General Diseases, 361 



right ventricle, then the right auricle, and least of all the 

 left auricle. Generally it is more evident in the columnae 

 carneae, and near the endocardium, than elsewhere. 



" Fatty degeneration of the heart may proceed from a 

 defect of healthy nutrition throughout the body in conse- 

 quence of some general disorder, or of natural decay in the 

 decline of life. In such cases the same morbid change is 

 commonly manifest in other, parts also ; in the arteries, in 

 the liver, in the kidneys, in the cornea. 



" But fatty degeneration may be limited to the heart, and 

 ■even to a small portion of the heart, and then it is owing 

 to some local failure of nutrition ; of which, perhaps, the 

 most common cause is a diseased condition of the coronary 

 arteries. You are probably aware that these two vessels 

 have no large or free communication with each other, and 

 it is a very instructive fact, that when one of them alone is 

 diseased, that part only of the heart frequently is found to 

 be affected which receives its supply of blood through the 

 imsound artery. Fatty degeneration of the heart is also 

 met with after bygone inflammation, whether of the mus- 

 cular tissue itself, or of its lining, or its investing membrane. 

 It is no uncommon sequel of hypertrophy. In every in- 

 stance the change seems ultimately traceable to deficient 

 nutrition."* 



There are no positive symptoms by which this condition 

 of the heart can be detected during life. The pulse may. 

 be intermittent, feeble, or slow, as in other affections of the 

 organ, and rapid exertion may produce distress. Beyond 

 these, the practitioner has nothing to assist him until an 

 ■examination after death reveals the real state of the case. 



The large deposits of fat on the heart usually seen in 

 obese animals, are usually unassociated with fatty degenera- 

 tion ; though the two may exist combinedi the former 

 seldom interferes with health. 



* Watson's " Lectures on the Principles and Practice of Physic." 



