This consists of inflammation of the sac in which the heart is contained. It does not essentially differ from other serous inflammations, as there may be exudation and liquid effusion, the quantity varying from a few ounces to a few pints. The disease is usually ushered in with a slight chill, followed with fever, or it may commence with fainting. Pain, oppression, weight, palpitation, cough, hurried and difficult respiration, frequent and irregular pulse, inability to lie on the left side, headache, delirium, faintness, anxiety, debility, restlessness, and great nervous irritability usually attend the attack. The face and extremities are swollen, and the urine scanty and high-colored. The essential conditions of fever are always present, the pulse sometimes attaining 120 to the minute. If the acute form advances for several weeks it becomes chronic, or may by insidious advances be chronic from the first. The symptoms are nearly the same as in the acute form.

TREATMENT. -- The treatment should be commenced by a lobelia emetic, an active purge, and the application of hot packs to the chest. The tincture of veratrum should be given in sufficient quantities to control the inflammation and lessen the action of the heart. Usually, from two to five drops every half hour is sufficient. If associated with rheumatism, colchicum, cannabis sativa, or macrotys racemosa, should be given. In malarial districts, quinine becomes necessary. Blistering or local depletion may be necessary in some cases.