PHRENITIS. 99 



Now is the surgeon's golden time, and his courage and adroitness will be put to 

 the test. He must open, if he can, one or both jugulars : but let him be on his 

 guard, for the paroxysm will return with its former violence and without the slightest 

 warning. 



The second attack is more dreadful than the first. Again the animal whirls round 

 and round, and plunges and falls. He seizes his clothing and rends it in pieces; 

 perhaps, destitute of feeling and of consciousness, he bites and tears hunself. He 

 darts furiously at everything within his reach ; but no mind, no design, seems to min- 

 gle with or govern his fury. 



Another and another remission and a return of the exacerbation follow, and then, 

 wearied out, he becomes quiet; but it is not the quietness of returning reason — it is 

 mere stupor. This continues for an uncertain period, and then he begins to strag- 

 gle again ; but he is now probably unable to rise. He pants — he foams — at length, 

 completely exhausted, he dies. 



There are but two diseases with which phrenitis can be confounded, and they are 

 cholic and rabies. In cholic, the horse rises and l\ills; he rolls about and kicks at 

 his belly; but his struggles are tame compared with those of the phrenitic horse 

 There is no involuntary spasm of any of the limbs ; the animal is perfectly sensible, 

 and, looking piteously at his flanks, seems designedly to indicate the seat of pain. 

 The beautiful yet fearfully excited countenance of the one, and the piteous, anxious 

 gaze of the other, are sufficiently distinct; and, if it can be got at, the rapid, bound- 

 ing pulse of the one, and that of the other scarcely losing its natural character in the 

 early stage, cannot be mistaken. 



In rabies, when it does assume the ferocious form, there is even more violence than 

 in phrenitis ; but there is method, and treachery too, in that violence. There is the 

 desire of mischief for its own sake, and there is frequently the artful stratagem to 

 allure the victim within the reach of destruction. There is not a motion of which 

 the rabid horse is not conscious, nor a person whom he does not recognise ; but he 

 labours under one all-absorbing feeling — the intense longing to devastate and destroy. 



The post-mortem appearances are altogether uncertain. There is usually very great 

 injection and inflammation of the membranes of the brain, and even of portions of 

 the substance of the brain ; but in other cases there is scarcely any trace of inflam- 

 mation, or even of increased vascularity. 



The treatment of phrenitis has been very shortly hinted at. The first — the indis- 

 pensable proceeding — is to bleed ; to abstract as much blood as can be obtained ; to 

 let the animal bleed on after he is down ; and indeed not to pin up the vein of the 

 phrenitic horse at all. The patient will never be lost by this decisive proceeding, but 

 the inflammation may be subdued, and here the first blow is the whole of the battle. 

 The physic should be that which is most readil}^ given and will most speedily act. 

 The farina of the croton will, perhaps, have the preference. Half a drachm or two 

 scruples of it may be fearlessly administered. The intense inflammation of the brain 

 gives sufficient assurance that no dangerous inflammation will be easily set up in the 

 intestinal canal. This medicine can be formed into a very little ball or drink, and in 

 some momentary remission of the sj-mptoms. administered by means of the probang, 

 or a stick, or the horn. Sometimes the phrenitic horse, when he will take nothing 

 else, and is unconscious of everything else, will drink with avidity gruel or water. 

 Repeated doses of purgative medicine may perhaps be thus given, and they must 

 be continued until the bowels respond. The forehead should be blistered, if it can in 

 any way be accomplished ; j^et but little service is to be expected from this manipu- 

 lation. The bowels having been well opened, dijitalis should be administered. Its 

 first and most powerful action is on the heart, diminishing botli the num'ber and 

 strength of its pulsations. To this may be added emetic tartar and nitre, but not a 

 particle of hellebore ; for that drug, if it acts at all, produces an increased determina- 

 tion of blood to the brain. 



While the disease continues, no attempt must be made to induce the horse to feed : 

 and even when appetite returns with the abatement of inflammation great caution 

 must be exercised both wth regard to the quantity and quality of the food. 



