312 HEALTH AND DISEASE 



corpuscles and enrich the circulating fluid, while the latter impart func- 

 tional energy to the kidneys and cause the removal of the effused fluid. 

 Much judgment is needed in the apportionment both of rations and medi- 

 cines; a sudden change from semi-starvation to plenty being dangerous, 

 and the exhibition of iron having a tendency to occasional constipation, 

 this should be corrected by laxative foods. 



In the dropsy of matured and aged animals, where we suspect heart 

 weakness, or where disease of the valves of that organ is made out by 

 auscultation, the treatment will be directed towards regulating the heart's 

 action, and general tonics will be prescribed to strengthen the system. 

 In those patients in which albumen is being voided in the urine, much 

 stimulation of the kidneys with diuretics is to be avoided, and doses of 

 iron, preferably the perchloride in form of tincture, will be found bene- 

 ficial. When dropsy is associated with liver disease, in which the gland 

 becomes hard and contracted, or other structural changes interfere with 

 the hepatic circulation, there is little to be done. Iodide of potassium in 

 three-dram doses twice a day may be tried, with careful dieting, and a 

 three-ounce dose of sulphate of magnesia now and again to regulate the 

 action of the bowels. 



Paracentesis, or what is properly known as " tapping ", is sometimes 

 resorted to, but is of very doubtful value. When the ordinary measures, 

 as outlined above, wholly fail, it may be assumed that some structural 

 change in one or other of the organs indicated places the case beyond 

 treatment. 



SPASM OF THE DIAPHRAGM 



The diaphragm is a muscle which, with its broad central tendon, 

 separates the chest from the abdominal cavity. Under some circum- 

 stances it is excited to violent contraction, which is repeated at shorter 

 or longer intervals, and sometimes continues for several hours. The 

 contractions are sudden and spasmodic, and so forcible as to shake the 

 entire body from end to end. The morbid action is accompanied by a 

 thumping noise, which might be mistaken for palpitation of the heart, 

 were it not that the sound emanates from a more backward position in 

 the animal's body, and the flanks are considerably agitated at the same 

 time. Moreover, the contractions of the diaphragm and the stroke of 

 the pulse do not occur simultaneously. The heart, however, is more or 

 less sympathetically affected, but in no case should there be any difficulty 

 in distinguishing between derangement of the one organ and of the other, 

 and especially if the moment of the heart's beat be carefully noted and 

 compared with that of the contraction of the diaphragm. 



