1050 Pericarditis. 



belt, or a compress made of tow or cotton, is applied to the 

 region of the heart and cold water poured over it from time 

 to time; large animals may be put under the shower. In 

 jjrimary pericarditis preparations of salicylic acid may be tried 

 in similar doses as in pneumonia (Vol. II.) or in somewhat 

 smaller ones, because their harmful action upon the heart is 

 here more easily exerted. Lactophenin, salicylic acid, antif ebrin, 

 antipyrin and salipyrin may be administered in very high fever. 



For weakness of the heart, cardiac remedies are indicated, 

 digitalis (in large animals 2-4 gm. daily, in small animals, of a 

 2 :150.0 infusion to which 5 gra. of potassium nitrate have been 

 added, one tablespoonful every two hours). Caffeine is also of 

 service (2-5.0 gm. or 0.2-1.0 gm. subcutaneously), camphor (cam- 

 phorated oil 20-30 gm. or 2-3 gm. subcutaneously), possibly wine, 

 alcohol, or ether. 



To promote absorption diuretic remedies and mild laxatives 

 may be tried. In excessive accumulation of fluid, with conse- 

 quent compression of the heart, puncture of the pericardium 

 should be considered. But in these cases puncture is not as 

 harmless a proceeding as in pleurisy because a portion of the 

 exudate may flow into the pleural cavity through the opening in 

 the pericardium, after the trocar has been removed (Moussu, 

 Qmeiner, author's case). 



Puncture of the pericardium is done with a simple trocar immediately above 

 the parasternal line, in the 5th or 6th intercostal space, but always within the 

 area of dullness; after removal of the exudate the pericardial cavity may be irrigated 

 with lukewarm sterilized water or with a mild disinfecting solution. If the exudate 

 is purulent it seems more advisable to open the pericardium by an incision and 

 to wash out the cavity thoroughly. During this operation it may be possible to 

 find and remove the foreign body (Bastin). 



In traumatic pericarditis Meyer's operation may also be 

 tried (Vol. II.). If this is not followed by improvement or if 

 the disease is already far progressed slaughtering of the patients 

 should not be delayed, because later on the flesh will become 

 useless for human consumption on account of emaciation or 

 sapremia or of general pyemic infection. In order to remove 

 edematous infiltration and thus make the flesh flt for consump- 

 tion Moussu recommends the removal of the exudate through 

 a puncture from the direction of the xiphoid cartilage (Fig. 182). 

 This procedure merits consideration also in non-traumatic peri- 

 carditis of cattle. 



With the animal standing, the positions of the xiphoid cartilage, the linca 

 alba and the left costal arch are ascertained. In the middle of 'the angle outlined 

 by these landmarks, above 20 cm. in front of the place where the milk vein runs 

 toward the V. epigastriea cranialis, the abdominal wall is pierced, an incision is 

 made through the skin about 20 cm. long, parallel to the costal arch, through 

 which a portion of the serous tluid which has accumulated in the subcutaneous 

 oonnective tissue will escape promptly. The muscles in the bottom of the wound 

 are then separated with the scalpel as far as the neck of the xiphoid cartilage, 

 the subpericardial fatty connective tissue is forced apart with one or two fingjers 

 of the right hand until the pericardium is reached, as is shown by feeling the 

 heart beats. The left index finger is now pushed up to the pericardium, and 



