Studies in cardiac pathology . espect especiallj; that syphilitic aortitisplaj^s so important a role, producing, as it does with great fre-quency, aortic aneurism, aortic insufficiency, and this statement does not invariably apply, however, is indi-cated by the experimental work of Fleisher and Loeb, who foundthat adrenalin injections, when combined with certain othersubstances, such as spartein sulfate and caffein sodium benzoate,produce both macroscopic and microscopic myocardial changes.^ The direct cause of these lesions seems to be a mechanical one. Thetypical seat of the
Studies in cardiac pathology . espect especiallj; that syphilitic aortitisplaj^s so important a role, producing, as it does with great fre-quency, aortic aneurism, aortic insufficiency, and this statement does not invariably apply, however, is indi-cated by the experimental work of Fleisher and Loeb, who foundthat adrenalin injections, when combined with certain othersubstances, such as spartein sulfate and caffein sodium benzoate,produce both macroscopic and microscopic myocardial changes.^ The direct cause of these lesions seems to be a mechanical one. Thetypical seat of the lesion at the base of the left ventricle, where the greateststrain is exerted, favors this theory. Furthermore, analogous conditions havebeen shown to occur in striated muscle in conditions of overexertion. The fact 1 Fleisher and Loebs article, Arch. Int. Med., Feb., 1909, contains also a resumd of theliterature concerning experimental myocarditis. See also a second article by the same authors,Arch. Int. Med., Oct. 15, Fig. 57.—Sclerotic .d Calcified Coronary Arteries. Specimen from the Museum of the University of Pennsylvania, showing the root of theaorta and the coronary arteries, the myocardium being removed by dissection. The vesselsare greatly thickened, and of masses of calcareous nodules and plates. 170 STUDIES IN CARDIAC PATHOLOGY that the injection of spartein and aclrenahn into dogs, whose hearts are relativelystronger than those of rabbits, does not cause the appearance of myocardiallesions, adds further support to this theory. These lesions are in all probabilitynot clue to lack of nutrition of the muscle-fibers as a result of contraction of thecoronary vessels, inasmuch as it has been shown that adrenalin does not cause acontraction of these vessels. Even small doses of adrenalin in the rabbit produce well-marked myocardialchanges, although these lesions show a tendency to heal. Pearce has shownthat large quantities of this substance injected in
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