230 



region. "When tlie disease is associated with influenza or rheumatism 

 some of the symptoms may be obscure, but a careful examination will 

 reveal sufficient upon which to base a diagnosis. "When pericarditis 

 develops as a result of or in connection with i)leuritis, the distinction 

 may not be very clearly definable, neither will many recover. When 

 it results from a wound or broken rib It almost invariably proves fatal. 



Pathology. — Pericarditis may at all times be regarded as a very seri- 

 ous affection. At first we will find an intense injection or accumula- 

 tion of blood in the vessels of the pericardium, giving it a red and swollen 

 appearance, during which we have the friction sound. In twenty-four 

 or forty-eight hours this engorgement is followed by an exudation of 

 serofibrinous fluid, the fibrinous portion of which may soon form acoat- 

 ing over the internal surface of the pericardial sac, and may ultimately 

 form a union of the opposing surfaces. Generally this adhesion will 

 only be found to occupy a portion of the surfaces. As the serous or 

 waterj" portion of this effusion is absorbed, the distinctness of the fric- 

 tion sound recurs, and may remain peceptible iy varied degree for a. 

 long time. When the serous effusion is very great, the pressure exerted 

 upon the heart weakens its action, and may produce death soon ; when 

 it is not so great, it may cause dropsies of other portions of the body. 

 When the adhesions of the pericardial sac to the body of the heart are 

 extensive, they generally lead to increased growth or hypertrophy of 

 the heart, with or without dilatation of its cavities ; when they are but 

 slight, they may not cause any inconvenience. 



Treatment. — In acute or subacute pericarditis the tincture of digitalis 

 and tincture of aconite root may be mixed, taking equal quantities, and 

 give 20 to 30 drop doses every hour until the pulse and temperature 

 become reduced. Bandages should be applied to the legs; if they are 

 very cold, tincture of capsicum should be first applied; the body should 

 be warmly clothed in blankets, to promote perspiration. W^hen the 

 suffering from pain is very severe, 2 ounces of tincture of opium may 

 be given once or twice a day; nitrate of potassa, half an ounce, in 

 drinking water, every six hours; after the third day, iodide of potassa, 

 in 2-dram doses, may be substituted. Hot packs to the chest in the 

 earl}' stages of the disease may give marked relief, or smart blisters 

 may be applied to the sides of the chest with benefit. If the disease 

 becomes chronic, iodide of iron and gentian to support the strength 

 will be indicated, but the iodide of potassa, in one or 2-dram doses, 

 two or three times a day, must not be abandoned so long as there is an 

 evidence of effusion or plastic exudate accumulating in the pericardial 

 sac. Where tlie effusion is great and threatens the life of the patient, 

 tapping, by an expert veterinarian, may save the animal. 



VA.LYIILAR DISEASE OF THE HEART. 



Acute valvular disease can not be distinguished from endocarditis, 

 and chronic valvular affections are generally the result of endocardial 

 inflammation. The valves of the left side are the most subject — the 



