152 SYMPTOMS. 



greater consistence, dryness and brittleness. and these 

 qualities depend upon a peculiar modification of the 

 infiltrated fat, which, although accumulated to a con- 

 siderable amount, leaves but few traces on the scalpel. 



When there is fatty degeneration of the heart in 

 addition to that of the liver, there is a feeble inappre- 

 ciable "cardiac impulse ;" very faint cardiac sounds ; a 

 very slow, feeble, or quick and irregular beat of the 

 pulse; with frequent attacks of giddiness, faintness, 

 difficulty of breathing on the slightest exertion ; and a 

 feeling of sinking at the pit of the stomach. 



When the kidneys become implicated, the urine is 

 diminished in quantity, is ^in-rully turbid, deposits 

 numerous oil-casts, and holds a large amount of 

 albumen in solution; there is likewise a tendency to 

 general dropsy; extreme pallor and pastiness of the 

 countenance. 



SYMPTOMATOLOGY. The constitutional symptoms of 

 a fatty liver are but few, and not very prominent ; 

 there is, however, general debility and want of tone in 

 the nervous and vascular system; the patient Hags, is 

 easily tired, and bears depletion, active exertion, or the 

 invasion of acute disease badly. 



"To the eye/' says the late Dr. Addison. in doscribin^ 

 a condition of the integuments, which he believed t 

 pathognomonic of fatty degeneration of the liver: 

 "The skin presents a bloodless, almost semi-transparent, 

 and waxy appearance. To the touch, the general in- 

 teguments, for the most part, feel smooth, loose, and 

 often flabby; whilst in many well-marked cases, all its 

 natural toughness would appear to be obliterated, and 

 it becomes so exquisitely smooth and soft as to convey 



