360 CLINICAL VETERINARY MEDICINE AND SURGERY. 



for farm work, and had never shown any disturbance which could 

 have aroused suspicion of heart disease (?). It had never had any 

 internal disease other than strangles. 



64. Sixteen-year-old gelding, brought for examination on the 27th 

 March, 1897. 



Was in heavy work. Between the previous December and the 

 commencement of March it had been very hard worked. A month 

 before its appetite was noticed to decline, and its condition to suffer, 

 while the limbs became greatly enlarged. The horse was rested for 

 about a fortnight. On returning to work it suffered from some re- 

 spiratory disturbance, and was therefore brought for examination. 



The hind limbs were oedematous, and almost half as large again 

 as normal. In addition to symptoms of acute bronchitis we noted 

 very strong pulsation in the carotid and subzygomatic arteries. 



On auscultating the heart the first sound was heard to be feeble and 

 double ; the second was obscured by a murmur which continued 

 throughout the long pause, — that is, by a murmur due to aortic insuf- 

 ficiency. All the accessible arteries exhibited strong pulsation. The 

 carotid and the subzygomatic visibly rose at each beat of the heart. 



Treatment. — Administration of iodide of potassium in daily doses 

 of 2h drachms for the first two weeks in each month. 



The horse still remained capable of work until the commencement 

 of August. Shortly afterwards, however, it had to be slaughtered. 



Autopsy. — Lesions of fibrous myocarditis. The aortic sigmoid 

 valves were thickened, wrinkled, and their faces irregular. The right 

 side of the anterior small valve near the corpus Arantii presented a 

 narrow perforation ; the lower surface of the left side, close to the free 

 border, was occupied by a vegetation as large as a hempseed. There 

 was marked insufficiency, a large space existing between the valves 

 when approximated. 



The anterior lobe of the right lung contained a patch of chronic 

 pneumonia, 



65. A fifteen-year-old gelding, brought to the School on the 5th 

 June, i8g8, to be used as a subject in the practical surgery class. 



The animal was thin, emphysematous, and a crib-biter. On aus- 

 cultating the heart a strong musical murmur, covering the second 

 sound and the long pause, was heard over a large surface. The first 

 heart-sound was diminished. There was no arterial "dancing." The 

 pulse was of practically normal volume. 



At the autopsy the heart was found to exhibit sclerosing myocar- 

 ditis of both ventricles and changes in the aortic sigmoid valves, which 

 were slightly thickened and showed several small indurated vegetations. 

 Although the right and left valves were perforated parallel to their free 

 border insufficiency was trifling. 



This case shows once more that a strong murmur due to insufficiency 

 does not necessarily imply large valvular lesions. The character of the 

 pulse was explained by the very trifling hiatus, and by the lesions of 

 the myocardium. 



