1048 Pericarditis. 



temperature (Meyer, Eber) is suggestive. According to Eber the ques- 

 tion may be decided even in those rare cases in which the temperature 

 rises more or less during the initial stage, the increased pulse rate 

 remaining unchanged in spite of the lowering of the temperature by the 

 action of antifebrin in doses of 50-100 Gm. per day. According to Otto 

 a peculiar muscular trembling in the vicinity of the elbows is of impor- 

 tance in this respect, which occurs especially after the animal has been 

 standing for some time. 



Fibrinous pericarditis might be mistaken for fibrinous 

 pleurisy when this has given rise to the so-called pleuro-peri- 

 cardial sounds. These friction sounds are purely pleuritic and 

 are characterized by being heard, together with the heart sounds, 

 only during either inspiration or expiration ; moreover, they are 

 heard synchronously with the respiratory movements during the 

 heart-pause. Moreover, pleurisy is rarely limited to so small 

 a space and therefore friction sounds, synchronous with the 

 respiratory movements, are also heard more posteriorly. Still, 

 it must not be forgotten that pleurisy and pericarditis may occa- 

 sionally be present at the same time. — In rheumatism of the 

 intercostal muscles the intercostal spaces are painful, but fric- 

 tion sounds are absent or at most dull muscular sounds are 

 audible. If a fibrinous pleurisy should also be present, as is 

 the case occasionally in the so-called pleurodynia of horses, the 

 nature of the disease will be sufficiently cleared up by the his- 

 tory of the case (Vol. 11. ). — From the endocardial sounds in 

 valvular disease the pericardial friction sounds are differen- 

 tiated especially by the fact that they seem to develop immedi- 

 ately under the ear, are sometimes increased by pressure and 

 become w^eaker on inspiration ; finally by the fact that they are 

 not quite synchronous with the heart movements. — At the very 

 beginning general acute infectious diseases may have to be con- 

 sidered, in ruminants especially anthrax, but in such cases the 

 temperature is usually decisive, since in pericarditis the tem- 

 perature rises are usually slight unless the disease has developed 

 upon a septicemic basis. 



Pericarditis with effusion might give rise to confusion with 

 pneumonia in those cases in which only the lower sections of the 

 lungs, in the neighborhood of the heart, have become condensed 

 and may therefore simulate an increased cardiac dullness. In 

 such cases the character of the heart beat and of the heart 

 sounds affords information because in pneumonia they are not 

 weakened at all or only slightly so, in contrast to pericarditis 

 with effusion. — In cattle, lung plagiie may cause a clinical pic- 

 ture which is somewhat like that of traumatic pericarditis, but 

 in most cases sufficient points of diiference are present, for in- 

 stance, the preceding digestive disturbances, the comparatively 

 small dullness, the striking weakness of the heart-beat, the com- 

 plete absence of bronchial respiratory sounds, the characteristic 

 pericardial sounds and slight fever or its absence. — In peri- 



