EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 381 



active congestion, and in exceptional cases a tubal souffle may be 

 observed. In most cases the animal has a paroxysmal, somewhat fre- 

 quent cough, due to reflex irritability of the pneumo-gastric. 



Cruzel in addition mentions a double respiratory movement like that 

 produced in the horse by broken wind. This is really the result of 

 hydro-thorax, and is not a constant symptom. 



D. General symptoms. When the disease has lasted a certain 

 time the patients show certain well-marked general symptoms : they 

 remain standing in one position for long periods, with the head and 

 neck extended, the front legs thrust outwards from the trunk and the 

 body rigid, as though the least movement caused them pain. The 

 general attitude expresses anxiety, the animals lie down with great care 

 and seldom remain long in this position, which interferes with the 

 functions of the heart and lung. In the last stages the animals 

 remain constantly standing, appetite is almost entirely lost, and they 

 waste rapidly. 



The course of pericarditis due to foreign bodies is very variable. 

 Sometimes death occurs in eight or ten days. In other cases the animal 

 may sur\ave for weeks, provided it is well tended. Everything depends 

 on the rapidity with which the foreign body moves and on the character 

 of the infectious organisms which it introduces into the pericardium. 

 Death is the inevitable termination, and occurs as a consequence of 

 cardiac and respiratory syncope. It may follow suddenly as the result 

 of a simple forced movement, even when the animal still seems to retain 

 some amount of strength. When the organisms introduced into the peri- 

 cardium are of marked virulence, complications such as septic pleurisy 

 and pneumonia may be observed, and death soon takes place. 



It has been suggested that recovery might follow a return of the 

 foreign body towards the reticulum. This view can only have been 

 advanced as a consequence of errors in diagnosis, either as to the exist- 

 ence of pericarditis or as to its nature. Pericarditis due to cold or rheu- 

 matism sometimes becomes cured spontaneously. 



Death, again, may suddenly occur by syncope when the foreign body 

 penetrates the myocardium, passes through it, and enters the ventricular 

 cavities. 



The return of the foreign body is not conceivable, at all events after 

 it arrives in the pericardial cavity. Up to that time the only dis- 

 turbance is of a digestive character ; no pericarditis exists. But when 

 for example the disturbance is due to long fragments of iron wire which 

 may extend from the reticulum as far as the pericardium, it is clear that 

 the pericarditis is of a kind which cannot be cured without leaving 

 traces. In our opinion, natural recovery is impossible. 



Diagnosis. The diagnosis of pericarditis cannot be made until such 



