¥ On Distases of the Heart, vol. i pp 241-3.
i








CHECK THE PROGRISS OF DISEASE. as


only did he continue well four years after his recovery, but T saw:
him again ten years after it, he being then twenty-one years old.
‘The heart's impulse was still considerable; the sound continued
long and loud and rough, but the young man had no other ailment
than occasional palpitation, and sometimes slight sense of discom=
fort at his chest: and this, although he was leading a loose kind
of life—strolling over the country as a ballad-singer, often getting
wet, and walking long distances of twenty miles and upwards in a
day, and thie, as he said, without fatigue.
Other cuses of a similar kind, though less remarkable than these
two, have come under my notice—cases which would warrant, I
think, a more hopeful prognosis in cases of valvular disease of the
heart in childhood than we should be justified in entertaining if
our patient were an adult, But consolatory as it is to know that
time helps in some instances to repair the damage done to the
heart in childhood, yet these fortunate cases are after all bub
exceptional ones, These exceptions, too, are not by any means
proportionate to the number of instances in which the original
inflammatory attack has been slight, or in which it has not re-
curred; but of two cases whose early history has been identical,
the progress of the one will be by slow degrees of improvement
towards comparative health, of the other by slow deterioration to
a painful death. In the latter case, too, a post-mortem examina-
tion may often fail to discover any such large extent of valynlar
disease as might be expected from the nature of the symptoms
during life.
