ON HEPATIRRHCEA, HAEMORRHAGE FROM THE LIVER. 13 
would have fallen, slight pawing*, and sweating* profusely. The 
farrier who was in the habit of shoeing* the horses was at first 
called in by the coachman, who proposed immediate bleeding*, 
supposing*, as he informed me, he had inflammation of the in¬ 
testines. This, I believe, was objected to by Mr. Sheppard, 
until I had seen the horse. I found my patient to be a bay 
g*elding*, aged, about sixteen hands high, and in good condition: 
he was uncovered, the surface of the body cold, and wet from 
perspiration ; and a deficiency of blood to the skin. The conjunc¬ 
tive, Schneiderian, and buccal membranes blanched—scarcely 
an injected vessel to be seen. The state of the mouth indicated 
much mischief: it was dry, cold, and the little saliva that was 
sticking about the tongue was viscid. Respiration slightly hur¬ 
ried ; extremities colder than natural; very considerable irritabi¬ 
lity of the intestines was manifested by the frequency of his 
voiding his faeces, the fetor arising from which w as unusually 
offensive; but the most remarkable symptom was the pulse—in 
number 46, but singularly weak, the submaxillary artery feel¬ 
ing nearly empty: the pulsations, however, were regular. From 
the peculiarity of these symptoms, the whiteness of the mem¬ 
branes, the state of the pulse, and the coldness of the skin, I de¬ 
termined on not bleeding; and I mentioned to Mr. Sheppard 
that many symptoms indicated internal haemorrhage. 
Treatment. —I ordered the stable to be kept comfortably w arm, 
the horse to be well clothed, and sent Barb, aloes 3 iv, zingib. sii, 
pimento 3ni, resin 3 v, aqua Ife.iss,, to be well digested over 
the fire, and administered warm. In two hours and a half I saw 
the horse again : the means prescribed had produced re-action; 
the membranes still whiter than natural, but redder than w hen 1 
first saw him; pulse the same in number, but a little fuller 
(there was now to be perceived a yellowish tinge in the mouth) : 
the surface of the body and extremities much warmer. I iiow t 
felt convinced that the principal mischief was in the liver, al¬ 
though there was evidently some slight irritation on the lungs, 
the animal coughing occasionally, and violently. In order to 
judge of my patient's strength, I had him moved out for twenty 
yards. The prostration of strength w as remarkable, considering 
that a few r hours previous he was in apparently high health. J 
left him for the night without bleeding. 
November 10 th .— Does not feed: the warmth of the surface 
of the body continuing comfortable, and the pulse 44, with a 
little more fulness, induced me to have recourse to careful vene¬ 
section. After taking away four quarts, the pulse faltered, 
and I pinned up. On the whole, he bore the bleeding well. 
Medicine slightly operated. 
