As these are generally coexistent, they should be considered together. The dimensions of the heart may be increased either by augmentation of its muscular walls, or enlargement of its cavities. The former is hypertrophy, the latter dilatation. The most prominent symptom is difficulty of breathing, produced by any exertion; also, palpitations, which are sometimes so violent as to shake the whole body. The secondary signs are violent headache, vertigo, buzzing in the ears, flashes of light, pulmonary congestion, pneumonia, apoplexy of the lungs, congestion of the liver, bilious disorders, and general and local dropsy. The patient's suffering is often extreme, and, unable to lie in bed, he is forced to assume constantly a sitting posture, with the body bent forward. Death usually occurs suddenly in syncope or fainting. Valvular disease is the most frequent cause, though they may be caused by rheumatic irritation, excessive exertion of the organs from any cause, as violent exercise, playing on wind instruments, violent passions, intemperance, etc.

TREATMENT. -- The exciting cause should be removed, especially valvular disease. The patient's habits of life and occupation should be regulated, and his diet moderated. Mild cathartics should occasionally be given and passive exercise engaged in. Digitalis is the special medicine; cherry laurel water is also used for the same purpose. These should be carefully administered. The tincture of aconite and colchicum should be given where it has resulted from rheumatism. In dilatation the tonics, cod-liver oil, and animal food should be prescribed. Digitalis is also specially required. Wild cherry bark is an excellent tonic, and as nervous symptoms are very apt to be present in females, opium, belladonna, valerian, etc., may be given with advantage. Every effort should be made to enrich the blood.