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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.)
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
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
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.
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.
Means inflammation of the bronchial tubes—the two
lung branches of the windpipe. It is dangerous only when
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
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-
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.
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-
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.
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.
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.
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
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
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
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 (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
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
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.
If not asthma, is a sequel of asthma. Its chief cause,
according to Williams and Robertson, is eating an undue
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,
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
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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