248 DISEASES OF THE CIRCULATORY APPARATUS. 



arterial pressure causes irregularity in the action of the urinary 

 apparatus, and from venous stagnation dropsy shows itself in 

 different parts of the body, especially in the extremities. 



Therapeutics. Keej) the animal as quiet as possible; give 

 nutritive, easily digested food (meat-diet), and such agents that 

 will lessen the fever and tone up the heart. The Priessnitz com- 

 press and cold-water compresses might produce better effects, but 

 they excite the auimal and produce more harm than the good they 

 do. Laxatives (sulphate of magnesium or sodium, calomel). As 

 heart-tonics give strophanthus, digitalis, etc. When the exudate 

 accumulates to an alarming extent we must resort to surgical 

 means and empty the pericardium by means of the trocar, as in 

 pleuritic effusions (see Fig. 38), using as long and as thin a trocar 

 as possible; an aspirating syringe-needle is the best. Select a space 

 over the dullest part of the heart and insert the trocar low down 

 in the left chest wall, taking care not to put ihe point in too deep 

 and injure the heart itself. 



The treatment of pericarditis is generally symptomatic. 



Dropsy of the pericardium (hydro-pericardium) is a collection 

 of serous fluid in the pericardium without any direct inflam- 

 mation of the pericardium. 



In health the pericardium always contains a small amount of 

 fluid, and it is only when we recognize by physical means a very 

 much increased amount of fluid in the sac that it can be called 

 Hydro-pericarditis. Dropsy of the pericardium may appear as a 

 symptom of various diseases (defects of the valves, inflammation 

 of the heart-muscle, diseased conditions of the coronary arteries 

 disease of the kidneys, and acute anaemia) as well as in connec- 

 tion with inflammation of the pericardium, and is generally accom- 

 panied with all the symptoms of general dropsy. 



The clinical symptoms are those of pericarditis ; the friction- 

 bruit and the increase of temperature are absent, however. The 

 treatment consists in removing the original causes, and, if this 

 cannot be cured, to puncture; diuretics (digitalis) are to be admin- 

 istered; but these, as a rule, produce only a temporary effect. 



Hemorrhage into the pericardium (hsemopericardium) is rarelv 

 seen. It may be caused by gunshot-wounds, by a bursting aneu- 

 rism, or by laceration of one of the coronary arteries. Death gen- 

 erally occurs in a short time by compression of the heart. Where 



