300 ' 
FK. KLAZEKOVTC. 
considered diseased. It is often very difficult to pronounce a 
precise separation of the diseased changes as the diagnosis de 
mands. Notwithstanding the diagnosis specifies a certain part of 
the heart as being diseased, it is perceptible that the changes 
have spread beyond the part and taken possession of the whole 
or greater part of the heart. It is different when the processes 
in the heart have about run their course. There we shall find 
the diseased changes at the particular parts diagnosticated, 
though traces are always visible of expanded processes which 
receded to such an extent that the heart could still perform its 
functions. In chronic diseases, as in other cases, the slow but 
steady growth of the disease always appears. To ascertain more 
definitely such changes of the heart, a special classification is 
d si ruble. 
(C) Changes of the Muscular Substance .—Anaemie and hy- 
peramie are often found in the muscle of the heart; the former 
usually as the result of chronic imperfect nutrition, for instance, 
in atrophy of the heart, neoplasm, a ossification of coronary 
artery; the latter, in the production of acute processes, chiefly 
inflammation of the heart, in various cousecutive diseases, in a 
few constitutional diseases, which appear with violent attacks and 
pressure of blood to the lungs and heart (anthrax and influenza), 
lastly, in suffocation, disturbances of the circulation and diseases 
of the vessels of any ^jnd. 
Ansemie is known by a conspicuous pallor of the muscle of 
the heart; on the other hand, hyperamie is known by a striking 
dark color and redness, and by a greater abundance of blood in 
the smaller vessels; in constitutional diseases often accompanied 
by ecchymosis. 
Effusion of blood in the heart, with smaller or greater de¬ 
posits, occurs, particularly in such diseases, during whose course 
violent and energetic contractions of the heart are present, as 
influenza, anthrax, severe colic, pericarditis, endocarditis and in¬ 
flammation of the lungs. As a rule, an effusion of blood is 
accompanied by intense degeneration of the muscle of the heart. 
Another condition we designate inflammation of the muscle of 
the heart. 
{To be continued .) . 
