until they have passed to the lungs, and have there received the vivifying influence of oxygen, can they enter into the real composition of the blood, and thus become active, exciting, disposable constituents of it.
"Like begets like" in very many instances. This axiom is true in relation to diseases of the heart. The rich, stimulating blood of the left ventricle urges, feeds, and actively supports any disease which may arise at that point; while the poor, impoverished, fouled, tainted, and attenuated blood which flows through the cavities of the right heart favors disease of a correspondingly low and degenerate character.
So long as the body is rapidly built up and as rapidly pulled down, disease of the left heart maintains an active character; but when the balance between nutrition and waste is destroyed—when nutrition becomes less active, while waste remains the same, or is more active than before—disease of the left heart loses more and more of its active character, and approximates more and more in its nature to disease of the right heart. In many this change begins at the age of forty; in others, not until five or ten years after that period. Thenceforward the tendency to inflammatory disease of the left heart declines—the tendency to degeneration increases. With the gradual declination of the one tendency and the gradual increase of the other, a period is at length reached when active inflammatory disease ceases, as a rule, to affect the left heart. At this juncture the left and right sides of the heart, hitherto dissimilar in their tendencies, are in this respect almost as one. The active tendency of early life has given place to the passive tendency of advancing years inflammation to degeneration.
Acute rheumatism—a fruitful cause of cardiac disease in the earlier periods of life—is seldom seen beyond the age of fifty. I have, however, attended a case of acute articular rheumatism at the age of seventy-five; but such an instance was an exception to the rule. After fifty, acute rheumatism gives place to a form of rheumatism which slowly produces rigidity of the coats of the blood-vessels, hardens and contracts the tendons, thickens and renders stiff and rigid the ligaments of the joints, hardens and lessens the articular cartilages.
Thus, then, according to a law of Nature, the ultima linea of life ends in—degeneration.
Apart from the influence of this law, can any accidental, casual, or avoidable circumstance favor this immutable tendency to degeneration, speaking more particularly in reference to the heart? Yes; many circumstances are daily, hourly, momentarily doing this. Thousands annually perish from heart-disease, whose lives might and would have been prolonged had but proper attention been given to the simple laws of Nature. These laws demand attention to the three great vital functions-the action of the brain and nervous system, respiration, and circulation.
