316 DISEASES OF THE HEART. 



ANATOMICAL APPEARANCES. The weight of the normal heart 

 amounts in adult males to about ten ounces, in females to about 

 eight. A hypertrophied heart may weigh from one to two pounds. 

 According to JSizat, the thickness of the left ventricular wall is computed, 

 in the male at five, in the female at four and a half lines ; the thick- 

 ness of the right ventricle in males being almost two lines, in females 

 one and two-thirds lines. The right auricular wall is one line in 

 thickness, the left one and a half lines. Hypertrophy of the right 

 ventricle may be considered to commence when the thickness attains 

 six lines in the male, and five in the female. The right ventricle is 

 hypertrophied if its thickness amount to three lines in the male, or 

 two and a half in the female. In the most extreme cases of hypertro- 

 phy, the left ventricular wall may acquire a thickness of an inch or an 

 inch and a half; and the right may be six or nine lines in thickness, 

 while that of the auricles may amount to two lines, or in the left au- 

 ricle even three lines. 



This increase in volume sometimes is most marked in the fleshy wall 

 proper, sometimes in the trabeculae and papillary muscles. The former 

 is most often found upon the left ventricle, the latter in the right 

 ventricle. Hypertrophy may be total, that is to say, extending all 

 over the heart, or partial, that is, limited to certain portions of iti 

 We distinguish three forms of hypertrophy, according to the capacity 

 of the hypertrophied portion where the capacity is normal, simple 

 hypertrophy ; where the cavity of the heart is enlarged, excentrie 

 hypertrophy; where it is diminished, concentric hypertrophy. In 

 the first and second forms, the size of the heart is increased ; in the 

 third, if the diminution of the cavity exceed the hypertrophy of the 

 wall, the organ actually may be smaller than is natural. 



Simple hypertrophy is not common. In many cases in which the 

 hypertrophied heart seems to have its normal capacity, its cavity has 

 been dilated during life, but has contracted energetically during the 

 agony of death, so as to cause the dilatation to disappear in the ca- 

 daver. This form is confined to the left heart, particularly to cases in 

 which hypertrophy of the heart complicates Bright's disease. 



Excentrie hypertrophy is the most common form, and is often met 

 with extending over the entire heart, and should the hypertrophy and 

 dilatation attain any great degree of magnitude, it may occasion the 

 establishment of an " enormitas cordis" of a " cor taurinum" In 

 some cases excentrie hypertrophy is restricted more to the left side of 

 the heart ; in others, to the right. In the former case, the capacity of 

 the right ventricle often suffers, as the septum, the muscles of which 

 belong, in great part, to the left ventricle, is made to project into the 

 cavity of the right ventricle. 



