364 Veterinary Medicine. 



so that any protrusion takes place only to a limited amount and 

 the function of the diaphragm can still be carried on to a reason- 

 able extent. In these cases there may be no very marked symp- 

 tom at the outset, though the animal is dull, listless and without 

 appetite, or, if he eats or drinks, it is liable to be followed by 

 slight colics and a double action of the flank in expiration as in 

 pulmonary emphysema (heaves). Pressure or percu.ssion in the 

 posterior intercostal spaces is painful. Cough when roused by 

 pinching the larynx is broken 'and abortive. These .symptoms 

 are not distinctive, however, and unless there is a protrusion of a 

 loop of small intestine, to give gurgling and drum-like sounds 

 the diagnosis of the case is liable to fail. The fact of a recent 

 injnry may however a,ssist in the recognition of the lesion. 



The chronic cases are even more difficult to recognize as there 

 is no record of recent injury and no fever. There may be short 

 wind, the animal breathing hurriedly on slight exertion, and 

 showing a double lift of the flank in expiration (Girard). In 

 place, however, of the tympanitic bowels and frequent passage of 

 flatus which characterize heaves, there is a tendency to colic, 

 e.specially after meals, and in a certain number of cases there are 

 all the symptoms of fatal strangulation, due to the contraction of 

 the diaphragmatic wound. When the hernia is made by a loop 

 of intestine there are the characteristic symptoms of thoracic 

 gurgling and drum-like resonance. 



Cases are on record in which the intestine protrudes through 

 one of the last intercostal spaces or between the ends of the 

 broken rib as a hernia and diagnosis becomes ea,sy by ausculta- 

 tion, palpation and percu,ssion. But in a large proportion of 

 cases the lesion escapes recognition and is only found on post 

 mortem examination. 



Lesions. The lacerated orifice in the diaphragm varies much 

 as regards situation, extent, form and the nature of its border. 

 In congenital cases due to an imperfect closure of the natural 

 openings there may be simply a round or ovoid opening, too 

 spacious to be filled by the gullet, vena cava or aorta as the case 

 may be, and capable in the different cases, of containing an organ 

 of any size from the omentum to the liver or stomach. Its mar- 

 gins may be perfectly smooth and even, without any thickening, 

 irregularity, fringe, clot or exudate. In traumatic cases on the 



