22 GENERAL EXAMINATION. 



extent; the odor of the skin is sometimes very offensive, especially 

 in dogs suffering with distemper. 



CEdema and emphysema of the skin are very important diag- 

 nostic points. By oedema or drop-y of the skin (anasarca) we 

 understand it to be an abnormal accumulation of fluids in the 

 skin and the subcutaneous cellular tissues. This condition is 

 caused by the fluids not being reabsorbed in the same proportion 

 that they come out of the bloodvessels. We recognize oedema by 

 a swollen, bloated, cool condition of the skin, with the obliteration 

 of all wrinkles; if the swelling is pressed with the finger, the 

 indentation remains visible for some time ; this may come from a 

 number of diseased conditions, and it is seen sometimes over the 

 entire body, but chiefly in the lower portion of the body and ex- 

 tremities, testicles, prepuce, abdomen, and chest. It occurs as a 

 complication in diseases of the heart, especially where there is 

 imperfect valvular action, in acute disorders of the kidneys, and 

 in the majority of prolonged acute affections. In rare instances 

 it is caused by true diseases of the blood — ansemia, leukaemia, and 

 pseudo-leuksemia. 



The oedema which appears in the locality of an inflammation 

 (collateral oedema) is of special interest to the surgeon, as it is 

 often the only visible symptom of the inflammatory process that 

 is going on under the skin. (Edema may be also seen as a result 

 of the pressure caused by tight or improper bandaging. 



Emphysema of the skin is where the skin looks as if there was 

 air under it. As a rule, it is confined to small, circumscribed 

 parts of the body, but it has been observed by the author where 

 the whole body has been involved. There is an intense swelling 

 of the parts, and on pressure with the finger the indentation, un- 

 like oedema, immediately disappears. On rubbing over the parts 

 with the hand a slight crackling sound can be heard ; on pressure 

 the air can be driven from the affected portion into the other tissues 

 beyond the border-line. This condition may be caused by the 

 admission of atmospheric air from the outside into the subcuta- 

 neous tissues by means of small wounds in the skin, especially in 

 the neck, wall of the chest, and head, or gas or air from some of 

 the internal organs by a perforation of their walls, such as the 

 larynx, trachea, oesophagus, the bowels, or stomach, in cases where 

 there is perforating wounds of the chest, wounds of the larynx 



