250 RUPTURE OF THE DIAPHRAGM AND STOMACH, 
found him being led out by the man looking after him. I 
immediately ordered him back to his box, though the moment 
he arrived therein he recommenced symptoms of violent ab- 
dominal pain. He lay down in spite of us all, and as speedily 
as possible rolled upon his back : the position he seemed to 
find most relief in, since he would retain it for minutes to- 
gether. The pulse was not thready, nor small, but of the usual 
fulness, and very quick — 70 or 80 perhaps. The pains were 
periodical — every five or six minutes, and so sharp that he 
twisted and writhed about in every direction, until he could 
lie down and roll again upon his back. In about half an hour 
after my arrival, while forced up in the standing posture, to 
admit of the administration of remedy, he, in spite of all 
restraint, bored his head forward, with rolling eyes and 
dilated pupils, as though the pain had driven him into a 
state verging on delirium. By ether and laudanum his pains 
were allayed, and even for so much as an hour at one time 
were suspended: they, however, returned again and again, 
until half-past 3 o’clock of the morning of the 12th, at 
which time he lay down and died without any further 
struggle. 
Autopsy. — We were not a little anxious to discover the 
cause of death in this case ; though it was evident from the 
time of the manifestation of delirium that death was entailed 
upon our patient. 
The abdomen , when first laid open in the usual way, presented, 
superficially, a normal aspect, both in the colour and position of 
the viscera ; on removing the large intestines, however, some 
bloody fluid was found flowing along the spine, at the bottom 
of the cavity ; while in front, the liver appeared to be occupy- 
ing more space than usual. But what was above all most 
strange in the manipulation, no stomach was to be found. 
Diving deeper still, however, into this mysterious comer, a 
hole was felt in the diaphragm, through which the stomach, 
and with it part of the duodenum, had escaped into the cavity 
of the thorax. The rent in the diaphragm was a large one, 
extending from the spine to its middle, as far as where the 
cordiform tendon commences, by which further extension 
seemed to have been arrested. The margins of the rupture 
did not indicate recent rent ; they were rather rounded and 
smooth, as though the breach was of some standing. The 
stomach was quite full of masticated hay, having that fresh 
character as though it was (as it was in fact) the latest hay the 
horse had eaten. It smelt strongly of the medicine the horse 
had taken, but otherwise presented nothing unusual to the 
appearance of such aliment in the first stage of digestion. 
