138 CLINICAL VETERINARY MEDICINE AND SURGERY. 



is brought about through the medium of the pneumogastric nerve, as 

 shown by irregular or complete loss of appetite, anxiety, somnolence, 

 or depression. Transudates in the large serous cavities, oedema of the 

 lower portions of the body, intestinal catarrh, icterus, and albuminuria 

 only appear at an advanced stage. 



I may repeat that chronic mitral endocarditis with complications 

 due to stasis in the veins of the systemic circulation is rarely seen, the 

 patients not being kept sufficiently long for such remote complications 

 to occur. Last summer, however, we saw a case which I will recall to 

 you. 



In the month of June a farmer at Bonneuil sent us a horse, bought 

 the preceding year, which for months had appeared in good health, 

 but about six weeks before had begun to fall away in condition, and 

 had up to that time lost about 100 lbs. in weight. One day an oede- 

 matous swelling was seen under the chest, but nothing else being 

 observed no precautions were taken, and the horse drawing a heavy 

 wagon set out from Bonneuil for Maisons-Alfort. During the journey 

 it frequently stopped for want of breath, and was thrashed by the 

 brute who drove it. On returning to the stable it lay down without 

 touching its food. 



The morning after it was brought to the clinique. It was very thin 

 and depressed ; the mucous membranes, and especially the conjunctivae, 

 were pale. The respiration was rapid, irregular, and showed a well- 

 marked double expiratory effort ; but the cough was strong and loud, 

 in no way resembling that of emphysema. 



Percussion of the chest revealed diminished resonance in the lower 

 third, especially on the left side. On auscultation the respiratory mur- 

 mur was feeble. The heart beat rapidly, and on examination two 

 murmurs could be heard, one systolic, the other diastolic ; while irregu- 

 lar intermittences lasting for one or two pulsations could be detected. 

 Certain of the contractions were bounding, and gave a distinct impulse 

 to the thoracic wall. The pulse was small, unequal, and intermittent. 

 The pulsations of the posterior aorta corresponded to the beating of 

 the heart, were unequal, and 70 to 76 per minute. Each heart-beat 

 produced an aortic pulsation, but the more feeble were not transmitted 

 to distant arteries. The jugulars were prominent, and showed a pulse 

 synchronous with the heart. The swelling under the chest had almost 

 disappeared. The temperature was normal. The urine contained 

 neither albumen nor sugar. 



These symptoms, the known frequence of left heart disease in 

 the horse, the absence of the arterial sign of aortic insufficiency — 



