DIAPHRAGMATIC HERNIA. 45 



return, however, during the night between the i6th and 17th October. 

 The animal rolled and struggled in violent pain. On the morning of 

 the 17th, having refused his food, he was sent to the college. He 

 arrived there covered with sweat, greatly depressed, and looking con- 

 tinually towards his right flank. The face was drawn, the nostrils 

 dilated, the extremities and ears cold, the mucous membrane cyanotic ; 

 the respiration was 32, irregular ; the pulse very feeble, and could not 

 be counted ; the jugulars showed a well-marked venous pulse. 



Rectal exploration disclosed nothing abnormal. On the catheter 

 being passed, only a small quantity of urine was drawn off. 



On percussion of the chest dulness was noted in the inferior half of 

 both sides. On auscultation the vesicular murmur in the upper portions 

 of both pulmonary lobes was exaggerated. Towards the middle region, 

 especially on the left side, a slight tubular wheezing sound was heard, 

 and in the lower third a liquid sound, especially marked on the left 

 side. We at first regarded the case as one of pericarditis, but, after 

 carefully examining the patient, M. Cadiot noted the splashing sound 

 and borbor\gmus, and delivered the diagnosis of diaphragmatic hernia. 

 To confirm the diagnosis he resolved to tap the chest. The animal 

 died at the moment we were about to perform the operation. 



Autopsy. — In the abdominal ca\ity traces of peritonitis were \isible 

 on the large colon, jejunum, and ileum. At its upper part, to\\ards the 

 left, the diaphragm showed a large opening, through which had passed 

 a considerable mass of abdominal ^'iscera, comprising among other parts 

 the stomach and some loops of intestine. These viscera were soiled 

 with food material. 



The chest cavity contained a considerable quantity of yellowish acid- 

 smelling fluid, holding in suspension fragments of food. The left lung, 

 congested in its antero-inferior part, and emphysematous throughout 

 almost its entire extent, was thrust upwards towards the spinal column. 

 The spleen was situated externally and posteriorly, and was almost 

 entirely in the thorax. It appeared normal. Its base was turned 

 towards the abdomen ; its point was advanced and slightly depressed. 

 Between the lung, pericardium, diaphragm, spleen, and chest walls, was 

 a voluminous greenish mass formed by the gastro-colic omentum (epip- 

 loon) filled with food. Towards the back, between the epiploic sac, 

 spleen, and diaphragm, were two distinct masses of intestine. The 

 first, situated above, was formed by a part of the small colon, about 

 twelve inches in length, covered by the epiploon ; the other, below, 

 lodged in the angle formed by the diaphragm and the left thoracic wall, 

 consisted of several empty loops of the jejunum, of a total length of 

 about fifteen feet. 



