1 6 C. W. M. Poynter 



C. Congenital Hypertrophy 



The condition was first suggested by Paget (1831), who said 

 that the condition is represented by an increase of all of the parts 

 naturally belonging to the heart. Columnae carnse are sometimes 

 hypertrophied ; in a case reported by Louis ( 18123) these had so 

 much enlarged as to touch and seem a continuous plane. Peacock 

 does not speak of a congenital hypertrophy although he discusses 

 the early hypertrophy due to destruction in balance of the cir- 

 culation as in congenital stenosis of the pulmonary artery. Vir- 

 chow (1896) said that he had seen several cases that he consid- 

 ered due to congenital hypertrophy. Simmonds (1899) reported 

 a case in which the heart at term weighed 44 grams; he sug- 

 gested that the cause was a growth disturbance in early life. 

 Other cases have been reported by Effron (1903) and Kalb 

 (1906). 



§ VII. 



III. ANOMALIES OF THE CARDIAC SEPTA 



A. INTERVENTRICULAR SEPTUM 



I. Absence of Septum 



Among the anomalies of the internal structure of the heart, 

 defective development of the ventricular septum is most fre- 

 quently met with. The septum may be completely absent, par- 

 tially developed or defective at the base. In the last the defect 

 may be of the fleshy or membranous portion. 



Schliemann (1831) considered the thin portion of the inter- 

 ventricular septum ftear the base as a pathological condition; 

 Thurnman (1838) described this portion of the septum as "The 

 highest part of the septum which occupies the angle between the 

 posterior and right aortic valves, is in the human subject formed, 

 not of muscular fibers, but simply of endocardium of the left and 

 right ventricles and strengthened only by the interposition of a 

 little fibrous tissue continuous with that of the aorta." He states 

 that the structure was well known to anatomists, also that it was 

 sometimes defective from malformation. I have been unable to 

 find in the anatomies of the time or those of the previous century 



