CHBONia ENDOCARDITIS : VALVULAR ALTERATIONS. 477 



venous system (cyanosis of the visible mucous membranes, etc.). 

 The right auricle becomes hypertrophiée! and dilated ; later, the 

 ventricle undergoes the same modifications. When the activity of 

 the right heart becomes insufficient, a pulmonary obstruction is 

 produced (dyspuœa), also thrombosis of this organ and dropsies 

 consecutive to blood stagnation in the vena cava. 



Characteristio symptoms of tricusjpid insufficienGy : Systolic blow- 

 ing and venous pulse. 



In the ox, Caguy has observed a great distention of the jugular 

 veins, venous pulse, dyspnœa, and dropsies. Schmetz, in a similar 

 €ase, has only observed a systolic blowing. 



ly. Contraction of the teicuspid orifice. It is rare in 

 man, but quite common in the ox. The phenomena produced by 

 it are : a diastolic bruit (blowing), dilatation and hypertrophy of 

 the right auricle, venous pulse, slowing of the blood-flow in the 

 pulmonary artery, partial thrombosis of this vessel aud consecutive 

 pulmonary embolism, respiratory troubles, dropsies, finally hyper- 

 trophy and dilatation of the right ventricle. 



Hering has observed a venous pulse in the jugulars of a horse, 

 also violent beatings of the heart and œdematous infiltrations in the 

 extremities, belly, etc. 



At the autopsy of a cow in which grave respiratory troubles had 

 been observed, Eggeling found in almost all the branches of the 

 pulmonary artery, thrombi derived from thickened sigmoid valves ; 

 in another he observed pulmonary embolic centres coming from a 

 thrombus of the size of a hen's egg, which was developed upon the 

 lateral wall of the right ventricle and was partially softened ; in 

 this case, also, an extremely laborious respiration had been observed 

 during life. 



V. Aortic insufficiency. This permits the re-flow of the 

 blood in the aorta into the left ventricle at the time of the diastole 

 and produces a diastolic bruit (blowing), which has sometimes the 

 characters of a shudder. The left ventricle, which is extremely 

 distended, is dilated and hypertrophied. Hyper-functional activity 

 of the heart determines in its turn a very strong pulse, the decreasing 

 curve of which is nevertheless abrupt, because part of the blood 

 which ought to go forward in the*arterial vessels comes back in its 

 tracks. The aortic diastolic bruit is sometimes perceptible upon 

 the carotids ; in man, auscultation of this vessel by the stetho- 

 scope allows us to recognize a systolic bruit that is sharp and short ; 



