CARDIAC MURMURS. ' 547 



valve, or that of Avarty vegetations or excrescences. In cases 

 where considerable collections of fibrinous coagula have been 

 found in the ventricles, and largely entangled amongst the 

 chordte tendinete, and which from their character appear not 

 to be post-mortem conditions, this systolic ventricular murmur 

 has been heard. 



I have heard it in a horse affected with disease of the 

 tricuspid auriculo-ventricular valve, there being also less ex- 

 tensive disease of the left side. 



b. When the murmur coincides with or runs off from the 

 second sound, known as the ' ventricular diastolic,' it may be 

 produced in either the auriculo-ventricular or arterial open- 

 ings. It coincides with the dilatation or filling of the ven- 

 tricles : if auriculo-ventricular, it is a murmur of obstruction ; 

 if in the arterial openings, a murmur of regurgitation. 



This bellows-sound accompanying the second sound of the 

 heart seems chiefly indicative of aortic insufficiency from 

 warty growths situated on the edge of the festoons, and from 

 a similar condition or a merely roughened auricular surface of 

 the mitral, or, more rarely, the tricuspid valve. 



c. When the murmur is continuous during both sounds, or 

 properly speaking double, it is spoken of as 'a ventricular 

 systolic and diastolic murmur,' a condition not of uncommon 

 occurrence in the horse. With the existence of this sound, we 

 may suspect aortic insufficiency and mitral obstruction. 



2. Exocardial or Pericardial Murmurs, or Friction-sounds. 

 — These are not unhke the analogous abnormal pleural sounds, 

 and when heard give the impression, varying in character, 

 tone, and pitch, of friction or rubbing. They are synchronous 

 with the heart's action, and may be systolic or diastolic, or 

 both, in this way seeming double from the short pause which 

 occurs between the acts. 



They are considered indicative of pericardial inflammation 

 in its earlier stages, or at least without much effusion or 

 adhesion. 



They are not invariably continuous, but may disappear after 

 existing for a few days, probably owing to the occurrence of 

 effusion ; while, when existing, they rarely overpower or mask 

 the true cardiac sounds. 



We have to remember always that in disease of other 



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