Symptoms. Diagnosis. 795 



authors in a dog. In this dog, which was suifering from catarrh of the stoiaach and 

 bowels, spasms of the diaphragm occurred in equal number to the heart beats and 

 immediately following these; besides spasms were observed, far less often and at 

 quite irregular periods of time, in different muscles at the head, neck and limbs. 

 The common origin of the spasms was plain enough here, and yet the contractions 

 of the diaphragm followed the heart beats. 



At times the spasms are observed in acute inflammatory 

 diseases of the thoracic organs, especially of the serous mem- 

 branes or of the pleurae. Finally myelitis in the neighborhood 

 of the center of the diaphragmatic nerves may occasion spasm 

 of the diaphragm (personal observation). 



Symptoms. The disease is manifested by peculiar rhyth- 

 mic jerkings of the body, which are strongest along the arches 

 of the ribs, and at first sight give one the impression of very 

 strong heart beats. At each convulsive movement there is a de- 

 pression in the neighborhood of the costal arch, whilst at the 

 same time the portions of the abdominal wall, which are situ- 

 ated further back, especially in the region of the epigastrium 

 the flank, bulges out somewhat; the intercostal spaces on the 

 contrary, along the whole extent of the lower part of the chest 

 or only in the posterior third of the chest show spasmodic re- 

 traction. With the flat hand one can distinguish short power- 

 ful beats in the region of the lower ribs, and these become 

 gradually weaker in all directions. 



The number of impacts may coincide with the heart beats 

 and then the convulsive jerkings immediately follow upon the 

 heart b,eats. With an accelerated heart action the movements 

 become more frequent; far more often, however, the number 

 of pulsations is higher or lower than the heart beats, or no 

 regular relation between the two can be established. In two 

 cases of the authors the spasms of the muscles of the 

 back ceased for a short time on percussion of the back. From 

 the nasal orifices one may distingaiish a sound similar to that 

 of a sol)bing, but it must not be mistaken for that which is 

 caused in clonic spasm of the abdominal muscles, by the jerky 

 and short expirations. The animals appear restless and gener- 

 ally show no appetite. The condition hardly ever lasts longer 

 than two days. 



Diagnosis. The only characteristic signs of spasm of the 

 diaphragin are the bulging out of the epigastrium and flank, 

 which are synchronous with the convulsive jerkings, and at the 

 same time the simultaneous retractions of the intercostal spaces. 

 In doubtful cases the hand introduced into the rectum up to 

 the place where the diaphragm is attached will immediately 

 detect the convulsive movements of the latter. The clonic 

 spasm of the abdominal muscles may be distinguished in that 

 one can see the contractions of the abdominal muscles, or feel 

 them with the hand placed in the flank, and moreover a retrac- 



