On fatty diseases of the heart / by Richard Quain.

  • Richard Quain
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: On fatty diseases of the heart / by Richard Quain. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    their characters, they resemble those in which the disease has been traced with the microscope. With the view of com- paring the two classes of cases, I have placed all the latter cases in a separate series. Thus we shall have of fatty degeneration, fully recognised, thirty-three cases. Of flabby soft hearts, thirty-five cases ; and of fat heart, fifteen cases; in all, eighty-three cases. I am not aware that any chemical analysis has been made of any of these degenerated hearts. It is not very necessary. The action of aether, and the refractive properties of the granules, readily testify to their nature. Moreover, the extent to which the heart is affected with the disease, rather than the degree thereof, is the measure of its effects: hence che- mical analysis could give but little additional information on the subject, beyond that above stated. with carditis, and describe a red, a pale, and a yellow softening. Hope (Diseases of the Heart, 4th edit., p. 310) follows M. Bouillaud, but thinks the pale and yellow varieties may sometimes occur in the absence of in- flammation. Laennec (Diseases of the Chest, &c., p. 565) describes this state of heart well. He says, the pale softening resembles in all respects the fatty degeneration which he also describes, save in not greasing paper. He denies the connection between this softening (in the absence of endo- or pericarditis) and inflammation, and attributes its origin to cachexia of the system. Akenside (Philosophical Transactions, vol. liii, p. 353) gives the history of a remarkable case, which he calls “ gelatiniform softening.” It occurred, as fatty degeneration frequently does, in a heart which had been the seat of former pericarditis. The subject was aged 14 years. Yet M. Chomel (Diet, de Med., 2d edit., art. Ramolissement du Cceur), render- ing the matter more confused, states this softening, in a youth of 14, to be the same thing as that described by M. Blaud (Bibliotheque Med., t. lxviii, p. 364) as “senile softening” of the heart. One cannot read the details of the cases given by these different writers without feeling convinced that, in the majority of cases, they are describing the same thing, and that this is fatty degeneration. Every sound pathologist knows that true carditis, by itself, is excessively rare (Meckel. Hist, de l’Academie, vol. xii, p. 33; and Baillie, Morbid Anatomy, 3d edit., p. 19), if it ever occurs. In low forms of fever the heart is softened, the cohesive power of its molecular ele- ments is diminished; the markings on its fibres are faint; and the tissue is easily crushed. It seems to me, highly probable, that all these varieties of softenmg, except that just mentioned, are more or less intimately con- nected with this fatty change in the fibre. M. Blaud, indeed, offers no other
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