Course and Prognosis. 301 



on the basis of belching, gag-gino" and vomiting and with the aid 

 of an exploration by means of the catheter. The stomach tube 

 should, therefore, be introduced in all doubtful cases. 



Course and Prognosis. The s^auptoms usually subside in 

 mild cases within a few hours and disappear completely after a 

 few more hours ; the symptoms of acute catarrh of the stomach, 

 however, not infrequently persist for a few days, and an accel- 

 erated and weak pulse may be observable for one or two days. 

 In some cases immediately after the animals appear to have re- 

 covered, the symptoms of acute gastric inflammation appears, 

 and they die from it. Pulmonary gangrene develops not un- 

 commonly within a few days, and is due to aspiration after 

 belching or vomiting. 



In grave cases (after the observations of the authors in 15 

 to 33%), the syiuptoms of gastric dilatation increase in intensity 

 and the patients die with manifestations of great restlessness or 

 after they have already quieted down somewhat. If the pa- 

 tients are treated early with the stomach sound they can usually 

 be saved. Among the causes of death may also be enumerated 

 suffocation, rupture of the stomach, rarely rupture of the dia- 

 phragm. The muscularis of the excessively dilated stomach 

 may lose its contractility entirely, so that the pains cease al- 

 most completely; but the forced respiration, the very weak pulse 

 and the anxious expression announce the impending suffocation. 



After complete rupture of the stomach the colicky pains sud- 

 denly cease, but the general condition rapidly becomes worse. 

 The animal becomes prostrated, shows extensive muscular 

 tremors, staggers and is bathed in perspiration; in spite of 

 quieting down it does not ingest food (in two cases of Sequens 

 the appetite for food and thirst was retained in spite of rup- 

 ture) ; the eyes become staring, the pulse beat rises above 100; 

 but it cannot be felt. Tenderness of the abdominal wall can 

 hardly be demonstrated. If an exploratory puncture is made in 

 the lower part of the abdomen, one can usually obtain a sour or 

 neutral fluid which is hemorrhagic and mixed with particles of 

 feed, particularly grains (Fig. 35). Eectal exploration meets 

 no resistance in the upper portions of the abdominal cavity, be- 

 cause in this part the gases are collected which have escaped 

 from the stomach. In cases which do not take a too rapid 

 course, one can feel particles of food on the peritoneum, which 

 is rough and tender. (Roughness of the peritoneum in itself 

 alone is no proof of rupture of the stomach or peritoneum, be- 

 cause it occurs in peritonitis due to other causes.) The tem- 

 perature sometimes goes below normal at the start, but rises 

 later if the animals remain alive for any length of time. 



Death after rupture may occur within a few quarters of an 

 hour, more rarely only after several hours. If the gastric con- 

 tents get between the leaves of the mesentery only, the animal 

 may live for several days, and then the symptoms of acute peri- 



