560 
RUPTURED LIVER. 
bred, about fifteen hands two inches high ; had been the pro- 
perty of the present owner about two months, and had never 
during that time been ailing, but was an excellent worker and 
a good goer. I was informed, he had the previous day per- 
formed his usual occupation, working an opposition buss to and 
from the Exhibition, and had been rapidly driven home : when 
taken off, he blovved very hard, and appeared unwell, refusing 
his food. No further notice was taken that night. 
On my arrival the next morning, I immediately proceeded 
to examine him, and found the following symptoms : 
Pulse 50, and small ; mucous discharge from the nose ; visible 
mucous membranes injected ; nose cold ; extremities deathy 
cold, breaking out into profuse perspirations; tremor succeeding 
the sweats; bowels constipated ; eye bright; and great rest- 
lessness. I had him placed in a loose box, his extremities well 
hand-rubbed and bandaged. I gave febrifuge medicine ; ordered 
him tepid water and bran mash. Visited him at 4 P.M. ; found 
but slight change ; pulse 54, and assuming the same character; 
the perspiration and tremor ceased ; body warm ; and he had 
voided his urine, which I was informed by the groom was of high 
colour. Ordered the same diet to be continued, then left him. 
Saw him again at 8 A.M. On the 4th he had taken a little 
tepid water, but continued to refuse food. The fseces voided 
in the night were kept for me to see; they were dark- 
coloured and hard. Pulse 76, and characteristic, small and 
thread-like; mucous membranes blanched yellow; mouth dry 
and pallid ; nose very cold ; extremities deathy cold ; body 
warm ; passed a small quantity of fseces in my presence, which 
were tinged yellow'. Gave aloes 3 ii, calomel 3 i, tartarized 
antimony 3 i, pulv. opii 3 ss, nit. potassse 3 ii, in ball. I must con- 
fess I was much puzzled whether to abstract blood or not, and 
hesitated for a minute ; but taking into consideration the cha- 
racter of pulse, combined with other symptoms, I ventured to 
abstract a small quantity of blood, though I was fearful of the 
result, yet I did not, at the same time, see any other resource. 
Syncope came on before he had lost a pint of blood, and he fell 
on his right side before I could close the orifice. I immediately 
got him up, and closed the vein. He continued very restless, 
frequently walking round his box ; his pupils much dilated. I 
stood by watching him for five minutes The owner requesting 
my opinion, I informed him it did not leave a question of doubt 
in my mind that there w r as a rupture of some vessel or organ, 
and most likely the liver. While speaking, my patient suddenly 
fell again on his right side, with his head in the manger; then, 
pointing his nose to his left side, stretched out his extremities, 
groaned, and died. 
