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20 arterial sclerosis. This disease is constantly being brought under our notice. Why so? Because particular signs are supposed to betoken it. But do they? Would it not be more true to say that they indicate its occasional origin? The point is that the search for a structural change has shifted its ground on to a functional disturbance—quite properly, as I think—and then incorrectly the arterial state has come to be regarded as due to the condition (sclerosis) of which it is in all probability the cause.

Then de motu cordis. Much work has been done of late upon the irregularities of the cardiac muscle. This work is well known to you and is of the very best, and not by a breath would I belittle it, for it is no doubt gradually emancipating a difficult subject of research from the mists of ignorance that envelop it, and by true Harveian method. But I may perhaps be permitted to say as a caution that it is possible to attribute to disease of the muscle more importance than by right belongs to it, and I believe it will be accepted in the future, as the result of further clinical observation, that many a case of arrhythmia, where we now seem to be inclining to muscular disease, is in truth an aberration of the higher cardiac centres, and as such no true example of pathological anatomy.