. Diseases of the heart and arterial system; Designed to be a practical presentation of the subject for the use of students and practitioners of medicine. induced, and independent of previous recognis-al^le myoeaidial or endocardial disease. Morbid Anatomy.—By dilatation of the heart is meant anincrease in llie caj)a(ity of its chambers due to rapid or gradualstretching of its Avails. In most cases hypertrophy is combinedwith dilatation and has preceded tlie development of the dilated heart is as hirge or larger than one only hypertrophied,but the muscl(! is flabby, and the organ does
. Diseases of the heart and arterial system; Designed to be a practical presentation of the subject for the use of students and practitioners of medicine. induced, and independent of previous recognis-al^le myoeaidial or endocardial disease. Morbid Anatomy.—By dilatation of the heart is meant anincrease in llie caj)a(ity of its chambers due to rapid or gradualstretching of its Avails. In most cases hypertrophy is combinedwith dilatation and has preceded tlie development of the dilated heart is as hirge or larger than one only hypertrophied,but the muscl(! is flabby, and the organ does not keep its slia])ewhen laid on tlie table. Extreme instances have been describedin wliicli tlie heart held up by the great vessels collapsed over thehand so as to cover it like a mushroom. This flabbiness is notcharacteristic of dilatation as such, but of all conditions of themyocardiiiiii in which tlie nniscde lias lost its tone and Avhich havepredisposed the organ to stretching. Ihese are cloudy swelling,fatty degeneration, etc. ? Slight d(!grees of dilatation, as well asacute overstrain, are not attended by these myocardial changes—576. ? V i fejt EXTEEIOE OF HEAET OF FIG. 42. SHOWING HYPEETEOPHY ANDDILATATION OF BOTH VENTEICLES. dilatation of the heart 577 tBey are often a part of the compensatory process attending valvu-lar lesions. When, however, compensation breaks down and dila-tation becomes extreme, the walls are found degenerated andflabby. The muscle is usually paler than normal and may becloudy or of a brownish tint, due to the deposit of pigment. As dilatation usually results from the further action of thecauses that produce hypertrojDhy, it has much the same distribu-tion. It may affect but one chamber or the heart as a trabecule and papillary muscles are naturally not concernedin the process of dilatation except in so far as the latter maystretch or lengthen in order to functionate properly wdthin theenlarged chambers. Relative insufficiency of
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