A CASE OF RUPTURE OF THE DIAPHRAGM. 159 
served as a fact of considerable importance, that, the more closely 
the lining surface of the sac is applied to the adjoining tissue, the 
more readily that tissue is attacked by inflammation. The more 
the parts are distended, the closer the internal membrane is applied 
to them, and the inflammatory action of it extended to them. As 
inflammation extends to the adjoining structures, adhesion between 
them and the parietes of the abscess succeeds, and their substance, 
softened, diluted, and absorbed, at length becomes ulcerated ; so 
that for a considerable period the skin alone resists the expulsion 
• of the fluid. This, at length, by erosion, is reduced to a pellicle, 
having the epidermis elevated in the form of a phylactena, which, 
no longer capable of resisting the increasing pressure beneath, 
gives way, affording an escape to a portion of the fluid, and the 
abscess is said to have broken. 
[To be continued.] 
A CASE OF RUPTURE OF THE DIAPHRAGM. 
By Mr. W. A. Cartwright, Whitchurch. 
On Monday, the 14th November, 1836, I was sent for to see a 
six-year-old horse that was unwell. He had been driven forty- 
eight miles on the previous Thursday ; and on the Friday he rest- 
ed. On the Saturday he went thirty-eight miles, on Sunday forty, 
and on this day, Monday, twenty-four miles, drawing a gig, and 
the weather, most of the time, being wet and bad. On the Sunday, 
when he came home, he was thought to have the gripes, and was 
drenched with a quart of ale well spiced, and which seemed to do 
him good. On the Monday, when he had gone to the extent of 
his journey (twelve miles), he was thought not to be well, as he 
would not eat either his hay or corn ; nevertheless, he was driven 
home, and went very quickly and well, and arrived at Whitchurch 
about one in the afternoon. He was put into the stable, but would 
not feed; he was also drenched with another quart of ale, &c. as 
before. At four o’clock I saw him. 
Symptoms . — He had been left in a very dirty and slovenly state. 
His pulse was very quick and small, and, I should think, at least 
80 or 90 in a minute. At every seventh or eighth pulsation, there 
was an intermission of one beat. I could scarcely feel the pulse 
at the jaw, but was enabled to do so at the chest. His respiration 
was scarcely quicker than is natural ; but there was a peculiar 
tucking up of the flanks in respiration, as in a broken-winded 
horse. This, however, was by no means violent, nor could it have 
