238 



ADVENTITIOUS GROWTHS IN THE HEART. 



Fibrous, (■(.irtihujinous, and honij formations liave been observed in 

 some rare instances in the mnscnlar tissne. Isolated calcareons 

 masses have sometimes been imbedded in the cardiac walls. Fibri- 

 nous coagida and polypous concretions may be foniid in the cavities of 

 the heart. The former consist of coagulated fibrin, separated from 

 the mass of blood, of a whitish or yellowisli white color, translu- 

 cent, of a jellj'-like consistence, and having a nucleus in the center. 

 They may slightly adhere to the surface of the cavity, from Avhich 

 they can easily be separated without altering the structure of the 

 endocardium. They probably i-esult from an excess of coagulability 

 of fibrin, wliich is produced by an organization of the lymph during 

 exudation. They are usually found in the right auricle and ventricle. 



Polypous concretions are firmer than the preceding, more opaque, 

 of a fibrous texture, and ma}^ be composed of successive layers. In 

 souie instances they are exceedingly minute, while in others they 

 almost fill one or more of the cavities. Their color is usually white, 

 but occasionally red from the presence of blood. They firmly adhere 

 to the endocardium, and when detached from it give it a torn appear- 

 ance. Occasionall}', a Avascular communication seems to exist between 

 them and the substance of the heart. They may be the result of 

 fibrinous exudation from inflammation of the inner surface of the 

 heart, or the coagulation of a portion of the blood Avhich afterwards 

 contracts adhesion with the heart. These concretions prove a source 

 of great inconvenience, and often danger, no matter how formed. 

 They cause a diminution in the cavity in which they are found, thus 

 narrowing the orifice through which the blood passes, or preventing a 

 proper coaptation of the valves, which may protluee most serious 

 valvular disease. 



Si/niptoins. — These are fre<iuently uncertain; they may, however, 

 be suspected when the action of the heart suddenly becomes embar- 

 rassed with irregular and confused pulsations, gTeat difficulty of 

 breathing, and the usual signs dependent upoji the imperfect arteri- 

 alization of the blood. 



Treatment. — Stimulauls, Avhisky, or carl)onate of ammonia, may be 

 of service. 



FUNCTIONAL AND ORGANIC DISEASES OF THE HEART. 



The distinction between f unci ional and organic diseases of the heart 

 is not easily made. We may accept as a guide that the character of 

 organic diseases of the heart is to ijrogress, and that of functional to 

 occur at regular intervals; active exercise almost invariably aggra- 

 vates organic but seldom increases the symptoms of functional dis- 

 ease, and that the physical signs generally are soon developed, and 

 remain permanent in organic, while they seldom exist in functional. 



