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Updated: June 1, 2025
Whether milk or any other substance containing lime makes fibrin deposits on the ulcerative surfaces more likely or more profuse, and therefore emboli more liable to occur, is perhaps an undeterminable question. In instances in which hemorrhages so frequently occur, as they do in this form of endocarditis, calcium is theoretically of benefit.
In severe cases a time may be reached when death of parts from the strangling pressure may occur, and then we have an ulcerative catarrh. This evolution will go on as determined by the gravity of the ancestral weakness, by the natural strength of the dynamo, the brain, and the severity of the debilitating forces to which it may be subjected.
"The swelling often presents an irregular surface, and various centres of maturation exist; but the evacuations only effect a partial and temporary reduction of its bulk, in consequence of the continued extension of the morbid growth and ulcerative process which often proceed towards the pharynx, rendering respiration and deglutition still more difficult, until at length the animal sinks from atrophy or phthisis pulmonalis.
Meanwhile the throat becomes sore and swollen, ranging, according to the severity of the case, from a slight reddening and swelling to a furious ulcerative inflammation, with the formation of a thick membrane-like exudate, which sometimes is so severe as to raise a suspicion of possible diphtheria.
Since we have learned that bacteria are probably at the bottom of almost any endocarditis, the terms suggested under the classification of endocarditis as "mild" and "malignant" really represent a better understanding of this disease. They are not separate entities, and a mild endocarditis may become an ulcerative endocarditis with malignant symptoms.
The periosteum is abnormally thick and vascular, the superficial layers of the bone become injected and porous, and the bones, as a whole, are thickened. When the whole thickness of the soft tissues is destroyed by the ulcerative process, the area of bone that comes to form the base of the ulcer projects as a flat, porous node, which in its turn may be eroded.
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