20 ON SPASM OF THE DIAPHRAGM. 
the pulse is more feeble, and the spasm not so violent. The 
latter is still more distinct during inspiration. The heart’s action 
at the side is now more easily felt, and it is nearer the time of 
the spasm than the pulse at the jaw is. The bowels are be- 
coming more lax. He has not eaten any thing, but drinks a 
little chilled water. 
12 noon. — The medicine is acting on the bowels freely. The 
spasm is considerably subsided. He is a little uneasy and 
griped. He will not eat. The pulse is very distinct at the 
heart, and, I may say, fuller than natural. He is comfortably 
warm. 
8 p.m. — He has been lying down the greater part of the day, 
and this afternoon is purging rather freely : he is a little uneasy, 
but does not roll about. The pulse from 60 to 70 — the spasm 
not subsided. Give 9j opii and 3'j pip* Jam. 
2d, 4 a.m. — The spasm beating a little, and he is rather un- 
easy. 
8 a.m. — I was sent for, as he was thought to be dying. [ 
found him very restless, and rolling over, and frequently getting 
up and down : he looks tolerably lively, and is warm. Pulse 68. 
Give Jiss tinct. opii. Is not purging, but the bowels are rum- 
bling a good deal, and he trembles. 
10 a.m. — No better, and, fearing enteritis, I took two quarts of 
blood from him. 
3 p.m. — Is still uneasy, but not quite so violent: is warm all 
over, and not purging. Give 3ss opii. Drinks gruel. 
4 p.m. — The spasm has ceased. Rub some lin. vesicat. on 
his flanks. 
9 p.m. — Found him standing up, and he had been so for a 
quarter of an hour, but the owner said he thought he was not 
much different or better: he looks lively — the mouth moist — 
respiration a little increased, and he is very warm all over, but his 
pulse is 120 ; and, were it not for this rapidity of pulse, one would 
think that there was but little amiss. His bowels have not been 
moved all day. Drinks gruel, and stales as usual. 
3d, 8 a.m. — He looks worse, and is evidently sinking. He has 
been standing up a great part of the night, and is so now. The 
pulse is not to be felt at the jaw, but distinctly so at the heart, 
and is there the same as last night, viz. 120. The respiration 
accelerated : he does not seem in pain, nor has he exactly the 
symptoms of enteritis. The bowels are not acting : his mouth, and 
the hand that has been placed in his mouth, has a peculiar smell, 
something like carious bone. I have occasionally noticed this 
smell in the latter stages of enteritis, i sec no probability of his 
recovery. 
