CHRONIC ENDOCARDITIS. 359 



diameter, weighing over twenty-six pounds. This tumour had deve- 

 loped at the expense of the muscular coat. Sections appeared greyish 

 in colour, and exuded a milky pus. 



The lumen of the oesophagus, which was partly obstructed by 

 masses of food, was greatest opposite the centre of the swelling, and 

 gradually diminished towards the extremities ; near the cardia it was 

 reduced to very small dimensions. In the centre of the swelling the 

 wall of the tube was four inches in thickness. 



The anterior portion of this growth had compressed and flattened 

 the bronchi and the last rings of the trachea, greatly diminishing their 

 calibre. Microscopic examination of the swelling showed it to be a 

 myoma of unstriped muscle — leiomyoma. 



CHRONIC ENDOCARDITIS. 



63. A six-year-old entire horse, bought at Beauce on the 14th 

 February, 1897, and brought to the School for examination on the 20th. 



The day after its arrival in Paris the animal had appeared dull and 

 tired. It was left in the stable. It only ate a small part of its food. 

 A veterinary surgeon who was called in at first regarded the case as 

 one of pneumonia, and prescribed external application of mustard, 

 and internally a mixture, the principal constituents of which were 

 tartar emetic and iodide of potassium. 



During the next four days the animal was not markedly worse, but 

 the symptoms persisted. 



At the first glance this animal appeared as though suftering from 

 some pulmonary disease. It was rather stiff and sleepy, carried the 

 head low with the eyes half closed ; the conjunctiva was moderately 

 injected and slightly infiltrated. The flank movements were more 

 rapid than usual, the respirations 22 per minute, and expiration was 

 double ; the pulse was 60, small and irregular. 



We auscultated the chest, commencing on the right side. The 

 vesicular murmur was very feeble, and in certain parts of the lower half 

 of the lung was almost imperceptible ; some borborygmus was noted ; 

 the heart-beats were especially noticeable, being unequal and irregular 

 in rhythm. This at once led us to examine the heart. We noted a 

 strong systolic murmur without particular timbre, which covered the 

 systolic sound and continued during the short pause. Furthermore, 

 the contractions were of irregular strength, and every three, four, or 

 five pulsations were followed by a pause, equal in length to an entire 

 cardiac cycle. Auscultation of the left lobe of the lung revealed 

 diminished vesicular murmur in the lower half. 



Diagnosis offered no difficulty. Evidently this horse was suffering 

 from old-standing mitral insufficiency, complicated at that moment 

 with pulmonary congestion. 



The animal was rested for a week. When brought back on the 

 28th February the secondary troubles noted on the former examination 

 had disappeared. Externally the animal appeared in good health. 

 The respirations were only 14 per minute. 



On questioning the seller it was learned that this horse had suffered 

 from strangles in October, 1895. A month after recovery it was used 



