Traumatic Pericarditis. Foreign Bodies in Pericardium. 457 



striking an empty glass with the back of a knife. This sound is 

 synchronous with the heart beat, though it may be intermittent, 

 the intervals representing the periods following the escape of 

 gas and the relief of the tension in the canal. This is one of the 

 most diagnostic features of this lesion, and is especially so in stall- 

 fed cattle, when the attack has appeared and advanced gradually, 

 with at first little or no fever ; when there have been earlj- gastric 

 disorders ; when percussion shows a line of flatness and tender- 

 ness from the middle of the diaphragm forward ; when there 

 have been functional disorders of the heart ; when dyspncea is 

 produced by slight exertion ; and when there is infiltration of 

 the dewlap and sternal region. 



Friedberger and Frohner note a blowing or rushing sound in 

 the large arteries, aortic and pulmonary, when compressed by 

 the exudate, and Cadeac and Brinot a blowing sound synchronous 

 with the contraction of the heart and with expiration, which 

 they attribute to the distension of the pericardium. Finally 

 Bernardin notes the exceptional loudness and clearness of the 

 heart sounds on the left side, behind the scapula, when the exu- 

 date is so abundant as to form a specially favorable sound 

 conductor. 



Treatment. As a rule treatment is useless, but as the result is 

 almost certainly fatal if left alone, the practioner would be fully 

 warranted in resorting to desperate surgical measures. In most 

 instances such measures have failed to save the patiept. In one 

 case the rumen was opened and a nail, engaged in the wall of 

 the reticulum and in the diaphragm, was withdrawn with a suc- 

 cessful issue (Johow). In a more advanced case the chest wall 

 was opened, opposite the base of the pericardium, on the left 

 side, and the foreign body sought and extracted. The cow re- 

 covered and was sold fat three months later (Bastin). As 

 already noted, very exceptional cases have recovered spontane- 

 ously by the slipping of the offending object back into the retic- 

 ulum through a spacious canal. In others it has taken a new 

 direction and emerged through an intercostal^ space. 



Prevention. This is the only satisfactory resort. The very 

 careful seclusion of nails and sharp-pointed bodies from cow 

 houses, and from barns in which fodder is stored ; the disuse of 

 baled hay, or the careful removal of the wires from the bales so 



