PERICARDITIS IN THE DOG. 167 



vascular and fragile new membranes which de\elop on the surface of 

 the pericardium, especially towards the base of the heart, at the point 

 where the serous membrane is reflected. This form is always very 

 grave. The five patients which I saw all died rapidly. 



In 1894 I had sent to me the bod}- of a bitch which had died from 

 hccmorrhagic pericarditis, and in which the peritoneal exudate was 

 very abundant. A year before I had tapped this animal for abdominal 

 ascites, apparently curing her — at least for a period of six months. In 

 this case, again, we found no tuberculous lesion, and animals inocu- 

 lated with the exudate gave no result. 



In a considerable number of instances, instead of following this- 

 well-marked course, pericarditis assumes a chronic character from the 

 beginning. Its onset is insidious, its course slow; and until the 

 exudate is sufficiently abundant to produce difficulty in breathing,, 

 it remains unrecognised. Then on methodical examination one 

 notes, as in the acute form, certain signs furnished by auscultation 

 and percussion. At a more advanced stage the physical signs become 

 aggravated, and are supplemented by loss of appetite, feebleness, 

 emaciation, and swelling of the limbs — final complications which you 

 have seen in several patients. 



The dog occasionally suffers from "dry" pericarditis of simple or 

 tuberculous character, which ends by producing numerous adhesions 

 between the two opposing la)ers of the pericardium. In this form 

 functional disturbance is seldom much marked, and the disease some- 

 times remains unrecognised until post-mortem examination. Even in 

 the first stages digital pressure over the intercostal spaces of the pre- 

 cordial region produces no marked pain. The only constant sign is 

 the rubbing sound, which usually persists for a considerable time, and 

 may occur either during systole or diastole, but is always synchronous 

 with the mo\'ement of the heart — a character differentiating it from the 

 pleuritic rubbing sound which is synchronous with respiration. When 

 adhesions have occurred the heart's action seems feeble, or the cardiac 

 impulse may be imperceptible on palpation. You noted this latter 

 S3T"nptom in a tuberculous dog killed a few \Neeks ago, at the post- 

 mortem examination of which we found very complete adhesion of the 

 two pericardial layers. At a later stage adhesion between these layers 

 may be complicated by degeneration of the heart muscle, producing 

 cyanosis, dyspnoea, ascites, and oedema of the limbs. 



In general, when the veterinar\' surgeon is called on to examine a 

 dog affected with exudative pericarditis, the disease has already been in 



