GENERAL DISEASES. 337 



of the heart is liable to this kind of disease, but most of all 

 the left ventricle, then the right ventricle, then the right auri- 

 cle, and least of all the left auricle. Generally it is more 

 evident in the columnae carnese, and near the endocardium, 

 than elsewhere. 



" Fatty degeneration of the heart may proceed from a 

 defect of healthy nutrition throughout the body in consequence 

 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 arte- 

 ries. 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 muscular tissue itself, or of its 

 lining, or its investing membrane. It is no uncommon sequel 

 of hypertrophy. In every instance the change seems ulti- 

 mately 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 ex- 

 amination 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 degeneration; 

 though the two may exist combined, the former seldom in- 

 terferes with health. 



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



