on between them was very large. The plexus
choroides was pale.

[Footnote 11: In this case, and in case first, the vena cava
ascendens had been divided, before the brain was examined.]

CASE IX.

A lady, about forty-five years of age, the mother of many children,
has been troubled during the course of the past year with violent
palpitations of the heart, and great difficulty of respiration,
especially on going up stairs. These complaints have lately increased,
so that she has kept in her chamber about two months. Her countenance
is florid; her eyes are clear and bright. She has dizziness,
especially on moving, without pain in her head. She had for some time,
a severe cough, which is now relieved. The dyspnoea is not yet very
distressing, except on using motion; it often occurs in the night, and
obliges her to rise and sit up in bed. The palpitations are very hard,
and so strong, that they may be perceived through her clothes; the
tumult in the thorax is indescribable. The functions of the abdominal
viscera are unimpaired. The pulse is hard, vibrating, irregular,
intermittent, very variable, corresponding with the motions of the
heart, and similar in each arm. There is not yet the slightest reason
to suspect any dropsical collection. The alternations of ease and
distress are very remarkable, but on the whole, the violence of the
symptoms increases rapidly.

There is no difficulty in discovering in this case an organic disease
of the heart, which probably consists in an enlargement and thickening
of the heart, and an ossification of the semilunar valves of the
aorta.

CASE X.

Levi Brown, a cabinet-maker, forty-eight years of age, complained in
February, 1809, of great difficulty of breathing, and an indescribable
sensation in the chest, which he said was sometimes very distressing,
and at other times quitted him entirely. Being a man of an active
mind, he had read some medical books, whence he got an idea, that he
was hypochondriac.

On examining his pulse, it was found to be occasionally intermittent,
contracted, and vibrating. He had some years previously been attacked
with copious haemorrhages from the stomach or lungs, which have
occasionally recurred, though they have lately been less frequent.
Eight years since he suffered from an inflammation of the lungs; and
about two or three years ago he first experienced a beating in the
ches