414 
REPORTS OF CASES. 
mouth. If lie had a chance to lie down he would do so in a 
semi-sternal position, with his body always inclined to the left 
and his head slightly twisted, resting flat on the left ear. He 
would then stay for a few seconds, then get up, move about in 
great agony and lie down again ; the whole front part of his 
body, principally the muscles of the neck, seemed to be stiff and 
hard, and yet they could be rubbed hard without any manifesta¬ 
tion of soreness or pain. If one tried to raise him by his fore¬ 
legs he sometimes screamed with pain. On one occasion I 
raised him by the hind legs ; he also screamed with agony. 
These spells, which at first lasted but a short time, soon in¬ 
creased in severity, and took between one and two hours before 
everything would gradually subside and left him exhausted. In 
the beginning he had but one, then two, and later on three and 
four attacks a day. Occurring after exercise, they soon even 
took him while at rest, in the room, during his sleep. The 
slightest excitement brought it on sometimes. 
One morning, when he was lying near my bed, I had an 
opportunity to watch him—stretched on his left side. I ob¬ 
served that during his sleep, he had twitching motions of one 
foreleg (the left), then the hind legs began to move by jerks, the 
neck also became affected ; during his apparent sleep he was 
constantly lapping with his tongue in and out of his mouth. 
After an hour of this condition he suddenly got up, moved 
about, ran under the pieces of furniture, moaned and grunted, 
and there came all of a sudden the fearful manifestations of 
choking, which made his general appearance so frightfully pain¬ 
ful. 
His general condition of health was so good when free from 
his paroxysms, his appetite so good, my inability to recognize 
by careful auscultation any organic trouble of the thoracic 
organs, made me tin willing to entertain the idea of an incurable 
disease, and I placed him under the various forms of treatment 
(palliative, it is true) recommended in human medicine. At 
first the inhalations of nitrite of amyl seemed to give him some 
relief ; chloric ether, belladonna, digitalis, cocaine, local applica¬ 
tions—all were used, but none gave a satisfactory or permanent 
result. 
The symptoms kept on increasing in severity ; he was no 
longer willing to walk, he had to be carried up and down those 
stairs which a few weeks before he so gaily paced and ran ; he 
no longer was willing to run on the long balcony, which he had 
so much enjoyed ; he feared to have the slightest excitement. 
