A. General Physical Signs.
SIMPLE HYPERTROPHY. HYPERTROPHY WITH SIMPLE DILATATION.
DILATATION.
Heart’s impulse slow Force increased, Impulse conveys a
and heaving as if sharper, more feeble undulatory
pressing steadily knocking, may impart sensation; force of
against an a shake to the body. successive beats
obstacle—in rythm May be felt on the unequal; rythm
regular, in force right side. irregular.
unequal.
First sound is dull, Sounds gain greatly in First sound short,
muffled, prolonged loudness and extent abrupt and clear.
and weakened almost of transmission, Second sound not
to extinction. Second especially if the specially affected.
sound full and valves are thickened.
clanging; period of
silence shortened.
Murmur with the first Murmur with the first Murmur with the first
sound present at one sound may be present, sound from
time and absent at from altered insufficiency of the
another. direction of the auriculo-ventricular
orifice of the aorta. valves.
B. General Functional Symptoms.
SIMPLE HYPERTROPHY. HYPERTROPHY WITH SIMPLE DILATATION.
DILATATION.
Strength unimpaired. Strength tends to Strength fails.
Power of continued become impaired.
exertion (especially
uphill) limited by
shortness of breath.
Visible mucous Purpleness and lividity Lividity of the mucous
membranes healthy or of the mucous membranes. Dropsical
of a bright red. membranes effusions of the
proportionate to the limbs and other
valvular or pulmonary dependent parts which
obstruction. pit on pressure.
Difficulty of breathing Difficulty of breathing Difficulty of breathing
occasional. occurs in paroxysms. great and constant,
with occasional
aggravations.
Pulse full, strong, Fulness of pulse Pulse small and feeble,
firm, tense, continues but much later than the
resisting and strength and power of heart beat. Regular
prolonged without resistance lost. or feeble, fluttering
jerk or thrill. and irregular. Venous
pulse in the
jugulars.
Rarely and never Indirectly and more or Palpitation frequent.
rapidly the direct less rapidly fatal. Faintness occurs from
cause of death. time to time, and may
lapse into fainting
and sudden death.
Pure hypertrophy rarely implies imminent danger unless dependent on some
pre-existing structural disease which impedes the freedom of the
circulation. If excessive, however, or if associated with dilatation the
animal is short-winded and unfit for all but the slowest work. It
predisposes to congestion or apoplexy of the lungs when its seat is the
right ventricle, and to congestions and hemorrhage in other parts of the
system, brain, kidney, lungs, liver, bowels, if in the left.
Asthma (dogs), heaves (horses), emphysema and tuberculosis in cattle are
occasional complications attended by grave symptoms.
_Treatment._ In advanced cases and such as are dependent on irremovable
structural changes in the lungs or elsewhere no treatment is of any
avail. In recent and uncomplicated cases in the horse and cow and in
some more advanced conditions in other animals, not used for work, a
palliative treatment may be profitably adopted. This consists in a
nitrogenous restricted and gently laxative diet, perfect rest in
fattening oxen and other animals, or in the horse moderate and carefully
regulated work, and as a medicament the use of digitalis or aconite. No
known remedy has any power to directly check the growth of the heart and
the utmost that can be expected of these agents is to lessen the
activity of the heart’s action and retard its growth. Digitalis may be
given as recommended for palpitation, or aconite in the form of tincture
20 drops for horses and cattle and 1 to 2 drops for dogs, repeated four
times daily. Strophanthus may replace digitalis. When depletion seems
advisable purgatives or diuretics should be given as appears most
applicable to the particular case. Iodide of potassium has been strongly
recommended.
When extreme dilatation exists with the hypertrophy, sedatives should be
given cautiously and their effects carefully watched as the heart is
often dangerously susceptible to depressing influences. When the disease
has advanced so far as to cause abundant dropsical effusions it is
futile to resort to treatment as amelioration can rarely be looked for,
not even to the extent of allowing an animal to be fattened.
The value of arsenic in most cases of broken wind (heaves) has suggested
the inquiry whether it does not operate directly on the heart. Leblanc
who advances this query might have quoted in explanation the known power
of arsenic to retard and arrest tissue change, with its natural
consequences, the diminished amount of effete matter thrown into the
blood in any given time, and the lessened necessity for an active
circulation to supply any great waste of structure. It may benefit such
cases in this way but does so probably to a far greater extent by an
influence on the nervous function analogous to its action in neuralgia
and other purely nervous disorders. Dilatation of the heart which
usually exists in _heaves_ is usually benefited by tonics which like
arsenic are destitute of stimulating properties.