394: LECTURE XVI. 



the wanting tissues, but as to any reproduction of a 

 new, functionally active part, that must ever be out of 

 the question. 



Herein you must seek the explanation of the circum- 

 stance, that conditions apparently very similar, and 

 which from a pathologico-anatomical point of view 

 might be declared to be identical, in a clinical point of 

 view lie widely apart, and that the same forms of 

 changes are met with in analogous parts, without, how- 

 ever the whole process, to which they belong, being the 

 same. When a muscle falls into a state of simple fatty 

 degeneration, its primitive muscular fasciculi may have 

 just the same appearance as if inflammation or perma- 

 nent tension had acted upon it. Myocarditis generates 

 forms of fatty degeneration in the substance of the 

 heart altogether analogous to those due to excessive 

 dilatation of the cardiac cavities. When one of these, for 

 example, either through some obstruction to the current 

 of the blood, or from insufficiency of the valves, is per- 

 manently much dilated, fatty degeneration of the muscu- 

 lar tissue constantly manifests itself in the part which 

 has been most stretched. This form, morphologically 

 speaking, completely resembles the early stages of my- 

 ocarditis, and in many cases it is utterly impossible 

 to say with certainty in what way the process may 

 have arisen. 



I have, in order to clear up to some extent these diffi- 

 culties, as they are presented by an important, frequent 

 and at the same time much misunderstood process, pre- 

 pared a series of specimens exhibiting really atheromatous 

 conditions of the arteries. For it is particularly in the 

 case of these conditions that the confusion, which has pre- 

 vailed with regard to the interpretation of the change, 

 has perhaps been the greatest. 



At no period in the course of this century has a com- 



