Symptoms, Course. 1099 



body cavities the effusion usually occurs rather early, first of all 

 in the abdominal cavity. 



The stasis in the brain and" its membranes causes more or 

 less striking disturbances in consciousness and attacks of ver- 

 tigo, especially while at work, which are sometimes repeated 

 very frequently, even as often as 10-20 times a day. During 

 such attacks horses frequently fall on their knees while in 

 motion (Katzke is inclined to consider this as a phenomenon 

 which is characteristic of heart lesions). 



The stasis of blood in the lesser circulation produces respir- 

 atory disturbances; foundering is in some of the cases due 

 to a valvular lesion. Chronic bronchial catarrh is a frequent 

 sequel of stasis in the pulmonary circulation Earely a bloody 

 or saffron yellow nasal discharge occurs in consequence of pul- 

 monary hemorrhage which, however, in exceptional cases causes 

 death by asphyxia. Epistaxis occurs, though rarely. Toward 

 the end of the disease pulmonary' edema develops almost always 

 as a terminal phenomenon. 



The passive hyperemia in the digestive organs produces 

 symptoms of chronic gastro-intestinal catarrh, and nutritional 

 disturbances develop at the same time. The stasis in the renal 

 veins leads to a diminution in the amount of urine, while the 

 specific gravity is increased and the urine frequently contains 

 albumen, and occasionally hyaline casts. 



A constant symptom of incompensation is presented by the 

 disturbed cardiac action, which finds expression in arhythmia 

 and feeble pulse while at rest, and still more on motion. 



Loosened portions of thrombi finally may give rise to 

 embolism in various organs. In this manner emboli may get 

 into the lungs from the right heart and into the other organs 

 from the left lung. Cerebral emboli and also cerebral hemor^ 

 rhages may be followed immediately by sudden death. 



Course. Valvular disease is characterized by a very 

 changeable course. Aside from the fact that its influence upon 

 the circulation varies according to localization and intensity, the 

 course is modified by external conditions and by work. While 

 dogs which often pass their lives in quiet comfort not rarely live 

 for years with valvular disease in animals which are employed 

 for work, especially in horses^ this becomes aggravated, rela- 

 tively early, to such a degree that they become useless for exer- 

 tion. For the same reason symptoms of stasis, the development 

 of which requires considerable time, are observed in horses 

 more rarely; they show instead signs of rapidly increasing 

 dyspnea and usually die suddenly of pulmonary edema, cardiac 

 paralysis or rupture of the heart, during work or while in 

 motion. In dogs the gradual development of the sequelae of 

 cardiac anomalies, up to severe edematous infiltrations, can be 

 observed far better; in cattle and in hogs ther.e is far less oppor- 



