76 DISEASES OF THE PERICARDIUM 



Medical.— Heart tonics and stimulants are indicated to 

 tone up the action of the heart, and to assist in the elimina- 

 tion of fluid from the body. Digitalis is of value for this 

 purpose, given to dogs in doses of 0.1-0.2 of the fluidextract 

 once or twice daily depending upon the condition of the 

 patient. 



Laxatives (magnesium sulphate 8.0-12.0, or calomel 0.05- 

 0.1) are indicated occasionally to regulate the bowels and 

 also to assist in the elimination of fluids. 



Surgical.— When the exudate accumulates to the extent 

 of greatly interfering with the heart action, indicated by 

 dyspnea, small rapid pulse, cyanosis, etc., paracentesis of the 

 pericardium should be performed at once. The operation is 

 not very difficult and is as follows: A rather long, small 

 exploring trocar or aspirating needle is thoroughly sterilized. 

 Shave the hair over the left cardiac region, wash thoroughly 

 with soap and water, and follow with alcohol; then paint the 

 surface with tincture of iodin. The needle should be inserted 

 at the lowest point in the pericardial sac so as to be able to 

 remove all the exudate and lessen the danger of injury to the 

 heart. Insert the needle slightly downward and forward, 

 and not too deep. The fluid will flow out in a steady stream. 

 Repeated operations on successive days are often necessary. 

 The skin wound should be protected by covering with flexible 

 collodion. 



HYDROPERICARDIUM. 



Dropsy of the Pericardium. 



Definition.— A collection of serous fluid (transudate) in 

 the pericardial sac not due to inflammation. 



Etiology.— This condition most often accompanies general 

 hydropsy resulting from valvular defects (insufficiencies), 

 myocarditis, diseases of the coronary arteries, chronic nephri- 

 tis, etc. It also occurs from pericarditis (see Pericarditis). 



Symptoms.— The symptoms are similar to pericarditis 

 (see Pericarditis) except it runs a longer and more chronic 

 course. There is absence of temperature, and frictional bruit 

 is heard on auscultation. 



Treatment.— Same as for serofibrinous pericarditis, which 

 see. 



