Studies in cardiac pathology . elyassociated with contraction of the smaller arteries, which, inturn, seems to be due to a toxic factor. The importance of arteriosclerosis or constriction of the splanch-nic area as a cause of hypertension and cardiac hypertrophy,which was prominently brought to the fore through the investi-gations of Hasenfeld- and Hirsch,^ and widely accepted, hasapparently been overestimated. Marchand, as well as Longcopeand McClintock,= were unable to corroborate the above-mentionedobservations. Neither experimentally or at autopsy could thelast-mentioned investigators find
Studies in cardiac pathology . elyassociated with contraction of the smaller arteries, which, inturn, seems to be due to a toxic factor. The importance of arteriosclerosis or constriction of the splanch-nic area as a cause of hypertension and cardiac hypertrophy,which was prominently brought to the fore through the investi-gations of Hasenfeld- and Hirsch,^ and widely accepted, hasapparently been overestimated. Marchand, as well as Longcopeand McClintock,= were unable to corroborate the above-mentionedobservations. Neither experimentally or at autopsy could thelast-mentioned investigators find any definite association betweencardiac hypertrophy and sclerosis of the abdominal aorta or thesplanchnic vascular domain. Cystic kidneys and hydronephrosis are often associated with These sections were prepared by Dr. George Hasenfeld: Deut. Arch. f. klin. Med., 1897, p. : Ibid., 1899, p. 579. Marchand: Verhandl. d. Kong. f. inn. Med., 1904, p. 60. Longcope and McClintock: Arch. Int. Med., 1910, p. Superior vena cava Right auricleCoronary sinus Tricuspid valve Via. 47.—SAr;irrAr> Skction of thk Jhohax. fSco (Icsrriplivf legend under Kifr. 46.) 150 STUDIES IN CARDIAC PATHOLOGY cardiac hypertrophy. Myocardial changes and disease of thecoronary arteries are often relatively slight in nephritis, and deathfrom heart failure is more frequent in secondary than in primarynephritis.^ It was formerly taught that the hypertrophy which occursin chronic nephritis, and even in acute nephritis if its durationexceeds four weeks,- affected chiefly, if not entirely, the leftventricle. Careful examinations by MuUers method have shownthat all the cardiac chambers are affected in 82 per cent, of thecases. It is true, however, that the left ventricle shows the mostpronounced changes, and that right-sided enlargement appearsto be definitely a sequel (Paessler). The hypertrophy is generallyregarded as due to increased work of the left ventricle in over-coming abnorma
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