162 DISEASES OF THE CIRCULATORY APPARATUS 



digestive organs of various kinds, and, finally, general nutritive dis- 

 turbances, such as ananiia, emaciation, etc. 



Symptoms of Valvular Deficiency in one Opening. Insufficiency 

 of the Mitrals. — The imperfect closing of two of the valves occurs very 

 frequently in the dog. Besides the alterations of the valves we find 

 hypertrophy and dilatation of the left auricle of the heart, and in the 

 later stages also of the right ventricle. 



The clinical symptoms are: Increase of the pulse and distention of 

 the artery, systolic bruit heard on the left wall of the chest, increase of the 

 second (pulmonic) sound, weak, frequent pulse, shortness of breath, and 

 later dropsy, etc. 



Stenosis of the Left Venous Opening. — This is generally accom- 

 panied by mitral insufficiency. It leads also to dilatation and hyper- 

 trophy of the left auricle and the right ventricle, and in such cases the 

 left ventricle is generally small, narrow, and contains little blood. 



The clinical symptoms are: Slight increase in the pulse, diastolic 

 bruit (this is absent in some cases) ; considerable increase of the second 

 (pulmonic) bruit, very small, irregular pulse; great difficulty in respira- 

 tion, and dropsy makes its appearance early in the disease. 



Disease of the Aortic Valves. — This condition of the semilunar valves, 

 causes a dilatation and hypertrophy of the left ventricle and flattening 

 of the papillary muscles. 



The clinical symptoms are as follows: A very strong heartbeat; 

 increase of the heart dulness on the left side, and a full, bounding pulse, 

 is very frequently noticed. This character of the pulse is also noticed in 

 small arteries that in normal conditions have no distinct pulse. We also 

 find shortness of l)reath, oedema, and dropsy of the dependent parts. 



Stenosis of the Aortic Opening. — Rare in the dog. The clinical 

 symptoms are a systolic bruit, a very slight sound of the aorta, small, 

 weak pulse, general amemia, etc. 



Imperfect action and disease of the tricuspid valves cause distention 

 of the right auricle and also a systolic murmur on the right side and a 

 strong, venous pulse. Stenosis of the right venous opening and defects 

 of the pulmonary valves are extremely rare. 



We very frequently have a combination of a contraction of an 

 opening and also a deposit on, or retraction of, the valve at that opening, 

 and also a single valvular defect; these two make a combination of symp- 

 toms that are rather hard to separate. 



Prognosis and Therapeutics of Valvular Defects of the Heart. — A 

 diseased valve must ha considered incurable, but it may exist for a long 

 time without causing any decided disturbance of the general circulation. 

 It is impossible to predict how long a " compensating" state will continue. 

 Mitral defects seem to last the longest. This conculsion is arrived at 



