500 
SPASMODIC ACTION OP THE DIAPHRAGM. 
and cheeks were swollen. On examining the mouth and tongue, 
I found a considerable soreness. t 
The sore mouth accounted for the flow of saliva, but the cause 
of the soreness of the mouth I was still at a loss to explain. 
Having made my examination, I began to institute some in- 
quiry into the history of the case. I was told that it had been 
driven in a gig by two gentlemen, the day previous, about four- 
teen miles. In this l said there was nothing to harm it, if it was 
not driven too much against time. They affirmed that this had 
not been the case, but that it was driven home at a reasonable 
rate, and put into the stable, its usual quantum of food, &c., be- 
ing given ; but that it had not tasted food from the time that it 
was put into the stable. 
I administered a laxative and ordered the legs, which were chilly, 
to be well hand-rubbed and bandaged. The patient was well 
supplied with gruel and mash, and kept as quiet as possible. 
25/4, 8 a.m. — Spasmodic action not so strong — pulse 60, and 
stronger — respiration a little more hurried — extremities cold — ■ 
mouth not so sore. I was also informed that he had been trem- 
bling very much a little before my arrival. I now abstracted 
more blood. Five pints having been drawn, I found the pulse 
changing its character, and I therefore closed the orifice. 
The laxative not operating, another dose of medicine was 
given, and an injection administered. Four hours afterwards 
another was given, and the legs lightly stimulated and bandaged. 
The mouth was occasionally washed with a saline lotion, and the 
diet was continued as before directed. 
At 8, p.m., I found him in nearly the same state as I left him 
in the morning, with the exception of his legs having gained 
warmth : no more rigors were observed, and the bowels had been 
a little moved. He also had taken a little gruel for the first time. 
2 6/4, 8 a.m. — Found him in a more favourable way — breath- 
ing calm — pulse 50, soft and regular — a general warmth all over 
him — the spasmodic action nearly subsided — the medicines ope- 
rating well, and he drinks his gruel more freely. Give him small 
doses of opium and camphor twice a-day, and wash the mouth 
three times a day with the solution already ordered : the gruel 
and mashes to be continued. 
2 7/4 and 28/4. — Still going on favourably. Continue the 
opium and camphor. 
29/4. — Still doing well. Discontinue the medicine. Let him 
be walked out a little, and fed moderately, until such time as he 
resumed his work, which was in the course of another week, and 
he has since done well. 
This case being rather out of the common way, I was often 
