1072 Myocarditis. 



horses. Finally, sudden death may occur in animals that are 

 apparently healthy and in which autopsy shows that somewhere 

 in the heart muscle an abscess had existed for some time, and 

 which had caused death by perforating into the pericardial 

 cavity or into one of the heart cavities. Such cases occur 

 preferably in animals that are continuously saved from all 

 exercise (cows). 



Diagnosis. Acute myocarditis may be mistaken especially 

 for acute peri- or endocarditis, since in both these diseases 

 the heart beat is usually much stronger and bounding. In 

 the initial stage the differentiation, on the ground of clinical 

 symptoms alone, is hardly possible. Later on, however, these 

 diseases may be eliminated by the absence of abnormal sounds. 

 — The general vascular paralysis which is frequent in acute 

 infectious diseases is characterized by the fact that the veins 

 are not filled very strongly and by the pale blue discoloration 

 of the mucous membranes. This affection is frequently asso- 

 ciated with acute myocarditis. 



The nature of the inflammation of the heart muscle can 

 be ascertained only approximately by considering the basic 

 disease or the morbid cause; especially a purulent inflammation 

 can be assumed only then when other factors admit the possi- 

 bility of metastasis. Aside from parenchymatous degeneration 

 or inflammation of the heart muscle, the kidneys also become 

 often similarly affected in acute infectious diseases, and the 

 albuminuria which is due to such an occurrence may be made 

 use of in making a diagnosis. 



Prognosis. The significance of parenchymatous degenera- 

 tion or inflammation depends primarily upon whether the basic 

 disease permits a removal of its cause. If, however, the 

 degeneration or the functional disturbances produced by it 

 have passed a certain degree, healing becomes impossible. Of 

 deciding importance in these cases is the tone of the vascular 

 walls and also the degree of impediment to the blood stream; 

 in general vascular paralysis, or in extensive infiltration of 

 the lungs the circulatory disturbances assume a threatening 

 character earlier, the heart changes being of like degree. 



The pulse rate is of importance in so far as, with an in- 

 crease to more than twice the normal, an equalization of the 

 disturbances can hardly be hoped for. If the disturbances of 

 the cardiac activity are less severe, the irregularity and weak- 

 ness of the pulse are again of unfavorable import. — In purulent 

 inflammation the prognosis is always unfavorable. 



Treatment. The cardiac weakness may be counteracted 

 by excitants or cardio-tonics. According to the intensity of 

 the functional disturbances, the following remedies may be 

 considered: Alcohol (in the drinking water); for smaller 



