General Diseases. 361 
right ventricle, then the right auricle, and least of all the 
left auricle. Generally-it is more evident in the columne 
carnez, and neat 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 bé 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 
unsound 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 nouncommon 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 combined, the former 
seldom interferes with health. 
* Watson’s “ Lectures on the Principles and Practice of Physic.” 
