1084 



Acute Endocarditis. 



The temperature is raised in all cases (Figs. 191 and 192), 

 but in slight attacks it is moderate, while severe cases are 

 accompanied by high fever. There are, however, exceptions, 

 and the great variability of the disease-causes makes it evident 

 that the type of fever may be subject to numerous variations. 



Disturbances in the general condition, which are always 

 observed, may be so insignificant in cases running a slow 

 course that they are not observed at all for a time, , especially 

 in swine which are more indolent and live in herds. In other 

 cases the attack commences with considerable indisposition 

 or debility; in horses symptoms of colic are now and then 

 apparent. 



With the gradual increase of circulatory disturbances 

 death occurs in some of the cases, while in others, especially 



in those affected with 

 the ulcerous form, 

 symptoms of metasta- 

 tic inflammation in va- 

 rious organs become 

 evident. Such meta- 

 stases ipay give rise to 

 purulent pneumonia, 

 or purulent nephritis 

 sometimes accompanied 

 by hematuria; to acute 

 meningitis, purulent in- 

 flammation of the 

 joints, etc. Similar 

 causes must be at- 

 tributed to the local 

 hemorrhages which de- 

 velop here and there, 

 for instance, under- 

 neath the cornea. 



In a very small 



percentage of cases a 



possibility of recovery 



may exist ; but in animals which do not die the clinical picture 



of chronic endocarditis usually develops. 



Diagnosis. The disease can only then be recognized posi- 

 tively when repeated examinations have demonstrated that 

 valvular insufficiency or stenosis have developed in a previously 

 healthy heart in a comparatively short time. A careful 

 supervision of the heart action and repeated examinations of 

 the heart are necessary the more, as the elimination of acute 

 febrile diseases (anthrax, severe forms of influenza, septicemia, 

 etc.), perhaps also of severe pulmonary diseases, is possible 

 only in this manner. Of foremost importance is the character 

 of the heart sounds and their transformation into murmurs, 

 but even such findings do* not afford absolute proof because 



Fig. 192. Temperature curve in endocarditis of 



erysipelas in a horse. Two days before death the 



number of heart beats was twice that of the 



pulse beats. 



