238 
DROPSY OF THE PERICARDIUM. 
dium; at least I have always found it so, although the liver in 
structure has been firm and sound. 
In my case-book I find twelve cases of dropsy of the pericardium: 
of these five appeared as a primary affection, seven were accompa¬ 
nied by or rather formed the sequela of other affections, as colds, 
influenza, inflammation of the chest, &c. Of the whole number, 
eleven were horses, and one a cow. 
When this malady shews itself as a primary affection, there is 
always the most danger; for the effusion of serum into the peri¬ 
cardium generally proceeds to such an extent as materially to inter¬ 
cept or altogether suspend the action of the heart, and thereby oc¬ 
casion death; while, on the other hand, when it presents itself in 
conjunction with or appears on the decline of other diseases, there 
is by far less to fear ; for in such instances I imagine the effusion 
ceases before any great quantity is formed, consequently its me¬ 
chanical effect on the heart will be less serious. 
Symptoms. —The disease is frequently ushered in with a shiver¬ 
ing fit—the breathing may or may not be affected; if it is, it will 
soon become right—appetite nearly gone. During the first stage 
the patient has a listless appearance; he lies down—the extremities 
are warm—the mouth not particularly hot, but has rather a disagree¬ 
able smell—the pulse at first is quickened. These symptoms conti¬ 
nue for two or three days, when the pulse lowers to nearly the natu¬ 
ral standard; but intermits at every third, fourth, fifth, seventh, or 
ninth beat. Sometimes it will continue to act for thirty times 
without pausing. In favourable cases, about the sixth day the pa¬ 
tient begins to be more lively and stirring; his appetite returns; 
the intermitting of the pulse leaves then, or may continue for nine 
or ten days, or a fortnight to three weeks. In one case this conti¬ 
nued for eight weeks, and then went off; although during that pe¬ 
riod the appetite continued good, and the animal was cheerful. In 
fatal cases, the order of symptoms changes for the worse about the 
sixth or seventh day. The listless appearance leaves the patient, 
and now he appears as if on the alert, and seems somewhat dis¬ 
tressed—the pulse becomes quick, irregular, and less intermittent— 
the heart palpitates, producing a vibratory effect on the whole 
body—its action is sometimes slow and powerful, at other times 
quick, irregular, and fluttering, rising from 50 or 60 to 100 or more 
per minute, and this several times in an hour. The patient be¬ 
comes more distressed; the breathing is again quickened; the ex¬ 
tremities grow cold; and about the tenth or thirteenth day he dies. 
For want of space I cannot say all I could wish. As to the treat¬ 
ment, I must be very short: my plan has been, in the first stages, 
moderate blood-letting, laxatives, counter-irritants, and, after¬ 
wards, tonic diuretics, and good keep. Blood-letting always re- 
