470 HEALTH AND DISEASE 



over the region of the heart, and there was a strong impulse indicative 

 of hypertrophy. There was also observable a distinct regurgitation of 

 the blood in the jugular vein or jugular pulse. No opportunity in this 

 case was afforded for a post-mortem examination. 



In some cases of this disease the pulse is remarkably slow, the beats of 

 the heart are generally feeble, irregular, and intermittent, and while exer- 

 tion increases the frequency of the pulse, it also renders it more irregular, 

 any severe effort soon brings about exhaustion, sighing, and giddiness. 



Examination of the heart during life reveals certain signs which are 

 said to be characteristic: the impulse is feeble, but is at the same time 

 well defined; the sounds are weak, in the case of the first sound almost 

 inaudible, and in very advanced cases the sounds may be altogether 

 absent; and it is noticed in regard to the feeble pulse that there is some- 

 times only one pulsation to two beats of the heart. 



RUPTURE OF THE HEART 



The various alterations in the structure of the heart, arising out of 

 acute myocarditis and the different kinds of degeneration, naturally lead 

 to a weakness and a diminution in the resisting power of the muscular 

 walls, which favours the occurrence of rupture. The determining causes 

 are: violent exertion, falls, excessive excitement, tympanitis, an overloaded 

 condition of the stomach or intestines, &c. Any one of these causes, 

 by obstructing the passage of blood in the larger vessels, increases the 

 pressure on the walls of the heart beyond its power of resistance. It is 

 stated by Zuill that the tear is usually located in the walls of one of the 

 auricles. In our experience it has most frequently occurred in the left 

 ventricle. The occurrence is usually almost immediately fatal; it is said 

 that in falling at the moment of the rupture the horse sometimes utters 

 a piercing cry. When the rupture is slight the ordinary symptoms of 

 internal hemorrhage are exhibited. The animal staggers, and, if not sup- 

 ported, falls, the visible mucous membrane of the nostril, mouth, and eye 

 become white and bloodless; there is difficulty of breathing, loss of con- 

 sciousness, and convulsions, and death occurs at varying periods, from 

 a few minutes to several hours. Obviously treatment even in prolonged 

 cases is not likely to be of any use, although it is sometimes effectual in 

 cases of internal hemorrhage from rupture of the vessels of the liver. 

 Here large doses of opium, with gallic or tannic acid, has sometimes 

 arrested the flow of blood, and the animal has partially recovered, but a 

 rent in the walls of the heart is necessarily irremediable. 



