ON SPASM OF THE DIAPHRAGM. 
24 
which, as Mr. Beeson, of Amersham, has observed, that gentle- 
man did not seem to understand, for it was clearly a case of 
spasm of the diaphragm. Here the pulse was 60 in a minute, 
and isochronous with the beating of the heart (spasm of the 
diaphragm). 
In the 15th vol. of The Veterinarian, page 66, there are, 
by Mr. Beeson, some very interesting and concise observations 
on this subject ; and, after noticing the error that M. Pastev had 
fallen into, he says, “ it is a remarkable fact, that in every case 
of spasm of the diaphragm that has come under my observation, 
the pulsations of the heart and the spasmodic beatings have been 
exactly isochronous. The spasmodic contractions always precede 
the heart’s pulsation at about the same rate as the pulsation of 
the heart precedes that of an extreme artery, which may be dis- 
tinctly felt, by placing the left hand at the heart, and the right 
one at the ends of the ribs.” 
In the same volume, page 500, Mr. Allison, of Washington, 
relates a case where, by putting his finger on the pulse and his 
eye on the flank, he found that the spasm preceded the pulsation 
a little, each keeping quite regular at its respective distance. 
From the relation of these thirteen cases, it appears that in six 
of them the spasm and the pulse beat the same number of times 
in a minute — not at the same time, but immediately after each 
other, and with great regularity; in addition to which, Mr. 
Beeson observes that, in all the cases he ever saw, the pulse and 
spasm were regular after each other ; in two of the other cases it 
may be implied that it was so. In three of them it is not at all 
noticed, and in only one of them (Mr. Sinclair’s) was it not 
synchronous. Now, the question is, why should the pulse and 
spasm be of an equal number? Are they cause and effect? 
On what side is the Spasm ? — Another peculiarity is that of the 
spasm being generally on the near side; for out of sixteen cases 
that are reported, twelve have been on the near side, one on 
both sides, and in three the sides have not been stated. Mr. 
Beeson says he has seen it in several cases, where the whole of 
the diaphragm has been implicated, but more violent on one 
side than the other. Now it is highly probable that in these it 
was “ more violent” on the near side. In a case of Mr. Tombs’s 
the spasm extended to the intercostal and abdominal muscles, as 
well as to the diaphragm ; but it only lasted in all of them for a 
few minutes. 
Pulse . — There appears to have been in these cases a difference 
in the state of the pulse. In many of them it was, at the jaw, 
almost imperceptible, and at the heart sometimes not to be felt, 
at others indistinct, and sometimes only a sort of echo, whilst 
