Il6 CLINICAL VETERINARY MEDICINE AND SURGERY- 



time ; expiration was accompanied by a moaning sound. On returning 

 to the stable it only took a little food and refused its corn. Next day 

 these symptoms were supplemented by cough, and slight discharge 

 from both nostrils. A veterinary surgeon who was called in diagnosed 

 the case as one of commencing pneumonia, bled the animal to the 

 extent of 8^ pints, and prescribed tartar emetic and iodide of potassium. 

 Up to the seventh day, although both lungs were attacked, no alarming 

 symptoms appeared. Between the morning and evening of the 

 eighth, however, the patient's condition became greatly aggravated. 

 I examined it on the following afternoon. Both lungs gave signs 

 of hepatisation ; and on auscultating the heart (the action of which 

 was rapid and feeble) I noted a slight soft murmur during the second 

 sound and the pause, a murmur indicating aortic insufficiency. The 

 history of the animal left very little doubt as to the significance of this 

 symptom. Nevertheless, with due reserve — because this murmur 

 might have been due to a valvular lesion anterior to the pneumonia ; 

 a not uncommon condition in hard-worked horses — with due reserve, 

 I say, I declared that the endocardium was inflamed, and that the 

 sudden aggravation in the animal's condition was caused in part at 

 least by this complication. Some days later the animal died. 



At the post-mortem examination we found, in addition to numerous 

 centres of pulmonary gangrene, lesions of acute endocarditis, which I 

 now submit to you. 



On the upper surface of the mitral valves and lower surface of the 

 aortic semilunar valves, principally towards their free margins, you 

 will see little greyish vegetations ; some fairly firm, others soft and 

 friable. You will also note that these valves are slightly injected and 

 infiltrated, and that they show no old-standing lesion. 



Five years ago I saw a similar case, so far as concerns the atiology 

 and localisation of- the endocardial lesions. In this case also endocar- 

 ditis of the aortic valves had occurred during the course of pneumonia. 

 The animal recovered, and although final proof that the aortic valves 

 were attacked could not be furnished, as in the first case, it was clearly 

 established by the subsequent symptoms. The pneumonia ended in 

 resolution ; but the endocarditis produced chronic lesions. After a short 

 convalescence this horse returned to work. A year later I again 

 examined him, when he was suffering from aortic insufficiency, clearly 

 shown by a strong diastolic murmur. This valvular lesion neither 

 disappeared nor diminished ; on the contrary, it ended by producing 

 complications, of which I shall speak in a subsequent lecture. 



A fairly large number of cases of acute secondary mitral endocar- 

 ditis have been published. You might read with profit those published 



