1080 Acute Endocarditis. 



bacteria from the blood of the mother to the fetus is also 

 possible, and this explanation must probably be accepted for 

 cases that occur successively in several young of the same 

 mother animal (Burke, Stephenson). Jensen and Frohner even 

 believe the transmissibility of the disease from animal to 

 animal to be not impossible. 



In contrast to man, articular rheumatism is not often com- 

 plicated with endocarditis in animals ; most frequently perhaps 

 in cattle, and evidently also under the influence of pathogenic 

 bacteria (streptococci or perhaps also staphylococci) which in 

 all probability produced the articular rheumatism itself. 

 Probably the endocarditis which sometimes follows upon rheu- 

 matic founders of horses must also be explained in this sense. 

 Inflammation of the endocardium must, especially in horses, 

 undoubtedly be referred to the action of streptococci when it 

 develops in connection with grippal or catarrhal pneumonia. 



The bacilli of swine plague are deposited in the tissue of 

 the heart valves after a slight acute general infection, or as 

 Jensen, Lohnsee and Eisenmann have shown, after the erysip- 

 elatous urticaria has run its course, and cause there an inflam- 

 mation through which the apparently recovered animals perish 

 in the course of a few weeks (see p. 68). Marek saw an acute 

 endocarditis being produced by the erysipelas bacillus in two 

 horses which had been employed for the production of erysipelas 

 serum. 



In many cases no bacteria are found in the territory of 

 the inflammation, a fact that must be explained thus, that 

 either the inflammatory virus had disappeared in the mean- 

 while, or that bacterial toxins absorbed from other organs 

 had produced the disease. 



Predisposing factors may be of import to such a degree 

 that formerly many cases of endocarditis were referred to 

 the immediate action of such factors. Among them are: cold 

 (frequent in horses, according to Trasbot), over-exertion, 

 traumatic influences upon the heart region, fracture of ribs, 

 etc. The chronic form of endocarditis also predisposes to 

 renewed acute inflammation (Fuchs). 



Pathogenesis. The bacteria which circulate in the blood 

 stream, probably rarely localize directly on the surfaces of the 

 valves which are contiguous to the blood stream while this 

 passes by them, less frequently on the parietal layer of the 

 endocardium, tlsually they are arrested in the capillaries of 

 the valves, and also at the same time in the blood vessels of 

 the heart muscle. The reason why the localization of the 

 bacteria mentioned as the second contingency takes place also 

 on that surface of the valves which is turned toward the lumen 

 of the heart, lies, according to Eisenmann, in the peculiar ar- 

 rangement of the blood vessels in the heart valves. The micro- 

 organisms, which have localized, and their toxins cause an in- 



