ibrating; at another, feeble and
confused. There is also sometimes perceived a pulsation above the left
clavicle, within the insertion of the mastoid muscle, commonly
attended with a visible fulness of the superior part of the breast.
The thorax feels, to the patient, as if it were girt across, and there
is a distinct pain in the heart. Both these sensations are aggravated
by a very hard, frequent, and dry cough, which however begins to be
less violent from the use of the scilla maritima. The countenance is
animated, and rather flushed, but not so much overcharged with blood
as happens in many instances; perhaps it little exceeds a blush, so
moderate that it might be considered as an indication of perfect
health; yet the head is greatly disturbed with dizziness, and
frequent and intense pain, and is seen to be shaken by the
palpitations.

The functions of the abdominal viscera are not much deranged. The
appetite varies, though it is commonly good; the intestinal
evacuations, and the menstrual discharges, are regular; the urine is
turbid, and so small in quantity as sometimes to produce strangury.
The abdomen and inferior extremities are swelled, and the distention
produces an uneasiness in the former, and pain and a livid colour
about the gastroenemii muscles in the latter. The pulse is hard,
without strength or fulness, slightly intermittent, variable, and
irregular; yet it has not so much irregularity as in most of the cases
recorded above.

This patient is uneasy in bed, though she raises her head almost
upright; her sleep is disturbed by unpleasant dreams, and by
startings, sometimes quite to an upright posture, without any cause
discoverable to herself. She can incline a little to the left side,
but never to the right, because it brings on a singular oppression,
and a sense of weight drawing on the left side. When most distressed
by dyspnoea she bends her head and trunk forward, and remains thus
seated a considerable portion of the night, often sighing quickly and
convulsively. She is subject to profuse sweatings, and very liable to
take cold, and is then more uneasy.

This lady is still corpulent. She has taken much medicine, under the
direction of eminent physicians, sometimes with temporary relief, but
most commonly without any. The exercise of walking slowly, in
pleasant weather, although it increases the palpitations at the
moment, is followed with relief from the distressing feelings, which
are increased