FATTY DEGENERATION
Fatty degeneration of the heart muscle may be caused by acute poisoning (as phosphorus, arsenic, etc.), by serious infections, or it may follow fibrosis of the heart or coronary artery disease. The symptoms are those of serious circulatory weaicnens, which does not seem to improve under any ordinary management. It is difficult, if the heart is enlarged, to determine whether there is more or less serious acute dilatation or whether the heart muscle has suffered fatty degenration.
The treatment of such a patient requires the best of judgment as to the amount of food and liquid that should be given, the regulation of the administration of laxatives, the sponging of the body, the means of producing sleep if there is insomnia, how much reading, conversation or amusements should be allowed, how much stimulation by stryclmin or other stimulating drug should be given, and whether or not very small doses of digitalis should he tried. These are all matters for individualizing, and for the best medical judgment which we are called on to give. How much repair can take place in a heart muscle when fatty degeneration has started we do not know. Such treatment will give the heart the only chance it has to recuperate, but the prognosis is bad.