This is frequently the result of general obesity and may completely envelop the heart, sometimes the layers of adipose tissue being an inch or more in thickness. When excessive, the pressure may give rise to atrophy and enfeeblement.
The fat in the auriculo-ventricular furrows may also be greatly increased, while infiltration between the muscular fibers is not uncommon, and may extend to the endocardium.
This condition is generally seen after middle life, and among high livers who lead a sedentary life.
Treatment.—The treatment is principally hygienic and dietetic. A rigid diet, with a sparing use of fluids, will generally accomplish wonders. No fluids at meal-times, nor for two hours after, should be made an absolute law. Exercise in the open air, as much as can be taken without unduly wearying the patient, should be rigidly enforced. Small doses of the juice of phytolacca berries may be given, but the effect should be carefully watched.
The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.