. Medical diagnosis for the student and practitioner. the Oration in Med-icine, read before the American Medical Association in 1912. There is a wealth of liter-ature bearing upon the drop heart under its many variants of title. But the significanceof its obviously defective musculature, misleadingly common clinical occurrence, tendencyto obscure its own dilatations even when decided, and direct and constant relationship tovisceroptosis seem to have been disregarded. See Prognosis in Chronic Heart Disease asAdversely Affected by Certain Medical Traditions. Jour. vol. 59, p. 685-690, 191
. Medical diagnosis for the student and practitioner. the Oration in Med-icine, read before the American Medical Association in 1912. There is a wealth of liter-ature bearing upon the drop heart under its many variants of title. But the significanceof its obviously defective musculature, misleadingly common clinical occurrence, tendencyto obscure its own dilatations even when decided, and direct and constant relationship tovisceroptosis seem to have been disregarded. See Prognosis in Chronic Heart Disease asAdversely Affected by Certain Medical Traditions. Jour. vol. 59, p. 685-690, 1912. THE DROP-HEART 601 the case of severe acute dilatation in a prostrating acute infection or so slightas to make its recognition a matter of difficulty. In the latter cases, thequick response to rest and digitalis is illuminating. Effect of Environment and of Sex.—The series of illustrations offered showclearly the variations in form that these hearts may assume and suggeststrongly the basic unity of the so-called small heart and Fig. 307.—Stomach of patient whose heart is shown in Fig. 302. They also serve to explain the puzzling orthodiagraphic contours whichhave been presented, for example, by Adler and Krehbiel.* A dilated or a dilated and hypertrophied drop heart may produce suchoutlines; a fundamentally normal heart, never. The so-called usmall-heart will be found almost invariably in suggestiveassociation with the visceroptosis of congenitally asthenic individuals andin most instances represents a dilated or hypertrophied drop heart. * Archiv. Int. Med., Chicago, vol. ix, p. 346-361, 1912. 6o2 MEDICAL DIAGNOSIS The drop heart is extremely common in the female; common in the male,and, probably, the effect of environment and mode of life in childhood has agreat effect in determining its strict adherence or relative nonadherence tothe type in development. In many if not most instances these individuals attain a degree of myo-cardial adequacy which enab
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