594 
CASKS OF CARDITIS. 
there is very soon, if not checked, fluid effused, and the sound 
of the heart diminishes in the same ratio as the fluid increases. 
So I find it, and so it was in Mr. Wheatley’s case. On the 3d day 
from the attack this gentleman tells us that the heart could not be 
heard, although it was before beating “ loud and quick and audi- 
ble at some distance.” On the 4th day, “ pulsation could scarcely 
be felt by applying the ear.” This was carditis, or perhaps 
endocarditis, originally; but th-e two quickly became compli- 
cated, as was shewn in the autopatic examination. To these suc- 
ceeded pericarditis. On the 3d day there was effusion, and as 
this increased, the intensity of the sounds of the heart’s systole 
and diastole decreased. 
Case. — A cow of Mr. Glover’s, an extensive brewer near this 
place, being ill, I was sent for. She was “ off her feed her secre- 
tion of milk was nearly stopped, and her breathing was rather 
hurried and laborious. On placing my hand on the left side, I 
could not detect the least sign of any action of the heart. I ap- 
plied my ear, but even this failed me. On compressing the sub- 
maxillary artery, I noticed that its action was particularly strong, 
more so than any I had known before. The pulse was about 75, 
with, now and then, an intermission. This strong pulsation at 
the jaw, and the absence of every sign of the heart’s action at 
the side, led me to give my opinion that the termination would 
be fatal, under whatever treatment the animal might be placed. 
Mr. G., however, wished me to proceed, and 1 did so. I gave febri- 
fuge medicines combined with diuretics and sedatives (but not 
digitalis, for I fancy I have seen it tend to produce hydrops 
pericardii). I bled her, and also blistered the sides of her chest. 
1 continued treating her for a fortnight; but, being convinced 
that there was no reasonable chance of her recovery, the owner, 
at length, consented to have her destroyed. 
Post-mortem appearances . — There was a large quantity of water 
underneath the serous coat of the intestines, and a considerable 
diminution of the mesenteric glands. On opening the thorax 
about three buckets of a brownish serum escaped, suspended in 
which was a large quantity of fat-like lymph. The lungs were 
healthy, though the pleura pulmonalis was in places thickened 
a little. The pericardium was one-third of an inch in thickness, 
and contained two quarts of serum. The heart presented an 
appearance beautifully exemplifying the extent to which vital 
organs may be diseased without immediately destroying life. 
On the left auricle was a fatty tumour, weighing between five 
and six ounces : there were also smaller tumours interspersed 
over the greater part of the heart. This cow lay down the greater 
part of her time. 
