INCIDENCE OF ORGANIC DISEASE 61 



In this connection we have already traced the bacterial 

 relationships of various septic conditions of the cerebro- 

 spinal lymph, and the simultaneous or immediately sub- 

 sequent appearance of similar pericardial or endocardial 

 bacterial involvement, in which alone the element of the 

 cerebro-spinal lymph is primarily involved, and which, by 

 the continuity of its presence along the nerve trunks, 

 secures the spread of the disease, from the cerebro-spinal 

 cavity to the cardiac cavities and structures covering, 

 lining, and interstitial. 



The incidence of disease of the muscular structure of 

 the heart in like manner may be traced to materio-dynamic 

 interferences with the nutrition of its fibres and their 

 consequent innervation, by mechanical, chemical, or bac- 

 terial causes owning a central nervine origin, and acting 

 along histological lines of continuity via the pneumogastric 

 nerve trunks, stretching from the cerebro-spinal structures 

 to the dependent cardiac musculature ; thus atrophy, 

 hypertrophy, fatty degeneration, and other associated and 

 consequent heart conditions owe their origin and incidence 

 alike -to interferences with the distribution of neuro- 

 muscular plasma, and the consequent lapse or perversion 

 of neuro-dynamic influence or energy, with the subsequent 

 evolution of disease entities, according to the particular 

 etiological combination of disease factors. 



Of course the heart, being beholden for its innervation 

 and nutrition to both nervatures, can be sustained in 

 functional wholeness and comparative health when failure 

 threatens from either side, and will only yield when both 

 sources fail ; we must, therefore, in estimating the probable 

 etiology and pathology of any disease of the muscular 

 structure of the heart, allow for this organic duplex nutri- 

 tion and innervation, so as, if possible, to adjust our 

 unfortunately usually only ameliorative treatment with the 

 greatest scientific precision. The various diseased con- 

 ditions named above may be due primarily to non-over, 

 or perverted, production of neuro-muscular plasma by the 

 central neuronal elements, to faulty neural conveyance 

 from the scene of production to the scene of delivery, or 

 to imperfect powers of assimilation of the receiving 

 organic or muscular structures, in whole or in part, and 



