CHAPTER II. 

 PERICARDITIS. 



Pericarditis consists in inflammation of the pericardial sac. It is 

 attributable to different causes, varying in importance and in causation. 



Specific pericarditis may be produced by the tubercle bacillus, or it 

 may develop during an attack of contagious peripneumonia. Tuber- 

 culous or peripneumonic forms of pericarditis as a rule form only com- 

 plications of chronic pulmonary tuberculosis or peripneumonia. They 

 are very rarely primary in character, and, like the allied forms of 

 pleurisy, assume a vegetative and adhesive form in tuberculous cases. 



Moussu has never seen the true exudative form either in acute or 

 chronic tuberculosis, but only vegetative and caseous forms. 



Simple acute pericarditis. Cases of simple acute exudative peri- 

 carditis have been described, and have been referred to chills, wounds, 

 or injuries in the region of the heart, and in a few cases to the 

 rheumatic diathesis. 



Such forms of pericarditis may occur, but probably are very rare, 

 for Moussu has seen but two cases. As the symptoms correspond 

 exactly to those of exudative pericarditis produced by a foreign body, 

 it is unnecessary to describe them specially. 



The only important detail to bear in mind w'ith this disease is the 

 possibility of cure by suitable treatment, such as the application of 

 stimulants or vesicants to the cardiac zone, the administration of sali- 

 cylate of soda or diuretics, and complete rest. 



The diagnosis, moreover, should be confirmed by making an aseptic 

 exploratory puncture with the capillary trocar. The nature of the 

 liquid withdrawn will indicate whether the case is one of simple acute 

 pericarditis or pericarditis due to a foreign body. 



Cancerous pericarditis is generally secondary, and is caused by 

 development of tumours on the pericardial serou§ membrane, and in 

 the myocardium. Moussu, however, has seen one case of primary 

 cancerous pericarditis, the tumours being found only on the periphery 

 ■ of the myocardium. The growth assumes a vegetative form with 

 moderate exudation. The symj)toms, however, so closely approach to 

 those of exudative pericarditis due to foreign bodies that only the 



