114 THE FARM DOCTOR. 



gested lungs. Later, bleeding may sometimes be beneficial in 

 strong subjects by relieving extreme difficulty of breathing and 

 high nervous excitement. Usually it would be injurious. Give 

 a purgative (horse, aloes ; ox and sheep, Glauber salts ; dog 

 and pig, castor-oil), foment the walls of the chest, and envelop 

 in a large mustard poultice until the skin is well thickened, 

 moderate the heart's action by digitalis four times a day and 

 follow the action of the purgative by diuretics (nitre, acetate of 

 potassa, etc.) Ointment or tincture of iodine may be applied 

 to the walls of the chest. In cases of extreme danger from 

 effusion the liquid should be drawn off with cannula and trocar 

 or needle-like tube, as in hydrothorax, the puncture in the horse; 

 or ox being made between the cartilages of the fifth and sixth 

 ribs. 



In case of rheumatic complication use alkalies, colchicurc, 

 acetate of potassa, and other agents advised for rheumatism. 



ENDOCARDITIS. 



Inflammation of the serous membrane lining the chambers 

 and covering the valves of the heart. 



Causes. — Inflammation of the valves in connexion with undue 

 strain in severe exertions or obstructions to the flow of blood, 

 the rheumatic constitution or certain other unhealthy states of 

 the blood. 



Symptoms. — The general symptoms resemble those of peri- 

 carditis. There are, besides, violent but unequal impulse of 

 the heart against the left side, accompanied by a metallic tink- 

 ling, a blowing murmur with the fiist, or even the second 

 sound, as soon as the contraction of the valves, or the clots 

 formed on them, render them insufficient to close the orifices, 

 and, if the disease exists on the right side of the heart, venous 

 pulse, general venous congestion and dropsical swellings. The 

 pulse, at first strong and sharp, becomes weak with the imper- 

 fection of the valves, in marked contrast with the continued 



