436 



THE CIRCULATORY SYSTEM. 



(Fig. 232), so that the function of the heart is seriously interfered with. 

 This occurs sometimes in general obesity, or as a result of chronic peri- 

 carditis, or in drunkards, or in debilitated or old persons. 



4.TION OF THE HEART LlPOMATOSIS. 



The lesion is excessive, the heart muscle being to a large extent atrophied. (The fat cells are represented 

 in the drawing, for the sake of clearness, of relatively too large size.) 



SEGMENTATION AND FRAGMENTATION OF THE MYOCARDIUM. 



Attention has been called by a number of observers to a condition of 

 the heart muscle sometimes observed, it is said, in acute infectious dis- 

 eases, in acute and chronic diseases of the central nervous system, and 

 in sudden death from a variety of causes. The muscle tissue is soft, fri- 

 able, opaque, and often yellowish. Examination shows a loosening of 

 the muscle cells from one another, as if by some change in the cement 

 substance segmentation or the fibres may be broken across -fragmenta- 

 tion. The significance of this alteration is not yet fully established, for 

 though in some cases it is associated with degeneration and other changes 

 in the heart muscle, in others these are not present and the alteration 

 may be agoual, or it may in some instances be due to post-mortem 

 changes. ' 



THROMBOSIS AND EMBOLISM OF THE CORONARY ARTERIES. 



Thrombosis. This may occur in association with endarteritis of the 

 coronaries or from their occlusion at their orifices, either by inflammation 

 of the aorta or by vegetations or clots on the aortic valves. While the 



'Consult Hektoen, Am. Jour. Med. Sciences, vol. cxiv., p. 555, 1897, bibliography. 

 MacCallum, Jour. Exp. Med., vol. iv.. p. 409, 1899, bibliography. 



