252 DISEASES OF THE HOKSE. 



doses every two to four hours, digitalis in the form of the tincture in 

 doses of 1 dram every three to six hours. Artificial Carlsbad salts in 

 heaping tablespoonf ul doses in the feed may be given three times daily 

 for a couple of weeks. Rest is of the greatest importance and should 

 be allowed for a few weeks after recovery seems to be complete. 



ENDOCARDITIS, OR INFLAMMATION OF THE LINING MEMBRANE OF THE HEART. 



Endocarditis frequently occurs as a complication of rheumatism, 

 some of the specific or zymotic fevers, specific poisoning, etc. This 

 is a more frequent disease among horses than is generally known, 

 and often gives rise to symptoms which at first are obscure and 

 unnoticed. 



In influenza we may find the heart -becoming involved in the dis- 

 ease, in consequence of the morbid material conveyed through the 

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

 in even remotd 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, subacute, or chronic. In acute inflam- 

 mation we find a thickening and a roughened appearance of the 

 endocardium throughout the cavities of the heart. This condition 

 may be followed by a coagulation of fibrin upon the inflamed sur- 

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

 into shreddy-like granular elevations. This may lead to a formation 

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

 tlie second or third day. 



Subacute endocarditis, which is the most common form, 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 generally occasions when the animal is exercised, especially if the 

 valves are much involved. When coagula or vegetations form upon 

 the inflamed membrane, either in minute shreds or patches, or when 

 formation of fibrinous clots occurs in the cavity affected, some of these 

 materials 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 majority of either acute or subacute grades of endocarditis, 

 whatever the exciting cause, the most alarming symptoms disappear 

 in a week or 10 days, often leaving, however, such changes in the 

 interior lining or valvular structures as to cause impairment in the 

 circulation for a much longer period of time. These changes usually 

 consist of thickening or induration of the inflamed structures. But 



