268 FUNCTIONAL NERVOUS DISEASES 



spond with the heart beat. In some cases synchronous 

 with each spasm a forced, noisy expiration is noted at the 

 nostrils. The patient usually does not eat and is restless. 



In cattle traumatic indigestion causing injury of the 

 diaphragm may be attended by diaphragmatic spasms. 



Course and Prognosis. — The course will vary from a few 

 minutes to several days; most cases recover, however, in 

 about two days. Generally speaking the prognosis, which 

 depends upon the cause, is favorable. 



Diagnosis. — The rhythmic throbs which produce synchro- 

 nously a momentary protrusion of the hollow of the flank 

 and epigastrium, with a simultaneous sinking of the inter- 

 costal spaces, are significant. In doubtful cases a rectal 

 exploration, the hand coming in contact with the attachment 

 of the diaphragm, is assuring. 



If the spasms are confined to the abdominal muscles a 

 marked twitching of these muscles may be seen and felt; 

 synchronous with them the epigastrium sinks in and the 

 intercostal spaces are protruded. 



Treatment. — The patient should be placed in a quiet place 

 and a subcutaneous injection of morphin given (grs. iij to vj). 

 Bromid of potash and chloral hydrate (5j) may also be 

 used. Attending digestive disturbances should be treated. 



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