore, each for himself, investigate this phase of Infantile Hygiene" and in this way we shall finally eliminate whatever errors the writer may have advanced and the true degree of importance which attaches to this subject be properly established.

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LOCAL APPLICATIONS.

BY R. R. GREGG, BUFFALO.

Another class of cases, similar to the foregoing, are those where the lungs being relieved, the disease goes to the mucous membrane of the nostrils, and congests that just as a cold does so commonly in the first instance before it goes to the lungs. A case of this kind was that of a daughter of the lady just spoken of, whom I attended only two or three weeks since for congestion of the lower portion of the right lung, accompanied by a severe cough. As soon as the congestion of the lung was relieved the nostril became very much "stuffed," as though a severe fresh cold had been taken, and the family feared such was the case, but I assured them it was not, and it all passed off in a few days without the lungs showing further signs of disturbance.

Another similar case, in results, was that of a patient whom I discharged cured, yesterday, Dec. 7th. This patient was a large, stout man, aged forty years, who for the first time in his life had genuine congestive or inflammatory croup. He had suffered severely through the night, and called me in the early morning, four days ago. His cough was violent, of as harsh or croupy

a sound as I ever heard, and accompanied with so great a sense of suffocation that it was with difficulty he could restrain himself from getting up and running to a window for fresh air. Expectoration very slight, yet a little did occur in his most violent paroxysms of coughing, and was bloody mucus. I administered Aconite 1000, two doses at intervals of two hours, and four hours later one dose of Spongia 1000th, and by evening there was a great modification in the cough, the expectoration of bloody mucus became quite free, and from that time there was little trouble in the case, excepting the second day, and after the croupy cough had wholly disappeared, he had every indication of having taken a severe cold in the head, without having been out of his room. I explained the nature and reasons for this in the fact of the congestion passing up from the larynx into the nostrils, when his wife spoke and said she had always observed the same result in their little girl, who had been quite subject to the croup; and she felt entirely safe when that occurred.

Again, another class of cases that occurs as often as either those where the disease goes to the nostrils or to the frontal sinuses, when cured in the lungs, are those where it appears in the throat, and also frequently breaks out upon the lips in cold blisters during, or after, the relief given the lungs. In all these cases the physician must exercise the most scrupulous care against every kind of local applications, gargles, etc., unless he wants his patient to have a relapse, or be left with a broken constitution.

While upon the subject of lung diseases, I will give another, from a different cause. About a year ago, a large, powerful man called to consult me for a severe cough from which he was suffering. The cough had its immediate origin in a serious form of chronic bronchitis. And this I learned followed soon after the suppression of erysipelas upon one of his hands the spring before. Finding Belladonna clearly indicated by the character of the cough and other symptoms, I prescribed easier and his breathing freer, and the next day the eryit in the 2000th potency. By that night the cough was sipelas broke out upon the same hand again. He called what alarmed, he called upon another physician, who to see about that, but not finding me in, and being somesuppressed it again, and the last I heard definitely about his case, his lungs were as bad as before.

will cite. A corpulent lady had erysipelas of the left Another case of suppressed erysipelas of the hand I hand last spring, which, under the advice of a physician, was treated with applications of cold wet compresses, painting with Iodine, etc., until suppressed, when followed great pain in the arm, and finally paralysis, which, upon being relieved by Rhus. tox. 200th, was itself followed by erysipelas.

And so the murderous work goes on; and the mongrels of our school abate not in their delight at imitating such bad examples.

None can plead want of proof, as so often said before, to correct such errors in their own practice, and point it out in that of others, for clear and positive cases are occurring everywhere and in great numbers, if physicians will but look for them. Only a few days ago I received by mail a pamphlet, describing Pond's New Phonographic Sphygmograph," in which was given the following case:

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A. R., nineteen years ago, had the first attack of palpitation of the heart; health previously robust. Three years ago had what was supposed a severe attack of sciatica; when this left, pain commenced in the chest about the heart; had about this time a fit, falling insensible for a few minutes; having pain, used Morphia, which habit has been continued ever since. Patient has had pain, palpitation, dry cough, distress after taking food, headache, sometimes dizziness, and occasionally a feeling of suffocation. The pain extends through from the sternum to the right shoulder; any excitement now causes the heart to beat with great violence, with throb

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