arbonate of ammonia. Prevent the
animal from getting up too soon, or the attack may immediately recur.
Afterwards, if the attack was due to weakness from loss of blood,
impoverished blood, or associated with debility, general tonics, rest,
and nourishing food are indicated.

HYPERTROPHY OF THE HEART, OR CARDIAC ENLARGEMENT.

Hypertrophy of the heart implies augmentation of bulk in its muscular
substance, with or without dilatation or contraction of its cavities. It
may exist with or without other cardiac affections. In valvular disease
or valvular insufficiency hypertrophy frequently results as a
consequence of increased demand for propelling power. The difficulties
with which it is most frequently connected are dilatation and
ossification of the valves. It may also occur in connection with
atrophied kidneys, weak heart, etc. It may be caused by an increased
determination of blood to the organ or from a latent form of
myocarditis, and it may arise from a long-continued increase of action
dependent upon nervous disease. All the cavities of the heart may have
their walls hypertrophied or the thickening may involve one or more.
While the wall of a ventricle is thickened, its cavity may retain its
normal size (simple hypertrophy) or be dilated (eccentric hypertrophy),
or it may be contracted (concentric hypertrophy). Hypertrophy of both
ventricles increases the length and breadth of the heart. Hypertrophy of
the left ventricle alone increases its length; of the right ventricle
alone increases its breadth toward the right side. Hypertrophy with
dilatation may affect the chambers of the heart conjointly or
separately. This form is by far the most frequent variety of cardiac
enlargement. When the entire heart is affected, it assumes a globular
appearance, the apex being almost obliterated and situated transversely
in the chest. The bulk may become three or four times greater than the
average heart.

_Symptoms._--In hypertrophy of the heart, in addition to the usual
symptoms manifested in organic diseases of the heart, there is a
powerful and heaving impulse at each beat, which may be felt on the left
side, often also on the right. These pulsations are regular, and when
full and strong at the jaw there is a tendency to active congestion of
the capillary vessels, which frequently give rise to local inflammation,
active hemorrhage, etc. If the pulse is small and feeble at the jaw, we
may conclude that there is some obstacle