88 CLINICAL DIAGNOSTICS. 



again. Their origin is not well understood. They are nearly 

 always noted in anemic animals. 



It is very important to distinguish between or- 

 ganic and inorganic heart bruits, but in practice 

 this is often very difficult. As a rule, soft, systolic bruits 

 (they do not occur during diastole) should be very carefully 

 estimated. Organic heart bruits are always accompanied by 

 hypertrophy and often alteration of pulse, and frequently 

 venous congestion. 



b. The pericardial bruits. These bruits do 

 not come from within the heart itself, but are extra-cardial. 

 They consist in frictional noises due to the pericardium having 

 become so altered that its surface is no longer smooth and 

 slippery, but rough and dry. The bruits are characterized by 

 being scratching, grating or rubbing, frictional tones not in- 

 timately related to either systole or diastole. Pericardial bruits, 

 when present, muffle the regular heart sounds. 



A pericardial metallic gurgling or liquid bruit, synchron- 

 ous with the heart's beat, occurs in the course of traumatic 

 pericarditis when fluid exudate and gas commingle in the per- 

 icardium. 



Diseases of the Circulatory Apparatus. 



Acute myocarditis. A diffuse parenchymatous affection of the 

 heart's muscle whicli attends severe infectious diseases. Symp- 

 toms: great weakness and debility, mucous membranes cyanotic, 

 high fever, heart's beat weak, systolic sound mutfled. Pulse very 

 rapid up to 1:20 in the horse; small, weak, arhythmic, inequal, 

 finally imperceptible. Course acute or peracute. Mortality high. 



Hypertrophy and dilatation of the heart. Can be present for 

 years without visiljle symptoms occurring. Symptoms: Pulse 

 strong, also heart impulse, zone of cardiac dullness enlarged on 

 percussion. Later when the heart is greatly dilated and the valves 

 can no longer close sufficiently, symptoms of bicuspid insufficiency 

 occur; pulse rapid, arhythmic, inequal; heart's beat sometirnes 

 palpitating, increased dullness on percussion. Systolic blowing 

 bruit, diastolic sound intact or louder than normal. Exercise 

 causes dyspnea from pulmonary venous congestion. Termina- 

 tion as in chronic valvular disease. Most common heart disease 

 of horse and dog. ^ 



