454 DISEASES OF THE CIRCULATORY SYSTEM. 



should be placed upon the surface of the left fifth rib, or iu front 

 of the anterior extremity, or immediately below the withers ; gen- 

 erally the sounds are absolutely normal, but less clear and strong, 

 especially when masked by other bruits ; blowing with the first or 

 second sound of the heart is altogether exceptional, and indicates 

 wounds of the valves or endocarditis. On the other hand, we per- 

 ceive almost constantly characteristic pericardial bruits, which are 

 variable according to the nature and quantity of the exudate. When 

 this is fibrinous, at the beginning of the disease, auscultation per- 

 mits us to recognize a bruit of friction which is pronounced, and is 

 produced by the gliding of the two folds of the pericardium. We 

 may also detect crepitation, shuddering, whizzing, blowing, and 7'ust- 

 ling. In general, the bruit of friction is rare ; it is only produced 

 at the beginning of exudative pericarditis. 



The liquid sounds are more frequent ; at times there is a sort of 

 splash (similar to the fall of a solid body upon a liquid surface), 

 which at times may be heard at a distance, at other times it is a 

 kind of snapping bruit, a gurgling, rattling fluctuation ; in some 

 cases there is a metallic tinkle, similar to that made by small drops; 

 in others, again, especially when the pericardium is extremely dis- 

 tended, it is dull and obscure. While the solidium bruits are 

 closely related to the displacements of the heart, the liquidium, on 

 the contrary, may precede or follow them ; quite frequently they 

 disappear momentarily ; in the large vessels we sometimes hear a 

 particular blowing ; these latter sounds, which are, as a rule, iso- 

 chronous with the heart movements, are weakened or effaced when 

 the exudate is reabsorbed. 



2. Pulmonary symptoms. Compression of the auricles by the 

 exudate soon produces a passive pulmonary hyperemia, which is 

 marked by an acceleration of the respiration upon movement, by 

 slight coughing spells, and by dyspnœa. The pulmonary affection 

 dominates the scene, and may lead to the belief of the existence of 

 pneumonia, of contagious pleuro-pneumonia, or even of tubercu- 

 losis. There are cases where the foreign body has produced pleurisy 

 or pneumonia. The persistence of the vesicular murmur, the ab- 

 sence of pulmonary dulness, and the cardiac symptoms, are valuable 

 signs. ^ 



3. Symptoms furnished by the jugulars. Four to six 



1 In cows affected by traumatic pericarditis, Cadéac and Brissot have observed a 

 pulmonary blowing which is similar to tubular blowing. — n. d. t. 



