Heart starvation / by J. Milner Fothergill.

  • Fothergill, J. Milner (John Milner), 1841-1888.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Heart starvation / by J. Milner Fothergill. Source: Wellcome Collection.

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    4 and rightly so, much less confident. It is a far more difficult matter to ascertain, requiring a wider range of information. Sometimes accurate acquaintance with physiological function will tell us more than mere anatomically-furnished data, will often, indeed, speak out articulately when anatomical data are dumb. Disturbances of function cannot be estimated by individuals who have not learned systematically to think for themselves; whilst a fourth year student will commonly make a very accurate diagnosis, when this depends upon mere acute observation of physical signs. A certain familiarity with a foreign language is admitted to be requisite in order to enable the individual to think in it; a certain intimacy with physiology is essential to accurate reasoning upon data founded upon such knowledge. This is a somewhat lengthy preamble, but it throws a quantity of side-light, not without its value, upon the subject of u heart starvation.” There are many conditions where “interstitial digestion ” or u tissue nutrition ” is impaired. We see at times a person whose muscles are well fed, but who is lean. Such is the condition of a man trained for some contest involving endurance; there is a maximum of muscle with a minimum of fat. Then at other times we see a man whose muscles are flabby, but who is well covered with fat. Here there is an opposite condition of nutrition, viz., a want of assimilation of albumenoids. A muscle well exercised attracts to itself more pabulum, as in the arm of the blacksmith and the leg of the ballet-dancer. Yes; so long as the blood is well fed and contains a sufficiency of albumen upon which the muscles, in their turn, may feed. But where a muscle is used very freely when the nutrition is defective, it wastes, or undergoes atrophy, as T. King Chambers has pointed out (Clinical Lectures). So, when the digestion of albumenoids is impaired, the two great muscles, the heart and diaphragm, in constant action, become more or less starved. This is very apt to occur when the liver is disordered seriously, so that the peptonized albumenoids which have passed from the gastro-intestinal canal into the blood, do not pro¬ perly undergo their further and final transformations. A number of cases have occurred to me lately which have shown this associa-