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In the course of the practice of medicine, as diseases and conditions are unconsciously classified, ideas gradually develop themselves that are not easy to formulate into the language of exact scientific observation. One of these impressions has been that in the debility following severe diseases, there is some more definite underlying condition than is usually formulated. The explanation alone of an exhausted and deteriorated nervous system is not sufficient. The attention is drawn to the heart muscle, and clinical observation, confirmed by the pathologic observations of others, has led to the belief that complicating myocarditis is an important factor in the course and progress of many conditions. The signs of disease of the heart muscle should therefore be studied with care. In acute diseases and wasting diseases, whatever may be their nature, there come times when it seems evident that the heart has participated in the debility and degeneration that
BISHOP LF. THE COURSE AND MANAGEMENT OF COMPLICATING MYOCARDITIS. JAMA. 1898;XXXI(4):174–175. doi:10.1001/jama.1898.92450040024001c
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