On the Treatment of Diarrhoea and Dysentery by Sulphuric Acid.

Abstract

the elements of its own increase, and while the developing process has a resemblance in this respect to that of a voluntary muscle, there is no power in the heart, as in the arm, of securing rest, and the consequence is, a disproportionate increase of bulk in the overactive organ. The purpose of treatment, therefore, is to imitate the -effects of rest an a voluntary muscle, and this is fully effected by the remedy prescribed above. It must be -evident that a careful diagnosis is an important antecedent of treatment in these cases. Where fatty degeneration is supposed to be blended with the hypertrophied tissue, there is already a disposition to leipothymia, which should counter-indicate the use of the acid, and reasons might easily be adduced why no success could be anticipated from its employment when the heart is flabby as well as enlarged, and its tissue is infiltrated with the products of inflammation. These points are to be judged of by general as well as special diagnosis, and by the previous history. The causes of a true hypertrophy are often accidental, arising most frequently from overeffort of the muscular system, and from the extension of rheumatism; these occur often in the healthy, and their effects are peculiarly susceptible of cure; but where the endocardium or the valves have undergone change the bruit remains after ,the preternatural impulse is arrested. I will conclude by observing that the most promising ,:ases are those whiclh, while classed as presenting pathological phenonmena, not only from errors of relative proportion of the part affected to the entire organ, but from the numerous disturbing causes which they introduce, must be viewed as resulting through physiological phenomena. There is probably as little relative difference between the hard muscular limb of a trained man, and true hypertrophy of the heart from mechanical obstruction, on the one hand, as there is between the flabby, voluntary, and involuntary muscles of the anzemic patient on the other. Indeed it maybe shown that, in ordinary development from the foetal to the mature life of the heart, a law is observed similar to that which governs its hypertrophic increase. It is in fact found, that the various parts of this organ attain their due proportions in connection with the increased demand made upon them; the ventricles enlarge as the Eustachian valve becomes closed, the auricles having their development arrested as the foramen of Botal becomes opened, or in other words, the conversion of the ventricles from a single to a double organ, is attended from the third to the fifth month, with the establishment of that due proportion between the ventricles and auricles-Gwing to the increased activity of the former-which, in early foetal life, was wanting, affording a normal instance of an hypertrophy proceeding in one portion in relation to another, in the same organ. At the fifth month of foetal life the left ventricle is more capacious than its fellow, but the thickness of the walls of the heart is the same on both sides. But afterwards, when the function of the left heart is called into full action, the proportionate thickness of the wall of the left ventricle to the right changes rapid!y; instead of remaining equal ,it becomes as four or even five to one. ON