Symptoms of Acute Articular Rheumatism in the Horse. 549 



all is tender, the extreme tenderness is referable to the joint, the 

 synovial sheath of the flexors, to the flexors or suspensory liga- 

 ments. As the general swelling subsides the rounded or ovoid 

 synovial distensions become more patent. The swelling and 

 tenderness may extend to the knee in which case the synovial 

 membrane of the carpal arch is especially distended and tender 

 from the carpus down, or in the hind limb the synovial membrane 

 of the tarsal arch is distended showing in this case on the inner 

 and outer sides in front of the calcis, and not infrequently im- 

 plicating the summit of that bone as a capped hock. 



In rheumatism of the shoulder the coraco-radial tendon and 

 pulley may be involved, causing a diffuse swelling on the point of 

 the shoulder. If the hip is the seat of disease the median gluteal 

 may suffer, causing an indefinite swelling over the joint. If the 

 stifle is affected the patellar capsule suffers and not infrequently 

 the tendon and pulley of the flexor metatarsi are involved. 



The most important internal complications, pericarditis and 

 endocarditis, are manifested by their usual symptoms, sharp, 

 variable, irregular, unequal or intermittent pulse, blowing mur- 

 mur usually with the first heart-sound, oppressed breathing, and 

 it may be muffled heart sounds, or dropsies. 



Course.. This is exceedingly uncertain. Some cases rriake a 

 rapid progress to complete convalescence ; others make partial 

 improvements interrupted by relapses ; others have the morbid 

 process subside in great measure in one joint or organ only to re- 

 appear in full force in another ; others leave complications on the 

 part of the heart especially and are rendered permanently useless. 

 Even should the heart escape, the health often suffers so much in 

 connection with the destruction of the red globules, the malnu- 

 trition, and the local disease, swellings and distortions of the 

 joints that a perfect recovery seems distant and problematical. 



