1X02 Valvular Diseases. 



made their appearance. The patients must therefore be pro- 

 tected from all influences which impose an increased amount of 

 work on the heart, which suddenly change the blood pressure or 

 irritate the heart in any way. It is therefore necessary to regu- 

 late the diet thus, that the animals receive no irritating sub- 

 stances with their food (which must be insisted upon especially 

 in carnivora), that not too much food is taken in at one time, but 

 that the usual daily ration is eaten in several small portions. They 

 must be supplied with pure air or led around in the open. The 

 work done by the patients must be supervised very carefully. 

 The animals are capable of accomplishing light, quiet and uni- 

 form work in proportion to the mildness of their heart trouble. 

 Experience has shown that, if these precautions are observed, 

 animals with heart disease may do satisfactory work even for 

 years, especially in agricultural employment. Finally the diges- 

 tion must be watched because fecal retention increases the 

 abdominal pressure, and therefore the activity of the heart. In 

 such cases the administration of mild laxatives, especially of 

 mineral salts, castor oil, rhubarb or aloes is indicated. 



In the stages of incompensation (and veterinary aid is 

 usually requested only at this time) absolute rest must be 

 insured and the action of the heart regulated. Above all digi- 

 talis does good service because the heart contracts more vigor- 

 ously and less frequently under its influence, so that the muscles 

 obtain more rest during the longer pauses. Larger animals 

 should receive, if possible, powdered fresh leaves (horses 2-4 

 gm., cattle 4-6.0 gm. daily), dogs an infusion (1-2.0 gm. ; 200.0 

 gm. of water; 2-3 tablespoonfuls daily), and the nitrate or 

 acetate of potassium may be added to increase the diuresis. 

 According to the investigations of Kunz-Krause & Eoder it 

 appears better to employ Folia Digitalis dialysata (for larger 

 animals 5-15 cc. per os) or the Digitalysatum Biirger (20-30 

 drops subcutaneously for smaller animals). Maceration of 

 digitalis leaves (maceration in pure water for 12-24 hours) may 

 also be given to advantage. Digalen has an excellent action 

 and is to be recommended, especially if dangerous cardiac weak- 

 ness is present (horses 5-15 cc, cattle 20 cc, subcutaneously; 

 or 15-30 cc. intravenously; dogs 5-15 cc or 0.857 cc. per kg. 

 of body weight) , but if required for prolonged treatment it will 

 be employed only in valuable or valued animals. Digitalis 

 being rendered inactive in the stomach of the ruminants (Sal- 

 visberg), those preparations should be selected for these 

 animals which are adapted for subcutaneous administration. 

 Diehl observed abortion in pregnant cows after the use of dig- 

 italis. The tincture of strophanthus (10-25.0 .gm. for large 

 animals, the same number of drops in smaller animals, daily) 

 has been found unreliable in contrast to Strophanthinum 

 depuratum, Merck, the good action of which is constant. It is 

 given subcutaneously in aqueous solution (soluble in 40 parts 

 of water) (0.002-0.003 gm. for horses, 0.00025-0.001 for dogs). 



