300 Acute Dilatation of the Stomach of the Horse. 



The stomach catheter often meets no opposition in introduc- 

 tion, because the esophageal muscles are relaxed. The stomach 

 tube removes abundant sour-smelling, sometimes fetid gases 

 and frequently also a rust-brown fluid escapes in a strong 

 stream, particularly after lowering the head. 



The circumference of the abdomen is onl}^ rarely increased, 

 and even then only moderately ; percussion over the abdomen is 

 normal. The intestinal sounds can be heard less frequently, be- 

 cause no food mash gets from the stomach into the intestines 

 as long as the affection lasts; in severe cases the intestinal 

 sounds are suppressed entirely. Cases complicated by catarrh 

 of the intestines or moderate intestinal meteorism are char- 

 acterized by more intense intestinal sounds. Abdominal pain 

 causes tenesmus and attempts at defecation by reflex irritation. 

 However, since peristalsis is insufficient the animals have a 

 fairly normal defecation only in the beginning of the disease, 

 later on they succeed only occasionally in their attempts at 

 defecation, or constipation becomes complete. Exploration per 

 rectum usually reveals a moderate, exceptionally also an ex- 

 cessive degree of bloating of the small intestines, especially of 

 the duodenum (this part is palpable immediately behind the an- 

 terior root of the mesentery, where the duodenum turns over to 

 the left side). The spleen is frequently pushed back, so that its 

 posterior border is displaced towards the region of the external 

 angle of the os ileum. How^ever, it is a mistake to attribute a 

 great diagnostic importance to this change of position of the 

 spleen, as is done by Forssell. For unknown reasons the 

 base of the spleen may become displaced towards the vertical 

 plane of the external angle of the os ileum in health, even in 

 horses which have been starved for days. In small horses one 

 can feel the blind sac of the dilated stomach in front of the left 

 kidney and the base of the spleen either as a tense elastic or as 

 a more or less firm rounded globular body which moves syn- 

 chronously with the respiratory movements of the diaphragm. 



The respiration becomes forced after a short time, a symp- 

 tom which is markedly in contrast to the almost normal circum- 

 ference of the abdomen. The pulse rapidly becomes accelerated 

 so that after a few hours the number of pulse beats is over sixty 

 per minute ; at the same time its strength becomes diminished ; 

 exceptionally the pulse is not more frequent than normally, but 

 it is always weaker. One generally sees an increased fill- 

 ing of the smaller, occasionally also of the larger veins, together 

 with cooling of the peripheral surfaces of the body, cyanosis and 

 perspiration. The temperature usually remains below 39° C. ; 

 but in cases complicated with inflammation of the stomach high 

 fever prevails. E. Bauer demonstrated an increase of indican 

 in the urine in primary dilatation of the stomach. 



Although the clinical picture of secondary dilatation of the 

 stomach is usually more or less clouded by the s\^nptoms of the 

 underlying primary disease, a diagnosis may possibly be made 



