SPASM OF THE DIAPHRAGM 49 



practitioner is occasionally embarrassed in the presence 

 of cases that prove stubborn under treatment, and because 

 death does occur in some cases quite unexpectedly. Al- 

 though recovery is the rule in this disease, the practi- 

 tioner must be reserved in his prognosis. The clinical 

 picture of a case of diaphragmatic spasm is a grave one 

 in the eyes of the client. For the practitioner the case 

 has no terrors, because he knows that most of these cases 

 recover in from two hours to as many days. Now and 

 then one dies, however, after the attending veterinarian 

 has in all sincerity assured the client that the patient 

 was in no danger of losing its life. And, usually, 

 not only is the patient lost in these eases; the client 

 is "lost," too. A safe rule on this point is to "view with 

 suspicion" all cases of this affection that show no 

 improvement within a few hours after treatment is 

 begun. 



Symptoms. The most prominent symptoms in 

 "thumps" is the thump. It is a thumping sound, usu- 

 ally heard in company with, or immediately after, the 

 heart beat. The sound can be heard plainly at quite a 

 distance from the horse. The animal is much distressed 

 and uneasy, the respiratory movements are accelerated, 

 and with each "thump" the entire body moves in a jerky 

 manner. 



The condition must be differentiated from an acute 

 exacerbation of heaves. This can be done by carefully 

 noting that the abdominal muscles in the flank region 

 remain rounded, lacking the expiratory flatness charac- 

 teristic of that act in heaves. If further confirmation is 

 desired, a rectal examination can be made. In a case 

 due to spasm of the diaphragm the contractions of the 

 latter can be plainly felt along the borders of the last 

 ribs, and these contractions will be found to coincide 

 with the thumping sounds. 



