CHRONIC ENDOCARDITIS: VALVULAR ALTERATIONS. 473, 



left heart is generally affected (iu 300 cases of endocarditis, they 

 were found 297 times in the left heart, and in 255 the mitral 

 valve was affected). The 37 observations of valvular affections 

 contained in our special bibliography ^ are as follows : 20 cases of 

 alterations of the left heart and 17 of the right; the mitral was 

 found injured 14 times, the tricuspid 15 times, the aortic valve 6 

 times, that of the pulmonary artery twice. It is especially in the 

 ox that the tricuspid seems to be frequently involved. In the 7 

 cases observed in this animal, 6 times the lesions were found on 

 the right side, in one case they were bilateral ; they were not seen 

 located upon the left heart iu any case. In the horse, on the con- 

 trary, the proportion is almost similar to that found in man : in 15 

 cases which were examined, 7 times the lesions were found to be 

 located upon the left heart, 3 times upon the right, and they were 

 bilateral in 5 cases. 



A table of Nocard establishes the relative frequency of the differ- 

 ent valvular affections in the horse. Of 42 subjects, 38 showed 

 lesions of the aortic valve; in the other four they were found upon 

 the aortic and mitral valves. The intensity of these alterations 

 was very different : at times the valves were simply thickened and 

 rigid ; at others they had undergone cicatricial contraction ; in some 

 cases they were covered with fibrinous vegetations ; in others, 

 again, they were gnawed, indented, or perforated. The diagnosis 

 had been made during life. In almost all these animals wa& 

 heard a blowino; bruit which covered the whole silent stao;e. The 

 intensity and sound of these bruits were of the most variable kind.^ 



Symptoms of general valvular affections. Valvular insuf- 

 ficiencies and contractions of the orifices produce a blood stagnation 

 above the lesion — in the left auricle and in the lung, if the mitral 

 is affected, in the right auricle and the general venous system when 

 it is tricuspid ; the diseases of the aortic and pulmonary valve pro- 

 duce a stagnation in the corresponding ventricle. Some circulatory 



^ See original text. 



2 Fourteen observations of chronic endocarditis — in very old horses, as a rule — 

 gathered by us, are thus divided as regards the localization of the process : lesions 

 affecting exclusively the sigmoid valves, ten cases ; lesions involving the mitral valve 

 exclusively, one case ; sigmoidal and mitral lesions, two cases. In none of these cases 

 have we found any alterations of the tricuspid nor of the valves of the pulmonary 

 artery. Thirteen cases of chronic endocarditis which we have observed in the dog are 

 thus divided : four cases of alterations of the mitral and tricuspid ; one of mitral and 

 aortic: five of mitral only; two of tricuspid; one of the aortic valves. — n. d. t. 



