Page:Transactions of the Provincial Medical and Surgical Association, volume 2.djvu/213

 that the frequent occurrence of phthisis, in persons who have this form of cachexy strongly marked, has led us to believe in its non-inflammatory origin. But we are disposed to assert our attachment to this view, the rather because such circumstances as we have hinted at, are by no means more common here than in other large cities, where many of the inhabitants are compelled to struggle with the injurious influence of close air, bad or scanty food, and squalid habits; and, consequently, our opinion is founded on the general history of the disorder in question.

Rheumatism is a most prolific parent of cases in this locality, but does not, as far as we have been able to determine, present any peculiar characters. Both in the acute and chronic form, it appears such as we have observed it elsewhere, whether with reference to the constitutional affection, the parts most frequently attacked, its sequelæ, or its amenability to remedies. Correspondently with its remarkable frequency in this place, we meet with a large number of cardiac cases, particularly pericarditis, hypertrophy, and disease of the valves. Simple dilation, which has no immediate connection with rheumatism, is of more rare occurrence.

Next to rheumatism in the order of frequency, we must place those gastric derangements which pass under the denomination of pyrosis, gastralgia, morbid sensibility of the stomach, &c. It very seldom happens that a patient complains of a gnawing pain in the stomach, without also mentioning that he is subject to the ejection of a clear glairy fluid. There is often tenderness at the epigastrium, but the tongue, which, for the most part, assumes a pale,