166 DISEASES OF THE CIRCULATORY APPARATUS 



result. Chronic pericarditis may also produce death; its action^ how- 

 ever, is slower. 



Therapeutics. — Keep the animal as quiet as possible; give nutritive, 

 easily digested food (meat diet or milk) and such agents as will lessen the 

 fever and tone up the heart. The Priessnitz compress and cold-water 

 compresses might produce better effects, but they excite the animal and 

 thus do more harm than good. Laxatives, such as sulphate of magne- 

 sium or sodium, Epsom salts, calomel. As heart tonics give strophan- 

 thus or digitalis, etc. When the exudate accumulates to an alarming 

 extent, we must resort to surgical means and empty the pericardium by 

 means of the trocar, as in pleuritic effusions, and must be careful to 

 use as long and as thin a trocar as possible. (An aspirating syringe 

 needle is the best.) Select a space over the dullest part of the heart 

 and insert the trocar low down in the left .chest wall, taking care not to 

 put the point in too deep and thus injure the heart itself. 



The treatment of pericarditis is generally symptomatic. If great 

 weakness of the pulse is observed administer wine, alcohol, ether, or 

 camphor; the latter seems to be best to use for this particular affection. 



Dropsy of the pericardium (hydropericardium) is a collection of 

 fluid in the pericardium without any direct inflammation of the serous 

 pericardium. 



In health the pericardium always contains a small amount of fluid, 

 and it is only when we recognize, by physical means, a very much in- 

 creased amount of fluid in the sac that it can be called hydropericarditis. 

 Dropsy of the pericardium may appear as a symptom of various diseases 

 (defects of the valves, inflammation of the heart muscle, diseased con- 

 ditions of the coronary arteries or of the kidneys, and acute anaemia) 

 as well as in connection with inflammation of the pericardium and is 

 generally accompanied with all the symptoms of general dropsy. 



The clinical symptoms are those of pericarditis; the friction bruit 

 and the increase of temperature are absent; however, the treatment 

 consists in removing the original causes and, if this cannot be done, to 

 puncture. Diuretics (digitalis) are to be administered, but these, as a 

 rule, only produce temporary effect. 



Hemorrhage of the Pericardium (Haemopericardium). — This is rarely 

 seen. It may be caused by gunshot wounds, by a bursting aneurysm, or 

 by laceration of one of the coronary arteries (see also spiroptera san- 

 guinolenta), rupture of heart, or the formation of tumors, etc., of the myo- 

 cardium. Death by compression of the heart generally occurs in a 

 short time. Where results are not fatal in a short time — that is, where 

 the blood oozes out slowly and fills the sac gradually — it is impossible 

 to make a certain diagnosis unless the diagnosis is based on the appear- 

 ance of acute anaemia. This is also the case when air (pneumopericarditis) 



