RUPTURE OF THE STOMACH 77 



The patient may now sit for several minutes at a time 

 on his haunches, or, as is more general, may stand 

 quietly, giving the uninitiated the appearance of greater 

 ease. His countenance, however, is still indicative of 

 his condition. It is almost ' sardonic ' in the expression 

 it conveys. The ears droop, the angles of the mouth are 

 retracted, and the teeth protrude in a ghastly grin. 



It is now that the vomiting — -the much - discussed 

 vomiting — begins to occur. Every now and again the 

 fluid-like ingesta of the stomach is ejected with or with- 

 out symptoms of vomiting on the part of the patient, and 

 the administration of medicines only tends to aggravate 

 his suffering. In some cases the emesis is but an in- 

 voluntary, though constant, dribble from the nostrils ; 

 in others it is an act of distinct and painful retching, 

 accompanied with all the equine phenomena of vomiting. 

 One other symptom there is which, if only constant, 

 would lead to diagnosis always being absolute. I refer 

 to the escaped ingesta being detected in the peritoneal 

 cavity when exploring per rectum. It is unfortunate 

 that this evidence is not constantly obtainable. 



The pulse now becomes more and more imperceptible, 

 the muscular tremors increase in severity, the breathing is 

 a shivering sob, and the legs are propped out wide apart 

 to keep the unfortunate animal from falling. When he 

 drops it is all over, for a very few seconds then ends the 

 scene, and the poor brute usually expires with the ingesta 

 gushing in streams through his nostrils. 



These symptoms are the ones that may fairly be taken 

 as diagnostic — that is, as far as we are able to diagnose 

 this affection. They will lead to a correct diagnosis in 

 the majority of instances. In addition to the signs here 

 given, however, the young practitioner must remember 

 that all the usual symptoms of ' colic,' as described in 



