556 EXTRACTS FROM MY NOTE BOOK. 
not many hours to live. This state of things continued up to 
the 21st, when 1 was resolved to make a last effort. The 
symptoms to-day are as follow: — Ears and extremities warm; 
seems lively, and eats bran and scalded oats with some clover 
pretty freely ; the pulse, that unerring guide, is standing at 80, 
(it never ranges more than two or three beats more or less). She 
has been several times bled, and was relieved each time. I 
therefore determined upon taking more blood, and extracting the 
vital fluid until the system was shaken by it. I kept my finger 
upon the submaxillary artery the whole time, and the following 
was the result : — The pulse was at 80 when the blood began to 
flow ; in a couple of minutes it ran up to 120 ! and then it 
gradually fell back to its old pitch (80) : the respiration all this 
time becoming less laboured. The blood which fell into the 
vessel was very pale and watery : I should imagine she lost about 
six pounds weight of blood. I could not detect much organic 
disease in the lungs : the heart, however, shewed ?mmistakeable 
signs of organic change ; and I came to the conclusion that I 
could do the animal no good ; for I had tried to the utmost of 
my power to abate the symptoms, and all to no purpose, which 
fully bore me out in remarks I have often made before ; viz. that 
when a case can be satisfactorily demonstrated to be one of di- 
latation, accompanied by other changes in the circulation, and 
the pulse obstinately remains on the average at about 80 for 
some days together, it is high time to think of giving up such a 
case as lost. I have been led to make this statement from the 
fact of my having carefully watched several such cases from 
first to last, and having minutely examined each after death. — To 
return to my patient. I now advised the owner to send her 
away to be destroyed; which advice was acted upon, and she 
was destroyed. I examined the carcass, which presented the 
following appearances: — I proceeded first to open the abdomen, 
and found the intestine, stomach, liver and bladder free from 
disease. The kidneys were soft and whitish — the heart was 
nearly white on the external surface — the pericardial sac con- 
tained about eight ounces of fluid — the internal structure of the 
muscle was literally full of a gelatinous substance freed from its 
red particles : this I was certainly prepared to find. The left 
ventricle shewed various red spots upon its lining membrane, 
and otherwise denoted that most intense inflammation had ex- 
isted ; the size of the heart was considerably increased, and much 
dilated ; at the origin of the aorta I found a large cartilaginous 
substance, half-moon shaped. The lungs on the right side 
were slightly congested — the left lung was partially hepatized. 
Remarks. — This case presented a greater variety of changes 
* than I have ever before witnessed : one thing deserves especial 
