Treatment. 1073 



animals wine or brandy, digitalis (in powder form, as infusion, 

 maceration or dialyzation), strophanthin snbcutaneously, 

 camphor internally, or camphorated oil subcutaneously, ether 

 subcutaneously, etc. Gmeiner always observed good effects in 

 myocarditis following upon acute infectious diseases from 

 caffeine (large animals 6 to 8 gms., smaller animals 0.5 to 1.0 

 gms.) subcutaneously every 6 to 8 hours. In very severe cases 

 the preparations of camphor are particularly indicated, and 

 occasionally even in apparently hopeless cases the occurrence 

 of heart paralysis may be prevented by subcutaneous injec- 

 tions, which are repeated every hour or every two hours. 



Aside from this treatment good effects may be obtained 

 from spongings and the removal of retained feces. It goes 

 without saying that absolute rest and good nutrition of the 

 patient must be secured. 



Literature. Berton, Eec, 1898. 289. — Cadiot, Bull., 1893. 374. — Friedberger, 

 Miinch. Jhb., 1877-78. 58. — Gmeiner, B. t. W., 1906. 409. — Johne, S. B., 1878. 

 19, 21. — Trattner, A. L., 1904. 489 — Zsehokke, Sohw A., 1900. XLII. 193: 

 XLIX. 320. 



(b) Chronic Myocarditis. Myocarditis Chronica. 



Chronic inflammatory processes in the heart muscle occur 

 in domestic animals much more frequently than used to be 

 assumed. A part of the cases described as idiopathic hyper- 

 trophy or as dilatation of the heart was evidently due to chronic 

 myocarditis. 



Etiology. Chronic myocarditis not infrequently develops 

 from the acute form. Further, abscesses developing , in the 

 heart muscle incite an increase in connective tissue, either in 

 their immediate vicinity or in more distant portions. Occa- 

 sionally chronic muscular rheumatism, chronic nephritis, chronic 

 endoarteritis, may act as exciting causes. Tuberculous foci 

 or abscesses with circumscribed myocarditis are sometimes 

 seen in cattle and dogs, exceptionally also in hogs, not infre- 

 quently in chickens (Folger). Chronic peri- and endocarditis 

 is sometimes also followed by chronic myocarditis, either from 

 a direct continuation of the inflammatory process or from the 

 same cause as the peri- or endocarditis, and in fact the in- 

 flammatory process may occur simultaneously in the heart 

 muscle. In a portion of the cases the disease undoubtedly de- 

 velops idiopathically for reasons that are not known. Occa- 

 sionally, perhaps, certain chemical substances or mechanical 

 influences and agencies leading to increased arterial pressure 

 may be of importance. Fleischer & Lode have produced necrotic 

 foci in the heart muscle in 59% of their experiment rabbits 

 after combined injections of adrenalin aiid caffeine, and the 

 necrotic foci were much smaller if adrenalin alone was injected 

 intravenously. 



Vol. 1—68 



