SUBCAPSULAR H/EMORRHAGE IN THE LIVER OF THE HORSE. 379 



encysted, and may remain permanently in position without producing 

 any notable effect. 



SUBCAPSULAR HEMORRHAGE IN THE LIVER OF THE HORSE; 

 PARTIAL RECOVERY; RELAPSE AND DEATH. 



gi. A lifteen-year-old dun gelding, seen about 8. p.m., i8th June, 

 1896. 



History. — Said to have been suffering from colic. At 5 p.m. a small 

 quantity of faeces had been passed, and the animal had afterwards 

 staled. 



State on Examination. — The animal was standing quietly, its head 

 thrust a little forward, its face drawn, pupils dilated, legs straddled 

 apart, muscles quivering, and its whole body bathed in cold perspira- 

 tion. The mouth was cold, the conjunctiva pale, the tongue and lips 

 were blanched and flaccid. The pulse was 94, very small and weak ; 

 temperature loof^; the respirations were about 31, shallow but not 

 noisy, and the nostrils were dilated. Within a few minutes the animal 

 began to walk round its box, cringing from time to time towards the 

 right side, turning its head in the direction of the right flank, but 

 seldom lying down. This wandering round was occasionally inter- 

 rupted, the animal standing in one place, pawing violently, stretching 

 out its head, and curling its upper lip. Vision appeared defective, for 

 the head was several times struck against the side of the box, while 

 the pupil scarcely reacted on the approach of a light. Raising the 

 head caused staggering. 



As the animal had been resting for ten days and had not been out 

 of its box, and as the attack was of sudden onset, the history threw 

 little light on it. The suddenness of the attack, the extreme depression, 

 dilatation of the pupil, paleness of the membranes, and general blood- 

 lessness seemed to point to internal haemorrhage, while the animal's 

 age, considered in conjunction with the known frequency of rupture of 

 the liver in the horse, seemed to warrant the diagnosis of ruptured 

 liver. As very little more could be done than relieve pain, a hypo- 

 dermic injection of seven grains hydrochlorate of morphine was given, 

 it being considered too dangerous to attempt giving a draught. 



This afforded some relief, and for about forty minutes the animal 

 kept wandering round its box or occasionally standing still and pawing. 

 Just as death seemed imminent, it went down rather heavily, struggled 

 a good deal, stretched out its legs stiffly, groaned deeply several times, 

 and apparently died. In about a minute, however, it gathered itself 

 together, rose and stood swaying about stupidly, but apparently in less 

 pain than before. At this time the pulse was about 130 to 140, small 

 and thready ; the respirations about 30, but shallow and quiet. The 

 temperature was not taken. 



Directions were given that the animal should be kept perfectly quiet, 

 placed on low diet, and general precautions be adopted against its 

 catching cold or injuring itself. In point of fact death was expected to 

 occur within a few hours. 



Next day, however, the patient was still alive and distinctly better. 



