ANASARCA, OR PUEPUKA HEMORRHAGICA. 509 



tion, that they seem to belong to a separate disease, and complica- 

 tions may completely mask the original trouble. 



In the simplest form the first symptom noticed is a swelling, or 

 several swellings, occurring on the surface of the body — on the fore- 

 arm, the leg, the under surface of the belly, or the side of the head. 

 The tumefaction is at first the size of a hen's egg ; not hot, little sen- 

 sitive, and distinctly circumscribed by a marked line from the sur- 

 rounding healthy tissue. These tumors gradually extend until they 

 coalesce, and in a few hours we have swelling up of the legs, legs and 

 belly, or the head, to an enormous size; they have always the char- 

 acteristic constricted border, which looks as if it had been tied with a 

 cord. In the nostrils are found small reddish spots, or petechise, 

 which gradually assume a brownish and frequently a black color. 

 Examination of the mouth will frequently reveal similar lesions on 

 the surface of the tongue, along the lingual gutter, and on the 

 fra?num. If the external swelling has been on the head, the pete- 

 chise of the mucous membranes are apt to be more numerous and to 

 coalesce into patches of larger size than when the dropsy is confined 

 to the legs. The animal may be rendered stiff by the swelling of the 

 legs, or be annoyed by the awkward swollen head, which at times may 

 be so enormous as to resemble that of a hippopotamus rather than 

 that of a horse. During this period the temperature remains nor- 

 mal; the pulse, if altered at all, is only a little weaker; the respira- 

 tion is only hurried if the swelling of the head infringes on the 

 caliber of the nostrils. The appetite remains normal. The animal 

 is attentive to all that is going on, and, except for the swelling, 

 apparently in perfect health. 



In from two to four days, in severe cases, the tissues can no longer 

 resist the pressure of the exuded fluid. Over the surface of the skin 

 which covers the dropsy we find a slight serous sweating, which 

 loosens the epidermis and dries so as to simulate the eruption of some 

 cutaneous disease. If this is excessive we may see irritated spots _ 

 which are suppurating. In the nasal fossae the hemorrhagic spots 

 have acted as irritants, and, inviting an increased amount of blood 

 to the Schneiderian membrane, produce a coryza or even a catarrh. 

 We may now find some enlargement and peripheral edema of the 

 lymphatic glands, which are fed from the affected part. The ther- 

 mometer indicates a slight rise in the body temperature, while the 

 pulse and respiration are somewhat accelerated. The appetite usu- 

 ally remains good. In the course of a few days the temperature may 

 have reached 102°, 103°, or 104° F. 



Fever is established, not an essential or specific fever in any way, 

 but a simple secondary fever produced by the dead material from the 

 surface or superficial suppuration, and by the oxidization and absorp- 

 tion of the colloid mass contained in the tissues. The skin may sup- 



