The difficulty of arriving at a positive conclusion as to the exact nature of the tissue changes existing in the cardiac muscle of patients presenting undoubted evidances of heart disease makes it prudent to discuss the following cases under a clinical title rather than one based on morbid anatomy, for few, if any, can distinguish between the signs of chronic myocarditis and those of degeneration, or can say when the molecular disturbance consequent on febrile or ther intoxication ends and the congestion with small-cell infiltration of a myocarditis begins. It is true that the physician draws his own mental picture of the changes in each case, but he will have difficulty in describing it in words that will stand the criticism of his audience.
The teachings of Dr. James MacKenzie and other members of the English school have done much to increase our knowledge regarding diseases of the heart, and
KERR WW. SOME FACTORS IN THE TREATMENT OF MYOCARDIAL LESIONS. JAMA. 1911;LVII(19):1517–1521. doi:10.1001/jama.1911.04260110017007
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