384 



LECTURE XVI. 



streaks which communicate so as almost to present a 

 plexiform arrangement, and pervade the substance of the 

 papillary muscles, whilst they offer a striking contrast to 

 the reddish colour of proper muscular substance. This 

 is the perfect form of genuine fatty metamosphoris of the 

 real muscular substance of the 

 heart, which differs most essentially 

 from obesity of the heart, in which 

 this organ becomes extremely fat 

 and adipose tissue here and there 

 so infiltrates its walls, that scarcely 

 any muscle is to be perceived. Be- 

 tween the two conditions there 

 always remains the notable diffe- 

 rence, that in the former case whole 

 portions of active substance are 



interrupted by parts which are manifestly no longer 

 capable of action. 



I have besides brought you another specimen of mus- 

 cle we obtained yesterday at the suggestion of our con- 

 frere Berend. A body, namely, with posterior (angular) 

 and lateral curvature (Kypho-Skoliose) was brought for 

 post-mortem examination, and, when we examined the 

 muscles at the point of curvature, we found the longissi- 

 mus dorsi at the spot where it passed over the projec- 

 tion, converted into quite a flat, thin, pale yellowish 

 mass. At one point the muscle has, with the exception 

 of a membranous layer, entirely disappeared, its red hue 

 has altogether vanished ; towards the lower part the 

 muscle also presents an abnormal appearance, but there 

 it is composed of alternate longitudinal red and yellow 

 streaks. This is the form exhibited by most fattily de- 

 generated muscles which we find in distortions of the 



* Fig. 114. Fatty degeneration of the muscular substance of the heart in its dif- 

 ferent stages. 300 diameters. 



