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either endocarditis or pericarditis. A certaiD number of these cases 

 subsequently developed the condition known as heaves, or gradually 

 failed in strength, with recurrence of attacks of heart failure upon the 

 slightest exertion, rendering many of them valueless. In th\) rheumatic 

 type of influenza we may often find the heart becoming involved in the 

 disease, in consequence of the morbid material conveyed through the 

 heart in the blood-stream. In view of the fact that many affections, ia 

 even remote portions of the body, may be traced directly to a primary 

 endocardial disease, we shall feel justified in inviting special attention 

 to this disease. 



Endocarditis may be acute or assume various degrees of severity. 

 In acute inflammation we find a thickening and a roughened appear- 

 ance of the endocardium throughout the cavities of the heart. This 

 condition is soon followed by a coagulation of fibrine upon the inflamed 

 surface, which adheres to it, and by attrition soon becomes worked up 

 into shreddy-like granular elevations ; this may lead to the formation, 

 of fibrinous clots in the heart and sudden death early in the disease, 

 the second or third day. This acute type of the disease, however, does 

 not always affect the whole interior of the heart, but is often confined 

 to one ventricle or may be in patches ; it may extend through the ventri- 

 cle into the aorta or the pulmonary vein ; it may affect the valves prin- 

 cipally, which are composed of but little else than the endocardium 

 folded upon itself. 



In acute endocarditis we invariably will find myocarditis develop 

 corresponding to the same space, which in intensity may i^roduce seri- 

 ous results through the destruction of functional ability or lead to 

 weakness, abscess, or rupture. Immediately upon the swelling of this 

 membrane we will find an abnormal action and abnormal sounds of the 

 heart. 



Subacute endocarditis, which is the most common form we meet, 

 may not become appreciable for several days after its commencement. 

 It is characterized by being confined to one or more anatomical divisions 

 of the heart, and all the successive morbid changes follow each other 

 in a comparatively slow process. Often we would not be led to suspect 

 heart affection were it not for the distress in breathing, which it gen- 

 erally occasions when the animal is exercised, especially if the valves are 

 much involved. When the disease extends into the arteries, atherom- 

 atous deposits usually develop; when the inflammation is severe at the 

 origin of the tendinous cords they may become softened and ruptured. 

 When much fibrinous coagula or cellular vegetations form upon the 

 inflamed membrane, either in minute shreds or jiatches, or when forma- 

 tion of fibrinous clots occurs in the cavity affected, some of these mate- 

 rials may be carried from the cavity of the heart by the blood-current 

 into remote organs, constituting emboli that are liable to suddenly plug 

 vessels and thereby interrupt important functions. In the great major- 

 ity of either acute or subacute grades of endocarditis, whatever the 

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