Boston Medical and Surgical Journal
with the fatty heart an arterial sclerosis. The symptoms in the higher grades of fatty heart resemble considerably those of fatty degeneration, and need not be here enumerated. Kisch has made sphygmographic tracings in four hundred cases of fatty heart with the following result : In thirty-six per cent, of cases there was a pulsus tardus ; in thirty-two per cent, of cases the pulse varied from one of a slightly to one of a completely dicrotic character; in twenty-four per cent, of cases an
... ase of tension from arterial sclerosis was shown ; in four per cent, of cases there was simple arythmia. The value of these examinations is, of course, slight of themselves. It is to be assumed, though it is not stated, that the patients had no valvular disease of the heart and no kidney lesions. " As regards the respiratory organs, Kisch found in many cases bronchial catarrhs. Naturally such symptoms as dyspnoea, and even pseudo-angina, were frequent. " The digestive organs of the obese are very likely to be deranged. Gastro-intestinal catarrh, dyspepsia, constipation, hemorrhoids are present, aud are due partly to dietetic errors, partly to the weakness of the heart and the incapacity or disinclination on the part of the patient to take sufficient exercise. An enlarged and fatty liver is of frequent occurrence, but its existence is not easy to make out by physical examination. " Urates, uric acid, and oxalate of lime are found in the urine. It is well known also that the obese are liable to glycosuria, and Kisch found sugar in the urine of many of his patients at periodic or irregular intervals. " Owing to the increased activity both of the sweat aud the sebaceous glands, fat persons are subject to ' catching cold ' and to attacks of rheumatism. Such skin diseases as boils and carbuncles are relatively frequent. " The bodily temperature shows an inclination to mount up, and in fevers the corpulent burn actively. Their feebler resistance to fevers was first pointed out by Hippocrates. Liebermeister states that they are less amenable to antipyretic measures. " Parallel with increase of fat is a decrease of sexual appetite and sexual power. Kisch found iu several cases absolute azoospertnia. Women are inclined to amenorrhcea and sterility. Among two hundred and fifteen obese women Kisch found forty-nine cases of amenorrhcea, one hundred and nineteen of scanty menstruation, and forty-nine of sterility. " The blood of the obese is poor in red blood-corpuscles. Obesity is, in fact, a disease of diminished aud perverted oxidation. There are not only too ffcw red corpuscles, but there is too much water and an excess of fat." REPORTED MORTALITY FOR THE WEEK ENDING AUGUST 23, 1884. Cities. Estimated I Population.