Occurrence, Etiology. 1079 



of tuberculosis. Hogs are usually affected by an erysipelatous 

 endocarditis ; less often the affection accompanies swine plague, 

 and has only in exceptional cases another origin (Liipke, Bang, 

 author's case). In dogs the disease usually follows upon 

 pyemia, septicemia, distemper, exceptionally also upon tuber- 

 culosis (Jensen observed 13 cases of ulcerating endocarditis 

 among 3,240 sick dogs). In cats and birds acute endocarditis 

 appears to occur only very rarely. 



Etiology. Acute endocarditis develops as a rule through 

 an infection, but the various infectious substances concerned 

 are at present only partially known. Comparatively often the 

 pyogenic bacteria (cocci, streptococci, staphylococci, bacillus 

 pyogenes) appear to be concerned in the production of the 

 affection (Trasbot, Cadeac, Albrecht, Csokor, Nocard, Kitt, 

 Bang, Liipke, Frohner, Joest, author's case). In hogs the 

 erysipelas bacilli are usually of importance as etiological fac- 

 tors. In ulcerous endocarditis Jensen and Thomassen have 

 found the bacillus coli communis in association with other bac- 

 teria; Kitt several times the botryomyces in horses; Luginger 

 a streptothrix in cattle. The tubercle bacillus was found by 

 Cadeac, Cadiot and Bergeon in cattle ; the corynebacillus renalis 

 by Cadeac and Scherzer in the deposits upon the affected heart 

 valves; the bacillus bipolaris also is probably frequently a 

 factor. For instance, Jensen found ovoid bacteria among other 

 microorganisms in endocarditis of dogs, and Bang as well as 

 de Jong observed endocarditis in swine plague (among 16,000 

 hogs dead of swine plague, 676 cases of endocarditis verrucosa 

 were found in England). Acute endocarditis has also been 

 noted in swine pest (de Jong). 



In some cases an infectious endocarditis develops without 

 an affection of the other organs and must then be considered 

 as a x)rimary disease. In the majority of cases, however, the 

 trouble is secondary in nature and the bacteria reach the 

 endocardium from inflamed organs (heart muscle, pericardium, 

 mediastinum) by direct continuity or, much more frequently, 

 from distant pathological foci with the blood stream. First 

 in this respect are pyemic and septicemic diseases. Wherever 

 in the body suppurating inflammations occur, like suppurating 

 wounds, inflammation of the umbilical cord, variola (imme- 

 diately before the suppurating stage or at its beginning), 

 puerperal fever, strangles, fibrinous-purulent inflammation of 

 the serous membranes, the malignant form of foot-and-mouth 

 disease, etc., the opportunity for localization of pyogenic bac- 

 teria on the heart valves may be given. Sometimes seemingly 

 quite inconsiderable losses in substance (ulcers at the tip of 

 the tail or elsewhere on the skin of dogs, bites, pressure wounds 

 in horses, etc.) or inflammatory foci in other organs (in the 

 case of Blanc's, inflammation of the bile ducts) afford a point 

 of entrance to the pyogenic bacteria. The transmission of 



