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scarcely perceptible; his looks greatly improved; his spirits good. Apparently he has no complaint, though he says that either exertion of body, or agitation of mind, will still increase the palpitation, accompanied with the beating sound in his head, which resembles that of a drum, and which is always worse in the horizontal posture.

The inference to be drawn from this case is, I conceive, quite sufficient to make us always cautious in our prognosis, however strong and clear diagnostics we may suppose we have to justify a positive opinion; for it is only the boldness of inexperience which will pronounce, with infallible confidence, upon the nature and termination of diseases, in which the most experienced and acute observers see reason to doubt.

In illustration of my second position, I now proceed to cite cases of

Palpitation, from heart disease, when the diagnostics were so obscure, as to raise a doubt of its existence, but which was Jinalh/ proved bj/ its fatal termination.

October 2, 1826. — Mr. H. P. was sent down to Liverpool, from London, by one, if not two, distinguished Metropolitan physicians, to try the effect which a few months' residence on the sea shore here, would have upon his complaint, which was supposed chiefly, if not solely, to be owing to an unusual irritability and debility of the whole nervous system. After remaining the prescribed time, and finding he was no better, his mother, who was with him, consulted me, and certainly I found him of a very irritable habit; and, although now 18 years of age, and his family fond of