456 HEALTH AND DISEASE 



The natural result of this is, that diseases of remote structures or distant 

 organs may so adversely influence the heart as to lead to indications which 

 may easily, although incorrectly, be ascribed to derangement of the central 

 organ itself; on the other hand, disease of the heart expressing itself by 

 detectable alterations in its own sounds and movements is responsible for 

 various forms of disturbance which occur in the digestive organs, liver, 

 kidneys, or lungs, or some other parts. At the same time, it is thoroughly 

 well recognized, as a fact about which there is no question, that grave 

 structural and functional disturbance may affect the heart without leading 

 to any manifestation at all which can be recognized as relating to that 

 organ. In other words, an animal may die suddenly from heart-disease the 

 existence of which had never been suspected during its life. 



Among the symptoms which are frequently referred to disease of the 

 heart are those which are described as subjective that is to say, sensations 

 which originate in the consciousness of the individual, such as pain, either 

 continual or spasmodic, oppression in the chest, momentary stoppage or 

 disturbance in the movements of the heart, dizziness, palpitations, and 

 sinking. That these sensations, which are realized by the patient, are 

 usually attended with extreme distress and apprehension will be readily 

 understood, although it is a fact that all these clinical signs common in 

 heart-disease may be experienced without any disease of the heart itself 

 being present. 



From the risk of error due to the existence of subjective symptoms, 

 which would be usually classed under the head of extreme nervousness on 

 the part of the subject, the veterinary surgeon is absolutely free. His 

 patients either have no nervous apprehensions in regard to the state of 

 their hearts or other organs, or, if they have, do not possess the means 

 of expressing them in an intelligible manner. 



Admitting, as must be the case, that disease of the heart of the horse is 

 not so uncommon as it has been considered to be, the important question 

 arises as to the best method of examination, for the purpose of detecting 

 any obscure symptoms, which may be sufficient to direct the attention to 

 the condition of the heart and the vessels immediately proceeding from it. 



At the commencement it must be distinctly understood that while 

 the veterinary surgeon is not subject to the risk of making an incorrect 

 diagnosis in consequence of subjective symptoms or sensations which the 

 horse cannot declare, he has to incur an equally prominent risk of arriving 

 at a wrong conclusion in consequence of the derangement of the heart 

 leading to disturbance of some other organs. The respiratory organs 

 are, of course, most likely to be acted on. Any serious derangement of 

 the central organ of circulation must necessarily interfere with the cir- 



