241 



Treatment.— 11 the cause can be discovered and is removable it 

 should be done. The iodide of potassa, in cases of valvular thick- 

 ening, may be of some benefit if continued for a sufBcient length of 

 time; it may be given in 2-dram doses, twice a day, for a month or 

 more. Ilj'drocyanic acid, in 30-drox) doses twice a day, may relieve 

 abnormal muscular irritability. General tonics, freedom from excite- 

 ment or fatigue, avoidance of bulky food, good ventilation, etc., are 

 indicated. 



DILATATIOX OF THE HEART. 



This is an enlargement of the cavities of tlie heart, and may be 

 confined to one or extend to all. Two forms of dilatation may be men- 

 tioned — simple dilatation, where there is normal thickness of the walls, 

 and passive or attenuated dilatation, where the walls are simply dis- 

 tended or stretched out without any addition of substance. 



Causes. — Any cause producing constant and excessive exertion of 

 the heart maj" lead to dilatation. Valvular disease is the most fre- 

 quent cause. General anaemia predisposes to it by i^roduciug relaxa- 

 tion of muscular fiber. Changes in the muscular tissue of the heart- 

 walls, serous infiltration from pericarditis, myocarditis, fatty degen- 

 eration and infiltration, atrophy of the muscular fibers, may lead to 

 dilatation. 



Symptoms. — The movements of the heart are feeble and prolonged, a 

 disi^osition to staggering or vertigo, dropsy of the limbs, very pale or 

 very dark-colored membranes, and difficult breathing on the slightest 

 excitement. 



Treatment. — General tonics, rich food, and rest. 



FATTY DEGENERATION OF THE HEART. 



Fatty degeneration may involve the whole organ or may be limited 

 to its walls, or even to circumscribed i)atches. The latter is situated 

 at the exterior, and gives it a mottled appearance. When generally 

 involved it is flabby or flaccid, and in extreme cases collapses when 

 emptied or cut. Upon dissection the interior of the ventricles is 

 observed to be covered with buff-colored spots of a singular zigzag- 

 form. This apx)earance maybe noticed beneath the pericardium, and 

 pervading the whole thickness of the ventricular walls, and in extreme 

 cases those of the fleshj^ columns in the interior of the heart. These 

 spots are found to be degenerated muscular fibers and colonies of oil- 

 globules. Fatty degeneration is often associated with other morbid 

 conditions of the heart, as obesity, dilatation, rupture, aneurism, etc. 

 It may be connected with fatty diseases of other organs, as the liver, 

 kidneys, etc. AVhen it exists alone its i^resence is seldom suspected 

 previous to death. It may be secondary to hypertrophy of the heart, 

 to myocarditis, or to pericarditis. It may be due to deteriorated con- 

 ditions of the blood in wasting diseases, excessive hemorrhages, etc., 

 or to poisoning with arsenic and phosphorus. 



