The wisdom of the body : the Harveian oration delivered before the Royal College of Physicians of London, on St. Luke's day, 1923 / by Ernest H. Starling.
- Starling, Ernest Henry, 1866-1927.
- Date:
- 1923
Licence: In copyright
Credit: The wisdom of the body : the Harveian oration delivered before the Royal College of Physicians of London, on St. Luke's day, 1923 / by Ernest H. Starling. Source: Wellcome Collection.
18/36 (page 16)
![lian heart the limits are set by the strength of the mus( fibres themselves. Freed from the pericardium the hes goes on increasing the strength of its contraction wi increasing dilatation until the muscle fibres are actual ruptured, and when the heart finally fails we find its su stance beset with haemorrhages. In the body this ove strain of the heart is prevented by the tough fibrous s of the pericardium. When the demand on the heart so great that the heart dilates to the limits of the pei, cardium, any further dilatation and resultant increast strength of beat becomes impossible ; the output ther fore falls off, and in the whole animal this diminish< output results in defective supply of blood to the muscli and brain, giving rise often to fainting, and at any ra' enforcing complete rest. Further activity of the anim becomes impossible and the heart is automatically give less work to do, so that it can recover, unless the increase activity of the animal and of the heart is a necessai condition of the animal’s continued survival, as in a fig] to the death. In this case, when the heart comes r against the pericardium, the fight is finished and tl animal succumbs. We find the same story in tl terminal changes of heart disease, where the process < compensation which I have described above become insufficient. Here again enforced rest may give time an opportunity for re-establishment of a sufficient circulatioi but with advance of the fundamental morbid conditio even complete rest becomes powerless to relieve the heart the output falls off, the circulation is insufficient for th needs of the tissues, and we get all the secondary result of failure of compensation—suppression of urinary secre tion, water-logging of the body and malnutrition of all it organs, which usher in the fatal termination. During the last few years great advances have beei](https://iiif.wellcomecollection.org/image/b30800985_0018.jp2/full/800%2C/0/default.jpg)
