235 



Wlieu dropsy of tlie limbs develoi)s, it is dno to weakened eirculation 

 or f iiiietional impairment of the kidneys. "When there is much weak- 

 ness in the action of the heart, or general debilit}- is marked, the iodide 

 of ii-on, in 1-dram doses, combined with hydrastis, 3 drams, may be 

 given three times a day. Arsenic, in o-grain doses twice a day, will 

 give excellent resnlts in some cases of weak heart associated with diffi- 

 cult breathing. In all cases absojute rest and warm stabling, Avith 

 comfortable clothing, become necessary, and freedom from work 

 should be allowed for a long time after all syjp.ptoms have disappeared. 



ABSCESS IX THE HEART. 



This is a result of mj'ocarditis, or it may arise from localized pyae- 

 mic infection or embolism of a coronary' vessel, causing disintegra- 

 tion and death of a part. Such abscess may be single and large, or 

 multiple and small. They maj^ weaken the heart sufficiently to cause 

 rupture of its Avails, or may embarrass the circulation by i^ressure 

 upon the orifices or cavities sufficient to produce death. 



Abscess of the heart cannot be diagnosed with any degree of certainty. 



PERICARDITIS — INFLAMMATION OF THE SAC INCLOSING THE HEART. 



Causes. — Pericarditis may be induced by cold and damp stabling, 

 exposure and fatigue, from wounds caused by broken ribs, etc. Gen- 

 erally, however, it is associated with an attack of influenza, rheumatism, 

 pleuritis, etc. 



Sijinjjtoiiis. — Usually the disease manifests itself abruptly by a brief 

 stage of chills coincident AAith pain in moving, a short painful cougli, 

 rapid and short breathing, and high temi)erature, AA'ith a rapid and 

 hard pulse. The fever is highest, Avith corresponding jJulse, in the 

 evening and lowest in the morning. In the early stages of the disease 

 the pulse is regular in beat ; later, A\hen there is much exudation pres- 

 ent in the pericardial sac, the heart-beat becomes muffled, and may be 

 of a doubled or rebounding character. By placing the ear against the 

 left side of the chest behind the elboAv a rasx)ing sound may be heard, 

 corresponding to the frequency of the heart-beat. This is known as 

 the to-and-fro friction sound. BetAveen the second and fourth days this 

 sound may disappear, due to a distention of the pericardium by an exu- 

 date or serous effusion. As soon as this effusion i^artly fills the peri- 

 cardium, percussion aaIII reveal an abnormally increased area of 

 dullness over the region of the heart, the heart-beats become less 

 perceptible than in health, and in some cases a splashing or flapping 

 sound ma}' become audible. 



If the effusion becomes absorbed, the to-and-fro friction sound usu- 

 ally recurs for a short time; this friction may often be felt by apply- 

 ing the hand to the side of the chest. In a few cases clonic spasms of 

 the muscles of the neck may be present. In acute pericarditis, when 



