VET INDEX | ANIMAL INDEX - OLD VET TREATMENTS AND REMEDIES.
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FARMING INDEX - OLD FARM PRACTICES AND REMEDIES FOR ANIMALS, PLANTS AND FIXING THINGS.
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DISEASES OF THE LUNGS.
The lungs, though very susceptible to disease, possess comparatively little sensibility, either in health or disease. They are peculiar to themselves, and are extremely varied in structure. The bronchial tubes constitute one part; the air-cells, in which the tubes terminate, another ; their blood vessels a third; the interconnecting parenchyma- tous substance a fourth ; the cellular and pleural mem branes a fifth. In health they possess a pale pink, spongy, light, and elastic interior, and will float in water. Jn disease they are reddened and solidified (liver-like), and sink in water.
In horses diseases of the lungs are more numerous in proportion to other diseases than in man. They are also more rapid in their course, death sometimes resulting in a few hours. Young horses are more subject to them than old. High-bred, tenderly reared, light bodied, long legged, flat sided, narrow breasted, and thin skinned horses are more predisposed to them than those of the opposite kind. The causes of them are chiefly foul air, especially when combined with heat; sudden changes of temperature, dampness, overwork, and mechanical and chemical injuries. (Percivall.)
PNEUMONIA
Means either congestion or inflammation of the lungs, independent or combined. Inflammatory pneumonia is either simple or compound. When complicated with bron chitis, it is called ‘ broncho-pneumonia;’ when complica ted with pleurisy, ‘ pleuro-pneumonia.’ Its progress will
80 THE DISEASES OF THE HORSE.
vary according to circumstances. Usually it reaches its hight in a few days, and gets better or worse in a few days. (Percivall.)
Robertson and Williams describe congestion as a distinct and sometimes independent disease.
Symptoms of Congestive Pneumonia.—Sudden or gradual. When sudden—the result of overexertion—the horse is all over in a tremor; cold sweat; no pulse ; legs deathly cold ; the frightfully wild look of the eyes—pupils dilated—and the boring of the head and stupidity of the horse, clearly indicate delirium. When gradual, the horse is at first dull, listless, heavy-headed, and off its appetite. Respiration gradually becomes more disturbed and oppres sive, partaking more of labor than of pain; pulse full and quick, but so feeble perhaps as to be hardly percep tible ; respiratory murmur lost; legs and ears deathly cold ; cold sweats; gradually sinks, and dies in convul sions and delirium.
Remedy.—Immediate bleeding—4 to 6 quarts.
Symptoms of Inflammatory Pneumonia.—There are three stages; the first may be either absent or unnoticed. First stage : Staring coat; legs cold, followed perhaps by rigor; head hangs; no appetite; has had a short, dry cough for several days, which comes on after exercise or drinking; dull, dejected, laggard. Temperature 103, 104, or even 106. Now come fever, quick pulse, hot mouth, injected membranes of nose and eyes.
Second stage : Breathing disturbed ; nostrils open and shut; flanks work laboriously up and down; breathing indicates oppression rather than pain or rapidity. In other cases the flanks hardly move at all. The nostrils are an important guide, as there is often a sparing, yellow, slimy discharge from one or both; pulse, at first, quick and usually distinct, but, as the disease progresses, is very apt, from fullness and oppression, to become indistinct; ears and legs colder than ever; nasal membrane moist and
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81
reddened ; horse sometimes stands constantly in the same place and posture, fore legs stretched out, head toward a door or open window, looking backward from time to time at its heaving flanks in a peculiarly despondent manner; never lies down.
Third stage : Respiration quicker and more oppressed ; pulse quicker, but less distinct; extremities cold; nasal
 Fig. 17. Usual position during a serious attack of Pneumonia.
membrane changes from red to a leaden hue; convulsive twitchings of the muscles of the surface; extreme un easiness ; up and down; reeling gait; haggard counte nance; delirium, convulsions, death.
Auscultation, according to D’Arboval, reveals a crepi tating, humid rattle around the inflamed places, with a louder respiratory murmur than in other parts. Percus sion reveals deadness in diseased parts, resonance in others. When the roots only of the lungs are inflamed, these tests are not present. Robertson says the heart sounds are also intensified over the consolidated (lung) area.
Remedy.—Box; temperature 60 to 70° F. Clothe body, bandage legs. Cold linseed tea; steamed food; fresh grass for horses, cattle, sheep. Bleeding in acute
82 THE DISEASES OF THE HORSE.
attacks if patient is robust. A few small doses of aconite tincture for acute fever. If fever of low type, as it usu ally is in hard worked town horses, sulphuric or nitric ethers, with camphor and ammonium carbonate, in draft; while ammonium acetate, potassium chlorate and nitrate are given in draft or drinking water. Potassium nitrate and colchicum for kidneys when not acting. Rugs wrung out of hot water to sides, with subsequent rubefacient dressing. Alcoholic stimulants, ether, nitrous ether, spirit of chloroform several times daily when melting of exudate (oozing matter) has begun, or earlier in epizootic attacks, or in weakly patients. Belladonna extract and camphor allay cough. Linseed oil in mash, neutral salts in drink ing water, with laxative injections, secure regularity of bowels. If laxatives necessary, oil preferable to aloes. Cooling mash diet in earlier stages; in later, digestible, nutritive food. For doses, see pages 13 to 29. For list of ‘ rubefacients,’ see page 36.
CHRONIC PNEUMONIA
May be a continuation of the acute form. It is insidi ous in its symptoms and dangerous; but it is mild, and its progress is slow. It may end in solidification or indu ration, or in tubercles, abscesses, and consumption, the same as the acute form described above.
Symptoms.—Horse appears to be merely unwell; no perceptible heaving of flanks; but little acceleration of pulse; no apparent pain, yet mopes about, dull and de jected ; appetite fastidious; seldom or never lies down ; coat unkind; general appearance unhealthy. Ask about cough. Examine nostrils for disturbed respiration, and also for expectoration from them.
BRONCHITIS
Means inflammation of the bronchial tubes—the two lung branches of the windpipe. It is dangerous only when
BRONCHITIS. 83
its secretions clog the tubes, choking the horse to death, or when it is complicated with other diseases. The latter is unfortunately frequently the case, for it is often com plicated with catarrh, sore throat, and diseases of the lungs. In fact, the causes of catarrh are the causes of bronchitis. Bronchitis is simply catarrh of the bronchial tubes.
The disease rarely exists independently. It is acute, subacute, and sometimes chronic. In the spring and fall it is sometimes epizootic, especially among young horses. When acute and favorable, it reaches its hight about the fourth or fifth day ; begins to decline about the sixth or seventh day, leaving the patient out of danger about the tenth or twelfth. If not favorable, the signs on the fifth, seventh, or ninth day are : Respiration becoming very oppressed ; pulse quicker and fainter ; skin and extremi ties cold; mouth cold and clammy; nostrils very dry. Pulmonic or pleuro-pulmonic disease may now supervene.
 Fig. 18. A horse dressed for Bronchitis.
Symptoms.—Breath hot; unusual nasal discharge; reddening of nasal membrane ; cough ; sore throat; dif ficult breathing ; febrile irritation, sometimes without an-
84 THE DISEASES OF THE HORSE.
tecedent shivering. Auscultation reveals a distinct cooing sort of sound, arising from want of secretion within the tubes. When the secretion returns, and in augmented quantity, the rattle is distinctly heard.
In catarrhal bronchitis, in addition to most of the above symptoms, the nasal discharge, which at first is but slight and of a watery or muco-watery description, in three or four days becomes of a puro-mucous nature and increased in quantity. The symptoms of catarrh and sore throat gradually abate and merge into that short and laborious breathing which clearly denotes high bronchial and pul monary irritation. When the horse coughs, which it does more now, an increased discharge is expelled from the nose ; when it hangs its head, the discharge runs out.
Symptoms of independent (uncomplicated) bronchitis : Sudden illness ; violent blowing and distressful breathing; sudden and copious mucous discharges from the nose; may obtain relief at the moment, but there is danger of suffocation, especially if the discharges are frequently re peated. These sudden and violent attacks usually soften down to ordinary bronchitis, but they sometimes increase in violence and end in pulmonary disease.
Epizootic symptoms : Exceedingly sore throat and pro fuse discharges from nose; sometimes white, sometimes yellow, sometimes even green, according to circumstances. The green tinge arises either from malignancy or green food. Great weakness of loins; also general weakness; low febrile irritation.
Remedy.—Comfortable, cool, well ventilated box; tem perature 60 to 65° F. Body and limbs clothed. Inhala tion of watery vapor from steam kettle, a large mash, or bucket of boiling water promotes exudation in dry stage, the inhalation to be medicated, as required, with expec torants, anodynes, or antiseptics. (See Fig. 14.) Fomen tations and mustard to throat and sides. Mustard in earlier stages applied for 15 or 20 minutes, washed off, and re-
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applied if needed. Spirituous essence of mustard injected hypodermically. Salines in drinking water for fever. A few doses of aconite early in robust subjects, where the symptoms are acute. Ammonium acetate solution, ipecac, and squill while membrane is dry and congested. Ben- zoic acid, eucalyptus oil, terebene, pilocarpine, mineral acids diminish excessive secretion. Soap liniment and laudanum rubbed into throat and down neck twice daily for difficult breathing, especially when the secretion is excessive. Belladonna stimulates respiratory center and eases cough; often conjoined with camphor, ether, chlo ral hydrate, and in debilitated patients with small, re peated doses of alcohol. Confections or gargles of opium, chloral hydrate, with glycerine, for cough. Potassium chlorate and ammonium chloride promote fluid secretion and moderate its quantity. Lobelia and opium where there is much discharge and paroxysms of cough. Ammonium carbonate when mucus is abundant and viscid and patient is low. Mash diet. Regulate bowels, if possible, by in jections ; purgatives dangerous in horses.
Remedy for Chronic Bronchitis.—Equable tempera ture ; pure, fresh air; comfortable clothing, which must be removed and patient wisped over night and morning. Salines, with or without mercurials, for congestion and fever. Terebene and eucalyptus oil stimulate bronchial secretion. Belladonna, balsams, and mineral acids dimin ish excessive secretion. Ammonium carbonate and chlo ride for viscid and irritating secretion. Belladonna and ether stimulate respiratory and heart centers. Chloroform, chloral, and opium abate cough. Mustard and other counter-irritants, carefully used, lessen congestion, irrita tion, and cough. Mustard in-rubbing. Soap liniment, with or without laudanum, often removes cough. Alco hol, ether, volatile oils, digitalis maintain heart action in weakly subjects. Sulphurous acid, creosote, eucalyptus, and other antiseptics inhaled or internally when secretions
86 THE DISEASES OF THE HORSE.
are fetid. Arsenic occasionally relieves inflation. Careful dietary; nutritive, oleaginous food. Linseed oil. Iron and other tonics promote convalescence. For doses, see pages 13 to 29.
PLEURISY (PLEURITIS),
Is inflammation of the pleura—a membrane investing the organs of the chest. When the inflammation extends to the lungs, the disease is called pleuro-pneumonia. The secretions of the pleura are usually watery, with or with out lymph. The water is usually of a clear, bright yel low color, closely resembling the serum of the blood, though in some cases it is rendered turbid by the lymph floating in it. In others it is red from being tinged with blood. In others still it is of a sort of milky or whey color, and fetid from being mixed with pus. The lymph consists of masses of gelatinous or albuminous matter, hanging about the chest in shreds “ after the fashion of a cobweb,” and sometimes forming what are called adhe sions or false membranes. It sometimes walls the water in as it were, confining it like pus within an abscess. It at first probably gives rise to more or less pain, as it in terferes with the free action of the lungs, but the parts evidently soon become adjusted to each other. Pus some times accompanies acute as well chronic pleurisy, and in some cases gangrene and even abscess of the side super vene. In chronic cases the pleura becomes thickened and tough, apparently less vascular, and assumes a morbidly white aspect. Sometimes it is studded with tubercle-like knots. Pleurisy of one side is rare; but the opposite side often takes the disease from sympathy.
The disease has a dangerous tendency. It usually comes and goes suddenly. Death is also sudden—a few hours. The chronic form is slow and comparatively painless. It may last for weeks. It may follow or be independent of the acute form. The disease is peculiar to four and five-
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year-old horses, especially such as are kept in warm stables and live high.
The causes are cold, immersion of legs in or drinking cold water when heated, sympathy with contiguous in flammatory diseases, blood contamination, morbid growths, external injury to membrane, overexertion, &c.
Williams describes ‘ epizootic pleurisy,’ which is “ pre ceded and accompanied by a low typhoid or adynamic (sinking) form of fever.” It lasts from one to two weeks.
Symptoms.—Slight chill or rigor; fever; uneasiness, gradually increasing till acute pain is manifested, when the animal heaves or rather pants violently at the flanks, puffs, blows, and casts piteous looks at its flanks; heat all over body, in parts actually sweating with pain ; great nervous irritation ; cannot be quiet for a minute ; looks here and there, pawing, lying down, getting up. Pressure on the rib spaces causes flinching, usually a characteristic grunt, and an attempt to bite ; a cough is often present, causing such pain that the animal, in its effort to suppress it, makes a sort of reiterated, hacking, half-cough of it; pulse very quick, firm, and wiry; mouth hot and dry ; breath cold ; nasal membrane reddened and moist; no discharge, unless some catarrhal or bronchial irritation be also present.
When there is inflammation of the muscles (pleurodynia) the horse moves in a very rigid manner ; may fall; steps slowly and very short; dejected ; back arched ; skin tender.
Id the chronic form the symptoms are mostly very dif ferent, and some the reverse. Instead of restlessness and watchfulness, dullness and dejection continue from first to last. Even respiration does not cause embarrassment until shortly before death, when the chest is nearly or quite full of water. The inflammation of the pleura is about the same, as are also the tenderness of the sides, the grunt, and the respiratory murmur. The cough, if it still ex ists, becomes faint and sore, and now and then causes the before mentioned grunt.
88
THE DISEASES OF THE HORSE.
These symptoms usually follow epizootic catarrh, sore throat, or bronchitis.
Remedy.—Hygienic treatment, as in pneumonia; bleed ing in acute attacks in vigorous horses and cattle. Emetic and antimonials in animals that vomit. A few doses of aconite tincture or calomel and opium for fever. Salines and antipyretics, as in bronchitis and pneumonia. Pot assium iodide and colchicum to promote absorption of in flammatory exudate. Ferric chloride tincture for debility and lack of blood. Digitalis and nux vomica aid removal of fluid. Rugs wrung out of hot water to sides, followed by in-rubbing of mustard, washed off in twenty minutes. Moderate counter-irritation with ammonia and soap lini ments. Pain reduced by opium or by morphine hypoder- mically. Tapping if necessary. (See ‘ hydrothorax.’)
For doses, see pages 13 to 29. For a list of ‘ antipy retics,’ see page 31.
PLEURO-PNEUMONIA.
For description, symptoms, and treatment of this dis ease, see articles ' Pneumonia’ and ' Pleurisy.’
HYDROTHORAX (Water in the Chest),
Is a very common termination of pneumonia with pleu risy. It may also follow compound bronchitis, or it may occur independently, the pleura furnishing the water. In some cases water in the belly and head coexist, accom panied by swelled legs, sheath, belly, &c.
The disease is dangerous, but it is sometimes curable. Tapping the chest with a trocar is sometimes successful. When water does not flow from one side, try the other. Some puncture between the fifth and sixth ribs, some the eighth and ninth, choosing the most dependent parts and the least likely to cause injury. Make an incision through the skin, and then introduce the trocar, with a rotating motion, obliquely and upward as far as it will go, or till
WATER IN THE CHEST.
89
water escapes. The stylet must be withdrawn as soon as resistance to the introduction of the trocar is felt. If the hole in the trocar should be stopped up with lymph or other substance, clear it with a probe. When clear and within the cavity water will flow if there is any in that particular part. The trocar must not be kept in unnecessarily long, as air will penetrate the chest through its orifice. The operation is sometimes repeated several times in the course of treatment. In an unsuccessful case Percivall withdrew ten gallons of water. After death, four days after the operation, there were six gallons more in the chesty and a quart in the pericardium.
Symptoms.—Eats daintily; looks disspirited ; on the approach of some one, rouses up for a moment only; short, quick, labored respiration, becoming more and more manifest as the chest fills with water. When the chest is nearly full, the horse exerts its utmost power; seldom lies down, but when it does, lies on the side containing the most water, and is soon up again. D’Arboval says the spaces between the ribs are enlarged. The pulse, at first small and quick, becomes accelerated and fainter as the disease advances, till it cannot be felt at all. Horse steps with fore legs wide apart and stiffened ; gait often unsteady and reeling ; breast, belly and sheath show drop sical swellings, which by degrees fall into the legs.
Auscultation and percussion reveal no sound, unless there is gas or air in the chest, which is rarely the case. Percivall says that if an assistant taps one side of the chest while the surgeon holds his ear to the other, the presence of water may be ascertained. In a recorded and successfully treated case, the sound of the water was com parable to that of water in a rolling cask.
Remedy.—Digitalis ; powdered cantharides ; potassium nitrate twice daily for a week. Then potassium iodide and iron salts. Pilocarpine useful in human patients. Iodine ointment and rubefacients externally, or insert under the
90 THE DISEASES OF THE HORSE.
skin of the chest a plug of tow moistened with an irri tant. When necessary, tap with trocar or pneumatic as pirator.
BLEEDING FROM THE LUNGS
Is rare. It is dangerous, but the danger depends on the origin, nature, and extent of the case. Plethora, high or very fat condition, and violent work or feats are con ducive of bleeding. The membranous tissues, being over charged with blood, are liable, on extraordinary exertion, to give way; but the bleeding may be owing to over-force of circulation. Wound of the substance of the lung is often the cause of sudden death. It may be caused by violence in hunting, racing, &c, or result from ulceration of the lung in consumption. ‘ Pulmonic apoplexy ’ (blood in the air cells) is said to be a dangerous form of lung bleeding.
Symptoms.—When from the bronchial membrane: Blood from both nostrils, usually scarlet colored and frothy, attended with more or less irritation, coughing, or snort ing and sometimes interrupted breathing; every time the horse coughs or snorts fresh blood is ejected, often through the mouth as well as the nose. The blood does not flow in a uniform stream, as in bleeding from the nose, which is usually from one nostril only, and is thus distinguished from bleeding from the lungs, but is influenced by the respiration and also the position of the head and neck ; the more the head hangs the readier the blood flows. Sometimes there is febrile disturbance, quick pulse, hot mouth, legs deathly cold, or one cold while another is warm.
Remedy.—Bleeding that cannot be got at, is arrested (1) by cold or heat applied so as to act reflexly; (2) by lead acetate, opium, sulphuric or gallic acid or ferric chlo ride ; (3) hypodermic injection of orgotin.
CONSUMPTION.
91
CONSUMPTION (Tuberculosis, Scrofula, Phthisis),
Is a specific disease, resulting from the introduction into the body of the ‘ tubercle bacillus.’ This mite develops irritation and inflammation, either directly or by the for mation of poisonous alkaloids, produced by its action on the tissues. Hard growths appear, consisting of one or more of three descriptions of cell—lymphoicl, epitheliod, and giant. They exhibit a tendency to necrosis, followed by caseation (curd or cheese), and occasionally by fibroid degeneration. The disease may be localized in various organs and tissues. It occurs in all animals, and is com municable from one species of animal to another. Cattle, poultry, and hogs are more subject to its several forms than horses, dogs, or sheep. (Dun.) Rare.
Symptoms.—First stage: Out of condition; rough coat; hide bound perhaps ; faulty or weak at work ; sweats on slight exertion ; coughs occasionally after drinking or when first brought out of stable ; short-winded. Duration uncertain ; weeks, months, and in rare cases years.
Second stage : Case develops itself more or less; respi ration probably slightly disturbed; if not perceptible at the flanks or nostrils, apply the ear to the breast or side ; by the latter means or by the hand tenderness about the sides may also be discovered ; pulse quicker than natural; short, dry cough now and then ; appetite fastidious and changeable, now good, now indifferent; never quite lost; spirits same as appetite; sparing issue of yellow matter from nose ; flesh lost daily; hip bones begin to project; quarters lose plumpness ; skin becoming tense and adher ent to sides.
Third stage : Increased disturbance of respiration ; the breath, mouth, and discharge from nose fetid; highly quickened pulse; troublesome cough, with occasional coughing up of expectorated matters through the nose and mouth; emaciation and debility; partial separation
92 THE DISEASES OF THE HORSE.
of coat, so that when but slightly twitched the hair comes off; dropsical swellings perhaps of the legs, sheath, and belly; complete loss of appetite ; general irritability; dis tressing, haggard expression of countenance ; irritable state of the bowels and great proneness to diarrhea; the latter is likely to result in death. Breath cold in all stages.
Remedy.—Generous, rather oleaginous diet. Maintain healthy functions of bowels and other excreting organs. No bleeding—not even where there is a tuberculous taint. Milk and flesh liable to transmit the disease to men and animals.
For pulmonary consumption (tuberculosis of lungs)— common in cattle, sheep, and swine : Careful, generous dietary. Good sanitary surroundings. Tonics, acids, alco holic stimulants, antiseptic inhalations. Arsenic sometimes arrests early stage of consolidation. Iodine liniments and rubefacients externally, also check consolidation and cough. Chloral and morphine relieve cough. (See cough.)
For tuberculous disease of the mesenteric glands : Di gestible, nourishing diet. Treat on the same principle as above. Feed off without delay cattle or sheep of tuber culous taint.
For tuberculous abscess of throat or other glands, (king’s evil) : Foment if hot and painful. Dress with iodine lini ment. If pus forms, evacuate and treat antiseptically. Liberal dietary, tonics, calcium chloride.
For tubercular arthritis (gouty inflammation), chiefly affecting young animals : Good feeding and sanitation; comfortable quarters. Apply flannels wrung out of hot water or hot oil, followed by mercury oleate and lauda num. Active counter-irritation is injurious.
For doses, see pages 13 to 29.
BROKEN-WIND,
If not asthma, is a sequel of asthma. Its chief cause, according to Williams and Robertson, is eating an undue
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proportion of hay, especially hay that is overripe, heated, old, dusty, or cut up too short. Robertson says that where “horses are fed on part oat-straw and part hay, both cut rather long, matters are not so bad.” Round, shallow- chested horses seem to be predisposed to the disorder.
Williams says broken-wind “ is fast becoming a thing of the past.”
Symptoms.—Inspiration is easy and rather quick, but expiration is a double action, two distinct efforts appar ently, after which the muscles relax and the flanks fall peculiarly. Respiratory murmur weakened or absent; loud, sonorous, sibilant wheeze, especially toward back part of chest. Rattling and hissing all over chest; resonance in creased, showing that the lungs are distended with air; chest seems rounder, &c
Cough: It is so peculiar as to be sometimes called “broken-winded cough.” It is more than short—it is half- suppressed or chopped off as it were, and so feeble as to be almost inaudible. It is often followed by wheezing, like asthma in man. At first, and also when it afterward comes on in fits, it is troublesome. When the disease is estab lished, and there is no special excitement, it is solitary (but once) as well as short and feeble.
Indigestion : Appetite voracious, yet condition lean and hidebound looking. Well it may be, for the dung looks like so much chopped hay mixed with oats and husks, caus ing flatulence and tumid, tense, drum-like belly, often pendent from weakness. Flatulence (expulsion of wind) follows exercise, coughing, dunging, &c, but subsides as the animal relieves itself. In inveterate cases the anus becomes weakened and is as often opened as shut. The interior of the bowel is sometimes exposed, while the anus itself protrudes and recedes with every breath.
Skin : Harsh, dry, and perhaps hidebound ; coat long, rough, and open.
Remedy.—Incurable, but relieved by careful dietary ;
94 THE DISEASES OF THE HORSE.
good, concentrated food, given damp ; water frequently, in limited quantity, but withheld before hard, fast work. Laxatives and salines occasionally. Rock salt, chalk, or whiting in manger. Linseed oil, with lime water, daily, in drench or with food; ½ to 1 grain of arsenic, in the form of Fowlers solution, may be given daily, or every other day, for months. Prof. Dick’s cough balls occa sionally, consisting of 30 grains each of calomel, opium, digitalis, and camphor. If used daily for a week or more, omit calomel.
For doses, see pages 13 to 29.
SPASM OF THE DIAPHRAGM.
The diaphragm is a large muscle separating the chest from the abdomen. Its spasms are caused by overexer- tion. It is also sometimes seen in lock-jaw. Its thump- ings, sometimes audible at ten paces off, are often con founded with palpitation of the heart. It may be dis tinguished from the latter (1) by a convulsive movement of the whole body; (2) by difficult breathing; (3) the pulse is small and weak and not synchronous with the beat of the diaphragm; (4) the heart beat is barely per ceptible; (5) sometimes profuse sweats and harassing cough.
Remedy.—Quiet; warm clothing. Good, diffusible stimulant. If symptoms continue, give opium. If the difficult breathing is dangerous, moderate bleeding.
For doses, see pages 13 to 29.
Rupture of the diaphragm is common, but is usually perhaps the result of after death swelling. Great inter nal violence may cause it during life.
Hernia of the diaphragm is like ruptured diaphragm.
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