ENDOMYOCARDIAL FIBROSIS IN THE CEYLONESE BY

1940). It differs from fibrosis of the endocardium and myocardium accompanying occlusive disease of the coronary arteries, anomalous origin of the coronary arteries, congenital fibro-elastosis and the fibrotic forms of nutritional cardiopathy. In endomyocardial fibrosis there is no disease of the coronary vessels and fibrosis is mainly confined to the endocardium and the myocardium underlying it. Information regarding geographical and racial distribution is scanty. It was thought worth-while, therefore, to report three cases of endomyocardial fibrosis in the Ceylonese. CASE REPORTS Case 1. A man, aged 23, was admitted with a history bf fever, difficulty in breathing and swelling of his lower limbs. He had no history of rheumatic fever. On examination he was jaundiced. His heart was enlarged, the apex beat being in the 6th intercostal space in the anterior axillary line. There was a systolic and a doubtful presystolic murmur in the mitral area. The lungs were normal The liver was palpable three fingerbreadths below the right costal margin. The spleen was not palpable. On fluoroscopy there was marked enlargement of the left auricle and right ventricle and the pulmonary conus was prominent. The jaundice improved and he was discharged in three week