PALPITATIONS IN THE HORSE. 



461 



heard at a distance of several paces (Simonin and others) ; these 

 abrupt and violent shocks, the number of which rarely exceed ten 

 to fifteen, are perceived very distinctly along the diaphragm (Gross- 

 wendt) ; they are gradually attenuated toward the front along the 

 thoracic cavity, or backward in proportion as the point examined 

 is in more or less close proximity to the location of the pelvis ; 

 there are cases where they seem localized to a circumscribed region 

 of the diaphragmatic partition ; in some patients they produce a 

 hiccough (Worz) They are mostly not isochronous with the beat- 

 ings of the heart, and these are not palpitating, but normal, or even 

 weakened. While they do not seem to have any connection with 

 the cardiac systole (Berghuis, Simonin, Boiteau, Bril, Worz, Her- 

 ing, Grosswendt, Soumille, etc.), it is generally admitted that they 

 are due to an irritation of the phrenic nerve by the movements of 

 the heart. 



Besides these symptoms we often observe a quick and small 

 pulse, an acceleration of the respiration, trembling, anxiety, gap- 

 ing, frequent extension of a posterior member, manifestations of 

 pain, etc. The duration of the affection varies from a few minutes 

 to two or three days, very rarely longer, though Leblanc has seen 

 it persist for three weeks. The prognosis seems to be less favor- 

 able than for palpitations ; of eighteen patients observed by Cart- 

 wright six died.^ The frequency of the pulsations on the left side 

 (Cartwright found these twelve times on the left in sixteen cases) 

 is undoubtedly due to the situation or distention of the stomach. 



Treatment. This consists of the use of antispasmodics, mor- 

 phine (subcutaneous injections of 0.4 to 0.6 gramme of hydro- 

 chlorate of morphine in the horse), bromide of potassium, hydrate 

 of chloral (25 to 50 grammes). For true palpitations we may also 

 have recourse to cold irrigations upon the heart region, to irritating 

 cutaneous frictions, and to derivation in the intestinal canal by 

 means of drastics. 



Bleeding, which was formerly much favored, is only of doubtful 

 efficiency. 



The obscurity which still covers the nature of the morbid con- 



1 This gravity of diaphragmatic chorea, as represented by Cartwright's statistics, 

 must be considered as altogether exceptional. Of nine patients which we have ob- 

 served none have died, recovery being always produced rapidly, whatever the treat- 

 ment applied. — n. d. t. 



