V^ ^ IMAGE EVALUATION TEST TARGET (MT-3) ^ \^ 1.0 Itt ^ ■■ U l£ 12.2 u lie 1.1 18 150mm /APPLIED J IIVMGE . Inc 1663EMllytainStrM( noehMMr, NY 14«C' USA Ptwrw: 716/462-0300 Fax: 710/268-6869 e 1W3. ApplM mug*, me.. /U nghli RmwvM \ ▼K^ CIHM Microfiche Series (IMonographs) ICMH Collection de microfiches (monographles) Canadian Inatituta for Hiatorical Microraproductiona / Inatitut Canadian da microraproductiona hiatoriqiiaa TMhnieal and MbNofrapiiic Ham I NoM iMimiqun at biMwr^tiiqiiM The Imtituta Hm atttmptad to obtain ttia bast origifMl copy availabia for fibnint. Faatura* of thi* copy nvbicb may ba biMioirapMeally uniqua. wMcb may altar any of tha imaiat in tba raproducUon. or wMcb may lifnifieantly chanfa tba umal matbod of fitaninfl. ara cbacfcao balow. □ Colourad covart/ Couvartura da eoulaur □ Covari damagad/ Couvartura andommaiia □ Covart rastorad and/or iaminatad/ Couvartura rattaurAa at/ou paliiculte □ Covar titia minini/ La titra da couvartura manqua □ Colourad mapi/ Carte* gtegrapbiquat an ooulaur D D n D D Colourad ink (i.a. othar than Mua or Mack)/ Encra da couiaur (i.a. autra qua Maua ou noira) Colourad platas and/or illMtratiom/ Plancbat at/ou iliuttrations an couiaur Bound with othar matarial/ RaliA avac d'autrai doeunianis Tight binding may cauM thadowt or distortion along intarior margin/ La raliura tarrte paut cautar da I'ombra ou da la distortion la long da la marge intiriaura Blank leaves added during restoration may appeer within the text. Whenever possible, these have been omitted from filming/ II se pcut que certaines pages blanches ajouttes tors d'une restauration apparaissent dans la texte. mais, lorsque cela itait possible, ces peges n'ont pas Mk filmias. Additional comments:/ Commenttires supplimentaires: This item is filmed at tha reduction ratio checked below/ Ce document est film* eu ttux de rMuction indiqui ci-dessous. L'Institut a microfibn* la malllaur examplaira qu'il biiaMposiibladesaproairar. Las dMailt de eet axempiaira qui sont paut-tra untquas du point de vti WbHogripbiqMe. qui pauvant modifier una image reproduite. ou qui pauvant axigar una modification I la mMMda normala da f ibnaga sont Indiqufa Colourad pagM/ □ Pagn rastorad and/or laminated/ Pages rettaurles et/ou paNieuMM 0P»gas discohNirad. stained or foxed/ Pages dioolortes. tachat«es ou piquies □ PHm detached/ PagM dttachias HShowthrough/ Transparanca □ Quality of print varies/ Qualiti in«gale de I'impression □ Continuous pegination/ Pagination continue 0 Includes index(es)/ Comprend un (des) index Title on header taken from: / Le titra de I'en-ttte provient: I j Title page of issue/ J j Caption of issue/ Page de titre de la livraison Caption of issue/ Titra de depart da la livraison Masthead/ Genarique (piriodiques) de la livraison I j Masthead/ Sratwutton] TRANSLATED AND EDITED BY M. H. HAYES, F.R.C.V.S. WITH NOTES ON BACTERIOLOGY BY DR. G. NEWMAN, D.P.H. VOLUME I LONDON: HURST AND BLACKETT LTD. TORONTO: J. A. CARVETH AND CO. LTD. 1004 [All >catr*«d3 TRANSLATOR'S PREFACE. Friedbergbr and Frohner's /,i,^h^,i. j translation, is not only th^ hi^^t .t " '" ^^'^ori^^ in German, but its ;U^h ^^^IX^^^Z:^ Tt adopted as a text-book on that sublcT by thi ^ f ^ ^'" colleges. Owing to the fact that l^^t^^ ^T"^ can m many cases be communicated to man anrfT! u- " rence in our meat and milk produclTs a^n ''"'•"='="■ public hygiene; the first voIumeTth^s trans.T r'"'"" °' doctors as well as to veterinary surgeon TJ T '"'"'' ^° -re ^ticu.rly concern the ^JZ::^^^^'' -'"^ -» In the Addenda to Infective Diseases (pp .„ ,,.,, , ^ ventured to supply the omission, in the oLnfl r^^'- ^'' Surra, South African Horse S ckLl T * f ' • '"""'"' °" Ixodic A„«mia in JamaTcTJI"'? ^,"'^"" ™"- ^'^^^'• few remarks on T-^.rX^.rJ-T^"' ^^ *^^« *^. *^**"*"' **'^. «JP.H.. 5-). Which I feel certl^:; T^^^;; Z r^^'"^ ^^''^ ^«^- . "ot very f.,„„ia, ^jy, ^^ scien^^ „ t ^ '"'^''' ^^ "« 'Pg'cal portion of this book ' ""'^^^"'^"ding the hacterio- ' beg gratefully to thank Hr r ■ IJe; respective help .ith the se^'ronT "°''^^' ^'^'^ ^- Professor McFadyean for notesTn 01^- """ *"'* ^"P'"«-«; P«g. and Swine Fever; Mr A^nT^r" ''"'""^"'"^ ^^ the Veterinary Department of the ^ I ^'''' ^'""^^ '"^Pector. Z" '■" ~'"P"'"« «atistics of ^'f ° ^''="'t"re. for assisting Mr. Sidney Vi,,ar for his noteToT'^^T " ^'^^' «"'-'n; ^V'Jcox for his note on page ^ ' '"'^ '^' «"<^ ^r. ""dertakingthistriion. '^''""^"^ E"''«. Previous to ^ the metric weiehu «,»„ enw. 01, pag« ,i. „d ,(,. ««"«««/ "s^i m this oomtry. are /?«.««. '° '"e chapter on ^^^,,^, ,, ^^^^^^^ M. H. HAYE& Vew Tree House. Ck.ck. R.obv. 'IS/ May, 1904. PREFACE TO THE ,r„ EDITION. 'f "" d«:o™„e, .„d r«,„h,. Have been ™,e i„ ,he don»i„ j epizootic palhology. that i, h« i„ " enlarge the contents of this boot t„ « j increase in it, • • " '° '"°'^ '°° «'«« «" ncreas .n .ts sue, it was necessary to ™ake several omissions, as for .nstance. the introductory diagnostic chapters. These delet^ paragraphs will be found in our text-book on ,h. .k 7 research vv u ^ methods of clinical res^rch. We have tried to gain space for new additions by intro- ducng abbreviations and by altering the type The add V question had to be ended by the rstLbeX '" In our last edition we have mentioned the French and Russian r'r °' ''' ^^- ^'^ '^-' - authorised Zz -..on Of that edition has been brought out in WicaTa Munich and Berlin. J^ebruary, 1896. FRIEDBERGER. FROHNER. J CONTENTS OF VOLUME I. CHAPTER I. iNrECTiVK Diseases: Septicemia and Pyxmia-Malignant Uidema-Petechial Fev.r «. . inema of Horses-Vesicular Exanthema of Cattle— Anihr., v.u- Foot and Mouth Disease-Variola-Rinderpes. X«^oT^ CHAPTER II. Miscellaneous Infective Diseases .- Texas Fever-Carceag - Intermittent Fever- Scarlet Fever-ChoUr. laasot Iroteosi-Milk Sickness-African Horse Plague-African H„r« neath-Karassan-Akpaipak-Black Death . ^ ..a^':;;^,^"^ CHAPTER III. CHRONIC Constitutional Diseases: Anemia and Chlorosis-Pernicious Amemi.-General Dropsy-Leuoemia and ^^^Jo'eucxmia-Haemophilia-Scurvy-Gout-DiaSes mS -Djah^tes Ins.pidus-Obesity-S.rcoma7.is. Carcino'Tosir 2 *'«ges 423 to 454 CHAPTER IV. Addenda to Infective Diseases: ''T^T'tL''''^^'^''' ^'"~" Hon^-Sickness-Disc^ Con- Sha^til"'* -"'""'••'"= I^y-.phangitis- Notes on Epi««tic '""SM 4SS to 483 CHAPTER V. Notes on Bacteriology CHAPTER VI. The Terms Infection and Contagium . Pages 484 to 510 Pages 5 11. 10511 CHAPTER I. INFECTIVE DISEASES. EUVSIPELAS-CONTACOUS SSiL ON^A or T^T" "' ^'^'-SWIN. -CHO..„A AND PlaOU. OF B«^D« " .v.'V "^ ^*"*» '"•''" OFHOESK-D.PHTHK.mc^tS^*'*;"" P"^""^* CONTAGIOSA Exanthema of Ho«8«-v«,cm« Jt~^"''*"-'^"''="'-*» Antheax-Rabib-f«*t !^n t« ^"I!*"* °' Cattli- RiNDMPMT. *"" ^°"« DistASB- Variola - SEPTICEMIA AND PY.EMIA. Sep.ic«nU Md p,r«ni. in generl-SepticmU of fowl-Septioemi. of geese. taction of the spleen and doudv sw^llinir «* +1,^ r "^ J'*™* heart, and other internal o^^ ^fSL a^atol'^''', ^k^'^' quarter-Ul. etc. ; such diseases must dso iT^ unL^^' I » INFECTIVE DISEASES. fact^K^J-tif r^^^^^ r-^a by the mtemal organs of animalHu^S t^Tt Tm "^ ^'^^ there exists no essential difference i^twZ^thh ^*'°^?P^»J'y. frequently so intimately combinerf foJ^f .? *'^°' ^^^^^ are entiation between them^rnot Jwat'^^^S *^^^ ? '^^^J ^««'- wespealcofaseptico-py^mia. StS^gCfj^p,,^-;;:^-^. bact^r^Sfp^rr^^prSitt-^'^^'r^-- ^') chemical poisons (toxins) wWch ^tS^to '■ i" t J'^ ^'^^^ Septic mfection, but not seotir ,^.cl • P*"^ poisoning." other animals by intS TSerbL^r ^'^ ° vano^ transitions and combinationfitwL 5^1 ^5"" ^« I. Bacterial septicemia fseotic inftif i^ ^ ^'^^ '°"ns. kinds of bacteria (coed Lid bacilS^'S;^ " '^T^ ^'J' ^*ri°"« which is originated by <^ci ifdiffiV^ Consequently, septicemia baciUi. Str^tococcuJ Z^cL t d mtr ^^ *''"' P^'^""'^ ^y the chief septicemia-prolSn^c^el Tw""'"' ^Z*'"^^""^ "^ streptococcus pyogenes and ^sta^Jhy W r^' ^"'' "^"^^J'' can also give rise to septicemia T^^^ P/ogenes aureus, that the respective hJmTZ J^T^ST:^ experimentaUy septicaemia of rabbits are nathoa^n!^^ 1 °* ""^^ ^^ of the bacteria coli. and S^.Z^TZl^^^^''''^-'--'-^^^^ 2. Septic intoxication consists^rS. k "*' products of the metabolJroVrcteria1::?L°" '' r°"°"^ or^c bases, fatty acids, and aromatic'Scte *°?,^''T^"^' tion of these poisons usually takes nla.^^f ^^ absotj?. is on the surface of the So^l^i!^^°™*^~"«f<>cus which the intestines, lungs. Lidifver L?"IT"^"^ °^«*"' ^"<=h as before-mentioned^Cgen^^'^Jketeria N^^^^^ T^'^" '^ '"^^ specially the bacteria of putrefaction ..n^^f^^^''^^^ ^"g^- chemical poisons by the ipTifde^L -^'"^"^^^ ^^--^ ^t^o^^ tissues, after these f\mri h^f L^T^' '^^ °' ^^^ ^''"^J serous foci. The al^^t^rof^h^^'^'dT. *'l P'^^'^* ^ pves rise to general SoxicaJoJ TWs Jo-' * "«**'^"^'» ^enlceri are the Hiosfdanlif^rSS -^-"d Proteus .ICu.^ of ?y.«Uiu-The micro-organisms of pye„,ia are SEPTICAEMIA AND PYAEMIA. 3 on the whole the same as those of septicaemia, and may be either cocci or bacilli. The most frequent exciters of pyaemia are the pus cocci, especially sucptococcus pyogenes and staphy- lococcus pyogenes aureus, which give rise to metastases by emigrating from a primary suppurative focus into the blood vessels. They are then carried by the blood-stream to various internal organs, where, on becoming arrested in the capillaries, the- set up suppuration. Pyaemia most frequently occurs from purulent breaking down of thrombi of veins in wounds, mucous membranes (as in puerperal uterus), lungs, hoofs, and navel ; injuries of bones ; and absorption of pus in internal purulent foci, as for instance, the suppurating lymph glands in strangles and pharyngitis. Pyaemia may also occur after contagious equine pleuro-pneumonia. Anatomy.— The most important appearance on post mortem examination of a case of septicaemia, is the changes of the blood, which assumes the colour of lacquer, coagulates imperfectly and swarms with bacteria. We find cloudy swelling and degenera- tion of the muscular tissue of the heart, liver, kidneys, and muscles of the skeleton, which often look like boiled meat ; frequently, sweUing of the spleen and haemorrhages in the mucous membranes of the head, intestinal canal, and bladder ; hemorrhages in the lungs, liver, kidneys, and muscles, and under the endocardium, etc. Septic endocarditis and enteritis sometimes appear. We may also observe an accumulation of colonies of septic bacteria in the kidneys (nephritis bacteritica) and other organs. The cadaver decomposes very rapidly and in some cases forms great quantities of foetid gas. The walls of the capillaries are thickly studded with bacteria, and their lumen is often filled up with masses of fungi. The leucocytes frequently contain bacteria. When the course of the disease has been very acute, the anatomical changes are often so slight that they may be easily overlooked. In cases of pyaemia, besides the pus cocci in the blood, wd find abscesses and formation of pus in various organs (pyaemia metastatica), chiefly in the lungs, liver, kidneys, and muscles. Morot found, for instance, more than a hundred abscesses in the muscular system of a cow which was suffering from pyamia. We meet with supp oration of the serous membranes— such as the peritoneum, pleurae, meninges, and synovial membranes of the articulations— and of the eye, in the form, for instance, of purulent choroiditis and panophthahnia. We may observe * INFECTIVE DISEASES. In some cases fbTteSt ' e if ' *"** ^^^ i'nperceptible'^ stage is soon followST tl ' J % T^' ^^'^ P^eliminaiy dulness of the menS faculSs mu^f "^f"'"' ^^^* ^^''^t^^ paralysis of the hinSqS^ di?fr 7 *'''"°'^' occasionally and ecchymosesTth^muS' 2-H "^ ''*^'"' ^«^°l°ration albuminous condition o1 the XTnH^*"'1' discoloration and Continued diairhoea applal tow^S r"^^'*' ^°^ °* *PP«tit«- affections are absent ^^J? IZ!? *''" '"f " ^^ » "^e. local days and may con W fo^ ^me^Srt'it'"'' '^ "^"^ fataUy in a few hours. Recoverii^?S;e "'^ *'"^**'' iui^S p"S:tm^S!^ra S ^h" ^^°"^ °^^-^ <^^*^- symptoms. The py"m1^f ^wS ^f P""^"*^ ^^^^^ ««°«al iiregular fever. wWch roften^^'rS^TSfdt'' '^ * "^'^ cordmg to the localisation we finT^ f .' ^^ ^^ "«^°"- Ac the lungs, which usu^y ;„^ S^tr^*^**^ inflammation of scesses in the liver. Se°JS 5^*°" ""} *^" ^"^ ' *b- taneous deposits of iu^wS^h^fln?"' ^^ ."^^^P^^ subcu- sometimesSgreat Sl^« t tt fo™ S \T '"'"^^^ ^<* ings on different parts ofth^ b^v™ ?^ PWegmonous swell- polyarthritis; and sm,p,L W^^^ ^ '""*''' "»«'^gitis; cord, with paralysis TST^.^^'''^;^ °* '^^ spinal gives rise to a hemorrhagic dia«Skw?; i,^ °"f sometimes mtemal organs and muS memb^^^ hemorrhages in the than that of septicemia, and v^{^^' ^^ ^T^ '* ^'^'^S^ weeks according to th;^at^?eSl7S^*^^.to several mortality is nci so great as in^.,*! • ^^^ ^^'°'»- The pyaemia, recoveries S rL? ^dT^""^' ?*^°"«^' «^«« ^^ always long. The cou^ ^f tte .i?"*^- °^ "^^^^^^^^^^^^ « account of the <^plicarnst^;S m'a^^c^ ^Z^^^ Diagnosis.— A diamosis nf n«„ * a septicemia is often verTdSLu "°^-*^»*™atic. ordinary be relied on are high fet^^H ^°' ?" ^I^'^^ ^J^Pto^s tJ mgn fever and constitutional disturbance SEPTICEMIA AND PYAEMIA. 5 which may be present in other diseases, such as anthrax. In pyemia, we have also metastatic or emboUc suppuration in various parts of the body, with, usuaUy, a primary suppurating focus. Acute glanders is the disease for which it may be most readily mistaken. Therapeutios.— The treatment of septicaemia consists in the mtemal administration of antiseptics, the most appropriate bemg camphor, quinine, and calomel in repeated small doses. Camphor may be used extemaUy in the form of linimentum camphora, or spiritus camphorae; and its stimulant action is valuable m combatting the excessive weakness. The various modem antipyretics may also be tried. The antiseptic treat- ment of the wound plays the principal part in traumatic septi- caemia. In pyaemia, which is aUnost always incurable, the same remedies are used as in septicaemia. The treatment is essentially surgical. .■•P**"""*»*» •* Fowl.— Legrain and Jacquot have described a form of pyaemia which is pecuUar to fowl, and which frequently occurs inLorraine. where it causes great loss. It is characterised by extensive accesses on the head and neck, and especiaUy about the eyes. If these abscesses are left alone, they may produce a chronic septicamia. which leads to severe and progressive emaciation that ends in death • but if treated surgicaUy. they rapidly heal. The disease can be trailsmitted to pigeons (which die in from 15 to 30 hours) and mice, and is caused by short, stout baciUi which have rounded and shining ends. These ^""^'^ I to 3 M long, and cannot be stained by Gram's r^;.K^*"„ *"'''• '^^^fl to Le««in and Jacquot. resemble those of the baciUus septicus agrigenus of Nicolaier. the baciUus saprogenus of Roaenbach and the baciUus pyogenes foetidus of Passet. which these authors consider to be identical with each other. The poultry infect themselves on the dunghills in which they seek their ftxxl. ■•pttearaila of Ooom.— Sakharoff describes a typhus-like summer epidemic of Russian geese, which manifests itself by high fever, diarrhoea and emaciation, and runs a fatal course in about a week. He found in the blood of Uvmg animals, spirochasta anserina. which resemble the spinlla of relapsing fever, and which he successfuUy transmitted to geese MALIGNANT OEDEMA. W Btlolofy.— Koch's malignant oedema, which Pasteur termed gangrenous septicaemia." is of special clinical importance. It is caused by small spore-forming bacilli (the bacilli of oedema. INFECTIVE DISEASES. fcteSr:."d,£;;ru.°j;^^^^ - Ubiquitous A rabbit wiJI die in fr"m ^4^,6 hr'^'t"' *^^ ^°""d- adema if a smaU quantity It nr^- "" fr°" malignant under its skin. Th'e Son tt^X^''"^" '^ p'^^^ contammation of wounds of tl^e sSThv *k" ^^sequence of etc ; but only when the bacuTus o? »i *''' '*'=^' ^^^^-^ust. cutaneous connective tissue The It^tt^'*" '"*° ^''^ «"b. of such infective material Is comn^il?^'?'*'"'' '"*° *^« "ood rently because the oxygen of t J? m!5:1^„'""°<="°"s ; appa- Inoculation from the cutfs is ^L ^°°^ ^"' ^^^^^ an«ro£s. of granuiation hinders th en r^iS 7^Tt -^^^ P^^^^ei Before the baciJJi of oedema r^^ ? ^**=*"* '"*<> bounds, cutaneous connr. c. ZTm^ ^T^'' ^*° '*' ^^e sub- pared for their rec... Jon "for?n\.' *°u* *=*^*^'> ^^t^nt. pre- nutrient fluids as i™^ wi ^.'l?^ *^^ P^«««nce of such infection must X,^S'fre?£ ' ^-l^ood. The site of ?he ^ oxygen. Si^u^nt?/ Se^^'^''^^™ ^^^^^ ^^ich con! rupted on the site 5\he infection "^^ «;e cu-culation is inter- .":s-"u:;ity.^-- ^^^^^^^^^:;z^ Of ^^'^X^.^:^T^:ZT:^ '^^ -^ ^^^Pe those -^^S^Z^^^kP^ ^AftTrt;S partly stiff, partly sUghL^TlnfT'^?''^''''^' ^^ ^orm divisions can be reco^Z^lC^lZ'''^''' ^'""^^ °" ^W<=h of bacUli attached to one a^oThlrS,^*' ^ reappearance from these threads. After 24 hou,^!t I!' %' 'P"*"^ ^^^^^op found in great numbers in t^e bS . ''"'.f °* «*^«™* ^ portal vein) of animals which havrSeHT"'*"^.^ *** °^ ^^e cadaver has been kept at a temL^^ T ^"^^^^tion. if the reason they may be fou^d a T™!!"'-.t 3«° C. For that hours in the blood of thTw L^u *'*^" ^""" « to 24 entire blood of the bcSy .n Jhe Id """"t ^''^""Shout the animals which have die^d of dLnl '",°' ^"^' <*°™e«tic re am their internal temwrat^rf' '° "' ^**^-' *"d ^hich l>elieves in the possibihW Jn^ t' * ^°°^ «'"«• Lustig the intestines b^Se S of^ ^'°'°'"« '°*«^t«d through hoi^ to support this theor; °^^''"'' ^"^ ^'"""^ cases in -y riX*:^^:;J--«^^^^^^^ malignant edema animals. mcludingguinea-pigsff'wnJSg^^nf °" '"""^'^ MALIGNANT (EDEMA. y rJ!*^^!^!^'T^^ '^'"" *»* malignant oedema are spore-forming rods anaerobic and generaUy very motUe. They Uquefy Ratine, can be stained with Gram's solution, are from 3 to j m long, Ld i Tto^ and are consequently about four time, ai long as hey are bSd SZih"t«TS.^ '"™ psuedo-thread, of froi .0 to 40 m iS SS.' Although the baciUi are at once destroyed by oxygen, the spores r»ist .rl^' disinfectants. During growth, the bac^ ^caise the^i^uS of carbonic acid, hydrogen, sulphuretted hydrogen, and c^rburett^ SsuTtheT^'5-^""' "" *•••' '"'»* "* emph;:seml 'in the^SS ^Zk^ K """■*** °"'y *" P^*^« ^°» ^l^^l* W«x» and air are excluded as much as possible, and assume in it the form of spore-bearing or homogeneous rods On the serous membranes the baSui become ^^i^»K^?* ■ ^^ afte"»ards undergo division. Only towards the th.v LI !k T*' ^'.*"*"" ^"^^^^ ^° ^^''y penetrate into the blood, where they are then found in the form of short rods, or as simple micrococci. \^^^^ents. PETECHIAL FEVER. (^- m... M.r^, ^_, ^.,^^_, ^^^ ^ ^ *>™>«rty l™mjrL'??DS?!I?^v^^— ™' disease ™ i»; PETECHIAL FEVER. g rs"£"X *^- T^' " * "*'" '>^P*°™' '^ diseases, such as straigles which have no connection with petechial itvtr. scar atina"^ ^v nr*"""^ *T' *" ""^^^^ ^y some a, scarlatina by others, as morbus maoilosus of man fDuroura hemorrhagica,. The name of morbus maculos^^^STr monly apphed to it in Germany, as for instance by Eberhi^. In France and Italy it was looked upon by some authorities bi^to l;.,?^ was traced, not to decomposition of the blood, ImJ ^f *"** temporary paralysis of the capillaries and f^Vth^T.*"^ ''°°^- ^^°^ ""^ others^tated that of ^11 LnH f P*''^*""* f »°thrax. Owing to the teaching tVmf ^n ?^ *^^"' P^*"""^ *"^«' ^^ «"PP<^d for a long S2 eln^r"L? "^ .^.^*^»<=°'d diseSTwhich theor^ was erroneous ; because it is neither infectious nor can it be S^t ^^ Tt*^°° *° '^""^ °^ to other animal B«^es the bacilh of anthrax have never been found inTe btood of hors« suffering from it ; and some of its symptom^ Sed toT*"^'". ^*^ *^^ supposition of anthrax. ^S^ faded to transmit it, even by transfusions of blood. ^ Dieckerhoff considered that petechial fever was simUar to "a^e" Zr^r'" "^^"^"^ °' "»">■ *"^ P™P<-d that tie ^^t.^^ J^'^T^'i *"*=^ *^ *^«*dy in use. should be retamed. We prefer the designation of petechial fever ^ leave undecided the question of its relation to mS 5^°^;r/f T'''»^°T''' ^^^'^ Dieckerhoff that the nam« ^Li if ^F^"" ^^'^ "petechial typhus" should not be Etiology and P»thogonod«.-Petechial fever is an acute mfective disease, the cause of which is uSw^ «,>J^ J**^tensed by numerous hamorrhages in the s^ ^Sri^Ss^'^T r°*"^^' ^"^'"'^^^osa. a^intemd orS; ™c^T* "»fl»™°^»tory oedematous swellings of the^ mucous membranes, subcutis. and submucoTAlthough The disease may appear primarily; it is usually a sequda to Feyious infective diseases, such as strangks. pt^tfa contagious equine pleuro-pneumonia. an^Muen^TC' ^Sh ot th"f r'^T^'^^ ^ter these diseases ChxSS 2,^ J ^u' ''^°'^'' inflammation of the maxiUary smuses. necrosis of bone, intestinal catarrh with suppuraS lo INFECTIVE DISEASES. know whether the ^ ^^ Jk?"^. *° ^^^^ »kin. We df^t' <^nce of several casTinleafdlfj"^*^ ''°'^. the . We are as ignorant of th- ^ ^® **™« «taWe. ^nature, and^^ nothing affi t°h *'^ ^°°*^"-' - of en en. he body. As hors^^S"* J,^*' ^'^ ^ ^^ich it J^ of latrines, are especially £1 To "^ '" *^* ^^«^ng d«ease; we may surmSThat fS • x ^ attacked by this the respired air. "^ "^ ^''^^ *he mfection is conveyed in to --TciS;:tp:;l^^-^^ ^ever of hor^ appears nterus. mastitis, etc. W^tfve JT", ° inflammation ofthe h«moahagic affections of the 1?'"^.*^^ """'^^d in do^ jweudo-threarf. VT^' ^'^^cned to one another a^A . ""™*<' ends, m nasal cavity, larynx, trachek h^^w ^^ .'"^mucosa of the oral cavity, stomach, i^tSe 'S '°°^f ^"^*' Pharynx! ^schokke assumes as the ca^^f?! *^u ^^*^ ^n'' skeletw endarteritis with the fo^aln of^.^'T"^^*^' » n,ycot?c jnfarcts. These change^T ' ° °^ ""^^ "^^ subsequent be clue to fatty de^aS, " ^^S^ ^^ Phospho^l^y walls m consequence of ininr,, bnttieness of the arteri^ «nallest h^moSia^i are foun^ T^^ ^^ the virus. The where they somet^S v:;Tsi^: ^1°'^^°"' ^«-hrie The largest are in the S^" where7h.\°^'* "^ *° * ^«°til "^, wnere they may attain the size PETECHIAL FEVER. ,, Of a man's fist. As a consequence of the hamorrhage, we find mflanunatory sero-gelatinous swellings in the subcuUs. submutMa, and inter-muscular tissue, which may lead even to sloughing of the affected parts, especially of the skin of the flexOT surfaces of the joints, intestinal mucous membrane, and 1^ frequenUy of the mucous membrane of the nose and pharynx Htemorrhagei into the cavities of the body and even death may occur from laceration of hasmorrhagically infiltrated parts or a parenchymatous inflammation may become developed' as for instance, in the lungs. Owing to gangrene of the inflamed tissues ; pyamia, septicaimia. or perforative intestinal peri- ch^^'M"- "* '"' "^^ '°<^vidual organs show the foUowing I. The skin, especiaUy on the most depending parts ot the body, as on the legs, muzzle, brisket and abdomen, becomes locaUy or diffusely swoUen, and infiltrated with hemorrhages, which vaiy m sue from a pea up to half-a-crown, and wWch give thj skin a spotted appearance after it has been removed from the body, post mortem. The skin over the swollen parts frequently shows lacerations and sores which may penetrate mto the muscles. The subcutaneous ceUular tissue appears on section to be infiltrated with serous fluid and blood, and is also considerably swollen. 2. The mucom membrane of the nasal cavity is covered with irregularly shaped blood spots which vary m size from 5„w T*K° ^ ^"? "''*' *"•* ^*^^^ frequently become con- fluent and thus form large sanguineous blotches. We sometimes find the entire nasal mucous membrane infiltrated to such an extent with blood, that the lumen of the nasal cavities is con- siderably narrowed. The infiltration is usually greatest in the mucous membrane of the turbinate bones. The nasal mucous membrane may show ulcers which may penetrate so deeply, as to produce holes m the septum nasi. Similar infilfrations and h«morrh^es are found in the mucous membrane of the nasal cavity and larynx, with consequent oedema of the glottis The epglottis and the guttural pouches are the seat of a sanguineous infiltration, and ulcers appear in the pharynx as well as in the larynx The retro-pharyngeal lymph glands frequently become swoUen and suppurate. Petechia are not very numeroiu in the oral cavity, m which they are chiefly found on the gums tongue, and inner surface of the swoUen lips, and may run into ulcers. The conjunctiva and the vaginal mucous membrane sometimes become swoUen and covered with petechia The IS INFECTIVE DISEASES. mucous membrane of the stnm.oi. i. hf«es occur under, m ^U IT^Ju'^^^ "^ "Po**- Kemorr. the «rc»a and in tie "^ W« "iv"; r"*"»°«' ""^^ •o finely divided, that T^uStU^'' *'**^*^««"«^'y gwyuA-blue colour. In the^STn,^"*' .°° '*^*^°°' »«" a of exudate which vary ^ ^ ^ ^ *^*^ *« find masses W. and which haTb2„Xt"^off '^S *° *"' ^ "'^ submucosa. and subserosa 7!^ ^^^ °*'**=*>^ ^e^brane, « infiltnited with^e iS^oSf "S* "' ""^ «*«»*^e braneismoreorles8swoUen«??.?r* ^* ""»«"» mem- which vary in size C a q^i' ^T^^J! *'* "*** °* "'<=«". diameter. These ulcere, wff £ ° *",?"? *° *»«' «ches in tunes granulate and foni ^ ^Z\X "^^'^^^ ^^' »ome. the walls of the intesSe^d tl ^ *"?***• ^^y I^orate tents of the intestine aJe ^me^ "^ .P«?*°ni«»- The con- changes a« best marS toth^^r'*'/?^ "«^- ^^^^ they are also found in the c«^™ , •»*«*^e.- although oTs^. Which parts the^h.^^'-^ V^en^^^^^^^^ ti^i^bd^^^^^^^ th<«e Of the pelvis, fc^uently show great nS, of ^ar^K*"^ °*"^^*«' «*<=- coloured localised hasmorrSriTinfiL ^^'^"^ or copper- and si«». The muscul^ g^ o^^^T **' ^°'" ^^ ondergo fatty degenera^n^Th»^*t ^°"* granulated and pale and of i ^ZT' nlt^^'jfS*? '"'«^<' J^mes PVB a marbled appearance to th^^"*** hamorrhages may comiective tissue S^oenSv'rr^**; ^« ^t^uscS cally infiltrated. Portias S mnf^f^-"*"^ ^'^ '^"'haX gj^fenous and are ^.t^ff T^^^JT' ^"*''*^« '^- becomes similarly affectJd it «» "''^^ *^"« «* the heart epicardial. subendoca^Sf 'J* ^^^ contain °'^«ou» sub- may assume a similar davTJ! ^ *^ haemorrhages; and alsobeh^orrhages"unt';^eSe^"^°'"- ^ -^ Par^cS^JZ b^t?*:f^rma?^' '"''P^^-'' ^^ wahiut to a man's fist and bv «, P^^^ ^^ m size from a a diffuse hamotrhage of "^t ]LZ ^ 'T^^' "^V P^'duc^ ^oupv. or mult,S ^pp^S' J ^ ^'^'^^ «tensiv1 "r^^^ri"u^"^'-^i h^^- ,-Tu^^ r «= ui wmcn may cause death. PETECHIAL FEVER. 13 by the entrance of blood into the abdominal cavity There 18 no distinctive swelling of the spleen. The cavities of the body often contain moderate quantities of bloody transudate ; and the abdominal cavity occasionally contains a large amount of flmd blood. 6. The blood shows no essential changes, as long as the disease progresses without compUcations. No bacteria have as yet been found during Ufe ; although the badUi of malignant oedema can be demonstrated in it soon after death, as weU as m horses which have died from suffocation. 7. Besides the above-mentioned phenomena, we find seconcbry changes resembling those of septicamia or pyamia and of suffocation ; and at times, the residual changes of the primary affection (strangles for instance) which preceded the petechial fever. Bymptoma.— The first symptom is usually the appear- ance of numerous dark red peUcMa. ».«., blood foci, on the more or less congested nasal mucous membrane. They are sometimes as smaU as a flea-bite ; but are generally from one quarter to three quarters of an inch in diameter, and frequently run together so as to form large blotches or streaks. Owing to their presence, the nasal mucous membrane assumes a peculiar dotted or speckled appearance, and may become purple through- out its entire extent, if the petechia be very numerous. It is at the same time more or less swollen, and exudes serous fluid In very severe cases the mucous membrane becomes gangrenous and covered with ulcers; the nasal discharge is frequenUy samous and discoloured ; and the expired air has a foetid odour In such cases, respiration becomes difficult, and the disease may take a rapidly fatal course with severe aggravation of the general symptoms. The eruption of the petechia may contmue during the entire course of the disease. Simultaneously with, or a few days after, the appearance of petechia on the nasal mucous membrane, we find cutaneous swdUngs which are often the first symptom observed, on account of ibea being more readily seen than the blood spots. These swelhngs take the form of wheals, and are from three quarters to one and a half inches in diameter. They may be distributed over the whole body, but are generally found on the most dependent parts, such as the limbs, lower portion of the face abdomen, sheath, and lower surface of the chest. These swellings at first vary in sue from an apple to a man's fist, and resemble INFECTIVE DISEASES. chest and abdomen TnhlTu, *''" '°^' »"rt»« «< the like that of a hip^o^tliiu, Te^.r' '''* '**^ ^<»"e« painful to the toucrSSd^hen t^ev T""^ "*^ ''»'<^ «nd a« sometimes a, ha^d ^ a SaJj'^^f"r °" ^^e head they faUs out. The nose-band of ^t Iw f, *" °" *''*"' °"«n indentation in the swelSn^ on th. fr*^'l!»% makes an simultaneous appearance of swellil' T' ^1*^ '^^^ »"d body .s characteristic of this S VJrl^' "^ *'''' severe, lacerations of the affer^^" . ° *''« »weU>ng i» of the articulations are veAf ull ''''" °' ^''^ ^^o^ surffce, grene may sm^rvene with *^'^'^- Cutaneous uan- of skin, aid Li^ZnirT^'^T '''°"«^"« °' pS« The smooth, dense s^^" oTaJ eTudt'''. °' 1"'^°'''°* '^'^"'^ serum, after which it b«^« «i "^^ * '«^ ^rops of sanious and exfoliates off in paW^Te^e T.T''''^'' *° *'»« *°"<=1'. palm of a man's hand • leavU ! ^f" "P *° t''** of the the underlying muscle ' irt L„T ''''''' ""^ «*«d to cutaneous necrosis, the skinTal ^"It "eS! "'?'1' ^"^<=' from conti ued lying down and fSI *f '^^"'^y to form sores especially on the nL (wheJe thi °^"" ^^^ °* ?'«»'«. place." edges of the lo^^^Vt.^r'^t^'"'^)' " ^^ arches. The rapid disappeaS^ce^°^A,f ''°'^,* « creased metabolism leads to^ a^' ^ ^'"f <=^ the in- matenal that may be present *'^'P*'°n of any nutrient ^'^^TZ.'^tj::''^^^,^^' -•^-^'hen the lower part S^ t?e heT ^°" ^'^^ '^' ^' <^^P^ opening of the ny * temperature of from^' toTx" C The petechias are in no way comiected with the fever which IS usuallv moH(>rafo o,.^ » Z rever. ^n" r u- u \. ™°^®f*te. and averages from 30.5° to 40 C. Higher degrees of temperature Ire observed chieflv when compUcations occur. The"^ frequency of tJI p,^ ^ not increased at the commencement of the attack; SdTugS 16 INFECTIVE DISEASES. rule, from i^to Ih^ '^^ J*' f**« > then, as k appearance of^comSr Tven 'in "* ^^T^ *»° *h« incr^ised frequency Jf thri is out of -11 "*^' *he than the rise of temperature A a i,t "fP^^Po^io" greater are not greaUy dead^ed? althtgh^ater '"'^^fi ^^*^« assumes a fatal course stuoor 3' °°' '* "** <"«»«» -^J^e animal i^equen^r^^erfr^ ^ ^^^^^^ ^T. try wLrsi t tcsrini's^-'r •T-- i^iorr°^™r;:stei=""^^^^^ "-- larynx, which .^'ca^X^^rf«^"'/° '**°°^'^ °^ th« of oedema of the gLfe xS^un/f r^ ^^^^^ ^ consequence because its sympto^' S nT ^T'l^^^^'"' T''"^^'^' haemorrhage of the lunes mlvl^ / ^^^- Sometimes expectoration being Sd^U^l^*^ ^^ *^« ^*<=t °* the of the lungs, by theT^ea^d a^^J ^ T^P^ inflammation bronchial ' rea^g ; g°^ene of 1 f "^ T^^^ ^"i smell of the expired air ^ ® '"^' ^y tiie foetid «dema of theT^.T^ tte SV'°*^ disturbances; and bined with cracW^VSL whiS ^"^'IJl'^y^P"** '^'^' ^ The-^^arelo^eS^SteTaSS^r**^^*"^"^***'""- becomes infiltrated witi, ^S^^ a^J'r"^'^'*^^* °"«° so swoUen ti^t it prolanS^ tS i' f "f^ ^''^^ become sanious or orange red R^' ^%^^hO'»aI fluid may be have been abl^: '^^ in ^S^ S^.'P^*^^*^ope! w: and retina, hemorrhages wWchhSTal^i„*^? '^'' T' "^°^°'<» of external influenc2^Ran h« J ".P^*'* wdependentiy eyes from exces^^'^t^3j:^. tT^t ^f.^'^^^" °* «»« the optic nerve from the SmeTa^se ^^^'^' '^t-ophy of and'Sl^T'l^s^r^^'eS^^ ^T^ ^^^P'-i hagic and inflammatory foci SS' ^i ^*'°" °* ^^^ ^""O"' without any gravTco^^rir*,- P^f* """^n ^tbin a week. of the maTatSL Zt^Z' ,"f °"«'* ^ *^« "^^Jority and swellingsT^^he st^^1^,*^l'^°''ha«ic^^^ which.i::^vemenf gi'dL^;^*Lts°S ' U 't '*^' ^*- haemorrhagic infiltration oflhe skb ^^ *l' °'^'''^*^' "»« branes is extensive, especiiv if th^™ ^ ""~"* °»«n- . especially if the mucous membrane of the PETECHIAL FEVER. ,7 p^rynx and intestines becomes involved, absorption of the mflammatory transudates will not usuaUy take place earlier • i^ ?*!?;! ^*°«.'^*^^'"^^*° ^*«^- Cases have occurred m which the swelhngs of the skin and mucous membranes disappeared quite unexpectedly and without treatment. These cases of sudden improvement have been observed even in ^f TS" ^K^""^ ^? ^"^^^ "P ^y ^^^ veterinary surgeon who treated them. Zschokke found, among 17 c4s, that tiie disease lasted, on an average. 16 days. The shortest duration, which occurred in a fatal case, was 40 hours • the longest, 43 days. Death may ensue in a few days, in' con- sequence of mtemal h«morrhages, rapid sepsis, suffocation paralyse of the small intestine, or whea the attack ha^ been the result of a grave primary disease. Gangrenous pneumoma (caused by foreign bodies) is particularly fatal If death takes place after the petechial fever has lasted for a considerable time, its cause will generaUy be secondary septicaemia or pyaemia, the symptoms of which wiU be • debihty, high mtemal temperature, depression and diarrhoea' Ulcerafang skin lesions require, as a rule, several months to heal. They may also cause cicatrical contractions, especially when they occur on the flexor surface of joints, prcSucin/ for mstance. excessive uprightness of the pasterns. In such cases It IS almost always better to kill, than to put the animal Zto^rJ^' """ ""' ^'^^^^^^ '^ ^'^^^ « very Diffarantial Dtefnoate—The respective course may run smiultaneously with petechia on the nasal mucous membrane and with curcumscribed swellings of the skin (wheals) In horses, these diseases are chiefly strangles, anthrax, septicemia contagious pleuro-pneumonia. pyemia, acute glanders, and erysipelas ; and m cattle, quarter-ill, " deer and cattle disease " septicaemia puerperalis, other forms of septicemia, malignant oedema, and poisoning by phosphorus and mercury. (>,nse. quently. it is not always easy to differentiate these diseases from petechial fever. especiaUy at the commencement of an attack. The presence of diffuse swellings of the skin with extensive eruption of petechia, and the absence of the specific baaUi of anthrax, quarter-ill. malignant oedema, etc., will make the diagnosis positive in most cases. The same remark holds good m the differentiation of petechial fever from urticaria and simple cutaneous ceUulitis. IS INFECTIVE DISEASES. «d^**^^\*^«^ « liable to many complications should be given with S'Sjtiir i"^*""' ""^ P«^^ 50 per cent. In 17 ^ ^ \ P"^ mortality averaires occurred (70 per L^T ^1*71^^ ^^^"""'^ « S symptoms: extensive fonnation of i?^ "^ unfavourable swellings ; tendency to S° f thl J"* ^^ inflammatory branes ; grave impUcationT^ tjl "^J^ *°^ '^'"cous mem" pharynx, larynx, and intestinl. * *'°"' "^^^'orane of the by swellinSThi^h SS tem^^rT °' ^^I °^ *=--i««s exceeding 80 per*" minutT?*" *!^f f^t^re j fr«J"««t Pulse. disappearance of the swellingsTthi "i^" *?^*^*'' '^P'*^ the expired air; inflammatK the 1 ,n °' ^«*^** «>»«" of mchnation to decubitus; pro^"Sirr'^'^'*^^'^"«^ ' depression. We may take a fo„ ^J'an-hoea ; and great in which the bodUy Snditio^ "^^^ "^"^ «' those SSs oftheh«morrh^Ld°wt£ssJhf r**^"*.' *^^ -^' the mtemal temperature notmSh oS?' *^ *PP*t^te «°°d, and already stated. SveiTs^pto^'^i^^^-o^al. As we have unexpected amelioration Md^„v^^ sometmies followed by not be too hasty in ord^^ S^T' ^^ '^^^^ therefore appear to be very^aveJy^^tS '^^*'' °* ^^'^ ^^^ch sho2?r ?p":S7rtm? wl''^?^^"«i °- fl«t care can freely move about ; ^d wiTo,SS%'° ^"^, the animal and surcingle. When dffiXln sttn. °'°''^ *^* ^^'^■'tall •f possible, give green focS^ or fS°S ''*' T' ^^ '^°"'^- the many medical agents wWch T^ ?!**' '"*^«- Among this disease, we may mentio^^ J ', ^° "^ to combat of lead, tamiic acirioTof ^. f T*^' ^*=y"c acid, sugar tions of iron, campho'^uto kSSf r>ij^'^*'^' P'-P^ potassium, creolin. ly^l. iSorSr^fT^^^**^'*' '"^^^ »* acid, and hydrochloric acid Vol "^^tine. sulphuric grammes in the drinking wateH or K^''^ ^""^ acid (20 as an electuary). AlTK medSn^^^^ ^"^ ^^o gramiies effect ; but in the largeTJoritv . P"?"'* *t times a good influence the disease ^ ^ °' "^ they fail to favourably P^ac^V^^'^lg'a^S^^ in the first drawing it upl^d layi^ it ovef V. ""f^^ "^^ "'«•' nose. Or we may follow To^XL °"'^*"* ^^ of the tubes into the nLrik iH^A 1^ f'* introduce metal ° niost cases, however, when this ' PETECHIAL FEVER. ,^ djjpnaa is compUcated with laryngeal stenosis, tracheotomy wiU be our only avaUable resource. We do not LrS «Sh S ^uIa f t^^^""^ ^"°^^ ^'^"t'on (alum. I partTacetate We use almmmum acetate as an external antiseptiToSv^hen the sweUmgs show breaches of continuity. Kother ^^s ^empby only munctions of pure oil or paraffin oiLtSerto L^n t ^Sly '^^Zt'^^Zr^. SS-m SZ Tl '^^""*^^' ^"* ^*^«^ the contrSy. from iSS ra4X^-"cL° ro^ uSl^S has strongly recommendediouuSchS tfi^^ I«ll«»»-Dieckerhoff 30 grammes of Lugol'ssolutiMT^^^ >n^ections one* daUy of 10 to and distUled wat« ^ to ^'t^ P?^' Potassium iodide. 5 parts . • UteratureofthelastfewyeaT^/^tffJi^cfT*""" "^"^ " "*« are very contradictory • infact Jw?- '^''* mjections of iodine •peak of them as aStX SL>m aT! ''"^'' '^''^ '^'^^' •»*»»«» who treated more than a d^ef ^^« ^^ even as mjurious. Zschoklte, of iodine. considersTt thtr resSTwir T'"*'*'^''*'**' '•'j«=''°'» he tad obtained with the ^I^^ u°' so good as those which Johne states tSt^the %TSf "SIT ^^ ^ ^°"^^y •«»P»oyed. of inline in Dresden L^- oul V? .."""'" u'"*'*^ ^"^ ^i«««o'« iodine and calomel at Se Tmelime *?J'^'* ^^^ *'«*'«* ^"» was treated exclusivdy wTth cSLrr;. !^ ' .""^ ' •**»"• ^^^^ tions of iodine were foUo3^b™^/^''T^- ^^ **° «««• Nec- lungs. We ourselves havI^bseL^nr'''''*^ ^'^ «*°«"'^« °* '»»« and bronchitis as a resuh of tt^-^ ?^'"""" ""^ «^«1*' tracheitis that horse, di,^ of J ^n^S^of Tl^T.^ """'^ ^^ ^-^'^ '«!»'» iodine. As about 50 perS^S L)l "'^^■'"''''tioned solution of without any medicinal 'rwTment I^H °* P*"*="*' *«^" "~ver this disease sometimes .S^v^J^if ^^PP*'"""^ •»»?*»•»• "»« of with favour the iodine mS t'^tmeat ; we cannot view Ty»h«. of M«.-Three forms of typhus are distinguished in man. 2* so INFECTIVE DISEASES. oamely, abdominal tvDhn. «, i plicatioiis. such aa inte™.! if **^°'n«». We find verv vL 'P***" nephritis, affection of S^lT""!!!' »*-««i^mmoL^; ZT""' now-a-days is only about ,i!i' *'°'^''"' P»«lys« «c 1?.. '""«'• --^-^ even on ^he^e^ ,;^««; ^U experiments '^de^^Hl^'y given negative resultT n ^ °' P«°P'e suffering fmm . I. ^*""« inammab. ?« ««• »•"«« "lapsing fever^l'^^'^'^ ♦« ♦?****"** *•»» in Oattl. TK especiau7on'Thr^tr^=^,"^'«'»i^e '^'no'^ST^elSn^^ ^f'***'- paralvs« ■ k; u ! "*'emities, dewlap anrf h^ •'^elhngs m the sldn suJS^n^ temperature („p to 4> r , T**"'""" ' '»°>ene^- Sn^" ° namination. I'n^^ f,t\^- !«» of appetite; Jd -rgs^"? r ?i2.S! ^^p-ag^ nj^^c^of-^-o^-r*' -d "Si^'r ^^P-Vre^Sd ro';::£^- ^^-s^s^ poi3onS:'•^^rt^ 'p^s^t -^"-Xtt^^iJ"T■S;"'^- J^' ''^*^- iae course STRANGLES. ,j S JStfelS: r^K."- "•' -''*-•• »« •- -- "P*** "d unfavourab,. The multiple haemorrhages of the muscular svatem «i.s,.h -«. m pigs, are not petechial fever; but, ^rKo^tl^!? T "T"" of the fibres of the muscles caused d^i^the frlL^rt^Oh '**'T Ellinger assumes, in addition to this, TLa^S^^^^r,^ the ammals. M a predisposing cause. "quired hasmorrhagic diathesis STRANGLES. Strangles in horses-Pjeudo-stmngles of dogs. JSJ?"'^-":^*'"'^'*' '' *° **="*« 'n^ective equine disease which consiste e^sentiaUy of an infectious catarrh of the muco^ s>chutz. Jensen, and Sand, the infective agent is a streDi tooKcus. which can be easily found in cover^lai preparaSS^ ofthe pus of the lymph glands, after having 1^ stSS amhne dy«, such as gentian violet. It can Lo be stained S Grams solution. Rabe states that the mother-ce^ ofT ;ST".k°* ''^^^'' "^ °^°'d '>^' ^Wch, when con! nected together, sometimes assume a square form, and po^ polymorphous properties. These baciUi may take t^TfST^ glanders ; or they may be oval or even circular, and may somc- bottom of the vessel, and on solid mutton serum, glassy trans! parent drops, which later on become confluent. inTw^h^ ctoudy masses are seen in each diop in the semm^t tul^ They have a pathogenic effect on white mice, and prodiTe S^v'meL^'M? 1 *^--'^-«-. and ilie^taSc pr" c^ by means of the lymphatics and blood vessels. VWien pure cultivations of the streptococci of strangles ^oculatld m horses. «iey produce abscesses in the sit7?f thrSiSton^ and strangles, when they are introduced into the na^^^5f^ ' „. ^<*«<«n«ai».— Strangles is contagious, and, perhaps also s™:Xt^^h^°"- '*='"** ''^'^ that'tfe cSd^ strangles form arthro-spores. namely, permanent cells which p^bab ly exist, and which may alfo /ow under ^«^'favoS able circumstances, outside the animal body. Succ^ftir^. » INFECTIVE DISEASES. Sr?'''«°-'^^^tS^t'S?*' '-" •- "»* strangles is peculiar to hnr^ VPeaiB sporadiS^^JoSS ??' "^^^^ ^^ hybrids. It fr^ucntly attacks 'hor^*S^£,-'^eP->oticalIy/and Jt "Wer horses, even up to 2k Z^H . ° ^ years of a«fe by Jensen. Sand, and othL\r^ °^ *««• «» was sho^ dunng the first few wee^^' "l?, ^ ^^^^r ; and also foS ^« observations of l^T^tt^'Z ''^' ^ccordiii to F«d«Uc strangles may STSnsSt^ .^S*'' ^^^^^o^^. ^d "»e streptococci pass from th^^u " **'^''- In such cases or^ of which'^XntnCl!; "^ '"*^' "»«^S ^ tte 7»7 i^^' AccordiT^^^ !fsdy explained by thTZL^ ^^u*"**' ^"*=h ^^ct^ £ ^°f /««<* confe/i^^^*'^o'^ha,ju:ter of the ' the m^S,^ weather in spring and?u^~"^°'>«.. «P«=i^y chan^^ duectly from the mucous mem k«^ ^ *^«» «to the ^ STRANGLES. »3 enters by preference into the lymph glands, in which it excites extensive suppuration. As was shown by Schutz, the coed of strangles can also pass through the walls of the capillaries with- out the help of the blood or of the lymph, and can penetrate between the tissue cells of the affected organs. It is probable that the contagium may enter the body also from the intestinal mucous membrane. This supposition is strengthened by the fact of the occurrence of abscesses in the mesenteric glands, with a normal condition of the nasal mucous membrane and the simultaneous absence of abscesses in the submaxiUary gland • by the existence of abscesses in the submucosa of the intestinal mucous membrane ; and by changes in Peyer's patches and the sohtary glands, which can sometimes be (!emonstrated The same remark applies to the lungs, the lymph glands of which, namely, the bronchial glands, are often found to be in a sup. puratmg condition. The period of incubation appears to vary from 4 to 8 days. Htatmpjr.— The former views on the nature of strangles are now only of historical value. This disease was regarded as^to cM? OT development or was connected with a supposed lymphatic eqnine Jdiosynjasy. Dentition and a peculiar state of^w«ther we^ato ^^ZJT":t*^'- °^"' «>°»'«*«^ »t«»8l« to be identical with scrofuU or with human measles. In more recent times, Trasbot as Sacco had previously assumed, declared that strangles were true horse-pox Trasbot. as Viborg and Toggia had doneta Uieir timT proposed that all horses should be inoculated with the lymph of horse- pox as a prophylactic measure against strangles. This hypothesis which M m Itself quite improbable, has been refuted experimentaUy by Delamotte. who demonstrated tiiat the inocuUtion of horse-pox does not protect horses against strangles. Furthermore, tiie fact rf the existence of different forms of strangles was advanced ; as for instance, strangles of foals; benign, suspicious, malignant slow metastatic, occult, gangrenous, putrid, astiienic, compound, and vesicula^ strangles; strangles caused by infectious matter which had to be eliminated from the body ; stirangles originating from glanders ; etc. Symptoma of ordinuy, mUd Btnui^M.— An attack of strangles begins by a rise of internal temperature varying from 40 to 4i» C. on an average. During the following days, the temperature faUs 05° to i» C. and does not again rise untU suppuration takes place in the lymph glands. It decreases simultaneously with the outvrard discharge of pus. At the commencement of the disease, the pulse usually remains more or less normal m spite of the high temperature, and onlyUter INFECTIVE DISEASES. "'^^'*SES. «•«. Its rate increases to •»uc nrst local Qvmr>« mucous membrane wS *"*"""*» ^ catarrh of ♦»,. may. in exceptional ^KJT^ '° ^^t^ nasal ca^^ . ^ o v«, ana tHe stasis of the ItTmr^K • ^ wn»ch surrounds thp often cause the developm^^?^^^'^^*^* *««'«»* lymph^«slb swelling * *fcess becomes known hv ♦k ' ^« ^nna- colour anw - '""e- i ne skm over thes*. «»«»♦- • T ^^ °° are STRANGLES. *S Among accompanying symptoms we may note : loss of appetite, which is partly due to the general feverish affection, and partly to the swelling of the intermaxillary space ; depres- sion ; occasionally, excessive weakness at the beginning of the attack ; oedcmatous swellings, especially of the hind-legs ; and often great emaciation, if the disease has lasted a considerable time. In spite of the very high temperature, the urine generally remains alkaline ; although it frequently contains a considerable quantity of albumen. During convalescence, we may sometimes observe a temporary polyuria, as in other acute infective diseases. At times, strangles is accompanied by a cutaneous exan- thema which usually takes the form of an eruption of wheals, the size of a pea up to that of half-a-crown, and spreads over the entire body ; or an eruption of nodules, vesicles, and even pustules, chiefly on the lateral surface of the neck, shoulders and sides of the chest. These exanthemata are characteiised by their sudden appearance, and often by their equally rapid disappearance. An eruption of vesicles may break out on the nasal mucous membrane, and in exceptional cases may spread to the skin of the alae nasi and upper lip. The contents of the vesicles are at first limpid, and become purulent later on. The vesicles soon burst, and leave shallow ulcers, which become covered with a thin scab and heal without leaving a scar. These vesicular processes on the nasal mucous membrane give rise to the idea that they are characteristic of a peculiar kind of strangles, for which, some writers have evidently mistaken cases of stomatitis pustulosa contagiosa, and frequently those of inflammation of the lymphatics. Elevations on the nasal muco IS membrane resembling wheals are rare. They take the form jf circumscribed, dark-red, raised, sero-luemorrhagic infil- trations of the mucous membranes. They vary in size from a lentil up to a pea, and are often surrounded by a red-coloured edge. Rabe states that the streptococci of strangles can pro- duce ulcers on the nasal mucous membrane in consequence of croupy and diphtheritic infiltration of the mucous membrane (see remarks oh the differential diagnosis of glanders, p. 282). OompUoatioiiB of Stnui^M.— i. One of the most frequent complications is the spreading of the infectious catarrh to the pharyngeal mucous membrane, with .'be consequent pro- duction of pharyngitis, which, in a few cases, may be the first symptom of strangles. Pharyngitis, thus transferred, is well marked. The patient suffers from difficulty in swallowing, INFECTIVE DISEASES. lymph ghmds near t^«L J2^°°' **^« ">« Janiyx ; andthl "?J' the ear. a^J^^lJ^n^S*? ^^^ ^^V «f the parotid gland. nuaX^i^^^^^tween the lobuki Th«e glandular sweUi^'^^^^P-te in the inflamma^ *^8e of pus. partlf Sdl ^*' ^ s«PPuration and ^on of the ph^^an^S^ "^J JST^y ^^-''b in the "naergoes caseation and iJ^«!?^' '" °ther cases the absce« ««id with subsequen^l^ST ^^^^ *^'»^. or bJc^ »ay attain an^^"^^^«°^ Py«nua. The aS^ co^uent. and the co^nTt^^^l^'^f ^"^ ^^^^ often becomes densely infiltratL^th . "^"*^« **»« P^**^ ^<=«^«xur under the phi^'^Sr*^'^^ ^S p^^Siy^pt^ran^feT^op^d^Srr^'^^ awearcumstances. the pusTn.. .* ^''^ *^« ™ost favour- ,:^ outwards, either Z:tiyo; ffr""^.^y«»PJ^ «^ JS^n ?*K ""'^ *"«t inwai^ ^to^ ir^"^ * ^^ 'o^ «»son of the mucous mem^nf k • P^»*n'°«eal cavity by *^t of pressure exerSSr^Th. ^I!"^ '^°°»« »*«otic on Ruction of gang«n^neL^^*'f«».• m ^^<* ««« t^e ^1T "*y °P«° ^^^HTell as^^"!?* '^"««* Mose a pharyngeal fistula. FistuL^o . °"twards. and thus from the submaxillary riacds anT^ ^^ '°™ ^ » similar wav the oral cavity. ^ ^'^*' *°d -"ay m a few cases ope" b^ cavSes'^t: sf^::rtr**^- -y »p^ !!1"P <=°"«h. becomes de^wl A^ i^***^°° fr°°» ^Wch ^y tnus lead to sevae dyspnoea. rT*^ PWegmonous. and STRANGLES. ^ mation and paralysis of the muscles of the larynx, and roaring, OT " whistling." The catarrh of the bronchi may lead to swelling and suppuration of the bronchial gls-ids. Masses of fodder are, in a few cases, found wedged in the guttural pouches in conse- quence of necrosis of its walls, and may penetrate even into the subcutaneous tissue along the throat atound the trachea. In strangles the guttural pouches, are however, rarely implicated. 3. Inflammation of the superficial lymph vessels of the skin of the head, with the formation of a large number of minute abscesses, is chiefly met with on the cheeks, lips, alse nasi, and sometimes over the entire head as far as the ears, even down to the throat. The numerous lymph vessels of the implicated skin are then inflamed, and the connective tissue which surrounds them becomes infiltrated with pus. This perilymphatic sup- puration produces in the course of the lymph vessels, numerous minute abscesses which spring from rosary-like nodules that have nothing to do with the suppuration of the lymph glands. TTiis inflammation of the lymph vessels may be followed by diffuse, phlegmonous sweUing of the lips and cheeks, in which case the mucous membranes of these parts become tense and frequently as hard as a board. There may also be simultaneous suppuration of the mucous glaiids which, on the eversion of the tensely swollen Ups, will appear as plugs of pus, and will give rise to minute ulcers. 4. Strangles is sometimes characterised by its tendency to form metastatic abscesses in a great variety of organs (pysemia of stranj^es), partly from the neighbouring lymph glands by means of the lymph passages, and partly by embolism throu^ the agency of the blood. Thus we find abscesses with peripheral swelling in the neighbourhood of the thyroid gland directly in front of the trachea ; middle cervical glands behind the trachea (with lateral swelling on the throat in the middle of the jugular groove, which swelling may sometimes burst on both sides and may cause roaring) ; omo-hyoideus and stemo-hyoideus muscles ; lower cervical glands (with formation in front of the entrance of the trachea into the thoracic cavity, of a tumour which may cause compression of the tracher and suffocation or permanent stenosis of the trachea) ; axillary glands (producing lameness) ; subcutaneous tissue, espedaUy on the lateral thoracic walls,' front of the chest, lower ribs, hypogastrium, flanks, scrotum,' udder, neck, withers, inner surface of the thi^, etc. These subcutaneous abscesses are accompanied by extensive swelling of the skin of the affected parts, the condition of which is fre- 38 INFECTIVE DISEASES. •tacM«, which often cSfa^ SS? " («"Py«TOi). StaSu between the intestines. The^ p^!?^ "^ *° ^'^''-'o™ We by periodic and often chLS " "^ani^Mted during purulent infiltration may^^ °^«"***^ °r 'ess size a^d ^ °^inflan,mationTthe J^":!^ '" *?« ^«^° (^th sy2 .rf- and local symptoms) sSi T 'hydrocephalus, bffi- ^bs^dparal^P„->;4P^-a^^^^^^^^ s«n .• * ''°*^' ^°^^' fetlock aSd^l ^***"^ • J°«t». especi- »appuratmg synovitis. sweWn; *°*'^'=°/"°«y articulation (S udder (suppurating mltS^^' ^** fi«»ctional disturbancS cause lameness that may last S^f^'u *''*'*^ « ^'Wch mav STRANGLES. f^ wbidi occur during the coune of contagious equine pleuro- pneumonia. 6. Strangles assumes a chronic lingering course, when a ckronic catarrh, which keeps up the nasal discharge, becomes established in the sinuses of the head, and in the guttural Touches, or in the pharyngeal cavity. The animal becomes very thin and suffers from indigestion, and frequently appears as if it was affected with glanders (the so-called suspicious strangles), in consequence of the similarity of these symptoms with those of chronic glanders. 7. Death from strangles is usually caused by the additional influence of septicamia or pyamia. In such cases, there is high fever and great depression; the pulse is frequent and weak; palpitation of the heart ensues; the animal becomes debilitated, often in a very rapid manner ; and severe diarrhoea sometimes sets in towards the end. 8. Strangles is sometimes complicated with petechial fever, most frequently during the stage of convalescent. Diff«Miitial Diagboais.— Strangles is mistaken chiefly for simple nasal catarrh which is accompanied by a purulent nasal dischaige, and which is tolerably frequent, particularly in young animals. It is distinguished from strangles by the fact that it never leads to suppurating inflammation of the sub> maxillary glands, although in a few cases it may cause swell- ing of these glands. To distinguish strangles from glanders, see tne differential diagnosis of glanders, p. 282, et seq. In doubtful cases it is advisable to inoculate white mice, which are immune from glanders ; although they are typically sus- ceptible to the inoculation of strangles. Strangles may also be mistaken for parotitis and mucous degeneration of the turbinate bones. Prognoals is favourable ; because the mortality is small Thus, out of 5,520 remounts and horses in the ranks of the Prussian army which suffered from strangles in the years 1888 to 1893, only 2 per cent died, in the Bavarian army during the last two years there was a mortality of 25 per cent. Rings- heim states that among 2,205 horses of the Danish army which suffered from strangles, only o 5 per cent, died during the years 1851 to i860. This surprisingly low percentage may be ex- plained by the fact that the ages of these horses were from 4 to 9 years. Krabbe on one occasion found among 1,789 JO INFECTIVE DISEASES. ^ X885. in 1^^ ^i?S r °' 3-5 p^ cent of 23 per cent, am^*' ^Jf^JV^* observed a ^rtality mortality in Denmark wi 26 -"*** I>«ring 1883. the ^r--. We may coie^::nSy Sr*«f?°?^^ ^^^ ^oi strangles islSut 3 pT^t ^* *^" *^«^ ""t- conihons we may mention^: ^bS?v fr^°"^ ""favourable youU. and complications. especiiVt*^^^"^ i„„ess. to h^^*:S^"«^ "onnaJ ^, it is sufficient to attend o the stable, and theSnSb^Sf^f?' *^'^"°"« ventilation digested, such as " gre^nS^^^."' ^°^ ^^<* <^ be S to give febrifuges toKd^Tl^ °^^*'' *"<* roots. It is usS ture. which ^abate^Seif^r*^"' ^«^ ^*«^ tli^r? days. The treatment of thfl ""***^ °°"°aJ conditions in a^et ^-^gical; its essSS^^dpXr^f^'y^Ph glands i^^^uiSy a long incision as earl JTZ?k^ ^ *° °P«° the abscess^ with >»ttem. TheearySsc^SV'^'^^-^^^^^foms a faU of ti,e interil temS^^, ^^ ^T ^ ^"^^^^^y foJowedTv duration of the d^^^"' *°d ^videntiy shorten the ^om Of allo^; aSTt? "^- '"^3' -i-t ^" oW "r°«-- "theswdlingisTdS^f "P«°" in a natiir^ 2?°° °f pus by fomenUtioS^'^'SLr ?*>; stimulate tiTe fo^ atecess with caution on ^^ta^l^' ^^ '^""Jd open the ^^thl*^^' J^** shauldT>Se oLv 'tTS^*^. °^ °'^«^"s and tiien work up to the ahJl ^'"y^the skm witii the knife P«»etrate the ab4ss. k is Sj^n!:!"'" ^°««^- ^aSi^ o ^t^pt in anotiier diUction i^ le :^r; *° "*"« ^^^nd titioners generaUy ^^IS'J^'^^'^^ in strangles nrac rem^es. such as'p^ai^^*^^ o|^ steam an/^t^^ of antimony and oriire)«fH ,j^^°°y ^^rude sulphide ,« y«^ .about x76o; Jd RuiL a'iut ^"^ A^l'^'^ ^ ^^^^ IS spread aU over Europe ^ P'"®^°* *"»« it Many old^^authorTc' n'^^d^i^frtf i*'te"^^ T °' '"-' which opinion Trasbot aSSs In^ * small-pox. with experiments were made withvar.??. °"™<^°"s unsuccessful it. This hypothesis h^ C^eS^>vV. ^""'°*'"^ ^«^* of Dupuis. who in no instance w^a We t TT '''?'^^^ against distemper bv vaccinatinr? J° P^"^"" immunity it to be a disease of devSmln^orj"^ ^T ^^^ ^"PP<«ed ^, It was recognised brwS«rCr"*'°°^ ^^*^°"- Blain and others at an earlV iSS ♦w ^^*""*'"^°' ^'^bfere by an infective ageS wd^n^ !,*^'*'™P"'" ^^ «P«ad transmission exp«Xente ^1^2"""?/ °"™«'-°'« artificial successful experiTente belT ThSe W P ' ^ ' «>« ^^t Trastowo proved by his e^rinwc f'^.^^'^^' and Karle. had not suffered fromX aS ' *^** ^^^^^ ^°g» ^bich it could be transmi^ed^t^J^''^^!^^^ to it; that dogs could be infecteTby U wi*""*^*^^' "^^ *^* <>" >vith his inoculation exirfmen^ . ,^ ** ^* unsuccessful to transmit it byinoculaSn^n H^' ^ ^*" °° ''« ^ able old. by introducS^ ttfxS^^SsSL^" 2 ^^^y^ to 3* months of the veside.into sm^^^^!?^"""^^ ^th the contents the result that the fint s^i^ ! abdominal walls, with iu 8 days. He llsTnrT^^ "^/* *^* <«««« appeared tation.w^chex;enWnt'^c^fi^irH«°^ *^^ '^ proved that the conta^urw^ £^.^^ ^T"^' ^^° f^^ber that it had sufficient SyT tS^H^- """" ^l^^'atUe. and certain degree. Venuta fo4d th^ ^"^ ?" ^^"^ air up to a varied from 4 to 6 dats kI,? u ''** P^"*^ °^ incubation which the grtater nuXr r^mS J^'^f *f 36 dogs, of he surmises, they had paLJd thr„ u ^^*^ ' *^"se. as distemper. He found SSlh. °^i * Z'"*^*''" attack of from 4 to 7 daT aLd th,*^ -^^ incubation varied temperature was the'firet sJLi *° /°"**^ °' internal appears, and only i^ ^yj^""' j^^"" ^*^*??r* ««ldom recovery takes place as eSylTe o!^/?' n>dd instances, generally confers immunity T^e cZ.- *^- ^^ attack n«y. Ihe contagium is contained in DISTEMPER. a the respective discharges from the nose and eyes, and in the blood. Although it is not destroyed by drying, or by freezing up to -20° C. ; its action is weakened by being kept for months m a dry condition. As distemper by inoculation has a mortality of only 10 to 15 per cent., Krajewski recommends inoculation as a prophylactic measure. Laosson made, on dogs and cats 98 moculation experiments, which positively demonstrated the contagious nature of distemper. He proved that the disease was identical in both of these animals, and that it can be reciprocally transmitted. He further showed that young cats and dogs became infected ahnost without exception ; that mature and old cats and dogs are less susceptible ; that the nasal discharge loses its virulence in 14 days; that the contents of the pustules are ineffective ; and that the period of mcubation varies from 4 to 7 days. Konhauser, whose inoculation experiments had a negative result, is of opinion that the contagium is also present in the milk of bitches suffenng from distemper. Btlolo^.— Distemper is a contagious, infective disease, the vmis of which has not yet been positively demonstrated. We have not yet been able to obtain pure cultures and their successful transmission. We only know that the contagium is fixed as weU as volatile. It is evidentiy much easier trans- nutted by cohabitation than by inoculation, and is probably as a rule, taken from the air during inspiration. Dogs become most frequently affected during the first year of Ufe. Among the 1,378 canme patients which were treated for distemper during one year at the Berlin Veterinary CoUege, 927 (two- thirds) were under 12 montiis; 269 (one-fifth) were under 2 years ; and 182 (one-seventh) over 3 years old. In rare cases, very old dogs may become infected. Puppies only a few weeks old may also suffer from this disease. Contrary to the statements of Krajewski, we have seen an outbreak of distemper in a whole litter of puppies which were between 2 and 3 weeks old. Although one attack generaUy confers immunity for a considerable time, some dogs become infected several times. We have, for instance, treated the same dog for distemper 4 times in a year. The chief predisposing cause of distemper is chiU, brought on, for instance, by exposure in tiie open air, particularly at mght and during cold and wet weatiier ; injudicious washing and bathing ; etc. Chill facilitates tiie penetiation of the 3 34 INFECTIVE DISEASES. j^« can never pKf dS^e™" Te^^ ^ ^°'** «' w^. recently imported. andmiSatSS ;. "^' P"°P««d. predisposed to this diseaU thpT ^^ ^^ ^^ spedaUy by. an unnatural ^^' ^%^^°''°' ^"^^ ^^ ^^^ pre udice against m^t for the ^!{ ^^ 'T^^- ^he old indirect cause of distemper ivn, ^ ^ *^°8* " °^te° the weakens the health o S and th?.*^ ^'"^ °"* *^* ^read priate food for camivo^f ' a ^^^ "*** « *he only appro- Bischoff and VoH^^h^^rif f *,° *'', ^^P^n^enHf get into a wretched Tligh^aS iTi"''^'^^ J^ °° bread predisposed to distemper is l/lr.lw ^ ^ T*" ^^- Progeny bitches, and from SwWch h-^'l.^^*"^^ ^^^ ^^y We nmnber of ^p^« ?*^!i° ^,!J°^ "P ^ «««sively instance, by cropping "SfSrs ^dtlT^^ hemorrhage, for a predisposing influence ?S ? ^'■'^^ "*=^«*«' "^ have become more fr^ue^Uy Ji^^e^^S H^^l *^* certain breeds « probably erroSous f the So« ^^ ^^''"'^' *^ ^then,. susceptibiUty being the faTt th^'^^ 't"^ °^ *^ *PP»««t numerous than others i?^ J^\ T^ l'^ »« moi« than one-third of 2 dS sXr.? ? ^^'^ *^* °»<»« pugs; apparently becai^ thit^^ • *'°°* distemper are able, and SoTbeLusTtri^^. "^ " ** P'«^* ^on- to distemper. * P"""**^ '^V special predisposition ^•^'^^SS-;^^^"^^- *»-d in the blood of airected they consider to be the trS^S^*? f^'^''' "^ ^''^' which PwUent contents of tbTpt^^^L^^^P"' «»«« found in the conjnnctival secretions of doBsXi^^ T^ discharge, and in toe -^ « the infective ^ent^^r^S'of:'''?^''^^ eonsated of globules, the s^rof whiS^!^^-.^^"" nucro-orgaaisms -^ute that they could har^y bT mt,^^^ ' ""* »''«y ^^'^ »« gether m smaU heaps, or are conn^tS^^h ^^^ wmetimes he to- ^e ««u«,. or lie in xo^oTfouTS T^^l Tf"" *". ^'^^ *"«' *>»» Mn be stamed a dark-blue with methliJ- ^ * "*~* °* P*'!'- They they disappear completdy^mtS^j'^^^^ During convalescent^ g^'onately to the i^*?" o/ toT^^^^ ""Jj:"^ » numbe; Kfbes statement, but leaves the au€stL !.7?v' ^"***'»'«er confirmed S;f^;°|««ni«n. unanswered Sr tee i^nl *' »P«*5«= "^ture of the«, the presence of micrococci M^thu £f^ ." ^'*'' KraJewski noticed tiasues. sputum. and^Ses X^ S"** ^ *^« ««i«>« of the bod? diplococcus. which he^ifuVatidiS' ^"^f^ *"•" '^''^^' • -I^c obtaineu 4,0,. cultures up to S^eL^^ " •"«'»">' »>'«»i»« b«S inoculations with ihtm rS, t^!^ ^^^*^''' '^'i ^Mdt nucc^ inoculauons. «M^ tam^/ ,2^^™ ^•^j! -Pf^^ aftHK y respects with those of distemper. For DISTEMPER. jj iMtaace then was generally a rapid rise of tempentture, and postules appeared on the site of the inoculation or over the whole bodv Verv yonnganimaU frequenUy died in consequence of this inoculation, wfai^ conf«red immunity on the survivors. Jacquot and Legrain found in the pus of the pustules numerous motile micrococci, which were from ?nL? ? " •"^'*^""«*"' '^^ ''"«:»». by uniting, formed diplococd. InocuUtions with their cultivations produced local pustules, but no dis- temper Marcone and Meloni obtained tiie same result with the micrococci which they found, and which possessed great similarity to staphylococcus pyogenes aureus GaUi-Valerio found in the lungs, brain, spiral meduUa and pustules of dogs suffering from distemper, ovoid bacteria which w«e I. as to 3-5 ^ long, and 03 ^ broad, and showed characteristic cultivations. Their inoculations produced in dogs symptoms of dis- temper, especiaUy those of a nervous type. Schantyr tried to prove, in a bacteriological work published in i8oa that canme distemper should be divided into three different diseaMs' which are respectively produced by three morphologicaUy, biologicaUy and pathogemcaUy different micro-organisms. He, however, sUt« !^Ih iT ^'^ ^u"°^ °* distemper are clinicaUy and anatomicaUy so much ahke. that they can be distinguished from each other only by an exact bactenological examination. He named tiiese three forms : abdominal typhus," " true canine distemper." and " typhoid." We do not feel mchned to give up the clinical unity of canine distemper for such bacteriological problems. "«i«iiiiw ror OoouraMio*.— Cats, wolves, foxes, jackals, hyaenas, and monkeys become affected with distemper as well as dogs, which suffer ftom it sporadicaUy. enzooticaUy. and even epizootically It is ahnost always present in large towns, in which it is the most common canine disease, and is particularly frequent dunng certam years. Among the 70.000 dogs which were suffering from mtemal and external diseases, and which were taken to the Berlin clinic during the years 1886 to 1894 the number of cases of distemper was over 11,000 (one-sbrth of aU cases). The proportion was about the same in Munich • for among the 2.300 dogs which were received in the Munich dime during 14 years and which were suffering from mtemal diseases. 650 were suffering from distemper. This - disease can also spread with great rapidity in the country Jonsson states that distemper raged so violently in Iceland that there were no dogs seen in large districts of that country. Accordmg to our experience, the majority of outbreaks of d^- temper occur during the summer months. Warmth seems to greatiy favour the development and transmission of the contagium. Bympt« its of the indi^diili o^ "^^ *^' '"°'* '"P^^t »ff«^tions by -isl^tiffSurb^rS^h^^ -^^ first manifested dainty and small aDDebTeT.H'f ' ^^"^^ vivacity. brisUy condition ^^Tco^VZ^J^^'''?^ *"^ ^^^«^ and tendency to ^^e' ^s^ Ta«^^*^*? /^ «^« »-• experiments, there is a considerable SL t Z°^''°'\ temperature, which, even iurin^ L ^ "^x **•" '?*!™*^ nses to 40° C, • and »t th» ,.^ ^ ^ °' mcubation. to 41° c'in sh^ht cii* lid to^oT"'°* of the attack, u^ to the fact thaf do^ put tZ t^ ""T' °°"- ^^^ when the disease hLteSm.^^ ^?"^*' *" * "»'«' ^^X ^rvations ^be^.^ror^ttat^S^'th^" ^**^* °*^ t^p^.^ii;^^thi^j-ecr£^^^ ^-^^s^ high te^^raturel^^iir^^XL^A^^"^- ^*- the eyes, and photophoS k ^n^^-S, ^^ ^^^^ fr°°» of the eychdsLor^r^Uy'^S-ted 3^J°rT "^'"S'*"* eyelids turgid. The disSre S^h« ^^"^' "^^ **>« serous. soJS becom'°« *««<» inembrane. ScopS^^f ^^'r*!? °" "*« "^^^ ""coi" very dry and chappe j-eased rate of breaS^g'l^d^^"?^ ^"°-^ Jy hoarse, sharp vesiciilar»««..;!r* ™a°««ts itself by cough : ca^hally affected^^fUac^ohrS' ^^^^ ^^^^^r "y under symptoms of increased resSat^ ^^T^ bronchitis , m breathing ; feeble. S^^^^^^SZ'^ S ^^'^ up by pereussion of thTSdc^' I^LT^- »^f*> be set up, and by their being tak^utTthS ?* T°^ «***^ the patients try to^n^^ k • ^'^ ^*°°'^' a°d which and^ or Sst? S^^ 0^"^^^ 7"^*^ '«"-<^ ^ animals which ca^iot^^v^fh. ' , ^°"°« *»<* ^eak the bronchi by SST^me ir!^'^^*^ P"«8°» fr«°» monia on accJuntTSu^Lf ? "** '*'*^ "^^""^ P°««- alveoli. Thispneumonk* «^t i"" up the air and puffi^KTcieSLT^Zfr''""^ * «>e hind- sequela of distempeJi^fa ^^'^^^^^^^ «<=tu«i is a frequent of the muscles of the tongue IS'/ * °°*^'^ P»«^J^ oat of the mouth ^f ;«k ■ ''''"-^"*°% hunTlooirfv Wnd<«.d. I>uring\e"1,uS:':rit°' '«^ -^^y comphcations have been^ °L***!^Pf • "^e following cataract in very raixj^ hil^ = ^eafaess; amaurosis- hydrtjrachis; |L of ^e' ra^^"?^* ^"^^^ ('<^8)l and complete idiocy ZSo^ST^' • '"'^ *°^ °»««4 . to our experience, the m^'S '"*""'"»>• AccorZg amaurosis with optic at^X aTl ^°'°P««'«°"« are! In a few cases, we have seen L^Lf^°'"'= hydrocephalus, amaurosis. ^^ '^^ unexpected recovery fro,^ sudi thema is h^tfy^t^'^ J^ characteristic pustular exan- fuid abdomen, and m^T Z^nT"" "^**^ °^ *he t%Si m abortive cases, which ^ tt muLT^P^r °^ *^*«^ It first appear? in the form ^t • ^* ^<* of this diseie t^ty-four hours deJe/rLto S**' ^'P°*»' whicrX-' rounded by a red rinr i£ ^^f? °°?"^^ ^^at ar« su? and pustules, which v^ ^^^ W ^'.'^^'^ ^^^ vesid^ even a bean, and dry lj dthTinte » * ^n°*^ »P to a pea o^ burst, and leave weeniL ° * yellow-brown cru^ or with desquarSSn T^; ^?, '^}'' Healing ^^^^ leaving bright pigmented n^ "^ "^"^ »bout 8 ««Jy oneTnwS from the epizootic chZ:i^Ti^^ '"*"*"* ^" ^" P^ »»«i fever. siaiultaW n^ll"^ *****^' y^"*^ of the SS^ tte pustules of distemper is of^* ?* demonstration of Jhe symptoms of cJSLt • .«^* diagnostic importance *'«8^'^ of the SL^,^?^ ""^"°° *hi<=h occur ^tt?: :* ^3-en. to r^pSn^'SrK'^^y-the^Lnt ^^««uve behaviour of Sds suffer, ^' <*aracteristic ever, absent from distem^ f k' ?rf^* fr°™ rabies is. how- •etUes the mattw ^"P®'' *ne further course of wh.Vh that of .4^^-it?KL'^P«*»» of distem^ mv^^'' '=*«n«=terTSe p^t.^r^ «"**^y ««t^ed ^S of the exanthema over ^e wLk^^^' H"' «P'd sprea^ of other symptoms of ^^^^ ^^' *°«^ the devdopS ««y. The exanthema S?*S';. "^'^'^ "'*' differenSn however, often occur sfanni?^ "*?'' *"** "»t of man« m whirh /.^- "w;ur sunultaneouslv in ♦ho HMnge, . '^""^^ case certain Diecfli.*,v«.. ^ *"* **«>e animal a correct diagaos^ J!T^^^°^ *" necessary for ^Z ^^ are thJe of rLS*S^ v^^ ^ *he r«^>«^v pneumonia. The naS mij^emb^""^"'^' *°<^ <=*^i or greatly congested swollenT^ '"^* "* «ther very pale ^eyish-green or duU^f^^^"^^^ with a thick. ^iS with coagulated blo^^^^^ ^""^^i^ y^hich S^d ^Wlte of the'^LinTte W aS'"*^.^^^^ ^^ Hamorrhagic ulcere are somSim^ ^ "" ^« ^o^tal sinus ^eofthelaxynxaS\:^^:Jr^«^^ The mucous me^-' ^J^ated with h«moiThag« co^r.H*"y"°°««ted. swollen, tmies shows catarrhal ulc^ 'ihe wT"" T'' ^^ ^'°«- *^- ^'^e laigo bronchial tubes often DISTEMPER. 4J fail to exhibit changes which might have been expected during life ; for the hypenemia and the swelling of the mucous mem- brane subside after death. The ^•'-aller bronchi are, on the other hand, frequently filled up with dirty-grey ana even bloody viscid pus. There are spots of congestion on the surface of the lu*^^, some parts of which may contain but little air, may be entirely free from air, or may contain more air than usual. The catarrhal inflammatory fod of the lungs are characterised by their hardness, absence of air, prominence, and dull-red or copper colour. Their section has a smooth or, in rare cases, a slightly granulated surface, which, whra pressed, gives off an opaque, chocolate-coloured fluid that later on becomes dull-red or pale green. In very young animaU we may observe the infiltration, into the parenchyma of the lungs, of a fibrinous exi^date, which is very soft, and which readily liquefies. This croupy hepatisation frequently has a lobar extension. The inflamed parts oi the lungs are sometimes densely studded wnth numerous suppurating foci, which vary in size from a poppy-seed to more than that of a hemp-seed, or are diffusely infiltrated with pus. Those portions of the pleune which cover the affected parts often undergo inflam- matory changes. The bronchial glands are swollen and in- filtrated with serous fluid, or with pus. In the digestive system, we find the mucous membrane of the stomach and intestines, especially that of the small intestine, congested and swollen, covered with tough, glassy mucus and often infiltrated with haemorrhages. In other cases, it is very pale, swollen, easily torn, and has a creamy covering. Fre- quently, the contents of the intestine are sanious ; and the mesenteric glands cedematously swollen. In the brain, we often find signs of oedema, such as : anaemia ; a relaxed and l ?it condition of the brain substance ; a watery lustre on the surface of sections ; flattening down of the convolutions of the brain ; and serous effusions into the lateral ventricles and subarachnoideal spaces. In a few cases, we meet with signs of purely venous cerebral hypenemia, as for instance, great congestion of all tne sinuses, venous plexuses and vessels of the pia, and the appearance, on the section surfaces of the brain, of numerous red blood points, which can easily be wiped off. Kolesnikoff found microscopically the brain substance, especially the walls of the vessels, infiltrated with leucocytes ; and Kraje^vski noticed dilatation of the vessels, cellular infiltration of their walls, filling of the perivascular •" tUFECTtVE DISEASES. the ganglionic cells. The rhV^ ^^ '°*° *** Protoplasm of ai.notweU.n.arCcoSstcte^'" "^'.'^"^ <=0'd. wW^ especially i„ the li^b^r^o^^ 1^^""* *°** ^^''^ "^ema. vabons have been conSmTbv ^T^^*^^' ^^"^^ °l»er- Paralj^is. we can find^JZes ^f^f^' f*»*f *^»*' '« acute albununous exudate alonglTe v^Li ^ °^ "^^^ *ith an- Jssue of the grey matter^of tlie Si *"^.^ *^^ ^*«"«tial distemper, a chronic, localised ^tS«?? .'°'** ' ^*^ ^ ^^'^onic a^phy of the cord. Hadde^^jr^S^ ""^^^^^ ^th partial bl^d-coipusdes in it. AccorS^/°tT t ^^^ °' ^"^gr^ted ?nd Its membranes in teverf r! J^ '*'^*' *^« spinal cord •nj^ted with a sero-fibrin?u77xuiS "« «"«" considerably noid and even into the sXtS" *M" ^^ ""'^^'- ^^^ ^cZ rachis may become deveWd^''u°^ *^« 'P^^ cord. Hydro- Among other chan^Zl "'"'^ *^a«es. "^ total quantity of the blSoTthr^r°*'°^' ^^^^^ ^ the degree of hydremia ; Xcitv L^^I^'"''^^ ***»» * certain epithelium of the W aSd kL '^^^ degenerations of tte of the muscular ii^e^^t'^rjt T ^^"°" discoloratr^^ coloured cloudy swelling and fattTn. '^""^"ence of dust- «dematous swelling of th? 1^!!^ t^'"«'ation of its fibres ;' condition of the bl<^ i„ con^K-^ *°* ' *"^ *°d greasy capped elbow and cap^^S hriftX^trr^'^-^^-^ symptoS"?^':^-^^ J::^:f °l?*««P«r is essentiaUy to subdue, ,•« loco a/fecUoni,7u ' "'^'^cmes which ar« able it has entered the bSy ""S u^h'me'r"" °' ""'"'"^P^^' after instance. According to our ^^1 '""'*• ^^^"'"eJ « a good used witi.advantagfiJ°ve^^P«"^«?ts. this drug can^ be have been the sfaJtine noi^f ^*l ^^''^ ^^^ digestive organs «I^ialIy in thelSSS K oi tt "^^^ ' ^^^ ^^taiS d»temper. good resulte f^ .^ iL'°"'f"'^ «'^*"*= '°™ o fames a day. in doses of o^Z^T:''^''^ ^'^^ °' *hr«e mfectant of the mucous membrSS. ?^°'"? **=*^ *« » ^is- The same may be said of ttrdilf * *'""*'^ *"** ''^t^'tines. mucous membrane by me^s of in^t??'*'°" °^ **»« respiratory cent.) which have a^ Sy g^ eilT "Ik"^"" <* *° ^ I^ of distemper. Our succeMr^n JT !^* '" ^^ bronchial form and puhnonary forms^^^SsLt'r ^' 1^;* °' ">'' ''"-^™ ^y the adoption of «eoIint?&^-3i^^-% ^^^^^^^ DISTEMPER. 45 atory mucous membrane; although in this disease we are often compeUed to use a purely symptomatic treatment, which vanes according to the localisation of the malady. I. When the eyes are affected, their treatment has to be earned out according to the rules of ophthalmology. A solution of I to I per cent, of creoUn is an admirable appUcation for sup- purating conjunctivitis and ulcers of the cornea. In the former affection, good results may be obtained with a i to i per cent, solution of sulphate of zinc, or in obstinate cases, with a i to 2 per cent, solution of nitrate of silver ; and in the latter, with a 2 per cent, solution of boric acid or quinine. We may treat parenchymatous keratitis with i per cent, solution of sulphate of atropme. A i to 2 per cent, solution of hydrochlorate of cocame (5 minims to be dropped into the eyes every 3 hours) may be employed to combat the abnonnal sensitiveness of the mucous membrane of the eyelids, which causes the patient to wipe and rob his eyes, and which, thus, often induces the fonnation of purely traumatic ulcers. In cases of blenorrhcea we may cauterise the inflamed mucous membrane with a point of pure or diluted nitrate of sUver, with one of bluestone or m very obstinate cases, with the thennocautery after a previous apphcation of cocaine. Opacities of the cornea of some standing may be more or less removed by robbing them with red pre- cipitate ointment (i to 20 cir.). Staphyloma and entropium require surgical treauT«nt. 2. The affections of the digestive apparatus may be treated m different ways. An emetic (^i^th to ^ih of a gramme of apomorphine hydrochlorate in from i to 5 grammes of water, subcutaneously) sometimes renders good service at the commencement of the disease. As a stomachic, we can recommend hydrochloric acid in doses of a drop by itself in water, or combined as foUows : hydrochloric acid i part tincture of gentian 4 parts, water 60 parts ; half or a whole teaspoonful to be given 3 times a day. We may also administer tinctura rhei aquosa and vinosa (in doses of a teaspoonful); decoctions of cinchona bark (i to 15 a tablespoonful at a time, by itself or combined with hyio- chlonc aad) ; bismuthi subnitras (o-i to 02 gramme) ; extract of meat (2 to 5 grammes) ; wine, quinine wine, condurango wine (from a teaspoonful to a tablespoonful), etc. Opium with small bits of ice is indicated in persistent vomiting. Diarrhoea may be treated with tinct. opu. 05 to 3 grammes ; powdered opium, o-i to 03 gramme; tannin, oa to 05 46 INFECTIVE DISEASES. gi^nune ; and in very obstinate cases with nit«.*« «« i Biuuuu X3 pans, aqu. toemcuh 300 parts ^ timo« Haii,, a teaspoonful or a tablespoonful. ^ ^ ^^^^^ 3. In affections of the respiratory organs we shoulH ««* ^Son'^«V T*""^ -lJch"rhaJe"me::;ioneSlor't?e relief of laryngitis, bronchitis, and catarrhal pneumonia Fnr cough, we get good results with morphia ^d cS wiSj we may prescribe as foUows : R monS» hXicW^rS Tti^nfi- ^^3 tsr. -S2 l;ThS S- T,,^°'»»**tions over, the la^nHid thST^e tf^n^r K*^' ^"'"'^^ "^"^«^ the^loymentTexS torants. such as apomorphinae hydrochloras (^i gr^e ^^ A* per OS) ; tartar emetic (only for strong animSTd t STu^ ^^^t^V"^ *° r «^«)^ ^^di ^f' :^: STZt,/ 11 ^ ^'^™°''^ ' '^'^ antimoniale (in doses ^a drop) ; mfusum senega (a teaspoonful up to a tablesZj! ful) ; and ipecacuanha (0-02 to 0-05 gramme), etc. '^'"^'P*^" ^cL "P*^..^"^ '^y disturbance of the central nervous ^s^ we prescnbe potassimn bromide and sodiZ^bS dLly)''slh:lVtrr°'' ^ t-W^Poonful. 3 £ /Z!, ♦ *'"P'*°°*" (^ to 4 grammes ; and chloral hvdrate iTmo^h?» rr**^ ^ ""*=*^' °^ subcutaneo^i^S of morphia (cm to o-i gramme). We treat paralysis and weai ness by stimulants, such as coffee (5 to 10 ner r^ iJl^. coffee with brandy, beef tea «w* «i ^ ■ " »°^o°). nyoscme (0005 to 0-02 gramme subcutaneously) • atroota. (o.oitoo.05 gramme); veratrine (o-ooi to 3 «Si?! S5°r^J°•°°^*° °°°3 gramme sub^t^^la^^J electnaty (Spamer's machine). '^usiy; , ana spedaU^'J^fH ^"T \^^^- ^^^""^ temperature) should be JpeaaUy treated only when it attains a great height or when to ti^JT"*''** P"^"^ '* '"^'^^ to become d^S to the more important organs of the body, especially tiK^ Tl»c mitial fever, and any dight rise of LpS, ^J t^^ MALIGNANT CATARRHAL FEVER OF CATTLE. 47 40° C, require no antipyresis. As febrifuges we prefer iStT Pynne (o-j to 2 grammes) and antifebrine ^25 to i^^^e?' ,^'S?n^'J '^.x'f "^^ temperature withgre'at cerST^Sd in a short time (i to i gramme every hour until the temoera that of antipynne or antifebrine. 6. The skin ^ection requires little or no treatment. Moist sore places may be dried with powders, such as i part of oxidr of zmc to 10 of talc. Tte appUcation of glycerSe He <^t o the dned-up pustules will hasten their removal food^ti??^ S „T f°u^ ^^' "^'y ^^*«^ °"tritious looa (the best kmd of which is raw meat minced or scranedl exanthema On Ao^i —»_< ""•^^aaiure. mere seems to be no MALIGNANT CATARRHAL FEVER OF CATTLE. Mdignant c.twb.1 fever of csttle-P^do-mlignwt c.t«rh*l fever of •neep— Mtlignant catwrriwl fever of hones. JSt*!n^;7^*^!fri?**"*^ **^«' ^ » *«««»« ^"'Wch occurs only m cattle and buffaloes, and has nothing in common S it^t^^'^*^*^?; W« P«««» »o exactT^wledge^^^ o^^?„^r\,-'** contagiousness, in comparisorwith SS^ o2^v^ T'*"**^'^^'^'^^*- Di«ct infection has been observed only m exceptional cases, and aU the inoculation ex- 4» INFECTIVE DISEASES. periments which have been made, have given negative results. Its cause is probably a cowshed miasma, which becomes deve- loped chiefly in damp, dirty. sheds with defective drainage and bad ventilation. According to Frank, this disease is generally found on moderately moist, loose soil, and not on very wet or entirely dry subsoil. It is possible that the disease may also spread by means of intermediate bearers, as for instance, sheep (Mobius), or, as we have observed, cattle-dealers. MaUgnant catarrhal fever is usually sporadic ; although its appearance as an enzootic throughout large cow-sheds and even villages is not rare. In some places it is a permanent enzootic, and may break out during several successive years in the same shed. A great number of such cases are on record. Sump saw an instance of the disease remaining stationary for 25 years on a gentleman's estate, during which time 225 cows were attacked with the result of only 3 recoveries. Although young and well-nourished animals are most susceptible, many of mature age also suffer. It appears that the disease usually occurs in spring. We know nothing certain as to the influence of locality on this disease, which is found in high-lying places as well as in valleys and plains. The same remark applies to the influence of surface water. Bugnion and Frank state that the period of incubation is 3 or 4 weeks. Chill, which was formerly regarded as the original cause, has, as in other diseases, only a predisposing action. An animal may become repeatedly affected within a short period. It has always been recognised that the disease assumes various forms, according to the respective localisation and intensity of the affection. Thus we speak of a nasal, abdominal, exanthematic, benign, and malignant form. The protean character of this disease in different animals has, for a long time, given rise to inexact and confused ideas respecting its pathology. Symptoms. — ^The symptoms of malignant catarrhal fever are exceedingly various and changeable. On the whole, this disease is a grave general affection, in which the mucous mem- branes of the eyes, respiratory organs, cavities of the head, ali- mentary canal, and urinary and sexual organs are attacked more or less severely, in a catarrhal, croupy or diphtheritic form ; and there is severe nervous disturbance, especially of the functions of the brain. Usually, several organs or several functions are simultaneously affected, but occasionally only one suffers. MALIGNANT CATARRHAL FEVER OF CATTLE. 49 I. IniHal symptoms. The disease generaUy beeins ranidlu witii ngoni and high fever, the tempeif tore li^bZ^l- hib^ts gre I. torpor, supports its head on the manger. ^hSds U very low The upper part of the head, especiauf the rerion o stE"^^^rt.^-lr^^^^^^ tiJ'Ju' 'y^^- P«>^ lachrymation is generaUy the Sr2TS"T'?? ^W*^'"'^" '^Wch case tears flow abrintly over the cheeks and there is swelling of the eyelids. exSve cor«estion of the conjunctiva, and^nsiderable ph;t^tobr with comequent closure of the eyes. The swelling of ttSS may lead to wdl-developed ectropium. In iteKeTpiS^ ^conjunctivitis becomes complicated with ordinar^^SS keratitis, m which case, the cornea becomes aftSS\nT^ at fast dull and smoky, and later on milk-white. Ulcers on the cornea are rare. We may also have inflammation o? the ms (mtis exudativa et adhssiva). in consequence of wS:l^ti^ « an exudation mto the anterior chamb«?of the eye. and^ take place; or the changes may lead to perforation of tte ^rnea. compUc^ted with prohipse of the irTand a^phy^J P^^.""' ''^'^ T"u*^ '°"°*«* ^y pendent Sffi^ Perai8t«it opacities of the cornea (leucoma) frequently oc^ ^affection of the eyes throughout its entbTcourJcS resembles equme periodic ophthahnia. ^ 1- ^' ^**;«^''«^ sympums consist at first of catarrhal and Uter on. of croupy and diphtheritic (sloughing) intomaSo^l the mucous membrane of the nose. larj^^^L^S^*"^' sory cavities of the head, with swelling of the lymph e^dT^ the <«rly stage, the nasal mucous meif bnme is^fbriS??^ or and diphthenbc material which leaves ulcers behind. tST flam^tory affection of the nasal mucous membrane is ac^m ^ed^ a nasal discharge, which at first is sei^u^r^ soon becomes purulent, lumpy, mixed with streaks S^ood dMoo oured and finaUy foetid. Respiration H^^t^: mucous rftles. The dyspnoea may turn into regular attacks of 4 I*..-*' - ■ so INFECTIVE DISEASES. •ufFocation on account of the lumen of the larynx or nose be- coming plugged up with croupy membranes. Croupy-diph. thentic masses are sometimes coughed up. When the inflamma- tion spreads from the frontal sinus to the cavities of the horn- cores, inflammation of the matrix of the horn (which represents the periosteum of the processes of the horns) may ensue. The horns wiU then be very painful to the touch, and can be easUy ranoved, or may even become shed. 4. Digestive symptoms. In severe attacks, the appetite decreases from the commencement, or is entirely suppressed In sUght cases, or when the disease is located in other organs the appetite often remains good for a considerable time. During the first few days, the oral mucous membrane is considerably congested, dry, and hot. Later on, the animal becomes saU- vated from stomatitis, frequently to such an extent that the saUva flows in long strings to the ground. In such cases, the mucous membrane is infiltrated with hasmorrhages, and mani- fests, especially on the palate, cartilaginous pad of the upper jaw, and cheeks, erosions and insulated diphtheritic deposits which vary in colour from yellow-grey [buff] to yellowish-white' and which leave ulcers behind after they are cast off. The MCTotic inflammation may also spread to the skin of the muzzle |md nose, in which case, the entire anterior part of the head may become swollen. Under these circumstances, the oral cavity emits a very bad odour. Further on, we observe constipation wtemating with diarrhoea, and symptoms of uneasiness as if from coUc. The fieces are foetid, and resemble yeast or liquid manure. They are frequently mixed with blood, and not rarely contain membranous shreds. Frank states that croupy deposits from the intestinal mucous membrane are sometimes passed along with the dung. Tenesmus is present at the same time, and the mucous membrane of the rectum is considerably swoUen. The secretion of milk usually stops even durine the first few days of the attack. 5. Unnary and genital symptoms are those of nephritis and cystitis. There is severe strangury. The urine often contains blood and the characteristic products of inflammation of the kidneys, such as urinary casts, epithelium of the kidneys, leucocytes, and albumen. According to Frank, its reaction is often add. The vaginal mucous membrane is hyperaanic, swollen, and sometimes shows diphtheritic deposits, ulcers and a mucous discharge. Pregnantanimalswhich are severely affected frequently abort. ' MALIOKAWT CATAMHAI. PBVBR OF CATTLE. 5, thi.**i^r" Tf^ Pl'y Um chief .^di, in Dunv case, rf •ndvervresuia rfinSf' "' ?°™^ '«»™« greaUy excited become shed in rare kSc^ st^, ^w ' P* ^^*» "^V tion. and severity Tttrranes. Inflammation of the bram has also been observed. We find similar changes in the spind cord :nie kidneys are iiu^amed and show fatty dege- neration. In the pelvis of the kidney we sometimes find cro^y deposits which may extend to the ureters and bladder lie mucous membrane of the bladder is inflamed in extremely varied T^' ** l*° *'*"'®^ "^^ *^«Py membranes, and infiltrated with hMuorrhaps. Among general changes we may observe : h^onrhages throughout the entire body, especially in th^ „^L .1*^^'*™'" membranes, in the mesentery and om«itum and under the skin ; fatty degeneration and spelling of the hver; fatty degeneration and discoloration of^ ^TIk'u uf"*LP"*"**^°° °* *^« <^^«^: dark- coloured and thick blood; accumulation of sero-sanious fluid in the cavities of the body; sUght inflammation of the pleune ; etc. ra*5S^ "* P»o«nori«.-The course of maUgnant oitarrhal fever is sometimes acute and even peracute ; at other times subacute, and even chronic. Death may take place as early ja from 3 to 5 days after the attack, aliough r^e^ may be delayed for several weeks. The disea^ lasts on an average 3 or 4 weeks. Relapses are so frequent that an J^ seizure may take place as late as the second or third During the first few days, we may often observe an apparent ^Wfi ^« PT,«* »' convalescence is always more or less protracted. In mild cases, complete recovery takes place in MALIGNANT CATARRHAL FEVER OF CATTLE. 53 about a month ; but may be retarded for double or treble that s^:^^piS7rati"t^s -- -- — Of rjL^ on the third or fo^Tv'^ft^*?* ^*" *«^ slaughtered onlv 6 nerV.^ T!r . ^ . *^®y •'«««»« »U- Fnmk saw «^ grave c.r.br.l.'^^tdtrjScr'SS tbe prevwoaly describe duuiges in tl^Zr^^L ^"^ which is by «o m«„„ S^L^^iS" ^ir^"^'' points to be considered • t ttUTT^ foBowng an ^Urrhal feverTasXt ^ ^t oTrLTr^^^ ^eartt mdjgnant catarrhal fever, the best-marked^pto^'*^^ tt<^ be^m« much more difficultth'^'^^i aSLi^S^:^^ with mahgnant catarrhal fever in the sameS^dlJ^Jh laron !S *^'""~'"°*^'*^«- Herewemay^rT^^"^- it^L?fe; been recommended to render th^^ of the shed waterproof. The infective nasal di^^i^d 54 INFECTIVE DISEASES. ^ frequently removed and thoroughly disinfected. Senen. tion IS also advised. No remedy has as yet been foilS. In former tmies, blood-letting, washing the sldn with vinegar. inhalatioM of vmegar, sawing off the horns, trepanning, andthe admuustrauon of tartar emetic and camphor wet« recommended. *^T'.u"**7 authorities, such as Frank. Hink and Ziindel. •ay that they have obtained successful results with the internal admmjstaition of creolin and carbolic add (5 to 10 grammes), and with external apphcations of these agents in the form of wasaes, inhalations, and ointments. Hink strongly recom- • S*^r*^°"* ^'^ °*^ "^^*y with a 2 per cent, solution L^^A I^^ ^"^^ *^^ symptoms are present, we recommend the contmued application of cold to the head, as for instance, by means of bags of ice and cold douches. This treat- So?,m!1^*!°.''°^*'*"*^°°«*^*- The other symptoms ^'^n^^llfS^r'^^'^*' antipyretics.^Llies. organs. The investipttions of Friedberger point to thi probabiUw^tS the mahgnant catarrhal fever of sheep i, caused by a cinU^nm wSI may remain in a shed for several years, and which canlSd^tTv S trananutted to a certain distance; because animaU^hi* h wmL to l^thy and separate shed, have become infectS^ A^Sm ^evS that he has found the contaginm in the form of a badUns of torn Tto I^ long, and of the thickness of a tubercle baciUns. T^SS us^C oc«« enzooticaUy, and in «>me instances. epizootSu^T "S ^^Uy feared. Formerly it was thoughVXt^ diiJe^ caused by simple coryza becoming " maligniuit " " deffenJ™.!--.. P-«ing into " gUu.de«." OtheTaJthoSIJSr of an tS^c^o™ Vi f^of^lSr*'^''- ^-^^^^-^entfcTwrtKe'^iShS The disease begins with symptons of suppurating nasal catarrh Jnjd together and from which a muco-purulent and (accoX?to^me writers), sometimes, a foetid substance can be soneezed ^1 !! ! muco» membrane is highly congested aT ,i:u:2"«^sy,Stor: S^^^hiir*"*^''^' .*»«'»'*i'»' "d « severe cases even symptom aln^^ P««moma or pneumonia caused by foreign bS 2S kS^ 15^""'T- S"PP«««"8 blepharitis, p^irul,mfcon)SrtiX kera^tis. and even ulcers and abscesses of the cornea are also »^n T^J zttr, '^^S:^^z\t^ »'>««n 5 rg^y!"pij2: rur* y^-^^^^y^^. ^"^n-iiLcri-viirs colour from orange to cinnabar-red. i, .woUen, Lid oJTen^etS MAUGNANT CATARRHAL FEVER OF CATTLE. 55 br^t«,h of ^-J^fr *^ ■ "PPnmtiiig dermatitis, •ccompanied l^ti^ -S^^^ ', f*?****' "tnUning to defecate, and .uppreM^ .^re.^riSLjri:^'"--'-* "-'•"<• ^^^ ^u^- less diffuse and ramifom nuSW «LuUv tS^T.o« Tl**' ridt r*T:* *"T' "'^'•' vanes'in'SLm's^^'To v^^Tk' ^^ cr^v^umnv ^ "*^ '?''' **• ^og-spawn. and tooth^ tous; the muscles of the heart are relaxed hH»»i. --!» x ^ 7 .. •ugnuy anected . m thorough disinfection of the sheds • and >n «h. «-i^n «^^ °* "^?' *"** """" ^ ^« *«™ °* electees ma^b^ "^ «< U» Phu^Ji^pl, iamb .^JSTS^r'toTSSf aiMCK. me other horse presented similar svmDtoma • »h-\,«- •. He^^covered. but remained blind in conseju^ce oH'^^S.TS !« INFECTIVE DISEASES. ENZOOTIC ABORTION. f S?*??"?^*!^"" *'**^ " *n infective disease amoiur tS^f^ " **PP**"*^*'yy«^- Although the nature of Sro>^!S^~, *''*° •Pi'ooticaUy ; and that ordinary aboSon tai^tu^^, sporadicaUy. in consequenceT^eSSS mwma, lias been proved to exist in the excretions of the eenital organs, and m the Uquor amnii of co^ which have ah^S^ meiLT"l°i *^> t««««nitted to healthy p^^cfv^s^J SJ^trtSH^ Consequently, the dii^K enTt^ Sed nL^^^-^'"'^ *'^?"«'* ^' P""'^ °« cows fro^ ^!^f^^- ^'^"^'^^^tJ'^fi^ttoexperimentaUyprodZ anSrtw,2 ^'^^ *=^°"o° o* an immature foetus. Kilbome and L^ in^ri"** ^"Pr»ti°g vaginal catarrh in cows ^Tn^ y^^Z of '^*'"**'°°.' ? ^''^ obtained fro^^ ^Sin^ • ?^ "^"^^ ^ *^rted. Turner sue- tte vaguial injection of cultivations made with the mem^^ of the ova of mares that had aborted, and witii the S?^ from the gemtal org«.s of foals suffering from umbihSl^ " which, according to him. has the samTorigin as epizootic S iiM. ^'^'^ ^ ""P'y P«>ved that epizootic a^o^4 ■ highly contagious, and that it can be tr^S! ^ L/: ENZOOTIC ABORTION. j^ "•nure, mter servants, vetennary suneons who had a Aor* ^pre^yly removed an aSii??TdZn^d £S^ Dour, and so on. We may also frequentiy trace the occnrrJ^. of an outbreak to the fact of the ^uid nL^r^ni^^* nant m the neighbourhood of the impUcated co^T^ ^ ^ t^^ tutors as defective nourishment, exclusive stall- feedmg. contmued in-breeding, and preceding ^ uZ2 wWch Frabnrg doraig the mt years o( 1878-iSro The fact .1,^ JsS£i° yr'r "'•^^ «^ »««?^^S^,.^' production of the disease, is proved by the reoeatedlv ohw^ occjurence of infective abo^on in'^pJJ^^^t J^oL"lt*'Sr'"*''^ ^"^ '^*^' ^^ «^ i° modersSds?^'j dS ♦!?. ^"f 8*"*° steppe-cattle, which Uve in the oj^ iTi^^?^^ Jk"^** y*^ (Kocourek). The mere putrefactio^ the after-birth camiot of itself originate the disease • iJ^JJ the occurrence of enzootic abortion is extremely^ iT^T ^n to tijat of the retenUon and putrS^j; ^th^r: trates through the vaginal canal and the os uteri into SuS, peral fever, with consequent impUcation of the membrane of in these cases of abortion, the foetus usuaUy is dead s^rfo confirm this theory. The death of the feL is a fii^i! ^fthe^^oi^"" ^^-^-tyetableto^e^dtS;';; a^S ?L« 7^^ °{ "°^'''** '"***«■ obtained from the ^1^ ^- *°** ^"^ "»* membranes of the ovum wi^sub sequent abortions in cows oiss shi>Pn ««,! ^V «• •" wws, pigs, sneep and goats. Biot states 5» INFECTIVE DISEASES. that the cause of tiie abortion is an infective inflammation of the ZT TTi^ °* *^* "*^- Nocard asserts that the conte! &r?S;^' '^S' ~°'"*' °* *^"*"* ^^ °* bacteria, is to be found between the mucous membrane of the uterus and the nt^a^T*.? f' ^^ *^** '* """^^^ permanently in the uterus, without havmg any injurious influence on the maternal SterTon^/ H T ' fl^ ^' '* *"**=^ ^^'^ ^«*^ membranes Z^ion S°° ^^ *^'" P^*"*' "^^ ^"^ ^nv^\Ay produces atxtttion. This contagium is also supposed to cause sterility by thB condition, kills the spermatozoa that penetrate into this ♦^nnT'"'^ observations made by Danish veterinary surgeons T^ K^"""* *^** *"^*'* *"^^ l»a^« passed through the iXt^. * '?'' °?y. '°'' *'°"? " *° 4 years, if no fresh infected cov s are brought into the sheds (Sand). rf„ rS?'?^?";"'"*** *°"" °* abortion occurs in cows usually during the third or seventh month of pregnancy: in mares durmg the fourth or ninth month ; and in p,^ during the tenTh or twelfth week. The premonitory sympto'L are: s^IS^g b™ "ii"' i^t ingestion of the vaginal mucous mem- rf^h ' ^'^^ <*^*y '" ™"^)' catarrhal, muco-purulent S^^f ^^. ^i:^^ ' «=<=^o°al fonnation of pimples the sue of a millet seed on the mucous membrane ; decreased yield «„'^.' a°d a col^trum-like condition of the mUk. Abortion gencraUy occurs about 3 days after the appearance of the «m«i^ ; "* ^™ ^- A persistent vaginal discharge oftei^ T^^^w^T^^"^^^^ **"" ^'*"^ «»« abortion, il conse- quence of which the cow may suffer from continued bad health and may become sterile. ♦.«S^'*"**°*~^*™Pby^*"8 ^ *•»« chief thing to be at- tended to meases of enzootic abortion. If the act of abortion onw begins, it cannot be stopped by the administration of opium onlS*'^*'" '*"'^y- '^'^ "°'* important and frequently the rS ! *^*''''' "•^"" •* *° *«^*^ «»« pregnant cows to another Shed as soon as possible ; or. if practicable, to turn them out to grass and to ngidly isolate them as regards feeding and tending it IS also imperative to completely remove and to render inno- cuous every after-birth and dead foetus. Each staU and the ENZOOTIC ABORTION. j^ !h^^'i!^!f- ?^f"^** ^ thoroughly disinfected; • the patients should be disinfected by washing the genital ^rganst vritt a Vl^l ^* f ,^ P"" *^°*-> ^*° *^« ^»P°a a°d ut^. T^ S SnfS^ "^l*"" *°^ ^"^ ^^* °* P^««°»°t «'ws should infcS? ftl!?i "" *K\r"' ^^^'^ ^"^"^"g ^°^« ^Wch might mfect themse ves by the vaginal discharge of affected animals and sows which have aborted, should bl kept away fr^ tte Futures for a few weeks (Gassner). In order to ^^ ^^e predisposition to the disease, we might -. to strength the constjhition of the animals by exercii a. . nitroge^XL tion S^ !!Ii . reappears in spite of the thorough disinfec- attend' r*°*^ *°^^'' "^^ '° ^P»t« °^ g^od feeding aTd attendance Consequently. Brauer attempted to protect the Stions'^r* *^\?^ ^y "«"^ °^ sSbcutaneL ^boUc in ections (two or three Pravaz syringefuls of a 2 per cent S nrrt ^'r'"" ""'^^ '^^^'^^ fortnTghl^LThe nK. • L T""""^^ """"^^ °* pregnancy. He states that he obtained good results with these injectioi in a seri« of SsT positive; others negative (Schleg). From a purely theoretical obtamed with carbolic acid; because that agent quicUv it^"" K^K?"" J^y ^*** sulpho-phenic acid, which is^^^^ It IS probable that the aUeged favourable resets w«e d^e to the simuluuieous disinfection of the external genital^^i^ purp^'^ylr™*'' f'^t °°* again be used for breeding chZn*^?u1/'«^*^*^^*"««^**<=o™PJetely stopped. A mfluence on the epizootic ; probably because it freshens uT^c dSL K^P'^r. ** constitution of the cows, and also. WKr,L l/Z'*^"**^ * '°"°«f intermediate bearer As fr«hly.bought breeding animals may be intermediaHL-ere they ought at first to be kept separate from the rest. 6o INFECTIVE DISEASES. .oeS5?S!If!"•~^!^u"^^*"■ «P'«»«c) abortion 19 a symptom of a specific mfective catarrh of the ntenu, which catarrh aDMai. to Z . Sr m ,^H t ' ""*' ''^ coMtitntional disturbance, and gives risTto no morbid changes in the tissues, with the exception of thi TJ^ Abortion is not an invariable symptom of this infective cata«h. ir.J^^^'^. *"* B«»UFloIoftr.-Bang and Stribolt have proved by the uioculauon of pure cultures that the dis««e is set up bv a v^ s^I non motUe baciUus. which contains one, two, or more ra^e^ th^ roundish or elongated granules. The bacilli vary greaUy ^ leiSh '• S thTl if methylene blue stain. They are most abundantly found m the yellow exudate which is met with in this disease l^twLnlhe ^e P^en^ !^f T^"^- *''* ^'"^'V <>* thriving t«t either wh« uie percentage of oxygen is somewhat less than it is in the air /«.\ nr when It approaches but does not reach 100. In atm^pS^oM^'t^! tol^w P*?^°'*«« °' ^^yg^. it thrives more or less ted^ or <^ to grow. The examination of mummififed foetuses has ^oSi ThaT^ bacilh can remam virulent for at least 7 months. chaJ^Sr^.Tl* S!S*"r?^" r'y characteristic ^0*/ mortem * omS tCJ,!* ?^ K ^' ^'y-ye"<"'. flocculent, slimy and more ™-!!tL exudate which is to be found between the uterus and foetal m«mbran« ; and (a) oedema of the sub-chorial connective S^ewhl^H Tr^'Jabo^r^rT'^ 'l^'^''' '^^' «^'^°'»' -^^tul ^"e .^^SIT . *^"«»» does Eot appear to be dependent on morbid chanses ^.^h of'ih*: :S:? '^"^"'^. '^•=^'» "nay^y not bepr^t.^" Tw^»?. '^' u ""^ "**y *^' ^'"""t causing premature deUverv nte baalh may become transmitted to the foetus Ld may hereby S nse to Its death .» utero. with mummification in some ca^. '^ ^ Th« Pariod of Ineubatioii (•".«., time taken by the bacilli to ut «« Bang^ who remarks : " It is self-evident that if the va^iaU to^' r^ajed as the chief port of entrance of ^^L^l ^Uon miS S?^i "^^ favourable opportunity of aU for^eittoi „ thTt J tl b^^I^L*^ "t^ ^k'^^* introduction of the vinjtt; "e u^iiS cw be effected^ Bang has proved that the disease can be set ud in th. c«Jt~ « r^S^' °* .V'* "'"™ ''^ " intravenorin]:cUon ^of pi' m«r'^j^«\ra^j*":rti- rsr"^ *«^" ^^°''»' »--'«. Bang and oth*e„ 'LTll. Z "^rZ^^^,^^ ^ S^' uoeMe seems to be idenUcal m cows, mares, ewes and she-soaU and c«be_^mmumcated from any one of these animals totSTS T. DYSENTEay. DYSENTERY, •hit .nim.l_B»l« d,«i.i^ I™, cocdfc^^^^ infiltraUon of its mucSL Ld .^hm' '"PP-^ting and ha-morrhagic i. unknown, is rS^norS^TcomaZ:' '"^"^^^^^^^ communicated by the e4cuation, «/ L^ ^'^^ . ^^ »nfection ig The disease appLs sSSlT^^d ^'"- "Jf*^* *™'" dysentery. symptoms consist oTj^^X^Sin^l^' "* ."*' ^"'P'"'- ^he >omiting ; mncous and^S,?nT^ * diarrhoa and tenesmus ; coUc ; of the Le, ; 1^d,^^SSn ^H ' '^^ ^"^ "^^^ ~»«""«° ComplicaUon, ^tiST^tT S to SftaS^'' f!^*^ disturbance, a diseased condition of the ^ti^iJ^ "wtance, abscess of the Uver, membranes, p^u^e J^t"J?to ^r ^£^."°" "' *''" '"^"^ in the administration of aS»ta)!fliJ«". ^«**Pe«tics consist chiefly [The most vaSwe^S,gTTh^ ^^^^t'^^''?''- "i^) »»^ doubtedly ipecacnanha.-TK.] *'***'°'°* «»* '">'»»» dysentery is un- r Th£ Dysentery of Suckungs. calvt*'S^?r?^'' 5^°**^' °* '"*='^°8« <*iefly occurs in N«rto nv2. f°jf '"*' P'*^' ^'^'^' ^». cats anH^ SilJ to S^r ^^"i^^**"' '* '* **»* "»«»* destructive diX severely attackwl ♦>.«♦ r""**fy- "any farms have been so W1P« cwt) In the y«n8&,, 55 p„ c«it. of .U the .iKted *«• INFECTIVE DISEASES. exclusively during the first 3 days of life. The animals often become affected directly after birth, even before they have taken any milk, a fact which goes far to prove that the mother's nulk does not participate in the production of the disease A further proof of the non-participation of the mother's milk in the transmission of the disease, is the practical observation, that dj^ntery also appears when milk from non-affected sheds or boiled milk is given, and even when substitutes for milk are employed. Etlolo^.— The cause of the dysentery of calves is, accord- ing to JcMen, an oval bacterium which appears singly, in pairs, or in the form of chains, and is either a pathogenic variety of the bacterium coli commune or identical with it. Jensen con- siders that the disease is not due to a specific contagium, but tc a pathogenic variety of the bacteripm coU commune, which U normally present in the intestine. The usually harmless bac- terium coU commune may become pathogenic, and may pene- trate as the exciter of the disease, into the intestinal mucous mmbrane, when the newly-born calf becomes exposed to debihtatmg influences, such as chill, errors of diet, etc. Culti- vations of the intestinal bacterium which has become pathogenic also produce dysentery when given along with the food to healthy calves. Intraperitoneal inoculation produces in guinea- pigs a fatal, very acute, sero-fibrinous peritonitis. Th- direct teansmission of the disease by experimental feeding with diarr- hoebc faxes has proved unsuccessful (Gutmann). On the other hand, It seems that the disease can be transmitted from one speaes of animal to another, as for instance, from calves to lambs and pigs (Kotehnann). It has been frequently observed that epizootic abortion and dysentery of calves occurred at the same tune. It was also supposed that the foetus might become affected by mfective matter which had penetrated the vagina of the pregnant cow, and that this theory explained the special frequency of the disease during the first days of life. Jensen considers both suppositions to be incorrect. Schiitz has con- firmed the results of Jensen's bacteriological researches. Ac- cordmg to him, the intestine is the source of the infection. The contagium is disseminated throughout the shed by the fseces of the mfected calves; and gets into the bodies of healthy calves by means of mtermedUte bearers, such as farm servants and the dung-soiled teats of cows. DYSENTERY. the "SST^^ " ?i^tS"^ characteristic about covered with mucus Sd pus wWcf^jJ .'""*=°'" membrane is bacteria. The epithelium^f tt^ 1^°***" * ^^^ '« were yellow, become J^'Sh ' ? **"«f «°ts. which at fast mucilaginous conation a^'^^l,^«':y*Wn; they assumra caUed "white" dysent^r^.nT*!^ *"*, *=°*g^ated milk (so- then very fetid. T^^tSf^^^^^y ^^ blood, and ^^e there is excessive weaknws^ «!S ♦k ^^^"^ involuntarily; Jnuously. suffers irom cS^^ *t d'"^*' "l. ^°^ «»^- flow from the mouth. iS Sen ? ., "'^ ^ ^^* *<» hours, although the avera^^rfS .f^^ ?*"* ^*^ ^ disease is from i to 3 dawT -fff ^ v""* duration of the 100 per cent. Very^rtuenti?!.^^'^*^ ^"*« fro*" 80 to one a^ter the oth^ Th^sS^L!? "*" *^^« <>' a shed die a very long time. ^"^^^ ^^"''^^"y "niain sickly for very^^titSeS^'"^^^^^^ become depressed and m«. they pass thin.^cS^ior feLT"^"^^ ^'^ *««" tempwature may rit^ to It?T^' .**** **«»• At fa«t the y "«» to 41.5 c. but rapidly falfa towards the «4 INFECTIVE DISEASES. end (Nikobld); respiration is accelerated, and saliva and mucus flow from the mouth. As with calves, the duration of the disease varies from i to 3 days, but death sometimes ensues m a few hours. The disease in Iambs is also specially prevalent during the first 3 days of life. According to an observation reported by Nikolski, 30 per cent, of the infected lambs become iU on the first day after birth, 40 per cent, on the second, 25 per cent, on the third, and only 5 per cent, sub- sequently. He also mentions that, out of a herd of 12,000 sheep, 50 per cent, of the lambs died from this disease. Dysentery is also lound in foak during the first 3 days after birth (Mazoux), and sometimes later on. The animal becomes depressed and restless ; the frequently-passed faces are foetid, or thin and mucilaginous ; the breath and the exhalations from the skin often have a very bad smell ; the eyes are sunken ; the animal becomes very weak, very thirsty, and greatly tucked up in the flanks ; and sometimes there is a cutaneous eruption, which spreads over the whole body, and is particularly well- marked about the anus. Dla^oris.— We diagnose dysentery from the fact of its enzootic character, and from the presence of severe and rapidly fatal diarrhoea during the first few days of life. In sucklings, the disuse is most readily mistaken for acute simple gastro-in- testinal catarrh, due to errors of diet and defective condition of the milk of the mother, which affection of the alimentary canal does not, as a rule, become developed soon after birth. Also, its course is milder than that of dysentery. Thumpaaties.— The sick animals should be segregated, the infected sheds thoroughly disinfected, the udder most care- fully purified, and the female organs washed out with a disin- fecting fluid, both before and after parturition. If the disease is enzootic in a shed, pregnant cows should be put a few days before calving into a fresh and dean shed. The observance of these precautions has proved to be far more effective than all the medicines that have been used against dysentery. It is advisable at the first appearance of the disease to give a mild laxative, such as castor oil for calves and lambs, and small doses of calomel (o-i to 0-2 gramme pro dost) for foals. Usually, rhubarb root (2 to 5 grammes for calves, and ^ to i gramme for lambs) and opium (i to 2 grammes for calves, and o-i to 0-2 gramme fw lambs) are given alfma or combined. We can DYSENTERY. ' its tincture. 7 to ta J^^^' t ""*^<* °* 0P»um, we may give grammes for h^te *S1 ? ?^** ^^'^ *°»^' »°d ItT^ in much ^ doses^h^ ** '*^ *^'=*'"" »*>°'^<* b« Pven doses menl3,iTbe^tTJ°"""'^ *''"P^°y'^- ^« intervals of 6 hwS) ^TS!^ i°° f ^'^f^ 3 times with tannin (i to 2 eSn^LT *?* diarrhoea has ceased. Also lambs) my te^Z^ttr'1''''' ""^ "'^ *° ^^S gramme^ quantity of JScTaSi Istri^L^^"'""^ "^"^ ^ '^"^ in camomile tea once^ «;»,>« .^?°**'. ^ ««»«»« of each tionisgreatlv^t^JK "****y^°''<=*^^^- This combina- * per cent. waTei^^^Lon t^^^^l^^^^^^P^'-*^ <>* * (three doses daUy of laLm^r. ^ ? T *" ^^**>' <=^^ of i litre for SJJL ^ETanl^.r, "^ ^^f f *^^**>' *«* ^^'^ etc. Wemay,S'S^'"!P^*^*^'f^°I'«Jte of bismuth, suchaslinStrd^tin^T^ mucilaginous demulcents etc.. alonT^rbin:?:?^^^iut^' "*""^ ^*^' ^^ ^' The Dysentbry of Adoit Animais. in ' ^"PP«^ ^ swollen; in P^ S^ 0^5^°"*^*=' '* ^ °*ten yellow diphthS: SJte w Ji ?r° • *°^ '=°^««^ ^th scars. l^econt^'ts':fSri„r^^;^^Ltidtrt."'""r' vanes from dirty-yeUow to thaJTbl^ ^k^^ **" '^'°" iniiammatorilyU^:::,^^'^,^'^^^,^^^ - S « INFECTIVE DISEASES. intestiiial mucous membrane is sometimes thickened and of a slate colour ; the muscular coat of the intestine, hypertrophied ; and the intestinal serosa in the neighbourhood of the ulcers and •cars, affected with adhesive inflammation. ■ymptoms.— As a rule, the disease manifests itself sud- denly by loss of appetite, high fever (40° to 41° C), rigors, debiUty, attacks of colic, and diarrhoea. Later on, the fseces become very thin, mucilaginous, frothy, discoloured, foetid, and even bloody. They are often mixed with undigested food, croupy membranes, and cast-off epithelium from the mucous membranes. At Ae commencement of the attack, tenesmus, and frequent, unsuccessful and severe straming to defecate are present, so that prolapse of the rectum may take place. Later on, however, the faeces flow involuntarily from the paralysed, gaping anus. The mucous membrane of the rectum is exces- sively congested and swollen. The ^animals evince pain on pal- pation of the hind-quarters. On pressing the right flank with the hand, we may sometimes feel well-marked fluctuation of the intestines, which are filled with fluid (Albrecht). Weakness and emaciation increase ; the internal temperature falls below normal ; and death often ensues in as short a period as i or 2 days, but usually not until 2 to 4 days. Mild cases recover in 2 or 3 weeks. The chronic course of cases which continue for weeks or months is probably due to the presence of intestinal ulcers. The prognosis, even in grown-up animals, is always doubtful. The mortaUty is about 50 per cent. DUENwntlal DUtfnosls.— In full-grown cattle, it is difficult, and may be impossible, to differentiate dysentery from toxic, mycotic, and enzootic intestinal inflammation. The results of fost mortem examination of cases of <'ysentery some- times closely resemble those of rinderpest. It is important to remember that in dysentery, only the intestinal canal is affected, and that a direct infection can never be proved. A distinction between dysentery due to a toxic or mycotic inflammation of the intestines is not always possible. ''••*»*•«»*.— Besides mucilaginous agents, such as linseed tea and a decoction of althaea, we give opium (10 to 25 grammes) and astringents, su^ch as sulphate of iron, tannic add, sugar of lead, and nitrate of silver. Coarse fodder should be avoided. BosiiM DyMBtorj from OoooidiA.— Zscfaokke, Hess, and GuiUe- dysentery: ^ «n rapid ,ucce«ion, untaTSal or'^Tjf ^f "^fi *^ *" "°'''" It appears chiefly when the animal, «r«*^ ^*"' *'*^™ affected, turned out to jLture, Md^^uTntlf i„"° '^^ "'' ^•'~ "»«y «• i« •uppoMd that the c^»» membrane, and memaUy in cattle by^tSa^in^ cJSd^"'^ ^ *" ^'^^^ ««?«*■ Wad-qnarters, ha, difficS?'in ItZ^In'^?' '^^ ''•»^«» «' the th* upper eyelid, b^me'^JJ^Slyl^t^'^'^^y «« down ; The appetite becomes suppre«3 2 torn J ^ A' •^•' "^«>- the thint is great Soni-»!!»Z^ ^ " 4 to 6 days, althoash patient becom^very ^S^' "r, «1,"™>8 '•»« «"' ^4 hours, the of the flanks aw dSs~o?lS!, f^* ~"'=' "** "" movwkeaS «:tion of the int«^T?iC Lf^' ^' ^*' "»« P^*^^^ the early stage, of t^ att^^^e^l*^"" *""'«» •»'« <>»• In more frequent than ^Z ittS^"^ T^- "^» "«*» '» «» coagula the siae of a oea b«n «, ^ ""•" ™«"** ^th blood «re case, there i^ at'l^t^e^' XZ^T ^* ' ^'''' ^'' '» -^ violent straining, in wSuZT;,"'^?' dwrrhoea. combined with or 3 days tat« an^S^S sL^ m^'°**P"" "*" *PP«« « found in the now thin ,^or^"''^»H "°°i «««n^ »" sometimes that inexceptionT^^^*!^''"r^y*»««- It may happen dysenteric diLh«a ^ p^rf^;,.'^""'" "*"'^«' *°*» »«^ tinal evacuation, alwa^Ji^LSl^^r^T"'- ^" ^'- "^s rrs^nrthrd* '^•^"^^ ^^^ -d?t!::oTSs^- •"''^- •««f.herr"L°'d^forn"r4«rL""'r'- 'r""^""- ^- with a normal condition of thrf^ r^"** '°""'^- '" «^d cases. or in , or 3 weeks ^oJly t^i/'S^^.'SS^P^*"'''^ = •evere caws with violent Lti^ i^t«t^i^ i. ^ " P'"~»- '«> may die within 34 houn rS JL f!^ hemorrhage, the animal dangerous. Relapses frequently occur; but are not '^^J^^-I^^o,^:^^ ^ -n to have a of the rectum shows thin btoodydt^ T.V T"*' "»«»>• membrane feces contain numerorcoSf "*' "'* P*t~hi«. The meJS^rtXiS'ti^hldl^L^^S '^'^^ '^' - "^ P^P'^ylactic cwolin. and lysol comW^eJtSh^.,!^ *^*" '' *"** ^ ^^"^ •i'*". that the infection^ pSp^i t^^l?^"'*!^ ^s it i, .up^' advisable to guard thn"lrt th^T^ ^^^^ ^^^ ^^^^ '* « water as pure as possible masonry, and to preserve the rain 5* 68 INFECTIVE DISEASES. ERYSIPELATOUS DISEASES OF PIGS. Swine Erysiptlas, Contagious Pneumonia of tht Pig, and Swine Fever. 0«ii«na RMBMka rat th« BfjaipdUUoiu IMmmm of Pftfa-r— Little was known concerning the respective differences between the epizootic diseases of swine, untiJ the investigations of EggeUng, Ldffler, Schiitz, Lydtin, Schottdius, Bang, and others, lately threw light on their respective etiology, symp- twns, and anatomical changes. Even at the commencement of the eighties, ahnost all the epizootics of swine were included in the coUective name of "swine erysipelas." The researches of the last 10 years, however, enable us to divide them into the following independent diseases : — 1. Swine erysipelas, which is a specific septicaemia pro- duced by a minute bacillus that manifests itself anatomically by hxmorrhagic gastro-intestinal inflammation, inflammation of the kidneys, sweUing of the spleen, and parenchymatous inflammation of the liver, heart, and muscular system. 2. Coniagious Pneumonia of the Pig or Swine Feper [see p. 85], which is caused by an ovmd bacterium, and occurs in two principal vsmeties, namely : (a) The puhnonary form, which appears as an infective inflammation of the lungs and pleune, with a tendency to necrosis and caseation of the longs ; and (6) the intestinal form, which consists of intestinal diphtheria with caseous necrosis of the intestinal mucous membrane. Hiaftorj. — The name of swine erysipelas (splenic er3rsipelas, swine typhus, contagious pneumonia of the pig, St. Antony's fire, and petechial fever) was formerly given to several porcine diseases which externally resemble each other, only by the fact that they respectively produce redness of the skin, which is a symptom as common to entirely different diseases in swine, as is colic or haematuria. In former times, the following diseases were, evidentiy, frequentiy included under the term, swine erysipelas : urticaria ; anthrax ; true erysipelatous inflamma- ti»-Wy -vend nature of swine measles \i^L ^^ °* opaaaa on the othe« drew atteSTo tht f^^S t^ "*^*'' ^''^^ "»<» was not anthrax It^^ TJ^ T°^ erysipelas (measles) eating of ^f^^CT^Zv^^ ^"^^ P~^***' *^« quences to man ThI. ^^ ^^ produced no ill conse- 2ntenable inT ^ ,J2*^« ,?«>n' became absolutely Who di«x,vered the'^Jf^an'2^ "^^'I^'.k^""^"' were immune to inor.,i«*i^ «iinracis. He showed that pin culatiorrth SeS i? °*, ""^'^ "«^ ' ^^ that S? Besides. tTe bJdSi^T^lTf'^y ^"^ ^^ °°t produce anthrax, pig. »«ffering^„°i^*^"L*"; °«ver found in the blood of described^e eSsiS i^^' ^' «*™»' i° '869. which consisted STaul 1^ T J° '^"^""^ ^'*^*^^« *^^ intestinal mucous memff .f ''*^ *^'^t^<'° °* «»e gastro- the hW. SS^^ m^r'U'S*? P"«°<*J^tous chaS^ in not attadc the iSgs ' ^ ^^^^ ^^^' «>d Si did human eryl^ ofCSLS t) S^^f wWch resembles scarlet fever of man It if aTl JT ^^ ^^ compared to t«nsmitted by ElaL ^d wV ;;**°?«°»a ^^ch may be •titutional distu^W L~r ^ "^ distinguished by con- of the skinTS»VlS,;™S^Sr ' *"** 'P*'"^ discoloration «^t. sp^ tetSL S?S^ *l^' ^°*^^ P°tion of the respiratwv ork^T^™ of the mucous membranes of the livS an7kiS ' ^T^J^'' ^'^ • *°** ^^ha^g^* i» the most dangerous porcine ep^tif lis!J^T ^"""^ *°** constitutional disturbance. Wknl SthT^*°°".'^ '^^"« redness of the sldn. which ^^^p^sl:^'^,^ * '»?o™ parts of the abdomen over TkI^i!^ u ^ *^^ posterior important anatomiXh^' oter^^'^'in'SrH "^^ "~* hamorrhagic eastio-int Jh3 • °^^^, "» the disease is a 70 INFECTIVE DISEASES. dunficatipii is the reverse of EggeUng's ; for his erysipelas is identical with Eggeling's contagious pneumonia ; and his con- tagious pneumonia is probably included in Eggeling's erysipelas. The names introduced by Ldffler have, however, been retained. Hu bacteriological researches have further furnished the foUow- ing results. His erysipelas is caused by a very minute bacillus which closely resembles Koch's bacillus of the septiaemia of ""ku* '* '"variably kills mice by inoculation, and either kills rabbits, or makes them immune against the disease after they recover from the erysipelatous skin inflammation which is fre- quenUy produced by it. But contagwus pneumonia of the pig IS produced by smaU ovoid bacteria which greatly resemble Gaflky's bacteria of the septicaemia of rabbits. Inoculations c\r/"".P"! *^*"*' ^ ""'=*• 8«»ea-P>g». birds, and pigs. Schlit* found and described, in 1885, Ldffler's erysipelas bacilli at first m the spleen of a pig which was suffering from measles and which had been brought fron^ Baden ; and later on, in pigs near Berlin. In the same year, Schottelius made similar observations in Baden. The nature of swine erysipelas has been fairly-weU elucidated by the protective inoculations and researches of Lydtin, Schottelius, and Schiitz. Pasteur Comevm, and Jensen have also studied this subject. About the time when the differentiation between erysipelas and contagious pneumonia was made in Germany, a very mfectious porcine epizootic, which was known as hog cholera, wnae fever, and infectious pneumo-enteritis, broke out in Amenca and England, and later on in Sweden, Denm'ark, and France. Its principal phenomena were intestinal diphtheria and pneumonic changes. Klein, Billings, Sahnon, Bang. Schfltz, and others examined it bacteriologically, with such conti-adictory results that the pathology of the disease still remains unsettied. The clinical and anatomical experiences however, force on us the conclusion that the American swine fever does not differ, as was formerly thought, from German contagious pneumonia of the pig. This subject is further discussed on page 85 et seq. SWINE ERYSIPELAS {Rouget du Pore). Bao^ology.— According to the researches of Lofller, Schiit*. and Schottelius, the bacteria of swine erysipelas are slender, with I im SWINE ERYSlPEJ^s. i^ute rods from 0.6 to 0.8 m in kngth. and cm be s «actnm only when they ut very highly magnified menion len. and Abb<'. illumination aSJatuTlSse bar-lli S rljrS^^ ^ '"^ capiUarie. ofSect^ ^^2 and othere state that they are identical with ther The- thnve best in dightiy alkaline extracts of the flesh oi lorS oxtn and pigs in blood serum and theaqueous humou^o ^ ev^ at a temp^ature of 36" C. Even at I temperatu^ of »«« C potatoes, infusions of phmts, or in broth made from the flesh STuSef tS^'' Z'^' ^^^''' '^''^'' ^^ consequently gS ^ti^ h ^'^f '"**<=« °* °«tri««t gelatine. Stab cultiSin ^e have the aspect of a fir tree or of a brush for cleani^ gtas8es.» These bacilh probably do not form spores. nStfe ing to Kitt they resist putrefaction. The bacilli can be easUv stamed with Gram's solution. "i" can oe easuy According to the researches of Jager, Petri and others, the ^,f,n ♦'^\"'^P"^ "•* ^^''^y'^ by slow dt^X from 50 to 80 hours; by water at 46° C in 20 mi^iJ^ by water at from 55' to 70OC. in 5 mhiut^ ; by ^tTat^- half . and by air at from -3» C. to -8» C. in 13 davs TT^^v are speedily kiUed by quicldime (i to 2). chloride olLe J^Z 100 . a hot solution of caustic soda or of caustic potash i to 100). carbonate of soda (i to 100). sulphate of iron (i tH) L? m^igana e of potash (i to 20). sulphate of copped (i to i^J Sd SL^n "* V*"*"^' antiseptics, such as coiJ^ve subliH; ^/^^- M- *=°°««»*^*«d solution of common salt, like th^ used for pickhng meat, takes 26 days to kiU the badm- !S*?T'^„^^- Ordinary boihng and roasting will not kill aU the baalh m pieces of meat exceeding one So in weLhT ^t two hours and a half boiling (notToasting) wS d2ro; them msmaUer pieces of meat. Sharp picklingfor not lesTS a month will kill all the bacilli in inl^ted mSt S^ thToS rsj 7* INFECTIVE DISEASES. KrSZJ T ?°*=^«* ^ ordinary salt meat for a month ; month w*^*' *°' ^ °*°"*^' ^d in smoked ham. for 3 meSS; n^' "^ "^ ^* *^«^ experiments that the o i^ meat Saturated solutions of boric acid, tannic acid kreeaic benzme chloride of zinc, and carbolic ;cid in spWt ^not accomphsh that end. even in 48 hours. The baay sometimes iTtSn^tion forms between the respective varieties of the complaint :— ™™"°" one we'S:e JTdSSlSed!' ''' '""'' '°™ °' ''^'^"^- '"^ » '•*• ^k/" f**"«^»f««»»i* is said to be a mild form of erysipelas the iTthe ^n? wounds of the skin), partly to the slight degree of virulence olrt ofTT'"'r'*T*°*''''*""P°"^*^''»««»^«^ susceptibiUty on the part of the animal. It is said that the bacilli of erysipelas hive been found m cases of urticaria (Jensen and Lorenz). Cons^uently 7h«e^o authora maintain that swine urticaria, which was foSy dSTril^ among cutaneous affections as an independent, ^nTg^. iS^ dom^i. "V^T^- '^'«e «» e^Ption of urticaria, as in oTer ^^llr^T^-.T^ ""^""y '^'^^ independently of erysipeSi' ^^^fT °* J""""" *"•* ^'''"^' P™^i'»'^ tl^^t they wiUbe%^ firmed by further researches, are very important; for thev ao^ to show that apart from ordinary urticaria, there is a sw^pto^UcTttll rash which may be regarded as a form of epizootic erySaT Acc^^„ to Jensen, the symptoms of this form are as foUo^ Th" dise^ « f rule, begms rather suddenly, by the animal ceasing to iSTtL^l high mtemal temperature from 415° 1042' C. and even to^8» C ^H S^'^nTT'''^ ^'L. ^•^*' ^*'^«' '-'^^ durinrtLUoing' ^ t^i ™ 1 'J**'^' •^'°«' '*°8"''*' "»'«• «"! so teak that U app^ as If paralysed. One or two days after the manifestation of the^ symptoms of the disease, more or less round. raisS^^X IpSL^ n^c" ^dSid^** HT^^ "" "»« •°'-' -*- surface"^? th^TgH u«^^T^ shou ders. which are parts of the body that in ordinary erysipdw usually suffer from no cutaneous changes. These spoU inc^W^K SnTe't'Sr"'?'' rK**.*^"" ''"''■"^' ^«'«*' <- more o.'^'^S^ generaUy square or rhomboidal, but may be round or oblong. T^ey "e 3 to 6 cm. m diameter, or even larger; are raised above the Sth^ •km only a few millimetres as a rule ; and often run togeth«- so 2^ to form Urge irregular, angular spots. They are of a dark-S ^lo^r Jd number from 50 to several hundreds. In very slight cI^wTm= T^ on the entire skin only a single, square-sll^'lti ^^ Sr ^, Sr;^ In'lTe'"?' '\''''' i-easTand the'aiimtftgS.' agwn to feed. In a few days, the wheaU disappear with desquamaUon of the epidermis ; or in severe cases, with slongUng of the sSS^h" ^^ INFECTIVE DISEASES. sequeU. UrticarUa^d tlTJ^H- ,Clm>'"c endocarditis is a rare Inoculations with pure cultivatiL of^;.i k ,, ^l"" '*"''* °* Pro- portions of the tissu^oS^tS^?!? K^*^, °* '^«=*^ '"d '^tJ' . negative result in Sg. (STg f-d^n,!"'*' *^~* '^^y' P"^-«» 3- ■ryaiyalM without MdaMs af th. .bf. /r- IS a very rare and a very acuteWm!!* . " (French, roK^rf Waiic) Jensen, with fever and with^raDDea!,?!- * ^ *'**^' ""^"ling to about the size of a man^^d on^T^u 1"^^' ^**- '«* ''^^"^"g'. shoulders. These s^^L *^^''' ^"t' «*>«' «>d joints of the the skin on the upper pa^t^d^dl n^ confluent, so that almost aU The red graduallJEmL^lrl T' """"^ " ''^"*° '"d reddened. or nearl/^iack ."^^tratS^^^L^^i LT ',™ "^l" "^^ ^'^''^ ness and warmth, become b^aJJ^^ ^^ '*** *''*^ sensitive- fonnation of a toe^Tei^tfon' Th.fr"''' T" "•*""«"* ^'^ "»« The resulting cicatricial t^^lfi™, ^" *"** **** °"«» ">* »«• subsequentl/conTr^^Jr^L^heTr*^' '*^ "''^ «^^'^8«' ^'l Some of the suffered ^e at a^* *,**''**' P"* '^'"^ «l«fo™«l. for I or 2 mont^ M^! ^ ^^^^ "**«"' *°d others linger on having bei,rUmanX Sg^tl^'^'^Sirt °'' '^""^ °* ^'"^ m size from spots that are'^asTrKa ^'s hf^r? °*^" ^"''» may extend nearly over the e^r! ?!Lf ^ ^'*' *° P***=*»" ^'»ic»» •hows that numerous e^S^J^'y^y; »«='«iological examinaUon of the cutis directly u^Cl^^' P"**'"* "* '•*« 'j^P^* «P«« and is follow^bn SenT^r.% ordmary symptoms of erysipela!. recovers ; but subL^n^Tb^t' ^S^Z"''^^ *^* "^"^ apparVntl^ cardiac affection.ThichTen^Tl^?=fot f^k^f ^"1' ^'^ cases, the pigs die from anoni^^^ x^ °' ^^^- I*» * few depression.^'5„i:t«t ,^P'^^^ ^hlrt'Z'T ^ ^ .'«" °* *??•'*»•• and redness of the skin in v«^: ^T "^^ °* breath, sUght cough, to such a high SLreT^TnT?^* ""^^'^ "** ««♦«»' : although no tation of the bS^«tlv ^Ir*!!^^- ^'''^ '^' ^« *»«» W times endocardS^ mS^iS ^hf V '^''°° °' "**' *"«*"• ""dVome the animal diwIriS^^ion^ n/ "^*''" " "**«» ""«««J a^d we may obser^ J«i«ro,T k T"^ P<^y^i>>. In a few cases. naUon, the St K^ the hLr» **"^"'^.*'"- ^ ^'"'< "^"^ ewmil right, less frequently rh^oer^ I "t"^! ^'"* *° '^ *««=*«» ^ 'he mitral valve fa the most fL^^ts^t'S'!! '^^^^'''^^^ "?' »"'» "" and thickened, and sh^w v2^^ ve«f V^^' ■ J^' ^"^^^ "^^ ""^"U*" in which large nurn^ ^^T!^ , ^t^''**"" '*^*'' deposit, of thrombi. toBang.endS.^"S^,^St*no^f;"^''.'°""**- "^'^^ ^ Which had passed ^uTan" "ac^e^itac^of-^eS^-ClS SWINE ERYSIPELAS. recommends that the segre«ttion^ ^ J l.^**!*- ^« therefore •hould be continued after thS^veln^f ^l^^ «">« erysipelas or that they should he ^^^^^^Z^^^^^^^^^- ^-.^ He«':an^e.'^fi:^^^^-^^o^^^^ from an acute attack. The aspect^ cSci^^.''''*^'"***«'«'''P«i from that of the acute form Althon^wr ^''^'P^'" *«*« essentiij^ the acute attack has subsWed. lie Si^^^P^"** ---ns goodS w drawn up, and there is wes^knws^S^hS ^ emaciated, the beUy The patient suffers from a S^^' st^ o^ii,T.^!K°'*°«" °* '>"><'^- several months, and which, it isT^d mL L ; .f*'''*' ^^''^ '^V l^t so^ed " scurvy " or " brisUe-«t?^ s'ucTi t'^^^"^ "r '•J-Pto'ns oi the hair, tendency of the bristles to fan 1? *>««>o"Jwges in the bulbs of of the gums. It'^is said tSrb^ii^ 11*^ "t'^'''^ "'* "'"""on tnnes find in certain orgaw esw^Sv Jth ^^P*,"""' ^* "^V ^me- dmges such as enteritis^dS S^veSL'^"'"'^*'^ '"^^' »««U with resulting chronic l^en.«^-i ., f ^*' *°** arthritis funsosa also stated tL r^nL'^ThTs^' cS'Tot^JJ'' '"'^'•''°''- ^^ and during the exacerbations of almos?^ th^^T*^** *^*' ^gir-ing It « an infallible sign of approacWngllato. '*^""= *^"»' *°d «»t ^'"^••'■' — ^^e ordinary kind of t^ni-,^*- ■ . a mortaUty of from 50 to sT^r cent ?T ' ^'^'P^^^ has losses from it in Baden were h!LZ\n ^^^"^ '*^*"' *^^ *he of aU the pigsaffectedwithervsiiXdi!? T^'^P*'■**"*• prognosis is always very unfavoSSel^ 1° .any case the fact that the finLdd "SS 'tin t "^y i«d«« by the and contagious pneumomrfn S»t UE'f ^'^'^^ hose from every other animal diseS CTnJSo "L W-^ temberg, 21,500 pigs out of a total «* ^ ^^ *° "^"*^- "ysiplas (6% ?S.,, lift a iSTlf k^r*" iS^v ^ Hess state that the vearlv lo« f rn™ ;l ^^\^?- ^schokke and to many thousands S^uiSsthnL ^tT^'f ""1 ^°"°** .^ich died of erysipclas'L Brittl^yl;^^ 3^^"^^^^^^^ ^"^ In France dminij 1887 out of m Z^ f^^^S i«»i was £120,000. 78 INFECTIVE DISEASES. AMtomioal OhaiigM.— In post mortem examinations of cases of the ordinary form of epizootic erysipelas, we find siens of septicaemia without any weU-marked morbid condition of separate organs. This septicasmia is a general infection which produces hamorrhagic and diphtheritic gastro-enteritis. con- siderable swelling of the lymphatic system, hemorrhagic or parenchymatous nephritis, acute swelling of the spleen, paren- chymatous hepatitis, and myositis. I. The hamorrhagic gastro-enteritis consists at first of ex- cessive inflammation of the mucous membrane of the stomach m the repon of the fundus. The mucous membrane shows a dark-red discoloration, which is partly diffuse, partly in spots; suffers from cloudy swelJmg; often has eminences on .ts surface ; is covered with a viscid layer of mucus • and may even have superficial scp The glands of the mucous membrane are inflamed (gast glandularis). The intestinal mucous membrane is swoUen, esj dally on the top of the folds narrow parts of the smaU irtestii e, and in the neighbourhood i^^^^f^ patches; is covered with reddish mucus; in- filtrated with hemorrhages ; an sometimes shows superficial scabs Less frequently, circumsc bed parts of the mucous membrane of the caecum ^nd of the anterior part of the colon suffer from a diphtheritic affection. 2 The solitary foUides and Peyer's patches present, throughout medullary swellings in the form of prominent raised patches of the sue of a grain of millet to that of a lentU. Sometimes they are infiltrated with haemorrhages and surrounded by a red ring We very frequently notice ulceration and cicatrisation of the sohtary and agminated follicles. The mesenteric glands become more swoUen than the other glands of the body ; ar« of a dark- red colour; and show softening. The surface of their section is dun-coloured with interspersed dark-red spots- and the paraglandulai tissue is hyperaemic, and infiltrated with hemorr- hages. 3- 3"*« *«w»»<»yA»' "ot softened as in fluid, which may be^ed^S? « u <>rane«-«)loored dear aiuicles. WeZ^m«tSt ""5"°'* .''•^""j' <'° "^ or in the do-XL^C^^^pSS^TtST^'" "^ *■?»• .t^i»«\tT?^'tsirHe^^'°-"= Md to a less extent totteC " "" '"*"^' CU«..-T..I "»™"" » not norly «, cannon In Continmul S wwir^' <*o»btful cases, we recommend the inociilaSon ^r^rnn^rrl^trji-onrehfS ?^r£;.^r^''d^'^anr^-s Hi coat stand, on end ; the Irotthing isl^S^T^ Ij! ^oc^r-TnocSSS r^^^-LTo^rC t: .ry«pd«i l»cilli can be «>sUy found in the'blli''o,'^re i.^' So INFECTIVE DISEASES. lated ammals. For more exact diagnosis. Johne recommends the prciKiration of a stab culture in the foUowing way. The spleen of a dead pig is first of all washed in a watery sohition of corrosive sublimate, i to i.ooo, and torn asunder in the middle ; a platinum needle whidi has been sterilised by being naade red-hot and aUowed to cool, is introduced into the middle of the pulp of the spleen 4 or 5 cm. deep, and is then stuck about the same depth into the meat peptone-gelatine. The test-tube containing the nutritive gelatine is held with its mouth downwards, and the cotton-wool plug is only removed directly before the inoculation. After 5 or 6 punctures have been made with the platinum needle and after the cotton- wool plug has been replaced, the test-tubes are aUowed to stand for about 4 or 5 days in the ordinary temperature of the room, after which time, the characteristic slender cultivations which radiate outwards hke a pine tree, or hke a chimney- glass brush, form in the nutritive g^tine. l>i«wwitl»lDi«gii«mta.-The following are the principal diseases which have to be distinguished from epizootic erysipelas : — I. Contagious pneumonia of the pig or swine fever differe essentiaUy from epizootic erysipelas by its bacteriological results (ovoid bacteria), and by the peculiar changes in the lungs and mtestines. According to Cadiot, the two diseases may abo be differentiated by inoculation. If, after inoculating a pigeon and a guinea-pig, we find that the former dies, and the latter remains unharmed, we may conclude that the disease IS erysipelas ; and contagious pneumonia, if the reverse of this takes place. 2. True cutaneous erysipelas, which is an infective disease and arises from wounds chiefly on the head, is characterised by an laiammatory, painful skin affecticm. with tendency to gangrene (sloughing of circumscribed pieces of skin, and of the tips of the ears), and is localised principally on the skin of the head. 3. Heat apoplexy, which occurs especially in very fat pigs during transport when the weather is hot, and which causes a purple discoloration of the skin on account of vascular engwge- ment. The post mortem appearances are essentially those of suffocation. 4. As a rule, antlwax occurs very rardy in pigs, and then it IS nearly always k>caliaed as glow anthrax, or as anthrax angina, SWINE ERYSIPELAS. of anthiu. "ypMas, confinns the diagnosis time, it ™ the a»tom ., SS4,™ f^^'l ^ an emet c, which we ,,» „„,.^Tr* "*** •" P™ hia cases by this^reaS.S,t S. . 'S^ " >» «°'- »< >" .0 be "criL .o's'z*c;v2'y'rs«.ti:f.** '» Similar grounds wh«>n tr-a*™ * • 'n^ective matter. On --L tS' 32is^!r'of"'Cdr'of^""?»!^ from the calomd cLStou ^7^ 5""^ *»' » '°™«1 ™«d, a. «» be^5.t ST^iL^'tS^^'^r that 2 or 1 lidtiPiir oi«o^ * "^awc. uDei recommends sho^bep^^-o^— .^a^TmS:"^^^' *or instance, the infecJeTonS not SL LT^.""^*,^ ^P*^*«» fr^™ be thoitnighly S£eS jr^^U- ^^ '°''^*'*^ ^*^«« «l»°"ld paid toTe Lti^Snl'f Se e^^e:^^ '"f^'^" ^^°"'<* ^ investigations made by the G^rZTT , ^^«»-<«ng to the quickSie dissolv^ in water h^T ?^"^ ^^^ °* "«»»*. of lime are effiS^tXb ^Ute p^^^^^J ^^ ^"o^'d^ not be placed at once ^T^slies S^JK^llf^iP'^ ^•'°'^^ kept for several days imder oj!!^^' ^ ""^^^ ^ previously ments. The con^^n „f ♦5^"'**'°° ™ '^P*^*^ '^"'npart- m exporting the iesh or offal of ^S^ha^Sfff f °" erysipelas, or in feetSne Dies on it tu , ^ ^^^ ^^ 0| n».. shonid oTTSTt'L n^^S^^.t,'T"?°° Of legal measures aeainst ..rvciLV ^ ■ m '^® introduction have been in force ^^^0^^' T^"" '° '^"^ ^^^^^ and since 1886 in S^t^r 3 T^ A f^-"^ ^'^ ^'^^^' in other countries. F^i::' tttu''?-^^"^ °^«* "«uuice, ine toJJowmg precautionary 6 •t INFECTIVE DISEASES. 1^ measures exist in Austria (law of the loth April, 1886) : The bodies of animals that have died from the disease, or of those which have been slaughtered and which show internal changes, must be rendered innocuous; the consumption of the flesh of animals which had suffered from erysipelas, is per- mitted only in infected places ; pigs which have been exposed to infection must be slaughtered ; and the transport of pigs among which the disease breaks out while on a journey, must be stopped at once, and the animals must be placed in quarantine. Prot«otiT« InooolAtloB aooofdlng to Paatonr.— Pasteur's protective inoculation is at present the chief prophy- lactic means employed against epizootic erysipelas. The exact method of preparing the inoculation material has not been published. We only know that Pasteur's vaccine is obtained by cultivating the bacilli several times in succession in the bodies of rabbits, and later, on in 'glasses containing nutritive fluid. The animals inoculated d la Pasteur become, according to him, only slightly ill, and acquire immunity to erysipelas. The method of inoculation is as follows : The pigs at the age of 9 to 16 weeks are at first inoculated in the subcutaneous connective tissue with a weak vaccine {premier vaccin), and 10 or 12 days afterwards with a stronger vaccine (deuxiime vaccin). The material for each pig costs about twopence half- penny, and may be obtained in Germany from Pasteur's labora- tory in Stuttgart. The following results of this inoculation method may be quoted : — I. In Baden, inoculation experiments were carried out during the years 1885 to 1887, under Lydtin. In 1885, 237 pigs of different breeds were employed. They were from 9 to 19 weeks old ; weighed from 11 to 47 kilos, and were distributed in 15 stations over the whole country; so as to give due consideration to the respective influences of climate, soil, farming, feeding, and absence or presence of the disease in localities. The inoculation was carried out by an assistant of Pasteur in the following way. The pig having been placed on its back with its hind-legs held asunder, about 01 c.c. of fluid contained in a Pravaz syringe, which had been supplied by Pasteur, was injected subcutaneously on the inner surface of the thigh. Of, the 237 animals, 119 were inoculated and the remaining 118 were kept as control animals. The inocu- lation of the first lot was made at two different periods, at SWINE ERYSIPELAS. . gj ^aTS^J "^ ""**^ <^*^*'' '"^»'')' »"^ " ^y» after- wtfds wUh a stronger material (rf*««^ „«,««). 'jwelve f;?*!!"^^?^' ^ **"* °* ^^ "9 "protected" animals. Sfi"* *»V*5* "/ ".'°"*'°'" ^"^»' ^«« '"Ejected to the influence of the mfection ; some of them receiving injections ^ZT^A \^T. ^'^' *°^ ""^^^ *^»"« *«d on the flesh of pigs which had died from erysipelas. The respective results of the protwtive moculation. and of the transmission of the disease by the virus tort or by infected flesh, were as foUows : (i) Out of the 119 "protected" animals. 80 per cent, reacted to the &st inoculation by a rise of temperature ; 15 per cent, showed aU the symptoms of erysipelas ; and 54 per cent. (6) died from erysipelas. By the second inoculation oi the remainiii iS pigs, 46 per cent, showed a considerable increase of temperature • 7 per cent, manifested weU-marked erysipelas ; but there wa^l no case of death. (2) Out of the 118 " control " pip 62 Z ^l^TT "1?^*? ^y contagium received from the inoculaSl ammals after the first moculation and 1 died of erysipelas. After the second moculation. 36 per cent, became infSted ^ it.^ temperature ; 4 showed well-marked symptoms of eiysipdas ; and i died from erysipelas. The effects of the Virus fort were as follows : (a) Out of the 60 " protected " !°""«*li r **" * '"«''* '^ °* temperature among 19. and control ammals, 61 per cent, became seriously affected and 40 per cent, of these showed weU-marked erysipelas. In au' t £h "^\ °^*^f ?°°*'°'" '"^^ died of the di^: tSr? K°*^ °?o °^ ^ inoculated pigs (5-6 per cent.) died in ^ ; but m 1887. only 2 out of 152 inoculaSi pigs (1.3 pS We can see from these figures that Pasteur's protective inoculation renders the inoculated animals to a certTextent and may thus spread the disease. Besides, the adoption o 2S TT ?Lr'"^*tio° renders the animals ser nusly iS J! t"?**"^ ^y * "^^t^ty o* about 4 per cent which exceeds by far the total loss caused by epizooSc^i^^ a6 nU nf"1?f '^'u"*^ inoculated with Pasteups vaccine t Zfil ,'.' ^^^^^ ^°'"°*^y ^^^t^'l ^th erysipelas by the first moculation ; 3 of them had to be slaughtered- 6 remamed sickly ; and only 2 made a complete re^ve'r No •ymptom of the disease was appax^t directly after the second 6» J As^o. IMAGE EVALUATION TEST TARGET (MT-3) 1.0 12.5 Ut l£i 12.2 l£ u IM 1.25 iu 150mm /^PPLIED^ IIS/MGE . Inc JM lesSEaMlttainStrMi RochMtar, NY 14609 USA Phon*: 718/482-0300 .^s^:s Fw: 716a88-S8e9 e 1M3, ApptM Image. Inc . AH Rights Rwcfvcd <* ^^ '<^ - ^. \\ ' V ^^ ^\ ^rv\ k ,^ «4 INFECTIVE DISEASES. inoculation ; but. later on. 9 became gradually sickly, and signs of ententis, endocarditis, and arthritis were found on posl mortem exanunation. Consequently, out of 46 pigs only 26 renamed healthy; and 15 of the remaining 20 beLne chromcaUy affected. Hess and Guillebeau assume that these untoward sequelae were caused by Pasteur's vaccine having become contaminated. They state that their confidence in It was shaken. Hess found that the inoculation was very hable to cause the death of old and fat pigs from erysipelas; and that the moculation of pigs more than 4 months old was hazardous. 3. In France, according to Chamberland, 1,067 died out of 75.455 young pigs which were inoculated during seven years (1886 to 1892) ; thus showing a mortality of 1.45 per cent It IS stated that before the introduction of the inoculation.' the mortality amounted to 20 per cent., and in some districts even from 60 to 80 per cent, of all pigs. 4. Dieudonnd inoculated during ^1885 in LorratKe 21 pigs, an of which remained healthy. He inoculated 283 pigs diuing 1886 with a loss of 21 per cent. 5- Jakobi of Obomik carried out protective inoculations in Prussta. He reports that the loss amounted to 50 per cent with old pigs. On the other hand, there were only 14 death^ among 1,036 pigs which were under 16 weeks old and which were moculated according to Pasteur's method during the yews 1888 to 1894. Roder had a similar favourable experience m Saxony m 1894. 6. Hutyra states that out of 787,772 young pigs which were moculated m Hungary during the years 1889-1893, only 7345 died (095 per cent.) in consequence of the inoculation. From this he concludes that Pasteur's protective inoculations might be used with advantage wherever the cost of the inoculation by the experience of former years, does not exceed the losses caused by this disease. 7- In 1893. in Wiirttemberg, 10 out of 32 inoculated pigs died, and the remaining pigs became more or less sickly. 8. In HoUand, 1,829 pigs were inoculated during 1890, and 407 PJgs during 1891 ; the result being that 17 per cent, of them died m consequence of the inoculation ; 64 per cent had theu- health more or less impaired, and the remainder experienced no ill effect. If we weigh all these experiences, we shaU see that it is not yet possible to form a positive opinion on the merits of Pasteur'i CONTAGIOUS PNEUMONIA OF THE PIG. 85 method of inoculation against epuootic erysipelas The rp«n xLo li^'l'^ ^^ "^^ ^^ IntLationaTwS^^'J^- o?±S?* P"**""**^' inoculation is an indispeSe S CONTAGIOUS PNEUMONIA OF THE PIG. AND SWINE FEVER. S^Slr';^^!^ "*^^ ^'^ '^^^^ Inspecting contagious 1883. There is no doubt that this disease h^ ra^ 86 INFECTIVE DISEASES. from tune to time epizootically before this date in Gennany and Austria, without its nature having been recog- ST" ♦, £ T^^ *""^ '* '**™^ *° ^""^ b«en confused chiefly with tuberculosis; a remark that specially applies to the enzootic so-called "caseous inilammafion of the in^esSie^^^^ which was described by Roloff and Bohinger in 1875 and 1876 It was only m 1882 that the nature of the disease w2 elucidated by the investigations of Eggeling and Loffler. In Gennany, it is at present the most widely disseminated and the most dangerous porcine epizootic ; although swine erysipelas has dSished « T^^u^^'^ ^ increased spread during the last few years, s probably due to the importation of infected animals from foreign countnes. ♦h/: ^° ^wj^"^, Klein was the first in 1878 to describe under the name of infectious pneumo-enteritis " (hog-plague, pig. typhoid, hog-cholera, and swine fever), a swine epizootic in wWch !« /""S"' ^™"s membranes, and. intestines are specially affected The mortahty of this epizootic disease, which appeared for the first time in a widely disseminated form in England dunng 1862, IS stated to have often amounted to 75 per cent. During 1885 m England, the disease attacked 40.000 pi^, out of I^n/?C l^^'^^'f '°^ .'°'°°° ^'"^ ' *°^ 35.00J Ss died dunng 1886 Klein distinguishes a benign and a maUgnant fonn, both of which he considers to be very infectious. on £ f^^^^' ?* ^"'^ °* Agriculture received from Parliament on the ist November, 1893. powers to order the slaughter of sw^e suffering from swine fever, and of swine which had been exLS to^e contagion of this disease. The number of pigs which were'^gMe ^' a.^ belonpng to these two classes were as follows —ly.yy^ in the v^ "it m,«t .1 ^°"?» J°r ^'"^^''y ^ ^'^ »*de against this pUgie It must be admitted," to quote the Annual Report (1896) of the B^d of Agnculture. " that there is but little in the hi^ory ofThe more rl^t o^Ubreaks to confirm the conclusion that the extinction of swine feveJ can be anticipated m the near future." The great difficulty in stamping- external mfluences which the virus possesses. (2) The long oeriod dunng which infected pigs may remaTapparent y healthy OT^S difficulty of diagnosing the disease during Ufe^TR.] 3. During 1877 and 1878, a generaUy disseminated con- Sfr Pn««mo'"a of the pig raged for the first time in North America. Detmers in Chicago tenned it "swine hog-cholera." This disease, which is stated to have mad CONTAGIOUS PNEUMONIA OF THE PIG. 87 Sh^* appearance in America about 40 years ago is We bv JL""^ T^°"^ ^"^ *° manifes/S liing life by drooping of the head, coughing, loss of ann^tP rap^ emadation. great weakness. 'pSar colotT he StT o^"[Sr:w'°'"*r*r • '^^ thTappearancrofp^ TIL Z i ^" °* ^^^ abdomen, chest, inner surf^ 1^^^' '^^ '^- T^« P"°"Pal chang^ found ZZst m^ern examination are those of inflammation of the l^g? ^We ^^L. i''^';^^""'"* °* ^'^^ ^y™Ph glands and mSnteric gands; pleuntis ; ulcerating chants in the colonrSc™ wl Vn^"*"""*'' ? ^^ parenchymatous changes in tiie heSJ We find microscopically in all the fluid parts of the b^dy bactS^ nm^ii^ ** '* '^ characteristic of the disease The Qfof^ .• ^^^* ^"® *°*al loss in 1885 to the United entiennmSrr^ c'l °*^*"* '^^^'Ooo (one-fifth of the ^^t T^^lK T^^ ""^g^d^dthe mild form of this epizooS S;«^t, 1 ' ™"'^'^ '**""^: and the severer fom Ta catarrhal pneumonia. He also called attention to tTe' Zt ^L^t""^ hog-cholera could not be identical mS^ t^e ct^r»i^''"" ^l^^^ (^°^ •" France as " ZZi^ i^SL "J'. *^' experiments with Pasteur's TdLL «lhXXTsn-ortr Srrints^- ?tio| -Trasiip-s -th^T •. ^^. £?if tssmaUer mortality; by the immunity of guTneapS ' hi the susceptibility of pigeons ; by the r Jty ofTS^^uWin^ m the intestinal canal (an almost constant lesion 1^ hJ-SoS and especially by the assumed fact that the bacillus of eSL IS ^ntially different in form and development from theTaJmS of hog-cholera cultivated by Salmon. This observer also aS vanced the opinion that American swine pl^T ^ tot t etiological unit ; but that it consists of two en?irdy indei^ndeS diseases namely, hog-cholera (ulcerating enteritis) ^fsw^* plague (infectious pneumonia). Billing on "he oth^r IT^ has conclusively proved the LtyTSmeric^s^lrpW and has shown tiiat its two forms, the pulmon^ aJdTe' intestinal form, are produced by the same b^teriiT^ 88 INFECTIVE DISEASES. the middle of Sptem^ iSS^Tn ;u ^fverd young pigs died in which place iJieepSZS ' ^L ^ ^* '^?** °* ^^"' fr°™ of ZeaLd. wheAuv^ S r ^P^^^*" ^nd the island Bang^d\li^ \, nunutely investigated, especially bv A^^l^' toZl^"^:^ f '''' Englisr,-./thJ contin^' T^;JZ^l^^' '^; ^P^°°«^ «P«-d to the diseases, are Kot onlv «mt«^-T P'« ^^'^^swrne fever are independent things, are op^lTt TS't? ^ItZZ"^' ^' ""*' "^^^^ ^ now briefly statethe re«vl^„ \, ^*^ «ap«nence. We shaU by bacterioloSu ^""^^ *"** ""PP"''^ »P«^« «s«lts obtained 0-4 to o-s ^ in breSt^ if ^"-^^SL , "?"" °* "'" "««*'' ^^ ^'^ by divisio; of the mid^il^ui^S^;!;* ^* '*? 'I*'''^'' '""^^ bacterium of septicemia of rabbits ^.Z*^ J- '^'^^ resembles the with it. It r^mbl« to aTeouli ^1^^^ '° *""«' » 'l^^ti^l chidcen Cholera and "ep'ticTmiT SmISgiS' 'sET. '"''^ °' peptone-gelatine show along the track ^^^1^;,n ♦^"""'^ " "•»** points which become conflu«tMdfo™irf?^ puncture, numerous white pnnctifbrm foci. Around X "feTtL^^T^ '^y'' ^*'' P«^P»"'«1 forms, and the gelatine do«^ noTLuefl T^^" f dirty-white waU bacterium grows slowly atThe hott^™ i J ««i»>vat»ons in broth, the connected flake. wS on the^l* ? ^ ?* ""■*"'^ ^ "»« fo™ of a twisted pig-tail o72 It iL^*"'"*^ *^« »*^«'' rise, up like a of the p^Utris liX ILZT "Ar'*/^ *"^y "^•'° the%urface on «,Ud blood-serum Th^T^uot^ cult.vat.ons appear iridescent and thus differ from the UcmTof «^ T"*** ^T*** ^"^'^ «'»"«on, within 2 day, afterTult. oval. It poMesses a bright middte ^i^e iL^fJ^ ^1' *"** ^* " »«««>• be stained with G^',«,r„tL"^jf^'**^ bactennm). and cannot pain, are said to have ^nnn!?* ?** bactena. which occur singly or in to their nutritive Zli^^'I^Zt't^'' *" ""/*'«° *=^"««» "^^g appearance of «xls. S Tha^ e^I ^t '" '"''"'="• "»"•»• »«»« to be partly rotatory Z ^^""^^"^"^ "»°^«"«'' « «id «n old cultivations. It is sta^^hi? ."'8?^ «=»^«. and to cease Of these bacteria kill L^ iL ^m^*.^'?'""" *'i '"^ '"""""^ S to 7 days. These h»rf«ri t- ^ "^y- *°<1 ^bbits in from glandular o^gans^ S^Z'^t^'^'r .1°''^'^ *'»• '?'«««• "oS that swine fever has a s^^fir »!?^ •** *^' "^y- A>«>- Bang ,tet« fonn of the disease n^JKl^**"""' " « «id that in the chrom^ tagiouspneuSSifTe'Jgl':^^,^" '™°', *"' ^'*"'"» ''?^^- of necrosis (intestinal nL^ii" ^"'""°'"^'' "** *«"» the badUu, and volatile. It can^lrfti J^ f"'^*^"'" is both fixed as the lungs. int^uSa^S s^'' fn^'"°* ™"*"' ^"'^'^ volatility of the conta^, m^^ ! • * consequence of the can be w^;rsi^sr^„,^acr°c;^ ^p^« the lungs In coSSL^Sf without any anpUcation of through the amnenSy 2?al unSr ?."'*° *^" "«»** the food and the feedi^tr^h * sTm To ^ th ^'^'^T^f <=««' for the infection. In exce^ti^n^i .u • ""^ ^P^*^ ^^'"cles through the sldn ^ ? nf ? ^^ ^^^ "^^^t^"" *aJ^« place The place of^S^^J^sSrtoXtTI^^ '^ ^'"'^^*^-- the disease. Th^we 1^^ , *^* *°"° assumed by of the lungs) on^n^wTU^tlfT"^ '""" (inflammatioj fonn (en^is)"C^e1Sj^ j""^^ -d an intes^^ frequenUy combined.* '"^estmes. These two forms are • Sidney VilUur consideis that the f«m — indicates the «»u of swine fevenLol^' ^T'^'''^'^ <»ft«' correctly London. «.d ,• «pon. of' IS^i^rf th^B:^"?'^"^* "^ ^^•^•• V^ and Thtrapaaus, ,896). suggest, however, that 90 INFECTIVE DISEASES. ni J'^^tT'^^*"'""^*^"" °' *•»« <«»«»» » «»used by traffic in «.?'♦),.• u ^"*^ **' wcubation is comparatively Ion/ «o days, and a minimum, it is said'1,f 4^;^"* * "^"^'^ °* r.,«'r"*?*"*~^°*^°"' pneumonia of the pie does nn* nm a umform coiir«o t^ ♦kI . j ^^^ °°^ not of the lungs or of DurP «T .h«morrhagic inflammation becomes eSeL; i,nfte?nr.;^ "^Jl,^*^ ^"^^^^^y appetite only a short\^rpl?^^,^ V^^ f^ \^^ staggers, and falls down • the temS^*„I ^ T '™" "«°"' to from 4os° to 42» r th»!? i ^^P'P^'^t^e « the rectum rises the beatbg of the h^^'J ^^ '' ^^"^ ^^^^^t »°d irregular ; diffic^t ^d afceSd ' t^^h ?P!rP«b'« ^ r«p3n i^ is a frequent mois coul'- 1^^- ''?"'. "" P'^"* • t^ere upper-urface 0?^"^ J^VS'^o^t ^ ^ S Z^ '^^^^ .wine fever, rte lung 1 Jon. ^TL^.^? ^f""« '" P'8» suffering from I" •.«iy is some- ^?Te°'L:rs'^'"^ ''^-^ " """• flammation which is so^^SL^ * Pneumo-intestinaJ in- tands of exanthemata TthTslT^^S'^l ^'"^ ^^^ous i°™ of the disease, which is ^1 ^' ^^^^^^^ <>' this observed, varies from a few da ' ! °"^ "°^* frequently a moderate fever (from 39^50 tt 40.,° c ."'r^^^' ^^^^^ '^ ajd spasmodic cough, oflen lasti^L ^^ ' '*'**"*' ^' P»i°ftJ. ^th attacks of sufftktinn. ^ ""^ * ^"^er of an hour the nose; heavy ZS 21 ""'^^'P'^ent discharg^ from of the -ucous^eS^^rt'heTS" '"^"^'"^^ '^--2 ^und of the thoracic waiS. A^^uu! ,? ' "^^ ^"" P«r<='«sion of rhonchi and suppressed r«r.^**'°" P'"''^®^ the existence which at first is sJSl'Z? °T '""™""- The anS g^t depression andTeaS^lss^di"* '^'?^' ^" "'^'f^te and may have difficultyTn ^Jlj;'^"""' °' ^««« 'oss of appetite •s generally present at tie Sr/S* k '^ ' ^on^^Kn chang^ later on. into S«a wt?' ^''"^' ^"^ «"«" Pi^nt from the commencment if ^k J"*^' ''"^^^^r. be s the chief seat of the S In ' ^^''^''^ ^aratus "1^« form on the tonguT^^s K^? "*^' diphtheritic and tonsils. The eyes ^' f„?' ^""^"^ membrane, palate conjunctivitis. keratiS^ S^h^'^^^^^h "^'^ '^ -™'«-- and adhesion of the eUlids ^f Z ^^"^ ^^^' ^^ swelling no striking changes; but in „fh^^ "^^ *•»« ^kin sho^ spotted redness, vesicle a^H k*", "^^ ""^^ ^^d diffu^ w ^d finally cm ts wS S^ '"'ll*^ ^*^ ^°l«nt pr^tus jmd Which vaiy - slStlX"a\r" *"« ^^^^'^y.' to Schmdelka, three different i^l * * '"'P^"*^*- According « swine fever, namely : (^I s^. '^^^^T"^ changesoccu? of the anus, lower sWfaS of {S tl,'''*"*^""* «« the region surface of the thighTwhich ^ .^^' *°^ '"^^^ and outer ^d takes the fom of r^ s L^^k ^"^^ '°^ 3 or 4 S!^' cles. and finally ^JLt.T\?''' '^ °' » lentil V^.' JPots. ib) A l^l^o^^S'"' "^^^ *PP«*^ on thSL "^"-^^^-^-'?-<=^trno?tSSsSnn;S * IfrsCTrVE DISEASES. 8 weelcQ • K.,* ». «-"«*rae lasts on an average from a to sist either rflroic'^.S'oT'ih*'^ '^P*°"" *=°'*- intestines The form^T a«ect»on of the lungs, or of the nary wnsumoln ™S^ ^"^^ ^^ *=^»^t«- oi puhno- feltinit rStK^S;„?«.r^?" *"™°"" "« sometimes «cordin| to ite coSSh^ ll '^'^' ""' ~l«'^y CONTAGIOUS PNEUMONIA OF THE PIG. 93 r^lf '^Sli'** ?** k' ' ^^"^ "^^"^ " f^y^ colour ^£Jr^ hI""^'""' "*""*""" y""^ °' grey-yellow [b^S- coteured], dry. caseous, circumscribed foci. Shich in peiicute «3es are punctifom, and about the size o grai,« of J^S i h^s LT '^^"''L!'^ *hey vary in size f^^a pin's hS from th?Sh r^ ^- •''"" ''^^^' ^"'^ "« «>«« »h^Jy delink from the other lung tissue by a red. inflammatory line of dem^ cation, and later on by a firm capsule of comiectivVSe TW yeUow deposits are dead portions of lung ti«ue fomed iu^ manner exactly simUar to that which takes%S in eS L ^Z Pj"j;r;r ""O"!*^; 'n consequence of a miStSe^r. mation of the lungs with hamorrhagic exudation andiuS* ^lor^r'r- ^ ''''' ^* ornecrotiflung ttle t^' be formed by the running-together of several of these fojf !«/ K .^ naemorrhagic pneumonia. The larynx trachea and bronchi contain a frothy, serous, or sani^dd S caUy mfiltrated. and theu- capsule filled with blcxKl. ^^ SZ ""1 ^^i*^' °"" " °P**»"''' ^'^^d with flaJ« S fibl id Ld M kT*^ r ^"^ »****»• It»«tensive accui^ulatSS'^v lead to hydro-thorax with compression cf the lun« ItS ^ITu^^ITa^ Pleur^^pear dou^y! fe Jt^ rough. Uke velvet. Adhesion of the visceral and parietal lave« o the pleune frequently takes place as a consequent of cS pleuntis..n which case, we often find thaTXS the ^Se S^preU^^. '"^ '" ^o-neadherent to anruSU':in: 3. The pericardium generally contains a considerable nnan cardium. constantly occurs ThZ;! f^hesion of the pen- K^o^ • ~""'"*n"y occurs, ihe muscular substance of tht- heart is relaxed, and is of the colour of untanned leaSS g^enStTtcT^^T*'^ ''^°" ^'^ °' h^morrhaS^ «ri K • "J^."' 8«at congestion, swelling, the presence of ecchymoses and ulcers, and the fact that the flSd con'ie^ 0I 94 INFECTIVE DISEASES. the intestiiies are thin and sanioiu Tn ,i. • . . pneumonia, the intctinal cha^^ J^t^t^".*^"^ con«st essentiaUy in a necroU? caj^ul^t^*^i**=' "^ tion. which .pedaJIy involve, ^^s tSch« T^ chai^teristic ^5/ «ofte« appearance of thrrhr^i -. *^ fom of contagious pneun,o5kT?he DrelL J^? '°****r' numerous yellow Jr grey^y^lto w S"? J?°" ^ '•» circumscribed spots or nSw iS thi ^ ""*^^' u *=^°"^y' the posterior j^ of the ^tu "ntttine rj*™^^*"^ "j especially on the seat of Pever'rStcll^rL ?' *°f nodules are somewhat prominent and tf" of 5^ V^ ""^ head of a pm or a lentil ; or they take thp *n™ !^ JT ! nodules that are about ihe siz^of a wa 0^.1*^' ~""^ which shows cu-cumscribed chani?*^ ^Z*^ ^ " ^"^* these nodules. wTS on tKt^t^nll P*'"**""*"' B«ide» numerous bufi.coloumicfoudv,n^t??' ""^°"* membrane, or ulcers which T^tm^nl^^TJ^T!^^ diphtheritis). sometimes reach to thTs^^.^^^^^^"'^^^:;:'' !^^;-^<'^ tion of scabs has also beenTbserved nnT '^P''****"*'^ ^°nna- of the mouth and intS. ^ ^''^ mucous membrane portal Ch Xi 2f swolSr SH''"' '^"^ *"^ *•*« trated. ^^^enUy ^de^^^aLuon ^c^SS^^ ^^e Im. IS enWged and its edges are rounded. S spSTonTh! fomd m it. ' ^*^"* ^*^* ^« sometimes frn,5' JfiK ^'"■''"^T ^"«°% shows signs of havine suffered from a fibrinous mflammation causing cloudy sweZf T^I^ tion, haemorrhaidc infiltration an^ tu " "^^^ swelling, conges- CONTAGIOUS PNEUMONIA OP THE PIG. 55 and'°v4'ar™t^ ^s^n^^^^te^S^^th^S^I^ emaciated removal of which displays ulcira or Z, ^^ *=™»*»' *»>• Numerous oval bacteria^. Sh. * "T*"'!"* cicatrisation, were inflamed, or ;rh^:i^l^ ^t n'L^^"^ ^""^^ bacteria Will decide douS^Th/Zr"'* °' *''* °^»J -^^a^^with Which co.4::r^^r^:r^.-txr- appearance ofuX^a X Kr.^\'"*^*^""« «^*'° ">e result will decide the^^estiln ''**^*^"°''^<=»^ »nd anatomical pne^mSrStfeliirp^'^raf 'T-^^ ~"*^- losis; because it also Iriv^^^ ^ simdanty to tubprcu- and in the intf es^i^ iT^h" 'S^i " ''''. '"^ respective bacteriolorical ^^^^ u *^*f»ence in the of various ages, as a rule »-"wus m time, and arc, also, pulmonary worms w^r?o,C^H in t*.,* P*^' ^ ^»«« i'* which this disea^. "*** '" *^* ^""8« °f P'«s suffering from combated only^^ "a^'^^^J^^ Xl^rS are : compulsory notificatioj of outbreST^'tJ^ h * °* '^^'"'^ prohibiticM of removal • s.,~.™v; x • *"* *^^**«« ! strict port of pigs ; S^'eS^ 1 ^'^ '^"^''' ^^ ''^■ dealers f S^roChlSn^^^lf "r"* ^'^ '^ ***" P°^^'°° <>« port ; and renderi^^S^ dead h^i "" "^^ '^ "^^ '° ^^■ proves that theTo^t^um ?n f^ff nocuous. As experience careful disinSirlheTnSe t^*'^ '*''' ^^"^'^^^J' «""^v«« slaughtered, and n;w stS ff tT^M"" T*^ * ^' ^»^°'^d be another site ' '* P*^'''^^' ^'^""id be erected on The statements which Congress at Berne in 1895 of contagious pneumonia IS hardly possible to find which evidently belong ^entS? * ** '""^ '"'^"'^tional Veterinary MsentiaUy agree with our theory of the idenUtO of the p.g and swine fever. He star^ th-!^ > ^y difference between the rcs^t wfbi^^* to the same group and differ morphoSSS?; 96 INFECTIVE DISEASES. only on account of diflferences in external influences (quantitative not qu^tative difference). In any case, the two di,ls« «nno l^ separat«l pathologically. anatonUcaUy. or from a veterina^ Suc^ ST^t '^"^- ^^""^^ ^"^ *"*• *°"°^°« conclusion, wWch wS Sllin'^'""°'"'^'"=?P*"^ ^y *''• Congress: " The two dise^« (contagious pneumonia of the pig and swine fever), from etiotori^ and practical reasons, should, under a common name, be added to S ^tin t "rfL*** ^ "*'"^''*' ^y '•»« State; their compSsorJ notification should be enforced; and they should be included in th^ or il^„™"*^ ,^'**,!!r ^"^J""' '^''^^''y *««'"'* °* swine-pnennonia or swine-erysipelas, because these diseases seldom or never occur in the epizootic form m Great Britain. of ^"nf'w-r''f'K^r"*"*** *PP°"°*«* •" '«9S recognised the unity of swine fever, which they say " cannot arise under any conditions which exclude the specific virus; in other words, it is not rsTv,S°c dis^e but one of the true contagia." The Committee did nTex- 'Siev^'l'STT""**** '■«'««-<=hes to swine erysipelas, which they «„™ A*° ^f 'i^* occurrence in .this country in the epizootic form. A considerable number of cases of the chronic form with valvular d«ease of the heart, have been discovered during t"'*- ^ou nZZ,!'^'T'°^ conducted by the veterinary officers of the BoL. l^l^Z H JT'' P*^'"** '" ''*" *•»" ^'o^y °* the pigs from which the diseased hearts were taken, it has been ascertained that the affection had not manifested any tendency to spread by contagton." The foUowing extracts from the Report may be of interest - nt thf"^"/ '*"""■• "?!! »* '^^fi-'ed as a contagious and infectious disease of the pig a^ociated with a necrotic and ulcerative condition ofthe mucous membraneof the intestine, the morbid condition be^^^ „ea^y always most marked in the large intestine. ^ " The dkease of the lungs which occasionally accompanies the disease in the intestine is either coUapse or pneumoJa. It is nec^ry Smr«^°°^'""' '"^^ '■" """^ °* *•»* experiments performed f^th^ Committee was pneumoma produced either by inoculation with pure cul ivations of the micro-organism, or by f,4ding with thT naturl! mat,.nal obtained from animals suffering fr^m swinf fever "In very acute cases of swine fever, the disease may prove fatal within , or 3 days, and then the only lesions present may ^ intense inflammation of the stomach or intestines, or of both • Ind S these exceptional instances a certain diagnosis cannot be made except forr^nf^H'''*''""'*''*^- " " " ^he acute and rapidly proV^^^ form of the disease is commonly met with. There are also, and a^ays inH « „ T'^"^ ''^'"^'^ «° °" "^"^ly *«"• «any ^^^ or months Mfl^^H J[ *" excessive state of development without being of s^ne fever.*"'' '"^^*°'~ ""^""^ "" '""^''^ '"^'^"^ ** *»"*8nostic '■ Some very important information in regard to the obscure form of swine fever was obtained by the Committee from the examination of swine which had been isolated for a period of a months on infec ed CONTAGIOUS PNEUMONIA OF THE PIG. 57 have been released. 1 Teve^ of tut """"^f '° "»" ""*'»*nr «»»»« released, the swine were at IhfreaUt^/ T^"^' ^'««» °* »»«« and the organs sent for ;«minltton Tn k' ^'^^it^. slaughtered teristic lesions of swine f^^^ZJtll ""' °* 'P*'"'"*'"' '''^■ swine/orTtfiTtL^wWch'St^'*'"' '" '"'>''''=' -^"^ '»»• diseased With a similar ^ ^?1SJ oro'Lr''""''*^''^ *'^'""' ''«=*°»'' '^^^^ examinauon of ^^he oriS S^rr^^'^^. °" ^''*' '^'*- great disproportion between^- !. remarkable feature was the «nal, and the Zht ,™ / V ^'^^'"'•^ed l«ions in the digest ve during life... '"'«^* ''^P*'""^ °* disease exhibited by the aS exposure to natural infection ^h?r '»y. ^eed'^K. by inoculation, or by that, taking the whoTe"? the ?Iuhr?h""" '**''' -" " ^ ** "o'*^ unexpected The weU-toow^ !^h 'k '^ '^*" remarkable and quite fever were not deveToJLi^atlnv tL'^'*'?^"' '^P'°-« «* »^« which, in some cases^umed a v^- """* '^"^ *^""*' °* »•»« <««««. no redness of skin ap^ar^tTn anv ^ exaggerated form. There wa^ there any indications^^ of wwerT;h?J 'h *"•" ''"*"'=•' "'^V ^'"> occurred in a few cases ^d c^tTnu^ for ^"'l "''«'^««- Diarrh«a instances constipation wT pr«ent f^ 1 4 * 1^°"^ """*' •"•» '» other variable in some of thTa^mfl, k ..!*'' ^^- ^^ *??««»«» was quantity of food up to the^^f^f d ' T^"'^" '^^^ """"""ed » fair the swine which Z.VZS pL^'^em tT"'' '° """^'^ -» of swine fever were detected Tn frZ ''^"^- J^nr pronounced lesions ulcen, partly or entirdrSied the/n^f '^""^ ^"'" ^8« ^t^"-*! from the attack... ^ ^' *'"' '"""'^ ^^^g- in fact, recovered in^tl' £d t^n^^'^olTelSS^^T ^ '''".^'«'' -•^^'^ -"^^ power in the hind XS t^uT'^'^T V^^-'^^ ot^, instead the indications wS' ^e'^tj *""»«». appeared, but evidence of the chronic oTotecurTfo™ * »''''«»tatingly accepted as early in the experiment. After a fe^H, ^t *"•"*' ''^ «^«^«»oP«d slightly sunken, the upper U^ k J '^^J^ 'he eyes became dull ^ loss of hair, ex^ing XsWn wWch '^'"'" *PPe«ance due to the cuticle. A stickTsec'reUon w« SSLS^ fZ^. 1^^ desquamating the skin of the forehead wasZ^M^ ^ "" ^^^ *»* the lids, elevated over the surf!^e TthriS^r^'the t»^ ^'^""^ ^ »"8»»"y tips of the eani were dropped fS^L^d'^^J^ ''"'P "*» «««" the generaUy dejected appearancT C^!?^l» ?' '^'^ exhibited a from time to time. K^her s^r,t„^ ° *•»«"»*'«» with diarrhea special attention. The p"S ateT'-'^ "^^^ "^ "^"''^ " '" "^"^ improved in size or in con^tio?- *ndS th\T*7 °* .*'^' '»'•* '»«'^« as in the other cases record^ wm Z^r^. '"^T^ ^ *^<«« '^'^. "The pigs usuaUykttSJd ti^ir^ '*^*^~'''"*- placed before them, but "ftetlalt^ .„ ?'t7^"' •'^^'^ ^^^ fi«t returning to the tn^^h ag°;;:"afr:l'i:t'^'*if'i?^'^« '""^ '^^' »8 INFECTIVE DISEASES. " 9» .Jannan^ 30th i of the 4 pigs was kiUed, and on post mortem e«nunaUon weU defined lesions of swine fever ^ere detecS ^Z w»e necrouc nlceis on the ileo-c*cal valve, and several large ulceis with necrotic centres in the colon, and the mesenteric glands were m j^hly congested. Other organs of the body showed'no Sdi^tto" Pow« to''l!^m^*fh'T'''°*K*° *"* *''" remaining 3 pigs as to their power to transmit the disease by association, and accordingly 2 voune pigs were put in the pen with them on February sth. * "On February 14th both pigs presented the appearance which has latdy come to be recognised as the ' swine fever exprLon.' i-f.i„ f ^'y •"8''* a=' '° those which wer^foTnd .n the pig kdled on January 30th, but in aU of them the majority of the ulcers were undergoing the healing process, and the mucous membrane « several parts of the ««cum and colon showed quite com^^teTatS^! tion. It was evident that the animals ,,rere re«.vering ««=»»«« The lesions of swine fever in the 2 pigs which had been Vent in V:X.T ''" '^"^ '"• """ ^'"^^ sth w„e ^iT deSei" «d ^J TI^"" ."* e"^ '^ ^"'y «°*'» »"d numerous in the c^^ T ^^ °u ^^"""^ ^ '"**' P*«» ^*'« '>«»"''8 rapidly, and there te no doubt that the pigs would have recovered."— Tr ] CHOLERA AND PLAGUE OF BIRDS. Chicken diolei. and fowl typhoid-Cholem of canaries and dudcs-Klein', fowl ^^^7^'^'^-'"''^' ''" -»eil-Vibriochole«of fowl Hirtory^Next to diphtheritic inflammation of the mucous membrane, chicken cholera is the most important and most common disease of poultry. It is stated that it was known in anaent times, and was considered by some to be identical with the cholera or with tiie typhus of man; hence the name. Others regarded it as a form of anthrax. Lemaistre states that It was for the first time investigated with an attempt at accuracy in Lombardy during 1789, and that it raged in the East Indies in 1817. It h^ settied in France since 1825. and has caused during 1830 and 1850. and from i860 to the present time, great oss« in poultiy. During the tiiirties it seems to have spread to Russia, Austna. and Bohemia, and during the last d«^des It has become common in nearly every European counti-y It CHOLERA AND PLAGUE OF BIRDS. „ inodeofinfectimrwJJL^^ "l^' f°»t°»i«l results, and - left iorT^r^t:'^^'^^^^yx'T'''^ transmitted topoultry and rabS 1^*^ the disease could be blood, secretion. aTd^ar^fS tt h ^ IT^^i**^"" •*' '"^^^t^* inoculation was i..«. u ^"*^ ""''«• Toussaint ordinary ScteriT of IL """""^ ^^''^ 'd«°«<=al with the have.^!?iXf cSdrtfons^tV^^^^^ 11^''''' - cannot be produced b^S^^ S^^^^^^ that fowl typhoid Pasteur cultivated the f„mn« • f •?" ?* ^P*"= substances. ^. proved in^S^^^rrne^JS^nt™? """■ "* He also recommendwl r.r«*«^*- • fo^^e^ed immumty. typhoid waTT'to. S"1|^'^!^°K o'^"'' ">"' Us method of prot«av.iZSf«^^i *'^'' ''"•=1" «sed shaped rods of the form of the We 8 Th« ' ^'^'"*' in the middle and translucent o7^ J" ^^^^ *^« constricted globules. Under com^:!:a;L:'^,-°^^^^^^ only as minute double noinf/ Th ^^ , . ' "*«y can be seen colours, but notSh Gr^s so£ '^^^eTt-^? "^"^""^ sist of small, hyaline whitPHL i? u ' ^ cultivations con- dose to e^cho£;^^"^;t^^'^ ^^f "" ^ 8«^* °"™b«" of the head of a pS SoL^ of ?^r' ^T\^''^ "^« <>^ White layer. wiSi i^lt'SJ^t:'::^;,'^ too INFECTIVE DISEASES. gelatme. The fungus grows best at a temperature of from 30" nf !S1"¥"/ *°*^ aJ«> 0° a solution of meat pepton. 5,Iution of^tract of meat and sugar. hard-boUed whiteS ^egg.'and soSS ST*; A ^/"* ^ ^ transmitted to all kinds of birds, rabbits, and white mice, by cutaneous, subcutaneous, and per- wT'in frnr? ''/ ""I'^V"^ ^"^^ ^«*- The inoculation toils m from 12 to 48 hours. In guinea-pigs, abscesses 2!oJS,f^ ,^ "".T"*""^- ^y ^*^ abscesses form in moculated sheep and horses (Kitt) ; and in man, when the con- is Cd^r Ki^t '?i*'*7^? '"^^^"^ ^^""'^ (Marchiafava and CeUi) Kitt observed that an injection into the udder of f« J- ^1 "P.,<=at"rhal mastitis, and that the bacteria were Z?Jh^ff *°'*^°'^*^«- Dogs and cats do not become ^S SJc J- "^^ ""."*" ^** °* I^'^t^' ^^^^ have suffered Z? ^*^ ' "^^ apparently the consumption of the boiled flesh does not transmit it to mankind, although Ziim has re- ported one case which suggests caution. The bacterium of fowl typhoid is one of the easily destructible T^^t' trJf^ ^y "^'^ •^S' I'y most of ^rS^! ^T^Ji al«ol"tely by boiling water, and by dUuted sulphuric and hydrochlonc acid (i to 500). Kitt has found that it S2 when exp<«ed for three-quarters of an hour to a heat of from Lor \L- '4 ** u '' °*** ^^ hy a temperature of -14 C. lastmg for 14 hours ; and that it remains virulent for 3 months V . associated with other bacteria. According Hueppe and Kitt state that the bacteria of fowl cholera are Identical with those of the septicamia of rabbits. OoouTwioe and DlMemlii»tloii.-Fowl typhoid, as we have ah-eady said, attacks aU kinds of birds, especially poultry pigeons, peacocks, pheasants, parrots, and canaries. It fre- quently stops the breeding of poultry by destroying all the birds m a poultry establishment, and even entire breeds. The infection IS communicated usually by the consumption of the taeces of infected birds along with the food or drinking water • and often by the feeding on the offal of infected birds which have been Killed. It is geherally introduced into a poultry yard by newly-purchased, infected birds; or by neighbouring birds, I tor mstance, pigeons which visit strange poultry yards The f \CHOLERA AND PLAGUE OF BIRDS. „! importation of foreign poultry is a verv r«mn,«« feed ^nj^i, ^zf ^^"'^e'^^ r"± the ba«Si. „r^- "'?<*°f ,■« Ao"" by experiment th/t m»r??!?**""^~^°'^^ *yP*>°'*^ « characterised by the re markable rapidity of its rnnroo -.^^ k *i. ^ ** of it* ~ri«^ T/ • u f°"^' a°a by the extreme brevity ot Its penod of incubation, which averages 24 houis and ^^7^T -^-Ttr^-^^^ s£n ^.e^^^Zp-dX^o^t;^-- been known to die of this disease whUe sitti^ onTheir ^S rdavl LT ' ?• °° f° ^''^'^ °°* '"Of* than from i to 3 days and sometunes for only a few hours. The bird losl^ Its appetite; is depressed and weak ; droo^its ^^ bW^ out ite crop ; curves its neck ; separates itsdf fro^^te feW Its plumage becomes ruffled; and thei« is a ^ of ntZ!.! temperature of from x' to 3" C wf^^Lu^ °JoSe^ g^arge of frothy mucus from the beak. aTd CSti^ Whaa accompanied by violent thirst, set^ in. :^e fSS TJL^ ^^PP^. "°^ whitey-yeUow. but later on they Lc^l muolagmous watery, green, and fatid. and consequentikX P^ near the opening of the cloaca be;ome s^SS^ D^^a T^rK "'L!!*** P^"^*^ "^^^^ ^d wheezing soS^ a^d Aonchi arefrequently heard. The comb graduSly Ti^bST The bird becomes more and more debiliSed. JL^ ^ beei°n^n!'?^ ^^' ^^ ^PP"«°% when the infection has been present for a considerable time in a poultry yard. Se lOS INFECTIVE DISEASES. ^^ "l^ ***""** * comparatively slow course, and mav then o^e^";^^e"sSrdeaS^/"^ experimenr^Srtd" steStW h.^ postponed for 3 weeks. Wertheim States that he has experimentally produced in oifeons hiT H« Sr^i^St^^^^^SiS aoD^aJ^Ur*""^ '"^'^ °* **•« »'*^^»'^ '^'"^ generally appears highly congested, and its mucous membrane. wpeciS S watr'^oZ '^*'- ""'^ ^°°*^°*^ °* "^^ intestinrmS oe watery, frothy, muco-purulent and yeUow, or bloodv and especially on the top of the intestinal villi, and sometimes ev7n ri^StLTa^ror Xered'-^-xS^ • -<^ --^^^^^^^^^^ thecolon. rectum crorJ-;:^^ he lymph glands of the peripheral group wlu^h is at to^oiLl* tog of the caK:um. is often swoUen to the size of a 1^ ^d takes the shape of the top of a mushroom. '^ °' * '^' *°** ^mtrSS^"*' f * "^^' •' *=°^«'"«* with red points (sub- epicardial hemorrhages), as if sprinkled over with dark-r«i dot, bi:^";;^^" !^e only changeUnt is severe' in^^^tio^ofS DiooQ vessels. The pericardium usuaUy contains a slieht mian y^f^^A ^' ^^"^ respiratory changes chiefly occur in The other changes are in no way characteristic We shZi' ^ember that the flesh of birds wLh have S of ^ho?d if ft^uently normal in appearance, especially when 2e SS^ M ttedise^hasbeenveryrapid. InoJSrcaLitisora ZTS °^ Sn Ihe T "^' '"^^" ^""^ ^*«y ^^ larda^us Xn^ ration. The hver sometimes shows dots. Dark-blue J^rf CHOLERA AND PLAGUE OF BIRDS. ,oj 'HS^t ♦^K °I**° »PPf a^very quickly on the skin. The bac- and in aU the organs of the body. In chronic cases caseous deposita are sometimes found in the lungs and i^a^Z contagious pneumonia (p. 85). in theTpilts of wW?h tie ovoid bacteria can be demonstrated (Sticker^ ' H.i^?*"*!!*~^*' diagnosis of fowl typhoid during life depends on the epizootic character of the (Urease ; its exceed jngly acute course; and frequency of diarrhoeT A^pkSu the morbid changes in the intestines, heart, and lungs, a^d Z the presence of the bacteria. It is hardly possibkto ^nf.2 blti:? r'? ''P'*'^"*^^ inflammation'^fT mucous mS! tensed by the presence of a diphtheritic coating of the mucous membrane of the mouth. It is often more difficJtto d^^S tJThoid from acute poisoning, for which it is frequS^s ;:^r2C::Lt^^; ^— canbedecidJdomy^Ta fowl manifesu white, lardaceou, "dLoSuon.^ ^V^S a^ in ^!^^~J^^- P'°8°*«^' ^ont'aO' to what is the case ww5, h^^^?"' '' '^^'y unfavourable in fowl cholera, in I^ T r*^*^ *''"'*«*" ^""^ 90 to 95 per cent. In s-^me cases, the disease nms a mUder course ; probably because the contagium vanes m virulence, and a certain amount of immu! ZZrV ""T^^ ^^ """ ^^^ ^*^S P*^ ^^'^^ a previous attack. Also, expenence teaches us that early treatment con- siderably decreases the mortality. Th«mp«atloa.— The course of the disease is so rapid that we are often too late in administering medicines, which, apart IQ4 INFECTIVE DISEASES. solution of stJph^rofl^nToVh T'^J M to i per cent solution of tanSn (i to V^ Z^\ ^^y^Woric add. or a weak fori sulphas. 5 rZ^ f^„^l'hu ^^'^^^'^°'''^^^^ hy««>*). tions^vei; hour to eel a^d f ^°j^ °' f '*^«^ °' *hese solu- to pigeons TTieS ^- ^ °'"'^*'*= '°*'' »°d a teaspoonful lactSSj^o hSSl Wrt'L"? "7 ^ administered pCphy- states tL heT^^ftf™^ !? "jfected poultry yard. NoU/d ''^' P!rtl^ ' P^^ "-" 1^^^^ ol^-^ ^^^suhcutaneous fro.^r£e57o" i:„^-^-«- Of tS^tealthy hirds with a hot Son Trin^* ' f ' ^J'o^^gWy cleansed either of carbolic acid or ST -jJ? *^?' *"■ * 3 per cent, solution the dead bodii a^d STi^al m«t J*"' T ^^'^^'^^hed. and sufficient deoth It 7. S^ Tf ^" "^ ^"^^ "^ Juried at a methcS^ of Sfecion ''"""^ *° "^^^ "^"^ ^^ this fowl typhoid, the inSti': rhi^s^ti^r^hix'^^^'^^ of typhoid attenuated by cultivatiZ iStT !. ?**^**"* inoculation of attenuated v»r^„ J T' . *°"°** that the domestic fowl required to bTino^Jiff-! ** *^* ^"« the attenuated ^S^Sfore ttev S^!^- ^ °^ 3 times with fore introduced a twoS in!v.^X ?^ '™""°*- "« *fa««- vaccine l-b^^J^ two-told inoculation, first with a very weak the cultivations ixp^t 2 J'^atten-ted by keeping which case, accorl^to pTste^'^ T„;„^. *° '° months, in we^enedbytheo^nlSerm'th^'r"' *'*^ "^^ ii^t^using the^wS^v^- •rd-X'a&ttir I 4 CHOLERA AND PLAGUE OF BIRDS. ,05 the se^d motion '^' ^" '"' *"*» 9 died ; and after died aJr I'LS 'noc^Zr^L'^S^T^V ''^^' ' a loss of 10 out of a totaJ of^A r .!^? '^°** • ™'^°« favourable i2«ilt, nf ♦iT ^ •- ^^^ attributes the very vm- inf^.t^poX'^p^^rSSSr "^^ ^^ ^^^ prot^Svet:^;^^"; ttvrxr :s*'^ r*'. "-*-'' dangerous; because thfSL^l^ rs^^i'^'^^ '"*" "*"^^ canari«!!!?d^SS?2!!^'?"*^;~*^"^ *"«^ T""?** »»»*« that iiom ordiniy fi^f J5^,^"P^"''"'»^««^« diseases which are different aaatonS^gt^orS'eftrj;!; ''*!''^'«''»W^ " in symptoms and muscular tremora w^^e™ !nH^^ "^ or 3 days with diarrhoeal tensed by th^S ZtT^j "'*, ^V'^- These diseases are charac^ P«»ent i^ th^ blo^^ oJuc^^ttS'd "'*'' ^'^V^*'* bacteria whiS^e but not in other Wrds ***"* *"^y ^ f"*^" '"'d ducks. Klala'a Fowl »*!—■■ rri ■ j proved immune to the inoculation. TJ^ !^ ^ '*°"»- ^geons after a period of incuLu^^^'g'l^'^^^ **'^' *«* « 3 days the liver and spleen wenT fe^«H » C^'^", °° ^*' '*<^'" e^aminaUon abundant int«£, m^us is ^» - *'**. "•* '"**'""^- ^« ^"'J "«u mucus IS almost a pure cultivation of the badlU. nianifeBted by TeprLS deK f^HI' ^f'" ^^ ^^'^^J^' «"»*' « thirst, and P^ir^Sb^^Z' »Xt J.'^. °* "PP*"***' ^«''«°* grey, later on yeUow. S^h^y^^J'"^':'''"' "»«» *»luish- a'orj'C. Most cases end iTH-ilK^^" ^he temperature falls the ninth and t^^h Sv ^.'^ **^*' ^"^ f*''*^^ »*'^««> a faculative baST whiS'L i^.^T* ? '"PP**»^ *° '^ «'»«1 by broth. It is disSSS Tm c^j'^ ''rati^^t^ on peptonised ve^ its sUghter infectiSSeM a^d .f^ '° **°i"* ^ •*» "l^^^' ^u"*. by inc^ulation to S^' ^t h^\'^P^''^'y °* transmitting ii days. " has a penod of incubaUon of 3 or 4 ticulariy numerous in the spS ^ J**^"' ^* **""'' "« P"' to be a chronic form oMyS^A i?^ ^T^.^/* ^» considered and almost uninterruptedTilence *^'«»«d chiefly by stupor from 8 to 14 days. »omnolence. The mfected animals die in 106 INFECTIVE DISEASES. y"" and which kills them by thf^S^^i. <^*'/'*'!« «"'*«•«. and joAo). on board ,hip during tLTZe\,mfhf*'H*''' " '*''• »** **"*?'»«=• caused by micrococci, nai^^^bv^h^ '^".T*" "*"' °* ^^'^' »' « Its development, aw^idSTto Woi« ^ / '^'"''''*'" ^«-'""«'« (Zopf). drinking water, ^tnl nl^r^lL" ^T'^ ^^ *'^*<» *^' ^ air in the holi^^he 8hir^'"'?7 "'"''•"*"* °' '»•• «»««. "d bad generally end, in delth tf- dlrLT** "" °* '"^ «**»«»*■ ^^ch drooping of thewin^dia^h^aln ^eca^^"^.*''""'^' <»*?'«»«. floor, and finaUy convulsion (^ ^! !!f^'^"""°f »«!"*"«« <>" «he the liver, and 1^ frequent? in^e luir^^r •**»*~«on *« find in terisUc grey and dirtv-whitr i«,H i^ P' 'P'**"' "*• kidneys, charac- niillet ZZ. andt^cr^clntS t^ilL?'=' "^ •^"' *^« «^* numbers. Local necrosis trMTedhv ^^*'^*' micrococci in great -2; sUght enteri. and ^^^^."^Z^r^^^^l^lZi^ :rZ DEER AND CATTLE DISEASE (5.//^^«,^ ^^...A.^,. «« *"" experimented with, rabbits arTLt^:* ^."^ ""' °* *" *«*««»>» hemorrhagic septicemia '* susceptible to the organism of ^r^^c^S^.Z^^P'^^^^^J-^^'^ -™'«-t cultures of and bufialoes. when sutee^S^' Si'*,*'' *"'* P'^t^'"* bovines successively increasing dcSr^^f,;^?!?*'^ *°' » '""g Period with tectivese«againsth.L^^! -t^^,"- ,^^^^^ P- of Munkh. ^d fiif ^cc^i"™'^ ^^78 m the neighbourh J of several i^oyTpS Td ^ «nzoot.cally among the deer oyai parks, and later on also epizootically. especially DEBR AND CATTLE DISEASE. »07 aid"i!ld piS^h^ S^jl"" r «"* -"fi-ed to the deer that wereTthe neX^h^ f?*' '°°" 'P'***^ *° ^^^^ «»*«« and domestic p^* yS^SS '^i'h T%'"^ *^ *° '""^ epizootic recurred in the follnJ^n„ ^ *•'** P'*'- The among the domestii animaJ, oH?* "S"""' *"*^ ^P'«»** ^d«ly J88x^ In sub-e^u^nt^^ ul^P?:,^^^^^^^^^^^ «^'^Jy during In 1889 it i:Sd thfoughilrX Sc^^^^^^ appears to have occurred among Lt«e"noth.r^'^^^^ '* for instance in th« i>«.. . f. *^*"'® 'n other countries, as formerly^h^^ewa^^Li^Z^v^^^r; °* Schliichtem. where only of II Z Th^y^ar iSf ,8^^'°^ ""J- '°° ^^"^ '* • ^ut out of 40 catUe wh^^we^^-^^ng fnThlf ^^ *^ Jfot' ^f "terrible^ e'^s ST:ttr:nd"";r- ^^'"' *»•« described by '' The VetTri^»i o "*^ "^^^^ "^^""^ "^^ deer and cattie di^ase T w^, '"n'*^^- ^^^ ^^^^^'^y "^is With the lingual f^^of Jhirit";:i^^ssrntm '" "^*''"' were not those 0^^^:^': J::^]:,Zj^-^'-^ " ^^^^l^^'St'l^fo!::^^ ^7 - -ct infor. made further on aK tL ? Y ^^" '■^**''" *° t^'* """arks hemorrhagica (J^;/m^«V»S^V.7^,^*«'?'^ °' septicemia Kitt. pSbere^ 3 H«h^ - "^'"^ *^ discovered by culation the^L^i"*^? ?!f *^',^* *° t'*"^"" by ino- from it. and d^^cS wWch J^"^'' /f, '°'^' *"<=^» <««» ing. Friedbt^r ^5 Fit k tin J^""*"* ^"^^ * '°*^ ^*«"- in the serum !t the ced^a Zir °""°*=*^« ^^ small bacilli the disease in hors^ ao»T .^^^r successfuUy inoculated in horses, goats, pigs, sheep, and rabbite. He pro portions coloured with the iSer^^ir o, 1^^ P'^."" ""* '*» 'e™in.l '^'-^'--^^'?i^S^;:n^,'!^^^^!^^'- •'•ving been ..^^ loS INFECTIVE DISEASES. 54 ho«„ from th^^L^nfT^ "^^ h«i died in exudate of animS XcTS^^^ " .v * "'^ "»** P>««ritic Prcmng the idSty of th^ tj t^ TST'J^ ' *'''» Doaitive rau «* s* / . ^^ lonns of the disease No infected animajT^ ^ consumption of the fltah of the^y'bylSf sSextfh' *"':^*^ """" *° "^ *«"« ^o enter periments prove SS ?he Sal S^' ^°^*^°" «' absorption of the conteriuSTZi Ir".'"*^.*^"^ after the possibly become inf^T^reat^thfbcSwr-- '^"** P'«* have died from this dise^ S Ij ^^ °/ *°""*^ '''^<=h to be caused chieflv ^Tf^' * f anthematic form appears small wo^^ o7the^W^?,l^"'?r°° °' *»»« contagimS into the head and ii t^'^^Xr^^dl"^,''-^^^ one animal to another has ne^er been ^ *«i5^T!»on from also been disseminatedTy the s^ of th^n, ?* ?"^ ''" other villages. Zeiliirer wLr+L "**** *"<* »'"»» 'n been employed tf^chT^J^ *° a case of a man who had died from t^d^tlrJ '^'''f^ °' ^"^ ^' that had m inis disease, mtroduang it into his own cow-shed. disease," namely exaSwaJr !™", °' ***** *°<* ^attie cated with thet^T\rzT:L"t r^^^'^''' """P"- at the same time. ' *"'" *°"^ *"> P«sent sideibfetwX^^e sSn"°andTbl".^ '*"" ^* ^^^ * «>- The skin is^mlZ^^XT^^Z'17'?!^''''''''^'''- intennaxiUary space ^LZ^^ fl * **^"*^ ?"*« (head, tissue is fr^e2Sr;e™ X^i'r?*^%?^"**"«°'"^^^^ extent, and tScfc^n^ ^J^^^.^'^y 'l!^*'"**^ t° ^ »o""ous comiective tissue 1 ;^^^^^^ f"^" °* *»»« subcutaneous coloured L^ 'aTotW . "^ ^^ * '^^^^ ^"be'-. "^ gold- hages of Sr'or l^L^'* » ^^^t^* ^th h«morr. and upp^ce^Sl^«nT; .The lymph glands (submaxillary sweUin^p^s5^.^j "» he neighbourhood oTS "«s are partly serously, partly hjemorrhagically infiltrated DEER AND CATTLE DISEASE. • 109 which CM. they bJ^e c^„,ry ?*^ "^"^ changes, in often forms gelatinous. lo<^^^-?; ^)^ "***» °' *he tongue times enlarged out o ^^^ J^ *°'^* »*»«" « »^' found the tongue of an « to li^ I ''*^°°' ''riedberger nearly 9 pou^. its ,Sace Varied"''*'*' '^'^' '^^ *° *«S toadirtybrown-red.lJ^^rt^li",*^'°" '"'" P"^l« red effusion, which weTthS iSe of X * .*^ T" '°"°*^ ^ar^ and which extended into the m^i of ♦if^ °* * "^'* ^^^' ofthet.. .containeralaSn^o«nlV°'^*- ^^e tissues yeUowflui -hich resemwidJL^^'^Vwff «*^^^^ lated. flowed from t!:e puipfeSrS J« ^^^ *='^- membrane of the pharA^-a^i^r^ !^^°^: ^he mucous In these cases. theS^ STappSrTo ^ '^^• Md dry. The respiratory mucoM ^^ ^ ''*'y "^"^^ in the same way. T^w^e fi^T '"?*'"*"« ^Y be swoUen especially in the ar^Sc 1^ •'°*^*' *"'^''«»' ^'^onchi. and brane. wU a^nlSl^^^l^r Wn ^Ar °"* ™^ Croupy changes have also beeTLn InT k ' *v*^ P''^^^*- ha«es are foSid in varioSs^^r *^« •'^n^hi. H«morr. membranes, in the ^es ^US^f^y ""^^^ the serous perfectly normal. ex^^Sktli^ i*^" ^"^- ^« "Pl^en is usual. The blood Sos^^wl'^S^.'; '"T'^f* '^^^ ">^ »«tence. The perirenal ^oimS^etf«""*'Z''°'^ *°*^ '^^n- trated with blood. Lastlv^t^^T ^"f "^ frequently infil- of h^morrhagic^terite ^' *^~* ^^^^^ ^^^ syiiptoma jela^c^sS^iS^"™' tf^^i^^ti^ t^^^ o, the lungs is dition of hepatisation f^„„v T^ t^ep^clves are in a con- inflamed. swSeT^d co3 ^r^*"^!: • "^^ ?'««« ^ plastic deposits oZritiTsZ^a w "^/^^rinous and purely date of v!^ '^Stv JSnl *^^-^«^*«)- A fluid exu «.». (».«.«, ana <.^^^;r^-^^ ill ' --lar of Sorrh^c enteSfs 17'°"' '"'™^^^^ development alltheorganfoftheSdJ; Not v^™?' °^i»™°"J^^- - epizooticaUy amone de«- t^n* • ^ ^^^^^ ^*^^ a^so occurs calls attentfo^rL epizX P .H ^'^^^"'' '°' '"'*^*=*' in Grunewald. nei S a^J ^^"^ "^^'^ "^^ » '874 head of deer. In spite o?'th^ ^^ *^^ ^^^ °f 2,ooJ ^ disease" can be ea^Sv anH ^.^ «"^«^ty. "deer and cattle ^ anthrax by the Jo^oLf faTtl '"k**"*^ distinguished from anthrax; absence oH^^^^^ent 'c^Th? "\ *'^ '^'="^'^'<>* characteristic tarry conditioner! J . *P^^*° *"<* °^ ^e present in anthrax"^ e^^S-^s^s^L^n^cT^' ^^k'\^* ^^^3^ refractory to anthrax diZT?.** P'^' '^^<=*» ^^e rather which c7n be "X;d tT^VrL^^f Af°^ "^^ ^'^-P- innocuousness of the flesh wh^n^.! T? ^^ ^^*^* «ase ; nity Of man to " dee^tS cltS Z^ ?-' '^ "^^ ^ -'^ ---' pi;rngn?Sntr?o%raL-^^^^^ changes in '< deer and cattie SseiT" te o?? T 7^^" '""« character, and are of the same1^« X \?:'^^^y '»ifonn irregular lung changes in nle^^ n^ ' *^"' ?^'"°e fro™ the is much slower. wlSTSttT'*' *^/ ?""« °* ^^^^^ " deer and cattle dise^? L f^l" u**^ P'"°^ °* incubation of its dissemination Tmuch lifter T' ^ *'' ''P''"*^ °* find only pectoral svmnto,^ k- u Pleuro-pneumonia we al«ent in^Les of-r^rUSle^V^^r^ T^^^^ suffer from " deer and cattie disease "whkhdiff.ri^' *^T '*° pneumonia by the easy and ty^^^l T^^fTJnl''^: 113 INFECTIVE DISEASES. I-- and cattle disease " for pleuro^^o^**"*' °"" °* ^**'' 3. Mistakes may also arise with malignant cedema wHj.k succe^ful. Fnedberger tned in one case a subcutaneous injec- tion of a 10 per cent, solution of carboUc acid anrtTh!^. ^ adnunis^ation of salicyUc add. but!:?tlTet?4 r^T^ll Zmn« Jk "^ !! 'l^^rter-ill. to make free incisioiTtaTo the swelhngs. with subsequent application of strong disinfw Vante SL??^r'"°^ ^^""^ '«S«lations for '^eer^rSJue oisease are the same as those for anthrax. in tJr^'S^caSr^!^"^'' •''5' ^" found in the blood and length and 03 « in brLd^^;^^^ '' °^ ^^^^ «* « « M i" thi^end,. an^ t^ 5Se'i^chS^int?bl:x^?lS ''S"* .o-»y ** Uon. they proved to be pathogenic to^ce S^ * ^^^ "^"^ pigs, goats, hones. dogs^sE^fraVd S^^"* "d^""!?^^ hemorrhagic tracheitis in rabWts. TW weiT-iZ-t^^^tf '!* "^ * of sepUcamia of rabbits chicken choi™ oT^ T^ *** **" '»^*«'i» the pig. Kitt stoted tw thu ^T ' ^"^ ^"tagioiw pneumonia of catUe^eas?" b2iSe S tli^di?''"'' !f •'^*""*^ '^»'' "«>«« and -mtomicTr^uir^ Si ^t^ttS^ro T^ P*'""--"^*-! -d also found that the bacteria in nt^^, ,"** **"• animab. He were present ^ X^T^^^^U^ ^^^^^ ^^^ tlut epizootic of 1878 from animals that had^J^'.T^ ^ '*'^''» *•*• Hueppe. from ihe examinS of thrmf,!. wh>rK*:?t!f *"" *»«»*" by Kitt, confirmed Kitfs o^^T^ T^^^r,^"" T '° "^"^ tioned unknown infective d««« -!wi w? .'**?**' *» *•»« above-men- oculating the bacS^i^ a^Tl^ "'SrSo^'^^H '""'."' "^ ^■ bacteria are identical with th««r«7T; ^ considers that these according to him Zr^ur^nl. "^T ""^ "**"" '^i'**-." which, infective*ple„S5n^o^" HeX«S£?t'S' ^»«'^. »y««is. or tbe infective disease^vXSi2rS:t,*^J.tn*SS^ DEER AND CATTLE DISEASE. m^^i^emV^:; ^^^.^-'^^i''" ^-^^ pleuropneumonia to £ lin^ i u T* °* ^ septicaemia haemorrhagica." catiTJe''""^cat't, '""";■"'' I*'"" ^"^'"^ '^^'''^ " <»- -»<> found T^^ .. ^ . "■ *°*^ "* ''•"'='* **»e »n>e oval bacteria were Sd sudJenlt ^t °^"*""' " J''"*"'^- '6 calves about TmoItC sZpl'Thig?tv«U^o"aSld'"'l " 1° '' "°''" *"• -^^^ showed gJt^ltZ^Z «K ^* f>a"li«Ba. Porf morUm examination ecch^os« ^dr^Th ' "^°'" P'""^'^' P ■''•^*«t« *»d numerous Tcutd^ fatJ s^mtL™^*"""-, ^•»«='^ti°« .xperimenu produced inSted «hhft? w '"^ '^^'"^' '^^^^- *"<» »ice- AU the ^^SSSleTwi^r,„f "=***'^'^''^ h^Bmorrbagic tracheitis and calves R„rir!.Kf^ L 'P***°- Bonga't* reports a similar disease of .^f^lgro^ came";^"fh ' T^' '"^""^^ '^''"'^^ septicmS HMTm^^tr^JTH "'"^^ bacteriological .osults. GuiUebeau and wSh^uriJthe^^t^r"^.^*^" '°™ °* l^morrhagic septicemia swelIin?on thf h^d^T^ acute pneumo-pleurisy. with, in some cases, that ofV4f"d'rand^^tSl^^^"*'''"• ^^^ "^* ^^•'»«-' ^^^^ und?r"S':;srr.'^s,ri:^"';'^T°.'r*'°'^ ^ ^'^^^ - "*'y Salerno, RomT a^d Te^ H i " chiefly found in the districts of cattle ^^% tt^^t'tZ^^i^"^''^ '■'''''""•^ "^"^ *"'» by Metaxa in .816 J^w^ re^^J^^^V "?"^"^ '"""*P^*-* :rjSLn2^reiLri;s£P"^^^^ occur, c^efli; ^ s^^^^l^z^r^^j^^ ^T^:^' j^'^'^: fever Ui* to ^2° C » •>»•.»», i~ x «•«"»»• 11 oegins with high s^-^-^i^"H=>3-r'" - -- ^^^ - disease in a district^ «nLn? '^ *"!• ^''* *^'"*"'"' °* the is 40 or so per cS 0„* LT^ ? °' '° '^5^' *"** '^e mortality connective ti^ueTf the »„^f '^'"" ^^'"i'^'tion, the subcutaneoj tissue o7heXl«Mngu"derth^*' '"'f '^^ '"'•'""*'^ «">«>«=*-<» yellow gelatinorTxudLt! S« ,n, ' "" ^^''^f *° ^ infiltrated with a • Linguard describes them as the same disease. -Tr. 8 114 INFECTIVE DISEASES. Nat,^1S«cT„^' u"' "^ V^ •^^*' '^*' '^''- "<» *"»•» Wood- «t.^ »?'~t»on takes place by smaU injuries of the skin. aUmentary and catUe d«ease") The contaginm is destroyed by drying, boiling .T^«f' P^.^^-t-fl-tion of carbolic acid, and 5 per cent. .olnUon of SSX*?^"- °^*« "*» Annamii recommend inocuUUon a. a ^'Sn^I'S'"^""- ^*^ "cceeded in attenuating the virus by the inoculation of pigeons, and produced immunity in bufialoes by inocuUting *„^^;=?^ *• occasions, with very minute quantities of the blood of mocu^ed pigeons. They state that during the years 1888-91, inocuUUon was performed on 1,986 buffaloes, out of which only 6 ^ cent. diS ^though formerly from 45 to 50 per cent, succumbed to the disease inoculation has excellent resulu. Buffalodisease has been proved to have occurred recentlyin Hungary. Dunng 1891. 4 per cent, of aU the buffalo calves suffered from it in ?» dS'm-, .'*'» "*! '^^'^ *"*'=''«^ '37 animals, out of which ^li«- "i '^J- ^«"*='"8 regarded this malady as identical with bo^e deer and cattle disease." Makoldy and Sequens. on the «^r^ ^r**" **^* " ^ ''^•'« ^•'^f •• »*«»««• '^ the same farm- yar^. buffaloes and pigs simultaneously exhibited symptoms of swine fever, while catUe remained unaffected. Gil recommends injections of 5 per cent, solution of creolin, and the internal administration of creolin m doses up to 50 grammes. Under this treatment. 5 buffaloes out of •7 *^ccovcr©Q» QUARTER-ILL. Quarter-ill in cattle— Quarter-ill in horses. History.— Quarter-ill (symptomatic anthrax, or black-leg) was descnbcd m former years, under various names, as a form of anthrax, and in France is caUed chofbon symptomatique. It has long been known that this disease is not infectious, and that the meat is qmte innocuous to man and beast. Even in former days, very exact clinical descriptions of the disease were made • as. for instance, that by Wallraff in 1856, which, as regard^ symptoms, is m no way inferior to our present knowledge of the phenomena of this disease. Also. Pfisterer, in 1870. came to the conclusion that the nature of quarter-ill is different from that of anthrax. Feser and Bollinger have, however, been the first to teach with certainty, by their etiological researches, that quarter-ill and anthrax are two entirely different dw^ases. Feser fully mvestigated quarter-ill while studying anthrax in the Upper Bavarian Alps in 1875. He became acquainted with quarter-iU in i860, and states that even at that time he found QUARTER.ILL. ^nZ motile rods in the muscle juice. He points io smaU ttm mofale. serpentine rods which have round^ 1^ ^1 m^nf the d«ease. By the subcutaneous inocullS ^ Se mud of certain places in the Alps in which the dis«^ h J hTn v«y common he produced its characteristic s^^om Sl^e sh«p. and rabbits. In the same year Bollii^^Sv^S Jhe baallus of quarter-ill in the form of a thin jZ rod^S roS the moculation experiments made bv them tiw. active durmg the waimer months (June, Julv and AnmiHTllJ [Pease states that quarter-ill camuw ■>».» i j • season in the swampy StliS. ^^^5^ • T **"?"« "** ~*«y Provinces of India._TR.] * '^J*" *^ North-West As a rule, only cattle between the afes ni , ™«»*i. 4 years become affected. Calv<^ ^d^ , 1^^ "*!,'^** digenous cattle over 4 years ^^rd^St^vT^i. ^^ "" of this, perhaps, is ^t the for^^L^^^ J^^ J^?" ttlT^T C*"'"""* °* ?^^ ^*^ '^^ rest^cte^nL ^d 8» Ii6 INFECTIVE DISEASES. foreign animals are put on the infected pastures, they may become infected at any age. One attack confers absolute immunity. It seems that pigs, dogs, cats, rabbits, grey rats, mice (at least to a certain exteS), andman are naturally immune to the disease. This statement agrees with the well-known fact that the flesh of cattle which Had suffered from quarter-iU can be consumed by man, does, and pigs without any ill result. Animals which are immune t,^T^ .^^ *^ '°™"°* *° malignant oedema. The inoculation of horses, asses, and white rats, produces only a local reaction m the form of a swelling. On the other hand, quarter- Ul can be easily transmitted by inoculation to cattle, goats, sheep, and gumea-pigs. In some locaUties. for instance, in the Uppw Bavarian Alps, quarter-ill occasionaUy occurs simultaneous^ with anthrax Hence it was looked upon in former times 1% a precursor of anthrax. 1 with ^^'i":?" ^*°^ '''7' *^*"' *"** 3 ho«« beoun. infected ^ ^^r*" **"""» *''* y*«" '89' 'o '893 : in Baden. 375 cattle from 1886 to 1890 ; in Austria, 376 cattle in ,886; and i^ sJSzeSid S33 « 1893. Schmitt reports that q«arter-iU caused veiv seT^L^^ eighties after the great inundations, so that, daring these yeus la ^„ P*r^t. of all the young cattle died f«m this d^ease. Ke J^ton of Berne, 1.728 cattle died from it during the yean 1883 to i88rthM o^*,r ^r'r ?"f *" ^^.cxx, during that ti^e. In thl tS^ to wn r^"' " '^"T"' " *^'* *° «=«=" throughout the wh<5e year^d to km so per cent, of all the young catUe (Theiler and Sander). Baoteriology.— The bacilli of quarter-ill {baciUi sarcothv setMtos boms) are very small, being only from 3 to 6 /* in leneth and I ,* m thickness, and are therefore about the length of tiie diameter of a red blood-corpuscle. They show lively, rotatory or serpentine movements, and contain, usuaUy at one end a bright oval spore, the greater thickness of which makes the ^ assume the shape of a club. Contrary to the behaviour of other baalh, they can be stained with Gram's solution. They are fojmd most abundantly in the affected subcutis and muscles, but seldom m the blood ; hence inoculations with blood are generaUy negative. They occur in great quantities in the bile and in the contents of the intestines (Kitt). In the blood, they are only found when the dead body has been kept for a considerable time Consequently, the bacillus of quarter-ill, like that of malignant oedema, is an anaerobe, which forms gas while growing in the QVARTER^ILL. Slrfii •'**K°?, °^* "^"^'* *°' ^*» development the oxygen which IS in the blood ; and it forms spores witiiin the dead bSv ^dogenous development). It is probable tlT^t ako d^dkf^ ertog^oi^ly in the sou. although this supposidonTs^fjS ^l^T^t^r^.^ ^^°^« ^« *^« fi^to obtain a pSe ^*^1 *^\*^"'»' ^J^i'^h he did in chicken broth. P^e tS,r r"'^**'^ ^y *^« abundant formation of «^ thus produong a large quantity of pearly bubbles and fr^' wbch clear away in from i to 3 days, and leavr* thS white sediment. The bacilli of quart^-iU beS aiir^ cannot be cultivated on potatoes hi the ordi^f ^°^' cultivations on gelatine are. however. very-Sl ^ ^l ElSL'f'T'^^.ir*'^ "^^^'^^^ with defte^d ^viti« biJr ^^./^"bed several forms of development of^hi bacdh. Kitasato states that they grow best at a temperatwe of from 36° to 38° C, but are able to grow evenliT tern perature between i6» and iS' C. The hi^er the tempe^t^" aK^th '^'™' ^'"^'^P^^ ""*^ ''^^ a4 to 48 h^ The investigations of Arloing, Comevin. and Thomas have shown that the virus of quartJ-iU is exce;dingly SSnt to external influences, especially when it has been^cwi^^u^ ^n^tion It wiU continue effective for a couple of year^ H^S mooter T^K^ ^T r' ^"""y *^« ^°°*^"™ ^venTl months The bacilh of quarter-ill is in no way influenced bv the bactena of putrefaction, by those of anthrw. or by ^yZ cold. The dried and finely-powdered flesh of ^Z wS have si^ered from quarter-Ul can resist steam ev^rioTc which degree of heat only weakens the virus, but does not destroy it. On the other hand, the fresh virus i d^t^^ bv a temperature of 100° C. in 20 minutes, and by boiling water in 2 minutes ; but the dried virus is destroyed only b^a^^' pe^ure of xxo" C. in 6 hours, and by boihng wati ^^ horns. The dry virus ,s also destroyed by the vapour gi bro- mme; watery solution of corrosive sublimate (i to s 000 ) (I to 50). bone acid (i to 5). hydrochloric acid (i to 2). ete Dis- infectants such as an alcohoUc solution of carbolic add.'qukk- hme. sidphate of iron, chloride of zinc, and sulphuric add which has been found that certain chemicaU. and. as ah^dy stated^ Il8 INFECTIVE DISEASES. ITJ^^y^ST^^. '^^'^ *^* ^^- Th« virulence of such attenuated baaUi is increased by the addition of lactic aad and, according to Nocard and Roux. by that of lactate of potash, acetic add, dilute alcohol, etc. "i lactate fl.of^"'"'*^.'?^"**'-"* » » wound-infection disease, SSllf «? "^^'J^ n^^*^^* ^^"^ **"« *° «»« absoiption of the baolh of quarter-ill into the body by injuries of Ithe skin or mucous membrane. These injuries, in order to afford the bacilli entrance into the body, must, as in the case of the badTS ^Ugnant oedema, penetrate into the subcutaneous comiective tome or submucosa ; for mere penetration of the skin or mucous ZT^L"^ msufficient. It is supposed that such injuries TJ^ ' ^^^l °" *^* ^'^ ""^ ™o»«», while the animal ^ gnuing, and that they come in contact with the contagium wluch IS present in the soU. Hess fpund injuries of the STn the pasterns and cannon bones in animals suffering from quarter- t^tZ 1 ?"^T that infection of the injulSi oral mucous membrane takes place when grazing, chiefly while the milk- !Sf . • J""? '^*^ ^''^'^ '"^'^ *hat the oral and ph^. ^cavibe- form a frequent gate of entrance for the^S, F«rhcdarly m steU-fed animals. According to the inooS w^erments of Arlouig, Comevin, and Thomas, an infection from the cow to the foetus can take place. The ^ves of co^ which have had quarter-ill seem to be immune. *^'''* °* ~^ Inoculation experiments have shown that the period of incubation averages 2 days, with a minimum of i dayTand a maximum of from 3 to 5 days. ^ Symptoms—Quarter-iU has a very rapid course, which It *'^,*«*=«Pti°'«' «°ds fatally in from one Ld a SS? to tf r^; SSr JL-'k^^^J*""** ^y rapidlyincreasingswellingof Ae skm, which crackles on being toudied; high temperature- secondary swdling of the lymph glands of the sldn ; and 2cS ary motor-disturbances. of i;^*^*"*^* ''^ qmrter-iU may appear on different parts of the body, and are duefly found on the upper parts oftte ^i,^ "'-S' '^°'^*^'"' ^°''"'" "^^^^^^ °* *h« «^est. loins, and sacrum. They never appear below the hocks and knees. Thev are 1^ frequently found on the palate, at the base of the tongue and m the pharyngeal cavity. The swelling is at firstTerv* small and painful. It rapidly spreads, may attlin extn^^^ size m a few hours, and may even extend over the whole tmak. I i QUARTER-ILL. ,,5 These swellings are then characterised by a crackling and ffttighng sound when the hand is passed over thaaToTwhen they are kneaded with the fingers. They give on percussion 1„T' *J^P*™^<^ ""od. and in their centre are insensitive, very dark-coloured. dried up like parchment, or even gangrenous! They become strikingly cold, and no pain is fdt by the animal wn«a an mosion is made into theni, in which case a dark-red jrothy, unpleasantly smelling fluid flows from the wound. Some- times, only one swelling of greater or less size appears: but more frequently we find several, which not uncommonly become confluent. The lymph glands in their neighbourhood are greatly swoUenand can then be distinctly felt as tumours under the skin. 2. The chief general symptoms are as foUows : sudden sup- pression of appetite and rumination, debility, depression, high mtemal t«nperature (up to 42° C), lameness, stiffness, and aragging of one leg Ln consequence of the swelling spreading to a hmb. According as the swelling becomes larger, thTother symptoms increase in intensity. The breathing becomes acce- lerated a^d difficult, and the animal groans, and is sometimes seized with violent attacks of colic. Death occurs with increased ^^ *°d ^ of the internal and external temperatareS In some cases the general symptoms are the first to appear • in others, the characteristic swelling of quarter-ill takSthe mitaative. A few mild cases, which showed slight swelling and moderate fever, and recovered in 24 hoiu^have bZ observed m aged animals. Arloing mentions a mild form of quarter-iU which is chiefly ii. vnifested by loss of appetite, shght cohc, tympany and debility. ppeaw, .h«f?K**T^r"?*® *^'** ""ovenng the swellings of quarter-ill show the ahready descnbed changes of dry gangrene. The sub- S!rS!IIl,*'°°^**=*^''® *^"^ ^ y^°*' gelatinous, infiltrated with blood, and contains bubbles of gas, which escape if an incision be made into the tumour. The muscles undoneath the tumours are of a dirty brown or even of a black colour. At other places they are dark red or dark yellow, and when exposed for some time to the air. they may have a golden lustre. TheVare brittle, rotten, porous, and very rich in fluids. They crackle on palpation or when incisions are made into them, and blood of a frothy, greasy, tarry condition and of a sickly foetid smeU issues from them when they are squeezed. The fibres of the muscles show extremely varied degenerative changes. The gases that ISO INFECTIVE DISEASES. are prwent m the muscles are inflammable and burn with a bluish flame on being ignited. They are stated to have but little smell or to possess an odour which is not particularly bad • on jSl^rl!f°'?I ** " ^T^ ^^ ^*y ^'^^t °^ carbureited hydrogen. They are also said to contain carbon dioxide, but no oxygen. An exact chemical analysis of these gases ha^ not yet been made, although it would be very desirable. As some t^^^Tlu^^ ^^^^ «^ "« 8*^«" °« *hen incisions are made into the muscles, it is not improbable that the muscles abo contam sulphuretted hydrogen. The lymph glands near the tumour are enlarged, and full of blood ; they contain h«. morrhages, and are sero-saniously infiltrated. The afferent lymph vessels are sometimes distended with gases, and then t«^e the appearance of strings of beads. We find changes, sunilar to thd thicker, havf rounded ends, are very motile, contain spores at one end ^d r^er'ZST*'^ club-shaped. The baciuT of anthrax on ^e moS. ?nH ^""^ T*" *"*•• "* °^ "°**°"» thickness, are non- motile and have characteristic pure cultivations n«ri- *"?.*" «Wa/i*^ "« inmiune ?o S /'^ u, *"* e^fceedingly susceptible to anthrax In ?U we .h^,M ^' '° r'**^*^y distinguish anthrax from^arter lU we should inoculate simultaneously a rabbit and a guin^. pig. If only the guinea-pig dies, the disease is quarterT^f ^L? ' '* " T^^' ^* predisposition to quarti-m' in animals is generaUy less than that to anthrax ^ ^^^^ »" "» Quarter-Ul may also be confused with septic metritis The differentiation in this case i3 also bacteriologi^. on^^^*"**"""'"^"**^-^ « such a maUgnant disease and Its course is so very acute, that treatment is gVneraUy^Stf taa INFECTIVE DISEASES. 5522^ cU^fecUnU into Cub^Ll^^'co^ST^^ b«iMTSah^ ^ ^' ^'y *PP'y^. as soon as the swelling SJlSiS^' ^ '877 in France. 32 head of catST^ cov^^from quarter-Ul out of a total of 1.875 (not quite 2 PmSL' wltSi*^'l±.T'"' " P««=*i<*ble. i. to avoid those iTi^" i^^ ^"""^ ****" '"°*" *o h*ve produced the diseuT LfJ^S" ®*''*^' '*^ ^**°"' » P"ture land wUch wa^ inteJL K^/ ^ ^T** °' *^* '"^ "°d not from the ^e^i^ti/""^^/" 'r^ *^* •^^^^^^^ ■^' >»' -^ with the I^y Fwcure lands cattle which have wounds on their na«f«m. ^ which are shedding their milk-teeth ""™ °° ^'*"' pasterns or the disease notTl«» ™ ****°' « ». however, true that K^ ^' " "*y ^ reasonable to apply to ^^. Jl almost the same r^ations as those for anthSx m l2^ done m several countries, for instance, in Si w^J^f oT lu^w i5u"* ■ <=°'"P"l«>'y notificatioVrprohibiS^ Of slaughter; prohibition of using the dead bodv with th. exception of the skin ; renderii75ie dead ^v^H A^.^^ umocuous; disinfection; anTp^odical ins^^^*" *^" ^^"^ Arioing, OomaTin and Thomaa (Lvohs mjniu^ tZ ^otective inoculation meti^od intrSuTed b^Tlo^^^^-^' ^d Thomas, is of great scientific interest Jd practSal te^ and mtnunuscular moculation of the virus sSmost always ««bS f^lf*'^*"^ f^ *^ ^^'^'^ inoculation p^^"*^ J^ i^T^***^ 'T*^.^P«^«°t« -J^ch were mad^^gave no result Workmg by the light of these observations, ttey QVARTER.tLL. „j inoculated 13 animal, at Chaumont in 1880 bv iniectimr Jrectiy mto the jugular vein, filtrated quart^-iU Jir^' wS hn^ !« . ^^ /^ P""'***' ^ '"*>°*^ Jater. to be quite immune to a subcutaneous inoculation of the virus- wS fcSi J u^ * temporary, harmless swelling, which was ^ foUowed by perfect immunity. They «ml^ Sat Z^ oitte hSiS J^K *"** """^ °' '*»» *=^«=k the dissemination of the bacilh m the comiective tissue spaces. Arloing Corned and Thomas also attenuate tiie virus ^ ti»e influ«« 0"^^ S^°;Lt"^*S; ^l •"°^"'*"°" exjerimente ^1e iuSS^* p r-^s^« s^^^biy^---; tT^;rB tive moculation greatiy reduces ti,J mortaUty 0?"^.^^ equal part,, whic^ are 5aci r.eUrSVrn,7 " t^'*'-^ ''"' " P«t into a thermostat for 6 S,^ to^ 6^f ftZ\., ^^ " '" "« to a temperature of loo' C in n^.rT' . * P'*'" ***"» exposed material.^ the renS„g „" ^ol,! of l^^r ". '*'.! ^"^'^ "' «"» or Mcond material The^.^!^i=? • I ^- *° °''***° *•>• stronger the weaker, anT aftemt«4 ^^h Z "» '° '""^ "**»"■ *"' ^''^ brown crust on the pC^^t ^ w T""^'' ,'^*'*"'''- ^he dried-up for a moderately long pTri^^oJ thl fi^**""*^.' "^ •""^ ^ ^'P' the crust which was dii^!?« f°' *.^* moculation, c, gramir, of in a sterili»rdisI1^S^t«lm™rT**y' °* '°°° ^•' « "«»"*<> ^'^'^ 134 INFECTIVE DISEASES. through damped clean Unen, and the filtrate is drawn into the,vri„„ The quantity of material required for each animar?. «V *''«»yn«'8«- a syringeful suffices for ,o aSimS. T^7itroTlK« tl*^'" ' ^^'"' wWc^«X^^"4h 'tt '"^^ " °'"^'"'^ ^^'^ with'lhTuo^ r„T.^ ' ?°°"'* °* '^"^ "J^^K* ^ introduced into the same woun? prevent the flowing out of the injected material. It is stated thit from 20 to 25 animab can be inoculated in tWs way i^^hour ^fS.^^p,?.ifs— i^-^i-l-ji- dis^e! *•*' inoculation, which produces no secondary were made in ,««, t ^ccordrng to Tisserand, inoculations w»e made m 1887 on 3,219 cattie, of which only .2 head (0-37 per cent » tt;^ On 'the Z'-T- ."' "^*='^ ""^y 3 <° '4 per It /^^ d^nj (. 7/^cent,*Sed '" •^'' °"' °* ^'°~ — --ulated animals. 50 1.J' ^"""J^"* »•»« e»mple of Comevin, Hess and Strebel made a ttf ovr^'c^rw^ ""^f °j^ " 5..*,./«j*it«beT:Ste: luai over 2,000 cattle were inoculated up to the end of !««,. an,i .'^^»S'^k'"'P' ^""°« ^'^^ ^^'^ summer on hiUs wWch te^e Jea^v mfected by quarter-ill, with the result that the mort^t^ fi SL moculated animals was 28 tim^ i-.- .u ... ™°"a"ty of the ones. He reo^tT thlf « «. , f" '"^ ''^^ °* non-inocuUted du^gThey^ ,88?,8S'«Ui.r'^ T" inoculated in Switzerland non-inoculated animals in the Cantr^f FreiburiTas 12* T"^. f ' than that of the protected 6.616. and 8 tim« more ^^8^* ^ ^^^^ ^na^e average loss among the inoculated and non-L^uhit^'S^" lutl thTw y^^^"" '884 to ,890 is consequently Tto i.?^ fn ^ ^ T°» '***• ^ *''• ^to" o* Be™ alone, ij 137 cat le were moculat^l with very satisfactory resulu ; for deatto torn ^u„t«!m decreased very considerably in the infected distxicu. F^r^^t^;^ : QUARTER-ILL. „j during the te^ y^frot^S^^t * ,!?^' '*?;^^ *^"'* ^"^ inoculated to .nject « the region of the shoulder, especially ^ ^nt'STS^e 1"^! 3- Sperk inoculated during 188s in Au^m« ,>,, extremely good results; for aUhough tiese cTtJe w^Vaf^^ ^'\ 10 graze on notoriously infected summer ^t^resoT^eTxtT^*?" not one of them, so it is stated, died of q^ter^ ' ^^l^^Z fo**' ever d,ed after the fint inoculation. On the other hW o^^' ^T non-moculated animals. 107 died of the dSe^e S« "886 ff 016 per cent, among i.aaa protected catUe, and 1.77 per cent^n^ln! frfm "onfoculated According to Wildn*;. there ^"Tnly oneTel^S from quarter-iU m Lower Austria among ion wotected /ni^fi x by »«.. of tiK, ,.«„ 0, boiling „,„ 5tnLuL^ S.-'"™;' ■n i).«u» ll«t. ,«, TO iaa, .moil, le, ,rot,el«l cult. 136 INFECTIVE DISEASES. q«*rter-ai. and the ineJuauS ff^h. „f '"'^- "^^ •**** »'^««* ^^ consequent uncertaintyTto the efflt^'n''K "" "^* ^"^ "• ^'^ cnlUvations of the biiSL of a jS^ , ^" ^ '""^ '***^y **»« P"'" especiaUy cultures onWa^r^^riL". ''**' inoculation material, contain Jreat num^ o^^^ ''t^^ "^P *°' * '°°8 ti=>« "d whid^ inoculation metC™! ^^^ "' ^^^ **»* *°"°'^n8 detail, of his plugged and !i put i^t^f c^l^dTkl^th^ P'"*" , " ^^^^ '"** ''"^ weeks. ConsequenUy i* TnoTtl^^JL »'^**'^ '^ ^^ **" "^^ after it has^n obtJne^. But H^.*" T *'"' "^'"^ *«'~"y must be used on the samTday for mtriS' ^ ',!'~'^"^' *"*« '°*'*^> get into the fluid when toe tZ Z^ ^^^ are in the air easUy becomes decomposed or mSSd^ it lo^h^T""^' ""* '""^ "*»«"«^ fluence of light!we use ft^ *;. , ^*'°*' "P*^** *>y *« in- .yringe which holdT' Tor lo^T'*'^'* *" °"^*°*^ P^^az's all. be sterilised brb^g waterTo wh- w,! '^"«* '^"'*'' «"* «* placed and the syr^re^^^^Z V^ "^"^ «" ** »i»P»y Of a disinfectant S^n ir:u;S„^"'ard S^ "^^ .^« ^ remain in the syrinee and .nJi\i: • . ' °«>des. some of it might •naking the iaS^^n'l'^ttlT'^Sl'^Lr "^k ^"^^ ^ may be uniformly distribuTed InH ^ • ^ ^.^'°' ~ *^* **»* ""»*«»»» placed for the thnTl^^'T *^ >ndiarubber plug is taken out and %tolding7heSt tS^w f '"*^ °' * freshly-cut chip of wood bi^e t,^£ a^^ toe'S'of^'r r*!!' '^'f^ "^ ^tuJZ^ taken up into the ^SSe If tL /J^ "^' "** **" *''«' »* «»iiy filled, contains air-KS" it Il^lH '^;.'"*'*** "' "^^ completely wiU come close to tSeil"^^ ^^f "L'""'* * ^^^ ^'^^ ^ "^ tube, which is held peS^Si^t ^u"*!" ** •^«=»«' «»« '"e test- filling completed. ES^tt?^ttir^'^'°''"""'P'~«^' "*»*!»• nuiterial subcutaneoSy ta S^ S^in^^ '.^"^ '^ inoculation headed extensor of the for^^ ^^.w *i",«>'»«'^ (*bove the fonr- with a dry doth biotd^rJ^ ^ "* ^*^ ^^ "^"Id be rubbed cannula has penetrated Uie^XTl" * "*'"'^«* ourselves that the We should aC?„L?tulV tS^"^- flJ", ti»ne. "« ^i~» ' ^^^ the needle does not go thiougrthe^AuW^ ,' m^ ^ *^« «" ">.t the inoculation matettel womU^L .u *°'^ °' •'^°' *" ^^ich case which hold, s or ioT-^« !^^K k'^' "l**" »''*•• With a syringe screw of the piston is'^^^^'^'*,^'"^^'-- been fiUed. the regSj n>ay be injected, and tf't^ «Jh ta!«Stii^%K *"'^*'"' " **"» ' «« turned back to the corres^n^J to?^? to. m "'^**"» "^ ^ out in a clean manner, inocuk^tio™ ™, L ?»°'P«lation be carried at «,veral difierent T^1^:^:^!y'!' ^l -\f -« test-tube been opened should not be k^nt i™. .v * test-tube which has of those tubes which ^e St JSiiS?^.^ °°" ■'^^' '^ ~»*"S of ao head of catUe. aC ST^I t^^^ *? "''~'*«^ *" »•»• "w '^ner use. toe test-tube, its remaining contento. INFLUENZA. or without a mUd feverish rE. It i,"'V' '^. ^"^"on. with mocttlation after from ,o to ,TS" on the .^JT"*^ '" '"P^* »»" The experimenu which have lien m, " **'' °* **« other side. a single inoculation conf^''iir':hrc^/V''" ^''^'' ^^^^ »^t sure by a second one." """"'y. which, however, is made doubly "nong catUe, Ganter saTa"ho«e jJe'^^ur '*""''''-"' ^ stationary havmg suflfered from high fev^ swLr„ ~""* "* ** »'o«n. aft« vonuting. and dyspnoea. >o J 1^^*' ?'*** depression of spiriu gelatinous, gasPe whole continent, and floSj cW.fl * ^^^^ ''''^ ""^^V the following the high roaroJt^^^e" 'f^^^T' ''"^'^y present in Berhn over two ve^n?'- « "^^tance. it was year and a half. From that 1^^ H^ ^T'^'^ ^"^ °«arJy a berger. Siedanigrotz^Lttig X^fndtl^^^^^ ^"^d" mvestigated and d^cribj' tl^di^^ °*'??. ^^ *Wy appeared in Northern Germany LdD^r^ J^ ^^"^^^ X89X and 1892. In the SL^ n^"\fr!J'^' affected m 1890 ; 2.407 in Tftnr • ^j '^I^ °°"^ became INFLUENZA. <>'}^y^r^^^ as Z of which hasnotyet be^Xot^'' 5i "S'^"""' "»« »**"* a very short time among a W „ ' u ^* ''^^^ "^ spread in "fitted, not in a diSe^teT^S^^ °' ^'^- '* ^ t^ans contagious pleu„,.p„eu^,^4"1,^^'"^ar manner, hke equine The contagium. 4ch S^fS^ ''^'"'^*='^'^« ^*^«on. I P-obably absorbed from ihl SSl^' ^^^^^^y volatile, w the air expired by affectS JThT T *°^ '« contained Jko m the excremente. ast^sWn ef*^*^*"* ^™^' ^^ berger it appear to 9111X1^^!^^""^*^^ by Fried- a°«^al body. On the oth^ han^i* "^""'^ °"*«'<^« the pr«erved for a very long toe J^thJ* ^""^t^ ^e sometimes to the observations of Jen^n i^n r,T^ '^y- According had the disease may be aWe to ^ ' '**^°°' ^'^'^^ havf and even for a yeaf oV^ bv c^™* '*^° "*^«« ^^ niontC m transmitting L diil^ to JSv"; •^f'^r^off succeeded and mtravenous injections of^eJlST*? ^^ ^-^cutaneous but Fnedberger and Arloing failed tnT "^^^^ ^"""^ ' susceptible to the contagil thi ""J^^. "^"^ "« ver^^ bemg independent of afe s;x hl?"*""^"^ susceptibili^ feeding, etc. The infectfon'ge^^^^'S: ^**,^^« "lanagement^ horse to horse ; though rt maTh^ ^- ?**=« ^^^V from beare,^. such as huma? ^\Z\u.r T"^ ^^ intermediate etc. In many cases. onrSck cSf. '^^; ^^^^onieter,. though a second infection or a rdarS ^^ "f^°°^ immunity An epizootic invasion of infl„^„ ^* "°* unfrequently occui y^- Towards thT end o?T d?"? *° ^* *°^ <>"« ^ ^o 'fer and milder. probaSy^aceouroT"' '"^"'"« ''«=°"'e of «ie contagium. At that toe thf. * ^^"^^ attenuation or less sporadic character ' ^ *P"°°*'<= assumes a more lite^trr^e S ft'aS.^r f""^' ""^^ '" -eHnary fjTlt'^7''J^ apt^'^ 'r*?-'' --aging from o? S^'tior^er^L^^iP^^^^ aPI^'^rderir:'rd"lS;;t^or^ - -«'« Ic. of «nguor m movement. The internal 9 IJO INFECTIVE DISEASES. « which i.,«j;. ^sXte r:«r., te'^rsTe jH noure. At first, the frequency of the pulse is hnf u**i- is often of a yellow eolo^ ■» » f™ «ses. The sderoHc 3. The tasMc strnfltms iorm an essential part of the disease The oral mucous membrane is gieatlv coi^i,.! IT^' of the disease, and colic 'maH^u?"^! ?L^ ar^SS mass^ (proctitis) Later on, the constipation often chances mto diarrhoea with considerable tenesmus. The f^^fS then of a thin, pulpy, and even fluid consistence an?^i^ tones have a foetid smeU. Tb. peristaltic actioToi the Wk « usually suppressed, and th. hind part of the tXiThie Sitl%T,^°°P'^'^- The urine at the begSg of the attack is alkahne in spite of the hi^h fpv»r o„^ I ^^ . T only when the intestin^ affection iil^^iS^^Sr? U IS nqtoftenalbuniinous,it frequX^Tj^^S^e qu^ti^g of desquamated epithelium of the bladdeT Somet^^ ?S animal stales very frequenUy (slight catarrhal cy^SSP ^ 4. A more or less severe affection of the Jyes is a rather INFLUENZA. ST^TcoS^teeW^^^^^S^^^^ At a«d even by an fJ^M^^^Jt^J^^^y^'^^ ^^^^i^ both eyes become affectS. tJTZJ'^' T*^' ^°«^y intolerance of li^ht <»«,* . °"* symptoms are tears of the eyeU aid Se52 omT °' *^f """""^ ^-"bZ' considerably. We hot^^S to t£%r^- ^i"** ^^^^^^ ^^ell sistentJy closed. ThemZncm! k °"''^' *°** ^^^ J«ept per- edematous, and oft^^'^ro^twi^^'i'^^ «» the fonn of an orJW-Si!i "^* ^^'^'^^ "** «y«"ds junctiva sclera frequenUv fl™f Protuberance. The con- and tumid ring ^ZTX^l.tllh^''''^'^'' -^^' muco-purulent secretion a«:St^t^Ji ""T^' ^ S^^' the eyehds. and the eyeball h^!tJ^ ^"^ ^^ «y«baU and The comea at the beSg^J^JST^*^^^ *° P^^^-^^- « indescent. smokyVSdaJfp^ « »?*'*ti** * S^y lustre, on. a blue or milky opachHSn? "^^^ "*'"* ^ust. Late^ siderably injected y^lZ^^^SV "^l^' '* » <=o°- swollen and assumes a yellon>loir '?" ' J^' ^'' ^™« sometimes seen in the mt^atZh *°^^*"^te and blood are these inflammatory c^^^r^etTn^ °* "*^ ^J'^' ^^ rapid manner. "*^ ot tHe eye disappear in a strikingly on ^e^SSTei^^tS'^astS^*^' '*^*'^* *PP«^ ch«t We may conclude tkaTSs^?^ ^°T ^ °* "»« caus«l by passive congestion i^ST^ "* *^"'' *° '^'^ and doughy, and becaLe tte^ a^ ^^ T P*^««' <=ool. heart becomes weak. AW ^tte^ w''^'^ *^" *"*^°° °f the I^ frequently, the swS ^ t'L'^T °' "*« ^^'^■ monous or erysipelatousTX^er •S.^r****'^ (P'*^*^- tremities causes the gJt Tte ^'tiff % "^^^ °* "»« el- swelhn^ often completely d^p^'^,*l^^ddUng. The approach of i«:ov^. iSSon of 3^ '^*f ^^ °^ «»« tendons is sometimes obse3^r« ? *^® ^^^^^ of the of wheals, outbreaks of s^T^h £ * Z^- "^' *° ^^Ption catarrh. At fi«tTere TTs^rn 'w " ^^"^ ^^^ pundent discharge from the n^ 'si^fj!^!" °"' » «»««>- 9* ija INFECTIVE DISEASES. during the coun. of the disea^,; and p«g„ant ma«, generaUy ^^'^Tt^^f''::^rr-'^\'''^ '^^^^- of nuy run on forTor s^^^fc. i^^ though «vere cases "cover in from 3 to 6 daT A, ^ """^^ ^^ "»»y falls, the appetite usUvlS;r.J^ T ** '^"^ temperature the bowels £om«r^«S'^"i*^' P*^**^*^^ **=«°" of swellings smaUerT anTLovet,' ^" 'P"** ''"«^**^' ^^e 8 to 14 days, ii a few^^^ ^""^ ''^'"P'*** >« from when L W hL''LT^,S^f^o- «t in. «peciaUy S ^e :^^o1r :>- ^^-.^tn^alXe^-^e "t^ jesf f^rSu^rbrS::^r^^^ of the tendency to necrosis of the L« ^^. ^* ^"^' ***^ and may secondarily «»■« (atrophy of a» standing. sensiuve lamin*. or by long diarrhea, Undo-vatiZT' Iht^ * ^ *^*'*'*' '*>*<^>*^oUable ' phUbMs. '^'"^'"'•*' «**«*««. muscular spasms, and INFLUENZA. portion of the stomach and teS^ ?^*"*^* °' *^« Pyloric miestiae. including the rwtumT ?h («PeciaIly of the large ^■•^tcd With sligS h^mSSe^^.'^^r^^'^^f^n-andinl! quanuted. The submucosal .Si. .'**. «P'*helium is des- to a high degree. sT^th/^u^ "^"^ ^'^'^'''^y ^^^^d translucent elevations wWchJveT.r'"^^*' '°""» t^ck. may attain the thickness o? a few centifr^ ^"Sf"' *"^ ^"ch they are found to contain a flSd wSr^' , ^ ^^ ^P^^ed lumps. Peyer's patches ^^^Z^ ,^**^ '" ^^'^""ous of the submucosal wS^^tio^J^^Jf **?°"' '"^^^^tion when inflammatory sweU^«^ » ^ '°"°^ ° the subcutis states that in the gL,„aS^.JfP:^«« '''' ^^°- Schutz particularly on the ba^ilt? sSa^ T^fiST*'^™^^ ^P»c«. IS generally clear, and wWch^nSnY? ^'** '^*'* * ^"^^^ *Wch ^th. veins may suff^'^frord^oTdVre^SS^^ The plexuses the^ lateral ventricles contained a'^C^tily Z ^J of th^heSlrLS:^^,^;^" - -/oUows : cloudy swelling of the spleen; sZu7^^SZ^\''%'''?''' '^'^^ the serous membranes, and ^ T ^ *^* mtestines. under gelatinous infiltration of the rp!^? ^^' ^^**' *°** b^^in ; mesentery; swelling of the iS „?T*^^" *^-'*"«' ^^ transudations in tih?ca42 of ^fti^^"^' ^^^o^^' serous coagulated condition S^Je bJlo^ body; and an imperfectly ^^**'*****— Influenza is a miM ^ ■ ^OTUhty. which varies at different t^l ^"«>« disease. The IS on an average from 0.5 to 4 ~r .^f ^S"" ^*^«°* P'^^^. beginning of Z ep^^ootic i^vas^' ?„V*, ^"^ ^"^^^^ »t the Dieckerhoff saw a loss of T^Tekt iJ T *°r^ '*^ «°d. Aureggio. one of 3 per c^ ^ "" 1'^°° wfected horaes ; INFECTIVE DISEASES. IJ4 lto)T. 'X cmW:rf!, S *P^«<= - Copenhagen froiJ^'^f^o.^^SSS^Jf^"*'"*. " distinguished dissemination over kr«S?A^ T°°*'*= occurrence, rapid benign character sSv^.v^i ~"°*^' «^* contagiousn^. pleuro-pneumonia by thS s^JT* r °™ **»"*"* contagious organs and of the e4bv?^ "nphcation of the di^tive by the sUght parSdprti^nL ?;.''''"' °*'/°"' '^P*°™^ ' ^^ pleuro-pnfumC^nhrch^ ZToi^'^TT'''''' :''''' ^ commencement of the attack ^l i? ^"f^^ ^^'^ *•>« pleun,.pneumonia andUu:^^ <^ be^Sf **", "^^T begmring. when merely een.^ «^r.. u* ""^^ ** t'^e of appetite, and weS i^pS^T '"'?^ '*^^' '°^ that ihese two dise^,St ^J^^ u * ?"** ^ mentioned When the ski^ h^tlv tLr^*^'"'^^ "^"^^ » ^°^' tumble petSui f^i ^Z ^ • ^^"'"^ "^y «'°»«^hat soon be dSti^shed bv'thH '^''''\'* *=^' ^^^^^e^' very ness of its cSIS ,te ^e!.. °'! °' P"*^'^' ^^ *he milS- wuree. ana its greater contagiousness. n-ing. and'atte^^ tol^t^ ve/S'be"^"^'" = cases, sufficient for our punxi w^!„ ^°" ^' "» '^^^'^ the weather is favourable^TT; w ! P^cticable. and when in the open air S.w i *f * *° ^*^^ "»« ^'^k animal healthy h^Ls'^a^d'So ^k° o^h^d^^^^ recommend givine lar^e n«r^T!l- x V °' °« °wn. Some ^0 die). The te^TSireT ^°^"^ <"^ *° ^5 Htres taltic action of tKwl ^^ ^ ."^"f^' *°^ *he peris- cold water. ^ ""^^ "^ stunulated by enemas of administration ofSbr^^et^kt Sf J*''" ''^"=^*' ^« in two or three doses offrom ?« * begmmng of the fever. rule, rapidly reducHie t.^ " ^ ^^ ^"^^' ^^'^'^^ «« » the co4e of^e 42L ^*"''' ^^ ^^^^'^^b'^ ^^A^ence alcohol. ^, camTL:"-J^fi,n.rh::.,^^^^^ ) INFLUENZA. •alt).- theinfla7maion^f the^"*^\°* '°^' *«d common of the .kin. with inunction, „1^' ^*'' **«>?'"« 5 the swelling •intent temperatui^T-^tranlf^r^^?^ *°^ *''« '''Sh, per^ in three dosM) T^^l hiuh^ T ^'°° «^*^™«» ^^ *« the infecteTand a tho^S Sf '.''""'I "* '^'P"**^ ^o™ be made. tnorough dismfection of the stable should adv^*:2'SSI?b7?Si' ^T* '^^ ^^^ l^ave been others. We, however s&k '^^ '"'"""y ^^ ^ustig and severe «gui;trorSn;f ^ ^?r°^ °*. P'^ckerhoff^ that advantage to tr^c^ti^t ^L^f ^*^°"* ^"'»'" <«»■ considering the ben mcoi^e .^L a-^ °°* """^ necessary. Lnstig. it might b? well tr?ntr!J *^'*'^' ^ P"P«»^ by in every case of iSu^,^ ?„ 0^^"*=%'°"^"^^ notification to this ^pizootic^rti^^^J^-^^''^'^^'^^^tion struction might alw be o^ven In ,v ''^*'**'- ^^"^ '»■ an edict of the Minister of ISi.,°u *^', J^^ject. In Prussia order, that in the eS of In oSlT /^^"'^ '^th. 1889) contagious pleuro-pZllT^" S^"T' ^ °' ^^« surgeons and the oolirA a„*i, •.^^'. *"* °®<^'al veterinary whfch shoulS ^ p^^l.T^T'om°1^ """ ^ «P«^ municated to the directon o h !. '^ P*P^' *°d com- the military authoriuS "^"^ establishments, and to PImmm of Oattl* Ma^^vit ^ , observed amonir cattir\vL...i^^^ *"' In«B«««ii.— BImt luve r«emb,ed «,„£ S^^iur^t^ut """' -<«tio Jwt^ m a sheds of 6 each, catarrhal ,^nf "* " '=***'*■ ^J^** were to bear fatigue. giving\v?y^^e ff n"'";. *'"*! depression. iaaWUty temperature (4i.s» to %• C ) Jh d!^'*"''''"*'"- dizziness, high intenuU membrane aid of thl con 'u^S^^Zr '*'''"" °* thenaLlmu^ of a farmlo.. of appetite. S^eal^ h '*'' "" ''^"'^ °^-«^ perature (39" to ITo' C inLr . ' <*««"ease of milk, high tem- .welliag akd yiow'^lour'if '."e'S^"^,. ""-^i^ous '.^^^, opacity of the wmea. blc^Hly eiudaTeTth "*' T^"" J*«l>rymaUon •ye. yeUow colour of the oral ^^1 ZJ.t,'^'^' ''^'^^ *»* «»« on the skin. The disease wScr?„H^-^"*' *"'* P*^**^ '^^^ to '4 day.. Spinka iwpo^u a .fmil " ""''*^' »«'«» from 8 a catUe diseasefwhich hT^eflTS^ '*'*• ""»» 'tates that in were constantly prewntLS^t.^""^' '^ ^''"^^K symptoms frequenUy compK wS^^^S VrT^"' '»«'«'»' 'K wa. With occasions tofiammationof^xr^rnS'^*"'' "** "'"Junctiviti.. Janson sute, that an eSStic wh^ *°** '°**™*' P*^ °* «»• "ye. rinderpest, raged in Japan dX;C«dI^,~^ "'^ "^^ ^^^ ^orm of a very acute. feveriTSd 1S!So^'l««S: '^Z'^^^ >J6 INFECTIVE DISEASES. tot oon.,ip..ion, wiS. 'u.e ^^^^2"^^"' ""^'*«»' "<» •» -I-cuUy the hock, and. in v^ «^ c!I^^ tf**'^. '••' ^*^'«- •««uive attack of emphyiema/ ' '"^ "*"** *~°» " tenSf SS^^J^TJJL*"*; *°*~"^« di.e.« of man. which ia -"Che. of Ser and ffi' itj^^ *^"*'''« '° '»« "««»» '" dmeruMA bv m«nr.i ™ ' **"^ ''^ • •"»*" baeiUus. has been .iHdS?o'^b^?s.%"ro?/aTS'':h.:L*' "^r- ^---^ ^ known for a long time hL diwc^^^^!^ " * ***'*^ **«* »»• »>««> ThebacilUofhnLnflSLrThS^?^^.*''"''"**' •"*""<'«' 'o "• •eem to enter T b^yo^'"^^?"'^'*'^"'^''*^ "''»• »?«'«». di-ue manifesu itsdTby LS^e^Si'' '^ '"f '^ »*»«««• The lA^yngiti., laryngiti.. LnfhitrS^ml!'- " « '^. *»•?«»•»». '««i»iti,. "d tendons. rtrThJXnomenIm.T^^ **~"**" "' "" "»'»«='- varied compUcations su^ «"°r ^^ ** awociated with extremely the bnUn. m^St^^JS miction of the lungs, inflammation of di— can iTtCStttS bj^!'*!^"*'* "«««' «»'« »»»•' the We have no proof Vb^nm.niL^*'?!' *° monkeys and rabbiu. It i. even i^iwl tSHhe t^l " '''"'"'*' ***'» ^J"^' »«««« together. In C op^^ they ^e^^^H T ^ ">^ "^^ «""«=»«» which are in no respj^t eUoloSl^eU^^^^ """u *"*""''• «*i»«"*». diiI«nce.betweenThe^\^^^e^*l.r,^"T*^^^ The respective •nd the fact that the tSS^L? of the ^ S^ ""'"*' Phenomena. w« v*rs4. has never been p^ to ia^M^ S^ "^ *" ''°»*' «' nwnu against the idenUtJ of the two dS^'^^ *" """« "«»• holds good with respect to any sui)i)LrfM.«?f^: ^' •*"* """"k and canine distempw! »«PP<»ed identity between human inflnenia EQUINE CONTAGIOUS PLEURO-PNEUMONIA. found with certaintT tk! "'*^*''^^ "*"«'" has not yet been each other. The ^L^oT^fi !f' ?^'' ^^y ^"^ ine disease occors enzootically, principally in EQUINE CONTAGIOUS PLEURO.PNEUM0NIA. ,3, places where large numbera of hones are k^nf . # • in cavalry reeiments am,« -4-!!a4 u .. *P* ' '°'" "»»t»nce, •nd «ta^X!^ 'dS. !Si •' ^"'"^"f estabUshments. than in the count^ nZi £ ". T'^ *'^"*°* ^" **>^« be more susceptibTe to irThaS^SMil 1° " ^"^ ^^^" *° perhaps, have dready h^J jTdiJS ^""S^' TV ^"^'^^ gives immunity *w sevend veL ^' *"*'='' generaUy although exception, ^"tor^^ommor'S"** *'*" ***' "*«• ««ceptible to pleuro-Dne«rnnn." T °.. "°"*» "« not »o that \n a tho^S^^SXS^" '."^"Z'"*- «""* »*»*« 245 took the diseue^?^ i^ n^i^ !"*• °* ^05 horses, only had the dis^ IS^nT^if °^ *k ^f J*""""* ; and 60 had than those^h a iSc coSS health are less susceptible -rng°^a^;L"i-" ^^^ in^rSiX^: toaTuLfbyfc^^r ^T' J""''™"'^ ^^ -'»»' by remount, su.d worwl hnJ. '*":i *°' *"'**"*="' ^ introduced to hon«. The infecti^ k ' *°'* ** t«ns™tted from horse mediate bearers «,.h' r^''^'' " "^^ "*"a"y by inter- surgeo!^ -"^o:S.lX"ho^d^uTL^r^^^^^^^^ strange stables, and ev^n d^^rSJ^S^K °''*?' J°'^'' population of garri«)n toMmfaJ, uifected horses of the civil tion for army h^^' !? * "T""*' ^^^ of infec- dangerous hL.,r?i; ^"^^^'^^t horses are particularly deposits). It hak ^t vp* ^ "'' **"■ ''•*^» <<^«ad lung" ti^miiion of "e S^* ^^'0^*'"''^ P"^«^ ^'^«*'^«^» by means of a miLm^It^,^^ *^*^* °' ^^«=* ^*«=tion. Of ^ conUgiuTo^^et: "'^'Z^XTo^^''''''^-' ^^^^rZ^f^J^-^rt f F^ ve^ated and sporadic cases may ^^^t '*'* ***** °°* uncommonly whole year^ve led to th.^.'" \'**"* throughout the may be pr^^i -^ fstaL?^? k? *^** *^" '"^^^^^^^ matter and"^ ma^ ^^H the di^ie'lo t^;^*''"* '''' * '°"« *^«' the other hand theTrr-Vl ^ to become stationary. On by the tup^^don tST Jl^?' '"'V^ "^J' "^ «ijain«- became attacked by the disease Srh^ healthy and aU of the hitter find the micro^rgLsm o^eftv r"^-^"P^'''»*^«°°tbe«'>ableto theydo^notconsid«itto2^fic ^ * *"" *"^ *'«'»««» that conslsfof 'JmS^oS KeS'^vh**'"" °* '^"^" Pleuro-pneumonia diplo-bacteria. and which W S^ fo^ed^r^f. ^"^^^ together^ of individual bacteria. Th«e ha^-nl u**^ *''" transverse division blue and all basic aniline^fou^'* d "^° ^ »»*^«^ ^th methylene they become decolourised wherc^.f^^T''*'^'^ ^ '^^ ^'^^^ time, recognise around them a rS^W^ in " "^^ "^^ «" «"»«- but cannot in others SubL^rf*^ " '*"°' *=*»*» «=an be stained produce small, wWtrspheniT^n^frwh"". "**'-'^'«'-P«Ptone-gSS and which do not s^refd "vS iS^^J^f ^*' "»' "^^fy the geUtine white flake, at the bottom o[ the t^^n '*'*"'"" ^ "^th ,how -U. opaque, grey ^^i-- LT.^l^^^^^LZs'^-T.^ZSZ I40 INFECTIVE DISEASES. to mice, rabbits, pigeons, and guinea-pigs, but not to d>« or fc-i ^."^TLX T^t mi^a se?f«nS Z^ ^Z^y Si «K^ T^'^h'' ^"**''*^"'"" degeneration of S^StaJ^S." SiTu^o^T?^' Z*^"""* *«> Schiitz. bacteria of contagio^ plemj! KwTthTJ "** "'*^* numerously in the lungs and in the eSl .^r^r^ P o"™' *"•* "• *^ ">«* ^^ « t»»e nasal discharKTand long time, especiaUy in encysted deposil,i in the lungs ^ Baumgarten and HeU oppose the view that Schfit,'. k.^.-: ^^^*"^, °"'^'8«>^°« »>*ve only an injuriouT^Sni on Se Se^nd^Tr'"^' *"*" **^' '''"y «•"«»>«»« »° »»»• pn^uctLn o^ H«ii f^fu ^ affections, especially of the necrotic foci of the pleuntk whth'^r /***** '^'- P"'~«^ inoculauon with Schutz's ES2S' 2i sta'« ttrh« ^ ""''"^ ** '^ *^» conclusions «i Schatz. He s^{^pa:i:ntf :srs ir ^ctSr---''- - * Anatomioal 01i«ngM.-In the lobular form of pleuro- ^ennT "^^"^^^^ ' ^' ^°^ * """^^PJ^ hemorrhagic, gan grenous pneumoma with secondary pleuritis and parenchymatous degeneration of the chief organs of the body «°^°y«»ato«8 thi/ke^H ^^ f°'i*°"'.°i *^* ''"•^*' °* g^«»t«^ or l«s size. of the lungs and m the lower sections ; and bright foci which ar« distinctly defined from the neighbouring tilL'^Vi^SS EQUINE CONTAGIOUS PLEURO-PNEVMONIA. ,,, r^al'^f^T^,:^^-^/ the hepatised parts. UsuaUy. be met with T^y^a^Tl 'Z? '°"**^"»^ °"^y °°« -"ay At first they are vL S^. "^f j'"'" ^ P»" *« ^ <=hild's head. hagic foci). Ld a^Tu^^d^d by a'^Xtishl "^T <'*"°"- kucocytes (Umited reactionaifiX^^^ti^ni • J °/ •'"'grated become yeUowish. i«semblp fiLT- ^" ^^' on. they and then'take th; STotca^S "wSTrv'J'^ °""°^' pea or as large as a hen's Ja^^Z' C^t "^^ ^ as small as a tissue. TheJI «v?ti2 «r.^« ^"^ ^^'^ ^^^'^t^ "^^otic lung T^ere are oTher^r^^h Tj^^e^l ^r"^ -^"^' (gangrene of the lungs) bv re^n «f^t^' *"**' ^^t^'y P"s lung undergoing ^tei dLSS^t'l *^' °'**°*^^ ?"*« ^^ the admittance oflr. We^als^find^Z" *^°'^"«°<=« ot the which are generally of ratSr at " '""^s^^PPu^ating foci, w'utish puf. mixed' l^deTdii^f^i^;; ^1:'''^. ~?^ ^ cauon of the necrotic parts) 1*^=., *! ^^"PP'^ative demar- of the foci which we hS^T^Lt des"riLd*:i t?r *'** "^'^^ ungs ; although, during Ufe dSIfaW l be seen in the localised affectfon may ^aveLfp^^^^^ °' «"<^h » must assume that absorotion ntlL :' . ^^^ "'ses, we The remaining tUHF^he SLt °'"°*'' *^"^ ^^ ^^^'"ed- and oedematoSs. ^"^ ^' "°™ °^ 1«». hyper«nic the"t2S,g^^:rt S^^hSTin 'th* T^' ^^*^- P^«-«'. from necroLTpo^L Sh *^"'^*' '°*i°"ty °* <=ases. is the lungs. ThS^^S^^'^ "J "*"**«» °° the periphery of foci bei^ print Th?"?' ^T"""' *PP^ without ttese lungs ^lyP'Ss tS^^tfo'^thl rJS°*^^ '*^* ^ *" visceral and costal lavereVf thl n. ^ ^ *^'^*y- ^th the and in spots, and ^S^L^^^'tTC^^S^'^ ""^'y and rough ; and are often covered^th^^t"^^ ' ^ .^"" Over them we find soft v^llnJ?, ^ J "^^ granulations, branous and party coi;,^^^!^'?.' ^'"'^^ *^« Pa^ly mem- can usually be ioy^ovei a reticular mamier, and which sedunent when the fluid has been Mt*^.*?- ^!' ^°"° a 143 INFECTIVE DISEASES. » »wy ra«jy present. The exudate compresses the Iim« -«^ pushes a™ away fr™. the th<«cic walls T^eoi<»S.o1 the «„.ded a«id becomtag ^janised, the tag, bZ^^^f S:X^"th:^.r '^"^- "' '"»°-' -i^oi^S ■».L''iLJl,aX''a?d^t?^dSnl«r,^''»"°S- ^£'^^4s^.'T:^S-SrS foci The W « enlarged, of a clay colour or s^metk^ icSc ^d presents signs of fatty degeneration. The ^^STJiacdd' a^d Its pulp uicreased and often infiltrated with ^morrhS^' ^d rn^tin^TgJ^: '^X^! SSfa^d e^ST^^^t ^ey.«d cotour on section. The musdes of the body^l^H and of a yeUowish-brown colour. We may freaueiX fin!i = n WrAa,« under the serous membrri ZSt^nd^ ditis. The blood suffers from less change than any of the SSS' \.^^»'**<=<>^meml»'ane of the stomach and int^stZrS^^' i^ymphatic gla^r^Jelwolltrdtrn^ ^.^^JJ:^-^ chi^mucous membrane is also swollen and infli ""^ th»y ^e easily together, lobular, ixregular d^2^ ^r^Tf^ ^'^^ ^ <=1<«^ cu^on. especially intte^?Z^^S.rio^ *"'!"" ^ '°"°<* o° Per- as directly behind the sho^Z^rZ*^"^ f *^' ^'^' '^ near the heart; and wSsTof^S^'^^^^^" "»«'«« side munnur. . The presence oflS^blr^Lrr"'" "^P'^atory be ascertained after the thkTdav of th^TT "*" S^^^^^^y J°»e we may observe thnDpSL^L Z***"^- ^* ">« «a«e d^harge. which sometimes S^S T h* "^.^r^^Uo^ °««1 near the nostrils. The cou^h T^ ° * brownish-yellow crust of breathing increase! ^ ^"'"^ ^«*^«^ ^d the diffiSy The extension of thp infl. at first manifested by the SHTt?"^ ^'°^ *° "^« Pleura is ^nsitive condition of the ^1^5 'T '^""**' *°^ ''^ *h^6 highly Respiration becomes aWo^"" fcL° *'' *^°f-ic walls': pleuritic exudate in the iW^c r«^ *b« accumulation of a more extensive; it assumes * mS' H^" ^"^^ *^™« and may extend over two-t4tk ^ °"^°**^ '^"on 5 cavity, on auscultation in s^t^.-'^^tf^L^o^l M4 INFECTIVE DISEASES. vesicular respiratory sound, or that there is bronchial respira- tion on the boundary of the duhiess. The change of lobular- pneumonic places into necrotic cavities is shown externally on percussion by a tympanitic sound, or by a cracked-pot sound (oUa rupta). The same sounds are heard with localised pleuritic exudates. With the increase of the pleuritic exudate, respira- tion becomes extremely difficult, and the horse while tiying to breathe, widely distends his nostrils, which, so to speak, take the form of trumpets. The course of the fever is sometimes typical ; at other times, atypical. If the disease runs a favourable course, improvement takes place after the above described symptoms have lasted for 6 or 8 days. This improvement is generally preceded by a critical polyuria and rapid lowering of the temperature. The recovery is complete after a period of convalescence, which lasts from 2 to 4 weeks. Such a rapid and favourable course can be expected only when the animal has not suffered from pleuritis with abundant exudation. In severe cases, the animal may die during the first week. Death is caused chiefly by a series of grave comphcations. LOBAR-PNEUMOKIC FORM OF EquINE PlEURO-PNEUMONIA. This, which is the milder form of pleuro-pneumonia, is charac- terised by its typical course and large areas of duhiess. Exu- dative pleuritis is rare in it. The inflammation of the lungs b^ins also on the antero-inferior parts of the lungs, and extends rapidly over large sections of these organs. In the majority of cases the inflammation is unilateral ; that of the left side occur- ring about twice as often as that of the right side. Friedberger found only 8 patients afflicted with bilateral pneumonia out of 70 cases which he had examined in order to decide this point. In the initial stage, percussion of the thorax pro- duces a tympanitic sound, which is seldom quite pure, and is generally somewhat dull. The second stage, namely, that of hepatisation, is distinguished by a dull percussion sound with the feeling of considerable resistance to the hammer. Tym- panitic sounds are also noticed on the boundary of the dull sound. In the third stage, we again find the tympanitic sound. This typical character of the percussion sound is not met with in abortive cases ; because, owing to the shortness of the course of the disease, percussion reveals no changes, or only trifling ones. At the beginning of the attack, auscultation of the lungs, EQVISE CONTAGIOUS PLEVRO^PNEUMOmA r,, breathing ; andt tte Sw^l^ 1°^. '1?^*^°"' ^'*>°«=W»i of the healthy parts of thT^ur!^ ' ^T '^^- Auscultation The rwmJ^*.-^ ^"■'V" respiratory munnur. of the fever and toTe eSenfff^*' •' V^^P^^ion to the height and is chiefly costal. xinLi?'^ mflammation of the lunp ; times give out a pecuui T^.*"" "^^f^ ^^^^ ^d some- believes to be due S^^tXS^'^S'of Til'^' ^"^«^^°« brane of the false nostril to thS TZ ^ ""*=°"* 'n«™- Pinxi air is abnormaUy hot -k. *^* °PP<«'te side. The ex- stands up with the fSe^e« as?L?Sr ''*'^''" ^^^^^V only on the affected side, ^dt car^^t ^^T' °' "^ '^^^ We may hear at the sa^7 tiL T^ » ^''"^ ^y movement. cough wweh is oftt%r«:i^T:p;,:^^'^^^^^^^ ^-^ the attack, in about 25 per cent of if^. ' ** begmnmg of severe ones, and in thSJ ^n whtwl ^' ""P^^'^^y •" the well-marked hamorrl^ char^J'.'r P°!""°™* »»'^«s a which may vary in S^ frS^ !!!** ^.^ » °^ discharge and which, on drvta^ fo" « ,, «**o°-yeIlow to dirty-yellow. The orin^ifSL oTTob^i^T '""*^ *^"* ^^^^ »°siils. that the stag2'oTZ,;ie^e^ tt-^l-"""™* ^ *yP'<=^ *» follow each other at SZ^i Jf?"***" V^^ absorption, abnormallv hiirh teSIr !?^* °* *"**«' The course of the usually ::rch^lS"n^hefifth'^ *^^^^- ^« '^^ resolution begins. S dSn^ ^tJJ""'^ ^y' »*t«r which wr. we^-^— rpSl-^.^s^?^^^^^ besides lobuK toba^°^ °*J!"« 'Pf^^ pleuro-pneuSonia. a series of symptoms wS^^k*^'^ ?"^.*^^' ^« "^^y ^ave and pleuritis or by ih^yTrnLT^^'^J^T °* P»«unionia disease we are consWe^ iS^ E.^'^^i *^" *^P«=* °^ th« and kidneys are someS Jzi^'.'^T^^^ °' ^le brain, that the iSgs my £ Z^ff^fi'^T^y ^'^^ «^t of the disease collected on^e^SasTon^?^ According to the statistS was absent in '^^^'iuf o^f T' *'^ '""^ ^^ ^'^ follows :_ ^ "* °* "7- The complications are as 10 146 INFECTIVE DISEASES. 1. A severe cardiac affection shown by parenchymatous in- flammation of the myocardium, which is one of the most common and most dangerous complications of pleuro-pneumonia, and which manifests itself by a very frequent and small pulse, that finally becomes imperceptible; palpitation of the heart; ex- treme weakness, and general symptoms of congestion, especially in the lungs (dyspnoea). 2. Grave gastric symptoms, such as severe colic, diarrhoea, and bloody faeces. 3- A hemorrhagic or catarrhal (parenchymatous) nephritis, which is characterised by haematuria ; presence of casts of blood and of exudates in the urine ; great weakness of the hind legs ; anasarca (parenchymatous nephritis) ; and increasing general anaemia. We have seen fatal cases of this complication, in which the inflammatory lesions in the lungs had completely healed. i 4. Septicemia and pyamia following the formation of serous and suppurating foci in the lungs. 5. Cerebral convulsions and symptoms of a leptomeningitis in consequence of the contagium of pleuro-pneumonia attacking the cerebral membranes (the so-called nervous form of pleuro- pneumonia). These cerebral symptoms are sometimes the first and only symptoms of pleuro-pneumonia. As a rule, death rapidly ensues from paralysis of the brain. During the progress of the disease, we may also observe copious haemorrhage of the lungs ; haemorrhage of the kidneys ; internetting inflammation of the tendons and their sheaths; laminitis ; internal inflammation of the eyes (iritis exudativa et haemorrhagica) ; roaring (frequently in 10 per cent, of the affected horses) ; epilept form convulsions ; muscular spasm in the region of the facialis and trigeminus ; muscular rheumatism ; arthritis; rupture of the spleen ; weakness of the loins ; paralysis in the region of the ischiadicus ; paralysis of the rectum, tail, bladder, and penis (in very rare cases) ; chronic endocarditis with val- vular lesions ; chronic pericarditis ; broken wind ; anasarca (a symptom of parenchymatous nephritis) ; pharyngitis ; phthisis pulmonimi ; general mal-nutrition ; general faUing out of the hair ; and paralysis of the pharynx. During the course or to- wards the end of an attack of pleuro-pneumonia, the affected animal may becotoe seized with influenza, strangles, or petechial fever, in which case we have so-called mixed infection. Coui.'se. — ^The course of equine pleuro-pneumonia is ex- pneumonia, or with a sl^Sf Sa^ Iff! T*^ ?' ^°^" *°™ <»' high temperature rem^Ts Jead^ fS!*'°" °'. ^'^^ '""«»• The to 8 days, after whi™ ^I^uldlJ^ftj' ""^""^^ ^°^ fr°™ 5 or pleuritic symptoms diS^!?^ c*"t' *"** ^'^^ Pneumoni? favourably; although the S„f 'f^ "^"^y end (2 or 3 weeks) than that of i^? convalescence is longer well-ventilated stSle or t tf ""*• ^^•^^"^^ ^^ a dry and the course of the Z'^' '"J^Ta^ tt' j^^^^^^^^ ^«»^ disease appear, the animal sho^atl*^'.!"*,^y™Ptoms of the and should be carefully nur^S ^ '^^^""^^ ^""^ work. 2. Abortive aitartv o.-^ •. breaks and und^fe^o" ble'eSLT '^^''■^'^ ^^^ -*" then lasts only for a few davS an?!^ <=°nditions. The disease of an infectious bronchTal cS^h Th™'' '''' ''''^''' ""^ely the respu-atory mucous membr^^ J^^u"^""^'"' ^***"J»« of forms of pleuro-pneumon™ W?fi„T^^^''*="^**'^«^^erer momtory symptoms of this diW ^n^^'^'^^^^ ""^^ P«- TZZ:f' °"^^ sympXlese'r ^--. elevation of f^^oun^:^Sc:^rar*'Li£^^ m those which have beTntorked -^0^° "^^^ ^^^^es ; mhorsessufferingfromgangre^tofSw"''^^ and by very serious consequen^^^ J^X" r "'"°°'* '^ ^''^^^ the lungs becoming caseated^^^l^^ ?°" "^""otic parts of pneumonia. The ?o^^^f ;°^P;f d. as in bovine pleuro- these encapsuled foci. gZS Ih? , ^^^°* *°^ °»°°ths in by the animal are loss oJ^S^^J^d "nahT^"^^ ^'^^ '^°^ Some horses become broken^SiS J''^*^ *° ^ear fatigue, marked sign of iU-health SucTcht^' -^"^ °'^''' exhibit no source of infection, if the enc^ted^r'.'^ ^' * "l^ngerous bronchus. The presence o? sS deS?.'*" ^^'"^'"^cate ^th a duce m the affected horse an "Stf IS ""^^ ^™«*^«« P'o- appaient recovery from thrprim ' ""^ J^^" ^***^ ^^' a^er JJ^/bserved by Schwar^S ?„"?.*'• ^" ^'^"^ ^ year-old cavalry horse contiSSd fat,, ^ "^**°'=«' » ^a- IO» 148 INFECTIVE DISEASES. that time, and his temperature, which was taken daily, was always found to be normal. Post mortem examination revealed in his lungs an old, encapsuled, caseous nodule, which, on ac- count of the violent exertion, had burst into the thoracic cavity and had produced, there, an acute sero-fibrinous form of equine contagious pleuro-pneumonia. Diftgnoals. — ^The diagnosis of this disease is sometimes very difficult, on account of the not unconunon occurrence of abortive cases in which there are no pneumonic symptoms. Taking the temperature of the apparently healthy horses twice daily, is often the only means for the early recognition of the disease, when it breaks out among large numbers of horses which are kept together. This use of the chnical thermometer has proved of great service, especially in the army. When dealing with large numbers of horses, it is well, for prophylactic reasons, to regard as contagious pleuro-pneumonia, any feverish acute disease which shows lung symptoms, if it occurs without any assignable cause. We should, of course, exclude pneumonia due to chill, foreign bodies going the " wrong way," metastasis, etc. Prognosis. — The mortality of pleuro-pneumonia varies at different times. It depends on the progress of the epizootic, constitution of the animal, character of the nursing, amount of the contagium absorbed, and nature of the pneumonia. The course is generally favourable under well-regulated dietetic and hygienic conditions, and when the infected horse is well nursed. It has been observed, especially in the army, that the fact of withdrawing the affected horse at once from work and placing him in the open, has a good influence on the disease. The mortality, which varies from 20 per cent, to nil, is higher at the beginning of an epizootic than subsequently. During 1886 to 1893, over 17,000 horses suffering from pleuro-pneumonia, were treated in the Prussian army, with a loss of about 4 per cent. The proportion was the same in Bavaria. According to the observations of Dieckerhoff, the loss from this disease amounts to 15 per cent. In any case, the prognosis of pleuro- pneumonia is on the whole not so hopeful as that of influenza. The fact that the percentage of deaths is almost equalled by the percentage of cases in which pleuro-pneumonia leaves behind chronic disturbances of breathing after apparent recovery, makes the prognosis still more unfavourable. In connection with the necrotic disintegration of the lung tissue, we often find, in addi- EQUms CONTAGIOUS PLEVRO.PNEVMOmA. .45, ctSaSc ime.S3?llrr ^'^ If.'T ^' *•>« development of met with. The ev!S. . P??''«">cWtic deposits, are also to adh«^ons of thet^'^H'^r '^^^<>-^y Pves rise and in other ca^ to T^T k ^J* ^^^''^''^ ^^ °f diaphragm, these conSL^tJi etc ^^^'''''^^ f^^ empyerTli for work, and thrTomrnn^^^""** *°^ *^"*^ <=*P*«ty wind." To this SSstTaSd^ .r'^^r*"" "^"^ °* " broken tagious pWpnTumoSa S °"'"" ~™P«<=*«ons of con- tendons.U3Srr:'h?c1,1ea"dr^^^ ^e mo^^'SX" ""^^o'f Sr"' ^^f *?^"* °* Pleuro-pneu- diseas^s. hasL aWeJ ex^Tr "'^°* ^ "^'^^^ '"^^"^tive found to be neitlr^^^n r^ USl ^l^? ?S ^° temperature, we hav* «no-«ii ^ ^ enecuve. i«"-'« •'«' «- hydrochlorate are'the chirf •«i» usea, m ootin of frr , oj to o*i gramme subcutaneously.— T>. EQUINE CONTAGIOUS PLEURO-PNSUMONIA. ,5, the diM«ie for a long time after they have appwjnUy recovered «pec.aUy when necrotic depo«t, which cSSTS^ vJSTi !r M ^ J*™^ ^ ^^ ''^- "•»<:•. convale^nt Ton«J •hould be kept under observation, and shiuld be i^?«i 7^ infected stable which suffer from catarrhal or internal diseasaT It » most miportant to disinfect the attendant ve^L^^i SS^ ti^T*' *"** ""^^"^y ^" »«o^' clothes.lXiS we^I^S^ thmnometers. New horses should be keptTr6 Mtoth?^-^***f°.'°*»"*^*^«- Opinions are divided htithv l^^♦*"^*^**"^ *° •'P^*^^' of*purposely allo^ Se di J!^ r '^ °* ''°"*» ^'^^^^'^ J^ave Pa««d through tfon^!?^V ^"«^"«°«y. this method of protective inocX to°S;:J"no\':' """ ^"^"^ '"^ *»•« ^*'- y-. "p^ na«l diachu^t^dAi^ !r^^ "' ''•"*='* *« »•» i^table cough • tivdy good, and theil^Ta mh^o^, ^Z'''" "T^ """P*"- initation of the SSnge^" "^^""^ comphcated with inflammatory ;;ith a difl„« exuteSaSTn ofTht^'ei^";?, "^tT"*" "^ the disease is generally mild tk. h- ^ ^^ <'^- ^» <»"«« <>< .table enzootic WchLTSmai?: tTUS^T' " '*'' l°™ "* * a suble, and is said to be dS^tlv ^nfi» ^U*" ^^ '°°««'' »° that "skalma" Tone of .h. !J^ ^"^l**""- "^i^kerhoff believes Pleuro-pneumonia-a^r '' eqS."e 'SSp^'^f ^^^ equine contagious under the heading of " influ«ua " '^'"P*' ^^^ formerly included I>iJ:rh^"^''rJat£;S^y\J^„Vose^^^^^ some Of Sl^^ne^^i^aS^tfll^^^Sr"^^^^ of the inteAial t^SUture^ 3^ foi r^'*^*^ in the rise and faU tively good. abwncJ^ry tStSn i'tST'' '''°*^'^ ""P^" of the respiratory muco "mmta^e LT^ "*" exception of irritation also belong. acc^gToS TxW^rl * ^"^ °* convalescence, other hand. we1^L« ^ ^t^ *° permcious anamia. On the pneumonia whiS Sy^^blSX«*"ri?*' ~"'*«***"» P»«««>- Weckerhoff. It seeiM^r!!^!? those of skalma as described by have been desPtcal TUBERCULOSIS. shelled niif fr/^nf«k ""•"/ luoercie), and which cannot be sQeuea out from the surroundine tissue Ae ife ^-n-.^^^. . gradually undercoes rpfr««.»7 . , "* *^®"* pensh, it calcificatLT TlhJ ^ ^^letamorphoses (caseation or tvDiS tXti« ^ micros.opical examination of a fresh ep.«aehoid cells wlach have round or ovS nuclTLH w^t contain i or 2 hariiu -, a x nuclei, and which i^und ceL th!t if * ^" '^^ ""**'■ ^""^ ^tJ» numerous smaU Biology of tho Taborolo Baoillu.. -n.- „ 11 resistance to various agentTpwae^edbi^ weU-marked power of to the fact that the bacmi^r^^ ^^ '"^ °* tuberculosis is due perish very quickly oS Ih« ^^ T J^^"'*^' '^^'^ »"'^«=1« b»«Ui even sunUgVof iuKlt to kiS^ ^^ !!, ''"P^*" «="•»*»" = minutes to a few how NnmenV , P*""*" "^J^"* fr""* » ^w of the baciUus ouUidteThe ^T^ u""*^* *" *"'^'*« development miasma is »'^"«' for 226 days. When in a H^..^^ '• '^5> days ; and on another, •ome years'^ stru^r mxt^^TV'^"^ ''' infectiousness fo; / wun respect to the influence of dUution on the ••Miy;„srci:°4'':rLfittS'rh'' "^'r^ '/^'«^-) «-"= ««e of a millet t^ Z^J ^ V" ""' °^ * """'«' «««1- Tubercle the either quite transpi^eEr o'paSr I h"" ?•"" *" ''^' °^ "'*"^' •««» be tubercuUr." '*''"*'' °I*'««''t. LasUy, mili«y nodules, may ormay not «e method, of h^ltaT "'"*^"^ "**°«« "^ calcification «k1 fibrJi connected with tuberculoid^ T^l -^ "^ more restricted to ehmnge. • rule, replace. " tS^ ' i„ J''* «"??«.«"> " n«l«le " or " tumour " mw^ l««cc. tuoercle m the dcMription of other di«ases.--T». ' 154 INFECTIVE DISEASES. acfaon of tulwde bacilli, the investigaUons of BoUinger and Gebhardt .wf^rif^r *^'^«» -h.n administered subcntSeou^W Jr d™^ .**"''• T^'^to* «lilutingthe virus seems to propoStefJ f<^ dJ^ .^T' of infection only when it is given by the .S^uth. « i r^*^^.^""*" '^"*' sterilised in less than 15 minntes when" ri:^S^TZt' '^\''' ■""' "y '^'^ •*«*' ^ °°« hour (IcSLd of^fo^ =. *^.f*l '•^^ '^"^K tubercular milk to a temperature to pLt, T,^ ""J" **** *"**"='" ***="" '•» "• These microbes, aSng or 4 hil foo ?*"; ^'^ "'^I'-y^ ^y * temperature of JS" c' continu^ L^i-^I i ^^ ■ ^°'' °'"' '^°"**- -^ 'o'-'tion of from Ath to Mb TtheS;^ .^T'''*/''*'!L"^'* '" *!""""« °* '^•^ 8 *« .2 times th^e 20 to afL^ Th "•**'l'"°'" P^'Pl"' ^ 'ender it sterile in from Slide of^' 'T! *'*^*^' ^ P'"*^'"^"^ by a s per cent, solution of t^r c^ir r/""' r*"*"™ '" p^'^*^*' °' *» ^p*"^. ^^^^ vapour. cr^^ or M^tli""* "^h"*"^' r^*' ^"'^ S P«' «»»• ^t«^ solutio^ o ^^onLr » *"**• *^ '^^ °'^'" ^^- » saturated solution of T^L 1:,T'^' containing , per dent, of bromine, or Jth per cent !L^^ • »*^°*°™ dissolved in oU or turpentine (SchiU ind pLher alcohol, putrefaction, desiccation, freezing « low as-S'T (Ser ' and a solution of soap (Guinard), are ine£ft:tual for this purpiwi. '' 1—2"*!^ Remarks on the Pathogeneaia of Tuberoo. t.?IrrK .*^.«."n™igration and the dissemination of the tuberde baciUi m the body are not uniform in aU species of anunab and as cattle, pigs, and poultry, in particular, exhibit a special mode of mvasion and distribution; we shaU deal here only with the general principles of the pathogenesis of tuberculosis, and shaU discuss special points .md pSuliarities more mmutely whfen we refer to the respective specS! untK ^l *^^ i"^^ *°**^ ^^ *^y ™ost frequently along jnto the respired air* and through the alimentary canal Consequently the lungs and the intestines are the cWef ports of entrance for the virus. At first, tuberculosis always ap^ as a Iwal affection which usuaUy becomes developed al^e place of entrance of the bacilli (lungs or intestines). However It not unfrequently occurs that the organs through which the baalh entered especially the lungs and intestines, remain free from the disease, and that the tubercular process becomes • Klein iMcro-^ganisms and Disease) tutes : " 1 have had guinea-pig, kent t.v«], and have hereby produced general luberculosi. in the grei^t majorirof Z^™^^ ■ ' .v."* ""ri* *■' *' air of any place where tubeoilou. J;r*>n, TUBERCULOSIS. Scle X B^'T consequence of the breaking down of thf S S of a^l Jh. ^'"^^*"u ^"^^^"^^ *"^«'^1«« spring Afipr^K- *r , *^® ne'ghbourhood of the primary tubercle After this, the lymph glands especially become iXted 7„' glands, mmtestmal tuberculosis, the mesenteric glands spleen gwnas, upper, middle and lower cervical &landewl»at rare cases of foetal (placental) tuberculosis ^ be explained, partly by infection of the fce^lSoSh S^iltt' "*** °/ tuberculosis. The number of tuK team in the semen of guinea-pigs which suffer from tuberculosa ^cn such ammals were paired with healthy feiSesTTe mdf^Zl«^^ T ^' ^' ^^"'y »P«^<* assumption that S^^hfT^ ^^^- ^°' '*"^ P"P<^ ^« a» important factor Se^'T^^^" ^^^^^^r^^' ''y their'^ansmirA ftLSSf J^® '^^. °* "'P^Jation. is therefore untenaWe^ Hereditary predisposition to tuberculosis is a subject UDon which saentific research has thrown no light. * '""J^* "P^" TubtfooKMi. twmsmltted by Food^The idea that TUBERCULOSIS. in feeding and ^noo^ZS^^l^''^STVT'''^r'' character of tuberculosis v^ clLlv h ^""^ '^*°™ fiTBt inoculation experime^ts^e tS^e^vTr***^- ^« from which time beean th.. pH^i^ • ? -^ Villenun m 1865, disease. ViUemin t^fe^i ' n^^*^ investigation of thS intra-tracheaUy. huSrSulL^L'"^*^^'^^' P^X the fast to iabSTthe faS^ir^"^ *°,^^*k. and wai infective disease the cam! nT^K^* ^"^^^"Josis is a specific further assert^' Sat'^^^f o? 11""''*'^^ ^^°*^« the "grapes" or const^Srof ca^ Tlebr*'^ ,"^*^ the serous cavities of the bodv ^A J^aTIu ^^ 'noculated with food. By these meam ^ TS ?* ^* experiments tuberculosis of'^caSjeJSnj'at of m^ '''^ *^' ''^^^^^^ °* lay stress on the dang^ of Se nSlk ofA ^^ T^ *^^ ^^^ *<> given to children^Lv^;^f„^^?^°n« cows being numerous convincing exSnenr\^i""°°'*'**^' ^y tuberadosis. by m^ oF^'^^t^^^^^y of Cyr a„d ot^r^F^eSTi^vSt^S^rs"'^^ '^ ^^-^' -• experiments. After feSinL^S^* L f^* exhaustive feeding of'^berculous cot/Kec^ed"^^ "°^ ^*^ *^ "^ out Of 8. in produdi' t^Sti^ o'f '^rTvSS "Tf lungs, intestines, and Uver GeriTrh Ha ^^^ ^^*"ds. that the milk and fl^h Jtubero^ Previously declared He Obtained. later'^^SST^^^tHS? rfei^"*^^' penments at the Berlin veterinarv o^^L? t^^ • ^"^ ^' 1870 to 1873. Gunther ^d Ss ll^tooJ^^ ^' y*'*" 94 feeding experiments with aiS o?^ddt^LSn"'^°"''"' and with various kinds of tubercSa^ ZlS i ^ 'P*"^ 24 positive results and 70 nSfor H k!^ T** °*'**^*^ A. tl»« p«iUv. r«,y„ w«» ahcMnurf by m«,y ™g.«„ I5« INFECTIVE DISEASES. opposition and denial. Thus in VLi .h. r ^'' '*™* sputum, and flesh, to men and animals were proved The most important year in the history of research in ^berculosis was 1882. in which Koch discoSred thT^^rc^ n^ o^er doX^'"'^°^ ^' ^"""^'y °' transiSssSn it no longer doubtful Thus. Baumgarten produced tuberculosis m every case by feeding with milk which had b^n S artxfioaUy with cultures of bacilli, ind Haug inv^abty obS We find from ihis^t^^^^n "LTSmT."'^''*.'"*'^ '" "'""^'• guinea-pigs and swine proved moss^'ib^' w.-"^ '""""^ ^"^'^ With human tubercnlai matter (,M^*e^l^7„!fP*""'*"'«J "PO" tubercular matter from cattu =„lf lu "''P^^enta were made with fourths of the ^^es^rinStioTwrr^TucSS"- "T' '"^ '•""■ sheep; three-fourths, in pigs^ onXf TlS,.!" '^^*'' «°**^ "^^^ in cats; and somewhat l^'Ilun one^^d in S^' ' l^^^CtT''; tuberculous cattle was mven r>„ ,^ ^ • *^' '3) The flesh of that pig, were founTto'T.^re'suSlb" 1^^ ''*^*•''; '«'^* that dogs were unaffected. ^ilLi ^'^ '^ ^^ *'*^*'" *'"'»*^' »«>«» milk of tuberculous cowTwaslfvl a^^o^"';':? ''*' "'««='• <-») The three-fourths of the pigs andLS of t^ » ^^ "*"• ""^ °* '^*»i«=»»' infected milk decrLKJi^e„2L*^^*T"f*'*"^- ^"^"8 susceptibility, the herbivotTSu Jl^^ '^' "* comparaUve racial then swinef and af t^Tei" Sn«-7« "^Jd'^bbir^?' •''^''"' '• ' animals (cats and dogs) were veTutUe affectS »^h k^ Carmvorou. with the exception of domesUc f^l A! h 1!!^' f^^ '"^ '*"* °* »" was found to possess th^SSt^t ;n^ tubercular matter of animals sputum of tub^Si men^^d tL^v „/ Z"^"? = *'»'"' «"»« »»»• lasUy. tuberculous flesh ^ °' tubercutous animals; and. a. a wdl !»«,, an, rt»«,, in caseou dejosita aaJTcSS TUBERCULOSIS. bovine tuberclM • j« * ^ . '^' and the milk, as a rule. onhTwhS Z ^t."^* °' tuberculosis virulence of experimental fJU J ""^^"^ " effected. The completely deZyT^ ^^,^^ ^'"^^^^V weakened, or time during which the bacSi^^i *'°"- 7^^ shortness of the tin^ frequenUy prevented S^ *?' '*"'"*'='' ^<» '»*«- experimental animals were more or. «• '° "^^ ««», the appears that thedilutionoTtrmatll? ""^'^t^We. Finally, u bacilh by the other fodder L 1^2,^, ?"**^g the introduced ^g^tive fluids. I-sened the" uSroftC^H ^^r"^^ ^^ ^- yght also have been promotS^^v *t 5 *'**^' ^^ich result djg^Uve fluids. To cC^t^lZ w""' ''^"^"'^^ °* ^^ of feeding experiments bv thr/^ * ' .^^^ener made a series stomach and also into the intesdnS ^^'^^^-'^tion. into "hi IW Th ^" ^"bjectS^to the acSnof th'e ^"*''^'"*' »°d juices. The investigations of «!*!o "*® ^*"0"s digestive shown that the gastric jSeweake^*,"^ *°^ ^^^^^^ have SL and entirely destroys itTeTotT w "^""^^^ °* *»»« bacU? and other research^^ tha^ the n^*. 7' ""^^ •°^«'' from S to act for a sufficien ly lo *''!: °!*"^^ SBstric juice, if allS bacilli, and even kills tfiem^ w •7'*^*'^ *»»« vitality of iS tins effect on the spo^^^hi^h 1''''*''^.^ ^^^ not prod^e and. without affecting SeTntti"? ^'* ^*° '^^ ^^^e set up tuberculosis of toe mienS ?"'j"^ membrane, m^y In this respect, milk* whiS 0"^ ^1*°^ <''**** mesen^a) •s the mo.t dangerous ^ent S"" ^'^ ^**=^ and^J^^' as a rule, it is f^ froi^SL'^f ^ » «»«<* less so ; be^J^' numbers, and is usuSly^;^:?°t*«« them only ^S penmental moculatiom ^S^^. "^ * ^^^^^ «^te. Ex P'gs with the juice exorl^?. Bolhnger made in g^in^ ?s!h V*^" nega^v^S '7J'^ '"^ °^ tubeSoi" 2schokke. Bollinger and nS^l u ** experiments of BanJ^ contain bacilhTs,^^ "^^roufr; ^'^ "«* °^ ^; and may therefore JS m I^ in?I«^ "*^'*" being affect^ ments of Gebhardt W r^H f ^^''^ ^«°t- Recent 6^2?' •^ of tubenmlou^ co^ Zyil' ^'■?*''* ^^^ the vSt' i6o INFECTIVE DISEASES. OoouwMio*.— Tuberculosis, leaving man out of the question 18 most frequently observed in cattle, pigs, and birds, and less often m carmvorous animals and horses. The apparent rarity of tuberculosis in goats and sheep is due to the absence of special research on this subject. Tuberculosis occurs very frequentiy in apes, monkeys. Uons, tigers, bears, and other wild animals (dromedanw. giraffes, jackals, panthers, jaguars, and arctic foxes) which are kept in captivity ; in rodents; and apparently m amphibia (Lechner). Field mice and white mice are immune. In Japan, the indigenous breed of cattle, contrary to what is the case in imported and half-bred cattle, are free from tuber- culosis (Janson). c»^S^^lJ^ .\**'^ *if* one-seventh of nunkind dies of tnber- mt!^L. ^\.^ ^"^ " * P*~»'*' "*» "ot a saprophytic mraxM.rgaiusm. although it may be cultivated in speciaUy prep*«d medui outside the animal body. Kanthack (AUboU's Sj^^^ Medutne) on the contrary, considers that it is nearly certain that this microbe IS capable of a saprophytic existence; that healthy persons are relativdy immune ; and that improved hygiene and the d«truction ™h tit a """""'P"^*. "e the best means for checking the I^^ ^^^ '^**"« mankind. He argues that condwuons drawn from expenmente with guinea-pigs should be received with great cauuon as regards th«r applicaUon to man; because these ro^ts aw extremely susceptible to tuberculosis, "and that the healthiest specimens, if moculated with the smaUest quantity of m.mm.K... tubercle bacilli. wiU succumb,"— Tr.] H»™"»y o» mammalian Bovine Tuberculosis. Histoiy of Tubwenloaia In C«t«e.-Tuberculosis of cattle is one of the oldest known diseases of our domestic animals. The Mosaic laws (Leviticus xxii. 22) contain rules that the flesh of animals which suffer from " wen or scurvv " S°'f wi-^ "^ ** *°*^- ^^ T*^™"**' especially Jhe Mischnal (third century), and the Gemara (fifth century), contain numerous enactments against the eating of such flesh. The kandi and timari " in these books probably mean tubercle. It IS evident that in the eleventh and twelfth centuries, tuber- culosis was fairly well known to the Arabian Rabbi Isaak Alfasi ttie Hebrew physician. Maimonides. and the French physidaii Raschi (1105). The book, Schukhan Aruch, which is a Jewish collection of rules on this subject, has been handed down to us from the sixteenth century. The Franks had in Germany, in the ninth century, eccles- iastical laws against the eating of the flesh of cattle and pigs TUBERCULOSIS. ^ r^SrJeT In "ryS'x^r?^ 1 ^« ^^ --»>-- have on sale th7fl«roPSJr T ^'"'^^^'^ ^ Munich to were passed in 1343 h, wSw^'"'^^ S^*^ J*ws X40X. in LandshoT- S «^ ^U/° '^94. in Passau ; in the Palatinate ; etc ItUr."'!^^^"'^'^' '° '582. in had eaten the fl«h of Lw.T'^'^ '^' " «*»dente ;ho in X677. In 1702 norinJ^^ve fde^™"^' f *^ ^ ^eipzic of the disease during Ufe ^ fIh ^TS'^"" °' *^" «y™Ptoms "French disease " ^ Jn^nf * *^* *^« *he name of the fact thaTrberrosIs r r^^ed J^L" "^ ^Z ^°'° human syphilis, which was re^a^^ •? ^ connected with by Hehnont. In coaseaZ... T.J ^*^® ^° ^"t used tuberculous cattle had Trd«trovi "^^ °' °"«^' ^ the yearly loss arising froiTth f^^u ^"*' '°' instance, in the P^ssian 3i« lo^t^""'^*" °' »««=ted cattle (1784). to about £^ l^T^^lJ^'"'^ *«> Graumami the violation of the^t^ ^^s^'^*^** **'* «°**=*«^* ?" ^^^^ ^P«=tion French disease ; " rejected the t^*** characteristics of syphilis, and deciareJ^'^elelJ^f Htlof h"°°"?°" ^*^ the same year, Keretine of Han J, ^ '"™*n food. In a report to the ^v^L^Tm Jf^c* '^"^ ^«^ « of Baden was of opiSTttat thf n,?"?"^"^*'*"*"' ^'^<^ flesh of cattle which were only sh^h^^^^ nught be permitted. GraSm dS»^ *** "^^^ tuberculosis, ment order of MecklenS^S^eS^^,'" T'' ^ *^°^«™' eaten. In consequence of ttL Tth?^!, '^ ?^* "»«»»* he made against ttTconsumptiM^l/i.fl °^ ''^<* had been were cancelled tbtoZZnt^L^ ^^°^ tuberculous cattle Aus^a in X788. T^Sn^xSz" Sd'^ "*' *'"°"«^°'^* to the inspection of meat Ar»7^2! ' . *^^ *ith regard (1) in which only the^l^eS^i,*^''^''^ hovine tubercuS^ the diseased pJts were to t dl^ll?" "hT ^ ' <^^ '" ^^^^ at a cheap rate ; and (3) iTwW^f^fl t *^* ""** *° »^ «>W entirely unfit for food. A s^ S-l!?^ '"'' ^*^"*^ *<> »>« mspection, was carried out u^^ Procedure, as regards meat II 162 INFECTIVE DISEASES. and others declared that the tubercles in cattle wen. 1v™,,k« sarcomata. Leiserine recardi^ thZT lympho- msease, although the mode of iniection may vary Ujuallv S .;. ^ toes and becomes mixed, in the f,Jm of duet ^^cSl^i ^ *d °Gu" '^•k'*' "«^«^' not as^umpl!;of ♦K * u . ^ Guannen, show that we must by thT^tSt ,*"^T'' ^"^ "^ «'»»J«» i"to the ^r air, m the form of dust, on the fnHHM- Ti..\r*l ""•« u*c support from the frequency of tife S^tion ^Th. '^ "^•''*! glands, and from thefact tLt in ^cT^shS wh^J hfff "^"^ fodder trough • *».- ♦,,». Jli ^ow-sned which has a common othe^ iS ;t *"^o«» animals which stand above the Ption, ot Heim. U«r. Bang, R«h anJotto^dso .^ ^» ScS^-^rtytr^irL^-dSi^''^ a laose ni fr«»« ^„ * x ^ transmit the disease, even after «» lApse ot trom one to four week* «»« "i^ in the bronXm* is *^*^''*^»«^"l*ti°° of secretion according to Johl? a^ T^ ^^ *^«^ *«»« i». arisi^mV;-^^or:f STUtt^rof^"^'^' up an inflammatory affection of th^i^ * °J *" '***^ facilitates the invSi^ of L b^l^X nS**'^*^''"* tuberculosis is also inrr^icJn k u ? Pfed»Position to diiKuTSliSI^'h ^?^ fr«q»M"ly b«conies ouch wow commonlVto oca^bf^^ predisposition seems not un- ci the m^: ^ '^^^l Z -^^onal debility bo^S"'lTl"^°'^ '' •'r ^*^ *^« niost widely-spread TUBERCULOSIS. *nd in some isoki ""«tive tissue Z. mX" ofad' " ' -^f ^ « - -'s TUBERCULOSIS. ,g^ u*nas or threads of connective tissue. ^ in th.^*°**"°^ ^'^ posterior mediastinal glands become enlareed tra^S'nSS^'/if^'^'^"^^^-'^ They"":. SS into^,r ^^ tubercles, indurated or caseoii, and chanced th' Sjf :^.'''"^^ ^^"^^ ^^-l"-«y -<^o- and'^com^^' able "n^Sr o^tJnjJT"' T^ f *^*^*^^ glands, a consider- underKrtuSr .!» K '?""^* ^^"^* *»* ^^^ body usuaUy immiiiil .l„H. ^r"" i"™* ; "■ fte posterior limbs, the very te^e S. °* «'°"* '^^ sometimes attdn a ~rit™ the "**»«<»«; c«»«y, besides the imputation of the ^Yr? "^"^ monbraae, omentmn. Ld m^te^ soWn '"5 "'^'^*^**'*"<^ caseous foci. Tuberculosis of the Elh "'** "'"*"y ^t'' ^ "^fon» swelling of Se Malpighian corpuscles (follicular hvoerolasia^ Th^ *. k , then^lves develop in tl^e lymph fofclT^ thl^^^S I70 INFECTIVE DISEASES. interminried m^f n^,^ ™„*° .^°'"" ""^^^^^ and often in the centrp ^"^P *P®*- These tubercles undergo by a caS^^ nf "" ^^^"tegration and become surroundfd Drocesf th» r *" *^* interstitial tissue, during which nephritis may t ^^^^ *'"«■ P^^^^^ymatous or hemorrhagic tzr ^r^™-" ^-^ rrs^h?ar^ST: m^al".^' '""'""^ '"^'"^^^"^ o' th« affected uterus whS t^e ;^ f «»»«l«ence of the disease, assume large dimensToS the nodules bemg situated either in the subserous intemuiuTa; u e^TS'Tomet'^ *^"^ r.'"*^ ''-^^ throughTtTth" of ™e pSta In ir*" ""' ^u ^ *"^*^^"^" degeneration cWH h, ♦ K , ° ^"^ <=*^^^' *^« FaUopian tubes become S^ Ae"t""'" P?"^^-*-'^- Tubercular processes^' pSteTorW?''*- ^^" ^'^^ *^*^^^*^' ^"be^'^"'^ modules of fed tub^^i^of Th 'r°"' '~=' '"^y ^ P^^"^*- We also cele "^"^o"'" °*. t*»e tunica vaginalis combined with hydro- esDeciaJiv^f *r , ^ '""*'°"' membrane of the intestine. SrT^'^frLl'tt^Y^"™^*^^ ^'^""^ *"''«^*='^- "^<=«-. -l^ch (lohn? tT ^ °'"T'^ •" **^« abomasum or omasum ^T^^' ^"^'•<=^«s may become developed under the mucoS membrane and serosa of the stomach and intestines tnlLlx^r °* *^" '^'^''' ^ ^^ of chronic general tu^rculosis appears as a diffuse, firm enlargement, in wWd^ case^ accordmg to Bang, the gland lobuIes,%n ^ JTm sSS'Tt'h TJ^ T"'°' ^'"""^'y ^^y -ioured^aS hamoShZl TK 1 ^^"""^ P*''"*' "^^ striations, and smaU siaerawe mcrease of connective tissue (chronic locahsed sues and which become caseated or calcareous. Consequentlv Sd t ,u ^^ ?°''- ^" **^« ^^ of the milk reirvoir^ and larger milk canals, numerous miliary tubercles are Dresei^ Enormous deposits of tubercle bacilli ^y be found evefXre m the udder. All the lymph glands lying above the ^teZl TUBERCULOSIS. 171 r^on of the udder become enlarged in every case, and may become mdvuated or caseous. ^ c«r/' J>~T"^" ^'i^^f "^ '"**^* '° *1^« *^«»« and spinal L^fanT ^^^"f?*^y *»»*'^ '« ^^^y believed. Semmerf^for ^tance observed 4 cases of cerebral tuberculosis a^ong 40 tuberculous cows. Tubercles, mostly of different ages and sS^I itTt^m '' y^"''-' ^^ - -« from TmSTet a«l ^i u^ °* * ^"^"^ *8g. may form in the pia mater tVlT tubercles are most commonly found in the pia mater at SSoJh n . ^'"f"'*"^ f°y **^*'- inflammatory changes; although, not unfrequently, they give rise to inflammation cltrTh.'^'' "J *'' ''^ (leptomeningitis basil^ub^" fn ! K Tu membranes of the brain may become adherent tL2t°?'K "1^ ^y 'S to ,0; and the flesh Labout^L" '^ *° '^ ■ '^^ «=«vit.^ wa, present in ,0 per cent. The foUotr^'t?'' ^""«^ tuberculcfa frequency of the disease in J^Sr St ^^J^^*"* «*^« '•»« comparative I. 2 3 4 S- 6. 7- 8. 9- 10. II. 13. 13- '4 'S. 16. 17 18, 19. 20. 31. 33. »3- 24. as- 36. 37 38. 39. 30. 31. 32. 33- Lungs ■ Visceral pleurae • Peritoneum ■ Costal pleune Bronchial and m«iiastinal giands Spleen Uterus Lumbar glands '. " Pharyngeal glands Trachea Udder Intestines . * • Ovaries Lymph glands of" the liver Lymph glands of the thoracic and Abdominal Heart ..''•• Kidneys . , ' ' ' Bones . ' ' " • Internal viscera (including the br;in) ■ Submaxillary glands • Diaphragm ' Stomach Larynx Muscles Iliac and inguinal glands Brain Spinal cord Tongue . Thymus gland Vagina Testicles 75 per cent. 55 .. 48 „ 47 .. 39 „ 28 ., 19 .. 10 .. 5 .. 4 „ 3 ., I ,. I .. I .. I .. 0-9 .. 09 ., 07 „ 0-4 „ 03 ., 0-3 „ oa „ 0-3 „ 0'i6 „ 013 „ 01 ,. o-o6 „ 004 „ 003 „ O-OI „ 001 „ 001 „ 001 abaS?^,;SLTL?lnfo™.^" """T* *•** '^"^ °* '^^ B«lin change, in the inSrorgatTrtr" ''"' P«*-'>°^-«'^ of tubercul^ .ndforobt^iugadeanitirfToir;— ruK::!^;^^^^ to thCM iraqn nteucbta, the TUBESCULOSIS. P«""nary a£fectioiis »73 o«U>e tubercle bacilli S^rtytS' l^^P *»' ^t-'-^. o/^nt PnHlaciag any tnbercutenSLgS^ i''"^!,^*' "** '"*««"«. 'rtthou P«i.oneal tnberculosis does not affectthfLJ^ K P'*"*' P«»ary organs, with the exception of t^^teJt ^^ ^** °* ^ abdZnS (port-i region). It generally o« ««Ption Pleune camiot spread direcUy to the iSton °^ *"*^«'«^ <>' the opposition oflfered by the lymph stret^^^'cTflTw, °^ *"*""" <" ^l*' TT»e parenchyma of the lunra also r^, ^ ^ *'°° '«r to front o the lungs ends either Sy^ tu^^n?""', ^'^"^ tubercS attacks the lymph glands Sni^ gSsTand 't ^'"^ *^ *' ^ to the pleura. Primary inteatinaiT-Klir, '• °'* *^™ ">«»ce spreads tuberculosisof theS.e^mo^fc?r« T "^^ *^ '^'^^^ ^«P and from th^ce'^^'^t^^X^S.^ ""''t'^^'^'^^'^'^^'^^'^f. intestinal tubercul<4 may 4iout^?„» ' ^'*^" t'^- PrtmaS Circulation and withourgew^l' 1 ««trumentality of the s^temk f bacteria have penet^atrtSjS; Sal vl"'^"''^" °' '*'^"^" the hver. If tuberculosis becomS IeL«rf. """' *""* "o' b«yond tioned primary foci. t^cSSiv! ^,^ *°^ *** *'»*' above men a« affected in cattle are soSwEluZS."* "'^ °'*"" "'"^»' Pleur. and peritoneum in 90 ; Uv "in « c „«? ^ "* '°° P«- ««t. ; and the intestinal canal in & • thT.^ ^ '■ "^ *"** Pharyngeal cavities the bones in 5 peT^t I^' w ,^ •*" «» So ; the kidneyfin 30 a^' is met with in e^peT^nt tX i^""^' ^-^e^-iosis of the ut^ -Id t«b«cuU«i.if^^eriries?n1';:^rnt°' 'i^"'"'" ^" ^^ ' *" ^ (6..000 catti^). thaTit sTj? dmtf :?S1" ?, t' "^^ ^^-ttoir and their glands were alone impSt^ f„H^r»°i*"*^'*««' "»« »nng, to the serous membranes and fS Sn^ ^*.*''* '^'^ "^ "'nlinS tuberculosis was found fn 3 pet cTnt* ^t '^ *" '° ^' «°'- G«^ various organs were as foUo^ ■ Y^^. ^^ '^^T, ^"^'^^^ ^ «»« 73 ; serous membranes. 57 , kidnew « « ? ; ^ ' >°*«tinal canal. lUatfBMia of I«mU uid ■■«■ , . 2«t«tag has laid down the foUowingp5Spl« !S!h ''°'-~»'«rt..- the official mspection of meat in the StS"..o£ "^'*' °"* " »74 INFECTIVE DISEASES. alone affected. (6) When one or rhnr- '«P«=t»v« lymph glands, are body, together wlti S^J'Jmb^Z*" :h'''^' ^^^'^ *•* "" the lung, and pleura, ; inte,^ S^"; Z^^^^ " *"' ^'""• peritoneum; intestinal canal Mriiv,r ^d fi^' "k** '*! "»P~tive canal, hver and uterus ta additioT/o ^ ^^ ''^~ '•" intestinal Without other organs^Lft2elun«Ji.'^"!°""^^ *" »««=»«!, aflecUons mentioned uXTft.aSifS^^ST^IT'''^!*^- ^'^ ^^ '«- a. Tuberculosis is gfZ2ua)^y^'^^"'^'^^°*'^'P^^'»^- pleura, or of the perito^^" S oT^S'th^ "k,"*' **'""°" "* '•>« tubercles are presenV in Mo«a^ «fn .***""■ ''*^'«« "^an' in addition to'^the morWd St"n ".^Thrtw^ ""'*'• '*^ ^^ !j:^riur-V^rS^a^nd'^£-^^^^^ The initial stage of the ^Jtion^^o^t^^^^lS'^' m exceptional cases have signs of fevS bmrnot^n'r « ^ ^on,. T,e syn^pton. v^ acc^^lg^t^ Tla^ ^j ^e^ I. Tuberculosis of the lungs manifests itself fir^f ^t ,ii u •tcceieratea. With advanced destruction of th» i.,,.™., *». • , pants the ribs heave, and the nosS^'^L^'dLS' '^:^. from the nose IS rare, as a rule. Sometimes, owing to SaSn o the bronch,. or breaking through of cavities of iSu^i^StJ^ bronchi, a considerable quantity of a muco-punilenTS S^ sul»tance IS discharged by coughing, in whicS^ Je^S a^h..a badsmeU. Itoften happens.if the sidesof tteXS cough. Percussion sounds are in many cases nonnal U .^^1 I °" "^" circumscribed spots, although usua% tisonly weak. The^ vesicular respiratory murmur ona4™JS^ the «te of diUness. In other cases, it is sharper thanTJal or we may hear riles (bronchitis), or, more SelvTroncWal respirauon (cavities of the lungs and bronchiec^lf) TUBERCULOSIS. coarse ; and the skin indaTtic^d hIS I .?*^ *°^ ^<>'"«* can only with diffi JJy ^ o!nl.H *^' *°"*=^' "^ «»»* ** the finger and thumb rhSeCS'M Til ° * '°^^ ^**««° decreases, and digestive d^^Zl/ * ^^P***^** graduaUy the secretion of ^ dinSL Jl *"'""'•/" ^'^^^^ ^'^""nt cases, we find the^a^S^,:!^^'^:?"'?"^. In some flatulence (tuberculosis of "he mXLIl 1^^' "tt'^'''^ pression of the oesophagus) mSTr^i ^^""^"^^ com- by increasing difficulfyT LaUo^n/^»,*'',.'''"**=*«'*«^ discharge, aSi shortni of SHfuhT , '*^^**^°°' °^ pharyngeal glands). ^ dy^^^ i^^'^^^' °/ "^« '"et'o- breathing; extended posiSoTthT head .^H?."^ '*"^°™'" increased sensibihty aid sweltae S tS i ^"^ *^^ "^^'^^ ^^ of the larynx). OccasionX wf fi„H^ * ^^ ^*"^'*=^*«» of coUc. alternating Sd^tS, J ^ mtemuttent symptoms of the intes^mTin'^ut^uS^^^^^ l^ematuria (tuberculosis^'tSl £d^' ^' td°™°*' ^''^^^' charge (tuberculosis of the uteLi The Iv,^"? * ^"^"^ ^' accompanied bv enlarirem^nt o!^ • a ^7^^^°^ are usuaUy lymphTands.'^S7 the^^t^'rTanl*'^ T^'""^ glands (lymphomas of the paSSddafS^' subauricular and lower cervical glands. glanS^f L It^^i' "P^"' '°^^*"« hock. hip. udder, ete. i^^^t^rS:rtTtZ'^' ^'°' normal; although we far mor^^Centlv fi„H ^- '"*^,'^ remittem. and even an intenrnttenXeX to ^x^T^^ a decided mcrease of temoerature in ♦!,» • t^ ^•' ^*^ of blood in the body stS^^^""' hT"^«- ^ *«>°"nt and the skin, the change i^^ST ^a^hT^'T ""'"^'^*« in the ndghbourhooHf L udlr and oulnT^Lf''°^°^ anaemic; emaciation is exc^ve .^^^/"^^da. become very the animal becomes in^SSv !;«! /^^ "^ ''^^'^ ' ^^ dies from diarrhoea ^TtZl^^^ ''*^' ^^ ^^^^y -^^^^^^l^lSfr::^''-^^^ course in tho".:^;;t"f^4^rr m^T ^'-^P^^^ease., external signs We^ ir^l f ^^ "^^ characteristic tuberculosiHi th^pST/SlacfSJ"' T.^^""^ °' sound is obtained over^ eLnl *• **"" P^^cussion 176 INFECTIVE DISEASES. usuafly asserted. Tuberculous of the peritoneum, when the genital organs are attacked, nmy nunil«t itself by p^„ sexual symptoms^which in cows are tho«s of nymphSa. The animals frequently come on heat and usuaUy ™^„ so f«r an abnormaUy long time. They become^eJJ exat«i mount their feUow cows, and do not bec^m^ frequ«itly that abortion is in many case, the first symptom of pleural and pentoneal tuberculosis in a herd (Roloff) The general condition often remains good for a long time We frequenUy find in this form of tuberculosis, the accessory symptoms mentioned in the description of tuberculosis of the lun^, especially emaciation and cachexia in the later staee of the disease We may sometimes demonstrate the presence of pentoneal "g«p«" on the rumen and on the poVti^S the Pentoneum which hnes the wall of the abdomen, by palpa- tion of the hollow of the flank (Kleinpaul). y y^p* 3. Tubnculosis of the brain may occur as an independent primary affection, and in most cases, is a complication of tuber- culosis of the lungs. Its course is generaUy characterised bv symptoms of an acute leptomeningitis. The animal shows great exatement and suffers from severe attacks of furv con- vulsions and spasms, which often closely resemble those of cerebro-spinal meningitis, or which may have an epileptiform character. Later on. these symptoms alternate with uncon- saousness. stupor and paralysis. It often happens that the patient coUapses suddenly. In other cases we may observe symptoms of affections of the nerve centres, such as staarers (rotatory and circular movements) ; oblique carriage of the head (tuberculosis of the middle ear) ; paralysis of ^e facialis oculo-motonus. opticus, and trochlearis; hemiphlegia • etc' Periodical attacks of excitement may sometimes be noticed* Tuberculosis of the spinal cord manifests itself by a heav^^ tread, high action, and finally by paralysis of the loins. 4. Tuberculosis of the udder may appear as a first and single symptom of tuberculosis in animals which are otherwise quite healthy, although it is more often secondary. According to Bang, It manifests, itself as a diffuse, painless, and compara^elv finn swelhng, usuaUy of one quarter (one of the posterior quarten as a rule) of the udder ; and more rarely, of two quarters. The mdk, contrary to what is the case in other inflammatory con- ditions of the udder, is at first normal ; but it becomes in about a month thm and watery, mixed with flakes, and sometimes TUBERCULOSIS. ,7^ though not always, it contains bacilli. We ourselves have frequentiy searched in vain for bacilli in the mUk of^^wWch were thoroughly infected with tuberculosis. BoSn^rn^vS ««t nulk rom the udder of tuberculous cows was SdouSy T^^rJiVl^ T'- °* the cases; although the 5em7/ stration of tubercle baciUi in such infected mUk succeeded m'^reTd'" "° "^^ '^' '^°"«" P"^ °^ "»« udder SSe more and more indurated, until at last they are as hard™ quarteri to the anterior quarters of the udder. The supramam- 5- In g«n*ra/ tuberculosis, the morbid changes described [rCo^i'^w^^'^B*''/"^'''" ^°"^ ^^^^"^ -" '-"^ m vanous ways. Besides, we may also find swellings of the ^^k^V°'^'' ^'."'^ '^^'^' ^*^«"«« *"d lamenef (tul^! c^« of L r^' ""7*" *" *^ before-mentioned tubercular changes of the skm and eyes. In very rare cases the disease ;u"»o.r"" * ^^** ^' '^"^ --- ^-*« ^ Gllnioal Diagnosis, as compared to diagnosis bv in because tuberculosis does not possess characteristic symptoms f^^tS^ofTr^ "* P^*^"*' ^P-'^y duringTefet T^th^^ * ^^- ^^*° *" *h« ™°« advanced st^ LL^^:^ " exact diagnosis from purely cUnical ^S s^Lw ~ ^ "T**- ^^ '^*' ^"'^h « denied without suffiaent reason by some, is of great practical importance in foren«c veterinary medicine; because^ from a 3 wi^t t 7^^\^r! °l^ r**'*^^ °* tub;rculosis „^K Ma rule, the slaughter of the animal. On the whole th? foUowmg dinical factors are of importance in the Tent o a diagnosis, tntra vitam, being required. 1. For 'Hbercuiosis of the lungs: The simultaneous occurrence of severe disturbances in nutrition, with symptomrTS affection coughing and the respective results of percuS ^d auscultation), and the enlargement of the exterJS^^^S glands, especially m cows and heifers. ^^P 2. For tuberculosis of the serous membranes: Increased rare oKasions). Md more or less extensive duhiess. Here perhap.. a knowledge of the breed may help us to Sive aTi 12 IMAGE EVALUATION TEST TARGET (MT-3) 5^5<^ ^ % 1.0 I.I lit Im |Z2 S Ijg 12.0 L25 I u 1 1.6 150mm /APPLIED ii IIVMGE . Inc leSSEutMtfnStrMI nochwHr. NY 14600 USA Plwiw: 71«Ma2-0300 Fn: 7ieaM-8oeo e tM3. AnUM hiigi, Inc., M N(^ RmwvW •«*'^ V\^ 17% INFECTIVE DISEASES. correct decision. The presence of tubercular proliferations of the peritoneum may be proved by introducing the hand into the rectum or by pushing the hand under the last false nbs. We may also mention incurable chronic flatulency with normal digestion. 3. For tuberculosis of the brain : Symptoms of acute inflam- mation of the brain, compUcated with lung symptoms, glandular swelling, and loss of condition. 4. For tuberculosis of the udder : The highly characteristic, at first diffuse, firm and painless swelling ; subsequent changes in the milk; induration of the udder ; enlargement of the lymph glands ; and proof of the presence of the bacillus in the milk by inoculation. 5. Besides being aided by proof of chronic tympanites taken in connection with symptoms of puhnonary tuberculosis, our diagnosis of tuberculosis of the mediastinal glands wiU, according to Albrecht, be facilitated by the introduction of an oesophageal tube. He states that, immediately after the removal of the gas by means of this tube, normal digestion reappears for a shorter or longer period in cattle, contrary to what takes place in non- tubercuious cattle. Up to the present, no practical experiments have been made mth the ophthabnoscope for diagnosing tuberculosis of the choroid and iris. Robert recommends, for facilitating the diagnosis, covering over, with a cloth, the nostrils and mouth of catUe which are being examined, in order to oblige them to adopt forced breathing, so that any abnormal respiratory sounds may become more easily heard. In a similar manner, an mjection of 03 gramme of pilocarpin, by inducing forced breathing, will enable us to hear a weU-marked friction sound in cattle suffering from tuberculosis of the serous membranes (Walther). Peuch states that we can mal-e an exact diagnosis by inserting a seton and inoculating guinea-pigs with the produced pus. BMtoriologioal Diagnosis.— The presence of the bacilU IS constant m the tubercular sputum of men ; but only in a small percentage of cases in that of cattle. Hence, in the latter, the bacteriological examination of the sputum is by no means so important, from a practical point of view, as in the former. For the same reason, the method proposed by Pais, of obtaining mucus for bacteriological examination, by inserting a cannula between two of the tracheal rings, is frequenUy TUBERCULOSIS. 179 without result. For instance, in the case of a cow which was suffering from fully-developed tuberculosis, we succeeded by this procedure in obtaining bacilli only after repeated experi- ments; and in only one single streak preparation were able to demonstrate the presence of a few tubercle bacilli. Nocard's plan of obtaining mucus from the trachea, by injection of veratrine or eserine, is just as uncertain. It is frequently so difficult- to find the bacillus, even in sections of the tubercles, that a large number of preparations have ahnost always to be examined. Milk gives better results for bacteriological examination. It sometimes contains a considerable number of tubercle bacilli, the presence of which can be microscopically demonstrated by staining (see further on). It seems, however, that the milk of tuberculous cows contains spores more frequently than badUi. As these spores cannot be stained, they escape micro- scopical examination; for which reason the bacteriological demonstration of milk is uncertain. We have failed to obtain bacilli in milk, even when the udder was gravely affected. Bollinger found that among 20 tuberculous cows the milk was infectious in 11 cases; but that the presence of the bacilli could be proved in only one of them. Gaffky states that the bacteriological c .amination of faeces affords valuable diagnostic results. In those cases which cannot be decided by the microscope, the only certain means is the inoculation of milk and other suspected material, such as vaginal secretions, uterine discharges, excised lymph glands, etc. According to the experiments of Arloing, Bollinger, Vemeuil, and others, guinea-pigs give better results for this purpose than rabbits. For inoculation, it is best to introduce a minute quantity of the infectious material into the abdominal cavity, in which case a general miliary tuberculosis with characteristic anatomical and microscopical conditions will become developed in 10 or 12 days. Hirsch- berger recently succeeded in transmitting tuberculosis to guinea- pigs in 33 per cent, of the inoculations he made with the milk of cows which were suffering from tuberculosis only in the lungs. A nearly similar percentage (37-5) was obtained by Ernst in cases which presented no symptoms of disease in the udder. Bang obtained a smaller percentage. Experimental inoculation of guinea-pigs and microscopical examination must conse- quently be considered to be the best means of recognising tuberculosis in the living animal. tto INFECTIVE DISEASES. r Ac<«rdu.g to EhrUch «,d Koch, the material to be examined (m"«,, mdk, pus etc.) should be spread out into the finest possible film upon diluted with from a to s times as much water, and mixed with sufficient acetic add to precipitate the albumen and bacilli. The preapitate is then placed on the cover glass, and is aUowed to dry in the air after which the cover glass is passed several times slowly through a gas flame. As soon as it is cool it is floated, with the film side down- wds, upon the cold staining solution, which is described in detaU further on, and in which it is aUowed to remain from 12 to m houre. According to our experience, the cover glass should rema^ in the cold staining solution this length of time, and not, as formerly stated, from half to one hour. A better plan, as we have found, is to place the cover glass not merely in the staining solution, but to heat both together over a gas jet untU perceptible steam is given off ; and after they have been aUowed to cool, to repeat the process once or twice in a similar manner. By this more expeditious method we obtain better preparations. The staining solution is pade in the foUowing way • 5 c.c. of aniline oU are mixed with 100 cc. of distiUed water and filtered. To 100 c.c. of this aniline water are added 1 1 c.c. of an alco- hoUc solution of methyl violet, or fuchsin. and 10 c.c. of absolute alcohol. This solution should be renewed every 10 or 13 days. After the «jover glass has been taken out of the staining solution, it should be rinsed in water and placed for a few seconds in dUute nitric acid (I to 3), by which it is decolorised, and it must then be again thoroughly rinsed in water. By means of this method of decolorisation, the tubercle bacillus alone retains the stain. The cover ^ass is finaUy putfor about five minutes in a i to 3 per cent, watery solution of Bismarck brown or malachite green, rinsed, dried, placed in Canada balsam, and put under the microscope. By this method the tubercle bacilU are stained dark-blue or "red, whilst all other bacteria and cells appear brown or green. 3. Wdgert takes a 3 per cent, solution of gentian violet, and adds a I per cent, of liquor ammoniz and 10 per cent, of absolute alcohol. If the preparations be exposed in this solution for 30 minutes to a temperature of 40" C, they can be decolorised in a 33 per cent, solution of nitric add for a long time, and even until they completely lose their colour, without impairing the deep blne-black staining of the bacilli. 3. Gabbet has published a new staining method, which, he sUtes, is the most convenient one in practice. He places, for two minutes', the dry preparation, which is made in the usual way, in a fluid composed' of 100 grammes of a 5 per cent, aqueous solution of carbolic acid and 10 grammes of absolute alcohol, ij which i gramme of fuchsin has been dissolved. Directly afterwards he puts it for one minute in a mixture of 100 grammes of a 35 per cent, solution of sulphuric add, in which 3 grammes of methylene blue have been dissolved. It is next rinsed in vater and examined in'this medium, or still better, it is rinsed in absolute alcohol and mounted in Canada balsam. The bacilli will then appear red on a blue ground. If a more intense staining of the bacilli be required, the first solution is heated for two minutes until steam arises from it. TUBERCULOSIS. i8l ' 4. According to Ziehl-NeUen, the preparation to be examined i« plMed in the usual way upon a cover glass, is passed through the flame, and is then immersed in a solution of carbolic acid and fuchsin, which is heated over a Bunsen's burner in a hoUow ground sUde on a ring of wire netting. The SAid soluUon consisto of i part of fuchsin, 5 parts of carboUc add. 10 of absolute alcohol, and 95 of diatiUed water. As soon as the solution begins to give off steam, the preparation is txken out and placed first of aU in a s per cent, solution of sulphuric acid, then in a 70 per cent. soluUon of alcohol, and finally in a solution of 2 parU of methylene blue in 100 parte of water. The preparation is then washed m water and placed upon the slide. 5. Czaplewski moistens with the carboUc fuchsin solution the prewjusly prepared cover glass preparation, which has been got ready m the usual way, and holds it over the flame tiU it gives off vapour. On draimng away the carboUc fuchsin solution, the cover glass is dipped from six to ten times into a concentrated alcohoUc soluUon of yeUow fluorescine. It is then dipped ten or twelve times in a concentrated alcohoUc methylene blue solution, and finaUy rinsed in pure water. 6. The baciUi are coloured as follows by the Ldffler-Frankel method which Kitt considers very simple and convenient. LSffler's aniUne water fuchsin solution is made by preparing, in the usual way, 100 ac of aniUne water by shaking aniline oU with distilled water and filtering through previously moistened filter paper. To this is added i cc of a I per cent, solution of caustic soda, which renders alkaline the neutral aniUne water. It is then poured into an Erlenmeyer-s flask, or just as weU, into a medicine bottle, to which is added 4 to 5 grammes of soUd fuchsm. The bottle is dosed with an india-rubber plug or cork and should be frequently shaken before use. One drop of this solution is placed upon the film side of a cover glass, which is then held in a forceps over a spint or gas flame at such a height that the fluid upon the guZ becomes graduaUy heated and steam rises in two to five minutes The cover glass is then dipped into the solution, which causes the differen tiating or double staining. This solution, according to B. Frankel is a mixture of 50 cc. of alcohol, 30 cc. of water, ao cc. of nitric acid, and as much methylene blue as wiU dissolve in it after repeated shaking. The solution, which we can easUy prepare ourselves, U filtered mto a medicine bottle, and can be kept in stock. A few cubic centi- metres are put into a flat glass dish, the drop of L6ffler's fuchsin which had been placed on the cover glass is poured off, and it is then placed imme- diately mto the blue acidulated mixture for i or a minutes It is then rinsed in water and placed upon the slide. The glass is dried and mounted in Canada balsam in the usual way. The tubercle baciUi are thus stained a pure red, the rest being blue. It is not necessary to prepare a fresh solution for each tubercle bacilli staining ; for we can keep in stock, in two separate medidne bottles, the two solutions namely, one for staining the baciUi, and the other for double staining! We further require only two glass capsules and can undertake the staining and heating of the cover glass preparation by holding it over a flame. If preferred, we can place the cover glass in the fuchsin capsule under the filter and then hold it over the flame untU the appearance of steam. The time required for staining is only a few minutes. Ck>od 183 INFECTIVE DISEASES. .Sr* '^'^' "^ •"" •" "*='^ With .U th«e method, of tion. we shaU fiadTtL theT^« at tt ". "'"T'Tk **'^ *^' ^*^'*'- neighbonrinK Ivmnh rt.„H. - * "*" *** ""* injection and the 8«atly enuSd spi^n O^^ "I?'' """f ""»• «ver, and in the develoVedTSuni^ Occas.onaUy miliary tubercle, become m^m many places, we may deduce the foUowing^nde8 for taberculm moculations .—The dose of tuberculin for homS aTttoU^th'"^*^'- SmaUer doses are sometimes ^a"nt although the reaction they produce is often too weak and too £^a Se o?.' ''^^'t" " ^""^""^ ^»I» corSts^eS whi!^h temperature (inoculation fever or reaction fevS which appears in from 12 to 15 hours after the iijS of the tober^uhn. If an increase of temperature of ^M^t of f.L '"'* " *° "^^^ ***«' «»« inoculation, the presm^e of tuberculosis may be assumed as probable. If befo^iS octdation. the temperature of the boviJe patient i'abnimX SwrS'*"j '* " I* 39-5° ^- °^ "°^ '« the rect^™ no S^^H^ °" T ^ "**^"- ^" "'"t ^«' point o"t ttat ^d^^nV."^^'' ^""'""^^ proportionate to the ext J attle r!. L ^' '^' "^ *^** excessively tuberculous l^^ZiZ"^"^^^ temperature than thL with slight ^^* r^"^"^- ^^'''' ^ "^^^ and old standLg cases of tuberculosis, tuberculin is not very reliable. oS! TUBERCULOSIS. 183 inocalafaon generaUy suffices. In doubtful cases it may be repeated aft« a few weeks. The evening is the best time to make the inoculation ; for then the rise of temperature can be olwerved during the foUowing day. The temperature must be taken at least four times after the inoculation, namely. 9, 12, 15, and 18 hours after injection, prior to which the temperarare should be taken at least twice, that is to say six hours before, and directly prior to the injection of the tubtt-' cuhn. The side of the neck is the best site for the inoculation, lubercuhn has, only in a very few cases, caused injury to the moculated animals (acute miliary tuberculosis, fatal intestinal hemorrhage, oedema of the lungs, temporary sterility, and contraction of the uterus). The quantity of the milk becomes diminished during the time of the reaction, to the extent of a tew quarts, m consequence of the resulting fever and loss of appetite. The milk secreted during that short period should not be used for human food. In several cases, beasts which had reacted to tuberculin nave, on being subsequentiy slaughtered, proved free from tuberculosis. Such failures in diagnosis have been estimated at 15 per cent, m Germany and at 4 per cent, in Denmark. Cattie suffering from the foUowing diseases sometimes react m the same way aL those that are affected with tuberculosis • actmomycosis, botryomycosis, abscesses of the lungs and Uver abscesses foUowing traumatic pericarditis, inflammation of the udder, caseous echinococci. distomatosis. diseases due to puhnonary worms, emphysema of the lungs, and chronic diar- rhoea. We may therefore conclude that tuberculin is not exchisively a reagent for tubercle bacUU ; and that it performs a smular office for the streptococci of pus and other micro- organisms. As it is not a specific diagnostic agent for tuber- culosis, its reaction cannot be accepted in forensic veterinary cases as a positive proof of the presence of tuberculosis ; although the fact of the reaction occurring would strongly suggest such a probabUity. TubercuUn, however, may be used with advan- tage for diagnostic purposes, when we wish to select animals for breeding, and as a prophylactic for combating tuberculosis in large herds. DiflSBMntlal Diagnosis in G«ttl«^i. Tuberculosis of the lungs may be cUnicaUy mistaken for disease of the lungs due to echinococd, after-conditions of pleuro-pneumonia, and verminous bronchitis. Tuberculosis of the serous membranes iS4 INFECTIVE DISEASES. S?* r**^"" *" P^~^*^ • tuberoaosis of the media.tmal Ssr:^ j^-j^-;-^,-^^- Sirs; (Zflndd) Xe.S^ V i!f ?'. °»*^e°«>t encephalitis ^rtLZ "'^' ""^ • «"<" "" micracopid Set^2« "S:'"^ degeneration (liver, spleen rd wLe^ "fljeys) bronchial pneumonia; pneumonia due to foreira b^es; bronchitis; peribronchitis; gastro intestinal SS° tion^^ji^r*/;';!.^'',^" '***'y '^^^^ t° the discrimina- aon oetween tuberculosis of the liv^r «„^ - u- ^^ multilocularis. The dis^ Zt „^ k ^ echmococcus ^ ^; -^ » a nUc, by «.. ^^"^ ^^^ Pro«nori«.-Tubercu]osis in cattle is curable only durinir the very early stages and when it is local. In all ^T! pr^os« is very unfavourable, and consequently Z ^l^t to do « to slaughter the animal as soon1«v3e ^ the strength by a rational system of food and mana^S^en?^ separaaon of the healthy; early slauehter of fhl c^u ' elusion Of affected animals'f^m ^^e^'^,!^:^ ^tlle Z TUBERCULOSIS. ,gj of raw milk ; and disinfection of the sheds. It is stiU an open question whetiier veterinary police regulations ought to be enforced against tiiberculosis. As regards this subject, Lydtin proposed the mtroduction of compulsory notification, pubUcation of cases, slaughter of affected and suspected animals, and poUce supansion of infected sheds ; tiiat indemnification for slaugh- twed ammals should be given; and that penal regulations Should be proclaimed. We venture to doubt the necessity as weU as the possibility of practically carrying out these sweepmg measures. The notification of cases is impracticable on account of the difficulty and the impossibUity of making a positive diagnosis intra vitam. The slaughter of aU cattie affected by tuberculosis would demand very extiaordinary sacrifices, owing to tiie great dissemination of tiie disease. We need consider only the foUowing practical rules :— (i) Tuber- culous ammals should be slaughtered as early as possible, wiUi reaprocal msurance or indemnification. (2) Early slaughter of the calves of tiiberculous cattie. (3) Destruction of tiie tiiber- cular parts. (4) Boiling of milk. We may mention as a forensic fact tiiat tuberculosis is, m some countiies, considered to be an unsoundness which may be covered by special warranty. Thus, we find the period of warranty to be 28 days in Bavaria, Wiirttemberg, and Hesse tor grape disease," and 14 days for bovine pleuro-pneumonia ; and 8 days m Prussia, 50 in Saxony, 30 in Austria, and 20 in Switzerland for tuberculosis. of tS!!^ f^P^ "* 0"«*»> iMI-otlon of M«»t.-The identity of tuberculosu of catUe with that of man has been proved by numerous ^1Z1^T^'?1^''^V^'^^ • ^y '•'«' uniformity of the anatomical S^Vthtt K '"^t'^"" '=»««'8«: and. above all, by the positive proof that the same baciUi exist in both forms of the disease. Gerlach I^.l,!l \ *** ^'".* ""* *" Germany that cases of transmission of of ^»^ ^^ ?*"" ^"^ "^ ^*^* ^y "^ n"^"" 'ar*- The tuberculosis ofcatt e, and m fact that of all other animaU, is consequenUy of the greatest importance to human therapeutics from a sanitary poUce point « •. kT^. .*^ "*• ^^^- *° particular, to consider the question of the smtabUityof the mUk and the flesh of tuberculous animaU for human food! i«n]:«j7 T^l 1^ °* tuberculous cows must be regarded as in- Ck^ ^*''-. According to the experimente of Bang tuberculous Sr„TrL^ "^ "^ ^'^- ^» « *>»«» needless to Ly tkat the mJk of tuberculous or suspected animals should be used only afte^ a^r^tW hil'i''"'*' *^ *'•' "^^ •" "^ "^ ■■ *" '»»« -^^ -t even apparently healthy cows may contain tubercle bacilli.* The drinking • See also page 179. i86 INFECTIVE DISEASES. 2nSJ ^^^T" *•" '*''• **^ *- *°™~»y recommended u . with «iV«,T. "****"*""« *o Fnu. the dilution of the mUk of commerce .™t«T* .!•■ *^*»-P»8» '''uch had been inoculated fBollinfferl in offer. aco^.^"tJ^e r^h« o,V"^"*' "** »"°'^"« *"« '»«*' •gainst infecu"n The G^^^ f ^^*''' "" P^t'^tion whatever tone 8Ute MniLiilTK^^r^ "*"'*"' P""** regulations of the present SwSi cJL '?^n ^e^^^nLT* "»' *« '"'d " food llJ^Se «-e o,^ J^STsTe' rat^'Tn'd^i^r^Tt'viirf o?ir^*^ Z general drilZTi't^ll^o^J^ oT^ ^' "V*^ ""^ *•»• of a fev««h general disease have manifested themselv« 4 wE Z exammed m every slaughtered animal. I»"rary tract must be i)asLi^*ff.t? *'^*°^ J^th sUght. local tubercular changes may be ^T^ i ^' "f " ****' "»' "«°°^ °f »»»« tubercular foT^ '^ less ioc2^!w "/ '"'^"^ '''^*='' "* »««=t«d with extensive, but doubt- less, local tubercular processes, may be sold under declaration i "!ii °*"">*- •. AU ammals which show marked emaciation ' and those which vCS!J Slrt" '^.r'"*"^* "> '^^ i»«itutio„ known in Munich .. ^r^'- ^ / '**■■' ™«'»'"«ket where inferior meat which hM be^ •tenhsed, u sold under declaration of iu condition.-TR. TUBERCULOSIS. ig^ iMallett tubercnUr changes in the flerfi, or rigM of a very recent infection ^the btood(.welIing of the .pleen. nreUing'^aU thT^iSSTguSS^^ imUaiy tubercle, in the Inng.. Uver, .pleen, or Iddney,). .toSd bTfmt^y t^Z *•»*!"«*«"»»«» o* the fleeh are doubtful (cpeciaUy wh«. Ijro^ that It ha. been thoroughly boiled, or better .tiU. .teriU.ed by TUBERCl'-OSIS OF PiGS. Orawal R«m»rto.-TuberaJosis of swine, especiaUy in young pigs, IS a fairly common disease, although it is far less frequent than tuberculosis of cattle. In the abattoirs of Ger- many the number of tuberculous pigs was from 2 to 4 per cent In 1891 the percentage in Prussia and Saxony was i ; and in 1894 m Saxony. 2. Among the 3J millions of pigs which were kiUed during the years 1883 to 1892 in Berlin, 56,000 (equal to 1-6 per cent.) were found to be tuberculous. During 1892 the percentage was 27 in Berlin, 1 in Dresden. 2 in Uipsic, 24 in Lubeck and4inElbing. In Denmark from 10 to 14 per cent of aU the slaughtered pigs are tuberculous, Tuberculosis is said to be very common among pigs in Belgium. Among pigs, which thus differ from cattle, tuberculosis is found to be most common in those that were less than i year old. The predisposition to the disease is greatest in improved English breeds. The chief causes which act unfavourably on the constitution of swine are : unnatural bringing up, fattening exclusive ^tall-feeding, and early forcing. The commonerthe breed, the less liable it is to tuberculosis. Hertwig points out that the pigs of Servia, GaUcia, and the Bakony forest (Hun- gary), which have been but Uttle improved in breed, seldom become tuberculous ; probably because most of them are pas- ture-fed. The ingestion of the tubercle bacilli frequently takes place through the milk of tuberculous sows. In such a case, all the members of a litter may become affected. The respiratory au^ must alsj be considered to be a vehicle for the infection ; because experience proves that all the animals of a stye often become simultaneously tuberculous. As in cattle, we must assume the heredity of tuberculosis in swine, because all the pigs of certain breeds become affected by the disease. Meyer has remarked that in castrated pigs infection may originate in the operation wound. Cattle often transmit the disease to pigs I«8 INFECTIVE DISEASES. from the centnfugal process used in dairv work 7^-ul I consumption of the tu'bercular p«tl oFT <^d b^y t^l^ «» transmitted to pig, by the tubercular sputum of man. froJ!^??!"*?!r*"*^™^'"3^—Tuberculosisof pigs differs oeve^oped food-tuberculosis ; as its starting point is eeneraUv in found m the affected organs. According to OstertaTtt^™ ^ulf "Th 'T ^ ""* "^*^ ^'^^^y - ti je^n^^iiel'^rd t^^'es^ thli^'""**'"? °^ *^"^ ""*=*«»• »°d formation o1 At the^e tt '""^""' i"*^'"** ""^ mesentedc glanci the tubercular inflaml ♦• . . *'**' pharynx, m which case tachSi tuJi^o^!^*'^'^.** '^"^ 'P'^'^ t^o»gh *he Eus- o^t^myemt peri^tiS^'^H '*"*r*°^ ^*^ "P * *"-«"l'^ necrosis^flLe^^ Fr^^r"*'*"*.^*** rarefaction and ♦n th^ u f "°" thence the process mav extend their surfacrbecS^e^nHnJ^f" ^* ^"°^' «sP«cially on The surfar*. of ti,^ i ^^ ^'^^ ^ * ?'«<=« of cartilage uca inis, we may find comparatively large TUBERCULOSIS. 189 cweous pneumonic foci, the formation of interstitial tissue and chrome bronchitis, with their results. In consequence of the dMeased condition of the pleurae, the mediastinal glands and the subpleura! lymph glands of the thoracic vertebra and sternum may also become infected. We very rarely see tuberculosis of the trachea and larynx along with tuberculosis of the upper middle, and lower cervical glands. Primary tuberculosis of tiie uterus IS also rare. On the other hand, general tuberculosis is common in pigs. . ■*•"•"«— According to CterUg, the lungs in general porcine tuberculows become affected in 100 per cent, of the caMS ; Uver in go • •pleen la 80 to 85 ; oral cavity, laryngeal cavity and intestinal canal, iii 80; kidneys and serous membranes, in 30; bones, in 15 to ao- and mammat, testicles, uterus, and articuUtions, in i per cent. This' Uble showsthat in pigs the spleen is much more frequently, and the serous membranes of the abdomen and thorax much more rarely afiected by tubwculosis than in cattle. Ostertag lays down the foUowing views on the diagnosis of local and general tuberculosis :— I. Speaking generaUy, tuberculosis in pigs is local, (a) when any organ with its lymph glands, as for instance, the intestine with the mesenteric glands, is aflected ; (6) when in certain cases two organs such as the tonsils and the intestine, with respectively the submaxillary and mesentenc glands, are involved, or when in intestinal tuberculosis the Uver only shows Umited emboUc foci ; (c) when the morbid condition of :he lungs, pharyngeal cavity, and intestine has not had an embolic origin a. Tuberculosis in pigs is general, (a) when disseminated embolic foa (acute miliary tubercukMis) are found along with primary afiection even m only one organ, as in miliary tuberculosis of the lungs, intestines and their respective lymph glands ; (6) wLen. besides, the primary afiec^ tion, restricted emboUc foci (chronic general tuberculosis) are found in at least two organs, as for instance, in the lungs and Uver along with tuberctttosis of the intestines, and in the lungs or Uver and uterus, etc. Symptoms. — ^The symptoms of tuberculosis in pigs vary according to the part affected. Frequently there is no external sign of the disease. Young pigs when suffering from inUsHnal tvberculosis ai« backward in growth and become gradually emaciated. The mucous membranes become very pale, and the skin covered with dark grey crusts {Russ der Ferkd, suie des forceUts, soot of young pigs). These symptoms are followed by various disturbances of digestion, such as vomiting, tympany, slight colic, and diarrhoea. The internal temperature is alternately high and normal. Later on, the patient steadily loses condition. The flanks are tucked up, the eyes sunken, and the belly pendulous. The adherent intestinal loops can frequentiy be felt from the I90 INFECTIVE DISEASES. ou^de as a hard knotty mass of the size of a man's fist, or even t'1 / "T "^^ 'ntestines be simultaneously affected F J!^n ^^'l'** *'**■'• ^ P>g^ ™n« a very irre^ co^ Fu^t of all we observe automatic movements. suchSr^n Td tunung round and round; convulsions ^d sp^^of^^f l^^Vi'^t trunk and limbs ; nystagmuTr etc^t f later side ; and pendant condition of the ears .K i° ''^'^"'^"* "/ <** '«»?« in pigs, the sufferer has at first « cervical lymph glands ; and eruption ofS^rclesTl^- / ^ of the eve (ATaTv\ Boo* • i • . '"''crcies m the mtenor ux uie eye (Azary). Bactenological examination is of We i«, portance for diagnosis in pigs than in cattT i.^ ^' pay ..to.«„n to the a«tomiSTta^ wU^T^ '.^ c«rful not to mistale for the chro^J*^^^ 7 ^t "* .{h„^;^s?s.^„^^jf,'r.%^,i°'r«' emanates from several points Sch^«°^ *?*™.*^**y» glomerates of the tubercK^Sle'SS^^iJ^i'^.'^^J- appear to be infiltrated by numerous s^aS^iTc^? ^ S^ rule, calcification quickly follows caseation *'*^"* *'^'- ^^ 2. In cAfonic pneumonia, changes are generally found in the TUBERCULOSIS. ,p, lungs, and, less frequently, in the skeleton. We find in the lungs only cavities or formations of sequestrum, varying in size from a pea to a man's fist. UsuaUy an adhesive pleuritis is also present The lymph glands most frequently affected are the bronchial' tracheal, and inguinal glands. When attacked, they become entirely caseous and present the appearance of a round sack filled with dried caseous pus, arranged in concentric layers with- out any calcification. The bacteria of contagious pneumonia can be easily found in the pus foci. It is worthy of remark that tuberculosis and chronic pneu- moma may occur simultaneously in a pig, in which case the presence of tuberculosis may be proved by experimental inocu- lations m guinea-pigs. As afready stated, the tubercle bacilli as a rule, cannot be found. No experiments with tuberculiii nave as yet been made in pigs. ■ovofkdou or Ommim laflamnmUoit of tha IntMtliiM — ^e etiology of the disease of pigs which was described by Roloff under Sl^iT"*; ^ T-^'^ ^ P"P"^y elucidated. It probably belong, partly to tuberculosis, and parUy to swine fever, and is characterised ^ pecuhar mtestinal changes that chiefly impUcate the colon, the loops ^ which form, by adhesion, a firm bundle. The individual intestinalwn- volutions represent thick eminences with divisions and cavities bv which the intestine assumes a rosary-Uke aspect. The waU of the iitestine IS thickened and covered with nodular prominences, the centre of which contains ca^us foci. Miliary nodule, are imbedded under the s^ and the submucosa. The mucous membrane of the intestine sho^ circumsCTibed, copper-coloured hasmorrhagic foci or necrotic disintegra- Uon. with scabbmg and exfoliation of the upper layera, and wmetow and ulcerated. Large tubercular ulcers, with raised and thickened marglM are found m the mucous membrane. The ileo-caecal valve frequS projects mto the c«cum in the form of a long firm plug, with a iSv ducoloured surface and ulcerated margin. The intestinw become ^ml t.me,naiTowedbyc,catri«Uon. The mewateric gland, become enh^g^ and contam caMous foci. «>-«Mgou Equine Tuberculosis. 0©curr«io«.— Tuberculosis is not a common disease in horses. Many of the cases which were published long ago are not altogether free from suspicion. On he other hand, it is not im- probable that a few cases reported as glanders were reaUy those of tuberculosis. In recent times, the presence of tuberculosis has been demonstrated more frequently in the horse than formerly. Bang has, for instance, collected ag cases In igi INFECTIVE DISEASES. S^tXcl^' ""' '' '''"^ '^'^'''''^ '^°"- were found to t^rr^io^irjittX^^^^ '"^^-^ place. According to Csokor S R.n. *f °? *?P^^ *° ^^'^^ the chief points 'of invtio^for t 'bacteri^^^^^^ along with the food is proved by the fact thl^tL V^Z ^"*'"''='* important tubercular changes aJefounH in *t ***« ^^^^^t ^nd most According to Bang, the^Srarn^ i ?w^°*'"' ^^"'^^ difficult to transmit tuberculosis to the horb;to lungs as weU as in ttlroufL Jr^^'o^"!!" '''' generalised by spreading simult^r^Hv^r iv"S SZ' We may find m the lungs small miliary tuberclJ^o^^r^?^^' nodules which are caseo^ ih their Mntrl»n5v' u ^* ^"^ the size of a wabiut Thes^n^nir ' *"^ '^^'''^ "^y »«»« infiltrated witr^eUow^^lTlc^r^ or Zf r*' ^*° * ^ ""^ the« WM a distinct histonr of thranimalLinl f°^'^"»'' « P«Po«tion of a^ milk. Now when one JecuThat Triinr'^^te" i""''^ '"^ "'* '"""'^'°"' •t any period of iu life fed on cows'litk ih^tT "" ' u *""""' ''"'«*«* « hM been met with in ho«es tha^radS,' ^ f^T^^"'* which tuberculci. obvious that if we give milk to ho,^«!^ •' u T ''"^ *'"'''"«•" It is sterilise the milk inL event oour^'S '".^•'"u " ^'*«^' ^' •»»«•" the milk WM taken were f'Jl f^r utercS.'*?"' '^•v *' ~^ ^«"» *Wch should be careful, if po..ib". rto atw "o attiLir'."*^^ '"'"' '^ "«'• "« «y. 90^ C. (taking the death-point of te tlJ^^^^'^iK^i'^'^r " "^ •° " "'.■T*^ "»'*"''« to the milk the peculiar tMtr^hlh^^f' ^ '^ '^• which is disagreeable, as a rule to honT An •■'''"« ^''^ *''■"<> •lightest degr2;«nok.d. renden h iill Zt , *"* '* '** «*' «'" « t«»e drinker.-'U. *"" "*"• unpleasant to the would-be equine TUBERCULOSIS. ,53 chial and mediastinal glands are swoUen up to the size of a man's fist, are hard to the touch, and have eminences on their surface. Theu- capsule is thickened and on section they appear grey with mtersp«sed yeUow foci. The portions of the ^urT wWch cover the tubercles may also become thickened. The serous membranes of the thorax and abdomen often show changes smiilar to those of bovine tuberculosis. The S«!fr^/^*?** r*^ "^^^ *»' conglomerated grey-yeUow. grape-hke tubCTcles. from the size of a poppy seed to that of a hmp seed, and sometimes with larger tubercles which may also become umted mto thick, nodulose, plate-like layers. Exactly the same changes are found on the perietal add visceral peri- toneum, omentum, and mesentery, in the form of nodules vwy- ing m sue from a millet seed to a walnut, partly isolated, partly strung together m grape-like or plate-like hunps. which may umte together and form tumours that may be as large as a man's fist. The mesentenc glands, Uke the bronchial glands, suffer change, and form tumours which may be as small as a walnut or S 1^^^ *!k* f*" ' ^*' °' "*y ^""« *»»« appearance of a string of beads that may be as thick as a man's arm, and frequently met with m the mtemal ihac glands. We also find tubercles of vanous sizes, and sometimes in great numbers, in the Uver, in the spleen, which is often enormously enlarged, and in the fadneys. with sunultaneous swelling of the portal, splenic and renal lymph gknds Tuberculosis of the bones (ribs knd dor«U vertebra), with dismtegration of the bone tissue, formation of ^^J°^\?- 1 '^°''' ""^ Periosteal proliferations have been faltS" '' ^ ""** tubercular changes occur in the SymptomB^The aspect of equine tuberculosis is not very charactwistic. ChnicaUy, we may divide the disease into two pnnapal forms, namely, a pectoral and a gastric. In the former, we usually find only symptoms of "broken wind " or asthma, such as chronic difficulty in breathing, cough, and ema- ciation, which m some horses progresses so rapidly that thev become ahnost a skeleton in the course of from 6 to 12 months. In othm. we find foci of ddness in the lungs, bronchial r^^: a°d 'iles. In one case, the coughing up of a necrotic ?'^l^^V*"°'^"^*^»»"*^°o«<=«*- A case described by Schmdelka renunds one vividly of human phthisis • the symptoms having been bronchitis, rapidly increasing debility. 13 »94 INFECTIVE DISEASES. ^ni.*^^ !* *°*"^ variations in internal temperature, linfrer- wgpleontis harassing cough, excessive difficult" in SaS g^atemaoation and. strange, to say. polyuria"^ Nocard^* to?he Jnfi J"?"*'^**^^''^* found tubercular de^sits ^.^ °, r ^'y "•t'^i"""? W« hand into the rectum which is^^°dtntr*h f'''^'^ » » ««ve intestinal affection. «Sr:„I^^ '"'^ °*''*" ""^*'" *^« °"°e 0* ""biMcal pyamia SwS *^?,^y:!?P*°"«.^«« identical with those of^^fc become emaciated, tucked-up in the flanks. Lp^t bemJd the coat becomes harsh and loses its naturaUy dossy aDDe^;r. cl ?hf S'S^ with diaixhcea. and from slight attaXo^f cone. The foal becomes debilitated, prostrate, and finally dies from exhaustion or p.-ofuse diarrhoea. On maM^t^TZJtZ exammation we find enlargement. caseation^aS iX^Z^Z the mesenteric and bronchial glands and cata;rhal cS^ of the gastro-mtestmal mucous membrane. Schortmami hwdS^bed an mteresting case of an adult horse sufferii^om SS py^ which could be traced to tuberculosis cf usJTbyTS impUcated cervical vertebra] "** penostitia of the tw J??*!"^ l>Jf* «^ the result of the inoculatio^fg^ea pip. Csokor pomts out that characteristic anatonScaJ Sws tologicd differences exist between the noduk of^l^dm ^d tubercular new growths. He states that tiie nodSikT^flZ^ in casesof equine tuberculosis are not so weUde^^^^Jj^ TUBERCULOSIS. ,95 glanders; that they possess a distinct inclination to form groups; and that each respective nodule becomes centrally caseated. He also remarks that the nodules (tubercles) in mUiary tuberculosis of the lungs possess a fundamental sub- stance which consists of three different kinds of cells, namely, giant ceUs, epithelioid ceDs, and round ceUs. The nodules of glanders, on the contrary, show only one layer of round cells, or connective tissue fibres, around a caseous, dismtegrated centre. Canine Tuberculosis. 0«c«rreii06.— Although tuberculosis is not a very rare disease in dogs, it does not occur so frequently in them as in cattle and pigs. During the last few years, over 100 cases have been observed : 40 by Cadiot ; 40 by Frohner ; 28 by Jensen ; and II by A. Eben. Its frequency appears to vary greatly in dif- ferent countries and towns. Among 70,000 dogs which, from 1886 to 1894, entered the Berlin clinic, 40, that is to say, 005 per cent., were affected. A similar number was found among the 9,000 canine patients at the Alford clinic during the years 1891 to 1893, thus giving a percentage of 0-44, which is about 9 times more than in Berlin. Out of 400 in Dresden, 11 (27 per cent.) were tuberculous. The percentage of tuberculosis in dogs Mras highest in Copenhagen. PathogaaMtla.— The reception of tubercle bacilli in dogs takes place most frequently by means of the lungs, which con- sequently are more often found {75 per cent, of aU cases), post mortem, to be tubercular than other organs. Infection in them, as m man, is generally transmitted by inhaling tubercular dust in rooms, etc. Less frequently the tubercle bacilli are received through the digestive apparatus, in consequence of swallowing tubercular sputum or tubercular food. Absorption through the skin is rarest of aU. It has been amply proved that when the dog becomes tuberculous, the infection has been derived, as a rule, from mankind; especially by inhaling the dust of a room occupied by a consumptive owner, licking up expectorated sputum, and eating food which has been masticated by a phthisical patient. On the other hand, the serious danger to human beings of having tuberculous dogs in their immediate neighbourhood should not be disregarded. t jmptoms.— As in human beings, canine tuberculosis runs 13* 196 INFECTIVE DISEASES. a chronic course usually in the form of pulmonary ohthisis Tn TZ^^Z^rf^'"'^ r^^ sj^ptom^oY^hfi^llL cin" oft^r!™^' ^^ • ""'"y '°°8 time, on which account owners often remain unconscious of the fact during the life ofS ammation of the lungs shows dulne^, the presence of <^tS seldom observed, because the patient swaUows it. TowXthe end there is accompanying diarrhoea ar.d sometim J^it« By that tune the animal is reduced ahnost to a skdlton Tute mihary tuberculosis seldom becomts develojiiT diff5^**"7*~^* puhnonary tuberculosis . sumes many ^ ^"k^^ ^"^^ *° «»« ^*"» of the rite LTs^eti^w totte neighbourmg lymph glands. Besides this, thert mTS mficafaon, oedema of the lungs. emphySma of the lu^ S^ bronchitis with bronchiectasis * oi me lungs, and fluid, which, m some cases, assumes a hamorrhagic charaSr tracting pfeuntis. which leads to adhesions of the lungs IW. may also be present a disseminated miliary. pleuro-tXrculoT E^hyema and hydrothorax may be ^S^'aTsecond^'pW ri^n^'i^'^?'^' 'T^ "** *^°"^*= ^y^P^ e^'^ (bronchial glands anterior and posterior mediastinal glands, and in a few ca«. tte mfmor cervical gknds) to become more orT^ ZIZ tonn sarcomatous conglomerations the size of a man's fist. The TUBERCULOSIS. «97 tumours show on section a dirty white colour and are infiltrated with foci of softening or tubercles. The mediastinum often becomes thickened and swollen to an unrecognisable extent. In combination with the swollen lymph glands, it sometimes forms between the two lobes of the lung, sarcomatous, lardaceous tumours which are covered with fine proliferations and remmd us of those of bovine tuberculosis. These tumours show on section, softened, caseated and calcareous foci. The diseased condition of the pericardium manifests itself partly by a sero-haemorrhagic, partly by a fibro-granular, ad- hesive pericarditis, and partly by miliary tuberculosis of the perietal and visceral portions of the pericardhun. Hydioperi- cardiom is sometimes present. Tuberculosis of the peritoneum is less frequent than that of the pleurae; the changes being almost identical in both. Swollen proliferations, similar to those of the mediastinum, sometimes form on the omentum. We seldom find intestinal tuberculosis (intestinal ulcers with swelling of the mesenteric glands). Tuberculosis of the liver, spleen, testicles, kidneys, etc., is usually miliary. *****•**•■•— The respective participation of individual organs in canine tuberculosis is shown by the foUowing figures. According to Cadiot, the lungs were affected in 80 per cent, of all the cases ; pleune bronchial glands, mediasUnal glands and Uver, in 60 per cent. ; kidneys! in 45 ; peritoneum and omentum, in 30 ; pericardium and mesenteric SMds, in 25 ; spleen and intestinal mucous membrane, in 10 ; and the heart, in 5 per cent. Exudative pleuritis and ascites were present in 50 per cent. ; and exudative pericarditis in 1 3 per cent. General tuberculosis was met with in more than one-third of aU the affected dogs. Jensen states that the lungs were tubercular in 75 per cent, of all the cases. In about haU the number, the bronchial glands, mediastinal glands, and serous membranes, especially the pleurae, were involved. The Uver and kidneys were equally often affected. Eber found that the lungs were impUcated in 80 per cent, of the cases ; the bronchial glands, in 70 per cent. ; the pleurae, in 35 ; the pericardium, in 10 ; and general tuber- culosis was present in 10 per cent, of the cases. According to Frfihner, the percentage for the lungs including the pleurae, was 90 ; for the liver' «o ; for the bronchial and mediastinal glands, 50 ; for the pericardium! 40 ; for the kidneys. 25 ; and for the spleen, and for cases of genera! tuberculosis, 10 each. Dia^osU.— The history of the case in dogs, often leads us to suspect the presence of tuberculosis. We usuaDy learn that the patient has suffered for a considerable time from cough, dyspnoea and increasing emaciation, and that every means of aUeviation which had been tried had faUed. The phthisical I9« INFECTIVE DISEASES. thHT r *^* °*°?. "^y J«»d us to suspect tuberculosis in the dog Gener^y. a diagnosis of tuberculosis wiU be justified If the dog » suffering from chrpnic bronchitis. pneumZf „; plwmtis. and from great emaciation. An exact <^ZoSs is htT'^^n'"' ""'^ '^ bacteriological examinati^roc^-' lation and, to some extent, by the use of tubercul n wl may find bacteriologically the tubercle bacilli S^ few ibS^ St^v T" ""l*"" "°'" ^«"»We results by examiSX wS'.??nt*' °^.*^"'?, 'y P""^*'"^ °* the^horax^d by injecting it mtrapentoneally into guinea-pigs (Cadiot) vJ^^ 1- ^°°^- «'*'"'"" *°' '"«« **°««) i« in maiy cases a valuable auxiliary diagnostic agent with dogs. It is a sWSir fact that the reaction sometimes takes pla?e as quicklyTfJ^m LLL^T/^'^'A^' inoculation. It is. however, l^eS m cases of advanced and general tuberculosis and w^th feverish Sjlr/ "°frT*°*^y "^"^ exacerbations, lowering^^the mtmial temperature, and may even set up fatal compUcSons In some instances, non-tuberculous dogs react to tXT£ aw?*f^^'?'*^~^*^''*"<=****"berculosis of the dog is incur- able ; for which reason and on account of the danger of iif^t^n o man. tuberculous dogs should be destroyed ^dthlTdekv In the early stages of the disease, we may try the effect of st^nghemng diet, open air, hygiene, and cerLn^e^cal^^nt/ such as creosote and creolin. In one case, we obtained coSer-' able miprovement by continued inhalations of creoC Tuberculosis of the Cat. Tuberculosis is not very rare in cats. As a rule, the source ?i? T"' f " ^'^' '' °'*^«^ ^^^ * tubercdo^ o^er gte m large owns are especially liable to become affected In Berhn. out of loo sick cats, one was tuberculous (FrShner) Jensen collected 25 cases in Copenhagen. TT^echS dSrH "" ^ ^.' "^•- '"^'^^^ em^aciation an«S debihty. dyspnoea, violent coughing, and dutaess of thelmS on percussion. Posi mortem we find the lunjs and Z S mu^ organs most frequently implicated. 'jeSSi obs^^^d mgiy seldom. The mesenteric glands and kidnevs suffer in many cases ; but the intestinal caLl and liver v^^^jf^^xie TUBERCULOSIS. 199 milk-white colour (from fatty d^eneration) of the section sur- faces of the larger tubercules is very striking. The lymph glands of the head and neck are frequently attacked. In two cases, the uterus and testicles respectively were tubercular; for which reason Jensen concludes that infection through coition has been absolutely proved in cats. In a few cases, tuberculosis with secondary affection of the axillary glands was found in the sub- cutaneous tissue, as a result of wounds. One cat suffered from arthritic tuberculosis. Jensen states that cats are affected chiefly through the digestive canal— a fact which we may infer from the frequency of the disease in the mesenteric glands. Not uncommonly, the digestive organs only are affected; although it appears that infection through the lungs is not rare. Nocard observed tuberculous arthritis in a cat which had been fed experimentally with milk that contained tubercle bacilli. Bollinger has described two cases of miliary tuberculosis, in which tubercles were present in the pancreas. In one case, Zschokke suspected that infection had been transmitted by man. Tuberculosis of Sheep. Tuberculosis seems to be somewhat rare among sheep. Only 5 cases were found among 340,000 sheep killed in the Berlin abattoir in the course of one year, 1888-1889. Among 130,000 sheep killed in 1894 in Saxony, there was a tuberculous percent- age of 0.15. The anatomical changes in ovine tuberculosis closely resemble those of bovine tuberculosis. Several observers suspect that infection is transmitted by tuberculous cattle through cohabitation and milk. Great emaciation, anaemia, and cough are the chief symptoms. In a case described by Rasmussen, a lean six-year-old sheep, slaughtered in the Copen- hagen abattoir, showed a number of defined tubercles, varying in Mze from a hemp seed to a hazel-nut. These tubercles partly projected out of the surface and were partly imbedded in the tissues. They all consisted of a thick capsule of connective tissue and caseous contents. The bronchial, mediastinal and thoracic glands and the glands under the shoulder blade were considerably swollen, firm, knotty, and studded with a cal- careous deposit. Some isolated pedunculated new growths were on the pleurae, and the liver was partly covered with tubercles and partly infiltrated. The first lumbar vertebra contained a cavity the size of a nut, and was filled with mortar-like caseous material. Similar processes were found in the two last thoracic vertebrK. loo INFECTIVE DISEASES. TUBBRCUIOSIS OF GOATS. Tuberculosis ik Wild Mammalia .uch^rri\ls*''uo^1i"'"^ t^*^*^ - -"•''^i'-l garden, tuberculosis '^^ ^' ''°"'' ^'f^' ?""»«»• «*»««. •*«.. Ll viftoni to Tuberculosis of Birds. »"«»cs or Diros. Amongst 1,100 hens dissected at the Leipsic '.^ TUBERCULOSIS. ,01 veterinary clinic, 106, namely. 10 per cent., were found to be tuberculous. Among the 700 parrots treated, from z886 to '^: *." 7i! ^^^ *^'"*^' ^70 (35 per cent.) were similarly affected. This disease attacks aU kinds of birds (hens, pigeons pheasants, peacocks, parrots, etc.). and not unfrequenUy occurs as an enzootic. In poultry, tuberculosis is gcneraUy located in the intestines, which, consequenUy, is the usual entrance of mfection. The transmission takes place most frequently by means of the faces of affected fowls, which feces contain great numbers of bacilli. Not uncommonly the infection is derived from tuberculous human beings by the eating of tubercular sputum and of food which had been previously masticated. It also appears that the disease is transmitted by the milk and flesh of tuberculous catUe. The heredity of tuberculosis, which IS beheved m by poultry breeders, has been proved by the ex- penmental investigations of Maffucci. Recently doubts have been expressed about the identity of the tuberculosis of bfrds with that of mammals, including man Koch considers that the bacilli of avian tuberculosis differe from true tubercle bacilli, although it is closely related to them. He l^ves open the question of thefr having the same pathogenic effect on man or not. Rivolla, Maffucci. Baumgarten, Stouss and Gamalela have also pronounced in favour of making a dis- toction between the two diseases and between the two bacilli • because human tuberculosis can be very easily transmitted by moculation to guinea-pigs, which are ahnost immune from the tuberculosis of birds. In contrast to human tuberculosis, the tuberculo^of fowl can be very easily transmitted to fowl and rabbits. The more recent investigations of Cadiot, Gilbert Roger. Fischl. Courmont, and others, tend to show that these i^°„. "^.°' *"^^*^°®** *^® produced by the same species of bacilh although by different varieties ; the differences between them havmg been produced by differences in thefr respective modes of nutrition. Anatomy.— In poultry, the anatomical changes are chiefly found in the liver, spleen, and intestines. The liver is infiltrated especially on its surface, by tubercles, varying in size from a millet seed to a pea, or even a wahmt. These tubercles fre- quently become massed together, and show, according to thefr age, a white, grey, or yellow colour. In the centre they are caseous or calcareous, and contain great numbers of tubercle baalli. Sunilar changes are found in the spleen. On the in- ao3 INFECTIVE DISEASES. tetinal mucous membrwie we may see miUary tubercles which ?LX If* T °* * ^' "*** ^^^^'^ "ubsequently ulcerate. Tubercles also form on the peritoneum, mesentery, kidneys, ovanes. etc. Tuberculosis of the lungs, guttural pouches, hewt. and pericardium is comparatively rare. The disease pretty frequentiy invades the lymph glands and articulations, wpeci- W* . ir *lf8»,a°d feet, in the neighbourhood of wWch T^T^rJS'.nH"', "*"*"!« *»'*«^ »rtl«tis and periarthritis. Tubercles and ulcers also form in the bones, skin, and subcuta- neous cellular tissue. »uia,ui* STBiptoiiis.— The symptoms of tuberculosis of birds are not veiy characteristic. The sufferers are feeble and become ^duaUy emaciated often abnost to a skeleton. The comb and wattles are pale and dried up. The mucous membranes of the chrome disturbances of digwtion. such as losTof appetite voimti^. and diarrhoea Towards the end. great SlbSftf^'d paralysis supervene. The diagnosis becomes somewhat Lier rtT«l^ symptoms art associated with local tuberculosis m Uie articulations, bones, and skin, in the form of sweUing of aI ilT TK 5°"**' "^^ °* ^"'"^'^ *°** unhealtiiy ulcere in the skin. The disease usually runs a rather sic y course. Tuberculosis of Parrots. This form diffen in some points from that of domestic fowl Th. S^SS. b^'"^^,''*"KPl!" *'^''«'' '"^^ ".pimto^ a^fi onlccolnt of the bmU mhahng the baciUi of human sputum alongNdth d«t de^itS to dwdhng-tooms. Next comes infection through the dUriti" aS!. ™SL^* ♦.. ' "^' "P«^y »»»»» of the head, and the mucow ^^?ll f. " characterised by new growVhs of homy skin. wS frequenUy attain a considerable size. They can be eaailv brokM. A« 7»? culoeis of the lungs and con unctiva is often met with According to a comp^tion by Eberlein. the skin was infected VnTithe^jJ^L" 6 JTJLSlS'ih *Sf ""'='^*«°'" « "percent, of i;u the c^. A. ^^1SLJ^ '^, ''"? ^ "" *~° "»« •»««» of a pin to a hen's egg ^^^ or oval and semi-soUd; and have a h^y. scaly surS From a d«gnost.c pomt of view, it is important to note hat the ^ ™„T^" ^**''*"' f*'""'* numerous bacilli, on cutting and makinc JriW^irnf"^- ^%*«*»»«*«>*t«bJcZ7ew growths ieS to the domam of surgery. Relapses are common. TUBERCULOSIS. Pseudo-Tuberculosis. J03 Thia name u given to Mine diseuM which ckxely reiemble tuberoulcwit (UatomicaUy and cUnicaUy, but are not canMd by the bacillus tuberculosit! Thm% diseaMf are of diagnoatic importance from the fact that they occur in cattle, and in aninu<« which are UMd for inoculation experimenU, in both of which cases they may become confused with true tuberculoeis. A correct conclusion can be arrived at only by bacteriological means. I. Kitt has dcKribed in caUU a baciUar. caMous, broncho-pneumonia which could not be cUnicaUy diitingnithed from tuberculosis. On bacteri'- logical examination he found baciUi of from i to i^ ^ long, of about tu. thickneu of the baciUi of erysipelas and capable of being stained wit' Gram's solution ; but no tubercle bacUii. A similar disease has been described as " bovine glanders," by the French veterina.-y surgeon Nocard. Courmont observed a peculiar bacillus in tubercular-like pleural nodules of OktUe. Stahr noticed in sucking calves a caseous non-tubercular pneumonia with a smgular bacillus. We may draw attention to the pseudo-tubercular pneumonic foci which are met with in diseases caused by pulmonary worms (strongyU) in cattle and sheep, such as parasitic tuberculosis due to nematode* or " nematode tuberculosis." Hink has observed in the lunp of a large ruminant, tubercle-like formaUons caused by " aspergillua fumigatus." Preisi and Guinard found smaU short bacteria with rounded ends m the tubercle-Uke calcareous nodules of the kidneys of a sheep. a. In guinta-pigs and rtMnts we meet with various proceases which resemWe tuberculosis. Eberth, Dor. Parietti. Zagari, Chantemease. Chamn and Roger have described a£fections closely resembling either tuberculosis or glanders in these two very important experimental animab. Tliese simulating diseases could be distinguished from the true ones only by their respecUve bacteriological difierences. Pfeififer described in detaU a specific and pathogenic baciUus pstudo-tuberaOosis, which he considers to be the cause of the so-caUed pseudo-tubercukMis of guinea-pigs and rabbits. This baciUus can be stained by Lflffler's solution but not by that Of Gtmi. It has many points of resemblance to the baciUus of glanders, but difiers esseniiaUy from that of tuberculosis. Inoculations of it produce caseous nodules in the liver and spleen, varying in size from a pin's head tea pea, and caseous foci in the lungs resembling the growths of glanders. n» fact that the abdominal organs participate in the disease to a far greater extent than the lungs, serves to macroacoirfcaUy distinguish pseudo-tubercutosis from true tuberculosis. The pseudo-tubercuhtf aodules contain no ^iant cells, and only a few epithelioid cells. The inocuUted animals die quicker than those inoculated with true tuber- culosis, on which account the nodules never undergo dry caseation, but show u their centre a pus-Uke fluid, as in glanders. 3. Ebstein and Nicolaier have found in the kidneys and lungs of dogs and cais a zooparasitic tuberculosis, which appears in the form of nodules, and which is caused by cyUndrically-shaped worms. According to Laulam«, similar nodules are produced in the lungs by strong]dns vasorum. Fotain has described in pigeons, tubeicle-like formations raused by aspergillua, and Corml has reported the presence, in an antelope. of similar afifections caused by an oval bacterium. 304 INFECTIVE DISEASES. ACTINOMYCOSI& ^Zi^''J° geiieral-ActinoayecU in Pip. Ho«e, .od Sheep-Acti- nomyce. Musculorum .uU-Botnfomyco.U in Ho«e._Actinomy^u of i????^^^*V°°'"y*^°^** "^ «*"« *° '^y ft»ng» (actinomyces). which belong to the pleomorphous bacteria and to the cladothrix group of fission algae, or fission fungi (Bostrom). According to recent investigations, they appear to belong to the family of 8trepto.hnx and to occur in different varieties. The cha-ac- tenstic feature of these fungi, as compared to other bacteria, is that they grow, not as single individuals, but as regularly built- up combined structures. These colonies or granules measure t *u* "^J^ diameter, and tfonsequently may be seen by the naked eye as spherical bodies which are about the size of grains of sand. According to their age. they are grey and gelatmous, and resemble maU lumps of mucus ; or they are greyish-white, opaque, and sometimes yellow, brown or even green. We can distinguish in the radially arranged colo^es. two layere namely, a peripheral layer of clubs, and a central layer of threads The former consists of pear-shaped bodies, the so-caUed clubs, in the axis of which runs a thread of myce- lium ; the contents breaking up into spore-like granules. When these clubs open out at their apex, after the manner of a bud. secondary clubs become developed, in the form of finger-like or hand-hke processes. As demonstrated by Bostrom, these clubs ue not organs of fructification (gonodia), but are forms of gela- tmous degeneration. The central thread layer consists of an entangled plexus of filaments formed by rods, which are of ♦i^T !iP^' *°** "* ™°**'*' ™ ^^t^"-' a°d by long spiral threads. Moreover, we find a granular substance consisting of round cocci-hke structures (spores) which have sprung from the filaments. The true organs of fertUisation are fomid in the interior of the actinomyces-granules. in the germ stratum of the filamentous layer. The growth of new colonies takes place by the separation of the filaments or spores of the old granules. It i« probable that the germs of the fungus in the form of rods or filaments are carried away by the leucocytes (phagocytosis and chemiotaxis). The tissues lying in the neighbo^hc^Tf ^e tufts die and become surrounded by an outer zone of leucocytes and later on by granulation tissue. The gelatinous degenera- ACTINOMYCOSIS. ao5 tion of the nodules (formation of clubs) is accelerated by increase of granulation tissue. The tufts frequently become calcareous. Bxitflolo^y. — Pure cultures of actinomyces on dried blood serum, which are best prepared by previously rubbing down the granules, form at first, according to Bostr&m, a thin gelatinous layer, consisting of fine transparent filaments. The layer grows and looks as if it were sprinkled over with chalk in consequence of the accumulation of little dots containing numerous cocci and filaments. After a fortnight, these white dots become pale yellow, pure red, or brick red in the centre, and confluent ; whilst on the periphery a transparent dirty-white stratum forms. Old cultures become puckered and hard. The fungus grows in a similar way on agar-agar, glycerine agar, and gelatine. On potatoes it forms grey, yellowish, and finally white granules. The growth is not stopped by the exclusion of air (facultative acerobic iMcteria). Experiments with cultures in animals have been mostly negative. Only WolS and Israel have succeeded in producing actinomycosis by inoculation. Pathogenesla. — Actinomyces, which are found originally on plants, seem capable of entering the body in various ways ; although the digestive canal is usually their first point of attsu:k. According to Brazzola, they vegetate chiefly on hordeum tnuri- Hum. He discovered quantities of them between the vegetable fibres of broken particles of barley which were imbedded in the gums. Johne, Plana, Bostrom, and others have found this fvmgus abundantly among the awns of com which were in the tonsils of pigs and in the tongues of cattie. It is generally sup- posed that transmission takes place by the fungus settling in small wounds on the buccal membrane, in the ducts of the glands, and perhaps in the alveoli of diseased teeth, or during the shed- ding of the milk teeth ; and that it grows and develops from these sites. It seems, especially with cattie, that the awns of grain, covered with this fungus, penetrate between the teeth and into the gums and tongue. If they have once effected a lodgment, they can be removed only with difficulty on account of the peculiar position of the hair on the beard, just as we see with spikes of rye which have become stuck on the sleeve of a coat. A favourite site for actinomycosis of the tongue is a point on the upper surface of the tongue midway between the dorsum and the tip. Hentschel and Falk point out that about 9 per cent, of affected cattie showed on that spot, lesions of epithelium which served as starting points for the infection. Bostrom believes that the ray fungus develops exclusively on grain, par- ticularly on the awns of barley ; and that actinomycosis is caused only by the penetration of such infected parts of plants. We find in dry grain, symmetrically-arranged air spaces, which have aa6 INFECTIVE DISEASES. fissured openings in which the fungus may remain dormant for more than a year in a dry condition. After that, when it is trans- ferred with the awn to animal tissue, it begins to grow luxuri- antly. It appears, as a rule, that cattle become infected only when they are fed on dry food (Imminger and Claus). The immigration may however begin in the lungs bv fungi contained in the inhaled air ; in wounds of the skin ; and by the openings of the ducts of the teats. Gooch observed that in a large herd of cattle which had been treated by setons. the majority of the wounds showed actinomycosis. A general infection over the whole body by means of the blood, as in tuberculosis, seems possible, although it could rarely occur. With regard to the rapidity of growth of the actinomycomata, Andersen observed that tumours of greater or less size developed in 17 cows out of 20 which were out on grass during the 5 months from July to December. , j j' '" Some observations suggest the idea that swampy districts are favourable to the development of actinomycosis. Bang and Jensen remarked on the epizootic distribution of the disease among the cattle of a seaside district of Denmark, in which place the sea had receded from a portion of a bay and left a lake on the reclaimed land, which was exposed to inundations. Cattle Which had been fed on barley grown on the reclaimed ground of this inundated district acquired the disease. Imminger Preusse. Claus, Roger, Davaine. and others, have made sknllar observations on tlie influence of swampy and inundated pastures AOtnomycosis is not a contagious disease. Attempts to trans- mit to other animals have been made by various persons, but always without result (Rivolta, Bollinger, Siedamgrotzky Per- roncito, Johne, UUmann, Bodemer, and Bostrom). Cattle, calves goats, sheep, pigs, dogs, cats, rabbits, and guinea-pigs have remamed healthy after inoculation. Only in a few cases re- action to inoculation was displayed by the formation of inflam- matory demarcation granulations. The asserted positive results obtemed by Ponfick, Israel, Rotter, and Hanau are, according to BostrSm, simply residual and encapsuled inoculation nodules. It seems that the ray fungus has a pathogenic effect only in the st^ of development connected with the awns of grain, and that It loses Its power of transmission as soon as it has entered the animd body, on account of undergoing some form of involution (calcification, etc.). The negative result of the inoculation ex- periments is of great importance for elucidating the question of the transmissibility of actinomycosis from one animal to another* ACTINOMYCOSIS. 207 or from one of the lower animals to man. The foregoing con- siderations tend to prove that infection cannot take place in this manner. OoonrrMiOfl. — Actinomycosis has been observed in cattle, pigs, horses, sheep, and man. The ra- fungus was first seen about i860 by Perroncito and Rivolta, diid by Hahn in 1870. Bollinger furnished the first exact description of the disease in 1877. Harz was the first to examine the fungus botanically and to give it the name actinomycosis (ray fungus). Actinomycosis is generally sporadic, though sometimes enzootic. Preusse has described an epizootic outbreak of this disease in West Prussia, by which 20 per cent, of all the cattle became infected. According to Imminger, the disease is parti- cularly rife in the Upper Palatinate and neighbouring parts of Upper Franconia. He is accustomed to treat yearly more than 100 cases of bovine actinomycosis in the Bavarian Upper Pala- tinate. Claus has collected 105 cases. Actinomycosis appears to be very common in Russia. Of all the cattle slaughtered in Moscow, from 25 to 55 per cent, are found to be infected with it (Oskolkow). Barret states that Canada shows the compara- tively high percentage of 2 ; Salmon puts the percentage for the remainder of North America down at 02. The disease is some- what rare in France (Cadiot). The percentage in La Vilette was 07 (Nocard). Peletti has seen himdreds of cases of actinomy^ cosis in Italy. His experience of the disease impressed upon him the fact that it is especially liable to occur after an epi- zootic outbreak of aphthae, on which accoimt he connects the presence of ulcers in the buccal membrane with the pathogenesis of actinomycosis. Neuwirth has made a similar observation. In Denmark the outer soft parts of the face and the neigh- bouring cervical region are most frequently attacked (Bang). In England the usual seat of the disease is the tongue ; and in Russia, the lips. Tne statistics of the abattoirs give the following figures. In Berlin there were 21 cases from 1885 to 1886 among 100,000 cattle (I in 5,000) ; and 2 out of 300,000 pigs (i in 150,000). In Augsburg, 8 in 23,000 cattle (i in 3,000). In Bremen, 2 among 8,500 cattle (i in 4,520), and 3 out of 25,000 pigs (i in 8,000). In Stuttgart, la among 12,000 cattle (i in 1,000) ; and in Hanover, i in 10,000 cattle. Ivanow found 2,000 cases of actinomycosis during 2 years in the abattoir of Moscow, in r^tiie slaughter-house of which Man observed 540 infected carcases ao8 INFECTIVE DISEASES. out of 150,000 (I in 3,000) cattle that were killed. At Warsaw there were 70 cases out of 350,000 beasts (i in 5,000). AnatomiOAl Olmngtts. — Bostrdm states that actinomycosis is a specific inflammation which occurs in the three following degrees in our domestic animals : (i) A degenerative granular inflammation (tongue) ; (2) a progressive purulent granular inflammation (cold abscesses) ; (3) a fungous actinomycoma (pharynx and skin). First of all a granulation tumour develops in the neighbourhood of the actinomycotic granules, in conse- quence of inflammatory reaction. This tumour leads to the formation of tubercle-Uke nodules and large roimded or lobulated tumours, which are termed actinomycomata by Johne. These actinomycomata are sometimes very soft, of a sarcomatous consistence, and of an orange colour.' At other times they are rather hard and firm to the touch,)of the consistence of a fibroma, of a whitish-grey colour, and sometimes spongy. They consist of a connective tissue stroma in which numerous nodules the size of a millet seed up to that of a pea are interspersed, and shine through the surface. These nodules possess the microscopic structure of granulation tumours and contain the sulphur-yellow actinomycosis granules, which are about the size of a grain of sand. They may form larger nodules by becoming massed t(^ether. Purulent disintegration of the actinomycomata gives rise to " cold abscesses," which are surrounded by very soft granulation tissue, and contain the small yellow tufts of the fungus. Actinomycosis of cattle usually appears in the upper or lower maxillary bones, where it generally produces very large tumours in their soft tissues and osseous tissue. These tumours we—; formerly known under the name of " wens," spina ventosa, sarcoma of the jaw, cancer, etc. Actinomycosis of the jaw commences with flat granulations on the gums and mucous membrane in the neighbourhood of the teeth, and spreads to the periosteum, and finally to the medullary tissue of the bones, where it soon gives rise to an osseous tumour. This swelling is the product of an ossifying periostitis, and of a rarefying granular osteitis, which gives rise to the spongy cavities, or lacuns that are highly characteristic of macerated bone, and are due to atrophy of the osseous utibeculs. On the other hand, the simultaneous periostitis is followed by an increase of the Hrcum- terenct of the bone with a peripheral osseous deposit. Fiom the maxiUary bone, the actinomycotic granulation substance may ACTINOMYCOSIS. xt9 advance, either to the skin or to the oral cavity, in the direction of the molar teeth, which become displaced, or finally become affected by the morbid process in the same manner as the bone. In cases of actinomycosis, the disease very frequently attacks the tongue, in which it takes essentially the form of an indurating glossitis (actinomycotic sclerosis or macroglossia), on which account it was formerly caUed " wooden tongue " {HoluuHge and langue de bois). W lotice, first of aU, underneath and on the sides of the mucous membrane of the tongue, circular, some- what raised brown spo+s, through which shine very minute yeUow nodules. Later on, we find similar spots, varying in size from a grain of millet to a pea, in and under the mucous mem- brane and in the intramuscular connective tissue. These actinomycotic nodules are round, hard to the touch, fibrous, and show a purulent, caseous, chalky or mortar-like substance in then: centre. In the neighbourhood of these nodules there is a considerable proUferation of connective tissue, which leads to atrophy of the muscle fibres, or to induration of the organ (" wooden tongue "). On cutting through the tissues of the greatly enlarged tongue, we find it lardaceous, hard, and even gritty. The cicatricial shrinking of the proUferated connective tissue eventuaUy causes contractions, erosions from friction, and vanous deformities of the tongue. The lymph glands of the tongue become studded with nodules and abscesses. As a rule, the actinomycotic proUferations in the pharynx take the form of soft polypoid or fungoid nodules or lumps which have a short peduncle and smooth surface, and which vary in sue from a pea to a goose's egg. iliese actinom-comata may give nse to difficulty in swaUowing and attacks' of dyspnoea. Sumlar nodules which sometimes have a broad base, and which vary m number, size, and consistence, may form in the asophagus rettculum, larynx, and trachea. Actinomycotic processes are of rarer occurrence in the omasum, abomasum, intestines, perito- neum, omentum, and mesenteric glands. Actinomycom&ta of the skin and subcutis are found chiefly on the head and neck. They usually form elastic, firm nodules the sue of a hazel-nut up to that of a mau's fist, or may be even larger. Sometimes these nodules are pedunculated ; at other times they are attached to the skin by means of a broad base They may present the form of a soft, granular, fungoid prolifera- tion of the colour of red meat, and are then covered with brown crusts, or with a purulent secretion. At other times, yeUow nodules, the size of a pin's head, shine through the surface of 14 - ^ ato INFECTIVE DISEASES. these proliferations, in the neighbourhood of which, the skin becomes thickened and indurated. Cutaneous actinomycomata may attain a very large size. Actinomycosis of the skin may be primary or secondary. In the latter case, it takes its starting point from deep lying primary foci, in, for instance, the jaw, udder, or glands. Tumours and ulcerous erosions form on the mucous membranes, chiefly of the mouth and nostrils. In many cases, the lymph glands in the neighbourhood of the larynx and the pharynx also become secondarily affected with actinomycosis from the mouth, larynx and pharynx. Actino- mycomata are found most frequently in the subparotid glands (upper cervical glands). They form firm, round, oval, or even elongated nodules, the size of a walnut up to that of a man's fist, and contain, as may be seen tmder the microscope, numerous typical tufts. The submaxillary and parotid glands sometimes become affected. i Actinomycosis of the lungs occurs in two forms : First, that of disseminated, firm, whitey-yellow nodules which become calcareous in their centre and vary in size from a millet seed to a pea (miliary actinomycosis) ; second, that of larger purulent foci of softening (cavities), which may attain the size of a man's fist, and which are filled with a grey, muco-purulent fluid (lobular actinomycotic inhalation-pneumonia). The actinomycomata of the lungs may spread to the pleurae, and even reach the surface of the body by penetrating through the ribs or intercostal muscles. The bronchial glands and the mucous membrane of the air passages of the head may become affected. Actinomycotic processes may form on the udder (mastitis actinomycotica purulenta fibrosa), spermatic cord of castrated animals, brain, spleen, liver, muscles, diaphragm, peritoneum, inguinal glands, vagina, uterus, in and between the cervical verte- bra, etc. Actinomycosis, Uke tuberculosis, may become general. Btfttlatlos. — ^The maxillary bones, tongue, pharynx, parotid glands and skin are the most frequent seats of the disease ; although exceptions to this rule are met with. Among the 105 cases collected by Claus, the maxillary bones (the lower jaw in the majority of such cases) were affected in 51 per cent. ; the tongue, in 39 ; tbs pharynx, in 7 ; the larynx and trachea, in 6 ; and the lungs, abdominal viscera and bones of the head, only in a few instances. According to Imminger, the head and neck are implicated in from 85 to 90 per cent, of the cases, and the tongue in only 4 to 8 per cent. Rasmussen found the jaw affected in 14 out of IS cases in oxen. Among 201 diseased cattle observed by Kuritzin, there were only 3 maxillary cases ; the tongue being almost ex- clusively attacked. Actinomycosis of the tongue appears to be particularly ACTINOMYCOSIS. zxi nn in France, in which country out of 130,000 cattle which showed 07 per cent, of actinomycosis, that organ suffered only in one instance. Oskolkow sUtes that in Moscow the lips were involved in 50 per cent, of the cases. Mari gives the foUowing figures from 541 cases of bovine actinomycosis which he collected : — ^^ 371 cases Submaxillary glands ijj Bones of the head ... Lymph glands under base of skull Upper bronchial glands Lungs Inferior bronchial glands Tongue ..... Pharynx ..... Bronchial glands Peritcaeum .... Pelvis ....'. Pleurae ..... Inguinal glands .... Wall of the thoracic cavity Wall of abdominal cavity Mediastinal glands Liver .... "7 SI 38 29 5 5 4 4 3 3 I t I I I I Bjrmptoms. — ^Although actinomycosis is of greater interest to surgery and pathological anatomy than to internal medicine, it sometimes presents symptoms which belong to the domain of special pathology. Thus, in actinomycosis of the tongue, pre- hension of food, and especially mastication, are impeded and even rendered almost impossible ; the tongue is swollen and painful to the touch; and copious salivation is frequently present. Difficulty in swallowing arises from implication of the pharynx ; dyspnoea, from new growths in the larynx ; and chronic tym- panites, from actinomycosis of the mediastinal lymph glands. In cases of actinomycosis of the outer surface of the neck, we find the parotid region swollen and covered with tumoure of v^ying size. Actinomycosis of the cervical vertebra may cause spinal paralysis as a consequence of atrophy of the spinal medulla from continued pressure. Actinomycosis of the lungs may also present the appearance of a chronic affection of the lungs (phthisis). The course of the disease is always of long duration. Cases of spontaneous recovery may take place, as in tuberculosis, m consequence of the growth becoming encysted and calcareous. Recent experiences with iodine have rendered prognosis more favourable. Actinomycomata of the skin, glands, and maxilla can be treated surgically. 14* 313 INFECTIVE DISEASES. Diir«r«iitl«l Dia^osU.— The diseases which are most easily mistaken for actinomycosis are tuberculosis (tuberculosis of the lungs and lymph glands), bovine pleuro-pneumonia, and foot and mouth disease. It may be mistaken for simple glossitis showing new growths in the pharynx (polypus, fibromata, and sarcomata), sarcomata of the jaw, lymphomata, cysticerus mediocannelatus in the tongue, parotitis, cellulitis, etc. On this accoimt, the diagnosis of actinomycosis during the life of the patient is by no means easy. Often the disease can be recog- nised only by a microscopical examination after slaughter. For diagnosis intra vitam, it is of importance to extirpate or to incise nodules or abscesses in or under the skin, and to submit them to an exact microscopical examination. The actinomycotic ero- sions which occur on the mucous membrane of the mouth differ ■ from aphthous ulcers, by reason of their base being hard and leathery. In all cases, the diagnosis can be confirmed only by microsojpical proof of the presence of the actinomyces tufts. Simple microscopical examination with the addition of one drop of concentrated liquor potassae suffices to demonstrate the presence of the ray fungus. The staining of the fungi gives a great deal of trouble and is not absolutely necessary. Among different colouring materials which have been used, we may mention a double staining with orseille and gentian violet, orcein, picro-carmine, haematoxylin, eosine and a mixture of aniline dyes. The cover glass preparations are made in the ordinary way. A smalTquantity of the pus or other material which is to be examined, is spread in as thin a film as possible on a cover glass. It is dried in the air and then passed, with the film side upwards, three times through a spirit flame, by which it must not be heated too highly. The cover glass preparation is then placed for two or three minutes in a solution of picrocarmine, or other colouring agent, after which it is cautiously rinsed in water or alcohol and examined in water, glycerine, or Canada balsam. If the ray fungi be present, they will show a bright yellow colour and the tissue will manifest a red stain. Tharapautios. — ^Formerly the treatment of actinomycosis was exclusively surgical, as for instance, by extirpation, caustics, actual cautery, incision, parenchymatous injection, and paintingi which purely operative methods are even now applied to actino- mycomata that can be reached externally. The deeper lying tumours, especially actinomycomata of the pharynx and the larynx, cannot, as a rule, be treated by an operation. For these ACTINOMYCOSIS. ai3 stugically inaccessible tumours, the internal administration of iodide of potassium has been foimd to be a specific remedy. Thomassen, who in 1885 was the first to recommend internal treatment with iodine, advises that each of the bovine sufferers should get daily, for 14 days, 6 grammes of iodide of potassium * dissolved in half-a-pint of water. The dose may be reduced to 4 or 5 grammes when convalescence sets in. It is stated that a visible improvement is noticeable after 8 days of this treatment ; and that the affection becomes cured, on an average in a fortnight, if the disease be restricted to the tongue and neighbouring soft parts. Numerous trials have proved, with a few exceptions, the specific curative effect of iodide of potassium (Fiirthmeyer, Bass, De Jong, Nocard, Oster- tag, Deslex, Reeks, Perinni, Havas, Gooch, Soucail, Hohenldt- ner, Krug, Schwabd, Walther, Sahnon, Bang, and others). The internal treatment with iodide of potassium may be supplemented by external application of iodine in the form of the tincture, or of Lugol's solution, either of which can be applied by means of a brush or injected subcutaneously. Itiipaotton of Moat. — ^As we have already mentioned * I am inclined to think th«t non-iuccess in the tre^« ^^ toxms become absorbed iuto the blood and produce, by means^f U serio^ rabbits and pigeons croupy membranes in the trachea, and wmettei^ Ka'^rr'"^. ^'''^'^^ ^ Pan-ysi*. Inoculit^™:;^ die m a few days under symptoms of exudative pleuritis and oedima. tS d»ease occurs chiefly among chUdren up to th^ tenth yt^Uis ver^ conUgiow ; and begins probably as a local pharyngeal i^ecUon ^ ZZr^n'^ ^f •*•* *«"» » *° S days, symptoms of S~l^ tnrbance (fever, malaise, and headache) first of all aoDear .^♦k!« difficultyin swallowing. The mucous membrane of ^ s^K^te^*^ greaUy congested and the tonsils swouS! Dirty-whiu CJ a^SS covenng membrane, soon form on the mucous membrai^eof thepSSS (tonjds^ uvula, and the palatine arch) with considerable swelli^JTS^ neighbourmg^rmphgUnds. The diphtheriUc process then sp3 to Sj mucous membrane of the Urynx, where it causes stenosis o^f ^ll^ (dyspnoea and suffocation), and even to the mucons membrane oT^ Wch. and bronchial tubes. The symptoms of a se^.tic genSTL^t^S^ ^ S^hth^v- 7^* "'^•* compucations are as follow! : ext^^ the diphthMitic mflammauon to the nasal cavity, oral cavity twm^nte cavity, conjunctiva, and intestinal mucous membrane ..wSi^fS^ articulauons; myocarditis: nephritis; paralysis of the ^^Vl voca^^chords muscles of the eye, muscles of deglutiUon. and. iL^u^y muscles of the extremities; and ataxy. The mortaUtv T v«^ S' Frinkel foUowed by Behring. was the tot to begi^Se^e^m^wtt ^^Z^JT^l'^''^^''''^ i-n»^gainsTSSrLi?;t remedy for. diphtheria. Behring succeeded in curinit bv the .^«^«« of the terchloride of iodine, guinea-pig, which had^^oily L2 ri^ Croupy Diphtheritic Inflammation of the Mucous Membranes in Fowl. n* ,?.*"*'^**^*»^^««=«»'Py diphtheritic inflammation of the mucous membranes m domestic fowl is not an etiological E-ii^?* *^°*^'.^"' - "«t distinguish at least twoltio- logicaUy diffwent vaneties, which, although they possess nearly •umlar symptoms, are nevertheless different to their nature DIPHTHERITIC DISEASES. 333 They may be described as foUows : (i) a croupy diphtheritic inflammation of the mucous membranes, caused most probably by bacteria; (2) a croupy diphtheritic inflammation of the mucous membranes caused by gregarines.* Independentiy of microscopic examination, the croupy diphtheritic stomatitis which is produced by gregarines may be distinguished from that due to bacteria, by the fact that it can be transmitted by inoculation only with much difficulty. In spite of the great contagious influence of cohabitation, the disease has been directiy transmitted by inoculation only in a very few cases. The inflammation of the mucous membranes caused by gregarines can, however, be transmitted by inoculation with the utmost facility. Avian Croupy Diphtheritic Inflammation of the Mucous Membranes probably caused by Schizomycetes. Btiolo^.— Speaking generally, this form is, next to typhoid, the most common and most dangerous epizootic among fowl It has become generaUy known only during the last 30 y^ Leisenng, m i860, appears to be the first veterinary auttior who described it. Ziim states tiiat Russ in 1861 was the first to describe chicken diphtiieritis. The existence of numerous publications by Italian and French veterinary surgeons referring to this disease, and otiier facts which we shaU presentiy discuss indicate that its starting point was in Italy and France, from which countries it was imported into Germany. This affection was formerly considered by many to be of a tuberculous natiire ; but later on, it was regarded as true croup, true diphtiientis, or a croupy diphtheritic inflammation. As tiie fact had been proved tiiat bacteria were frequentiy found in the inflammatory products, the view was generaUy adopted that these fission fungi possessed a patiiogenic importance : a sup- poMtion which appears to be correct. Recentiy, various more or less conti^dictory tiieories have been advanced about otiier forms of fungi. Rivolta refers tiie cause of chicken-diphtiieritis to two distinct species of fungi, which he calls " epitheUomyces croupogenus " and which develop only in tiie skin and mucous membranes, but not in tiie tissues or blood; thus entirely differing from the cocco-bacterial affection of tiie blood in diphtheria of man. In cases of croupy diphtheritic inflam- • Single-celled puasitet which belong to the tporacoiu— Tiu M4 INFECTIVE DISEASES. mation -of the mucous membranes of pigeons, Loffler found in the different exudates and in the liver, numerous bacilli which were somewhat lunger and thinner than those of the septicemia of rabbits and which had rounded edges, besides several other kinds of fission fungi. Subcutaneous injections of pure culture of these rods produced necrotic inflai^miation, and in mice a characteristic infective disease. By the retro-inoculation of a pure cultivation which was obtained from the Uver of a mouse, into two pigeons, diphtheritis of the oral cavitj-was produced in them. Loffler believes, however, that these bacilli should be demonstrated in a series of cases, before they can be looked upon as the true cause of pigeon-diphtheritis. Eberlein constantly found in diseased partridges, chain-like bacilli from 2 to 5 »* long and from i to 2 /i broad, which were rounded off at their comers and which contained spores. Ooourrenoe. — ^The inflammation of the mucous membranes caused by bacteria occurs, except in rare cases, only as an epizootic and attacks chiefly fowl and pigeons of the finer breeds, particularly those imported from Italy and France. German country fowl rarely suffer. Young birds are more liable to become infected than old ones. Parrots and water- fowl become attacked as weU as gallinaceous birds (domestic fowl, turkeys, guinea-fowl, partridges, peacocks, and pheasants) and pigeons. The chief cause of the large increase of the disease is the modem taste for fancy breeds, which has greatly stimulated the importation of foreign birds. Poultry shows, which have become more and more fashionable, certainly aid in the distri- bution of this malady ; because sufficiently severe prophylactic regulations are not adways applied to their management. Symptoma. — Hardly any disease is so polymorphous as croupy diphtheritic inflammation of the mucous membranes caused by bacteria. Sometimes the mucous membrane of the mouth and pharynx is attacked ; at ether times, that of the nostrils and lining membranes of the accessory cavities. The affection may be limited to the mucous membranes of the eyelids and eyeball, or it may spread from the mouth into the larynx, bronchi, and alveoli of the lungs. In other cases, the alimentary canal may be the chief seat of the malady. The skin may also become involved. These respective local mani- DIPHTHERITIC DISEASES. 135 festations may appear singly or combined. The period of incubation lasts for a few days (p. 229). I. General symptoms.— The general health, especiaUy in mature, strong animals, is but little disturbed at the commence- ment of the disease. Differing from the course of human diphthena, the local changes may be fairly weU advanced before the Illness of the patient attracts attention. We desire to lay particular stress on the fact, which has been denied by othw wnters, that the internal temperature, even when the symptoms are severe, never rises to an inordinate height, either at the beginning of the disease or during its progress. AnomaUes in the distribution of the blood, defective nutrition and emaciation with then: consequences, are to be observed during the further progress of the complaint. Thus we find that the collapsed erectile tissue on the head (comb and wattles) is dry and of varying temperature ; the superficial heat of the body is uri- equaUy distributed ; the visible mucous membranes are pale • and the feathers ruffled. The bird is off its feed ; it graduaUy ceases to lay if it is a hen; it becomes depressed in spirite and feeble; droops its wings; makes only a feeble resistance when taken hold of ; and likes to isolate itself . Before the fatal ending of the disease, the internal temperature sometimes falls. • .?*x^*'®°* «^°ws slight symptoms of brain irritation, qmckly followed by cerebral depression. 2. Croupy diphtheritic infiammoHon of the mucous membranes of the mouth and pharynx. The first symptoms, which usuaUy escape notice, are hyperaimia, and a slight swelling of the mucous membrane, which very quickly gives place to a deposit re- sembhng hoar frost in appearance. This covering, which is thm at first, perceptibly increases in thickness, generally within 24 hours, and graduaUy changes into a white, fairly even shmmg, (aseous substance of a rather tough consistence,' and very firmly adherent to its base. The thickness of thi^ deposit, which soon assumes the aspect.of a pseudo-membrane may vary from i to ij mm. Its colour graduaUy changes to dirty yeUow, and later on to brown. Its surface bSomes rough and fissured ; and its consistence, dry and brittle The bu-d IS usuaUy obUged to breathe with an open beak, the head and neck being stretched out, and inspiration and expiration are very labonous. Prehension of food and deglutition are more or less seriously impaired. The favourite seats of the attack, which is not distributed over the entire surface of the mucous membrane, are the soft and hard palate'with the cleft IS 336 INFECTIVE DISEASES. of the palate ; inferior surface of the tongue with the frxnum and tip of the tongue; inner surface of the cheeks; angles of the mouth ; and especially the neighbourhood of the superior portion of the lar3mx. From the angles of the mouth, the affection usually spreads to the sldn. When the deposit has been removed — ^which, as we have already said, can be done only with difficulty — ^there always remains a more or less deep, uneven, greatly reddened or bleeding ulcer with eroded edges. We may notice at the base of this ulcer, various fine, villous proliferations, in which case isolated vascular loops project into the plates of the exudation, the removal of which gives rise to haemorrhage. In the further progress of the disease, either the deposit becomes detached and a perfectly intact mucous membrane then becomes exposed to view, or ulcers re- sembling hard chancres, form, with probable loss of tissue and even necrosis, as for instance, that 'of the tip of the tongue. 3. Croupy diphtheritic inflammaHon of the mucous membranes of tiie nasal cavity and neighbouring cavities. At the beginning of the attack, we find in the neighbourhood of the nostrils, a serous fluid, which later on becomes dirty-yellow, greasy, and dries up, and then partly plugs up the nostrUs and nasal ducts. If we press the nasal cartilages, vre shall obtain the discharge of a fluid which is at first serous, and later on, more or less slimy, and is finaUy of a milky-purulent character. As a consequence of this discharge, the respiration becomes laborious and snuffling. The bird sneezes, by doing which, mucus is discharged, and at the same time, the patient frequently shakes its head. We find in the cleft of the palate inflammatory products, which we have already described. The process then very frequently spreads to the lining membrane of the cella infraocularis, which is more often unilaterally than bilaterally affected. Under the median angle of the eye and behmd the root of the beak, there is a protu- berance of the soft parts, which is hyperaemic and collaterally (edematous, painful to the touch, and generally hot. Pressure on it produces an abundant discharge from the nostril of that side. This swelling goes on increasing, spreads chiefly under the eyeball and towards the rear, and may finally attain the size of half a walnut At the same time, the corresponding half of the hard palate increases to at least double its width, and bulges out into the oral cavity. In its further progress, the tumour over the cella infraocularis becomes tense and firm. If opened eariy it will discharge a thick, creamy fluid, or a soft, cheesy sub- stance. Later on, the dirty-white or yellowish contents become DIPHTHERITIC DISEASES. aa/ dry and crambUng, or present the appearance of tou-'h. thin membrane or flakes lying closely together. By enormous a«n«naUit.ons of the dried-up exudate, the before-mentioned smus frequently becomes dilated to such an extent that it may attam a diameter of 2 or 3, or even 4 cm. The continuaUy- increasing pressure causes displacement of the neighbourii soft parts, espeaaUy of the eyebaU, other half of the paUte. etcTj S?f f"^"" at«>Pby with absorption, in consequencTof which the head becomes greatiy disfigured and misshapen. The bird IS of ten hardly able to open its beak, or to feed. 4. Crottpy dtphthmtic inflammatum of the mucom membranes of the larynx and trachea. Considerable exudative accumulations take place m the neighbourhood of the opening of the larynx on the mucous membrane which Unes the larynx, and on the upper part of the trachea, which can easUy be examined in birds, espeaaUy in large domestic fowl ; the resulting dyspnoea being proiH>rtionate to the degree of stenosis. The breathing IS deep and laborious ; the air being, as it were, pumped v! and the b^ » held wide open. The bird gives uttef^ce to pecuhar whisthng, singing, or wheezing noises, combined with »TL^f^' ^^^' *°d panting, and frequentiy dies of suffocation. The coughed-up matters partly accumulate in the pharynx and partly adhere to and soU the throat and breast, ^eir decomposition gives rise to the disagreeable, sickly smeU Jjich we may perceive, even when at a considerable distance from the affected birds. 5. Croupy diphtheritic inflammation of the eyes. Catarrh of the eyehds is the first symptom of this comphiint. The mitial hyperemia of the conjunctiva soon changes into a muco- purulent catarrh, the discharge of which coS at the median angle of the eye and flows away. The eyelids and their neigh- bounng parts become oedematous and hot ; and the ey«Sds have a great tendency to stick together. By forcibly pulling them open, vent is given to masses of inflammatory producte wmcn are at first of a serous and muco-purulent nature, but soon become caseous and then assume (corresponding to the form of the sac made by the eyelid and eyebaU) a^Mni-lunar or lenhciUar^shape. If the eye is left to itself. eitteJ the eyebaU becomes atrophied by the pressure of the accu- mulated discharge, or. as very often happens, the diphthaitic process spr^ to the internal parts of JhTeye and^ca,«J^ It severe destructive changes (panophthahnia). At first the disease spreads from the conjunctiva scleia.to the cornea' IS* »2» INFECTIVE DISEASES. which becomes affected by a superficial, smoky opacity, and which subsequently becomes swollen and opaque from paren- chymatous inflammation (keratitis parenchjrmatosa), in which case a firm cone of exudation of varying size often quickly forms on the thickened, and now perfectly opaque cornea, and presses the eyelids asunder. Finally, suppurative perforation of the cornea and purulent panophthalmia with subsequent destruction of the eyeball, occasionally take place. 6. InUsHnal affection dm to croufy diphtheritic inftammoHoH of the mucous membranes. This affection of the intestinal canal consists in a more or less extensive catarrhal inflam- mation and croupy diphtheritic infiltration, which, as a rule, occurs only when one of the previously described local maladies has been present for a considerable time, and usually ends the course of the disease. Ztim states that it occurs early, as an independent complaint, in ^ter-fowl and turkeys. In addition to an increase in all the general symptoms, diarrhr>a sets in ; the faeces being foetid, very thin, pappy or mucilaginous, and sometimes mixed with blood or bloody pus. Ziim states that this diarrhoea causes excessive debility, dulness, and stupor, and, when it appears in a severe form, is a forerunner of death. 7. Affection of the skin in croupy diphtheritic inflammation of the mucous membranes. The transmission of the croupy diphtheritic affection to the skin appears on the eyelids and comers of the mouth only to a small extent in the form of cutaneous ulcerations. Similar changes may also be found in the neighbourhood of the anus and on the lining membrane of the auditory meatus. Pathologioal Anatomy.— The po^ mortem examination of the usually emaciated and anaemic cadaver sometimes shows, besides the already described changes which could be demon- strated during life, accumulations of whitish-yellow secretion in the bronchi, which appear to be filled with firm, crumbling masses, whilst the parenchyma of the lungs manifest signs of atelectasis or oedema. More frequently we find simple tracheal and bronchial catarrh with more or less extensive catarrhal inflammation of the lungs. Cellular fibrinous peri- carditis, subepicardial ecchymoses and cloudy swelling of different organs, such as the liver, are by no means rare. The catarrhal inflammation of the intestinal canal is often confined to the upper and anterior parts. Ziim sometimes found the caecum and rectum completely filled with yellow, stratified DIPHTHERITIC DISEASES. tag masses which adhered firmly to the intestinal mucous membrane ; and that the intestinal mucous membrane was frequently ulcerated. All authorities are agreed on the results of the microscopical examination of the excreted matters. The soft caseous discharge from the conjunctiva consists, for the greater part, only of round cells which cannot be distinguished in any way from d^enerated leucocytes. They vary in length from 0006 to 0009 mm. and are distinguished by their great tendency to become rapidly broken up. Usually, a la^e number of bacteria, chiefly micrococci, are also present. When the inflam- naatory products are treated with a watery solution of methylene violet, the uniformly small micrococci may be seen in enormous numbers. The same result is obtained by the examination of the more recent aggregations in the mouth and pharynx, except that pavement epithelium in the exudate is more abundant in them and in the cavities of the head, bronchi, etc. The before- mentioned round cells quickly change, even in quite freshly excreted masses, into a fine granular detritus, so that the results vary according to the age of the dischaige. - Coiiwe.— The course of this croupy diphtheritic inflamma- tion of the mucous membranes is always slow, and generally chronic. It usually lasts for weeks and even months, until the affected birds succumb to the disease. Only young birds, especially pigeons, form an exception to this rule ; for they die of the disease in a short time. These facts agree with the few inoculation experiments which, up to the present, have been successful. Trinchera observed after inoculation with nasal mucus that the period of incubation was from 7 to ao days, and that the symptoms slowly increased in intensity for from 8 to 15 days. He found that strong animals recovered their health in froir «x) to 70 days. Krajewski states that the period of incubation in domestic fowl is from 4 to 10 days. According to the experiments of Babes and Puscarin, it lasts only 2 or 3 days in pigeons. Pvognoala is generally unfavourable. The comparatively hopeful cases are those of pigeons ; of acclimatised, strong, well- nourished fowl ; and of birds in which the process is limited to the pharynx. As a rule the disease is difiEicult to successfully combat, and supposed recoveries are often only apparent. Thus it happens that birds which are regarded as cured may, on being returned to their usual haunts, prove a cause of infection to their ajo INFECTIVE DISEASES. healthy companiont ; and the diaease consequently acquires an insidious character. The average mentality is from 50 to 70 per cent. Th«mp«atles. — Prophylaxis plays an important part in the croupy diphtheritic inflammation of the mucous membranes. It consists in exact examination ; maintenance of quarantine for several days' duration with every newly-bought bird ; ab- staining from exhibiting birds at those poultry shows which are not under veterinary superintendence ; carefully observing each bird ; paying attention to suspicious s3rmptoms, especiaUy nasal discharge, tears, etc. ; segregation of the affected from the healthy ; scrupulous cleanliness in coops and cages ; periodical disinfection with carbolic acid, corrosive sublimate, creolin, 13^80!, etc. ; and destruction of the lyxiies of birds which have died from the disease, and of the Hitensils that have come in contact with them. If in spite of the foregoing precautions, the disease has once broken out, its course may be favourably influenced by early treatment. Careful nursing is more efficacious than medicinal agents, among which we may mention the following disinfec- tants : carbolic acid, creosote, tar, creolin, lysol, chlorate of potash, permanganate of potash, corrosive sublimate, chloride of lime, tincture of iodine, salicylic acid, boric acid, sulphate of iron, liquor ferri perchloridi, sulphate of zinc, tannin, oil of tur- pentine, caustic potash, nitrate of silver, lactic acid, etc. These have been used either singly or in various combinations. We have found the application by a brush, of a solution of corrosive sublimate (i or 2 in 1,000), or one of creolin (i or 2 in 100), to be very effective when the disease is localised. Other practitioners have also frequently obtained good results with creolin. We can recommend the removal of the pseudo-mem- branous inflammatory products, especially in the case of pigeons, only when it can be done easily, and without causing haemorrhage. Our own experience prompts us to deprecate forcible removal and cauterisation of the base of the idcer. The tumours over the cavities of the head should be incised, their contents removed, and the frequently severe hemorrhage prevented by inserting a cotton-wool tampion saturated with liquor ferri perchlor. We have found fumigations with tar especially effective in relieving the affection of the air pa^^es. Ztim recommends internally and extemaUy a mixture of 150 grammes of a decoction of walnut leaves (15 grammes to a litre of water), with 20 grammes of DIPHTHERITIC DISEASES. »JI glycerine, 5 grammes, of chlorate of potash, and i gramme of saUcylic acid in 15 grammes of rectified spirit. Of this we may give (mce or twice daily, from a teaspoon to a tablespoonfal to large birds ; and from a quarter to half a teaspoopHl to pigeons. We should also paint the parts with this solution twice or thrice daily. For the intestinal complaint we recommend tannin or sulphate of iron (in a z t-) 2 per cent, solution or in pills made up with butter and white bread ; for pigeons 0-2 to 0-5 gramme ; fowls 0-5 to z gramme ; and geese 0-5 to 2 grammes pro do$i). Avian Ckoupy DiPHTHBRmc Inflamiiation of the Mucous Mbmbrames caused by Gkegaxines. ■tiology. — Gregarines or psorospermia, which are called coccidia when they are enclosed in a capsule, are exceedingly minute protozoa, consisting of smaU lumps of protoplasm, and possess the power of amoeboid movement in their early stage. In their further development they become encapsuled. In shape they may be cyhndrical, spherical, oval, or elliptical. They are very widely disseminated as parasites in the animal kingdom ; and are found not only on birds, but also in rabbits, rats, dogs, and even on fish, snails, and earthworms. The history of the development of these interesting parasites, which always live together in countless numbers (hence the name gregarines, «'.«., animals that live in herds), has been elucidated chiefly by Eimer and Leuckart. In their early stage they are naked inhabitants of epithelial cells. By penetrating into the cells of the mucous membrane of birds and by filling up these cells (in many cases completely, so that the enclosed gregarines assume the appear- ance of large nuclei), they produce grave disturbance of nutri- tion which tends to induce necrosis of the parts attacked. Rivolta and Silvestri were the first who traced to psorospermia (naked gregarines) an epizootic which '< roke out amongst fowls in the neighbourhood of Pisa in Z872, and which these authorities personaUy observed. Gregarinous croupy diphtheritis is distinguished by the ease with which the disease spreads from the mucous membrane of the mouth to the sldn of the head. It can be readily transmitted artificially, and in general is not difficult to cure, especially when it is confined to the mucous membrane of the mouth, pharynx, upper part of the larynx, and skin. Symptomsa — ^The clinical phenomena of avian gregarinoos aja INFECTIVE DISEASES. diphtheritis agrees in all particulars with those of bacterial diphtheritis when thiese respective complaints affect the mucous membrane of the head. Here, also, the symptoms are essentially those of croupy diphtheritis of the mucous membrane of the mouth, pharynx, air passages of the head, larynx; conjunctiva, etc., with secondary intestinal affections. Gregaiines may also give rise to primary and independent enteritis (Ziim). In gregarinous diphtheritis, the skin is much more frequently unplicated than in diphtheritis caused by bacilli. The cuta- neous affection consists of hypertrophied nodules on the skin, which are known as gregarinous epitheliomata (efithditma gregannosum of Bollinger, and are identical with the mol- luscum coHtagiosum of man). Their favourite seats are those parts of the head that are not covered with feathers : root of 'the beak, neighbourhood of the nostrils, angles of the mouth, lobes of the ear, parts adjacent to the t external auditory meatus, wattles, surface of face, edges of the eyelids, intermaxillary space, and especiaOy the comb. They sometimes spread over the feathered parts of the head, throat and neck, and may occur on the outer surface of the thighs, abdomen, under the wmgs, and in the vicinity of the cloaca. At first, these epithe- lioma.ta appear in the skin, as flat nodules, which soon become prominent, and which vary in size from a poppy seed to a millet seed. Later on, they usually attain the size of a hemp seed. TTiey are of a reddish-grey or yellowish-grey colour ; often show distinctly in their earlier stages of development a peculiar greasy nacreous lustre ; and are rather firm to the touch. Their surface soon becomes covered with a dirty-grey, yellow-brown, or red- brown crust. They are discrete and disseminated in consider- able numbers on the erectile tissues, etc. They vary in size according to their age ; and frequently lie rather close to one another, so that the affected parts look as if coarsely granulated ; or they are crowded together in such a manner as to give the appearance of laige warts with divisions through them, or of mulberry-like hypertrophies. Even single nodules, to say nothing of groups, may attain the size of a lentil, pea, cherry- stone, broad-bean, or larger object. The older they become, the rougher, and more covered with knobs will be their incrusted surface. If the edges ot the lids of the eyes be affected by these tumours, they will become nodular, swoUen and closed. The conjunctiva in this case also suffers; it projects outwards; becomes catarrhally inflamed ; assumes a yellowish cobur at DIPHTHERITIC DISEASES. 333 the seat of eraption; and its surface becomes covered with crusts. Purulent conjunctivitis may appear, and the inflam- mation may spread to the sclerotic and cornea, with keratitis and panophthahnia as the result. If, as sometimes happens with pigeons, the eruption of nodules extends over the whole of the skin of the eyeUds and its neighbourhood, the entire eye will become covered with mulberry-like proliferations of various sizes. OoiiAaa and Prognoaia.— The course nUia Candida, which grows on fresh^cow-r^ rotten wood, and thrives in uncooked cows' milk and on nutS mejumscontaamng sugar. Plant has cultivated the ?uZ?^d produced the disea^ in fowls by inoculating pure cuKo^ The ftmpis IS found m human beings (sucking babies) Sv^' foals, and espeaally in birds. It forms a mycelium whirhrnn' Tn^' T^T ^.f """'^^^' °^^ - cyKcr;wX ce£ {gomdta), and can be stained with Gram's solution. Pathog«neri«.-The settlement of the fungus on the * mucous membrane of the oral cavity depends on cerldn cLm "^^^ ": "\ ''^'l""* y^* '^'^ *""y ascSained. YouthS constitutional weakness, gastric disturbances, defective cfeaS of the mouth and feeding on milk and on food contain^ rS proportion of starch, seem to favour the growth T^t^ PARASITIC STOMATITIS. 339 Decreased power in chewing and in swallowing appears to assist the adherence of the fungus to the mucous membrane of the mouth, by the prolonged retention in the mouth of food sub- stances which are inclined to form acids. In human beings suspicion is especially directed to the mother's nulk, a portion of which may be left in the oral cavity of the baby, or may be brought mto prolonged contact with the mucous membrane of the mouth by frequent vomiting. Martin observed a case of the fungus being transmitted from a child to a fowl. Anatomy.— The local affection appears to be restricted in fowls to the mucous membrane of the oesophagus and crop. We notice first of aU, on the otherwise quite intact mucous mem- brane, smaU white spots, which become enlarged and confluent They finaUy form a white, grey, or yellow substance, which is frequently divided by clefts into compartments, and which is of a crumbling or greasy, croup-Uke consistence. If we remove this membranous deposit, we shall find that the underlying mucous membrane is reddened, or that it has undergone slightly ulcerous changes. ' The microscope shows that the described deposits on the mucous membrane are composed of cast-off pavement epithe- lium, between which the fungus penetrates in the form of fine decussating filaments, that are plaited into a dense felt. On the ends of these filaments we can recognise the formation of spores as well as free, spherical or oval, green spores. ' Symptoms.— The symptoms in fowl, with the exception of the before-mentioned anatomical changes, are not very cha- racteristic. The affected birds are depressed in spirits and become emaciated in spite of their possessing a voracious appe- tite ; the crop is distended ; a sour smell comes from the mouth • and death ensues with violent convulsions. * DUroMntial DlatfnoBla.- This stomatitis may very easily be mistaken, as often hr.ppens, for otiier inflammations of the oral mucous membrane; for croupy diphtheritic stomatitis especially m fowls ; and for aphtiious, pustular, and ulcerous stonaatitis in mammals. The essential data for correct differen- tiation can be furnished only by the microscope. Thoimpoatics.- Besides strengthening the patient with good food and by overcoming contingent gastaic distiirbances. 340 INFECTIVE DISEASES. we »hoald be most careful to cleanse the oral cavity and to keep it aseptic. Plant recommends, in particular, the painting on of a solution of corrosive sublimate (i to i,ooo), as well 3 the removal of the deposit. TETANUS. Matm*.— Tetanus is an infective disease caused by a specific bacillus. Kitasato, in 1889, isolated the tetanus bacillus which was described in 1884 by Nicol^er, and obtained a pure cultiva- tion. The tetanus of man, the tetanus of animals, and the tetanus which can be produced experimentally by inoculation with soil, are respectively caused by one and the same pathogenic organism, that is, by the bacillus of Nicolaler. Battteriology.— The tetanus bacillus, in its Spore-containing condition, forms, according to Kitasato, rods in the shape of a pin or ladle with a terminal spore 6 to 8 /* long. In its sporeless form, It consists of rods which are just the same length, are straight and rounded off at the ends, and appear singly or in groups from two to four in number. These rods possess a weak automatic power of movement and form long, slightly undulating pseudo-threads. The tetanus bacilli stain weU with the cus- tomary aniline colours, and also by Gram's method. For the spore containing bacilli, Ziehl's double staining may be used They are obligatory anaerobes and consequently grow only when au- is excluded, and better stiU in hydrogen. Cultivations thri\e m sUghtly alkaline, pepton-containing gelatine, agar-agar and broth. An addition of grape sugar (2 per cent.) or sulph- mdigotate of soda (i per miUe) accelerates their growth. The cultivations are characterised by theu- empyreumatic smeU. The smgle colomes have a certain similarity with cultivations of hay bacillus. A dense centre is surrounded by a fine, uniform wreath of rays. The gelatine slowly liquefies with formation of gas. ^Tetanus bacilli thrive best in a temperature of from 36° to 38° C. Their growth stops at a temperature lower than 14" C At the temperature of the blood, spores form in 30 hours ; and with one of from 20° to 25° C, in not less than a week. The resistance of tetanus baciUi, especiaUy in the spore form, is very great. Thus, for instance, the action of a 5 per cent! TETANUS. S4t solation of carbolic add continued for lo hours, has no effect on the spores (Kitasato). Dried spore-containing tetanus-pus retains its virulence for over i6 months (Kitt). Clams used for castration may remain capable of transmitting the virus of tetanus to horses for eighteen months, evsn after they have been placed for 5 minutes in boiling water, or in a 4 per cent, carbolic solution (Nocard). On the other hand, the spores are killed by being exposed to a temperature of 100° C. for from 2 to 5 niinutes in a steam sterilizing apparatus. According to Tizzoni and Cattani, mineral and organic acids, even when con- centrated to the highest degree, produce no effect whatever on the spores. The spores in the cultivations are^ however, killed by a I per cent, solution of nitrate of silver in one minute ; by a one-tenth per cent, of the same agent in 5 minutes ; by a i per cent, solution of corrosive sublimate in 25 minutes ; by a 5 per cent, solution of creolin in 5 minutes ; by a i per cent; solution of permanganate of potash in 10 minutes ; by a 5 per cent, solution of embolic acid mixed with | per cent, of hydrochloric acid, in 25 minutes ; and by a solution of iodine in 6 minutes. Chlorine, chlorinated lime and tar possesses a destructive action on the spores, which, however, resist putrefaction for a long time. Iodine trichloride seems to possess a particularly strong anti- septic effect on the tetanus spores (Behring). The spores are exceedingly resistant to the digestive fluids, especially to the gastric juice. Sormani states that they may grow and increase even in the intestine. [Caiottgeau (Cad^ac's EncyclopMie VMrinaire) tells us that in a state ol nature, the microbes of tetanus exist in the form of spores which do not manufacture any poison. But if they are introduced into the animal tissues under certain favourable conditions, they go through a form of development and subsequently secrete their toxi&s, with the result of setting up this disease. If these spores are inoculated by them- selves into healthy tissue, they are unable to produce their toxins for the time being, and wiU in aU probabiUty be destroyed by the leucocytes. Some of them may, however, remain aUve though inactive for even 3 months or more, and, under conditions favourable to their development, they may subsequently become virulent and produce tetanus. Hence the fact that occasionally the period of incubation is unusually long. The conditions in question appear to be those irtiich diminish the resistance of the tissues, by repelling the protective leucocytes ; one of tlM chief of these conditions being the presence of certain common microbes which produce pus, and consequently favour the development of the micro-organisms of tetanus. Suppurating wounds are therefore particularly j^ood breeding grounds for the bacilli of this disease. Injury and the presence of foreign bodies also act favourably in the same 16 H» INFECTIVE DISEASES. •Ungw wiO then be of tetiai«._TiL] *^ '*"' ^^ '*" h.JElf^?!^*^""^''^*?*" ****^'" °' malignant oedema, the UaUus of tetanus » an ubiquitous bacterium. Numerou^ in- SSf ^n ST^r** ^'"'^ P~^*^ *^* »* «»«" everywhere in gnlen mou^d and is not restricted to any geographical limit T^ mocuktion of garden mould from BerhnfcSttLgS^ ^ found to produce tetanus of a uniform t^. Mould ri^hT SZiK'TT!' fP^'^^y horse-dung, forms a particukrly favomable abode for tetanus badUi. which are. on thVT^xount! ^^ \r^*"** °J t**^'**- ^^^'^^'^ *°d Veillon found them even m the dung of healthy horses and cattle ; and Sormani d«covered them in the faeces of dog,, rabbits. giiinea-pS^ mjce. and from these bacilli produced, by inoculation, tetenus in SL^nn' ?*'^r*»°°**>'««P^«»<»t frequently by the pene- ^bon of e«th-containing bacteria into wounds. (W- quently. so-caUed traumatic tetanus is the ordinary form of the disease The most frequent causes of tetanus aJe wounds from splinters of wood or gravel soUed with earth ; injuries of «L.S! ^•,^"*'?"i*''°*''**°**S**^*"<*°»^; tread withsub- sequent soihng by dung, excrement or earth ; contused wounds w™,^H, 'T "1*=*'°*^'=* ^th street dust; and operation wounds. ^peaaUy those of castration, performed without anti- w^fnH; >l f "^^^ also be set up by infectious secretions of wounds either by direct contact, or indirectly, by instruments to which such secretions may adhere ; or by the falling of tetanu^ spores m the form of dust, on wounds. It has been clearly demonstrated that the dust of hay may be the bearer of tetam^ baolh. Evidently there are many other intermediate bearers It has not yet been decided with certainty whether infection may take place through the intestines. ^ bJ^^ZJ^ ^'^*^!T^ ^^ ■«°' "^'^ «»« o* t*'*-™ which had cTnt^^^ «*"''^.'^ ^ ^»^ "^t had been exercised onT^e *S SL^T^'^t J*«/ding-track had at that time been laid dow^ Zt S^^""*. Z^''^ ^ '^ °^^^ fr*"" »«^P» that had teougl? • « ^ ^^^^IJ"""* from Australia to Calcutta, ^d which conS Si. ^Jt! T^' * P*~*^ »"PP'y °* °W '^- ConsequenUy <*«<>«>uwuoii oi ue oiseue. The obvious lesson is that whon ■n..h ««Hre is appli^ to gn>und on which horses^e to ^Ix^ "2 iactove objecte diould m &r as pouible be removed torn ^!^] TETANUS. 343 The views fonnerly held concerning the action of tetanus bacilli on the animal body were erroneous. It has now been proved that tetanus bacilli can alone, and not necessarily asso- ciated with the bacteria of putrefaction, of pus, etc., cause tetanus. The tetanus bacilli are however distinguished from most bacteria, particularly from those of septicxmia, by the fact that they do not penetrate into the blood and tissues of the body, but remain in the site of infection, from whence they poison the body by their products of metabolism (toxins and ptomaines). Tetanus is therefore a toxic infective disease, in which a sta- tionary vegetation of bacteria leads to a general intoxication of the body. This circumstance explains the observed fact that inoculation with the blood of animals suffering from tetanus always gives negative results, whilst inoculation with the bac- teria-containing pus of the infected part produces positive results. The local colony of tetanus bacilli forms, during vegetation, chemical products (toxins and ptomaines) which have an action similar to that of strychnine, and which poison the body from the focus of infection. Brieger has demonstrated the existence, in tetanus cultures, of four strychnine-like toxins, namely, te tanin, tetanotoxin, spasmotoxin, and a hydrochloric add toxin These toxins are rendered ineffective by the gastric juice, intes tinal epithelium, by many chemical agents, such as perman ganate of potash, and by a temperature of 150' C. (Feimi). They are to be found in very great quantities in the tetanised muscles, in the blood and urine (Courmont), and in the milic (Brieger). Tetanotoxalbumin has lately been mentioned as the most important toxin. The possibility of the transmission of tetanus from one animal to another, was demonstrated for the first time by the experiments of Carle and Rattoni in 1884. Recently, Kitt was the first to transmit pure cultivations to horses, sheep and dogs with the result of a typical tetanic affection. OoouTMnoe.— Tetan'is occurs in all domestic mamm^iiiff but most frequently in horses, asses, and mules ; next to them, in the smaller ruminants (sheep and goats) ; and most rarely in dogs and birds. In the tropics and other hot climates, cases of tetanus including those of man are decidedly more numerous than in colder regions. For instance, Wagenfeld states that tetanus is so frequent in St. Domingo that a gelding costs twice as much as a stallion. In general, however, tetanus is a rare disease. In the Prussian army there is on an average only one i6» S44 INFECTIVE DISEASES. CAM of tetantit in z.ooo tick hones. For instance, 33 cases of tetanns occurred in 1890 among 36,000 sick hwies. Within the last 7 years, only 270 horses (40 per annum) were attacked by tetanus in the Prussian army. According to Hering, z case of tetanus occurred in 3,000 cases of disease amongst the cavalry horses of Wiirttemberg. Sometimes the disease breaks out with •orprising frequency, indeed epixootically, among sheep and horses. ROll and others have called attention to the fact that in veterinary hospitals tetanus is often not seen for months, or only very rarely in single instances ; but that at other times, a, 3 or more cases are brought in together. The occurrence of these temporary and local enzootics is explained by the in- fectious nature of the disease. Although a direct transmission of tetanus from diseased to healthy animals does not occur, it is nevertheless possible that a horse suffering from tetanus may infect the stable floor for a long time, ko that the bacilli of tetanus may get from the floor into accidental wounds of healthy hones. Mestre saw 3 successive cases of tetanus in 3 horses which had occupied the same place in a stable. Horses of high breed and strong constitution seem more susceptible to tetanus than underbred and less vigorous animals. A horse seldom gets tetanus twice (immunity). Nevertheless some horses have suffered from tetanus 2 or 3 times within a year. Among cattle, tetanus most frequently attacks cows and calves; among sheep, lambs; and among goats, bucks. Fowl are supposed to be immune. Tartettos of Totaaas.— Formerly 3 kinds of tetanus were recognised, namely, traumatic, rheumatic, and toxic tetanus. According to recent investigations we must reject the theory of the existence of rheumatic tetanus ; for cold, like in other diseases, appears to play only the part of a predisposing agent. Traumatic or infectious tetanus is the ordinary kind. Al- though experience teaches that any injury may be followed by tetanus; this disease develops by preference in contused and lacerated wounds, gun-shot wounds, punctures in which the. foreign body remains, injuries of the nerves, tendons and fascia, wounds of the extremities in particular, and especially injuries of the feet of horses, contusions of the paws of dogs, and small and insignificant wounds. In horses, the chief sites of infection are wounds from gathered nails and pricks in shoeing ; and to ; leaser extent, wounds from tread, corns after having been cut TETANUS. US out, sappurating land-cracki, and especially injuries to the sen- sitive sole. This predisposition of injuries of the hoof ia ex* plained by the theory of the wound booming infected by dung. Spinola, very long ago, laid stress upon the danger of tetanus from infected wounds. It is probable that injuries of the hoof are much more frequently the cause of tetanus in horses than is usually supposed. Hartmann, for instance, showed that all the nine horses which were infected by tetanus in the course of several years at Dresden were found, on exact examination, to have suffered from haemorrhagic pricks in shoeing, or injurious pressure from nails driven too " close." The fact is important that tetanus may occur even in wounds already healed and after the formation of a cicatrix (scar tetanus). Among other injuries conducive to tetanus are : saddle and harness galls, fracture of the vertebrs, fracture of the skull, bums, lacerations of the skin during petechial fever, penetration of foreign bodies into carious teeth, etc. Tetanus may be observed after certain operations, especially castration. It has been proved by experience that nearly all the buck-goats which are castrated by certain methods, esped* ally the ones by which the scrotum is opened with the knife, die of tetanus. For this reason, castration is now performed by ligaturing the entire scrotum, by including it between clams, or by the subcutaneous ligature of the spermatic cord. Although tetanus in rams may occur independently of castration ; in some years it appears enzootically or even epizootically as a conse- quence of that oi>eration. Tetanus is liable to occur after the castration of bull-calves, especially when the scrotum has been ligatiired, or when the spermatic cord has been subcutaneously Ugatured. Besides castration, other operations — such as in- serting a setcm, appljring a dam in cases of hernia, docking, nicking, pyro-puncture, subcutaneous injections, etc. — ^may be followed by tetanus, which, in such cases, was more common formerly than at present. The disease occasionally occurs in sheep after inoculation against variola and after the introduction of hellebore root into the nostrils. Since the introduction of antiseptics in operations, cases of tetanus have become rarer than they were ; which fact is a fmther proof of the infections nature of the disease. Internal wounds as well as external ones are frequently the cause of tetanus. Thus, cases of tetanus are not very rare in cattle aftet parturition or after abortion. It appears that, the majority of cases of tetanus in cattle are caused during parturi* ufi INFECTIVE DISEASES. tion by injuries to the uterus and vagina, difficult births, and putrescent decomposition of the , after-birth, etc. Guibert is doubtless correct in saying that in cows, as in women, the ob- stetnaan is sometimes the vehicle by which tetanus is trans- nutted from a diseased patient to a healthy one. Lesions of the mtestinal mucous membrane, such as intestinal ulcers (Hering) may form the starting point of the disease. In newly-born animals, especiaUy in foals and lambs, the open wound at the navel may be the gate by which the infection of tetanus enters the body. In such cases, this disease may occur in lambs enzooticaUy and epizootically (Taanus neona- torum, and tetanus agnorum). Tetanus is also frequent amonii older foals. * It has been stated that tetanus can appear without any provable solution of continuity, as for instance by concussion falls, etc. It IS probable uiat in these cases the infection takes place through an injury which has been overlooked. Pttriod of Inoubation.— The time tetanus takes to appear alter an mjury varies very much, being usuaUy a few days. The shortest period on record for traumatic tetanus is 6 hours ; the tongest, 6 weeks. The time after parturition is, on an average from 5 to 8 days ; although it may vary from a few days to several weeks. In horses the period of incubation after inocula- tion is 4 or 5 days; and in sheep. 2 to 4 days ^Schiitz). OaasionaUy tetanus develops in spite of the wound having been freated antiseptically. The average period of incubation in horses may be taken as varying from 4 to 20 days. .»~i?^ **Jff'" •*** **« <=*«»« •>»<»» freqnenUy in poisoning oy nS^n": T^t " fr''?»"»'*»y ^'^'ved in dogs. Br«dn, nicltine. KS f'«^"'' «»««">. e'gotiM. and other alkaloids also produce a S^! l^l- ?^ *•*" ^^^^ °' tetanotoxalbumins ;^d other r»nS!!!l^*t*lw**^"' *«=°''l'n8 to t»»e oW view, developed after a I^Sll^ * *? the skin, especially after sweating, by draughts of air. cold ' patient has takea a chdl. In other cases there is a longer interval. For ^^' "T" 1^"^ ""* •»' ''^'^^ t***"™ 8 day» after a cold bronght on by a shower. In young animaU, as in lambs, cold is often S^rSnT" " ""l«P«^^<»«»« of tetanus. Blame has often bttn laid !^^ " •**"" *"•* *^^ ''^^^ "^ »*t«»««J on W«h and open ground ; exposure when grazing during rainy wither : and chiU afur TETANUS. 247 washing the body. The existence of rheumatic tetanus has not been proved by exact investigaUons. In a case of Aeumatic tetanus in man Carbonne and Perreio found tetanus bacilU in the bronchial mucus. Oenenl Symptoma of Tetanus.— The tetanic spasm begins usuaUy in the muscles of the neck and head, and spreads from thence to the throat, trunk, and extremities (descending tetanus) ; but may appear first in the hind-quarters and extend forwards (ascending tetanus). In the former case, the symptoms commence with a stiff, stretched-out carriage of th head, and with spasms of the muscles of mastication. In the . ter, with stiffness of the hind limbs and spasms of the tsdl muscles. The first symptoms are sometimes obscure, and may consequently be overlooked for several days. The disease may, however, break out suddenly with extensive tonic spasms. The spasms frequently b^in near the site of the injury. The groups of muscles which become attacked by the spasms are as follows :— 1. The muscles of mastication. — ^The tonic contraction of these muscles is called trismus, or lockjaw. According to the degree of the spasm, the lower jaw remains in more or less close contact with the upper jaw, and consequently prehension of food and mastication are either rendered very difficult, or are entirely stopped. 2. The other muscles of the head are spasmodically contracted in different d^;rees. The spasm of the muscles of the ears causes the ears to be " pricked " and their tips drawn together ; spasm of the recti muscles of the eyes induces retraction of the eyes into the orbit, with protrusion of the nictitating membrane ; spasm of the muscles of the nose produces dilatation of the nostrils ; and contraction of the dilators of the upper lip gives an abnormal shape to the opening of the mouth. The muscles of the tongue, of the swaUowing apparatus, of deglutition, and of the larynx, are also attacked by spasm. 3. The contraction of the extensor muscles of tht neck causes a stiff, stretched-out carriage of the head and " ewe neck." The muscles of the neck become hard and tense to the touch. 4. Spasm of the extensor muscles of the back manifests itself by an extremely hard condition of the muscles of the back, loins, and croup. Either the neck is stretched out and the back and croup are carried horizontally (orthotonus), or, what is more frequently the case, the neck is " ewed " (head raised and drawn back) and the vertebral column slightly depressed (opisthotonus). A lateral curvature of the cervical vertebrae (i^eurothotonus) is not so often seen as the previously mentioned conditions ; and 348 INFECTIVE DISEASES. !ll'°°^'' f^»*"« of,tl»« vertebra {emprosthotonus) is rarest of a «*«Sf* r ' *^Pf"f"y •" ho«es,> raised and frequentiy forms a straight line with the back. n jr «« -«,iL^^*^™..°* ?*. '"'"^ "^ '** ^•'«*« ™akes the animal .^?IJ° ^^V*"*** "* ^'^'^^ **^« *°« and hind legs are stiffly sketched out lateraUy. and respectively, to the fr^t and r^, ^r^"^^ "' ^^«^««^<=^b« bent only with difficulty! 6. The contraction of the muscles which compress the abdomen g.v«, the ammal a tucked-up or " herring-gutted " appear^ diffiLt ^^^^^ '"'"^ "' inspiration renders respiration . Bf id^ these spasms, the animals show, in various degrees S* '^1 """^^^^y *"^ »'^*«*«^ ''^* »mV«W/i^y. Thich mamfest themselves m excitement, ^dity. and exacerbations of tte muscular spasms ; although the amount of the irritation may be very shght. Thus, for instance, a loud noise, as the banging of a door, may cause the animal to faU down " all of a rSS'»ni^ V^ T ?^°*'*"y ^^ ™""^' *Wch. in severe tSth*?u S^^^T**'^*^ >" ^"y ^''"'^^t ^d is diffused over the whole body. In other and especiaUy in slight cases sweat may be absent. UsuaUy the internal temperature is but little if at all mcreased. Only in fatal cases is the elevation of tempera, ture constant, though often it is very high (42° or even 43° Q. i« »S^ L* '^'"^ *^' ^^°'^ ^^*b- This high tempSatuii usuaUy contmues some time after death and may then rise to £„. ' Z ''"'^ '"°"- ^" * ^°'^' 24 hours before death. h^^^Z^f t ^^'"P^™*^ o« 39 2° C. ; one and a half hours before death 412° C. ; at the moment of death. 44° C^ and 50 minutes after death. 454° C. The frequency Vf the pulse is not increased at the commencement of the affection. In Jight cases the pulse may remain normal, which it generaUy does, with only a trifling increase in frequency, un^ severi exacerbations set m. In many cases, the rate of the pulse rises only during the last few days, and may then be from 70 to 90 beats ^^ minute in the horse. The frequency of the t^^r^'^Ju'^u ~°*'''"* recumbent, is much greater than* that of those which keep on their legs. The pulse is of ten hard and smaU. and the waU of the artery spasmodically tense. In many cases the pulse is full. soft, and easUy compres^ble Increase in the rate of breathing is shown generaUy at the com- mencement of the disease, and may become very high when the •pasms spread to the muscles of the chest and abdomen. The TETANUS. 249 rate of respiration varies greatly according to the excited condi* tion of the animal. As a rule, it graduaUy increases in cases which end fatally. It may amount to four times its normal standard, without the frequency of the pulse being increased to any marked extent. When the affection is at its height, the number of respirations in horses rises sometimes to from 80 to 100 a minute. Respiration is usually more or less shallow, on account of the fixed condition of the ribs, and the restriction to the movements of the diaphragm in consequence of the spasm of the muscles which compress the abdomen. We may also notice c3ranosis and catarrh of the nas^ mucous mem- brane, coughing, laryngeal, tracheal and bronchial rhonchi ; and in fatal cases, symptoms of hyperaemia of the lungs, oedema of the lungs, hypostatic inflammation of the lungs, and often pneu- monia caused by foreign bodies. The first indication of the participation of the digestive apparatus in this disease, is afforded by its action on the prehen- sion of food, which is difficult or even impossible, although the appetite may be unimpaired. Some patients can eat compara- tively easOy ; others, only with much trouble and after great exertion, can manage to consume a portion of their food, which frequently accumulates in the oral cavity, and becomes putrid or falls out. Considerable salivation is present. The slight movements of mastication, especially in horses, are accompanied by squashing sounds and smacking of the lips. The animal can {^neraUy partake of sloppy food easier than dry. Regurgita- tion is very conunon iu consequence of spasm of the pharyngeal muscles. The patients are always fond of playing with the drink placed before them, and make frequent, although very often futile attempts to satisfy their thirst, which increases during the course of the disease. As a rule, the peristaltic action of the bowels is somewhat sup- pressed, and defecation is alwajrs ddayed on account of the rigid contraction of the muscles which compress the abdomen. Mic- turition becomes less frequent and more difficult, even to com- plete retention of urine, in consequence of which the bladder becomes excessively dilated (spasm of the sphincter vesicae). The urine has generally a rather high specific gravity and some- times contains albumen. Its reaction is usually not changed. Frequently occurring and long continued priapism may be noticed in stallions, and even in geldings. Consciousness is perfectly preserved with all animals close up to death ; although the feeling of terror is usually mani* 350 INFECTIVE DISEASES. fested in a very unmistakable manner. The state of the infected animals arouses in the ppectator. and especiaUy in the surgeon who treats them, deep compassion for their helpless condition. '^ Tbtamds in Particular Kinds of Dombstic Animals. th.^!l ""!?^ ^ ?• fnUy-devdoped stages of the disease, stands with the head nused and the neck stiffly stretched out, and sometimes " ewed " especiaUy m foals. As we have already said, the ears are stiffly pricked aiid ri^!!r*^ !?*," V^^' '«*'i»^K « of the ears of hares ; the nostrils are ngid aiid ddatedmto the form of trumpets ; ihe eyes are sunken : the mctiutmg membrane protudes; the pupils are dilated ; the veins of the head are tense and prominent ; foam and saUva run from the mouth • the ^w ^'.*°'* '""*"y ""^^ " ""'« ^° °'"' «<*•• To enlarge the area h!,^^'.? fP;"*' *»>•»«»'>»» ««onies the tresUe atUtude (spread, b^v^n r^H t '^•^.''ot.^ge it. on at most, now and then rocto^ body to and fro on his stiff legs. The appearance of the face betraw Sf .SJ:^''^ "^^ ««"«»«>'• S*-«»» g'ooP' of the muscl«^Sj the masseter and cervical muscles, are remarkably drv vm^n^t sh^defined. a. if they had been chiseUed out, ^^d LStlyTa m" e of excwBive tension. Sweat may be seen on several parts of the bodv «p^y at the base of the ears, sides of the neck and'^t? aid JaS£' n^^atiinr'"?^."^- R«Pi«tion U difficult and accelerated! 11 we approach the ammal we cannot faU to note the anxiety and terror which It evinc« on being touched, and especially if its head be handlS. ^ wmgs of the nostrils, external muscles of masOcation, and muscles Of at, neck. back, loins, croup and tail, are tense and as hard as a board t S! .V?**-., " " ^i^' *" *''•' "»• P**"*"* respectively a.,^ ^ the tail and ears, which resume it more or less rapidlyon the restraia^ ^JIT"^ "^ '^ ^"" ""•«"» membranes^^of Uie head^p^ congested. The jaws are firmly closed and cannot be forced open. When tortUspurpose, the fingers are introduced between the bars of the mouth.' S ^ ^**''"*!!?*' "* tenacious mucus, or turbid, whey-like fcetid S^ hlf*^ " "^ ^th particles of food, flows from the i«,uth. On £!,i!^. * "^' "** ^"^ ^^"^ ^"« to iU full extent, so that it the antaal out of its staU. the movement to the rear is accomptohed oSSy wiO. t^e greatest difficulty or not at aU. The horse turns with extreme Md ra»es h« legs, which he uses Uke stUts. The g,Ut, whii mLy graduaUy improve a littie, is exceedingly stiff and straddling ^ mJ^ ?**"• *•»« »yn»Pto«n8 of tetanus are frequently modified by the d»e«e being comphcated with acute or chronic wptic eidometritis. '^^Se animals assume, with outstretched limbs, the tr«itle-Uke. rigid attitude J«ady described. The head and neck are stretched out ; Se ^^ ?if ^^?T'"' backwards, upwards and outwards ; the exprcSSn^ ^li^ ".K •™^. "'. •^*»» ' »»»• 'y* •" deeply retiact^fntTth^ ^t ,^ '.h "l^r^ membrane, a. in tiie hoii. covers the gr^t« ^.i-"/'^**?' "P'*^^ **»•" *^« head is nused; the mu%^ Z •omstime. dry and wann ; and the mucous membrane of the mo^ to TETANUS. »Si hot, and secretes quantities of tongh foetid mucus. The lips are some* what drawn back ; the mouth is spasmodically closed ; the lower jaw is firmly fixed to the upper one ; the muscles of mastication are tense and hard as a board ; the tongue possesses little mobility, is hard and some- times firmly fixed between the jaws ; the muscles of the throat, back and extremities are hard to the touch ; the spinal column is sometimes arched (emprosthotonus) ; and the abdominal walls are at times drawn in laterally in a peculiar manner, so that they form a flat surface down- wards, from the ends of the transverse processes of the lumbar vertebrae. Great difficulty in breathing is met with only towards the termination of the disease. In consequence of the suppression of the movements of the paunch, tympany of the left flank frequently appears in a few days. Defecation and micturition are delayed. The locomotary movements are stiff, awkward, and often entirely suppressed. The hocks are some* times rotated outwards, and the tail raised. Reflex irritability is usually less altered than in the horse. In aheap thehind-legs, and, later on, the fore-legs, are stiffly stretched out, so that the animal generally rests immovable as if on four stilts. The tail is igid, carried straight out, and is frequently deflected somewhat sideways. The neck is stiff and " ewed," and the jaws closed. Later on, the animal drops down and lies with its legs extended straight out, the neck being drawn backwards, on which account respiration is rendered excessively difficult. In other particulars, the symptoms of the disease agree with those in horses and cattle. From existing literature it is difficult to obtain an exact description of tetanus in lambs ; for tetanus in them has frequently been mistaken for other diseases, especially pysemic polyarthritis. The symptoms of tetanus in foats are the same in every respect as those in sheep. General tetanus appears to occur very rarely in do^ M611er found among 50,000 diseased dogs, only 2 cases of general tetanus. We our- selves failed to discover a single case amongst 70,000. Partial tetanm in the form of trismus seems to occur sometimes in puppies. Recent inoculation experiments prove that dogs are not absolutely immune to tetanus, as was formerly supposed. The symptoms of general tetanus consist in a stiff, stilty gait ; extended attitude of the head ; ^evation of the Beck ; the ears are stiffly pricked, and sometimes laid back ; staring, anxious expression of face ; protrusion of the nictitating membrane ; corrugation of the sldn of the forehead ; trismus, which renders the patient incapable of barking ; extension of the muscles of the neck (" ewe neck ") ; stretched-out and stilty attitude of the legs ; orthotonus ; opisthotonus ; erection of the taU ; excessively increased reflex irrita- bility, especially on being suddenly touched ; etc. In pl|[* the symptoms of tetanus are essentially the same as in other The tonic spasm usually begins in the muscles of mastication and spreads rapid' y, as a rule, over the entire body (trismus, orthotonus, and emprosthotonus). In birds, Dreymann has described one case, namely, that of a turkey. The gait was stiff, the head and neck were extended, and the entire muscular system was stiff and hard. The beak could be opened only with difficulty, and finally became firmly closed. The wings lay close to the body. The membrua nictitans was protruded, and dyspnoea was present. as* INFECTIVE DISEASES. Pathologtoal Anatomy.-The results of a post mortem examination of a case of tetanus are usuaUy negative. Sinular to what IS the case in narcotic poisoning, there are no charac- teristic anatonucal changes. Any changes that may be found are only secondary, or are set up by accidental complications. Thus we may sometimes find in the spinal cord, haemorrhages softening, accumulation of serum, hypersemia, oedema, Ttc, which changes, however, may be entirely absent, or only se- condary and are frequently tranmatic. We may find in the course of the nerves which proceed from the wounded parts in some places, a pink injection of the nerve sheaths, very minute haemorrhages, and swelling or softening of the nerve fasciculi {neuntts ascendens). On account of impeded oxygenation, the blood is usually of a dark-red colour, tarry and greasy appear- ance, is greatly discoloured, and is imperfectly coagulated. It contams free haemoglobin, and is inclined to escape from its vessels and to become absorbed into the surrounding tissues. we may observe numerous extensive ecchymoses, and large samous and gelatinous extraversations. especiaUy under the serous and mucous membranes. The lungs are generally hyper- amic or cedematous. and hajmorrhagic infarcts, splenisations, hypostatic pneumonia, lobular, gangrenous pneumonia, and vesicular and interstitial emphysema, may also be present in some parts. In the heart we find epicardial and endocardial haemorrhages, particularly along the furrows of the blood-vessels and over the papillary muscles, and fatty degeneration of the myocardium. Rigor mortis, which is generaUy highly deve- loped, appears rapidly in the muscles, which may be in a normal condition, or may be of a dull, dark-red colour, and infiltrated with haanorrhages. On other occasions it is bluish-brown, or yellow-brown, and soft as if boiled. In the muscles, we can sometimes find, by the microscope, a granular cloudy swelling with loss of transverse striation and spUtting up of the muscular fibres m layers. The liver is usually enlarged and is frequently erf a yeUow or yellow-grey colour (fatty degeneration and infii- taation). The spleen is swollen, gorged with blood, and flabby The bladder is usuaUy considerably distended by the accumu- lated urine, and its mucous membrane is often infiltrated with haemorrhages. Ecchymoses are not uncommonly met with on the mucous membrane of the intestines. Prognosis.— The prognosis of tetanus is usually very unfavourable. The mortality amounts in sheep and pigs almost TETANUS, »S3 to 100 per cent. ; in horses from 75 to 85 per cent. ; and in cattle from 70 to 80 per cent. In dogs it is comparatively smaU. Out of 270 horses which were treated for tetanus during the years 1887-1893 in the Prussian army, 203 died. In newly- born animals the disease is usually fatal, especially in lambs In catUe, the prognosis of a case of tetanus following parturition IS less hopeful than of one of ordinary tetanus. The chief un- favourable symptoms are : early and excessive trismus (horses m which trismus is not foUowed by general tetanus mostly recover) ; rapid spreading of the spasms over the entire mus- cular system; excessive dyspnoea; rapid and considerable mcrease m the rate of the pulse and in the height of the tem- perature ; falling down ; profuse sweating, etc. The fact of the disease running a protracted course is favourable. With horses we may hope for recovery when the patient lives beyond the fifteenth day of the disease. Srhindelka observed 4 cases of tetanus in which a com plication with influenza had a peculiarly favourable influence. In all 4 cases the muscular rigidity abated simultaneously with the commencement of the first feverish symptoms, and recovery followed. Bassi states that a similar effect was pro- duced by parturition in a mare. Couw*.— The course of tetanus is variable. In horses, it is frequently very brief, and then ends fatally in i, 2, or 3 days. Recovery in rapidly developed cases has never been observed. The animal exhibits at an early period of the disease, excessive trismus, spasms over the whole body, dyspnoea, greatly increased reflex irritability, profuse sweating,' considerable acceleration of the pulse, and increase of tempera- ture. If the horse falls down, it will die as a rule very quickly. UsuaUy death takes place in about a week's time. A fatai course of tetanus may run for a or 3 weeks, or even more, if the spasms are slight and more or less local, or when, after a cure, complications, such as pneumonia due to a foreign body, set in. Thus, Kohne had a case of a horse which died from ex- haustion and cavities in the lungs on the fifty-seventh day. Recoveries rarely take place earlier than 3 weeks, about which time the spasms usually abate in a gradual manner ; the appetite improves ; respiration becomes more tranquil ; the movements become freer ; and the animal becomes convales- cent in 5 or 6 weeks ; although stiffness of gait and consi- d^ble tension of the muscles of the spine may persist for a aS4 INFECTIVE DISEASES. much longer period. Convalescence is generally prolonged for some months. In cattle the coarse is less rapid than in horses. The spasms take longer to become developed, and are not, as a rule, so intense. In exceptional instances, even lo days or a fortnight may pass before complete trismus sets in. Acute cases which end fatally in a few days may also occur in cattle. Recovery does not take place in less than a fortnight. Contrary to what we find in horses, the disease seldom lasts longer than 3 weeks. In sheep, death generally occurs in about a week ; and in acute cases, which are not rare, in 2 or 3 days. The course of the disease may be equally rapid in dogs, especially in cases of traumatic tetanus ; but in other cases it may end fataUy in from 6 to 10 days. Un(der favourable circumstances, recovery, as a rule, takes place in 12 or 14 days. IMfferential DIagnosia.— Tetanus may be mistaken for a number of diseases, as for instance, cerebro-spinal meningitis, rheumatism, eclampsia, catalepsy, rabies, convulsions in aewly- bom animals, and pyaemic polyarthritis in lambs and foals. The differentiation, as a rule, is not difficult. The continued tonic spasms of the different groups of muscles, the perfectly preserved consciousness, the absence, at first, of fever, and the characteristic aspect, render diagnosis easy. It may, however, be difficult to distinguish infectious tetanus from poisoning by strychnine. The extreme rarity of infectious tetanus in dogs, the suddenness of the attack, the rapidity of the course, and the greatly increased reflex irritability in strychnine poisoning, are valuable diagnostic facts. Thcmpeutios. — Our own experience and that of many others teaches us that in the treatment of tetanus the administration of medicine is of much less use than careful nursing, of which the most important points are appropriate dieting and the avoid- ance, as much as possible, of excitement from external causes of irritation. We should place the patient in a quiet, dark, and sufficiently large stall or loose box, and well bedded-down, in view of the possibility of his falling on the ground all of a heap. If the straw used for litter be too long, it should be cut in two, so that the patient may not catch his feet in it and fall down. Horses should, if possible, be placed in slings, which we, con- trary to the experience of other observers, have always found TETANUS. »Si useful, when we have been able to use them. The excitability of the animal, which is perhaps at first somewhat increased by the employment of slings, soon abates. The great advantage of sUngs lies in the fact that they safeguard the patient from unexpectedly falling down, especially during the night, and thus obviate the possibiUty of prolonged continuation of the recum- bent position, which is always followed by very severe exacerba- tions of the disease. Feeding is a very important question. If dry food cannot be eaten, we should place before the animal, if possible, green meat, sloppy food, such as gruel, and above all things, fresh water. The food should be given frequently, and in small quantities at a time, so that it may not become spoUed, which slops, gruel and bran mashes, very soon become. When perspiration is excessive, the clothing should be frequently changed. Dressing the coat, which is approved of by many, should be avoided, on account of the excitement it causes to the patient. If retention of faeces and urine persists, we should, in the larger animals, back-rake the patient from time to time, and should apply slight pressure on the bladder with the hand. We may use the catheter in females ; and enemas with the smaller *"inials. As regards medicinal remedies, we may exhibit narcotics tentatively, as for instance, enemas of chloral hydrate, 50 to 100 grammes or more, pro die, in two or more doses, or, say, 10 grammes every hour, in thin mucUage for horses ; subcutaneous injections of morphia ( j^ gramme of the hydrochlorate for horses) • inhalations of chloroform; injections of ether into the rectum (25 to 50 grammes pro dosi). Medicines should not be adminis- tered per OS on account of the danger of trismus being set up and of the liability of the drench or baU going the " wrong In cases of traumatic tetanus, it is of the utmost importance to apply as soon as possible appropriate treatment to the wound by disinfecting it, removing from it penetrating foreign bodies, excismg or cauterising the infected part, or even performing amputation. Animals can be undoubtedly saved by this local treatment, if it be early employed and if it be practicable We must, however, remember that an exact examination and special treatment of the wounds in the larger animals may be attended by considerable difficulty. With injuries of the feet of horses. It IS frequently nearly impossible to raise the leg off the ground without mcurring the risk of causing the animal to faU down If, m such a case, the condition of the wound urgenUy requires a 356 INFECTIVE DISEASES. local treatment, nothing is left to us but to place the horse under the influence of chloroform, by the aid of which we may perform the necessary operation. We have not sufficient data at present to pass a final judgment on the value of neurotomy in traumatic tetanus. Rosco states that plantar neurotomy was followed by rapid improvement and cure in a case of tetanus caused by a gathered nail. As prophylactic treatment, we recommend the carefu' disin- fection of the place of residence of animals suffering from tetanus. Clinical experience has taught us that the stalls and loose boxes of infected horses continue, for several years, to be dangerous centres of infection (Hartenstein). InuBoalty afKinat Tatanua.— Behring and Kitasato have ex- perimentally proved that animals may be rendered immune to tetanus by successive attenuated pure cultivations 'of tetanus bacilli which have been suiUbly treated with iodine trichloride. This artificially-produced immunity depends on the fact that ceU-free blood serum of these animals possesses the power to render inert the toxin produced by the tetanus bacilli. The system of the animal which has been protected by inocula- tion, consequently contains an efltective chemical substance, namely, an antitoxin, on the presence of which, in the blood, the power of immunity depends. Inoculations with the blood serum of animals which have thus been rendered immune to tetanus, are supposed to confer on other animals immunity against subsequent infection with tetanus toxin, or infection with Uving tetanus bacilU. Behring made these experiments with small animals, such as rabbits, guinea-ings, and mice. Schfltz, Koch, Behring, and Kitasato carried out this method of obtaining immunity in horses and sheep. The animals experimented upon were repeatedly injected subcutaneously with different quantities of cultivations of tetanus badlli, which had been mixed with iodine trichloride and had thus become weakened. The proportion of iodine trichloride, which at first was feom half to one per cent, was gradually reduced to a quarter and then to an eighth per cent., so that the cultivations used for the immunising injections were of increasing virulence. This treatment, which was continued for about a month with intervab of several days, rendered the experimental animals immune to even fully lethal cultures of tetanus baciUi, which proved fatal to the unprotected control animals. From these experiments Schfltz arrives at the following conclusions : " Horses and catUe can by Behring's method be protected not only against an infection with living tetanus bacilli, but also against the injurious effects of the virulent subsUnces which are formed by the tetanus baciUi in cultivations or in the animal body. The power of resistance of horses and sheep which l^tve been rendered immune to living tetanus bacilli and to the specific virus of tetanus, becomes increased by continued subcutaneous injections of cultivations of graduaUy increasing strength, or of graduaUy increasing quantities. The Wood of these animy^ acquires immunising properties, which increase proportionately to the increase in the power of resistance." GLANDERS. »57 M£fari«?fc«« ^ • ^* '* produced no contive effect on «-*».it l22S X " *- P^ved by the experimenU nudeTS: GLANDERS (Efuinia, MaUeus). Gknden In hoH—Ghndm in «U «d b.«u of p«y-Gl«der. in »«.- L.ympliangitis epizooticn. Hlrto»y.-Glanders (glanders and farcy) is one of the oldest known diseases of horses. Aristotle ind Hipp^« !z! acquainted with farcy, and glanders of the donke?^l%oZ^ autii«,. Apsyrtus and Vegetius. have deso^gl^iS TS Vegetans recognised several kinds of glanders f "«S^,^? espedaUy that of the nose and skin (" Se^hunJdu^J,' rsr"^i '"*^f^^<««Ages.giLdr::Lt:s^t; tte Gmnan hiws, to be a legal unsoundness (breach of ^tyf The mfecbousness of glanders was recognised as earivT tte be toaramitted by the air. Van Hehnont (1682) consideiSit to be Identical with human syphilis. Even in UTg^ Sa,mier gave precise directions about disinfecting sSbesST Z^h '^^Vk"*** ^^'^^^ <'764) recomm^dSTieSS slaughttt of horses suffering from glanders and segr^Tof suspected animds. The identity of glanders aJd^y U' cteriy recognfaed at that time. At the end of the eSLZ oentun^. Abildgaard and Viboi^ in Demnark prov^ by a ^ number of «periments that glanders could be^tnuTmitUS Z iT '"".T^"' ^^ investigators demoted a" this early penod, that the virus of glanders was fix^ twlJ S'ol^ S^*^,^^ ^'^ '-P^*°^ airTtSlie^! fusion of the blood of horses suffering frx>m glanders is f«l2i eflicacious for transmitting the disLe thii inSiUtioL^ ^etaons or of pus ; and that the virus loses its^of ^e^ T^l^^^T'^'""^^^^- Similar experiments were ™^ m England by Coleman and Delab^ Blaine, who recoimSed On the other hand, the theory of the contaaousn^ of JMpcaaUy m France, the view taken by the Alfort VetiwinaA, S^sSLf* ^'"f^ '^*'* "^^ spontLeously tL^^S^ of strangles, was far more widely accepted than the doctrinTof Its contagiousness, which was stoutly supported b^ ^^^^! 17 •St INFECTIVE DISEASES. nary Coll«ge of Lyons; the consequence being, that precau* tkMiary legnlations against glanden were abdished, with the remit that the spread of the disease increased to an extracvdinary extent in France. At that time, glanders was looked upon as taberculoeis (Dupny), or as simple pytemia (Vatel and Bouley). It was only when Rayer (1837) had proved the transmissibility of glanders to man, and when Chauveau (z868) had shown that the vims was contained chiefly in the firm component parts of the infective material, that the fact of the contagiousness of the disease was again accepted. The theory of the spontaneous origin of glanders was accepted by every one in Germany towards the middle of last century. It was believed that glanders could be produced by the injection of pus ; and that strangles could turn to glanders (Bering and Funke). Glanders was looked upon, respectively, as a tuber- cular disease, scrofula (Haubner), pyaemia, diphtheritis, general dyicrasia, and cachexia. Virchow was the first to declare that the nodules of glanders were independent anatomical forma- tions, which he placed under the heading of granulation tumours. Gerlach was the great advocate for the exclusively contagious origin of glanders. He threw much light on the clinical and diagnostic aspects of the disease. We are indebted to Leisering for the first exact anatomical description of glanders. The first bacteriological researches were made in 1868 by ZOm and Hallier, who found a fungus which they believed to be the cause of glanders, and to be identical with that of human syphilis. In the same year, Christot and Kiener thought they had discovered the micro-organism of glanders. Bouchard, Capitan, and Charrin, in 1881-82, sought to isolate the virus of glsmders. It was not, however, until the year 1882 that Ldffltf and Schiitz succeeded in finding the true bacillus of glanders, in cultivating it, and in transmitting it to other animals. Their researches have furnished the positive proof that glanders is a specific infectious disease, produced exclusively by the bacillus mallei. BaotepioIo|{y«— According to LdfBer and SchUtx, the bacilli of glanders are rods, the length of which is from i to 3 ft, w from one-third to two-thirds the diameter of a leucocyte. They are from 5 to 8 times as long as they are thick, are straight or slightly curved, and have rounded ends. They are somewhat thicker and shorter than tubercular bacilli, and are generally found in couples connected together longitudinally. They stain GLANDERS. >S9 In iolutions of methylene blue. The cultures on gelatine appear on the surface of the gelatine, as smaU. limpid, y«Uow. trans- lucent drops, and assume, Uter on, a milky-white colour. The potato cultures, which are very characteristic, form after the tmrd day a uniform, amber-coloured, translucent covering, which assumes in about a week a reddish tinge similar to that of sub-oxide of copper. A greenish hue appears in the neighbour- hood of the cultures. The bacillus grows best on solid blood •enim of horses and sheep ; on neutral broth made of the flesh of horses, cattle, fowls, and human beings; and on slices of potato. The temperature limits of the growth of the fungus are 20" C. and 45° C. Consequently, summer heat favours its growth, which is impeded or destroyed by temperatures under 30" C. and over 45° C. For this reason it is impossible that an ectogenous development of the fungus can take place. Ldfito failed to obtain cultures on infusions of hay, straw, or horee-dung. Glanders appears therefwe to be a purely contagious, and not a miasmatic or miasmatic-contagious affection. As a rule, com- plete desiccation of the bacilli of glanden destroys their viru- lence in about a week. According to the experiments of LSffler. a penod of 3 months is the longest time the dried bacilli retam their activity. Cad&c and Malet state that the bacilli can be killed only by gradual drying; that they resist putre- faction from 14 to 24 days; and that, when mixed with w^ter, they continue virulent from 15 to 20 days. Bacilli which are not dried, cannot live outside an animal's body for longer than 4 months. LOffler therefore considers that 4 months is the maximum period for the infectious material to retain its virulence, and that the published reports about stables remaimng infectious for many months and even years, are erroneous. Lofller regards the formation of spores to be very doubtful on account of the slight power of resistance possessed by the baalh. Rosenthal, however, treated glanders bacilli taken from old potato cultures after Neisser's method of staining spores, and obtained exactly similar forms as with the spore containing badUi of anthrax. We must therefore admit the possibility of spore-formation. Many contradictory statements have been made about the power the badlli po8se&> of resisting the action of disinfectants. Some authorities state that an exposure to a temperature of 55» C kiUs them in 10 minutes, or of 80° C, in 5 minutes ; and that they die if left for 5 minutes in a 3 to 5 per cent, solution of carbohc aad or creolin, or for 2 minutes in a watery soluticm of fii nnm ago INFECTIVE DISEASES. chlorine, a i per cent, solution of permanganate of potash, or in a one-fiftieth per cent, solution of corrosive sublimate, etc. The experiments of others show that the bacilli are not always destaoyed by an exposure of half-an-hour to a temperature of 100° C. (Brombeig). For practical purposes we may say that a I to 1,000 solution of corrosive sublimate, or a s per cent, solution of creolin or carbolic acid, is sufficient for disinfection. Iodo- form considerably impides the development of the bacilli out- ride the animal body, so that their infectiousness is lost when they have been for some time under its influence. Inside the animal body, iodoform impedes but little the development or the dissemination of the bacilli. According to the experiments of Gamalda, the virulence of the bacilli of glanders may be in- creased by passing it through the body of the earless marmot [spermophUus cttiUus], or rabbit. Although the digestive fluids weaken fresh cultures of the bacilli of glanders, they do not kill them (Mozarski). Oooorronoe.— Glanders is essentially an equine disease and affects donkeys, mules and jennets, as well as horses. It is transmitted from the horse to many other animals, including man, either in the natural course of events, or by experimental infection. The order of comparative susceptibiUty to the virus of glanders possessed by certain animals is somewhat as follows :— Field-mice and guinea-pigs ; the cat tribe, including lions and tigers; dogs, goats, rabbits, and sheep. Pigs and pigeons are scarcely at all susceptible. Cattle seem to be quite immune. In fact, there has never been a single well-authen- ticated case of glanders observed in them. The long-established practice of isolating glandered horses in cowsheds has never produced any bad effect on the cattle residing in these abodes. House-mice, white mice, rats, domestic fowl, and linnets are immune. There is a great difference in the individual susceptibility of horses to the virus of glanders, which some readily take, while others may remain for months and even years in a stable with glandered animals without becoming infected. Glanders, like tuberculosis, has certain predisposing factors, the chief of which are: ovfer-exertion, too little food, faulty stable management, defective ventilation, chill, and disease. The spread of glanders is therefore greatest during times of war. Although glanders is far less frequent at present among horses than formerly, thanks to veterinary police laws, it still GLANDERS. continues to be the most dangerous equine disease, in aU latitudes and in all climates. 261 It occurs (1888); 1,337(1889); 866(1890); 981 (1801) 8« /,8o,V SV,«A,^^ ^r^L • ! T*'* "^"^ °° account of having glandeni and siv» the following figures for the respective yeais r-a 740 1i877i VL?/,li«r The dBease was most rife in the districts of Oppehi. Brombe^ P^' t In S^^'*!:^' ''""^ •**=*"'• glandered in 1891 and .89a. infitJ?£^r886 tlsj."^'' '""'' " "" Gennany^(S.6a3) bSm. to 8*^05*' iH^th^ ^"** ^"**^' •"^"K *•»* «™« P«iod amounted l"^-r ™^^^^^^^^ .8. bJn^Slild LvtlSir' h"'^"' *k* '^'''* °"°"-» "f "orse, which ha^ fSw. l„,8oc fi duni^Sthe yew. ,895 to 1901 in England are u •ft^ "J" ^^' -^7 «=*»«*! «« >896, 1,196 ; in 1897. 1,324 ; in 18^ i i« , ta 1899. 1,269; in .900, 1,8.4; and in .901, 2^ TbtZ^^'l^ ^gover^mem for the ^ppre«io„ of ^i.rfL iZ^^Tt^'^llt been carried out in an inefficient manner. London and Gla^w i~^.TJ! gr«t «n.re. of g,.„de« in Great BriUin. D»X"he L^Tfew^ tlL« "S^TsIv^T" *'»««,'"»°"8 °" *^y hone.; but. thank, to £ ri^k^oflt'^1 ^ °" ""'""'y ^***""*^ Mthoritie., the« WM not a Sf ^ °f8landcn among army hor«. in Great Britain from October, ml large extent among our army horM*— T«. cwnparanveiy 362 INFECTIVE DISEASES. Prnnia, 78 ; Servia, 95 ; Belginm, 138 ; France, 1,130 ; and in Algiers, 1,548. It would be difficult to decide whether this increase of glanders from north to south, as Ldffler assumes, is due to greater warmth of climate (the badllns of glanders, as we have already said, thrives only at a temperature of over 30° C), or to insufficient veterinary police regulations in the countries in question. 8. During the 10 years from 1877 to 1887, there were 4 cases of g^deiB each year among 100,000 horses in Sweden (Lindqvist). 9. Woronzow estimates the number of glandered horses in European Russia at 90,000, that is, 4 pro mile. Pathogenesis. — ^The transmission of glanders from an infected animal may take place directly or indirectly through extremely different intermediate bearers, such as harness, clothing, pails, stable tools, fodder, litter, grooms, and other agents. The respective discharges ,from the cutaneous ulcers and from the nostrils possess the highest degree of infectiousness. The bacilli of glanders may occur in any organ as well as in the blood, which does not alwa}^ contain them, except when the infection is general throughout the system. Caddac, Malet, and others frequently obtained positive results from inoculation experiments with the blood of glandered horses. The respiratory organs are most frequently (in nine-tenths of all cases) the gate of entrance for the virus. The bacilli, like those of tuberculosis, probably reach the nasal mucous mem- brane by being inhaled along with the air in the form of dry dust ; by the reciprocal smelling of neighbouring animals ; and by deep respiratory movements, as for instance, dtiring severe harness work. We may here point out that the presence of cartarrh predisposes the respiratory mucous membrane to the penetration of the bacilli. According to the experiments of Renault and others, it seems to be very doubtful that the bacilli of glanders can be directly exhaled into the atmosphere and thus brought into contact with the air passages of healthy animals by inspiration. It is much more reasonable to assume that the transmission of the bacilli takes place by the bacilli- laden nasal discharge flowing out or being blown out, and by its becoming dried and then inhaled in the form of dust. Ex- periments to transmit the^di^ease by the direct inhalation of the respiratory air of glandered horses have always been without result. It still remains an open question whether or not the nasal mucous membrane must be morbidly affected before it can successfully receive the infection of glanders ; although an affirmative answer has apparently been given by the ex- periments of Cad^c and Malet. It is probable that the bacilli GLANDERS. a<53 of glanders, like those of tuberculosis, can penetrate through the uninjured mucous membrane. They may also be introduced along with the inspired air into the lungs, where they then lead to the development of very minute bronchial-pneumonic foci. Glanders in the lungs, like glanders of the air passages of the head, may occur primarilj'. In fact it frequently happens that the lungs alone are affected, or that they show the oldest chMges. Analogous conditions are present in tuberculosis and acti- nomycosis. For these reasons most authors believe in the possibility of a primary affection of the lungs in glanders (Leisering, Gerlach, Bollinger, Roloff, Pflug, Rabe, Roll, Csokor, and Johne). At the same time, it cannot be denied that some cases of apparent primary glanders of the lungs are in reality secondary processes which had formed, by embolism, from the glandered ulcers of the nasal mucous membrane, after the primary foci had healed and had consequently escaped notice during examination. It is well known that the fresh ulcers in the nostrils may arise secondarily from old glanderous deposits in the lungs, from which the bacilli are carried with the expired air to the nasal mucous membrane. Even the acceptance of these cases cannot justify us in denying the possibihty of primary glanders in the lungs. The skin is a second gate of entrance for the bacilli of glanders ; farcy, which was formerly regarded as a separate disease, being nothing else than glanders of the skin. A primary infection of the skin is, as a rule, possible only when the skin has been previously injured. Cases of primary glanders of the skin are consequently uncommon. Far more frequently the skin becomes infected secondarily as a result of general glanders set up by emboli. Contrary to the case reported by Babes, Nocard failed to make the bacilli of glanders penetrate the uninjured skin of donkeys and guinea-pigs, by the inunction of a bacilli-containing ointment. If infection takes place after such an appUcation, we must assume either the presence of an abrasion of the skin, or that the continuity of the skin has in some manner been injuriously affected by the friction empbyed. In horses, the virus of glanders penetrates the body least frequently through the digestive canal* This fact has been • For arguments in favour of the ingestion theory erf the transminion of gUnders, see the remarks of Nocard (Journal of Comparativ* FathtUigy, Dec. 1897) and Hunting {y*t*rimtry Rttord, 8th Jan. 1898) on that subiect. McFadyean {Journal 0/ Comparativ* Pathology, Dec 1897) takes the same viaw as Fiiedberger and Frohner. — Tk. 264 INFECTIVE DISEASES. proved by the generaUy negative results which Viborg, Gerlach Liautard. Cad&c. Malet and others, obtained from thdr «-' penments of feeding horses on glanderous matter ; although a tew of these experiments gave positive results. Renault suc- ceeded m mfecting 6 horses out of 9 by feeding them on sumlar material. Nocard and Sadowski were repeatedly successful m transmitting glanders to horses and ^ by teetung. pe rare cases of the infection of sucking foals may omitfang the supposition of infection through milk, be ascribed to mfectaon through the inspired air. On the other hand, dogs, cats, and wild ammals (lions, tigers, panthers, and bears) become infected, comparatively frequently, by feeding on glandered flesh, m which cases it is possible that small injuries r' the mucous membrane of the mouth may form the starting point of the invasion of the bacilli. No case of infection by thT^ine of glandered meat has yet been oliserved in man ; although many glandered horses have been eaten by human beings, for instance, during the siege of Paris. mether cases of transmission observed in coition are those of infection of the genital mucous membrane or of infection by the inspired air, cannot always be decided. Only in a few cases have glanderous ulcers been found on the vaginal mucous membrane of mares. There is, however, no doubt that the S" ° ^^^' ^^ ^"^ °* tuberculosis, may pass from the mother to the foetus. o. ?^^^'f ™*^ ?^^*^ ^°" * ^°^ centre in the same manner lymphatics. In the last stage of a chronic course, the process may be r^tncted for a long time to the lymph glan«»--According as glanders is situated nf ti! '"^T'*^ o"*" .^'^t*™*! organs, we distinguish glanders of the nosfails and glanders of the lungs from glandeif of the SKm. In former times, the term glanders was restricted to : GLANDERS. 26s glanders of the nostrils and lungs ; that of farcy being reserved for glanders of the skin. When the animal wi affectedtaSr- a^Tded ^^ ^ ** '^" "^^ *™*' ^' ^^ ^^ *° ^ ^^^'''<^ th« tZ"?'^ *° '? P"^^' ^« l^^^e cl^oaic and acute glanders ; li ^^ the ordinary, the latter the rarer kind. Acute glanders rapidly ends m death and never becomes chronic; though chrome glanders usually becomes acute. There are man,^ S^. ?^^^*"J*'" ' x°"^** ^ sometimes acute and sometimes cliromc. The chrome form assumes an acute type if the disease becomes general, that is. if the blood becomeVinfected with great numbers of bacilli. In the same way. ordinary chronic tuberculosis turns into acute miliary tuberculosis. As a rule chrome glanders ends fataUy in consequence of its producing elSe« f ''*'?1 1 *?' ^y' *^** '^ *° ^y. general acut! &^:. I°nditlonB in Ohronio Gl«iiden.^The anatomical changes in chronic glanders are specific inflammatory processes which are accompanied by suppuration, ulceratipn. granulation and cicatnsation. Their most frequent seats are on the respirator mucous membrane, in the Imigs. lymph glands, skm. and subcutis. Other organs are not so often invaded. I A , ""Pt^'^y ^^o^s membrane is the usual seat of glanders (glanders of the nostrils). It occurs in two forms as circmnscribed nodular glanders, with the formation of ulcers and cieatnces ; and as diffuse or infiltrated glanders. Nodular glanders, which is the ordinary kind is most c^X". "^ '?"**!? °" *^' °^^ ™"^^"« "^'"brane. ^d ista chiefly found m the upper portion cf the nasal cavity, namely on the nasal septum, and in the cavities of the turbinate boni' The affection commences with the appearance of nodules," which vary in sue from a grain of sand to a miUet seed, and which are of a glassy, translucent, gelatinous condition, of a roundish or oval shape, and of a dirty-grey or greyish-red colour. These ,nodules project somewhat above the surface of the mucous ifl a66 INFECTIVE DISEASES. membrane,''are surrounded by a red ring, and may attain to the size of a pea, as a maximum; Some of them are isolated, and others are arranged in groups. Microscopically they consist of a large number of lymphoid cells, which break down in the centre, with the bacilli lying between them. In consequence of the fatty and purulent disintegration, which sets in very rapidly in the centre, the nodules become yellow and change into ulcers after the purulent breaking down of their summits. These ulcers are sometimes superficial (lenticular), sometimes deep, crateriform, surrounded by a hard, prominent edge, and frequently, on becoming confluent, form large ulcers which have irregularly serrated and eroded edr s and a lardaceous base. They are sometimes covered w a brownish crust. The ulcers may increase in area or in d. :h, and may even involve the underlying cartilage ot bnne, :hus causing per- forations of the septum nasi, distensions of the maxillary bones, exostoses on the turbinate bones, etc. The hallow lenticular ulcers may heal without leaving any vis,, e changes ; but the deeper ones, after granulating, leave a radiating, star- shaped, or ice-flower-shaped* cicatrix, which is either smooth or homy, and which, according to the form of the ulcer, may be of an irregular oblong form. The nasal septum, or the alx of the nostrils, are frequently covered with these scars. These ulcers and cicatrices are also found in the maxillary and frontal sinuses, in the guttural pouches, and in the Eustachian tubes, where they may produce pachydermatous thickening of the mucous membrane with accumulations of a muco-purulent secretion. They are also frequently met with in the larynx, and especially in the region of the lower vocal chords, from which the suppurating process may extend to the arytenoid cartilage and cause its partial necrosis ; in the trachea, particularly on the anterior surface, on which numerous long, oval ulcers of the size of a coffee-bean up to that of a hazel nut, or long, pointed, serrated scars are frequently situated ; and in the bronchi. In addition to these ulcers, a catarrhal inflammation of the mucous membrane is always present. Diffuse or infiUrcUed glanders manifests itself as a diffuse catarrh of the n^ucous membrane of the nasal cavity, and neighbouring cavities, with superficial ulceration, thrombosis of the veins, inflammatory infiltration of the submucosa, con- siderable thickening of the mucous membrane, and the formation of a pecuhar, radiating cicatrix. • The ir«.flower is the mutmMamtJUmum er»sUMiiiMm.—T%. GLANDERS. 267 2. In the lungs, both the nodular and infiltrated forms are found. In nodular glanders, we find in the lungs nodules* varying in size from a grain of millet up to that of a pea. They are grey by transmitted light, glassy and pearl-grey by reflected light, and are surrounded by a haemorrhagic ring. Tne centre of the nodules shows a pale yellow point in consequence of caseation and disintegration of the innermost cells. These nodules are of different sizes, of varying numbers, and of different ages. Along with new ones, we find caseous, calcareous (the calcification of the nodules of glanders is disputed by some), and encapsuled nodules. The formation of a capsule by a connective tissue membrane is induced by a reactive inflam- mation in the neighbourhood of the nodule. These nodules are either (a) of an embolic origin, and are then situated principally in the periphery of the lungs, the larger ones being at first red, wedge-shaped foci (infarcts), and their structure the same as that of the nodules of glanders on the nasal mucous membrane; or (6) they represent lobular-pneumonic foci, in which the alveoU are filled with red and white blood- corpuscles, and with desquamated epithelium of the lungj. Very soon, disintegration in the centre sets in, and, in the periphery, a reactive inflammation, which manifests itself at first by a dirty-white, lardaceous, shining, inflammatory ring, out of which a connective tissue capsule becomes developed later on. In other cases, the foci suppurate (cavities of glanders) ; and, finally, glanderous nodules may appear in the neighbour- hood of primary foci in consequence of a glanderous inflammation of the lymphatics. Besides these nodules, we find symptoms of chronic bronchitis, peribronchitis, parabronchitis, bronchiectasis, atelectasis, gelatinous infiltration of the tissue of the lungs, and less frequently circumscribed or exudative pleuritis. Infiltrated glanders of the lungs forms tumours the size of a walnut up to that of a child's head, and consists of a diffuse glanderous infiltration of the alveoli and of the interstitial connective tissue (lobar or greater lobular broncho-pneumonic foci). Frequently the infiltrated parts of the lungs very closely • NocMd points out that when gludered horses are treated with mallein, a certain proportion ' gradual emadaaon ; imgabi le^- h^-T^"^'' periodical ble.du,grt,iJl^."ri^^™,™>'i: cough; base, and their eroded raised -*v^ iT- . Iwdaceous importance to «^ ^. ^ ^^' '* " °' ««** practical wiponance to search on the mucous membrane under the ale 18 274 INFECTIVE DISEASES. of the nostrils for these ulcers, which may appear independently of any nasal discharge. We should be careful not to mistake them for accidental wounds, which are often in lines, and covered with a firm scab. The nodules and radiating, star-shaped cicatrices are also of diagnostic value. Scars resulting from injuries are irregular, usually striated and quadrangular. An irregulai, remittent or intermittent fever is always suspicious, if it arises without any other apparent cause. Emaciation, unthrifty coat, broken wind, and cough are, undoubtedly, suspicious phenomena, when it is probable that infection has taken place, which fact should be borne in mind by those who own large numbers of horses. (6.) The artificial illumination of the interior of the nostrils with the rhinoscope furnishes us with a valuable optical means for the exact examination of the nasal cavity, and especially of its upper portions, which could not otherwise be seen. This instrument has been used for a considerable time in veterinary practice, and has been greatly improved by Polansky and Schindelka. (c.) Trephining the antrum of Highmore was first proposed in 1851 by Hertwig, and in 1859 by Haubner, as an aid to diagnosis, for which purpose it has been often used since then. It is said that this operation enables us, in cases of the disease, to find glanderous changes in the antrum. Its value, however is very much restricted by the fact that, in glanders, the mucous membrane of the antrum often remains unaffected. Besides, a non-glanderous inflammation of the mucous membrane of the antrum may produce a thickening effect on it. Also the glander- ous changes, mentioned by Haubner, are frequently absent from the wound caused by the operation, even when jlanders is present in the immediate neighbourhood. {d.) The extirpation of the submaxillary glands (Haubner and Bollinger), with the object of examining them anatomically, is by itself of doubtful use, for the following reasons: The characteristic foci of glanders may be absent from them ; simple induration of these glands also occurs in chronic nasal catarrh ; in attacks of strangles, purulent foci may be disseminated in the glandular tissue ; and sarcomatous and carcinomatous metastatic deposits may be found in these glands. On the other hand, it is very easy to examine bacteriologically the glanderous tubercles found in the parenchyma of the gland, so as to demon- strate the presence of the bacilli. We may consequently conclude that extirpation of these glands, combined with their bacterio- GLANDERS. ^7$ logical examination (cultivations on potatoes), is a valuable diagnostic means with living animals (Rieck, Chelchowsld. and othere). According to Rudenko, the bacilli of glanders can be tomid m the lymph glands, even when these glands are but little, if at all, enlarged. («.) As far back as 1843. Bouley proposed the artificial Productton of fever as a means for hastening the manifestation of symptoms m cases of latent glanders. This procedure is founded on the long-established fact that the presence of fever tends to render the course of chronic glahdere more or less acute. In recent times, Lustig recommended for this object that horses suspected of glanders should be made to work hard and that attention should be paid to variations in their tempera ' ture. and also to the occurrence of bleeding from the nos^ Cagny and others state that subcutaneous injections of oU of SXder *^' "^^' '* '^"'^"^ ^'"'^^ ^'*°^^ ''»*° (A) Auto-inoculation (maUeosation)— the inoculation of sus- pected animals on the abraded nasal mucous membrane with their own secretions, such as the discharge from the nostrils or from f^^Z^ ™*'^^ i*""" "^ *° ^^-^y diagnosis. The bv R^~T^K ^"'^d g^«^«y- I^ very many cases treated xl^^l Tschermng St. Cjr. and othen. the experiments r.Kulted m a merely local and narrowly-restricted glanderous process, or the inoculation faUed entirely. It is evident that fi^ ♦ T"^ """^ °' '*^' ^^^'^Sh by no means absolute immumty to auto-inoculation. '«"iuw. vJ^LTf- ^^^f*^ "f ^^^ ««»'««^« is certainly the most ^blei^osbc means at our disposal. For tWs purpose, ass^. horses, and gmnea-pigs are the most suitable. Dora are less so ; and rabbits least of all. Loffler considers the field- mouse to be the best subject for inoculation experiments with pure cultures. Kitt gives the preference to thrvole romcoS terrestris] and hedgehog. The L. if it were lesl exS^ would be the best of aU for practical purposes ; becauSTE glanderous inoculation is almost always followed by the acute form of the disease, which then runs a fatal course in 8 or 10 days. Next to the ass the horse is the most suitable. Zr^^*- 'T"^u ***** '"'S**'''^ '^"^^ ™"«t °°t be accepted unconditionaUy; because the material used for inoculation s^bCr ^° ^"" n^'^x ^'^' "^^ ^"^ tbe experimental subject, and especially if it be an old horse, may have been 1 8* 276 INFECTIVE DISEASES. sufifering from latent glanders, and, on that account, may have failed to react. Horses, as a rule, are too costly for this purpose. We recommend guinea-pigs on account of their cheapness and certainty of the inoculation taking effect. These animals, after vinilent inoculation, manifest all the characteristic symptoms of glanders ; one of the most typical in males being inflammation of the testicles. Male guinea-pigs are conse- quently particularly good subjects for these experiments. Their employment, however, possesses the drawback that, in their case, the average duration of the experiment will be as long as a month. LofBer recommends the following method for in- oculation : The hair is removed from the lateral surface of the abdomen, and the skin is pinched up into a fold and cut with a pair of [rowelling] scissors through its entire thickness, so as to make a gaping wound of about i cm. in length. A previously heated steel needle is inserted into the wound, and is moved to and fro under the skin so as to form a pocket, which serves as a receptacle for the inoculation material. For this purpose we prefer to use the discharge from the glanderous ulcers, either in the form of pure pus or lumpy masses. It is well to inoculate three or four guinea-pigs for each experiment. In such cases, the first symptom is redness of the edges of the wound, and the formation of a roimd or oval ulcer with a suppurating, infil- trated base and a thickened edge. Towards the end of the first week the neighbouring lymph glands swell to the size of a pea, and even up to that of a chestnut, and form abscesses. Some- times the entire process heals spontaneously from this stage. More frequently, however, inflammation of the testicles takes place during the second week, with the formation, in the testicles, of nodular spots, which develop into abscesses and discharge pus rich in bacilli. These symptoms may be associated with purulent arthritis, and cutaneous or subcutaneous nodules, which suppurate or burst. When they occur on the face, they frequently take their origin from the periosteum of the bones, and sometimes eat through, into the nasal cavity. Finally, the nasal mucous membrane, becomes affected ; the animal sneezes, and breathes with difficulty ; a discharge, which dries up into crusts, issues from the nostrils ; and death takes place generally in the third or fourth week imder circumstances of great emaciation and exhaustion. In other cases, the patient succumbs by the end of the first week, though now and then not till the eighth week. According to Cad^ac and Mallet, GLANDERS. »77 chronic glanders may also develop with caseous foci in the lungs, heart, liver, spleen, lymph glands, etc., and then runs a course of from 2 to 4 months. Chronic indurated glanders in gumea-pigs may sometimes heal spontaneously. Besides the d^nbed changes, we find, post mortem, nodules in the lungs, spleen, omentum, testicles, and retro-peritoneal tissue; ulcers m the nasal mucous membrane ; perforation of the septum nasi ; and partial destruction of the facial bones. The blood contains no bacUli, contrary to what is the case in the organs affected by glanders. The absence of glanders is proved just as clearly by repeated failures, with one or more animals, to commumcate the disease by inoculation, as its presence is demonstrated by positive experiments (Loffler). The dot has also been recommended as a suitable subject for inocula- tion (Putz, Galtier. Reul, Molkentin. and others). A seton saturated with infectious secretion is placed under the skin of the nape of the neck. On the third day an ulcer, resembling a hard chancre, with a purulent base hard edge, and irregular shape, appears on the site of the inoculation and gradually becomes enlarged with marked symptoms of constitutional dis- turbance. We cannot form a positive diagnosis from these symptoms which, in the majority of instances, are the only ones present. In rare cases, farcy buds and ulcers appear on other parts of the skin ; the joints, especially those of the hind limbs, become attacked by acute inflammation and the patient suffers from hemorrhagic diarrhoea, purulent conjunc- tivitis, ulcerous keratitis, emaciation, etc. According to a personal communication by Neimann, inoculation experiments in 300 cases gave only 4 negative resulu. Dogs are not very suitable subjects for inoculation ; because, when infected by glanders, they rarely manifest •^-neral symptoms, and in their case it is always difficult to form a correct judgment from the condition of the cutaneous ulcers. Lisitzin and Buchner prefer the oat to the dog as a subject for inoculation. These animals are inoculated on the upper surface of the neck, and show from the third day a swelling at the site of the inoculation. Alter s to 7 days a typical glanderous ulcer appears in the neigh- bouring tissue by metastasis. The cats which died in 2 or 3 weeks showed, post mortem, glanders of the nose and lungs. Peuch transmitted glanders to sheep from donkeys. Rabbits, though formerly much used, do not answer ; because they die, after being inoculated, more frequently from septicemia than glanders BesidM^ as Friedberger has proved, a period of 2 or 3 months is requtfed for observing them : also, the results they give are not uniform. If. after saturating the inoculation threads with nasal discharge, we dra\- them through the skin of the cartilage of the inside of the ear, there wUl form at first, purulent boils the size of a hemp seed up to that of a pea and irregular ulcers with an uneven and suppurating base and rais2 edges. These ulcers sometimes perforate the cartilage of the ears. They may, however, heal spontaneously. Friedberger considers that these changes are not very characteristic. Later on. if the inoculation be .successful, a discharge will issue from the nostrils, and death takes place a7« INFECTIVE DISEASES. after about a month*. By post morUm examination the lunn and spleen are found to be stufied with glanderous nodules. Lflffler coiuiden flald-mlM to be very ,ood subjecto for inoculation with pure cultures of the bacilU of gtanaers. They, however, die of septicemia when inoculated with the nasal discharge. Death takes place •n 3 or 4 days after the inocuUtion with pure cultures. On the kI! UK ?^f »""« '^•n o" the second day, they remain apparently h«lthy. After that, they lose their vivacity, their hair standT'on end^ they cow^ together, refuse to eat, breathe heavUy, and suddenly fall down dead without any preceding convuUions. Post mortem, we find on -ifi^h ?K° ♦»>* ">°*="»f«°'' a greenish or dirty-white infUtration. from which the swollen and corded lymphatic lymph vesseU proceed to the t^l^H^-F^ f ""^ '^l *" infiltrated with numerous pale yellow small foci. The liver is stuffed with numben of grey nodules, which are absent from the lungs, and which are very rich in bacilli. The nasal muco,« membrane and skin are in a normal condition. The inoculation. fi^iH nf t'?*' !f ?"''' '"*" " ""*" I^""' «» *»>« »»•=>«• Besides the field-mouse K.tt finds the wol. (arvicola terresiris) suitable for pure Th!^*^' i" .V^ *"""*• "** 'P'**"* ""^ ''*"•"*' ff^'""^ *«» niost frequently anected. Kitt also recommends for this purpose the hadtfahotf (erinaceus 'uropaeus). which becomes affected with ve^i^ characie!^tic glandenTf the spleen and lungs. Kranzfeld and Grunwald inoculated the Mrl«M marmot {spermophilus guUatus) with glanders. (A.) The bacteriological proof of the presence of the bacilli is tbe most certain diagnostic means ; but it can seldom be carried out in practice. Only on unopened glanderous foci (glanders of the skin, pustules of the nasal mucous membrane at the entrance of the nostrils, and in the lymph glands) can we succeed, under aUnecrasary precautions, in obtaining a characteristic culture of baciUi on serum (minute, yellow, translucent drops) or on potatoes (a honey-coloured coating). Of all these means, the only practical one is extirpation of the submaxillary glands Cultivations can be adopted for diagnostic purposes only in exceptional cases, as for instance in veterinary coUeges (Kitt) An exammation of the nasal discharge or of the secretion of an ulcer for bacilli is, as a rule, without result ; because the baaUi of glanders which are in them do not possess any character- istic staining. The above-mentioned secretions swarm with numerous other bacilli which stain in exactly the same manner as the bacilh of glanders. As these secretions are also more or less decomposed, it would be very troublesome to prepare a pure cultivation from them. Consequently, the inoculation of animals, is, as a rule, the only practical diagnostic means which remains to us. Method, of 8t*liiH.< thoB^iim of01»nd«M.-The technique of staming the baciUi of glanders is so unreUable, troublesomTand tedious that the practical veterinary surgeon will ha;dly ever^^dertaJe GLANDERS. 379 it (Kitt). The foUowing method* are recommended. 1. Laffler-t &nt r»L°i 'T"''' '■ . *"*•. ^'^ «'- preparation, are made in t^ «.lL and psMed 3 times throngh a ipirit flame) ; placed from « to 10 S/o" "i ' •^"1'°'' *" '"«»»'y'«''« blue (30 C.C concentrated ilcoholic solution of methylene blue mixed with 100 c.c of a Mb per c«t o" Sc^i^d'^H^"' = '"' '*" " *'" «cond, in a . per'i^..^luTo„ Of lactic acid; nnsed m water; and examined. To make the cover £ ™h^»*?° H *i' ^T «'^ °° "^^^ *"• »«="«°« «" »'««' 'material «i„2 LJ^J^f ?' * '^''"*'' •" *•"* "***"*"« «»'*'• ^Wch consists of caustic potash (I to ,0.000), after which it is dipped for one second into a 1 p« cent, solution of acetic acid which has been stained a hock-yellow by the addition of a solution of tropaolin. and is immediately after- Th'^t."!!^/".^."""* ***•'• '• Laffl*' >>« recently begun to sti^n w«.,^ f ♦ glanders M follows: Koch-ErUch's genti'an ^olet-aniline ^.«h^ *°" " """"• "^^^ *" ••!"*' ^'""""y °* a "^l-tion «>« caustic n^ a ' "^f*'- "' °* * °-5 P«' «=««"• «>»""«« o' ammonia. The cover glass or the preparation is placed for about 5 minutes in this mixture, and is then put for not longer than . second in a i per cen^ solutwn of acetic acid to which as much of a watery solution of tropaolin has been added as will make the fluid assume a Ught straw colour^nd the cover glass or the preparation is then immeuiately rinsed in water. me^^ni hl.^ 'h° '^"""'' *" * "^''*'"''' of a , per cent, solution o methylene blue and of a i per cent, solution of borax, after which it is rinsed m water or in dUute alcohol and dried. («.) MaUein, which is a preparation made from the bacilli of ganders, was first manufactured and investigated in i8qi by Kalnmg and HeUmann. as a means for diagnosing glanders analogous to Koch's tuberculin. The numerous exi^riment^ which have been made with mallein during late years in Germany. AuBtna, France. England, Russia, Denmark, Belgium, and other countnes, have not yet resulted in a conclusive decision respecting its value. MaUein can by no means claim the great pracbcal importance of tuberculin. Contrary to the assertions of Preusse, Foth. Dieckerhoff. and others, Schutz has pointed out that maUem must not be regarded as a typical i^ent for glanders.* *^ ^ In carrying out inoculation experiments with maUein (Foth's dry maUein m doses of 005 gramme is the safest to employ), the foUowmg pomts are worthy of notice. The temperature having been taken every two hours from 6 o'clock in the ^21'^/'^'^^'^?'"^' ^''^- "'^^^"P" Sep. ,898, states: "All that ■ fnte ifG^Zfy!" '^ ~'^'°" '-^ "^ ""••' "^ ^^^^^ of -»- - aSo INFECTIVE DISEASES. inoming, the injection is made subcutaneously on the lower third of the right side of the neck at lo or ii o'clock on the same day. According to the reaction to the inoculation, the horses may be divided into the three following groups :— 1. Horses with an increase of temperature of over 2° C. and a double fever curve (Schindelka) are said to be undoubtedly glandered (?). ' 2. Horses with an increase of temperature from i-z" to 1^9° C. may be suspected of glanders, and should be subjected after a or 3 weeks to a second or even a ihird inoculation. 3- Horses with an increase of temperature of not more than 1-2 C. are said to be positively free from glanders (?). Attention must bf paid to the temperature of the body at the time of the injection of the maUein ; for with horses having a^ naturally high temperature, a mijch higher reaction (2-5'' to 3 C.) must be manifested before we can be certain of our diag- nosis. Horses suffering from fever are said to be unsuitable for inoculation; because they either show no increase of tempera- ture or exhibit a decrease. T^e perusal of the literature on maUein teaches us that the statements regarding lU diagnostic value are very contradictory. The most im- portant point in the maUein question is the anatomical proof of the presence of glanders. As Schutz points out. it is evident that many cases of inoculation were at post mortem examination regarded u glanders ; because there were found in the lungs, nodules which were in fact quite innocent, and which occur very often in healthy horses Olt has proved that these nodules are mostly of parasiUc origin, as they contain the lifeless embryos of echinococci. It has also been proved that other diseases react typicaUy to maUein. as for instance, inflamma- tion of the lungs, emphysema of the lungs, bronchitis, lymphadenitis alveolarpenostitis, caries of the teeth, and melanosis. It has also been proved by numerous observations that many healthy horses react to m^em; and that in several cases horses which were undoubtedly snffermg from glanders did not react to maUein. FinaUy there is the danger, especiaUy with bad preparations, of glanders being set up by the inoculation of maUein. Putting all this together, we must arrive at the conclusion that maUein plays at the present time only a subordinate part in the wagnosis of glanders, and that it should never be used as a diaKUMtic by ifjelf, but only in conjunction with other diagnostic means. [TTie weight of EngUsh veterinary experience is strongly in favour of reganLng mallein as an extremely useful, though not an absolutely infal- hble, means of diagnosing glanders. It can be obtained from wholesale vetennary chemiste either pure or dUuted. The latter, which keeps good for only about a fortnight, consists of 1 volume of the former to o wlmnes A J*!*^" *" **»*^'' * P«* «°t- o* pure carboUc acid has been dissolved. About ao minims of the dUute maUein is used for a hypodermic injection GLANDERS. 38 1 The ■ynnre should be sterilised before and aiter lue. The followinc procedure for applying the mallein may be emptoyed : take the animal's temperature— iweferaWy, an average of the morning and evening tem- perature— for the two previous days, as well as that of the day in question inject hypodermicaUy into the side of the neck for choice, the dose of maJlein (i c.c); and take the temperature about 6 hours after the in- jection, and ewry subsequent 3 hours, up to, say, the aist hour, inus used. maUein produces under ordinary circumstances the three foUowmg reactions in infected animals— I. A large, hot. hard and painful swelling at the seat of inoculation, a. A well-marked rise of the internal temperature. ^ J." ^"•*"""<«»*' disturbance, manifested by depression of spirits. debOity. loss of appetite, " blowing." and muscular stiffness, especially 01 the fore extremities. Respecting the reactionary swtUing, McFadyean, to whom we are greatly indebted for his researches on the use of maUein writes • " In interpretmg the local reaction to maUein, attention must be paid to two pomte. v«., the extent of the sweUing. and the period at which it reaches lU maximum size. The rule as regards the first of these is that in the non-glandered horse, the swelling that forms at the seat of infection is seldom or never more than three inches in diameter, while in a glandered horse it is seldom or never less than 5 inches in diameter, and not rarely ,t is neariy twice that. The rule n^Omg the second point is inat, in a non-glandered horse the local swelUng attains iu maximum •ize during the first 14 or 16 hours after <>te inje- -a, and then rapidly decUnes. so that it has nearly or lUtogette Uwippeared by the twenty-fourth hour. In a horse suffering from gl» *», thTtumour contmues to increase in sue to about the thirtieth hour aiw inoculation ; It persuu for 2 or 3 days; then gradually recede* wd does not finaUy disappear untU the fifth or sixth day (Nocard). 1^* .^d lympf itw vesseU may be seen radiating from the tumour, whiok ^-te- so painful as to cause lameness of the fore-leg of the side upon «i *»» tuaied." The side of the neck is chosen for the site of the injecte », »t ofien a flat surface for the observation of the expected sweUi*. The reactionary rise of Umperature— which under «. mrr circum. stances, is at least I.40 C. ; usuaUy about 22' C. ; and sometimes as niuch as 4 C— is characterised by the fact that it remains i . consider- able time at iU maximum height; its principal mamlt ion l/e,ng Def-een the eighth and sixteenth hour after inocuUtaon Ve m#y consider that a horse reacta to mallein, as far as tempmtu * con- cerned, if the rise is from normal to 39-33"' C. The inutility of the mallein test in /wmiA Aorws (with a t«i^» "« of, say, 389 C. or more) is well shown in two cases reported in tlM / of Comparative Pathology. December 1893. The respective tempr ot these horses at the time of inoculation were 39.5° C. and 3* ■n»€w temperature after inoculation, instead of laing, feU ; the cw^ of the swelling at the seat of inoculation was normal (being about the .. ze of a walnut) ; the appetite of one of them continued good ; and yet both of them were proved by post mortem examination to be thoroughly infect«d with glanders. The reactions may occur in horMs which are suffering from dise^« other than glanders. aaa INFECTIVE DISEASES. No dangw of tranamitUiig gUadm to incnmd by the use of th» Bultoto employed in EngUad ; because thia nuUein ia exposed dnrinc »w P?**"**** •<» * degree of heat which ia amply infficient to destroy UM iMiiderous vims. ...i^^'*i*°!f °' "^•'° *" followed by more or less immnaity to the actton of this agent, consequent, apparently, on iu curative inHuence.- OUniMl DIfliwwitUi DlagBo«i«.-Glanders mav be mistaken for a great number of diseases, of which the following are the most important : — • I. Simple chronic nasal catarrh gives the most frequent cause to suspect glanders; because its course is characterised by chrome nasal discharge, swelling of the glands, and sometimes with superfiaal ulcers. On that account, it was formerly regarded as the first stage of glanders. A considerable time tor observation is always necessary to distinguish positively between the two. Simple chronic catarrh is, as a rule, accom- pamed by no scars on the mucous membrane, and can be permanently cured by local treatment. Inoculation in other anunals will conclusively decide the point. Cultivations on potatoes have only a doubtful value. 2. The chronic catarrh of the accessory cavities, especially of the maxillary sinuses, and of the guttural pouches, is frequently mistaken for glanders. Here also a long time of observation 3 often necessary. Besides, the curabiUty of the affection by trephining, etc., must be taken into consideration. In cases of canes of the teeth, an e.\amination of the teeth and oi the odour (whether healthy or foetid) from the mouth will decide the point. A case observed by Siedamgrotzky shows that canes of the teeth with chronic inflammation of the maxillary anuses and glanders in these sinusts may be present at the same tune. The presence of necrotic and tumour-like processes 01 the bones m the neighbourhood of the nasal cavity (ethmoid bone, etc.) may lead to a mistake. Inoculation is speciaUv miportant here. ' 3. In strangles we frequently find the development of lymph- angitis with formation of ulcers on the head, throat, etc. The rapid htaling of the lesions and other symptoms of strangles generally render the diagnosis easy. The differentiation between ganders and chronic metastatic strangles is more difficult. Here, moculations and pure cultivations will decide the matter. Rabe has described a case of ulcerous metastatic strangles which was very hard to diagnose, and showed ulcers in the nostrils, palate, pharynx, and guttural pouches. In- GLANDERS. asj oculations in guinea-pigi were foUowed by death. When the moadated animals were bacteriologicaUy examined, there were found m them rod-like bacteria which could not be morpho- logically distinguished from the baciUi of glanders. The micro- organisms were proved not to be the baciUi of glanders, only by cultivations on potatoes and by inoculation in white mice. Kabe consequently considers it absolutely necessary, after having obtained a positive result with inoculation in guinea- pjgs. to make cultivations and to inoculate them in white mice in order to be certain of the diagnosis 4j FoUicular ulceration of the nasal mucous membrane heals rapidly and Mathout cicatrisation. It spreads to the skin in the ne^hbourhood of the nostrils, and is usually complicated only with a slight swelhng of the glands. 5. Stomatitis contagiosa pustulosa is localised chiefly on the mucous membrane of the mouth, and is distinguished by the fact of Its course being benign. 6. Injuries of the nasal mucous membrane from external influences such as hot steam, smoke, foreign bodies, linger nails, etc^ can easily be recognised by an exact examination. The subsequent acatrices are distinguished by being generally situated on the lower end of the nasal cavity (septum nasi). Thev are oblong, striated or angular, and occur frequently in the same position on both sides. They are flat. hoUowed-out. and sometimes surprisingly thick and prominent. Traumatic acatnces have very rarely a radiating appearance. 7. StmpU Needing of the nose, in consequence of traumatic caus«. aneurysms, angiomata. phlebitis, varicose veins, etc. of the nasal mucous membrane; hypenemia of the head' hyperaemia of the lungs ; and inflammation of the lunes mav be d^tmgmshed by an exact examination, which ^' have iftheTS '"**^*" ^°'"P*^^*^^«»J«™orrhage n^.^'J^Zu'^"' T'T^' "^^^^ycosis.melanosis. and other ^I^ A ^r ^^'^^ °* *^^ intermaxillary space and other eS^f?" * Ik ^"^ *^' '^^'^^on and microscopical exammation of the tumour taken in conjunction with the negative result of the potato cultivation will decide the question 9. Leucamta has sometimes a great similarity to glandere in We^ ofT"* '■ ""*.*=*** '^i' ^'^^'y' swelling of ?he glands, weeding of the nose, mtermittent fever, swelling of the ex f^r„^' ""^ t *^%«P!?^*ri"™. «tc. ThrSLntiaSon "L frequently possible only by an exact examination of the blood 384 INFECTIVE DISEASES. in which a surprisingly large increase (characteristic of leucxmia) of the white corpuscles wiU be found. In glanders, on the contrary, the increase in the number of leucocytes is but moderate. Inoculation is valueless ; for in leucaemia no morbid secretion is available. 10. New-growths in the nasal mucous membrane can, in many cases, be proved only post mortem. Among these we may include angiomata of the septum nasi ; sarcomata and carcino- mata of the nostrils and accessory cavities ; enchondromata ; rhinoscleromuta ; osteomelanomata ; polypi; and benign chronic fibrous-hypertrophies of the mucous membrane, which often closely resembles the changes of infiltrated glanders. 11. Parasites in the nasal cavity {pentastoma tanioides, and gastrophtlus nasalis) sometimes produce the aspect of glanders in the nostrils. 12. Lymphangitis (simple inflammktion of the lymph glands) IS frequently mistaken for farcy and cannot always be easily distinguished from it. The fact that lymphangitis develops usually m the neighbourhood of wounds does not always make the diagnosis certain; because glanders may also develop from wounds, and because the primary injuries in cases of lymphangitis may have healed up and disappeared. It is specially important to remember that lymphangitis is usually a local affection ; that farcy is a symptom of general glanders ; that lymphangitis frequently progresses very acutely with fever and great tendency to the formation of abscesses in the lymph glands; and that farcy usually progresses slowly, without fever and with but slight participation of the glands. The abscesses which appear in the progress of lymphangitis have smooth edges and heal rapidly by granulation ; but the abscesses of glanders are crateriform non-healing ulcers. In farcy, the cords of the affected lymph vessels are narrower, as a rule, than in lymphangitis, in cases of which the neighbouring tissues generally participate in the gelatinous infiltration. To make sure of the diagnosis, an inoculation or the cultivation of the bacilli s often indispensable. 13. Phlegmonous inflammations of the skin on the extremities (elephantiasis), head and other parts of the body, and py«mia, especially when it i? metastatic, may give rise to a suspicion of glanders. Here also we have to depend on inoculation, because the discovery of the starting point (wounds, bruises, etc.) of the inflammation is not enough ; tor glanders may also proceed from solutions of continuity. GLANDERS. 28s 14. Urhcana is fugitive, and causes neither the formation of abscMMS nor the sweUing of glands. The tumours of the skin which It pves nse to are benign. The same remark applies to ectma nodosum. ^^ 15. POechial fever is distinguished from acute glanders chieflv by the sHght amount of fever that is present, and by the fact that the extensive sweUings of the skin are never nodular. in«Hir***r***** Diff«w»ntlal DIagno.i..-As patho- l<^ca^ anatomy caiinot be discussed in a text book of special pathology, we shall content ourselves by briefly mentioning the principal pulmonary changes for which glanders of the It^t^ r^^u '"°'* '^^^y mistaken. We may, however, state that the macroscopical or microscopical result does not always suffice for a correct diagnosis ; but that, very frequentlv the clinical and etiological conditions have also to be studied' and the bacilli sought for. w/n-SL'"*^ °* °^'^ **°"^ frequently contain, in greater or T , .M • <="careous or caseous encapsuled nodules the size ufwS^ f °! Pf *f *** {echinococcus, sclerostomum, etc.). and which are to be looked upon as a phlebitis obliterans Ldosa „h- J T ?"f r,°""'. **"* *° ""^"y ™°"*« *°«»gn bodies or to inhaled dust {chattcosts s. nodosis pulmonum). They may be distinguished from the nodules of glanders-for which they are often mistaken-by the fact that they are all about the Lne 5? L ^u f°*=* °* °*^^'' glanderous lesions (especially ^L^*S?*T °I ^^"^ enlargement of the bronchid JSds), and possibly by the demonstration of particles of plante etc in the nodules. Csokor. Kitt. and others state that true n^iul^ TL? !" .^"°* '^°'"* calcareous. Confirmation of this J -™" r'^^^/'^^y facilitate the anatomical differential diagnosis of glanders. 2. The embolic and, as a rule, subpleural nodules (varyimr in siie from a pea to a hen's egg) which occur in the lun« of animals suffering from strangles, pyamia, etc., and which are •ometimes scattered over the entire lungs, are mostly of the sanie sue and age, and appear at first as wedge-shaped hasm- orrhagic infarcts. As the embolic nodules of glandere possess the same characteristics ; proof of the absence of other glanderous Changes or the demonstration of a non-glandered primary centre will be required to decide the point. *- y u« 386 INFECTIVE DISEASES. 3. Tuberculosis of the lungs is distinguished first of all by the difference between the respective bacilli. Those of glanders, according to Csokor, are broader than tubercle bacilli and seem to be composed of small and alternately light and dark cubes. Csokor further states that the nodules of glanders consist ahnost entirely of lymphoid cells and that the nodules in tuberculosis are true granulation tumours which contain three kinds of cells, namely, giant ceUs, epitheUoid cells, and lymph cells. Finally, tuberculosis of the lungs is also frequently compUcated with tuberculosis of the serous membranes. 4. Sarcomata and carcinomata of the lungs, which in many cases cannot be distinguished macroscopically from the grovirths of glanders, can be easUy recognised by aid of the microscope. 5. Actinomycosis and botryomycosis of the lungs can be mistaken only macroscopicaUy for glanders. The micro- scopical appearance of the ray fungus and the blackberry- hlce sphencal tuft of the botryococcus ascoformans will decide the pomt at once. The presence of myceUum-Uke threads of fungi, which may be seen by the microscope, will leave no doubt as to the existence of pneumomycosis of the lungs. 6. Bronchial, peribronchial, and parabronchial processes, bronchiectasis, very minute multiple foetal atelectosis, chronic mterstitial-pneumonic foci, lobular catarrhal-pneumonic changes, dead echinococcus cysts, etc., may be mistaken for glanders of the lungs. The characteristic nodules of glanders and other signs of glanders are, however, absent from them. The liver and spleen of old horses often contain multiple calcareous, encapsuled nodules of different sizes, without other changes, which might be indicative of glanders. These nodules are emboU from the intestines, and are partiy of vegetable origin. Therapeutlea.— A spontaneous cure in glanders, as in tiiberculosis, is possible, but is of extiremely rare occurrence. It is probable that reputed recoveries by the administration of medicines have no existence ; although a great number of remedies have been tried, and veterinary Uterature, especially that of the sixties, is exceedingly rich in reports of such ex- periments. Compounds of chlorine, bromine, and iodine ; salts of copper, mercury, silver, arsenic, and strychnine ; preparations of u:on, carbolic acid, alcohol, etc., have been tried. Levi and Neunann state that they have successfully used, as an intra, tracheal injection, Lugol's solution, which consists of iodme 2 parts, iodine of potassium 10 parts, and water 100 parts. GLANDERS. 287 ♦ho**t,^ mtrairaclieal injections are not only useless hut in K« i««t. J 'nsiances (janson). The other cases ar«» 0Uan/S::*tfle"sSdrLT^^ only of historiSll^est.^ ^''' ^''''"^' *°^ °*^«"' ^ sist8^n°S I^*r°^'°°^f °* extinguishing this disease con- mJii^ '^^^'**'°" °* *^« ^^«'«* precautionary poISi whicS S?U?"*^^' ^^"^^^ ^ '"^^^^ ^ ^ unsoundness daj. ; in Saxony and Austria. 15 days ; akd in sSand ,0' being examined by a veterinS^T^.I^„^ 'T "^.^ ^"^ "'""''V ^'^out disease, except in The ^^'^STk '*"J5'^ *" ** ^"^ *«"" ^^^ country, like AustriL^d L th^^ ^^* * glande«-free suffer ftom this dis«^' 1^ h c R "^■'«'"«- ^'^'='» ^^ '"ely abUity, in this connt^l, ^' . ^**" "^"^y suggeste the advis. of 3 or 4 i^ ~'''''^»'°''' °* *PP»y«>g the maUein test, with a quarantine which is as follows is wrfi -TVif 7^ ^'' ^- ^5>S. 296. and 345), taking in?o ST^t tS^ Mdi^^iJ^^P""^. ^ "^ ~'^»^' "^^^^ faUibly diagnosUc "*^° eondiUons. maUeia is not in- ^^^'^t^^J"'Z'^\:r^:'^ °* *PP--» ^landen, should be and swellingTthe's^e o iiJt'^^ on Y 'T"*"**^ "*"* °* temperature testtitSth'Sin'tS st;Sd"£: d'l.r"' '"^"^^ ^°"« '•»°'-«> •« («) Those wWch^^ ^*'^**'^ "**° '*° classes, namely _ UJd^ as tSthTas L'^'r;/-' "*'*^ consequently sho.Jl be react, and whkh on th^ ^ '^ " concerned. (6) Those which sl-uld be a^\:^eJ':itrnS;in^r<^ t.Sf tiL^''^*^^' "^ -nths. » any of this second di^on?\7te;rctSnr d^vl/^S,,: 288 INFECTIVE DISEASES. sigui of glanders (including those of farcy), they should be promptly destroyed; and all the others which have ceased to react for 2 successive injections should be declared free from this disease. Nocard justly points out that the manifestation of external signs of glanders is the last stage of the disease, which then has become general and has thoroughly overcome the power of resistance of the system! Hence the treatment of such cases, even by maUein, is generaUy hopeless. At present, mallein is largely employed in England for the unintentional dissemmation of glanders, by owners who use it to find out the condition of their horses, and who, on obtaining the required information, sell those that react. It is almost needless to say that infected animab which manifest no outward sigas of the diseaso. are the most potent of all means for spreading it. — Tr.] Olandan in Oata and BMMte of Fr«y.-The ca^s of glanders which appear m cats, lions, tigers, etc., after feeding on glandered horse- flesh, are generaUy acute. The affection consiste in an acute inflammation of the mucous membrane of the nasal cavity, antrum of Highuore, larynx and trachea, and is characterised by a greenish, dirty, and, later on. bloody foetid, mucous discharge ; excessive difeculty in breathing ; swelUng of the submaxiUary glands ; swelling of the nose and even of the entire head, and of the legs with lameness ; formation of nodules and ulcers on the skin, with gangrenous patches of the skin the size of a man's hand • diarrhoea; emaciation, and prostration. Death takes place in from 8 to 14 days after infection. Olandan in Man.— The symptoms of glanders in man are of great importance to the veterinary surgeon. Although the predisposition to the disease is usually not very great in human beings, cases of glanders unfortunately occur now and then, especially among veterinary surgeons. Human glanders is particularly common in Russia ( Woronzow and Pedkow) The parts usually affected are— the hands, nasal mucous membrane Ups and conjunctiva. After a period of incubation of from 3 to 5 daw' the mfected part becomes swoUen and painful, with subsequent inflamma- tion of the lymph vesseU and sweUing of the glands. Fever is often the first symptom, and is almost always foUowed by a nasal discharge ; ulcers on the nasal mucous membrane ; pustules and abscesses in the skin ; ulcers in the oral cavity, pharyngeal cavity, larynx, and conjunctiva ; articular swelUngs ; high fever with grave general disturbance ; and sometimes intense gastro-mtestinal trouble. As a rule, death takes place in from a fortmght to a month, and in some cases even in a few days In other instances, the disease becomes chronic, with a duration of months or yeara. Bacteria exist in the blood in cases of acute glanders (Wassilieff). Besides the above mentioned symptoms, the correctness of our diagnosis depends on the possibiUty of infection having taken place, on retro- vaccination in horses or guinea-pigs, and on proof of the presence of the bacilli. Treatment is usuaUy of no avaU. The only hopeful cases are those which are purely local, and which may be cured by deep cauterisa- tion of the glanderous centre, as we saw done in a recently infected person. Lymphan^tia BpiwMjtioa.- UnderJ the respective names of epi. BOVINE PLEVSO-PNEVMONIA. ETC. ,8,, «d *nd«n, occurs BOVINE PLEURO-PNEUMONIA, ETC. Ameri«»n oxen. 8o«ts-Ep,zoot,c .nflan.mat.on of the lungs in m^^^;^^' fi«t account Of the appearance of pleuro-pneu- s"S Sir r? ' *"** °' *^^ seventeenth century. It is stated that p.' pneumonia was observed in Hess/fnr ♦k! ^ rr ^r" ri" '""'" ^■>»^"« "r.xt was at the beginning of the eighteenth centurv when it nr^ on H Zr!k^^' ^^ ^''^^ ** P«»» ^tailed reports chief charactemlice of^^"',^ ^,f T"^ "^ jAich »as «g,„g severely at that time. Zi dSlST' in E-gkndf and to S to Snce F™™^,'^ ""^'^ the whole of GermanyVF^r^d ^Z ''^ 'Preadover n.ence.en. of U. nii;;.ee.T;er;,'^^ r.^! tn^ 19 390 INFECTIVE DISEASES. of Western Europe. During the forties it spread to America. Africa (Cape Colony), and Australia. Btiology.— Pleuro-pneumonia is an infective disease peculiar to cattle. It cannot be transmitted to any other species of ammal except under certain conditions. It may be described generaUy as an infective inflammation of the lungs and pleura (pleuro-pneumoHia bovum contagiosa). We possess no positive knowledge respecting the nature of its infective material. The mfection may be introduced into a cowshed either by diseased cattle, or, less commonly, by bearers such as cattle- desders, attendants, utensils, fodder, dogs, etc. The sheds in busy cattle markets are very dangerous centres for the dis- semmation of the disease, which, for this reason, is enzootic in sugar-beetroot districts, where, on account of the great abundMice of M^h and beetroot parings, there is a large demand for. and traffic m. cattle. All cattle are not equaUy susceptible to the contagium. It is generaUy supposed that about i in 4 IS unmune. The disease is spread in sheds and farms fr^T^^ .^y !J^ "^P^ ^- I«*«<=t«d cattle can transmit It even dunng the period of incubation, before any symptoms are api^rent. The disease is particularly infectious when it is at Its height. The animal remains capable of transmitting the disease for 8 or lo weeks, or even longer, after the infection. espcaaUy when necrotic foci remain in the lunirs • sundar to ,^t happens in contagious pleuro-pneumonia of the horae. Walley estunates the duration of infectiousness in cases of encapsuled necrotic f od to be as long as 15 months. The disease maybe conveyed by the respiratory air for as ereat li*^ Ji ^.'^^ °' ™°"'- -^ *^<*y stated, it is hlTh^f J attendants, fodder, dogs. etc. ; and more rareW iL^* ?f* J* slaughtered animals, which, as a rule, seems to Iwe Its infMtiousness on becoming cold. In exceptional cases the^ontagium is transmitted from the pregnant cow to the The contagium possesses considerable resistance. It mav contmue virulent in infected sheds for several months, and even over a year. Laguerrifere proved by inoculation that ^rtions of the lungs of cattle suffering from pleuro-pneumonia retamed their infectiousness for a whole year at a temperature between 5° and 6° C. The period of incubation iHn^ average from 3 to 6 weeks; the minimum being 8 davs and the maximum 3 months. Animals which have onc^ BOVINE PLEURO-PNEUMONIA, ETC. ,9, pa^ through the disease renuin immune either for several years, or for the remainder of their lives. stained prepar^SL t^e^Vwer^s^LdJ h """i^- ^° *•»" "- which could be staLied onh^ I^Ik '"'^""<*«* «>y a diitinct envelope, fcomcultivate?„^S^. '^iL t*^**' f^^-^^' ««» *» ab.^ »S day. at ordin^n^tS^,£^? '"^*"'' •'"*^' *» ^^^ » to and sUghtly J^e"r^to^«^^TH'°*=?*^''''^*«'»»»^«' StabcultureipLS JLl^SwWc?iSi: "*"* ^"^ "»»"• the colour oi cream and finall^Se vS; fZT^? * *«'' """°«* of 67" C. for a Quarter oT^k ^'^*™* XeUow. Exposure to a temperature I-o/ula«on'e*xK"nu' VZT^^^'^^T^T' "' ^•^^'• lungs, produced in cattle do^l.'° *''* culUvations into the pne'LL. ^Th Itl^uStirrjr^'tr/ "h'^**' - «»«»ive fro^eurJp„^oS\o'r?ue^:m':"^^^^^ ^''^ '"^ "^«^« foun^SSg""ciJle\f;?e'^d°L^'' "''■^'""•' "^^"^ »»-» '^ »« gelatine, and fo^n^XS T^^l JhS**"'^.^:'''''^'-'^ *'> "»« bovine pleuro-pneumonir^catUe %nS^Z. *-! .u° I^ * diagnostic for more eaiuy aff^ted by tL S«f tl^^,^" "-^f^^^ ^>^ much that pure cultures rendi^^griL^e^tS"""^- " » «l«"tated inoculauon for Vl^r^Z.^^Z>^^^^,^ *•*« '''^^ prove that the pneumo-baciUus is the cau^f ^Z^ * ^. ^P^^ments from subcutaneous in^ZS^n t„m^« ^^"P""™"*^ Cultures inoculated, produ^ T^'S^te^^^'^"" ^f -trapulmonarily thelungs and on the serous m^^^" ^Tv^ t^^'^r*"""^"^ " after the inoculaUon, deposits the si« of a S «^ ^V ""*'' ^y- Its presence m certain districts is constant, as in A^tfTS' I9» 393 INFECTIVE DISEASES. f 2?^ A •^^' *"^'" •°'"* P*^ °^ Germany. America, Afr«a. Asia Mmor. and Australia. The Eastern Europ^w countries, as for instance. Russia, are comparatively free vrith the exception of the Western frontiers S? sea^^^!' ^e ^TtJ^. "?* frequently met with in large herds in which there Ltn^ V ??^* °^*=*"^'• *"** *^*"« 8^«»t thoroughfare^ Pleuro-pneumonia has been observed in goats (Spinola Koppitz. and others), cameb. buffaloes, bison. aLd yafa It i^ most hkely that the reported cases of pleuro-pneumonia in pigs were founded on error. This remark also appUes to the ripute^ cases m man. and especiaUy in children. The fact that a form of pneumoma which occurs in children is anatomicaUy related to pleuro-pneumonia, has no bearing on the subject. It is im- portant to know that the flesh of dnimals which have died from pleuro-pneumoma can. as is the usual custom, be eaten by mankmd without any injury to health. **^!^'* "* BpliUinlos.— 1. In Germany during the last nine y«« (.886 to .894) about ,o,ooo cattle (say ..ooo ^ annuL) suffeS torn pteuro-pneumoma The foUowing figures show tl^ great decre^e m th" frequency of the disease in Germany during that Ome • . 778 r.M6) :t . efi SJLtion^^ • ^' "^^ "• * ^ '*°*- ^^ ^ consequence of the •J" Jn-^"*' '^~«*^8 to F«"«=h. 23.582 head of cattle died of or iZl ^t%: T.T ***' P!«««>;P'>«'"»o'^. during the ten year, ^om 876 to 1885. The figures for the respective years are as follows : In '876. 3.1 17; m 1877, 1.980; in 1878. a.098; in 1879. a 364 iT 1880 Z^^J*'J'^ r '°t*» »»"» P»id as indemnities within these ten years amounted to ^2,5,000. These figures, compared with those of the iS Sn^-uZk rr*'"* ***' ^T"' '^'^ "^'^ * '«'"<=*-« 'fi^ct on pfeiS sut^ „. ^™*°-^- ^'"' ***=* " particularly weU proved by the statisucs of earber times. Thus, there occurred in Rhenish-Pn«sia dunng the ten year, from .835 to ,844, no fewer than .00,000^^ of pleuro-pneumonia. '"".uuw wiaes 3. During the last s years there were nearly 10,000 cases of oleuro- pneumoma in Grea, Britain ; f the numben. bling 1^7^437. ^ in GrL"BriUir-lT.r '"^ '*"'* P'"^P-«»«'°"« has been . rare disease .v.tIJif *^°*''* ""'*''" »''°*' ** «'•" *"'«« ''hich hu attended the .y,tem of .tamp.ng.out a. regard, bovine pleuro-pneumonia in Engtand In Se rdS'we^^ *J:r."l*''/' ^ ^"'"^ «=o-'PuLry.,a„ghte;r^n;JSc^: 591 cattle were found to be infected ; in 1891. 778 ; in 18^, ,34 • in ,893^! BOVINE PLEURO.PNEVMONIA, ETC. ,93 depaAmeat of th«' v'i ' ^ u ''*'' '•'°^"» • •"»*» «»< 7.866. In th« were affS^m .J*; ^^7 ""'' °' *" ''' "'"' ^ '"^ «'-''*- 7' }n ?w'^'"^/u"'' "'"'' *"• •"»«=''*d during ,891 and .80a In thatc^Se^^^Lttir^i^T*^ '^ ~""*"' '" *"' ^P*"°« '*^»'*«»- Th- ^i.- °°°'*»° «*"« died of pleuro-pneumonia from 1810 to 18^ .i— !r u '^ Queensland suffers a yearly loss of Z&ionnn f« ♦•rif?t*""^*""^'*"° P"*"™*""* » anatomicaUy charac- temed by a progressive interstitial pneumonia with secondary nt:t^ 7h"^- . ^'"*?y •"^5' °°« ^'^S' *^« l«*t^ a rule! dur^U^n^f tl^'^rr °""^ ^'*°«" ^^ -~^^« *o «^^ ..«oii ^"^ ^t^**^ healthy lung shows, in the initial stage. smaU. crcumscnbed, inflanunatory centres the sire of a hSl- nut up to that of a walnut. The interlobular tissue in it is hyperanuc, permeated by single ha-morrhages and infiltrated by serum. The reddened lobules of the lungs are suirounded by bright margins, which are i to 2 mm. broad, and which are Wled with a serous or lymphatic fluid. When the deposits are itrS'Jf L'".i*'?" ' ' '".'^' " ""^ '" •«9'' **• ^' «perience uxl the restrictions on the importation of live stock give us the assmance that thU r^i**"'*" which formerly devasuted our henls. is now ^ S^ 2^' sporadic occurrence A««na. which in ,892 adopted the sptem of pole-a:Z •Upleuro-pneumon.. affected cattle and all cattle which had been expiLd to S contagium. is now, like England, but little troubled by the disease JctT 394 INFECTIVE DISEASES. J^dal. the pleune become opaque and covered with dight infl^toi^^S'' alL^ di.ea.e we find instead of the lobular TT.e iJ^n^TcoSSSy^'Xro? Z ''"^l *"' ^'^• heavy (weiehine mZ7,^V^i . ^™ consistence, very cmdde v3St iSto \^\r^ "» water, and does not 3udc«ed into b.^d^^'^wSS'*'*'"* *^r '^^ •^•»« dirtv-white InH^j K ' . ''"^ *" "'^""^ 'roni orange to recently infected lobnl^T ha«. ^7^ . dirty-yellow. The dark bJown^C SS/r* * blood-ied. reddish-brown. or the oId^n« v^i^'**' "** hepatisation). The colou; of tisation). The cen^f^ ^/'*^*!J***^ ** «"y (grey hepa- usually in the «t»««r n * ^^"^ *^*y ^^e tl»e oldwt. are inSi'obi^'l l'fi"r''*P*,*^*^°- Some of th" while others aS meiSy Sr^^l"'"?*' °', ""'^ compressed, bright interstSlS we^SZ; ♦k .Tk^^^^^ *^^*°^« "»« an cedematous iXiZ^i^^ ^^^'^ "^^ ^' ^' oi fibrinous, gelatinous.^? inr^^l ifd ?' ^^TJ P'"*°- formation of advent/tious cZ^ti^'e tSue S /'""l ^'^ ^'^^ m the lines are dilated hke ^ca^\^Vu^ f l^^^^'^P'^^ fibrinous fluid. In robust Lir^tS:t^£teTth*T"1°^ croupy and firm • hn* ic «* - exudate m the alveoU is of wiak aS^^n In the^r """""^ '^"^" ^ '"'^^ through theTuT^be foiSS /°™«^ ^' a section made changes, the o^rWhvS^VnfSfr"*^*"- besides these walls are infiltra^U^S X^Ld ^'- T^ "" **"**«* • t^^^i^ thrombosis. The bl^vSS'^ '^/'™*° ^ "» state of small h^morrW i^er^h. "^T*^^ ?°* *^°™W «»d ?rdrare'l:rfl^°^t^ fSn"^ ^^-"^^ «>« -^-tS^ n»a^! wS'aTso'SLr'* "?*^ ^"' »«°»branous. fibrinous can easily tdc^^'^S*^ ^T^^- °' ''^^^S. and whiS and ma/a^J:^-,-- -r If^^e a^^cular suHa. BOVINE PLBURO^PNEUMONU, ETC ,9, E. c^T "L^W'"' "d is infiltrated with fWtes « lump*. Similar fibrinous masses often !■• nn ♦!.- * ^ of the pericardium. ^^ ° ^'^^ °"**' »"'*«^ in i' ^i* *'. *?* *'*'**^ ^^ '^^ P"»«°t for »ome time we fiiiii do? ..f "^^l-P*^ °* *^* '"^^ i°d""tion. dcatriSon^ »^SdtS^S^;',rr^'.'"pp'^*^">' «*<=• At first S;^ suaal infiltration becomes dense, solid a j dry, and chamw^inte firm com«ctive ti«iue which makes a cnmdKoi^e^e S «» bemg cut with the knife. In oth^pS^ ^^av^ fatti -en^ation caseation, calcification, or ^p^tion iT JS2 ^tte enclosed lobules of the lungs, in ^J^l^°^«^ oT^ ^jstmg suppuration, become ^.nous, andW a«.t A .^ /i,^ ^ ^'''*'°°* °* *^« J«°8s may remain un-intestinal mucous me^biine ' '^''" °° *^* from 3 to'e'^-^tJr"*' °' ^'"^*^°° ^"*« ^'^ «» average m 3 to 0 weeks, with a maximum of 16 weeks and a minimum ^ J Noise Hke that ««fc when snow give. w.y under the p««„« of the foot- «96 INFECTIVE DISEASES. divided into • chronic and an acute stage ^ -I Jut., a. a nUe. .teCTu^^it^^rin 'i^CJ c:::;^^ duration may be restricted to onlv a fewrf-« f!^ p*««Jt» *^ or moving .bout. tl»n u oUkt tim«. h ^^n^ PfeMed. The ammal U slightly feverish thrfnt^m-iT^ ^ ^o.of^d'^'i^y's.'S'r.'sK^- ■■■'™. •iwt and tt^elboUT^ "T^ Witt the fore fcp .jd, *4. Which i.z..t«°ss ^ M„^ rriTi *" purulent and foetid P..rr,«ci«« j ^° ™*y become lato on . dSrtu^T^S.'^ri'^''^'^'"' siderable portion of th^ i«„«r, wrncn extends over a con- boundary.^Si ai^Hn^^' f ^ i^tquentiy a horizontal or. if uSnot pS we he^in T *, '^"t' ^*^*='^*^ '»'^«. ronchi. and a fS*i'*"ii'^;^ ^h'T'^'^r^^*^""' •epilation is much incSSed ^e r2^.S T^' *^' ':*^'^" auscultation coincide withrwelf^rlL^L^'Tp^-j BOVINE PLEVRO.PNEVMONIA, ETC. ^, examlitttion which have been .Ireadv discuM«d in «« *• •bout uneasily Th« ,.««- «7* . ^ *"* *°*™*' "oves albumen. TLamaiS. nit" ~^"* '^^'^ quantities of the patient b^o„l^^eml"5^"Sd"''^^^ ^'"^y' develop on the lowerS ^^ oflh. 2^?*'°"' ?•"'"«» lap and on the lower Dart«/fhl^ ! . ^^^ ** °" ***« dew- been ied on g^f^° Tt ^n^T*' '*'°'^ *^"^ ^^^^^ »»»ve sloppy ^oodr1aS^';:^'«*iXm"^H'"S''^*°" slower, though more mali^ianrT^* . **** ****«»»« » to 50 per cenr^DSS^JaUy^t^^^^^tli T^ ^" ^° weeks after the commencemenrof A^^Xfta^^'^A *° ^ ally, m severe cases, it mav ocr.ir^ ^ ^^' 0«=*Mon. about 30 per cent ".1?^^ ° from 5 to 8 days. In that c^^oSch^e. ^th'^hS^'^^'^'y " '°*»'"P'^*«' - lungs. The tot^oss ^Xe^tivStsT JT^ '° *^* per cent, of all the infectSSafe TtH^ **• *~"* ^o to 70 of at least 50 per ceni r!^!^' * n^nmium mortality smaUer numb^r^ c2^ m^Zl recovery takes place in I about the fifth 4^he aL^fsZ~7'°*°*.«'"^»«« °« tracted for several weeks « tS ,»^!" ^"^^^^cence is pro- stitial exudate gl on ve^^^'o^^'P^^; °* *^« copious inter- the course of the diseas^lT aSve InH fr'^'^'P*^*"^ "^ there being only a^hf .« ? ! •^** *^* symptoms mild; breathing"lSttm5!StSt^ti^lTrj'"*"°" ^ *^ camification. adhesion to the ^iTofl ^.''^J''^ a98 INFECTIVE DISEASES. reminds one oi taSSf of ' J?.^ *' ^'^^ °' ^^'^ **i»««« pleuio-pneumonia^nrrfr^ *1 "°^' """^ ^^«=l> '"alady in abortvT^ haT th^^ r'""^ complicated. The diseai after mil; Sis *'^ P^'^*"*^ ">** ^elapses often occur ani^°a^^m"tSc.^^5tS ^ ^^ increases in a fewweelT^ tJTIv ' .v *^5 n«™ber graduaUy spread in the tln^ti orX"from%'r? "•'**^"" *^ may finaUy become enz^tic in h ^^■\ *°.^ "°"*^' *°d greatly in different enSS t„ • ""i^^^^ °"*^ ^^^es the dLase alw^^ S^^", previously attacked districts sanitary stX^Sd^^ fc^'T^^'^'^y "^^ *yP«- I"' influence. *°*^ ^*^^ * ^«^ unfavourable pleuro-pneumonia mLT^t ** '° exceptional cases hepatis^tion of"^3g« "'^ "'"*' ^'^ ^^ «»»- in ^e^;^':?S:Xme'; f *-r'«i <=MnicaUy. especially BOVINE PLEURO-PNEUMONIA. ETC. ,^ to ^SS. '"fteTaJ'"::^™ Pleuro-pneumoiua. do not react dence during life, ouSZ2^f;"S ^ Pleuro-pneumonia. Evi- m.y; u'^S.r^ «^„TrS:^ *^- " '^ an, caUU disease " Pleuro-pneumonTon ISZ*f^r; '''^^ * «"^* ^^"^ty to differentiation i. foundS^^n iT "^T^" aPPearance. The the exanthematic MdihHn • f ."'""^^'^^^^ occmrence of <»ttIedi.ea«Ta^d"ntteSJr'/ '^^"^ " ^^ ^d and the infltmmaton^ pr^T™, *h ""^ "' °^ *^« «°»« age, pneumonia (see p. iS^^ ^ ""''^ '°°'^ ^*« ^^ in PW acHnomycosis, diskZuosts of k^ i^' "^^^'^^^ «/ <** lung,, portant practicalloint whi.?T u "^^^ atelectasis is an im- a«ain«t the unr^utKct^hattJfJ^';- r°«>"«Iy advanced of pleuro-pneumonia is t Je mth^°*'*^.*°**°"^*^ "iterion which consist, in an incr^ Hr^dth'^rf'^.^^" f ^"^ ^'^• nective tissue with hepatiSLn nf <^ *^® interstitial con- various ages, and cS^^ll^ f ' '"^P'^^^'y Inng tissue of It » to X hoped ^^ttZ °^^*"°'«. «J^d«s of colour, diflferential diaSwiTidU L T ,*^*"^ P*"*^ *^« anatomical demonstrationlf^rth:^^^^^^::;^;;^^^ ^acteriol^c^ and«;SS""or^i:e^^^^ ^^y Prophylactic been used, havi had no SSZ e Jj".'^ ^^\^^ *° *^« P^««nt results are obtained fro^e nrof . "* *^' *"''*^- The best sures laid down in thV WriS ?S "^^ T**'^*^ Po«<=« '"ea- episootics; the meet imS^e ^S""*"!^**" ^*^ ^^P«=t to slaughter of aU aSmabS^n^ ^"^ ,*^* ^^'^'^ orders the » the most certS mt^TA^.".?*"~-P°««"°nia. TTiis 300 INFECTIVE DISEASES. S S^w^'!" , ^.'"*' authorities recommend that it should not be used for at least a year and a half. cou^SSr? "^n*^ " ^"^'^ 'T'^^ pleuro-pneumonia in some l^T ' ? "f*"'*^^' ^ '^y^ >° Bavaria; 30 days in Saxony ; and 14 days in Baden. ^ has'n'^^*SL*^'^^''"~P"*'*»»'»*'^-I°«^ati^^ c^^n^ . *°'" * '°"« ^^"'^ a» t*>e principal means for combatt ng P uero-pneumonia. As early J^ the beginX of iXr S^elT'" n"^ "^ ^^""">y ^y Hau^annlmd ratfn^; ? eniployment was greatly increased by the investi- gatoms which were made in 1851 by WiUems in HoUand^^d which were pubhshed in 1852. Since that time these inc^^a tions have been practised in nearly every countiT^rthe hterature on the subject has been veJy copious. In spite of ^ ^. the question as to the value o^ SoJation as a p ote^tiS a^ pleuro-pneumonia. has not W received a finS a^wS^ tin^'u^t adv^tes of inoculation, among whom we may men- start from the well-known fact that one attack of Dleuro-nneu remainder of the animal's Hfe. By inoculation, a local soedS mflanunatory process, which is analogous to Siat hTthe^' produced and is foUowed by subsequent imm^ ^f ^*e S ^' i?°f a*'"" also shortens the stay of the diseaLTa shed The 1^ after caudal inoculation are statedtobe in sigmficant. Haubner calculates that tiie mortality from the mociJations is from i to 2 per cent., and that th V of the tails are lost m from 5 to 10 per cent, of the cases. In HoUand among 59,180 cattie inoculated in 1878 and •79. the mortSitv made m HoUand, Saxony, Anhalt. and AustraUa are cited u S'h^ IJ 1r^ of inoculation. Further evidence on tlS^ Stz S,;^L°«^ ^i^l-^^"'^ ^y '^' P^^""' ^«'"^t» obtained by .^drn^.^! f°-. ^^«™"ationoftheafifectionbyinoculation l»S!^i "°''^^*'''"*^***'^'^"^«=ommendedasafarcheaw methodtiianstampingout. which entailsgreatpecuniary^aSS^ Degive has calculated that the results of inocESSS m (hffarent countries from 1850 to 1883 show that 27 pToenT of 6.706 inoculated animals, and 26-9 per cent of als, mv, mooilated beasts, became infected '^ti "fjLo-p'nS^S BOVINE PLEURO-PNEVMONIA. ETC 30, 1875 : 951 in the ye« 1877 ; 157X^^1^'''^? "S' ^"^ in the vMr T«fl^ T* 1 •'7 mine year 1879 and finally to II the inoculation of dus or mill- a„ • • , . appeare after ri«. in fKo tlZ^ F ' ^^^^' inoculation never jtives that their immunitv is credited tn tha. a«-^* x '"^.""*«*»« ana Inoculation would t'LSef^fclti tt'c^S^t L' l^r't^i* to other districts and to be artSZ kto^o ^. r"""!^ of inoculation state that the IosTJL fiia^oniroSn very considerable, and that the mortality Setimes^^ that of pleuro-pneumonia. They further assert 3,?t ?n^ V1V.IH «? P^j,^«°t- To this we must add loss from decreased yidd of milk, emaciation, etc.. as results of the inSuTn They also point out that the disease frequenUy spreTSl sphe JOS INFECTIVE DISEASES. P«t.»d, Uj. di«a« shows „o dKTOs., "T^^c fa England .• where the oBcial reuort hvs mrti^i!^ , •™"*' "" doubtful value of obligatory Sa^rn ^p W^^ml^* oDJigatoiy. In other countnes, as in Holland, the decrease in the number of cases was not perhaps the co^uenr^th^ moculation. bv the simultaneous appDcatioH? veteSLl^ states that m Belgium pleuro-pneumonia increased in soite of inoculation from 1.481 cases in 1867 to 2.800 casSt is/r but that It decreased rapidly in consequence of the appSn o % :^t?88^""a "";?"" ^^" ^'^S' -ses''il;i^° to i.i»7 cases m 1883. According to a table made bv Kitt tZ number of cases in England decreased only af ti L apouL?„ of severe protective measures in 1878. diLg wlSZj^^ were 4.590 cases. These numbers fdl to ^r^rllqan^ to t^e°?n;°J^;- «f'^-P°«'«»onia decreaJ^in^LCi^ the mtroduction of the German Imperial laws ^v^J^ Baden, where from 1870 to 1880 there was a yearlvloss of ' n n? per cent, of all the cattle from pleuro-pneSa^n^a sin.u case occurred in 1885. «'«nioma, not a single It is diffiailt to draw a definite conclusion from the resuective argmnents of the advocates and opponents of SocuS^ I! any rate, inoculation seems to be uSul. not ° a SSi w as a means of shortening the duration oiL ep^^'^S^^L^e stationary herd of affected cattle. We certaiily regard ilS ^the diseased animals as the best meiTSr S^^S^' pendently of the ammal body, can be annihilated along with it Stampmg out. strict disinfection of the tainted sheds aJ?^ •* evacuation for a long period. consequentiToSr at^^J^ fS chance of rootmg out the diseasTSan inoculation • St* foot-note, p. 293.— Tk. BOVWE PLEURO-PNEUMONIA. ETC. ,03 affected pajts are cut out of the fr««h i..n.» t> the removed portions of the un« we obS„ .^^ 8~"« P***'"" ««"«» "n to coagoUte, and should thenS.Tt£2S''^'T'^'''''"'«"W use ., lymph the fluid which is obin^ hi i^^'^^'^'^'^f" ""•'>• 0«»»e" Ution tumour on the tail, and wwTiTlSH »« k""" "*•*' •'*'° '•»« '««=»- efltoct. The site of the i^oculaHon b o^^Se H ^^7 * «=<"»ParaUvely mUd about 8 to lo cm. from the Up AfL " m« u ^P**' "* "» **" and « made at one or two spots^tht h^,^"™?/ '""^ '^''- "*" '»«=»'ation made to penetrate the subcutL tTI ^'kT"!!' *'^*='' '">°«»0 «« colour of yellow hock, and should never Wv 7''' ^ '='«*'• °* "»« the lung,, but only from those p^S^e^^^" *™" '*'*=~"'= *«=' « The inoculation " takes." on aHverawin^ti" "'"**«'"'* »'«Pati«tion. moculated animals. After a pS^ v^.^n^'Lf * '° ^ P*" ««*• °* ^^e appear on the site of the ino^Sn^"! from , to 4 weeks, there under normal conditions, is ^t llSer th^ T**'"^ ''^'^S- *Wch. accompanied by slight fever and Serat^",! ^? ' *««' *»<» ''Wch ii not quite pure, extensive swemn/^th? 1^ breathing. « the lymph is tip. high fever, and symJtoS o/sep J«.^^'* J *" "^''^ necrosis of the appear. These sympioni aTabo ob.^^!5^ T*^ P^*"^' '^ Probably on the dewlap orTthr.^t S'he taS^I "th" ^ '"'^"^"onTmade must be avoided for the inoculation t«?u '"'='• *'«""»* *^^ Places inflamed, we must prevent r^.^nt .' **"* **" becomes exce^vdv septic treatment, Idl^^^'^^T'^'''' "*"'' ''y fr«* incisi^a^t^ already mentioned, the m^^J^; 5^0^.^"" "'J^' «>«crotic7;. ^ and the loss of the tips of thrtSls ZT.T""^" *">«" *» 3 per cent! second inoculation is'^made iS' tZ 8 '^^' "'"*• Sometimes a above the site of the first inocX^on m J"^^ °° * ?"»«» «tuated diately under the last wuS^S^Ik^ ^"^ ^^^^tes the tail imm? and saturated with lyS* RuSe,^^^ ^^« * »«*«"> 3 mm. bro^ this method, with a mSty of fj^^'S^f *S.1 '*"*'"'*"« """'^ torarely foUow this method T^e^wS, .^"^J^-^^qn^nces are said become developed between the nlith 2 tL^""^ "^ '^'^ inoculation ini r r--^^^ oSX*^ ''ii/ui:*'"'" °''^' - ^- therpr^-.S'fp'^,- »rlteS 't-- - -n ffi inserted into the large l^S^^i^T^ST '"'^ °* »niaU cauS neighbourhood of the inoculatil pS '^.'^°'« . developed ia the fiUed and are then quicklv cl«*rt.f ?!f*K . coUecting tubes are half Whilst the lymph r^g S*' ^t"^''^ ""-^ °* » spiht flaSe clos^ with a stopper of wlddfuf toTev^t^e""*'^ "' '""^ ""^^-Kl ^ tubes which can be sent aay^ie^e thr^Li*'Vl'^*=* °' *^- ^n these form for 6 or 8 weeks. iT^ sut'ed fhlr^ . ^^^ " *" attenuated ^ suffice for the protecUve in^^at S -f* Z IT^ ''^ '^ »y»S moculatingacalffromtimetotimrfrLh? J* ^nU-grown beast. By the thoracic cavity and are incisM onSe S J'* """'"'^ **''«•» ""^ of by means of a sterilised knife^"^!^*f ^ '° * '^'P''' °* ' «=«. J04 INFECTIVE DISEASES. " «»;■ •»»fved off, and the part washed with soap and water, and moistened with a ^Intion of sublimate {. to looo). or of creohn (i to ao) ^d K«^ """^^^ introduced through the sldn obUquely inwS and downwarfs. and the contents of the syringe are injected into the ;:S"^;.h^?!!'*:?-jr*' ^^ »•" »*^« "• *^°»^ -ith cotton wool which has been dipped in sublimate coUodion (, to looo), and the icm broad The subsequent local inflammation resembles thft of erysipelas. Sometimes a portion of the tail, or the whole of it, becomes necrotic and « cast off. The local reaction is more violent af^Th^ injection of warm lymph than after that of cold lymph l>fa„/'^T'^ n •'•'«=^<"«— Besides caudal inocuUtions, Thiemesse. ff^^\^f'^- ^^'K";"' Sanderson, and othe«, have tried injecUons of a ±, I " ^^^^ "*'** *''* j"«"'" ^«^- The '«««♦« are said to be very good and more certain than those of caudal inocuUtion. It is said to ha^ given rise m one case to a marbled inflammation of the lungs. Scptio nraro-Paaamoiite in C»I»«fc-Under this name Pais describes an epuooUc disease of calves which has a striking similarity to pleuro-pneumoma. The disease appear* to be a form of sep^La accompamed by pleuntis and pneumonia. It runs a very acute course' with fever and great difficulty of breathing. The pathological chaxjei in the lungs closely resembled those of bovine pleuro-pneumonia. P6U sutes tha the cause of the infection is a rod-Uke bacterium, wiiicrS very hke the respective bacteria of contagious pneumonia of the pig sepucamia of rabbits and " deer and cattle disease." Its pure cult^w produce a disease very similar to contagious pneumonia when inocu- h^J o^tf ' w "^"l' '^^^'^' 8"««a-pig,, calves, and young homed cattle We may easily distinguish P61s' disease from pW pneumoma by the microscopical demonstraUon of this bact^um Galtier found the cause, in calves, of an infectious pneumo-entS which occurs particularly in Southern France, to be thVpneumoJSs Zr-forT^tnT" ^ «-»» « ^^' sucking-Jigs, andlT" bemgn form m cattle, sheep, goats, and fuU-grown pigs, and can be ^mitted by inoculation to these animals, l^sympto^ ^.^t S bronchitis, pneuinoma, pleuntis, inflammation of the intestines, pericar- S^' ^ '°'»f«^ degeneration. The mortaUty in this disea^ Tvery high. The fact of havmg successfuUy passed through one attack doa not confer immunity. «"««.» uoes Beresow has observed in Russia an epizootic pneumonia of calves with gastro^tentis. There is lung hepatisation in foci. inflammaUon of the fourth stomach and mtestines, ulcers in the abomasum. and sweUing of the foUicuUr mesenteric glands. Only calves of 8 weeks old and under became affected ; the majority being from 3 to s weeks old. The disease lasts for 3 or 4 weeks. The symptons are : cough, mucopurulent nasal discharee suppurative conjunctivitis, diarrhoea, emaciation, and weakness ' Perroncito has described an infective pneumonia in calves which caused great loss to farmers, and which is due, according to his reskrches to the micrococcus ambratus. The colonies are nail-shaped, and pun! cultivations on gelatine and agar-agar have an amber-yeUow colour. The disease attacks calves up to the age of 3 months, and is said to occur also m suckmg-pigs. DOVRINE. calvi. ^' '*'" descnbed simUar pulmonary inflammations in .imSS^S?l?L'^»»*^"^«»0«>^-In .894 there appeared of the lung,. wlu"h iTrbeen \nt^ ,2,"^? ^ *" •'P"«'«*= inflamiaUon established it«l£amo„g^"r.^";tiy.S^ 8oats from Saanen. and andinSchmalkalden ll!hm^^Z!Z' '" '^« Saxony Alp, (Pusch) out «K,n after the ariv3 of ihe J^tnrom'^ °' '''' t"*"*' ^'^'='' »*°^ consisted in cough, dwpn«a L5^.? ^°'^.S.mmenthal in Switzerland, cussion, mucous *^nJrdSr'°*"'fr^.*'°'J °* 'he thorax on perl membrane,, d^^onZ^Ln T t^''^'*«*»' «< the mu^us weakness. Post Zum e^^Zt^n sC^ /ir""" *"""**• "** ««»* and pleuriti,. The disease^T^lTi'SC.T ^ S'T""'* "' Pneumonia tion varied from 8 tr.o^v^^^l'^'T;^"'* **** P^"^ «* ^^-ba- herpes-like eruption on the nS'boSh^ L?h *^"^ "^"-'"^ » people against getting g<«U £,m S^™ *c'"°""'- P^-^h warn. Colony, Hutcheon obser^^ln^„g ^S''"^ '-Switzerland. '^ Cape pneumonia which had been intmH.5 J k * "»f«t>ve form of pleuro- were those of seriouTchS t^^S Sd LtT"* '^'^- '^*' » W«« third, of aU the cases. pS^Uv; ^^1. '^* *"'''^ ^**"y '« t'^o- by 3o per cent. The i^S^Thu^^^^L^'r;^ *•»« '-^'t^Uty Juquesnoz and F6rir have o^^Z^^"^'^ *° I"*'"*'"- supposed to have been ^ of true ^^co^orJ^^Z^ZT NoJatrtssr^iiSivr b^: •« P™««. where it caused grea los«!s during the thirties of last centui^. espeddl/in ?&1^7^d'S;r***^'1°'-'\'^*'**°^P*«^- From the y^ Hun J^ K -f "°°*'' "* ^'"*"*' "PeciaUy in Bohemia and Hungary where U was widely disseminated at timeTw for ^stance from 1859 to 1862 in Bohemia. In 1I30 it w^l^tJo duced mto Switzerland and France, where it ZL^^^ great l<»8es among the horses of the breeding WtaSnenS^ m 1836 mto Italy; in 1843 into Russia ; a3er^nSo^rie«' SllSfd'^'fTir*^"- AccordiitoR6U?rU^o^' m England and Belgium. Although it was very prevS iS some years in Gennany; it has^ahnost enSy^S^ smce the mtroduction of the German ImperiaS S^ to epuootics. For several years not one case has be«i^ tioned m the statistics of the German states ^^ous views^ve been held respecting the nature of this d«^. It has been commonly supposed to be identical vZ 2^^ ^?V '^"* P^«-" Even in recent times k^ considered to be syphilis transmitted from man to m^^ wuS oth«B^ The above-mentioned authors assumedlhat the di^ ^transmitted at first by syphilitic Arabs to she-asses ^iJC ^nl..^.^r "J*^- Lagu«"^^« therefore proposed ti^ name of • syphtlts des fquides" for this disease whichis of ongm IS unsupported by any proof. Others state that thev We seen several cases of glandis'and farcy spring fLd^^^^ and consequently they regard it as identic^ with gland^ of Sken for T, **=^P*'°°*' <^»^. t™e genital glanders was mis- taken for dounne. For a considerable time, dourine was S hV"' *""^°" ^ ^ independent disSTof X spmal cor4 the pnndpal symptoms of Sch were stated o^ ^ysis. It was caUed on that account " paralytic SeSe" (Strauss nerve disease " and " breeding pkralysis " S is The fact that two entirely different diseases, namely, dourine and v^icular exanthema, have been for a loi^ time dSd tote cLr'^VV'*=°"*^« ^^■" grltly ~nXtS malady. The old hterature on the subject contains many DOURINE. dourine. namrbetweenTL% ^ *!!'' "»*"P>ant form of the true charai^ wWcVi^ STr^'^^^li^xf "*°"»«'^. at the present day y^e^re^rSJtir ^^^^^^''^S- E^«n dinical. bacteriolcLc^ 1X^7 '."*' *"** ""^^ «>°»Plete the etiology andl^nto^, „?!rf ' "V°™»«on concemii^j dourine. >S;chweS*J.^s/fiS: two disease. especiaUy !S taken by von Thanhoffer S:rvt';ecoStir"''*"^^ ""'^"• organs, and fr^ tLS rZ. 'nembranes of the genital '>ody. It is eSu^^Sy 'tf^l'Sed' tC^J '"f^^*^"" '^ *^« the act of coition from staUi^ ^ mtl J •"*'''"°'* *^""'« quently. it is chiefly dissei^^ted ^5; *t "^'^ "'"'*• ^'^• especially by stallioiw^ w, ^""°« ?* "'^^ring season, stallion may for im^UTnlt^lM?"'°*^y ^^ ™*^«»- On* The infective matter in tLefo™"?' "^"^ ~^«ed by him. to Thanhoffer, in the v^Li ^°^'' '" ^°"»<^> according medullary roote of te SerT'''°'"' ^'"*°' '?'»*' ^^^^ the blood. On accou^t^ftf 1 "r*" ^"'^*'«*'='«). and in the infective matter mv remain ^ " f°"^ °* *•>« « system disease, as HeJ^f J^the wT.h°' '"°"' *^ * ^^ Th* inoculation with the^tfo^^ Ik °'^' '*° ^ transmitted by Nocard has found tSTin^ ? J ^ ^^^^^^ ""*=°«« ""enibranes centres of sofSg^T h^p^f^^r*'^ «>« ~«t«nts of t?e ing the disease. Inoe*^^^ and found that therdiS after TTJ"^^' °' *^« ^^^^ 5?:r'to^^r-LTb~ According - Kodloff . jte^roS:rt^e E^h^U^^^^ or phlegmonous swemij of tSf^? °°' T ^'* '° *° oedematous females ; and of thl^Ktl^''^ ^^ '*^ "«' hbourhood in th. disease has condn^^^:?^t'lrr^"J^'°^^^ A^*- "r some tmie. the skm of the sheath 20* 30« INFECTIVE DISEASES. frequently becomes indurated and considerably thickened. Catorrhal swelling and thickening, ulcers, and scars nuy be seen on the mucous membrane of the labia fudendi of the v^ina and of the urethra^d on the outer surface of the penis. T?e ulcers may be superfiaaJ or deep; and the cicatrices smooth and viin' \^^^^ «J«^ated- The mucous membrane of the vagina often shows arcumscribed, pustular or viUous hvoer- ta^phies, by which the calibre of the vagina becomes contrac5«i. On the vulva and perns we also find unpigmented spots, corre- spondmg to the former seats of the ulcere. The testicles are eithw enlarged or decreased in size and contain caseous centres of inflammation. Between the tunica vaginalis and propria we find adhesions of comiective tissue and villous proUfeiations. TJe connective tissue of the epididymis and spermatic cord is often infiltrated by a yeUow gelatinous exudite. The udder w sometomes inflamed, swollen, andfiUed with abscesses. ♦o Je° * 'P'?*^ '^^^. *** *°**' according to Thanhoffer, symp- t^sof myelomy«)9is, which manifests itself as a m^Hs '^^,'^Pca centralis, as a syringo-myeUtis (a central meduUary Jderosis), or as a locaUsed degenerative process. At more ot l«8 numerous places the spinal cord is attenuated; and its b^veree sectionsare asymmetrical, softened, and permeated with red spots. The grey matter is atrophied, and contains pulpy centres of softening of greater or less size. The spinal memnges ^ opaque, adhesive, hyperamic, and have a consider- able quantity of serous fluid between them. The microscopical examination of the spinal cord reveals abnormal changes in the ganghonic cells, namely, in the nucleus and body ofthese cells "" ^^ uf r°<=«»«'' neuroglia (which is considerably in- creased, blood-vessels, etc. The membranes of the brain especially the pia mater of the cerebrum, are hyperwmic and opaque The ventricles of the brain contain a considerable quantity of serous fluid, and the brain substance is sometimes very oedematous. The inter-fibri«ar connective tissue and the neurilemma of the larger nerves, 1*^ come from the spinaJ cord are gelatinously infiltrated. The lymph glands in the neighbourhood of the genital organs are often swollen, pigmented and poroeated with caseous foci the size of a pea up to that of a nut. In the abdominal cavity, the subpe .oneal tissue is also gelatmously infiltrated, and the mesentenc glands may become swollen to the size of an apple. In one case Ruthe observed rounded ulcers on the intestinal mucous membrane. We find on the skm, in greater or less number and in various sizes dr- DOUKWS. ^ skiMuiSr ^ ^ "^^^^ *°^ ^«»<'-°e«'o^of the consists in sweUi^ of «.' ^* 'ymptom in the stallion wS la?..r Z^^ ^'^ P®°"' especially of the glans penis pWm J^r^v takT"^, ^»e considerably swoUe/and^' iiiutiiusu may take place, sunilar to what ^m^*i^^ v cues nothtog CM t^^J!,^'^,'' .*"!>'«'■ '■" »»»y fected ; the .^^6^^' °'^ ""^ is to. of dl .f. Md toCSL St.'SS T"'"' *'«* ^ *• S va«iiu k mtiTT,,.; i^ „ Th« mucous membrane o( the ay shifrSSr posiS,n i^^ ^S ^rf * ^r*'"^ ^'^•^- ^'^"g which t£rs«; become moderately hard, and then slowly disaDDeaTThS favounte sites are ihe croup, neck. should^Sr^d SlT LTin' *'A^^^^r;:sX1si^''orr^^^^^ 2lPSi— "iJ^nees; knucl'^^ef ^hindf XS^^; rrrLuS\^rn:r*^raiTect::,"r^^ '°^^^ exlub^ permanent trembling fvl^thn^e iSy.^ or S paralysis, as for mstance. that of the lin, Aa«J ^^ \T DOVRtNB. ^„ S^v*!I,%S!"k- P* ^***"* **«""- ««»""»«»y emaciated. Bones and nbt become very prominent. The skin b«»mesdrv and the coat stands on end and loses its rioss ^^^t^' animals manifest pain when the luX ^^oHs pS^ '^f •ensonum becomes more and more dull s^ WmS^dT^! Sren"?r %•*"*"« "** expressionless^ptlTn^ ' wSs the end tiie sufferer peisistenUy maintains a r^mbent oSn and finaUy pensh« from hypostatic inflammatio^ of th^u„S' ^pticaemia mduced by the decubitus, or genenU aicS' Somehmes m the final stage the patient suffers C na^SSi C^/^f^ °L"" '^^"^^^ glands, and con^nc^^L Laguemfere has observed severe internal inflammation of theTv^" The appetite continues normal longer than ^ther funcdon': chfjS?."^ *■** P»ognori«.-The course of dourine is always SZih i? r"*« ^^'^^ti^" ^^ from 6 months to a y^ T^^t n^y extend to 4 year, or even longer. Inv«5 few instances the disease runs an abortive course, in which S ^mori,.d changes are merely local. Relaj^^^^eti^ SlntomT''^'"^' improvement has beeliToticed. ^^ local symptoms frequenUy disappear when paralysis sets in ahn,Tr,^'°^°'" " unfavourable, as the mortality amounts to .n^!. ^i ""*•' *°^ •' """^ unfavourable in stallion 5«S Ltt^ Recovery is possible only at the beginning of^ parSl*'SSiP^"^-^*°'*' '^' "^'<^» »nd spinal paralysis mamfcst themselves, it is often very difficult to sSSiTh^ slow course. The diagnosis is more difficult in the stalhon than m the mare ; because the external local chani^ are fr^q lently not visible in him. in which case the d^ a^^ reco^ . d only by the fact of the stallion infecting Sv^ ^^ which IS an acute and usually entirely benign exanthema of tiTe hT^2T "^"^ '°^ f "^^ very simil^to thoi oHou^^e but without any general disturbance. Formerly severed of v^icular erythema have been frequently diagn^ed^^oiSS^ The inflaru lation and formation of ulcers on ^^^ m^^ Sr?^h "^y ^^'.^ ^st^l^en .or glanders. iS^X S £t:^f2t '^P' ''"''' "* simultaneoS^ i^^ in tms case the further progress 0. the disease and inoculation JM INFECTIVE DISEASES. experiments will enable us to decide the point I'Megraoaou mflanunabon and pyemic processes with swelling oiSumvh stalhoM which are suffering from an ichorous purulent ScL« may be mistaken for dourine. Here, also, the fuXr^S' oins may be mistaken for the second stage of douriS! in th?w^""";TJ".**"*°* *^ ** "'^t ^ successful only n the first stages of the disease, and then only by treating the c^J'"'"'" S*^ disinfectants, such as solutioi. r^p^^y^l corrosive subhmate. carbolic add. etc. Late^ on the kicS application of disinfectants and astringents (soluSoks of 1^ S ^' f P^*" °* ^°' «**=•> ^ ^^^ only a palliati^ effect, pe external swellings of the skin, udder andl^nh glands should be treated!? incislons-.:^SU^biSt s^ST*"^'"*;'*" '°*-^y. the usual SSfrh^°aL' syphihs. for instance, corrosive sublimate oi to 02 eraZiT po^«um iodide 10 to 20 grammes, and arseJc i to i ^l' l^ ^° ^* "°* unsuccessfully, it is said. A, spiiSTa ysis may be treated with strychnine and irritant cutan^i -unctions It is stated that the disease has C S^T^ cured m staUions by castration ; the supposed rationakof the iS^^^"^ *^**; "^ *^« i^ection^rinS i^'^' testicles, their removal would include that of the virus. ^^il^T^'^-^"'^'^''' » 8«»' number of ^SnStion «i«oa 10 monkeys, and the following positive results are claimed :_ I Jn I!l^„"*' (Aurias-Turenne, Gailleton, Waller. Klebs. and others) 3. la cats Auaas-Turenne, Bradley, and Diday). • 4- In dogs (Auaas-Turenne and others) S- In hones (Mathieu and others). 6. In pigs (Matineau, Hammonie. and others) VESICULAR EXANTHEMA OF HORSES. 3,3 SSlJSfSfth'^SS-T **~ *''•""•**• ^« "^^^ »«-«' *>«*■> able. mn«nA«.r/M . *'*'' """"" membrane of the urethra, namelvTue SS^tK. '^ "* "^'■' '•»* '='*P "* '1°«» being merely a puroSSt mi»!!l!!l'^'**' "^ ^°''*' *"** ^*^ °* Berlin have succeeded in trans- X *iJtet*hc'l^'^"'' ''y •''«="»*«°« of Pri«nary virus, totm Si^^d •pe.. In both caMs, secondaries followed the primary symptoms.-TV] VESICULAR EXANTHEMA OF HORSES. ■tiology^This vesicular eruption in horees is a generaUv ^TZ^ tyP»«^y progressing, infective vesicular exShma ^d ,ln7. S "^"T^f^' °' th« vagina, and skin of the vulva ^Ir^l^^* P'*'*' '* ""'^^ ^^ P'^^^t heading only because acute exanthemata. It is met with in many animals mos« frequently in horses and cattle, and rarely in shee^^u. Td pigj. The natuw of the infective matter is not pre^y knovm T^edjMwe can be trai«mitted with the greatest facilifyrLTe ounelves have observed in our inoculation experim-u The SSon "^^"T* "^*^*^ ^y °*^^ '^^' ^th^-t previous Sl^Si ^''tu '*"^' °**y ^"« i°f«=t«d. during sucWng. o^ Sr &"°"*^; '°'';^'" "^'"■*°« °^ *^« nose^eyes, ^d on SLS^T'" ?T*' ^'^^^'S' Hess, and other^). The mfective matter » found only in the contents of the vesicles nuiSr^^ *P*^.*^'= *°' *»"« ^**"'°° '"^y infect a large inT^ u?^* ;^P«'^°«« attack does notinferimmunity; tafact. .taUions which have recovered from the disease often bMome again infected after a few weeks (Steinhoff). The erup- if al!S" .^^ transmitted to man. especiaUy to the hands mirv liJ?" • *n. * '°"" *^*=^ ^^^^^les smaU-pox. and ^r^^V"^^ °* ^"^ «°*^« ^'"^d axiUarTganT and to a feverish increase of temperature. The patient Wer always make, a rapid recov^. The v^fc^ S ^rrT^Lnf*T*^y ^^"^ "P°° »° ^^<^« as a kind of horse- Si. iu^\ Inoculations in cows and calves are said to produce characteristic cow-pox (Peuch and Galtier). 314 INFECTIVE DISEASES. ♦n ■y"?l»*®"»— The period of incubation varies from i to 6 days; but is often only from 12 to 24 hoim Tn ordinary mild cases in mares the?e appears. Ltti T^n t Je inner surface of the labia pudendi and on the greatiy r;ddenS If ?'♦>!?' °* * ^'"*'' "P *° *^*t o* a pea- These vesicles Ly at first be transparent, and in their further progress may chZe to vanous shades of orange. They have ! Z, tCcoverine S SeXon^fhr '°"S? "°" "'^^^^^^y '-^ thVneighb^urS onTh.^,^H !f °° ?' °"*'" ''^^^^^ °^ tb« swoUen vulva, or on the under surface of the tail, where they also appear The Zl^'L^r'^^P '!*"'°" ^*° fl** "^<=«" which h^vSTdJpi; nma. ihese ulcers often become confluent, and covered with a brown scab. On healing, they Wve beWnd rou^d smcTtT white acatnces. Frequently there is present, at tte LTS^' eczema great sexual excitement, desire to m^cturateTd S or less mte^ vaginitis. There are no sympt«^ of ?ev« or other constitutional disturbance. In stallions the penis is swoUen, extemaUy reddened and in some plac«. especiaUy in the cervix of the ^nis, it L c^er^ ^L^^^""l ^^''f^ *"** P'"*'^*'' which ^bs;,u^tly^^ ulcers of greater or less depth. These ulcers on hSing leaved unpigmented cicatrix. In ran. cases, the ecze^r^i to the outer surf«« of the sheath and scit>tum. JHue^S^^d ^U^ ol^erved the eruption on the imier surface o? tl^^tSi wlfS K*^' *"** °° *^ *^°**' which had probably bS cdSl S'°"*^S^*^ *^^ ^*^°° °* ^ inf^ted Ze d^ aS^i ? "■* '^"^ * *^^8« fr°™ the urethra; andS! ajmnals frequently stretch themselves out to suS'and diuw mi^'^^fstJ?' '™£*'°° ^ '"^y '^'^ spontan^Ssly i^ STy «mS"'^ ***" 3 or 4 weeks without the application antenorly to the udder and even as far as the chest anrf JT ^orly to the hind legs as far as the hocks. The l^prveS and the lymph glands become attacked and suppZte^d o^^ge, and sometimes extend into the uterus. We mav observe at the same time grave constitutiomd dS^bance Sh fever, stiff gait and considerable emaciation. accTm^Sd^ln VESICULAR EXANTHEMA OF HORSES. 3,5 after the inflai^^^- swIlS^ hr/T??!*'^"''"*^^ ^«°^ disease mav mn7 S« ^ ** subsided. In stallions the variet vSie^^Sl' »nc.s,ons. etc.). The benign and a^tringe? ^lutirrtrasToi" r**?,.^^ '^'•°*^*^* lysol. coiSive subSef'St^ et '"'"^'^ *^'' "~"°' horses is about 20 times as ^^ « !?f ; ^* ^^'C"!*' exanthema of agreeinthefactthatthey^eCt^eqSlv^ll^'"!, ^*' '«'^•^"• during the covering sea^n. M^ can^of ^ ^ ""^ " 'P'^*' '^•^'V- this d«ease, as in ofheT^tiL ^t iLS *' ^^^ ^'^^ «"*«» °* that during the last few Wl frJ^l" Germany. It seems, however, catUe have been obser^^^^Se bIS^? p ^ •"* "^"^"^ exanthema of and Meiningen, Cawd wLh^?!^ f'S^l ^ Schleswig, Saxe-Weimar During the^la^tT^i^'Sl^^'u^ T?" *"' """" ^'*-~-^- 1.700 cases of vesiciar ex^[he^"fS.,il T^^ altogether about The respective years showX ^^ ^«*"' ^°'°~ ^ ^ «"»«• 316 INFECTIVE DISEASES. VESICULAR EXANTHEMA OF CATTLE. B«ology.-This disease, the nature of the virus of which sWlremams unknown, is very infectious. Freq3y aJ tSe coivs of a viUage become infected by the samrbuU C^es of S^rhoSes'T""'".?^ '' '^^'^' ^ »ore coSTnTy' bTei ^.11?'^.°"'^^*"*^* ^'^ "^"^^ by intermediate «^t^: f P«ciaUy when close together. For instance the wiiption has been transmitted to cows that were at X^nd of ct^rSSe'^ ^^2f " f*' ""^^ infec^rcottd ten f1.^4htSd°^of^S^^ saw me mlection m 669 non-pregnant cows, and also in cows far advanced m pregnancy, and in calves of 5 wwfa^W ^n mann maintains that the infection can be' ^nSued byTe Z: ^'^'' ^'"^^ *°d °«»«" state that ^Ue nuv te Sf^e^ 1S3L.*™":. "^^ ^""' '"- instance, ii' Hmi stp^^an^l^t^r^^^r^"^ """'^ ^ ^**^^ ^ varSTfrI!°f*?^7^'' ^""^^ ^°^ °* incubation in cows W^™ ? ^^ '^ ^^^y*' *^*^ * maximum of 10 days. The tork red pomte or spots, and gives off a mucous dischanre re sembhng the white of egg. It also develops trand^cS^Sv-S^ v^ T^ pustules the size of a grain of millet up to S o?a «;&tSt^rsst^^^^^^ J^eTa^g^w^^ke ^^^^J^lr^^S^ they leave white ^. Ze of wWr^L^oot^-^ ^^'Zrt^' ^"°""^ ""^ ^ P^^ to'^eZl'/and^'lS nmd quarters are very sensitive and irritable CoMiHi.«w! eczema is frequently present, so that T^Lls^TtiSv rub themselves and whisk their tails. TTae^X move ^a VESICULAS EXANTHEMA OF CATTLE „, we find necrotic lesions the sixe of a walnut up toX^If! ^ egg, on the mucous membiane when^ for in^?o!, ° * ^*" ' quent after-consequences of this disease ^ the perns, especially on the glans and a thin llE^'J °" several months, with granular hvcertrnnhir «* ' """"8/or ImoTO, also occur m very many othenriso hnil«,..~r ^ the other hand, the ^iS TTC^ V"™' °» for from . to ; m^ntT to" sS ?S"°"^ •'"°'^"" t. n^taken fcr UanTn-^ith' S^.'^rtT,^ S ^frtoeent h-t^^lTur; to"^ro,1Slto'^^^ "" ^^^sulphate of copper. ^Iphate of irTiSo^^t »': rabbits we have obaerved a vmv j-^r^^?^ •npetior breed of ve ooaervea a very mfecUom mflammation of the external Jit INFECTIVE DISEASES. geniUl organa (vulva and prapnce) which wu e. m- «« u^ . ANTHRAX. Anthnx in genejal-Anthm in oUtle-Anthimx in hone»-Anth«x in A^n d^Zl^^u ^^^ ***" Oldest- known infective rSTo* w!^' ^* *PP!*" *° ^ *"«^«* to ^ «»e Second Book of Moses, ix. lo, as the sixth plague of Eevot In the ^^ hv^ ^^ '^°?'* *° "^- "^^ epidemic which was ^bed by Homer m the First Book of the Iliad, and which raged amongst men. mules, and dogs, seems to be anthrax. Ovid has given m the Ninth Book of his Metamorphoses^ eraWv ^description of ^ outbreak of anthrax.^ P,„taih^^ ^itS^^'TT" "^'"^ f ^"* 740 B.C. with a severe epi«X^ u^r\ ^T^"^ **; Hahcamassus (488 b.c.) and Livy (425 B.C.) relate examples of epizootics of anthrax in which the ^attacked, at first, cattle on pasture. ^tZettl, McnfiasU ammals. priests, herdsmen, country people and finajy fte entire population. In Lucrinrius (^ b^ w^ tod for the first time the name of " ignis sacer " a^hed to antLS and m Columella, the name of " pustula." VirgU describ^^n mfectious ovine disease which waa^transmitted to ma^^ni which produced deep pustules on the skin. PUny mentions a disea^ of bods in the province of Narbomie. in GaJ. T^eZl of the migration of nations. The Arab physicia^ desoS anthrax as "Persian fire." Mezeray (966 a d ) ^ thT&S to use the name "Ignis St. Antoi." Joi^es Wi2^^* smb^ m the second half of the sixteenth^ ^ ^^ ^. S^S?naT. in^ ^'^5'; i^^' ^^ '599). during which peri* and boUed P<>Utoes%Ug^hUyX^ri.Sl„ ' "?k ^P'""" «'•*'««• «^ grasses, with the adition of p«^ £l .."l*^^' *"*'^*'" *»* """V infusions of pea-straw l,Sce^T^l?*^' "^^""^ neutralises Uieir acids, potatoes, and'SLhT<;eS^rSn;Sr h^'^"'' '^'^* "«» amount of water, whichnwrt iSStS^^T ""^ ''^"•»- ^ «»**i» for the development S SrbSSTr if **''°' *"''"*"• »''~«»«y to ,0 hinders Seir devdS.m«f^Tht ^5'^''';?'^"'°^ °* waterl^ water and in cool spring v^T^koStSr*^ die « a day in distilled temperature of a ro^m or of ,^ ^^torSLJ^^r?^ ""•• *'"**'^ considerably mixed witi» orgai^c^ue^^^f * ^"7>'»'«t«^Wchis water (WoWhUgel and RiedelT Tht iT^liir • u^* temperature of weU blood, are de.S,y^ by ^g ^r.T^i Z^ ^^^j' »*«« "«» layers, in a or 3 Week, f aK ^ tWck Jl^ ' "* °'«'«»te»y thick nJJif^SofanX^ iS^^i^Hi^-fi ^Svelo. never ^evelo^tSi SttSI'o? L'lS^tSvi'';^ r^" '^'^ tarn sufficient oxygen for tiiat purp^TK^^T^^** *^ "*" "«»- the fieri, of a skiined anHut^^S^iS ^ijf^' »***«• *^»»t *«*«»• develop, even if tiie flesh is exZ^T^Uv^ h^*"*" •'*"'" ''«'« ■nmmer temperature For .h!^^^ several days to a rather high lemperature. For the same reason, anthrax bk>od enclosed^ 21 333 INFECTIVE DISEASES. tubM loMi iu power of infection after 8 dmyt. On the other hand. aporea and bacilli form on the aorface of the fleah of animala which have died of anthrax, and which have been iut np into joints, if from the beginning there haa been a aufficiency of moisture and warmth. Boechetti found very virulent bacilli after 8 montha in meat prepared in thia manner, and Savareae found them in a aauaage which had been made of anthrax fleah 4 montha previoualy. According to Semmer. aporea alao form in the internal organa. («) Temperature ia a very important condition in the development of the bacilli, the moat favourable being one of 35' C. Temperatnrea above and below that atandard either retard the action or nullify the virulence of the anthrax bacilli, the devdopment of which ceaaes entirely at la* C. and alao if the bacilli are buried deeply in the ground ; becanae the temperature of the ground ia always under ia» C. Development ia com- pletely arrested at 45" C. and death takea place under the prolonged influence of a temperature of 55' C. For the preparation of his inocula- tion material. Paatenr haa taken advantage of the fact that expoaure to high degrees of temperature decreases the virulence of these microbes. With thia object he cultivated for a long time the baciUi under oxygen at 42' to 43" C. Tonasaint produces his inoculation material by warming the bacilli up to a temperature of from 50" to 55' C. The bacilli are killed by cold only in very rare cases. According to Feser, the cold of winter does not afiect their vitality unless it falls under - 10" C. and continues as low as that for at leaat 3 daya. Gibier prepared atten- uated inoculation material by cooling the bacilli down to — 45*. Klepzow autea that a three days' exposure to a temperature of — a6' C. does not destroy the bacilli. (d) Arloing sUtes that light, especially sunUght, impedes the nowth of the bacillus. («) The baciUus of anthrax ia desbnyed by pitlrtfaeHon. if exposed to its influence for a long time. Feeding experiments have shown that it is killed by normal gastric juice. Even spore-containing bacilli are iriH»H by gastric juice in half an hour (Straus and Wnrtz). (/) CkemietU agtUs influence the bacilli in various ways, either by checking their development or by killing them. Thus, devrlopment is stopped by corrosive sublimate (1 to 300,000—1,000,000), mustard oU (I to 33,000), potassium axsenicate (i to 10,000), iodine (i to 5,000), bromine (1 to 1,500), salicylic acid (i to 1,500), carbolic acid (1 to 1,000). toric add (i to 800), quinine (i to 600), etc. The bacilli are killed by corrosive sublimate (1 to 30,000), formaldehyd (i to 30,000), creolin (t to 1 5, or carbolic acid (i to 100-300), thymol and salicylic add (3 to 1,000), pern anganate of potash (i to 1,000), sulphurous add, alcohol, etc. On the other hand, the bacilli appear to be unaffected by dther the external or internal em|doyment of iodoform. Forster states that the bacilli die in from 18 to 34 hours if common salt is sprinkled on them, and in less than 18 hours when the spleen, blood, etc., of animals affected with anthrax arto salted. He also says that the spores retain their vitality after having been salted for months. The same remark applies to brine for pickling meat (Abel). 2. The spores of anthrax are fonoed only outside the animal body, by the free ends of the bacilli becoming continually elon- ANTHRAX. J3J gated. The protoplasm of the filaments which have by this time sprung up, becomes granulated and the spores make their appearance for the first time in the form of very minute and highly refractive granules, which gradually enlarge into true oval spores. The bacilli are produced from the spores by the spores becoming elongated in the direction of their long axis towards one side in the form of an oval, cylindrical proc«». This process graduaUy grows into a baciUus. and the spore becomes disintegrated and finaUy disappears If from an mfected animal the spores get into the soil, they may remain there in a state of arrested development for many years; ten or even more. The spores, quite inde- pendently of the animal body, may however vegetate in the soil and surface water, which fact is of great practical im- portance ; for it explains the manner in which the disease becomes enzootic in certain districts, in which the contagium may retain for many years its capability of becoming developed without the importation of fresh cases being necessary for its appearance. We also see how the disease may spread in any direction by the instrumentality of feeding materials, soU, flowing water, mundations, etc. The anthrax bacillus is conse- quently not only an endogenous, but is also aji cctogenous bacterium. Under the latter condition it produce a mia^iatic ; and under the former, a contagio-miasmatic infective disease. [Observation of the enzootic manner in which anthrax occurs in certain tropical and semi-tropical parts of the world such as Eastern Bengal, Manipur, and Burma, in certain year^ and seasons, among different kinds of animals, as for instance horses, cattle, and buffaloes, apparently without the agency of mfection of one animal to another, strongly supporte the theory that, under favourable conditions of soU and climate anthrax bacUU can maintain a vigorous ectogenous existence! In countries bke England, on the contrary, their life outside the ammal body is probably that of exotics.— Tr.] tho2J^?tSS"£Sr*^**'"'.'*' ""•■»'*~' •'•»"«« '^^ from S^rtS^!r^* O^yK^-t^dacertaindegreeofheatareatoo necessary for the formation of spores ; the most favourable temperature bemgT^C T7^ ^ . ^^ " '^^^ f ' ***^ ^*^ » temperature varying from ^' to as C. and consequently under the influence of summ« heat or^ r^t^^wT^'"'' "* * ^^""^^ '*^'^- According to Arloing, Ugh^ wSS^ i** '"" " ".'""""• "•* «^ ^ November, accorLg to Ward) unpedes and even entirely arrests the development of both badlU 21* 3H INFECTIVE DISEASES. aad •pons Th* spont ofltr much mora naitUnc* to vuiona iniarioiia •nccMfnUy bMT npoaiin to no* C. for lo minut« or to - iio«c w «oUa, cUorine, bromine, and iodine. T> « kiUed by . , toTSS ■o ution of corroeive .abUmate in lo minutes by . a d« cent Jj^ «^«Uon of chlorine, bromine, or iodine in i%7^ bTa TpeTST action of cr«,Un in 48 hour. (Eiaenber,). uTSoWJ^I^i tonnaldehyd [i to 1.000) kill, them in an hour. The^wraalLJS^ Wr^^ter having been pUced for ao day. in a ,^ c^TsSS imV±' '9*»*y. '» • 'o P" cent. K,lntion of ly»l; orTrl^ ''* "**"*'• °*°»«ly' by the alimentary camU by the skm and the natural 6penings of the body. aS^ by the lungs. In cattle, the bacteria are usually rived S'lS**^*?*^ canal ; and in horses and she^J ^J^ or by the mtestmes. r j ^ «"ii, h.„H. iu^^'* "^ *^ »'^'^. which is the usual form, compre- antnrax. anthrax without external manifestations" "anthrax without localisation." "anthrax fever." etr^^e been givim. The spores, and in less number the bacilli are received by the animal from the food and drinkinT^t" mLt™ ^^ oj.'-^^tio" bei^ the small intestine. thS mu^ membrane of which need not necessarily be injured. Although tiie aad ^toc juice, as m tuberculosis, kills most of the baS It IS unable to mjunously affect the free spores. The principal ^^1 ^°\*^t T"^^ ^*^*^ *°*^ «« those^^ materials which have been grown on or near places in ^S ammab suffmng from anthrax have died, or hkve been super- ^^^^' °' ^""^ deposited their excrements ; and fodS obtamed from mfected districts. Some of the spo^s whirfT^ ANTHRAX. 3»5 contained in the suriace of the soil may become, by rain or dust, attached to various food-plants, or some of the infected soil may adhere to them, as for instance, to potatoes, turnips, etc. Water which carries the spores into the intestinal canal may, like fodder, be taken from infected places, such as wells, swamps, bogs, ponds, puddles, etc., which were contaminated by dead bodies of infected animals, tanneries, wool-washing establishments, etc. The infection may also be imported in artificial manures, unbumt bone powder, hair manure fi'om tanneries, blood manure, etc. Camivora may become infected by feeding on the dead bodies of diseased animals ; and sucking animals, by infected milk. The spores may be introduced by the renewal of the flooring of the stall or of the litter by, respectively, infected earth or infected bedding. Pasteur's supposition that the spores were brought by earth- worms, which, according to Darwin, bring up soil to the surface from below, and thus cause a constant renewal and mixing of the superficial crust of the earth, was declared by Koch to be untenable; because, as he said, the temperature of the ground at a depth of from J to i metre was too low for the formation of spores, and because it was experimentally demon- strated that the contents of the intestines of worms which had been kept in anthrax soil were proved by inoculation to be non-poisonous. Bollinger has, however, experimentally proved the correctness of Pasteur's view. Five per cent, of the earth- worms of an anthrax pasture sent to him was found to contain the contagium of anthrax. As Karlinski, Proust, and others have shown, the spores of anthrax may also be disseminated by slugs and even by insects and larvse which are found on untanned, infected skins (demiestes vulpinus), and which excrete anthrax spores in their faeces. 2. Infection of the skin is the cause of those cases of anthrax to the local manifestations of which, " carbuncle disease " and other names have been given. This mode of infection is com- paratively rare and appears only sporadically. In such cases, the bacilli and spores penetrate through wounds in the skin and mucous membranes of the openings of the body, while the animals are grazing, and by means of infected utensils, bites of shepherds' dogs, blood-letting, infected instruments in operations, skins (even tanned skins), insects, especially the musca dotnesiica and vomitoria, and various kinds of gad- flies and simuliae. Bollinger and Zeilinger succeeded in pro- ducing anthrax in rabbits by inoculating them with flies which 336 INFECTIVE DISEASES. had been caught on an anthrax cadaver. Anthrax has been expenmentaUy produced by rubbing cultivations of antSx^to the slon of guinea-pigs (Machnofif). 3. Inkalation-aKthrax is the rarest form. In it the suores penetrate through the lungs into the body. It L wfJ? ^en**"y P-ed that healthy organs o' ^^Z^^Z ^iZ T °^«'-/eser. Buchner, Lemke. and Enderient Besides these 3 kinds of infection, it seems possible Sit the disease may be transmitted from the mo\S to X 8"^eslro"f*^ "'"^'^^ ^*^' '°' -t-ce^ -c!rj^ tii^t Te LX^ "" transmitting anthrax to the foetus S tSt Z^ fi^ea-pigs. Malvos and Rosenblath • r,-. . f" inoculation experiments prove the tians- ^^^%u *^u' ^^ °* ^"^^ fro™ the motheJ toX £Sel^t°;?^ w P^^*°*" '« °°™^y impermeaik to &tlS:?ch"SL"hfeT"^ ^^^« ^-^«.^<»-^ »i and »xes been SSkenT ^tl^ V^r °' '5^^^^ ^'^''^'^ ^^^ ^"^a«on-S^.";![,'Sre^- -^^^^^ to fti^ pigeons, are immune. Fish and LpUbL «SciSlv fr^ v«y rarely suffer from anthrax. Fo^ knSl^, nf' animals a certain amoun?TiSSnu^ty ^^"'^ '°°'*" "* '^'"^ S^bv La iT^V'^Py' ^^ «>" '^Wch has p;J3v anea up by long-contmued summer heat Walrt R«i,i t>^^: at whiViTl, ^P^^oer , but becomes arrested durine winter at which season cases not unfrequentlv occur hv mJo^« ' containing dry fodder. "^"''""^ °«=nr by means of spore- O^otmpbU^ l>l«trib«tion.-Anthrax is distributed ANTHRAX. 329 all over the world and in nearly every country. In Germany it is chiefly met with in districts where the soil is boggy, largely composed of vegetable mould, and having an impermeable subsoil. The principal anthrax districts in France are Beauce (Eure-et-Loir and Loiret), the department of Seine-et-Mame, Sologne, Burgundy, Poitou, Guyenne, Languedoc, Forez, Lyonnais, Auvergne, Dauphin^, and Provence. In Russia, anthrax is found most frequently in Siberia, Astrakhan, Oren- burg, Perm, Novgorod, St. Petersburg, Archangel, Finland, and Lapland. It occurs in Switzerland, Austria (Galida and Bohemia), Italy, England, Spain, Turkey, Africa, America, the East Indies,* Persia, China, etc. The money loss from anthrax in cattle is often very great, espedaUy during the so-called anthrax years. From 1872 to 1875 it amounted in Upper Bavaria to £15,000 (over 900 head of cattle and 40 horses). During 1874, in the single district of Potsdam (Prussia), 2,000 red-deer and fallow-deer died from it. The total loss in Prussia from 1878 to 1883 came to more than £75.000 (over 6,000 head of cattle, 3,000 sheep, 300 horses officially registered, not counting numerotis cases which had not been reported). In France the annual loss from anthrax amounts to many millions of francs. In former times it was even still greater. Delafond states that in the thirties the annual loss in Beauce alone was 10,000,000 francs (about 5,000 cattle and 300,000 sheep). The department Seine-et-Mame has had since 1859 a yearly loss of about half a million of francs ; and the department of Aisne one of 120,000 francs. In the government of Pskow, during 1884, 4,000 horses, nearly 2,000 head of cattle, and 1,000 smaller domestic animals died from it (W. Koch) ; and in the government of Novgorod, from 1867 to 1868, nearly 40,000 horses, over 8,000 cows, 0,000 sheep, and 500 human beings (Grimm). ■totlstlos of ■plftomlos.— Id Gennany from 1886 to 1894 about 30.000 animala were attacked with an average mortaUty of from 96 to 97 per cent. Cattle (33.000) suffered most, and after them sheep (5.000). cases in horses (1,000) and pigs (350) were comparatively tare. There wwe only 50 cases in goats. The losses in the respective years were as follows '.— •Anthimx U fsirly weU distributed all over India; but is particnlarly prevalent in EMtera Bengal (Assam and Cachar) and Manipur. Loodianah disease and Manipwri hone disease are local Indian synonyms for aathrax.— Tit. 330 INFECTIVE DISEASES. hot^VIC^^"^*^^.^"^'^ ^« *»" «" •» average i-4 catUe ca ^'.K ^^ •*?• °°3 P***' "** °~ ««»*» infected. Gei^^In A^tria^'LlSr "*'** "' "'»* " ""»"« as those of A^tr^ »„H T^^ " ' ■?"»«« ^»M particularly rife in Galicia. Lower a Qoi .he«, %.! attacked ; and in France. 1,306 cattie and t^ !^U>V^'-^ "^ "* "*^ ^' '^''^ » Great BxTt^. I. ^morrhages by which aU the organs are often permeated, sub ^r™!*"^' ^^^^^^'^ ^<* haanorrhagic infiltrations of the submT f'l^^?"^ o* the mesentery and mediastinum), submucous (mt«tines) and subcutaneous comiective tissu^. of tL 1 °f .^ *P'**" *°<^ parenchymatous inflammation of the krge glands of the body (Uver and Jddneys).^^ leukoc^.S's '°°*"**°° °* *^' ^'^'^ "^^ poikilocytosis and all thJ^^ P">^^<^^ of the baciUus of anthrax which is found in au the organs, espeaaUy in the capiUary blood of the internal The following are slatutict of anthrax in Great Britain :- ANTHRAX. 331 oigans (spleen, intestines, and liver) and in the serous gelatinous infiltrations of the mesentery. The individual organs show the following changes :— The vessels of the skin, on skinning the animal, appear to be densely filled with dark blood. On closer examination, we may observe under the epidermis and in the tissue of the cutis small hasmorrhages which in some cases raise the epidermis mto the form of vesicles. In anthrax due to inoculation we find in the skin, circumscribed, firm nodules of the size of a entil up to that of a bean, with partial necrosis of the thickened tiMue (the carbuncles of anthrax). Where there is considerable OBdma of anthrax, the skin suffers from wide-spread necrosis. The subcutaneous connective tissue is permeated with blood centres the size of a lentil up to that of a shilling, and is of a slighUy blood-red tinge. In the oedema of anthrax we find arcumscnbed or diffuse gelatinous effusions of a rather firm consistence and frequenUy of a very considerable extent, which vary m colour from orange-gellow to yellowish-brown, or are permeated with spotted and flat extravasations of blood. Also, purely s^ous mfiltrations occur. The neighbouring lymph glands are considerably enlarged, permeated with hamiorrhages and oedematously infiltrated. The gelatinous mfiltrations in the subcutis on the neck and along the trachea down to the chest are very large. The muscular apparatus of the body varies in colour from a dark brownish red to violet, is infiltrated with hemorrhagic spots, and is very soft. The muscular tissue of the heart shows similar changes (parenchymatous myocarditis). In the cavities of the body (abdomen, thorax, and pericardium) a samous fluid is found in moderate quantities. Haemorrhagic extravasations of different sizes are seen under the serous mem- branes and epicardium, and particularly on the mesentery and mediastinum. The subserous connective tissue, especially on the mesentery, anterior cavity of the mediastinum, and in the neighbourhood of the kidneys, is gelatinously infiltrated, on which account the neighbouring lymph glands are con- siderably swoUen, filled with serum and permeated with hamorrhages (mesenteric glands and mediastinal glands). The internal organs (spleen, Uver, kidneys and lungs) contain a large quantity of blood. All the larger veins and the heart are fiUed with blood, and the surrounding tissues show sanious imbibition. The sfdeen is considerably enlarged (from a to 5 times its 3Sa INFECTIVE DISEASES. normal size), either uniformly or by prominent tumours. The pulp of the spleen is soft, more or less fluid, and stained dark red. The capsule of the spleen is frequently extravasated with blood, and is always very tense. Sometimes small raised vesicles with sanious contents are to be seen on its surface. The liver, like the kidneys, is highly congested and appears somewhat enlarged. The parenchyma is infiltrated with blood- centres and the cells manifest various kinds of degeneration (parenchymatous hepatitis and nephritis). The portal lymph glands often appear enlarged, and the retroperitoneal (perirenal) tissue is infiltrated with a serous, gelatinous fluid. Also, the sub- peritoneal tissue on the intestines and on the abdominal walls is frequently gelatinously or haonorrhagically infiltrated ; and the peritoneum inflamed. The nature of the lesions of the internal canal varies ac- cording as the disease is intestinal anthrax, or anthrax caiised by inoculation. In cases of inoculation-anthrax, the intestine is frequently normal. In other cases there may be subserous haemorrhages or swelling of the mesenteric glands. The principal changes in intestinal anthrax are always found in the small intestine, chiefly in the duodenum, and more rarely in the colon. In the slighter cases of intestinal anthrax the mucous membrane is affected sometimes by a circumscribed, sometimes by a diffuse swelling. It has red spots, is infiltrated with haemorrhages and covered with erosions, especially on Peyer's patches and the solitary follicles. The bacilli of anthrax are often found in extraordinarily large numbers on the surface of the mucous membrane. Necrosis and ulcers become developed in those parts where the bacilli most thickly congregate. In very severe cases we often find akeady on the abomasum or on the three first stomachs, gelatinous and.sanious infiltrations of the mucous membrane. The mucous membrane of the abomasimi, and especially of the duodenum, is, in consequence of excessive hyperaemia, dark red or almost black, and is covered with erosions and ulcers or necrosis, which may extend down to the sub- mucosa. The contents of the intestine are bloody, and the submucosa is infiltrated with a serous, gelatinous, or haemorrhagic transudate, so that the mucous membrane often projects in the form of large tumours into the lumen of the intestine (oedema of anthrax). On the site of Peyer's patches and solitary follicles, we find flat or prominent nodules (carbuncles), the surface of which is covered with diphtheritic crusts and bacilli. The mesenteric glands are at the same time greatly enlarged ANTHRAX. 33J and haemorrhagically and cedematously infiltrated. We seldom find the described lesion in the rectum except when its mucous membrane has become infected on account of its having been cleaned out with infected hands (carbuncle of the rectum). In this case the mucous membrane is swollen into thick pro- mmences, and is partly necrotic and its surface is covered with blood. Among the organs of breathing the lungs are greatly con- gested, cedematously infiltrated, and show ecchymoses in some places. The entire respiratory mucous membrane is consider- ably reddened and affected by ecchymoses. In particular, the mucous membrane of the pharynx and opening of the larjmx IS often so cedematously or gelatinously infiltrated (angina of anthrax), that excessive stenosis of the larynx takes place. The contents of the trachea and the bronchi consist mostly of oloody froth or mucus. The brain is fuU of blood and studded with ecchymoses, and the surface of its membranes often exhibit hamorrtages with an accumulation of sanious serum in the ventricles. ':x- travasations of blood sometimes occur in tbn anterior chamber of the eye and under the retina. All tha other organs (the sexual organs, urinary organs, sahvary glands, thyroid glands bones, articulations, etc.) show haemorrhages, and the urine frequently contains blood. The blood is dark-red or ahnost black, has a tarry or vamish- hke lustre, is of a watery consistence, and shows very little tendency to coagulate. It does not assume its normal red colour when exposed to the air. The red blood corpuscles appear m various stages of disintegration, and consequently their forms are very irregular (poikUocytosis). The number of the leucocytes is considerably increased (Uucocytosis). Between the blood corpuscles we find, especially in the blood of tiie spleen, a considerable number of anthrax bacilli. The bodies of animals which have died from anthrax are often well nourished ; they remain limp for a long time ; grow cold very slowly (absence of rigor mortis) ; become quickly decomposed; and, as a rule, become greatly distended with' gas. The visible mucous membranes are of a purple colour ; blood flows from the natural openings of the body (mouth, nose and anus) ; and the rectum is sometimes prolapsed. All the foregoing lesions may be absent in very acute cases (apoplectic form of anthrax). The characteristic bacilli of anthrax are, however, always present in the cadaver. 334 INFECTIVE DISEASES. Qmamnl •ymptoma of AnthHo.— The symptoms of anthrax vary not only in the different species of animals, but also m mdividual cases, according as the intestinal canal, sldn, lungs, etc., are respectively infected. It is even possible that the symptoms of intestinal anthrax may be quite different from the usual ones of this variety of the disease ; or symptoms of metastatic affections of the intestine or serous membranes may become prominent in anthrax of the skin. The nature of the affection may vary essentially according to the amount of the virus of anthrax received by the animal body. Abortive cases and remittent forms of anthrax may also occur. The characteristic features of all these forms of anthrax are the suddenness of the attack ; severity of its course, w*ich usuaUy ends in death in from i to 3 days ; grave general disturbance; high fever; tencjency to hmnorrhage of the mucous membranes; and the presence of the bacilli in the blood. To these we must add the different local symptoms such as carbuncles and oedema of the skin ; intestinal trouble • brain compUcations ; and difficulty in breathing. Anthrax has been classified according to its course {anthrax acutissimits, acutus, and subacutus), or according to the presence or absence of local manifestations. We consider the latter classification to be more appropriate than the former for clinical purposes. Forma of Antlinx without Vlsiblo LooaliMktion. —These forms, which can be divided into peracute, acute, and subacute, are generally due to ordinary infection by spores or to experimental feeding with spores. 1. The peracute form is known as apoplectic anthrax, and gives nse to symptoms of cerebral apoplexy. The animal becomes suddenly ill, staggers, falls down, often gives vent to a bloody discharge from mouth, nose, and anus, and dies in convulsions after a period of iUness varying from a few mmutes to i hour at the most. Frequently the patient is found dead in its staU in the morning, or may die suddenly while at work, pasture, or feeding. This form occurs most frequenUy m sheep and cattle, and particularly at the commence- ment of an epizootic. 2. The acute form runs a somewhat slower course and lasts from a to 12 hours, the maximum being 24 hours. The animal soon becomes feverish (40° to 42° C.) with an ex- tremely rapid rise of temperature, and shows either signs of congestion of the brain or of congestion of the lungs. In the ANTHRAX. 33S former case, the chief symptoms are : restlessness, excitement stamping, kicking, rearing, beUowing, attacks of fury, ronninK to and fro, convulsions, spasms, grinding of the teeth, foUowed by stupor, insensibiUty, staggering, and finaUy death as if from apoplexy. In the latter case, the usual symptoms are creatlv accelerated and difficult breathing, wheezing, panting, groanin/ palpitations of the heart, excessively frequent and very small or imperceptible pulse, cyanosis of the mucous membranes of the head, bloody discharges from the natural openings of the body hematuria, staggering, convulsions, and finally death from suffocation. Sometimes there is a partial remission of the symptoms with a rekpse after a short time {anthrax remitUns) In some cases we observe, before the commencement of the stormy course of the disease, premonitory symptoms of dumnished vivacity, sUght disturbances in digestion, constina- tion, tenesmus, etc, *^ 3. The subaciae form is termed aiMrax fever or intermittent anthrax, and is the ordinary kind which attacks horses and cattle. The symptoms are generally the same as those of the acute form, except that they are more clearly defined and the course is longer ; 24 to 48 hours being the average duration, and 5 to 7 days the maximum. The phenomena of fever (ngors, unequally distributed temperatiire and general disturbance of health) and those of congestion of the lungs and brain are more clearly marked, and are frequently complicated with severe intestinal tiovbles, especiaUy colic. They may abate so frequently that the disease may be erroneously supposed to be of an intermittent natiire. Fomis of anthrax with visibto looaliMtion appear to arise usually from infection by bacilli, as they can be experimentaUy produced in the form of carbuncle bv inoculation. ' The carbuncles and adetna of the skin, which are known as carbuncle disease," chiefly occur in horses and cattie, and may also appear m dogs. The carbuncles are circumscribed cutaneoia sweUings, which are at first hard, hot, and painful ; and later on cold, painless, and tending to become gangrenous. The cedenul of antiuax consists of diffuse, flat, doughy, cold, painless, and frequentiy fluctiiating swellings of the skin. The duration of the disease is from 3 to 7 days. Recoveries are more frequent than m cases of anthrax without external manifestations Fever may appear before or after tiie formation of the swellings.' 336 INFECTIVE DISEASES. CfbuncUs and adma of th» mucous mmbrant, Kt nmiXv lound on the mocoas membrane of the mouth (anthrax of the tongue),m the pharynx and larynx (ai^Jb-o* angina), and in the rectum. At the same time the patient sa£fen from fever dyspnoea, laryngeal stenosis, difficulty in swaUowing. general cyan(»is, swellings in the intermaxillary space, and on the throat and the chest, painful straining to defecate, etc. Death takes place m from la to 24 hours. This form of anthrax is most frequent in pigs and dogs. ♦-J^'f "»»»» fonns in catUe are : " apoplectic anthrax " (p. 334). .nthiax form., and eq>eciaUy anthrax fever; in sheep, apoplectic anthrax- in doga carbnndes ; and in pig., anthrax angina and anthrax of tiie tonkne We should be cautions in accepting suppoMd caM. of anthrax in pip. 0«ii«ral DiagBoais.— Iii the acute or subacute form a correct diagnosU during life can be made only by a micro- scopical search for the bacilli, or by the knowledge of the epuootic character of the disease. A bacteriological examination of the blood very frequently gives a negative result, because the baalh chiefly congregate in the internal organs. It has conse- quently been proposed to examine the blood of the liver after pimcturing that organ with a trocar and cannula. The difficulty of the diagnosis intra vitam is further increased by the fact that the symptoms of the disease somewhat resemble those of smiple congestion of the lungs or brain (although anthrax is to be distinguished from them by the presence of high fever) poisoning, rapidly appearing septicaemia, etc. Consequently an exact diagnosis can, as a rule, be arrived at only after death The demonstration of the bacilli is generally necessary for the anatomical diagnosis ; for the microscopical result is rarely suffiaent by itself. Johne recommends the following method for the detection of the bacilli : the cover glass preparations which have been prepared in the usual way, and have been drawn three times through the flame, are stained for about a quarter of a minute (at the utmost for half a minute) by dropping a 2 per cent, watery solution of gentian violet on the cover glass, which must be cautiously warmed, along with the solution, washed for a moment in pure water, and afterwards for 8 or 10 seconds in a a per cent, watery solution of acetic acid, and finaUy very carefully washed again in pure water A drop of water is then appUed and the preparation examined with a magnifying power of at least 400 times. Klett advises ANTHRAX. 33^ EHflif'* T?'!^ ***'' *''« "~^ »P«ad out on it should ttotr*! fl ^ "I '^"' ^''^ '°'°*' ^°«»' drawn 3 S through the flame, stained for a few seconds with a wate^ s^utaon of gentian and rinsed in water. After this. d^Se^ water „ dnpped on the stained side of the cover gl«^ which L t "1°« *»™«d by being pas«.d from 6 to » tirn^ "^ough the flame. It is rinsed again, placed on the oS By both methods the characteristic capsule of the bacillus of anthrax is made distinctly visible. ^ " °^ ^''« ^acilJus of Inoculation is another aid to diagnosis , the most suitable ajnnals being mice, rabbits and pdSa-pi^. Sh^p. if avS able are very good subjects for inoculation. The ^apiSs confirmed by the occurrence of death after a T^^J^ «lm wf ^7h*®*^' demonstration of the badlH in the SJ? tJ; * y ^^°^ intestinal anthrax by inoculation with the feces of the infected animals. An ordinary smaU wound m the skin will suffice for inoculation with SpSS ?Zr ^^wr*^.^" **«=**^ *°^"^« « unsuccessful, aHor instance with blood from the surface of the body or large; bteod' L^J^t 'T^ "" ^*^ ' *^«° *^« in<4lation Lt^ «^cd with oth«- bacteria ; or when it is in a state of de. we can examine them for the presence of bwdUi only by a very finVlmd most ej^S 22 33« INFECTIVE DISEASES. i i Biiciwcope, which few vetwiury ■nrgMMn can aford to boy. We ahonld fwnember that, beiidee the builU of anthrax, the affected flesh contain* many other Uada of bacilli which cannot be dietingulriMd from each other with an ordinary micnwcope. In order to avoid mistaking the baciUi of anthrax for harmless bacilli, we should make inoculations and subsequent bacteriological examinations, in rabUU and white mice for instance or should prepare pure cultivations. IMAMWitlal DiatfBoaia in 0«BMmI^As the various diseases which may be mistaken for anthrax will be discussed in detail when referring to the respective species of animals, we shall here content ourselves by giving the following brief descrip- tion of those bacilli which possess some similarity to the bacilli of anthrax. 1. The se^ bacilU, or the baciUi of decomposition (especially bacterium termo) are distinguished from the bacilli of anthrax, usually by their being motile, and by their rounded ends. Other bacilli which closely resemble the bacilli of anthrax, and can be distinguished from them only with difficulty, are some- times met with. In such cases, the peculiar morphological relations, especially the presence of the capsule of the bacilli of anthrax, must be looked for, or test inoculations must be made. 2. The bacillus of quarter-ill is shorter and stouter than that of anthrax; the ends are rounded ; and the bacillus is very motile, forms gas, and produces in cultivations variously folded dirty- white membranes. Being an anaerobic fungus it cannot be culti- vated on potatoes. 3. The bacillus of malignant oedema is thinner than that of anthrax; it is not articulated, and has rounded, not cut-off ends; it does not occur in the blood ; it usually possesses slowly rocking movements ; and grows out into very long and, fre- quently, circularly arranged threads, which are free from spores and produces bubbles of gas in the cultures. A piece of tissue containing the bacilU of oedema placed in gelatine, forms around Itself a white globe of fluid, the surface of which seems to be covered with fine needles. This bacillus can be cuJtivated only with great difficulty in laboratories (Kitt). 4. The bacillus subtilis (hay bacillus) is thick and short, shows osdllatory movements, and has a stout flageUum at both ends. This bacillus develops from a spore perpendicular to its longi- tudinal axis. Although it is aerobic, it is of much less importance m the differential diagnosis of anthrax than the other fungi we have mentioned (Kitt). m ■aMIli ANTHRAX. 339 ProgBoals in 0«B«ral is very unfavourable; the mor- tality being on an average from 70 to 90 per cent., and 100 per cent, in apoplectiform anthrax. After the epixootic has con- tinued for some time, the disease sometimes assumes a milder t]^. Some animals acquire immunity for a short time from a previous attack. Recoveries without any treatment are not very rare. Tharapttnties la 0«i«nU.— Prophylaxis, which is much more important than treatment in cases of anthrax, consists first of ^ in the thorough destruction of the anthrax cadaver, and in the careful disinfection of the contaminated stalls. The destruction of the cadaver is best carried out by burning, when possible, or by burying it at least at a depth of 2 metres, and at some distance from roads, houses and pastures. It may also be rendered harmless by steaming under pressure sufficient to break up the soft parts. For disinfection we may use corrosive sublimate (i to 1,000), creolin or lysol (3 per cent.), liquor chlori (2 per cent.), or chloride of lime (z to 3). An attempt to reduce >Jie infectiousness of anthrax stricken districts should be made by draining swampy and damp ground, regulating the water supply, and keeping animals away from sus- pected pastures and suspected welb. A change of habitation can seldom be carried out as easUy as one of food and water. The medical treatment, which is not always successful, consists in the internal application of hydrochloric acid, creolin, carbolic add, or salicylic acid. Medicines are rot of very much use ; although abnost every agent in the pharmacopoea has been tried. Meier reports instantaneous improvement and quick recovery in three cases of anthrax by the administration of 50 to 200 grammes of creolin. The following agents have also been recommended : corrosive sublimate (subcutaneous injection) ; carbolic acid and salicylic acid (10 to 15 grammes or more per os in cattle) ; iodine in the form of Lugol's solution, namely: iodine 30 grammes, iodide of potassium 60 grammes, distilled water 360 grammes, of which 2 tablespoonfuls in a quart of water is to be given every 2 hours ; chlorine water ; arsenic ; phosphorus ; hydrochloric add ; liquor ammoniac ; oil of turpentine; etc. It is customary in the subcutaneous form of the disease to administer neutral salts and other aperients, and small doses of calomel. In congestion of the lungs and brain, phlebotomy deserves a trial. The carbundes of anthrax on the sldn can be treated by long and deep incisions with 22* ■.ll;.Ji^^-!l-^...^ 340 INFECTIVE DISEASES. I II subsequent application of disinfecting remedies, or the actual According to the investigations of Ogata and Jasuhara, the prote^iv! Tnd curative efiect which has been obtained in certain inSfd^e^^ patients that had suffered respectively from these diseases, may also be obtamed m anthrax. These observers state that e^^ t^bl^ S ammab wh«h are immune to anthrax (dogs, white .^U, id £S) is wwi. 'T"*"'"'*' '"l-tMce which had disinfecting properties and wS^tr S "*'*' r *"" ^'^ ""'^^ *»'««' observation*: we 'mu.t sTenirh olT '"'"'** '" »«™'°-tl>erapentr Emmerich, on the oS experiments with rabbits, recc .ends at an outbr^k StraY^e^'urj^'^'^'tf "' ^r^*'°'' *»* *=*"'«• '"'•^' «'d other ^m2^ with attenuated cultures of erysip^as. He states that the cocci of TTir. Tr" Tr^"^'^ "' ^^^ "••* '" " anthrax-infected o^-m 111 « *^f*' **^* ""* *^''«» *=*° successfuUy combat the b^S anthrax. Pawlowsky says that the coccus of pneumo^a the^Av lococcus aureus and the baciUus prodigiosus have^a sS ^ff^t. ^ *^' ♦>.J!r**^*V^* Inoculation ngainst Anthrax—There are three forms of immunity to anthrax, namely, acquired immunity from havmg successfuUy passed through a previous attack- ?^d mimumty. as in the sheep of Algiers and Barbary ; and i^^dual immmuty On the other hand, it is impSle to r«id^ gumea-pigs rabbits, rats or mice immune (L6ffler) ; and 5^ '^J^ "***^ "™""°« °°^y *itl^ difficulty. (Emler pro- fn^^ r*^ " ^^ "^^ ^""^ 7 «"»«« consecutively by moculation Man possesses no immunity. We can. by inocu- lafaon, produce in sheep and cattle an immunity which is how- ever, only partial and lasts for only a short time Toussaint was the first to make use of protective inocula- tions m anthrax. He heated anthrax blood which was free from fibnn. up to a temperatiire of 50° to 55° C. for 10 to « minutes and used it directiy afterwards as an inoculation mate- nal, although he had no tine conception of the causes of itij immunising action. Pasteur, however, was the first to prove that unmumty was obtained by attenuation of tiie bacilli. The virulence of tiie bacilli of antiirax may be reduced by various means such as heat (Pasteur. Toussaint. and Chauveau); com- pressed oxygen (Chauveau and Wosnessenski); antiseptics (Chamberland and Roux) ; and sunlight (Arloing). It can also be weakened by cultivating the bacilli in the blood of inoculated ANTHRAX. 341 •heep (Metschnikoff), or in the body of frogs (Lubarsch). Pasteur produced his inoculation material (vaccine) by the cultivation of bacilli at 42" to 43° C. in oxygen. He obtained his weak vaccine {premier vaccin) by a cultivation at the above-men- tioned temperature continued for 24 days ; and a second and stronger vaccine (second vacctn) by a cultivation con- tinued for X2 days. The animals are at first inoculated with the premier vaccin, and after, from 10 to 14 days, with the second vaccin. The results of hundreds of thousands of inocula- tions « »«ilU by (X to6oo)f^ra4da". S'of"SSiaS: of^S?, to°', ^S;?*"" «^^ 10 days. Gibier makes his inoculSn SiK hi !L''°~-S«») *>' perature of the bacilli to - 4c» C 1o« o^^. 'L reducmg the tern- th^ through the boSes ti ^^T cZZf '^l'^^'^- ^"^^ made vaccines respectively for caitlT.nH^ u ^ P«noncito have two as hitherto d^) Sng oT the l^iS^f £[ ""'y."" '*"'««» «* Of ~.t„„ Of tt, o.„ „,fc k, tt, ^.ir., L iS^s 1^" •«i«-«I~«.Utl«u-Th.M,«,«.u«.«<.,«.,.,„,h,^, ANTHRAX. 343 important protective inoculation experiments which have been carried ont daring the last few yean : — 1. In France, which is the fatherland of anthrax inoculation, during the years 1883-1893 not less than 3,396,815 sheep and 438,824 cattle were inoculated. Out of that number, reports were received concerning the results of 1} million cases of sheep, and 200,000 cases of cattle. The mortaUty in the latter amounted to 0-34 per cent. ; and in the former to 0-94 per cent. Before the introduction of inoculation, 5 per cent, of all the cattle and 10 per cent, of all the sheep were said to have died from anthrax. The finanrial gain from inoculation is estimated in cattle at £8o.o(x>, and in sheep at ;£20o,ooo. 2. In Austria 350,000 sheep and 130,000 cattle were inoculated i la Pasteur during the years 1 882-1 887, with a decrease in mortality, it is stated, of from 10 to 14 per cent, to from i to 2 per cent. 3. In Hungary, from 1889 to 1893, there were inoculated 87,430 cattle and 388,743 sheep, out of which 0'i4 per cent, of the former, and 1-28 per cent, of the latter, died from anthrax. 4. In Russia 20,000 sheep were inoculated in the district of Cherson in 1888 (Skadowski), with a loss which was due to the inoculation, of 05 per cent, of the inoculated sheep, and 03 per cent, subsequently died from ordinary anthrax ; making a total loss of o-8 per cent. It is stated that the loss from anthrax among non-inoculated sheep amounted to from 10 to 33 per cent. ; and that ewes inoculated after the third month of pregnancy produced immune lambs. The loss due to the inoculation in cattle (15s head) was 0-75 per cent. Skadowski recommends the adoption of protective inoculation in all places where the annual loss from natural anthrax amounts to 2 per cent, or more. In the Crimea, 4,564 sheep were inoculated in 1888 with vaccine obtained from Odessa (Bardach), the result being that 3,478 (8oj)er cent.) sheep died owing to a mistake having been made between the premier and second vaccin. Inoculations made with Pasteur's vaccine produced similar un- favourable results in the district of Odessa (Gamalela). Wysokowicz states that in the district of Cherson the loss due to inoculation i la Pasteur amounted at first to nearly 2 per cent, in 1885 ; but from that year to 1888, out of 30,000 sheep which had been inoculated, only 170 (0-87 per cent.) died. According to Woronzow 1-25 per cent, of 7,000 inoculated sheep died in 1890 ; but none out of 200 head of cattle. It is stated that the previous annual loss was from 10 to 12 per cent. Pod- moUnofi reports that during 1892 and 1893, 67,000 sheep were inoculated in the district of Cherson with a loss of 0-43 per cent. ; 1,450 horses with a loss of 8 animala ; and 3,652 Cattle, with a loss of 2. According to Ekkert, 38,936 sheep were inoculated in Southern Russia from 1883 to 1889 with a loss of 053 per cent. In the year 1890 th»5 loss varied in inoculated adult sheep from 0-03 to 0-3 per cent. ; in lambs, from o>i to 3'6 per cent. ; and in particularly well-bred lambs the loss reached I3>3 per cent. I The losses through natural anthrax fell in the inoculated flocks from 8-12 per cent, to about 01 per cent. Lange inoculated 928 a"i'"a<« without any dying ; and Gordsalkowski, 24 . 500 sheep with a loss of 0-3 per cent. Beresow sUtes that in 1890-1891, 68,287 sheep were inocniated with a loss of from 0-3 to 0-8 per cent. ; 916 hones, with a loss of 03 percent. ; and 1449 cattle without any casualty. Of the inocu- lated sheep, 3-3 per cent, died from natural anthrax after the inoculation. MHfr^ 344 INFECTIVE DISEASES. 0.3 per cent. ; and in the lluer 7 J^ L*""**^*^ '^ *^« **»»»« ^ died of anthrax; consequently the total^Tf th *•*' «<^«lated sh^ '■'6^n".Lrti.i t.Lr'r ^^^-l^i^^'^''' -'*'" ^ now speaks unfavourab^of it I^thf °"*' °' inocnUtion. Vicentini. 168 inoculated animals di^ OtJer tof^r" °* ^'«>"' '« <»" « -;^e o. ma. ^ve ^den^ta^I - ^trd-TaSlS^-^ 8.' Jn Sn'Jts^^ ,^e* tr" ^"7'^'^ ^*''-* -y loss in X89. death from anthrax" ""'" "''*' "''*"'*'«1 during ,88<^.890 ^th on, hav^«^S'viic:Stm thl^S'^S -J^^^^^^y-^- n„«le in En^lana method into that counl^. ^^ ^ inadvisable to introduce PasteuS Anthrax i^ Cattle. accession of high fever with arT I? , ^^^ '* * ^"dden ^° C. ; the ^Sse trv:Zfj^,Sl^''^P^^'-'- of 41' or the minute). smaU. ^dZ^X^T^vZri^"" '"'k1 °°^«' *» membranes of the head arp TJLr ^ ' *^® "^^^^^ mncovis cyanotic ; the conjunctiva iS SJrl'i ^'^ "^« ^^^"^^^S and considerably Ue^; "a^dlk^,^*:^,^^^^^^ The external temoerahirp nflil ul ^ ^® ^^ *»th tears, the hair stands ^t^d fc^^^^ '^ .""^"^V distributed ; and there is great depr^l^ ^Tell^r'sf" "^ ^'"P^"^^ ^ =rove?S.eTo^ ;S^- >^?^^ i^hinX uLTers"^ pelvis ; seZ.^ ^^U^'hS^^'^^' ^^ A-^- and' pressionless look • on^ '"'« "le nerd ; assumes a staring ex- Instead oTstu^'r] aTtL^'T, ^^^'^ -ebral disturbLS. the animal m^ b^^'^.^^^'^Z "^^ ^ "^^^^ '^^'"^ «" ^ against any object it^ TncJun ter'.r" 7' "°u^ '^^ "^« may have symptoms of exLwT' ''• • ^° °*'*«'" <=ases we f hanges in tSn^ gS I tacTmTvl*''"' "^^ ^PP"-* mstance. constipation St tv^n, t^ ^^'".'"P^"^*"*' «« for diarrhoea, which are ;e^.L^^^"''' '°"^' and bloody cattle, and which s^meSesClH^'^^'T °* ^^'^ '^ ANTHRAX. 345 nostrils, eyes, anus, and vagina), and death usually ensues in from 12 to 48 hours on account of general weakness and stupor, preceded by convulsions. Peracute Anthrax (anthrax acutissimm) is observed, as a rule, sporadicaUy in very strong individuals, and at the commence- ment of an outbreak. The patients die either quite suddenly, or in a few hours, with s}rmptoms of cerebral apoplexy or poison- ing. Previously healthy animals are sometimes foimd dead in their stalls in the morning. Subacute anthrax is comparatively rare, and lasts from 3 to 7 dajrs, or longer. It is distingxxished by repeated re- missions of fever and considerable emaciation. The carbuncles of anthrax appear in cattle either primarily or during the course of the acute and subacute form, and affect different parts of the skin, such as that of the head, neck, chest, shoulders, abdomen, sheath, udder, flanks, or limbs. They are mostly isolated, circumscribed, or diffuse, and are little, if at all, painful, and then only at the beginning of the attack. They are of a blue-black or dirty dark- red colour, and when cut through are found to be gelatinous or lardaceous, but never suppurating. They become, however, often gangrenous, in which case there is deep gangrene of the skin. Carbuncles in the mucous mem- brane of the mouth (anthrax of the tongue, anthrax of the palate, and gloss anthrax) show themselves in the form of vesicles and nodes of var ng size in the tongue and mucous membrane of the lips, cheer. , and palate with profuse salivation and difficulty of swallowing. Carbuncles on the mucous membrane of the rectum cause great straining during defecation, with sweUing and prolapse of the nucous membrane, accompanied by a bloody discharge. In most cases the cause of this implication of the rectum is injury inflicted during back-raking. DiflSBMntlal Diagnosis of BoTine Anthrax.— The diseases for which anthrax is most frequently mistaken are : poisoning, inflammation of the brain, cerebral apoplexy, pul- monary apoplexy, heat apoplexy, death by lightning, rabies, gastro - intestinal inflammation, leucsmia, foot-and-mouth disease, and quarter-ill. As the course of the disease is very rapid, it can often be recognised only, fost mortem, by finding the bacilli and by employing test inoculations. With reference to the differentiation of quarter-ill see p. 121. 346 INFECTIVE DISEASES. Anthrax in Horses. a« ^tST'Sa'if T*? ** "'P*'^ °° *°*h«« » horse, quen^ti;ent^'^tSa^^"xh?d""*^ '^"" has been S:* anthrax districts. where^L 2 t?T ^'°***"y «="»" ^ become infected, lie al^mtlf * 1°"*"*^*= ^^^^^^ "ay by means of tte fodirlf^ °* f"*^*^ *P°'« »' baciUi cause. AnJhrSTirti^ 's consequently regarded as the usual and EuropSTi^rih^TTr *"°°^'^* '^^"^ «* Asiatic tricts whi^are^iJlJ f * '^T' '^'^"^y ^ ^^ampy dis- lying coun^es ^f ^l,^ ^T^^'^^l ^"*=' " *^^^o- plague" (Haupt and m^^T 1 ''J"°*" ** "Siberian African protected tStoS^S J ^T"*" South-West «>*fe." /*.. blood dS^ (1 ' dST "^l '' ?*' "*™" °* " ^^^''- municated along ,^X^t^tf ^' "^^^^T ""^ ^ ^'"■ transferred indirectlv fr«^ !r5? ™f * ^« 'I'sease may be ways, as forSS^^utST^n h' ''^''P /° '^^^ ^ <>*« leather (Bob«tS) ^ '^ °* '"*^*** ^^«=t«d the only expl^^CthL'T^o^ff'h'"' "''^' ^^^^^ ^ of anthrax in the armv ^n^hT \ ^ iL'"* 'P*''^*"*^ «««» X5 hor^ were affec^'wii" ^d 1'^'\^^k""^ ^^^^^ years 1889 to 1894. *** *^°™' anthrax in the acuSTSSr^r^^rSsr^o '"TT^^y - ^'^^ ing from 39.50 to 4i. -all4 ; restlessness, and convulsions»??S, ''.Vj^^'^ (excitement, at the begimung pf thrS^^ ^^^^/'^''T'' ^^^ symptom of anthrax in Ss T^tl,?*** '^'^ *^^**^t«^tic is followed by watery dSric ^LS."* T^ ^^*'' *»<» respuation is exceeTngly^ctr^ra^rdiffi^,- ^'^'^ ANTHRAX. 347 carbuncular swellings of the mucous membrane of the pharynx and the larynx, we find symptoms of angina such as salivation, difficulty in swaUowing, large swellings in the region of the larynx and the pharynx, dyspnoea, and even suffocation. Death takes place with increasing weakness, profuse perspiration, etc., in from 6 to 30 hours, on an average. In a few cases the disease may run a fatal course in from a quarter to half-an-hour. Recoveries are very rare. Carbuncles on the skin occur chiefly on the hypogastrium, lower part of the breast, inner surface of the fore-quarters and hind-quarters, scrotum, vulva, etc. The swellings of the hind- quarters cause lameness. This form of anthrax runs a course of 2 or 3 days. Gloss anthrax, namely, carbuncles in the mucous membrane of the tongue, have been found on rare occa- sions in horses (Gresswell). [For convenience sake, we may divide equine anthrax into anthrax accompanied by swelling ol the throat, and anthrax without this symptom. In the former, the disease seems to be located chiefly in the organs of breathing ; in the latter, in those of the abdomen. The one might be termed the thoracic or respiratory fi^nn ; the other, the abdominal. Fred. Smith (Veterinarian. February and March, 1897) sUtes that the latter is abont 4 times as common as the former in horses. In the cases I have seen, principally in Assam and Cachar (India), the respiratory variety was the mure frequent. As addenda to the symptons described in the text, I may state that the animal suffers from depression of spirits and stupor. The breathing (in the thoracic form), which is almost entirely abdominal, as may be seen by the heaving of the flanks, becomes more and more hurried, until at last the animal foils from exhaustion, becomes convulsed, and dies, apparently from sufiocation. There is sometimes a flow of a rusty-coloured fluid from the nostrils, and often, towards the end, and after death, a discharge from them of foam more or less tinged with Mood. I have never seen the disease loll in less than 3 or 4 hows from the first appearance of the symptoms. The course of the malady may run on for 6 or 7 days. The mortality from anthrax in India is probably about 80 per cent. When there is swdling of the neck, the nose is poked out, and the neck (especially abont the region of the throat) and intermaxillary space become swollen, often to an enoimoos extent, so that the head and neck become hard and immovable, as if they were cut out of a single piece of wood. The amount of the sweHing, however, greatly varies. In the abdominal form of anthrax there is sometimes {ttotapae of the rectum ; and, in a few cases, serous tumours form about the flanks, underpart of the belly, and scrotum. To state the matter generally, the symptoms of anthrax are those of impeded respiration and of infiltration into various tissues. Hence, the painful breathing, the interference with the functions of the brain, the semi-paralysed condition of the patient, and the local swellings. — Tr.] 348 INFECTIVE DISEASES. I>ifr«v«Btial IMatfniMiB in n guished chiefly bv i^^ aV^"^'^^^^'^ » <^»tin- variety and 1% t^Tli^^i feverish couhk.. and by the never appear in regZ^fuc^l^it ^r°* T^*"""' "^^"^^ quenUywithpetecWaHev-^ff • /* /* ^^ihmd most fre- aln^ady mentioned v,h,n ^ZrZ^^' ^ ^« ^»^« was frequenUy. even in S tL^ ^*^ J*''**' ^^ ^'^ anthrax, which view s iTc^^th^, *"' ''^'"^^^ ^ » ^nn of anthrax have not hrnfli^v*"^ ^°^'' ^<«" the badUi of With pete^Wa] f v^ 'Z ^? *! "'^ °^ ^h* ^-"als St^ fever, either by S^^l^ *"«"!?,*« t° transmit petechial correct diagnosi^o^SLca^beLr'*^!^""'/*^* '*"«»• A stration of the badS ^d^ ^r ""^ ""^^ ^^ *^« <»«™on- rabbU or a sheep brtoo^SltS..*'"^""**^^ '""^ ^^ to a aucous^^2„*f;'^J^«;J^^«Wng «,d injected condition of the for congesuon of the l«n« wSk i„'',^'r*^~*^~»««»«'ni»t«to^ the paUent fight, for Sh aS ^1^ 'hstinguiahed by the factlS^ »«ni-„ncon«io«nes. ^Tt^.^JT^JL^'^' *^ ^«P'«»i<>«> ^d ^**!?'**'='**'^«°'*hen^ki,!St ""^''- «*^d«. the of the head, intennaxillary space «nH ^l • ***' 'y^P'om of swelling (P- 421) is by no mMTatone^h^tT? f ~°"°°'' **> «»th. SaadS veterinary surgeonsl^oCey;^*S*'^'r'«' *>'««^yEtS.h the same error. In fact the au^'inr^ "* ^""^^ ^*^" have faUen into h^ published the .Stoo?St^^rV'^,'^y»tUed until Erganism /,» (4) Diflerence in theXSt^Tf ^^ restriction in diet to dTTodd^ Sickness being geZ^^Z «ld '^J'i^b^ge; thaT^f HoS^ copious flow of 4„orrniu^%Ociri,*^*'^^^ **"» *» «trem^ of^e bronchial tubes ^t^fl Jj^ VSa^^*"""' ^ """^ ^ickn^ appearance of the blood. (,) tj„"k1„ 'f! ^^'fierence m the post mortem (9) Absence of the bacillus anthrSin' H^^Ts^JS!!^^ '« '^^ «,«d«. Anthrax in Sheep and Goats. "apoplexy." T^p^L t^be ^Ir^l '"""^^^J' ^°^ as i'l^ars 10 be ahnost always due to fodder. ANTHRAX: 349 Stings of flies, injuries of the skin during shearing (Nocard), etc., may in some cases be the direct or indirect cause of the disease. ■ymptoma.— Anthrax attacks sheep generally in the apo- plectic form {anthrax acutissimus). The animal appears as if suddenly stricken with apoplexy, staggers, falls down, is seized with spasms and convulsions, and dies in a few minutes with a discharge of black blood from the natural openings of the body, and is often found dead in the stall in the morning. The course of acute anthrax lasts somewhat longer, although generally only from 30 minutes to 2 hours. We sometimes find symp- toms of congestion of the brain, such as excitement, restles.sness, running to and fro, staggering, etc., and at other times, symp-' toms of congestion of the lungs, namely, very accelerated breath- ing, frequent pulse, palpitation of the heart, cyanosis of the mucous membranes, bloody discharge from the natural openings of the body, etc. Subacute anthrax is very rare in sheep. It is sometimes ushered in by premonitory symptoms, especially by digestive and intestinal troubles of an inflammatory nature. Frequent and strenuous attempts to dung, with constant whisking of the tail, is a characteristic symptom. Carbuncles are seen very rarely on the head, throat, or udder. The course of anthrax in goats is similar to that in sheep ; but is not so severe as a rule. Diffanntial Diagnosia.— Anthrax in sheep has been con- fused most frequently with malignant oedema. The affections which Haubner and others described as anthrax, and which were characterised by crackling sweUings of the hind limbs, were certainly malignant oedema.* In cases of doubt, Cadiot and Reis recommend that pressure should be made on the nose of the patient with the fingers for a few seconds, to excite urination. It is stated that haematuria is always present in anthrax. [Anthrax in sheep is often confused with braxy and louping-ill. — ^Tr.] Anthrax in Pigs. Pathogen— 1». — Swine er3rsipelas (p. 70), which was for- merly ahnost universally regarded as a variety of anthrax, has • With respect to this statensent. Tie Jewmal of Cemp, Path, and Tkerap., Sept, 1898, lenwrks that " it b &r more probable that the cases refened to were quarter-evil. "—Tr. 3SO INFECTIVE DISEASES. more or less immuneTMtte? t^,vi! '»**^* ^'^"«- P«« are them only with gr^t <^St^iXt Z^^J^T^'"^ *° ment, of BraueU:Rena^.ToLunt l^o^a "'^*t»*>° «P«i- in which case Ic^lffSftion, Vn^K ^"^^'""-•''fwted animals,* auDear TK^l ««f^f "* *^* pharynx and mouth usually appear. These remarks are confirmed bv the T»r»n* -!Z: • ments of Crookshank, who has ^^^t\lt J^ t*^^' duced in both old ai^d you^ SVv^- ^ ^ ^ P™" the dead bodies of ^^iS^^'l^TroT^ °' 14 pigs die of anthrax within 6 da^^V Trombitas saw on the ft«h of an anthraT^ted cT^.^'vJn'Ta^ ^ 't m pigs of a Polish and Chinese tit^ ^l ♦!, .v °^^^^ took ^ at the begiZ^'^f 1r,S^.*J: S^m^^"" bably from the follicles of 5e tonsils. Accl^tn w ^~" the trachea to the lower ^o^e SlndT ^* ""^ °* of the fore-quarters and ttn,!riJ!L ■ . ^ *^® '""^ ''"^ace of the pha^Sd^^sSTaT^ ° T^*""^ °* ^^"^ attitude of lie head aEdc Wr!f "^^^l.^""' «tel>in«. stiff ing. regurgitation!^o^tii^ci^Tli,f S"'*^ "^ '"*"°"- of the mouth. dispnoea^nJ^^ u u °"'*^'" membrane anthrax: 351 quently become purple and even black, are seen on the mucous membrane of the tongue, palate, lips, etc Zschokke has described in pigs the occurrence of carbuncles on the sldn o' the back. TTie anatomical changes in anthrax of pigs consist in a gelatinous, hemorrhagic infiltration of the parts surrounding the pharynx ; haemorrhagic swelling of the lymph glands, spleen and liver (according to Crookshank, the spleen may be normal) ; and hyperemia of the other organs. In some cases, enteritis with submucous and subserous haemorrhages is present. Al- though the spleen and blood contain only a few anthrax bacilli, they are rich in putrefactive bacteria, the presence of which greatly increases the difficulty of the microscopical demonstra- tion of the anthrax bacilli, and transmission by inoculation (Crookshank) Anthrax in Dogs and Cats. Our knowledge of anthrax in dogs is very defective. Accord- ing to Straus, age confers on them comparative immunity. This observer states that newly-born dogs are extremely susceptible to anthrax when inoculated with moderately virulent material. Bardach inoculated anthrax intravenously in 25 dogs from which the spleen had been removed, and in 25 normal dop. Of the former 19 died of anthrax; of the latter only 5. The eating of meat infected by anthrax seems to be the mosi frequent cause of the disease in these animals On this account, anthrax occurs in dogs usuaUy in the intestinal form and m that of local anthrax of the mouth and pharynx Ownevm saws dogs out of 7, which had been eating parts of th dead body of an anthrax-infected cow. die on the evening of the same day. Peuch saw a case of anthrax from feeding on mfected flesh m a dog which had a wound on the tip of its tongue Some supposed instances of anthrax in dogs are probably nothing else than cases of ptomaine poisoning, which is a disease that was formerly frequently confused with anthrax in man. Cats, Uons, and other camivora may become infected with anthrax m a sunilar way to dogs. Anthrax in Birds. Pathogaiiaaia^^Pasteur states that birds are immune to anthrax on account of the high temperature of their blood ; but that they may be made susceptible by reducing their bodUy 35» INFECTIVE DISEASES. found in hi. expemnenK^U v^ vt^ niS^*''*?'^ '^' breed. a« .u^eptible to SlT S^?T°^'^ '"' Perroncito, Hsu Kitt ami !^wll!^' u . ' ^***y' I^A'tr. with their S^tion eTlS^' ^'^l^"? "•«»*^^« «-^''^ l-nd.tJeinocSre"pSro?F:Lt;?iE.Sr?" ^'^^ from dyspnoea and bloody diarrhoea and thiT J!^' ^ '"**" and corpora cavernosa (imb^T^kSl JeTS "*"?^«^« are comparatively frequent, and^p^^ ^eSv o„ ^''"°^« Mettles conjunctiva, tongue. palate^'SS^^^wSblS^noT'' of the feet, ete. Mistakes are of ten msSebr^;!-^^^^"^ ducken cholera, cerebral apoplexy. and*tSr<:j^ "*** hJSStSvSenS^si'^l? *'""''* ^ '^''*"' ''"'«''«». tanner, whilst cutUng u?tKa3«kTt ^'^^ "* °' " *^«=««»> »^S b«nc.e.(„„uU'nt;r^^^^^ the for. o? car- of the pustule is followed by fever ai^uM^'K .. ^''••PP««nce anthrax mostly occur, ftom'^I'tw ^^tTfL "^ T^"*' '"'"""• mahgnant pustule consists in iT. nLfT^T C ' ^^ treatment of orby the «L of strops. L,a„tf,.?K "^ '*" '*'" *«'°- "^i^^on and carbolic ^^"""8 *^"'*«=tants. such *» corrosive subUmate. creolin RABIES. 353 RABIES {Hydrophobia). R»bl«» in Bential-CMin. wblw-Symptom. of nbiet in mM-Bovine imbta Hl«*o»y.— Rabies is one of the oldest known diseases of ammab. In the fourth century, b.c, it was described by Anstotie, who writes: "Dogs suffer from madness which puts them m a state of fury, and aU the animals that they tote, when m this condition, become also attacked by rabies." We find aUusions to it in the works of Virgil. Horace, Ovid, and Plutarch. ComeMus Celsius, who lived in the first century of the Christian era. was the first to aUude to human rabie^ and to employ the word "hydrophobia." Dioscorides recom- mends exasion of the wound as a protective remedy; and Oalen m the second century gives special remedies for rabies. Among the older authors we may cite Plinius the younger. Columella, and C. Aurelianus. No allusion to rabies is to be found m the Uterature of the Middle Ages. Bauhin. in 1501. mentions in his " Mtmorabilis historia lupornm aliquot rM* 'Mym (the transmission of rabies by wolves to man). In 1604 an epizootic of rabies broke out in Paris (Andry) ; towards the end of the seventeenth century, in Italy (BagUo. Ram- muzm) ; m 1708, through Swabia (Camerarius and Scharff) • m England; and from 1779 to 1807. in America. especiaUy thr .jgh the West Indies and Peru. Towards the end of tl^ eig..t ^nth, and at the beginning of the nineteenth century rabies ^^J^ T^' ^^l ''^**''' °* ^'"<»P*> ""^ many «w«u» „ere offered dunng that time for the discovery of a remedy for it. The names of Chabert and Hunter should be kept in remem- brance for the good work they did in the investigation of this disease. An epuootic of rabies raged amongst foxes from 1803 to 1830 m Southern Germany and Switzeriand (K6chlin and ftaajue). During 1814 and 1815, Viborg in Copenhagen and Waldinger m Vienna unproved the methods of the experimental investigatiwi of rabies. In 1817 and 1818. Delabfere Blaine and Greve in England greatly enriched the clinical knowledge of this malady. Rabies was prevalent during 1822 in HoUand • dunng 1823 and 1824 in Berlin ; and during 1824 in Sweden and Russia. In 1828. during the epizootic which raged from 1823 to 1830. Hertwig published his "Contributions to the 23 354 INFECTIVE DISEASES. better understanding of Rabies," which is a report of a £reat ofTawL '^/'^y-:-^'-^ experiments on iuiZ^Z OBease. In 1832 Youatt in England and Prinz published theu- works on rabies. In the thirties the disease J^ veS and 267 cases occurred in Hamburg. oLig 186? rabS bwke out a, an epi«>otic in the Rhenish^countSnd i^ Pr^ee and from 1863 to 1871 in Wiirttemberg. where sJJSals' From 1862 to 1867. and again from 1873 to 1876 it r^ed S k"?SJnv^S '""? *° '?.^^ S--y = ^«t ne^oufexSt^ ment. anger, jealousy, too high feeding, etc Vi^chow ^d supposition. It is only dunng the last few decades that the accepted. In the year 1881 Pasteur greatly increLsd oi«^ of protective mocuktion, and gave a ^rmanent impuL o further expenmental researches. ^ Etiology -The infective matter of rabies has not vet been produced in a pure condition in spite of thHa^ts' 3 roi, «abes Pasteur, Koch, and others. Pasteu/ however has shown that the virus is purest in the centrd^ae";,us°^tem Obrain and spinal cord) of infected animals, ^d !^ s^ r^h^ penpheral nerves, salivary glands, lachrynlal glaS^. aque^t^ humour of the, eye, pancreas, mamma., Lticlw. IdSieT^^ m theu- secretions. In the urine the infective mtt^^^H a?p^?o"Xr?l.°*'*'/^""°'«^°"- The nervous s^em appears to offer the most favourable condition for the deS" -J RABIES. 355 ment of the virus, which does not seem to be contained in the Wood. The contagium is at aU events fixed, not volatile ; and is purely endogenous, not octogenous; that is to say, the antaal body is absolutely necessary for its development. Paul Bert proved that it is a solid body, by filtering the saliva o£ S A?°*?u ?"*^ P "**' °* ^^^ P^*^ ^^ by then showing that the filtrate was mnocuous. Pasteur found microscopically in the brains of rabid animals fine granules in the form of extremely minute points which could be stained with aniline solutions, and which he regarded as very minute micro- organUms. He did not succeed in cultivating these bodies, which he considered to be neither micrococci nor bacilli The recent investigations of Babes show that the existence 01 a characteristic micro-organism of rabies cannot be proved even by our most modem bacteriological methods. These investigations, however, point to the probability of our beine able to cultivate through several generations, from the centrd nervous system of rabid animals, an unknown substance which possesses the capabiUty of producing rabies, and behaves to external agents, as a rule, Uke a bacterium ; although it is much more resistant to carboHc acid than any known bacterium. Babes cultivated this substance and produced rabies in dogs rabbits, guinea-pigs, cats, rats, and mice by inoculating it into the vitreous humour of the eye. or between the cerebral mem- branes by trephining. Anrep obtained from the brain of rabid rabbits an exceedingly virulent material which appeared to be of the nature of an alkaloid. The vitality of the contagium of rabies seems to be greater than was formwly supposed. The inoculation experiments carried out by Hertwig by means of the saUva and blood of rabid dogs gave negative results 24 hours after their death. Wbier on the contrary, found that the saliva remained virulent for 34 hours, and Mergel observed that the brain continued virulent for 15 days. Similar results were obtained m Dorpat. Pasteur preserved the brain of rabid dogi for 3 weeks under a very low temperature (-12° C ) without the infective matter losing its virulence. This organ It kept in mout carbolic gauze, retains the contagium in an active condition for months. The infective matter remained rSl! i?M J""u^ "^""^^ **"^ ^^'^^^f' when kept in tttbM which had their ends closed by fusion. Pasteur proved that the virus can retain its power of infection for 4 or k days when exposed to far advanced putrefaction. It ws» 23* 356 INFECTIVE DISEASES. According to Viala, the contagium of rabl J ™« ■" ''*?'• for over 5 months when keptlU? ^d tol "^^ f"' as the vehicle for the contagSm R^kn^ tf ''^f ?^°« pointed out the very impoiSTfact 2S ft °'"'* ^*^' beforetheappearanceTfrab^XsSf^SitaL.^^^ ^^^ and is consequently virulent' XSdltr^d^;!;;*'^"^ of incubation. It is verv dnnhtM-tlu ■ °* *^® period ;n U>e digestive 1^1^ ^'^^ZT,^^^ tS^ sahva of rabid animals, as Galtier stateTw^. ♦!, '• ^' ***■ saliva in his experimente wkh rabbite wf * ^ "^^^ '"^^'^ that the ingestTS the S S iSS-of^biTiSr?* '^"'^ produced any injurious consequences ?s a S^**?- "7*1 we may mention that NocS fed a yomi^ ZTf^'^1^' on the bram and spinal cord of r, L\^a • . months Ul result to the fox^ Wir^Ukoli ^^ thft' r?-"*-^^ destroys the contagium of rabi J n„ ♦? *u 1 ^"*"*= J"»ce to poiit out that^hri^tr^rrriioi ^ °*^^ ^*°^' ^« have rabid animals S^p^uS2^Va^fM"~?*i?°" °' "»« °»^ o' Perroncito anrcSa Stiuc^ 2^?^"^' ^'«' ^^ B^^dach). oculation with tJfmtiSS^'Sl ^o^ ZuSTT'"" t^ '"• which had become rabid by LacXZ c^»' *''" '"°*^*'" °' state that they have observ^h^^J?^- tiSS'on'o? ^ The experiments of Renault. Roux. Sti^TS^t^h *^- and others on this point have nn tL I^ ! ^*8ran, Bombica, results. In any ca£^ the hi ' hS *^V««>*^*^. Pven negative certainly ver^r^r^' ^*'"*^*^ transmission of rabies is -According to the inve,tiSSi''of^*'BS?^.^"S~' ****** the rabic virus is destroyed by aTper ce^ Sw "'I R"o and by of liguor tnn. ; s Sr oin^sSuSn ^H'*°'.t ' ^ «=«"• •<"»«on acid, and a ,0 per^c^. -.utirrnit'^t^S^li-^^-^^^^^^ RABIES. 3S7 sulphuric acid and liquor amnionic in lo minutes ; by a 4 per cent. aoluUon of boric acid in 15 minutes; by a i per cent, solution of permanganate of potash in ao minutes; by a 5 per cent, solution of carbolic acid in 50 minutes ; by a 3 per cent, solution of carbolic acid in 60 minutes ; and by a 2 per cent, solution of carbolic acid in lao minutes. According to this, creolin is the strongest and carboUc add the weakest disinfectant for the virus of rabies. We learn from the experiments of Celli that the virus of rabies is rendered inert by hot steam in half-an-hour ; by a temperature of from 50° to 60" C. in i hour; by one of 45" C. in 34 hours; ^y corrosive sublimate (i to 100.000), permanganate of potash (from 2 to 5 per cent.) and alcohol (SO to 90 per cent.) in 24 hours; by a 25 per cent, solution of alcohol in s days; and by a 15 per cent, solution of alcohol in 7 days. The emulsion of the brain substance instantly loses its virulence when it is slightly acidulated with one or two drops of acetic acid, or when it is made slightly alkaline with soda. Pathogenesis. — If the virus contained in the saliva of a rabid animal penetrates the skin, it may remain for a long time at the sitt of the bite, or it may enter sooner or later into the body by means of the blood or along the nerve-tracts. According to the most recent investigations, it appears that the virus of rabies moves from the bitten part chiefly within the nerve-tracts in a centripetal direction to the central nervous system, possibly enclosed in migratory cells (Duboud, Di Vestea, and Zagari). It is evident that the virus becomes best developed in the brain and spinal cord ; the former being the principal seat for the development of furious madness ; the latter for that of dumb madness. Inoculation experiments have shown that the disease breaks out most rapidly from duect inoculation into the brain, under the dura mater, and that the period of incubation is proportionate to the distance of the site of the inoculation from the brain. The period of incubation is longer than in other infective diseases, and in dogs amounts on an average from 3 to 6 weeks, with a maximum of several months, and a minimum of only a few days. [Hunting puts the usual period at about 25 days.— Tr.] The virus may remain for a long time (as we have ah-eady said) at the site of the bite and may become, absorbed only in small quantities at a time ; or it may rapidly and in large quantities penetrate into the body. According to Protopopoff, the younger the animal, the shorter is the period of incubation. Ooourrenoe. — ^Although rabies chiefly attacks dogs, it may affect any of the higher animals, even birds. Out of all the 358 INFECTIVE DISEASES. etc- ofS „f JL-- --- ^r Cr^ Some animals ^V^^tTZs^'^'''^. »* other times. It goes without J^JtlSrS. H "^"^"^^ ^"""^ty to •*• in places where t^^ 7* llr~ "^ '' "*«* fr«q«ent there is much Sc a^ t^w""?"' °^ ^^^S*' "^^^^^ere the protective police 'me^^^ ^5:,^,°]^' -Penally when the disease being transmitted frnm !i !' ^ **=<^°""t <>* «'«'54.itisfreque7tly^rj*^„ ,uT .^°f *<> wolves, and vice and plains^ wh^rwoJJ^s^e foS'^^"^*?' °' "°"°t«^ pathian Mountains. R^Jl ete ' ^ '" *^' ^°^*«' ^ar- animals annuaUy become rabid T^lZl ^ ***'«» "*> 'oo other are as foUows :_ '"• ^" *««'« ^r the individual yeara 1886 1887 1888 1S89 1S90 1891 1893 1893 1894 l^ note, p. 36rj. it i, statedThTt'raS ^\T " ^'~* ^""^ l^cause a six-months' qnaranUne his N^ ''i *^'"" '" Australia. South Africa is pr^cuLy f^'f^ ^Wel""^ "I "^^^ ''°8»' for many years was one of a doK wWch^f V I ""^^ «^ "Po^ed Elizabeth, by Britton. in iS^j] I"^ *'*'"'** '° ^ "^id in Port other infective diseas^hZ ^ Kables.— In contrast to RABIES. 359 fact they are characterised more or less by negative appearances. The general changes, which are in no way typical, are as follows : The very emaciated cadavers become rapidly putrid, and, in the case of the latter domestic animals, greatly distended by gas in the hind parts of the body. The blood is thick and of a dark-red colour; the muscles appear granular and affected with fatty degeneration, and the heart, liver, and kidneys show parenchymatous degeneration. The mucous membrane of the mouth is congested and swollen, chiefly at the base of the tongue ; the tonsils are enlarged and inflammatorily infil- trated ; and the salivary glands are hypersemic. The mucous membrane of the pharynx and larynx is reddened, swollen and even studded with small haemorrhages. Various kinds of foreign bodies are sometimes found in the pharynx and oesophagus. The stomach frequently contains straw, hair, feathers, pebbles, pieces of brick, particles of wood, bits of leather, portions of whipcord, and other foreign and indigestible substances ; but little or no food. Wortley Axe found foreign substances in the stomach of 90 per cent, of 200 rabid dogs which he examined post mortem ; but no trace of food. He considers that this condition of the stomach is the most importjuit feature of the whole autopsy. Galtier found foreign bodies in the stomach in from 50 to 70 per cent, of 300 rabid dogs of which he made autopsies. The mucous membrane of the stomach is congested and swollen ; and small haemorr- hages and haemorrhagic erosions are frequently seen on the surface of its folds. The intestine is generally empty, and its mucous membrane and the mesenteric glands are congested and swollen. The spleen is hyperaemic, swollen, and sometim2S infiltrated with haemorrhagic tumours. We find in the urine, albumen and sugar ; and in the case of dogs, biliary pigments. The respiratory mucous membrane is purple and the lungs are full of blood. The changes which are found in the brain and the spinal medulla are very inconstant. Sometimes we find hyperaemia, oedema and extremely minute haemorrhages ; but at other times no changes are apparent. Csokor and others state that a considerable accumulation of lymph corpuscles may often be seen with the microscope along the capillaries and within the walls of the vessels and m the grey matter. The vessels of the grey matter are dilated and show micro- scopically small haemorrhages and hyaline thrombi. According to Babes, some of the nerve-cells possess vacuoles and im- migrated roimd cells, and manifest nuclear division ; and 36o INFECTIVE DISEASES. the leucocytes of the dilated vessel. ,.««♦ • .. n-d. a««boid bodies whiS'j;^e^°S^,t;rur *^^' after the comimJSmentTtht^«! *"'' T "^^ °' "^"^^n' but only when the ^JLI wL^r''T°°">^I *?« «*^ recoveries in rabid dogs^md So^^*' t^T^* ^ «*° i absolutely reliable ^r^ot^y^^ ^^ *^J. "^ °?er must therefore be regarded as^^Tf^ ^" '*^*"' *'^*=*» jj^^^ cgaraea as an ahnost invariably fatal Hertwig found that only 37 ner cent «wi, oculated by him became infectL^oS « *?^ *°™*^ ^• The compitive s^L of^ Z '°*'^* ^ P*^ «=«"*• fact that in inoculatSm fh. ; *^- ^^ '"'"* ^ «J"« to the not adhere to'Thtfnr^a^^rt"^^^ ^^''"-^^^^ ^- meffective on the hair or on Vh-T^ ' . '* "**y «™a»n it may be washed ^a' bv tt T^"'' k "•' *^ ' ''^ "»** inoculation. In the «Z. ^ haemorrhage caused by the that the £te of a ra^ a^Z,"! "'^ *'=.'°'"* *" "»« *»ct rabies. It seems that on ?^ °^ °°* invariably produce .cent.of thosTSutenbvx^HH """"""^u ""^^ ^^^ ^° *° 3o per puts the ^cen2^eLTHaubt*^T^'*'=*^ ««^g College of%ons7:t\*o ' ^t^^'J'^^L ^ ^eterinarj calculated that in Austria ^.,„- lu ^' ** 33- RoU percentage among ho^^w^"^,.:/^ ''^^-^^7. the she^.50; -onl pigs. 36ran5t.o4° 'oar.? "*'^ ^'^ -en^^TSXt^^^er™^^^^^^^ - phySS^Tor^t^'is'^/f ^a!STfIfr!r°* '' ^^^^^ P™* symptoms of the disease Alth^^h *^ appearance of the cauterise the woLTSS thll^t "f '° "'°' *" ^^°"^^ ^*ays add. coiTosive ^ubwf et - T"""' ^**''^' ^"^P'^"^ or the cicatrix; we shoSd. f^): i;eS'V':as?; ''"? P"* means to our domestic animlic ^ • "^°». apply such Prophylaxis conSsS cSefl^lS/'^^r"' • ^^^^P^io^al cases, tective measur^of whth t? tbe apphcation of indirect pro- policereg^Sof .S'J„it%^* Z^"""^ ? ^"^ ^™- r^ utility Of this lawlas^^e:'tlf e^r r^ - J^^^^^^^^^ rabies: 361 of a tax on dogs, by which the number of dogs and consequently the number of cases of rabies were decreased, as was statistically proved in Bavaria. In large towns the compulsory wearing of mu2zles, combined with preventive treatment of the wounds, and the establishment of a tax on dogs, have proved a most exceUent means for checking the spread of rabies, provided of course that the muzzles effectively answer their purpose. In Berlin, for instance, the compulsory wearing of muzzles has greatly diminished the prevalence of rabies. The following statistics show the benefits to be obtained from these pro- phylactic measures. In Bavaria (tax on dogs, 1876; law in r^ard to epizootics, 1880) the number of rabid dogs decreased from 821 in 1873, to 11 in 1885 ; in Baden, from 53 in 1874 to nil in 1885 ; in Saxony, from 287 in 1866 to 16 in 1885 ; and in Prussia, where only the law for regulation of the epizootic was in force, from 672 in 1878 to 352 in 1885. [In Great Britain, the regulations against rabies, which were first put in force in 1886, have proved singularly ineffective, considering that this disease is communicated only by the bite of rabid animals. The statistics of canine cases are as follows : In the year 1887 (217 cases) ; 1888 {160); 1889(312); 1890(129); 1891(79); 1892(38); 1893(93),' 1894 (248) ; 1895 (673) ; 1896 (438) ; and in 1897 (248). The faulty regulation of rabies in Ireland has long been a serious danger to life and property in Great Britain as well as in Ireland. The good effect of the muxzling order of 1896, despite its partial application, is shown by the following table of canine rabid cases : — Hontb. LoDdon. pot Into font 7tbIM>.) SnmT- (HusUag ndv pat into mrsetta whctejwr.) UddtaMZ. (M nsrilDs otd« patbitoten ■Tth nb.) Tanuaiy February March. April . May . June . July . August. September . October November December ao as 22 II II 12 14 2 I 4 2 4 '5 12 II 7 3 3 4 2 2 2 I 2 II 9 4 ! 1 1 I I s 2 2 As suggested by Hunting, the muzzling act, to be reasonably effective, should be put in force — ^immediately a case of canine rabies is reported — throughout the surrounding country, say, for a radius of 10 to 20 J0S INFECTIVE DISEASES. n»U«t ; ud shonld be ooatinawl in th^t .». «»- . eovw a fairly loiw w»i«i nTi-f "»t am for a tenn taiBeient to month.. D^nT^ SS-w *"'"'**'°"- ~y. *>' not !«, tlua 3 make cmain that thTwaniSn™ Tf\, ^^ ^'^ P" 3«). lo •• to Until I«und g.t. a dJir^Tf h^th il!!!'?.' Ir" *^ "«-• PortaUon of dog. from it into C~^ b^ ^^ '."*" *"'*^- »»» «" under quarant^ ^^ iLS^ S^So^aX^fin'' """^ *»"' wpect to foreign coontrie. Snri. ^»!!.- Vr«amt in operation with PracticaUy T^\nZ^^^tn^''tj^^'^°t '*^' « vie ce of remain. T con.tant^aS^'Tthe'JjL K^V""* "** ^'»»™^' •equently be permitt^d^T^ --I Kingdom, and dwnld nm. in RiMsia. TTie reLt^S^^^rL '*^* '•^•' » Particularly frequent be ..very deeiraSTe^rent «pSSly" ij'lt'if" «^««»«"« -uld •cnitiny into claim, for «-^rv» *TL ^'. *' "*• •*"« "nie a rigid theaniLtoare^^SrSforSTot^^' '*°«^-*" °" *•»* ?'« «^t •largenumber^l^*^i3XP"^;7">^^^^ At preaeat •heep^og breed. (colufor^KJuS^'^f^ f'f ^ '^«« '»««y belong to •ithough they are never mS>yS^Sif^.T**J'^ ~''°*'y P~P»« = K;^i?:S7nir.i^!!^-^^^^^ repeated J^S!?' ^^^f^ng '* from dogs to monkeys and by poSeroumaTtTe^JL'r ""^'^ *° '"°"'^*J-- ^« *S skin or unc^er the duTaCer'r;! ?^^^^^^ produce rabies inXsbTt' ~nH ^?^k'"'^ '^'''^' ^^ "<>* immune bothTonatS'andJS'^T^*^* ^""^'^^ted animals times, Pasteur nuhSr ^^"*' mfection. In more recent use of th? dSd sn^n!? Tl^" P'*^ °^ immunising by the from a rabd rabWt 'Sr .?*' "^mbranes are removed cerebeUum.1nd cu "tf ^^^076^^ "'"^ " "^ ^ ^^'^ pieces are tied to threads whth "" ^*"«*''- ^«« and the bottles are fillS^\K-^* «apended in bottles; potash, anHc^d JtfhTo? "^? ' ■^''"•'^*^ ^"***^ then kept atrcl^ ^ ".ru^e^^o"? ^Jt^f,"^ ^riatrb^^ds^r^rf ?i '"^ "^ -^•^«^- °^ cording to the 1^^ /L'^''''^'' gradually decreases ac rabbit Secot'Xt:d°'in^'r"*'°". ^°^ ^^*"-' ^»rth material whirh t u^ '^''^' ***«'' inoculation l«>urs;T8 dayT ^fcenX*-^. <^«<1 /- ^ to 48 «ays, wfcen the desiccation has lasted from RABIES. f»3 3 to 5 days ; and in 15 dajrs when it has been continued for about a week. Animals may be made immune to rabies by at first inoculating them with very attenuated material, and then gradually increasing the strength, so that they can finally bear the strongest virus with impunity. These at- tenuated inoculations sometimes cause the inoculated animals to become affected with a temporary and partial rabies. According to Babes, it frequently happens that dogs temporarily exhibit, from 8 to 14 days after the inoculation, depression, loss of appetite, emaciation, nervous symptoms, morbid desire to bite, and even paresis of the posterior ex- tremities. Pasteur states that the effect of the virus increases and the period of incubation diminishes, in proportion to the number of rabbits and guinea-pigs through the bodies of which the disease is transmitted. The strongest virus is prepared as follows : the experimental rabbits having been trephined with a trephine of 6 mm. diameter, a small quantity of the central nervous system of a rabid dog that has just died is injected aseptically under the membranes of the brain with a Pravaz syringe which has its needle bent at a right angle; the result being that dumb rabies breaks out in 15 days. If the injection be made subcutaneously, the development will be slower. When, after this, the virus is transmitted through a series of rabbits, the period of incubation, as we have already said, becomes gradually shorter, namely, 8 days in the twenty-fifth rabbit, and 7 days in the fiftieth rabbit, with which the maximum of virulence is reached. With an inoculation of ordinary fresh virus, the period of incubation is 15 or 16 dajrs. These statements of Pasteur were tested by a French com- mission, among whom were those eminent savants — Paul Bert, Bouley, Villemin, Vulpian, and Tisserand. This com- mission fully confirmed Pasteur's statements, and consequently there is no doubt that the virus of rabies can be either weakened or strengthened. Also, we cannot deny the possibility, in the future, of rabies being successfully combated prophylactically by protective inoculation. Pasteur attempted to immunise human beings after they had been bitten, by inoculating them with attenuated virus. He applied this p-acess first to dogs with a positive result. Altogether there have been inoculated from 1886 to 1890 by Pasteur and in the ao Pasteur institutions in Russia, 364 INFECTIVE DISEASES. directly underihe MTof ^\^^ *^ ^"^^ » ejected from i to I C.C. TilJ^^ Z""" \ * '^'^^'y °* material i. used and then^.^^j^K*'^* 7^"* inoculation finally a material of the W^h^^i,," ^y "''''*^ ^^ « «Uted that by this «S:«^S^ n,^. ?"• " *^P^°y«^- '* reduced from i6 Ta^^^r 'T ,?*^ '" «»>'«» h« been •chniko£f. Ultoann, bS^5 ^?>, ^^"*t"' ^*°*^"i' "et- Bordoni-UffredS de^ Re^S^^*"^ °?*"^- ^°° Fri«=h. declare that their r^VrhiT' ^*? *°** "^''"r authoritie^ derived frJm ple^? ^^T" *^* "*> '^"•fit can bT qaenUyitTn.^SritStto'r*'"*^*"'^^- ^on^' on this subjectV^Eve^ aS,i /S"" «***^** ~"*=^'»'<'° method of curative ZnSn^ ^* "^^^^ °' P**te"'» foUowing points F^?T?f' ^.""'* °°* "^erfook the of tlTSte^^^pJ^^r^iufi^- ^.tel^^^ ?°^ -"^ according to Bollinger, onirf^om 8 to 47 £2^**^ *^'"«' *nmimum at 16 per cent aic« ^^* ^^a^teur Puts the whether the bite^L^„ i^t'J k'^^'I**"' ^ "^V «««». -merely suspected oTraS^^s^n!™.^ V**''^ "^"^ «' by one by. respectively; ?Lteu^Vm»nf* of protective inoculations number of the^ paSn"' ^ X*°,? ^!*«='>"''^««' » «=ertain accounted for by the fact th»* ^ f mortality may be basbeenprevioSytuteSsid p«rr^ "^u"^ "^« -^""d is in any case too crad«T^ Pasteur's method of inoculation institutiL.exS:srv™?frhai^';Li^°:j:'*f«^^^^^ ^°«>- unsuccessful. It hac k»„^ i .?^' *°* method is stiikinj?lv of the melSod ^d)Klc<2:i.tTr ' ^P-^S^ or. even origina\rr2 i^^STr^*'' T'"" °1 ^*^'^^' gomg considerations w^ m,,7* persons. From the fore- establishment TZtZ TL7"" -^'^ ^"^«^ *hat the m France to be absolnS,?; *** "^^^s is considered even prove thatr^ven^\" $^P^^!r.',I' ^^ocard). Statistic animals, tax onl^ ^^^'"^f /" '^^ contagious disease of large towns, are Sv ^J^^^^^^ "^^^^ °^ ""^^^^ in amply sufficient to successfully combat rabies RABIES. J«5 ■« Mattods ■# PvotMUv* ud OwiUlm Imm- -I. Hbgym otw inocnUUon nutterial in difhrant ttmigtha. He pnpuM thcM conceBtiationa from tha spiiul cord of imbid nbbito with ult water (i to s.ooo. i to a.ooo, i to 500, i to aoo. i to 100, and I to 10) and makM racceHive inoculations, beginning with the weakest concentration. By this method dogs can be rendered immune against both the natnral vims of rabiM and the fixed virus. H6gycs' experimenU seem to prove that immunity may be conferred by diluted fresh virus repeatedly inoculated a short time either before or after the »nimat has been bitten. In 13 cases of dogs which were inocolated subsequent to infection, recovery took {dace after pronounced symptoms of rabies had appeared. In man, however, recovery from rabies by means of such inoculations has never taken place after the appearance of the symptoms. 3. Hdmann and Ferran y Qua have shown that the greater the quantity of Pasteur's inoculation material (Inrain emulsion) that is injected, the more rapidly and the more certainly is immunity obtained 30 to te c.c. of the emulsion have, for instance, been injected >ub- cutaneously in one dose. The tolerance of the body to such large doses depends on the fact that the virus is injected only under the skin. Should other parts, such as muscles and nerves, be injured at the same time, the inoculation may be foUowed by an attack of rabies. 3. Babes states that Pasteur's method, though efiective for ob- taining immunity after the bite of rabid dogs, does not succeed in the case of bites by rabid wolves, for which he uses the blood of immunised dogi, and injects 30 grammes of it for each dose in the abdominal region of the bitten person. This inoculation of blood is stated to have been successful in 34 cases. 4. Galtier has demonstrated that herbivora and omnivora may be rendered immune by intravenous injections, not only against the conse- quences of subsequent bites, but also against bites already received. $. Protopopofi placed pieces of virulent spinal cord for, respectively, 30, 46, and 60 days in glycerine broth, and, having thus deprived it of its virulence, he found that one or two intravenous or subcutaneous inoculations conferred immunity against the infection of rabies, and also i»evented the appearance of the disease after infection. Out of 19 dogs which had thus been protected, 10 remained healthy after having been infected with the fitrongest rabic virus, even after it was injected into the brain. Protoi>opofi actually succeeded, by his method, in preventing an attack of rabies after intracranial infection. Of all the methods of anti-nbic protective and curative inoculation, his procedure seems to hold out the greatest promise for the future. Canine Rabies. Bjmptoms. — ^The clinical appearance of rabies in dogs as in other domestic animals, occurs in two forms, namely, furious madness, and dumb madness ; the former being the more frequent. Pasteur considers that furious madness takes place when the brain is attacked, and also when the virus has been directly inoculated into the brain ; and that dumb mad- \?> V. v*> \\ .<^ v^ .^ ^ IMAGE EVALUATION TEST TARGET (MT-3) 11.25 ltt|u Itt IM laa 1X6 Itt I2j3 L8 ISOmm LIED^ /APPLIED J ilVHGE . Ino 1663 ElMt Mam SirMi nochamr. NY 1460B USA Ptwrw: 716/482-0600 Fax: 716006-5860 e ISaS. ApplM hMgi, me., M ngM RmwvM ^ A ^ -•I 366 INFECTIVE DISEASES. neously. The two are ^x^Svnll? ^« *PP"*^ »"'^**- and the same disejT ^T^ „"^ °S *****^°* *°"»» <>* one held in fonner tST^A^^v ^IbS^* ^"^^^ " ^" madness, and vice vend We 1?* , ^^"^ ^ ^'^'^^ <»«««> fact that there are many inte^^- ^/^^ '*'«» "Po° *h« two varieties, which oft!^^™^^*'* *°"»» »«t^n these that a distinction t '^^^s^J^^ "*° ***=' ^"^'^ »° ^^^^^^ couS'"^ "^ * ^"y *yP'<=^. acute, and absolutely fatal 1. Furious rabies has three stages :- S Sf P':!"?"i*°'y or melancholy stage (b) The untative or maniacal stage ^ (0 The paralytic or final stage fn>m^xJt^^h:t' t'd °J ".''" ^"^^ - - average preliminary siLc^iU!!l'°r*^«« "^*° J^^^^^^ The ofthead^al.SchCL^?!"*"?' "" *^" altered behaviouJ nervous, irritky^fri^^d ^S"*.' •'.""^1^^^'^' «^«*«». It likes to hide itJl« SuSSr?'*^**^'"'^*^*^**' aad often starts up suddeT? or itVav^ST **" "^^^-Place. affectionate and confidinT W h ^ ^T** «traordinarily itching of the site ^Zliit^Z^^ '"^'' ^°'" *° *b°°"»«^ is a characteristic per^^sion oT^^l Y- f ^ "^^ ^^^- '^^^ 2^i^i in pica (^cS *» of licldng cold objectlTS'^,^^^ *f-Jr^> is fond across Its way. and sometimes si^^eiJL iTS* *'''*'" '°"'* stijw. grass, earth, stones. ^^T^c^^^T^^^''^^ and even its own faces a^d^e SS;. n^^ — *uihu can neiuier swallow nor drops do^?thf^Lr"n£^„°' *^' ir' ^*"' ""*=^ out. This condition is fX^ bv ' ^f *^" *f"^* '**°8^ quarters, which maniJtsVtsdnn,*^ ^^^" *** ^"^ ^d- increasing bodUy^Ssl Th^ 't^genng stumbling. and by anTSry blU^^bS Jp^arS^^ "J^t^^^t'"*""; weakness and Hpnr»ca.-»« _u- *^'"'"J"*"> witn symptoms of exdtement"tha^;^S/Smrr::S'*' h^ P""''^"" °' the animal dies betwMiTZ fiS? % u x.*""^ '^'- ^'^aMy on the tenth Sy oTTcSLL f,2 ''«^*• °'-'f * »"™um. general exhaustfon ParaW 'of th/ri^ °* '^' '"^^ *°<* appears in the eary sS^ S.^L '^'Tif*'" sometimes desire to bite sets i^&i^e)^ ^^' ^^'^ *^« ">°'*>'d havf^in^^de^^X tS H^rt::^?^ '^ -'^- about 30 C. or more a^^!?i ^''^' *^« temperature rises statement wh£h T'c^ J^^T*"^ ^^''"'^ *^^ *'°^-» in one case. ^111^ fZn?^ *'°"' °" "'^ experience H hours before SiJh.** m , cases a temperature of 40' C. chiefly'^rti.e'^^ett^;^"^ ^"^ *^« ^°- '<>- irritation or m^T Co^u'Ift*^,^^^^ °* «^e «tage of Ij^jaw^^pears ^^^^ SSj-^TS^^lat theXn't^^^^^*^ itl*'''^ '*^*' "^° — 'y -^t- ordinarily rST ^"^'^ ""**"*=^ »^« <=«rtainly extra- of this disease in these^SaTS^v^^rJ? ""^^ '" '^^ »y»P»<»« opinion, rabid dog, .l^lBr^r^tSr^iT,**^ '^'?^» *** ^^P"^ their legs; they show g^t av«^n L™ . "* *^^ **" '**'««» in th. diagnosis oi VSi^H^^ l' P"™^ top<«ance RABIES. 369 aggressive and morbid inclination to bite, paralysis, especially that of the inferior maxilla, and the typical course of the disease. If really rabid dogs are segregated and watched, the symptoms just mentioned will become apparent in a few days. If to this we add the negative result of the post mortem examination, we shall be able to make a pretty certain diagnosis of rabies. The presence of foreign bodies in the stomach is, in conjunction with other suspicious circumstances, a valuable diagnostic factor ; but it is not sufficient of itself to positively prove rabies, in which disease it sometimes happens that the stomach contains no foreign bodies. Besides, foreign bodies may be found in the stomachs of non-rabid dogs. Sometimes the knowledge of the place from whence the suspected dog came is of diagnostic value. We have, for instance, diagnosed rabies in a dog by the fact that the animal has beeu recently brought to Berlin from Russia, which is a highly-infected country. The difficulty of forming a correct opinion is greater in dumb madness, in cases of well-trained dogs being affected, and when the medical history is incomplete, than under opposite conditions. In the former cases, diagnosis can be made only by the intracranial transference of a fresh piece of brain or spinal cord to a dog, or rabbit, for instance. This method is especially applicable to cases in which human beings have been bitten. Instead of intracranial inoculation, which demands great attention to detail, Nocard recommends that after depriving the cornea of sensibility with cocaine, the anterior chamber of the eye of a healthy dog should be injected by means of a Pravaz syringe, with a piece of the medulla oblongata rubbed down with distiUed water. By this procedure rabies appeared in from 14 to 17 days in over 200 instances. We may perform the inoculation with greater precision by carefuUy rubbing down with a little distilled water a small portion of the bulbus of the medulla oblongata, straining the fluid through fine Unen, and taking up the filtrate in a Pravaz syringe. Ten to 15 drops of a 5 per cent, solution of cocaine are dropped into the space between the lower eyelid and eye-ball of a dog which is firmly secured. When the cornea has lost its sensibility, It is perforated with the needle of the syringe and i or 2 drops of the emulsion are injected into the anterior chamber of the eye. The emulsion should be made as aseptic as possible, so that the eye may not suppurate. Intracranial and intra- ocular injection generally produces furious madness; sub- cutaneous and intravenous inoculation, dumb madness. 24 »o INPBCTirS DISEASES. ■iu.I.j?^^..*™"'"'*'"™*'"" of the brain Dan- tentative adnunJstraUon of curare. ""uuc. ana oy tbe Bovine Rabies. Etlolo^.-Of aU the domestic animals, next to don tie are most liable to become affected wiih rabiel. ^t • During the years 1887 to 1896, inclusive, the followinc were ih* «..^- T^VK • ?'^ ^ '59 ^^' '* "^P- 43 cattle, ai h««e., «,d aoIwTnl The high position in thU lirt ooeupied by deer U due to thTStX «r^" were attacked in one year (1887) — Ti. ^ ^" " ™* *" ™ »«=' »»*» *Sr <«eer cattle RABIES. 371 only are cattle more numerous than horses ; but dogs are more aggressive to the former than to the latter. Rabies in ruminants IS usuaUy caused by the bite of dogs, and seldom by one rumi- nant biting another ruminant, as observed by Cope and Horsley among the red-deer in Richmond Park ; or by rabid horses, cats, or pigs. The site of the bite is generally on the fore part of the head (generally on the lips), and on the hind-quarters. The period of incubation averages from 4 to 8 weeks, and rarely extends to several months. Mieckley proved in i case that it lasted for 327 days ; and Monro records i of a years and 4 months. The minimum duration is i week. Spinola states that pregnancy in cows prolongs the period of incubation. As already mentioned, 2 cases of supposed hereditary trans- mission of rabies to the calf have been pubUshed. Bsrmptoma.— The furious form of rabier is more frequent in cattle than dumb madness. The ch*istcteristic symptoms generally manifest themselves by butting with the horns and stamping with the feet. The attacks are often so violent that the horns become broken. Other affected beasts dig up the ground with their horns and feet. The morbid desire to bite is less marked than in dogs. The expression of the face is generally wild ; the eyes staring and prominent ; and the conjunctiva cong^ted. Sometimes the animal continually bellows with a p«»liar alteration of the voice. Excessive secretion and dribbling of saUva, and continuous constipation with severe straining to defecate, are constant and strik^ju symptoms of rabies in cattle. This tenesmus may be the first visible sign of the disease. Some patients yawn continually for hours. In many the sexual desire is increased. At a later stage the move- ments of the hind-quarters may become stiff and straddling, and general paralysis may set in. There is finally excessive emaciation, and death takes place in from 4 to 6 days. Ladague has observed, in a few cases, an intermittent course of rabies in cattle. DiffeMntial DU^oaia in CatU*.— We have here to consider : inflammation of the brain, especially tubercular basUar meningitis; poisoning, particularly lead-poisoning; gastro- intestinal inflammation (Papa) ; foreign bodies in the oesopha- gus; new growths on the reticulum (Meyer); dermanyssus mites in the outer auditory passage (Stadler and Schuemacher) ; malignant catarrhal fever ; anthrax ; rinderpest ; sunstroke • 24* ST* INFECTIVE DISEASES. wdtement in conaequence of deprivation of liberty (Kfihne) ; Equine Rabies. by ?h""ihf o7^il!ri" ^°^ ^ "*"'y ^'^y tranmitted oy tne bite of rabid dogs; m rare instances, by that of ^. ^J°'^i ^' P****^ "' incubation ^mLTLS ever, an>earB to have been exceeded in a few cases • fm Ran ^^^ r °* '^3 days; ZOndel. one of sTdkys ^S Gotteswinter. one even of 20 months. ^ ' r«tSSf?*"!lT^*''**i°"** ** ^* ««"bit unsteadiness, mdessness, and terror. They paw the ground with their f^ stable gew; and sometimes manifest an itching irritation on ^f^ V^'^'y^H^ "^ "~**>^ "^^ o°^« lips m^zS to^il^ .^^u *"^ ^^^'^ seized with an irresistible iS^ tobiteandkick. Some lacerate and mutilate their own bodS by tejnng the skin, testicles, etc. Others will rThS alS Bv ti;?^ ? '* " ^*1? r *° *^^' '^'^ ^ »>ite and pSl at it ^lU^^ T^ *****'• *"** *^«° *^« ^y of theinferii muDlk. totam horses remain in a dared indition- and f^W ^* *?S; ^^V'^^'-^^y. «>ey ^ not touch' their rooaiata: on. Other horses masticate everything that sets betwe«i their teeth : they even take up their dZld^w Ij^cvmce severe thirst. Great Sesire to^c^T^^ mc«»sed sexual exatement are characteristic of equine rabies SteUions try to mount mares, have erections, and hivoluntarUy ti^L^^' ?"** 5**^°** "^"^^y ^ »««'°' *«««». strain to unnate. and mamfest excessive irritation of the pudenda. ^ZS^^u\?^ "'^*' °* deglutition sets in. the food^ returned through the nose ; the animal works its jaws continu- ,Wo^ "»^e^ng. gnnds its teeth, shakes its head, and swishes Its tay. These symptoms are associated with convulsions and muscular si»sms in different parts of the body. espedaUy in the muscles of the head (lips and cheeks), neck. abdom«S!^ ^^^ symptoms of colic, such as groaning, frequent lying down and gettmg up. straining to defecate and even prohipse of the rectum may occur. Finally, general paralysis sets in. the animal staggers in its walk, knuckles over, gives way at the fetlocks RABIES. 373 and exhibits a groping uncertain gait, and, as a rule, soon becomes paralysed in the loins. In some cases, paralysis appears at first in the muscles adjoining the wound, as on the lips or on a forefoot (Gerlach and M^nin). The temperature of the body rises from normal to 40° C. or more ; and the beats of the pulse may be increased to double or treble their usual number. To- wards the end there is frequently a general outbreak of sweat. Death often takes place by apoplexy as early as 24 hours. The average duration of the disease is from 4 to 6 days. Dumb madness, in which the morbid desire to bite is absent, is more common in horses than in cattle. Diflarantial Diagnosia. — In horses the following diseases may be mistaken for rabies : Inflammation of the brain, staggers, abscesses of the brain (Kopp), excessive horsing, colic, inflam- mation of the stomach (Olivero and Allemanno), rupture of the stomach, and paral}rsis of the loins. The psychical cUsturbances, morbid desire to gnaw and bite, straining to defecate and mic- turate, symptoms of colic, local itching irritation, aiid increased sexual desire are phenomena of diagnostic importance. Rabies in Cats. Bymptoms. — After an average period of incubation of from 2 to 4 weeks, rabid cats show great inclination to run away from home, and a strong desire to bite and scratch. The injuries caused by rabid cats are more dangerous than those inflicted by any other domestic animals ; because cats jump up on persons, and try to lacerate and scratch the face. They also attack dogs, of which they show no fear. Their voice becomes characteristically altered and hoarse. Death takes place between the second and fourth day. Rabies of cats may be confused with helminthiasis. Next to dogs, cats are the most frequent agents by which rabies is transmitted to man. Pasteur estimated that among 12,000 persons who had been bitten by rabid animals, iz,ooo were bitten by dogs, and more than 700 by cats. Rabies in Pigs. Symptoms. — Rabid pigs show at first great restlessness, nm wildly about, scream, squeak, dig up their litter, hide them- selves, attack man and beast, and exhibit a great desire to bite. They secrete an abnormally large amount of saliva, slaver, and frequently swallow foreign bodies. At the commencement of 374 INFECTIVE DISEASES. Rabies of Sheep and Goats. and ^ LdT^nn* fK "*1 *" *^* *''*"' ^•^^^h «»cy lick and push aeainst tliA,v wiT' • *^«c*«d animals crowd °>ankind. IfLoX «n?^ T*^ *y?*^ *"** *^<"ty towards stamp wik teS. S^a'sSTif u'i ^'^'^'''^ ^''^' and will bite even stone liev S^ ! ' ;" ''*'** "* "^°* °* them, wildly, and assume ^l^rJ^I^^° ^"^^ "P °° ^*'J». »ort cessi^e weakn^w^tf ^S of^f ST'^Jl"' '*"• =*• in. and the sufferers ^^^ a- V**^d-q«arters soon sets period of incSn T^L "» ^^^^ 3 to 6 days. The most cases, tte SStion i^^rA^T \ "/ ^ '^^' '« great part of an en1£ h,^Lv^ "^t^'' ^^ ^^^^^^^ » theinfectionisduetraS::L'S^(S^el)'" rare cases TT>e symptoms in ,oais an. essentially S'^i' as in sheep. Rabies of Birds. and jump ab^utT a Zrrr:J^ *^"* continually, screech, other anJ even hli tr4":?rSSrand'^7 '^**^. ^'^ thus tear pieces of cloth from^S. wk ?*"**' *"** °^y these bits of cloth. TheTvS^^ ^°?^ ^** *^ *° ***"«* stagger; becomrpar^'y^i ^dT ^™« ^°r ' "^^^^ period of incubatioS is S 6 weet Sth °' ^ ^^- '^ stated, of II months. ' ""^^ * maxunum, it is FOOT AND MOUTH DISEASE. 375 FOOT AND MOUTH DISEASE. Foot and month ditcMe in cattle— Foot and mouth disease in theep-Foot and mottth diteare in pigs— Infectiotu aphthae of hofies— Infectious aphthae of dogs— Infectious aphthae of cau and labbits— Infectious aphthae of biids— Tcansmission of mouth disease from cattle to man. History.— Foot and mouth disease (aphtha epixootica) has been knowj for a very long time. It was well described by some observers in the middle of the eighteenth century, when it broke out with great violence, especially in Germany and France. It raged from 1809 to 1812 and from 1819 to 1823, particularly in Southern Germany, Switzerland, and Italy (fluniva, Handel. Lux, and others). In 1839 it was introduced into England, where, since then, ten great outbreaks have taken place (Brown). In the forties (1845-1846) and fifties (1855-1857) it spread over the whole of Europe. Among recent epizootics we n ay men- tion those which occurred in the years 1862, 1869, 1^)71-1874, 1875-1877, and 1883-1884. During 1871, 700,000 head of cattle, both in England and in France, became infected, with a loss of 7,000 head (i per cent.) ; during 1872 in W irttemberg alone, 50,000 head, with a mortaUty of 1,500 (3 per ant.) ; and during the same period in Baden, 150,000 head of cattle During 1883 in Great Britain, the disease attacked nearly half a million ; in Prussia, Austria, and Italy, .60,000 in each country ; and in Bavaria, over 100,000 animals (83,000 cattle, 15,000 sheep and 5,000 pigs). In the German empire during X890, over 800,000 animals became infected ; and during 1892 over 4,000 000 (in Prussia alone over 3,000,000). The last great epizootic inva- sion of foot and mouth disease in Germany took place during the years 1890 to 1892. In some years this usually benign disease has assumed a very malignant type, particularly in 1892. For instance, the loss in Bavaria alone during the months of August, September and October of that year was over 3,000 head of cattle. Similar experiences have been made in former times. Thus, 2,000 head of cattle died from foot and mouth disease during 1839 «» the cantons of Bern and Freiburg. During 1872 there were heavy losses from it in France and Bavaria. Btlolofy. — ^Foot and mouth disease is an acute infective disease belonging to the group of acute exanthemata. Its con- tagium is both fixed and volatile and can be transmitted either 176 INFECTIVE DISEASES. ^^e^^li;:^^ ?? intermediate beam, to other «u„d.. ine infective matter, the nature of which is not fullv knal^i ticTlrTtt^y ""•• "^^ •"• P^P^tion. and exhala-' i. il^^^^ °! ^^ contagium varies greatly, according as it .n tt. ,«. h.v. d^d „p. .id *. X^^^ '„V,JnS "tJ^TSL'JtS th. ctef. of ft. ioot b^J^J^Zt^ «» *« tininateSrr iS^d^ ^.^^^^^ the inspiration of'«,„. attendants. espeSSy^ "^Sk^ ^TT,""** '"^^^^ ^^^ directly by the^^ Inl^^TT^- .S««l^Ws are infected place. ^'"*™^- -^ »n*«-«tcnne infection may also take can be abS^b^L di^n" * "^ P"''*"'' *^* "»« virus !-^. Any ^^ !?; S^U^^S 1„ro;^ '^ ?* -stance, cattle and sheep can be inL'S^ly ^^ f^^ ' , ^^ FOOT AND MOUTH DISBASB. 377 cattle, and vies venA. The ttiiciaic infected red-deer and fallow-deer. is sometimes spread by _/.— Noaotti tutw that he haa constantly found in the pore contents of the vesicles, a micrococcns which can be easily stained in a solution of aniline. He made pure cultures of it in nutrient material outside the body, and inoculated it successfuUy. Klein claims that the infective matter of foot and mouth disease is a micrococcus which he cultivated artifldally, and which produces characteristic cultures as a diplococcus and streptococcus, ao or more cocci being some- times attached to one another. Klein made these cultures on suiuble nutrient material (soUd Mood serum and soUd nutrient geUtine), and found that they assumed the appearance of soft, punctiform, granulated membranes, mbick consisted of small drops lying dose together. He states that he produced foot and mouth disease in sheep by ftdding experimenU with these cultures, but that subcutaneous inoculaUons gave negative resulu. SchotteUus states that the cause of infecUon is spherical formations which are attached to each other in the form of a rosary, and which resemble streptococci, and consequently he has given them the name of str*ptoeyUs. Subcutaneous injections of pure cultiva- tions produced in cattle a feverish affection accompanied with salivation. Kurth found a similar organism, and called it streptococcus imioltitMs, the cultures of which gave negative results by inoculation. OeemvMKM. — Foot and mouth disease is a malady peculiar to ungulates, and therefore occurs chiefly in cattle, sheep, pigs and goats. Horses, dogs, cats, and birds are less frequently attacked. Human beings become easily infected. All wild evea-tocd animals (red-deer, roebucks, fallow-deer and chamois) and wild ruminants in zoological gardens (camels, llamas, giraffes, antelopes, aurochs, buffaloes, yaks, zebus.* etc.) are liable to it. It is stated that draught-oxen poitaess less predis- position to it than other cattle (Peschel). An attack confere no subsequent immunity. In fact, an animal may suffer several times from this malady in the course of a year. Foot and mouth disease is of great importance from an agri- cultural point of view ; for the pecuniary loss is generally very severe, in consequence of the rapid manner in which this disease spreads through the entire stock of a country. From 25 to 50 per cent, of all the cattle may become infected ; traffic and com- merce suffer great restrictions in consequence of the l^al enact- nients that are put into force ; the loss in milk and its products is heavy ; sometimes the mortality of the infected animals is comparatively high ; and the value of the survivors is depre- dated by decrease in their working powers, and by diminution * The wbu is not found in a wild state.— Ti. 37* INFECTIVE DISEASES. m tteir bodily weight. The losses thus caused in 1881 in England were estimated at a million sterling ; in Fran« k 1871 rli'^°°r°°°' ""^^ Switzerland, at ^00.000 yearl^ S S^.^ "^ "''^ *^' ^' *P"°°«*= were'reckoned at we "ITS';;;? £r:r/.r. 'n:: :z:t^^-^,TT:: ov«^7.ooo.ooo animaU we« attacked. Tb^ ^l^T. ^'re^^e ^ Yaw. 1886 . 1887 . 1888 . 1889 • 1890 . 1891 . 189a . 1893 . 18^ . Totel. Catti*. ToUl 13.603 31.868 82,834 555.178 816,911 821,130 4.I53.S37 500.342 «92,6i3 7.168,016 5.366 ".723 37.164 26^.375 433.235 394,640 '.504.299 204,832 93.921 ShaapandOoaU. Pig». 2.947.555 6,368 1.839 14.400 4.74S 19.786 35.884 im 54.404 153,808 244.282 IJ 2,208 2,210,986 438.252 220,402 75>io8 66,287 32,405 3.251.808 968,653 The disease was absent from the German Emoire in th« «w.«»^ - . « food, largely contributed T^'u^LToI^ZZ^ l^i!*'^~ obUiSl^*«ZJ^!L tr„ ."^ restncting iu disseminaUon, were c*tt^nLk«tr^ -^ ^^ temporarily prohibiting the holding of SytrSc^'iSs^'s^'' "' ""•* '^ '^'' » " "-•• *»"-•- ^y tJi^r'T '*'.t !f. '*'*• i»«=>'«»ive. the number of animals attacked bv foot and mouth disease in Great Britain, were a. fS!T^^t!»^, FOOT AND MOUTH DISEASE. 379 «>»«?. 3.673 ; and swine, 107. No animab were reported to have been attacked during the years 1887. 1888, 1889, 1890, 1891, 1895, «896 and 1 897. Since the year 1877, more sheep appeared to have sufiered than cattle.— Tk.] Symptoms in Cattle.— Foot and mouth disease mani- fests itself in cattle by the appearance of vesicles and ulcers on the oral mucous membrane (mouth disease), and on the skin of the coronet and on the skin of the interdigital space (foot disease). Sheep, goats, and pigs are usually affected only on the Symptotns of the oral form of the disease in cattle.— Alter a penod of incubation of, on an average, from 3 to 5 days (with a minimum of from 36 to 48 hours), there is a moderate rise of temperature (up to 40° C), which becomes norm^ as soon as the eruption appears. Appetite and secre- tion of milk become diminished ; rumination is suppressed • the mouth IS generaUy kept closed ; and slight salivation takes place After 2 or 3 days yeUowish white vesicles, the size of a hemp seed, appear on the gums, especially on the toothless part of the anterior maxiUa ; on the edges, base and lower surface of the tongue; on the buccal mucous membrane ; and on the lips 1^ vesicles graduaUy increase in size, so that they sometimes become as laiige as a five-shiUing piece or even larger ; and they aJso often become confluent. These vesicles, large and smaU stand out prominently from the surface and contain at first a yeUowish. limpid fluid, which graduaUy becomes turbid. The bursting of the vesicles leaves on the affected mucous mem- branw moist, highly reddened, and very pamful erosions. denu- pox remains active even in sheds for a month to 6 weeks, and is destroyed by putrefaction, high temperature, carbolic add, etc An attack confers immunity from subsequent ones. This immunity may be regarded as permanent, rr»n«i«UriTig the short life of sheep. Spo INFECTIVE DISEASES. , . - ••—The conne of Ml atUck of variola MMuaUy divided into 5 itaget, namely ; incubation, initial period, eniption, suppuration, and exsiccation. X. The ptriod of ineuboHoH is about a week on an average. a. The initua $tag4 (tUuKum proiromonm), which lasts a day OT two, is marked by fever, catarrhal affection of the mtioous membranes, and erythema of the skin. 3. The st*g4 of erupHon, which continues from 6 to 8 days, manifests itself by the sudden appearance of red spots Hke flea-bites or pimples, which turn into firm red nodules the si«e of the head of a pin, and are surrounded with a red ring. They are chiefly found in the neighbourhood of the orifices of skin fdlides. After a few days the tops of the nodules become pale and turn into bluish-white vesicles, which, especially in cases of inoculated vkriola, are depr««sed in the centre and are filled with limpid serous fluid. At this period the pocks are at their highest state of maturity, and are then most suitable for inoculation purposes. 4. During the stage of tupfmraiion, which lasts a or 3 days, the contents of the vesicles become turbid and purulent ; the veddes change into pustules ; and the d^ression in their centre disappears. The temperature, which had decreased during the stage of eruption, again rises. 5. During exsiccation the pustules gradually dry up into at first yellowish, and later on, dark-brown crusts or scales, which become detached and leave behind white shining cicatrices or brownish-red spots. The process of eitsiccation goes on for 3 to 5 days. Differing from the foregoing normal course of variola, several of the pocks may run together, and form laige pustules (variola confluens), or the eruption may be complicated with a hemorr- hagic diathesis (variola hsemorrhagica), with gangrene of the skin (variola diphtheritica) in many cases. 0«n«na Renuuto on th* Anrtomy of YarioU.— If we follow the development of variola under the microscope, we shall see at first that the cells of the mucous layer above the papillary body swell and form here and there pale flakes which contain no nuclei. Afterwards, the papillary body transudes a serous fluid, and all the epithelial cells of the stratum mucosum dissolve with the exception of a few, which becoms drawn out into trabecula, and threads by the accumulated exudate. The vesicles thus fonn, between the papillary body and the homy VARIOLA. 391 layer, a cavity which is filled with fluid, and has trabecule and threads intersecting it. At the same time the papillary body and the cutis lying under it become inflamed, swolloi, and infiltrated with round cells. The pustule develops frtnn the vesicle by an abundant immigration of leucocytes from the papillary body into the fluid of the vesicles, and by the purulent breaking down of the septa. Healing takes place by the exsiccation of the pustule, and by the absorption of the cellular infiltration under the crust. The epidermis becomes replaced from the rer using tissue and from the edges of the sore. The origi of the depression in the centre of the vesicle is explained in uifferent ways. Some say that it is caused by the hair follicles and the oruices of the sweat glands, which lie in the centre of the pock* ; others, that the trabeculae in the interior of the vesicle prevents the centre of the pock from rising up. It is also ascribed to the inflammatory infiltration of the sldn at the periphery of the pock. Tavlola of Moi hu been much longer known than that at animals. It was recognised in ancient times, and spread, especially in the ICiddle Ages, over Western Europe, where, even daring the eighteenth centnry, there was as annnal mortality from it of neariy half a million. The practice of the inoculation of small-pox is exceedin^y old, and has long been current in India and China. From '.hence it came through Asia to Constantinople, where Lady Wortley Montagu had her son inoculated in 17 17. From Constantino^e the inoculation of smaJ-pox was flist introduced into England, where Jenner propoeed vaccination in 1798. From England it was brought to the Continent. Sheep-Pox. Btlology. — Owing to its well-marked epizootic character, sheep-pox is of greater economic importance than the variola of any other domestic animal. The infective matter is fixed as well as volatile, and possesses such vitality that it wiU continue virulent in sheds for as long as 5 or 6 months. Animals which have had the disease, whether naturally or by inoculation, will remain capable of transmitting it for 6 weeks after recovery. It can, however, be speedily and effectually destroyed by diluted hydrochloric add (Nocard), i^ per cent, solution of carbolic add, 5 per cent solution of chloride of zinc or quinine, xo per cent. * The ides here is that the hair follicle or sweat glsnd being firmly connected to the underlying tnie skin, pcerenU the epidermis at its external attschment from rising under the influence <^ the pressure exerted by the fluid contained in the vesicle ; and that, in confluent variolB, the said connection with the tine skin becomes destroyed.— Ta. s»» INFECTIVE DISEASES. solution of pennanganate of potash (Griinwald), and by aU the stronger antiseptics. The contagium chiefly spreads by infected recently recovered, or inoculated sheep ; or by intermediate bwrers, such as shepherds, dogs, clothes, wool, skins, manure, todder, raUway-trucks, etc. During the course of the disease the milk IS very virulent. Ahnost aU ordinary sheep are suscep- tible to the contagium with the exception of newly-born lambs, which remam immune for a short time, or may even continue per- manently immune if the ewe had been inoculated shortly before lambing. On the other hand, it is possible that lambs may be suffering from variola at the time they are bom, or the foetus may die m the uterus in consequence of the infection. Algerian sheep (Chauveau) and Brittany sheep (Nocard) are more or less immune. The variola of sheep may be transmitted either naturaUy or by moculation to cattle, goats, pigs, horses, and men. Schmidt and others have described a case of ordinary infection in man. Also, yanola of man and cow-pox can be transmitted to sheep, me direct mtroduction of human variola into the blood in sheep produ<^ a general eruption of variola (Kuchenmeister and iappe). *-..?!*'*^"'~.°°^« '**^' " G«™any, 4,79a sheep became in- Z^ ^^ '"^^- l*" ^^'^ •'*"*'* "** *'»• *»«»• being East Prussia. Germany has smce then remained free from this disease, except in 1889, ^ ?. "J^T^*" T***^"' ^'^'•' "^ *i"'«^"y extinguished, occurr^ lJtf;«d «7k ^' Vfl'' V ^ *^*- "* *" *»»« »»»•*? ^ Austria werf affected, with a mortahty of one-third. In 1887, 17,000 sheep suffered £m .I^ITt T''= "L '*"«'• '°'°~ ^ Hungary: and in the 4 years from 1887 to 1890. neariy 150,000 sheep in Roumania. Symptoms.— After a period of incubation of. on an average, 4 to 7 days, with a minimum of 2 or 3 days the animal becomes feverish, has rigors, is depressed and weak, hangs Its head, and ceases to feed and ruminate. The tempera- ture rises to 4i°-42° C. ; the pulse is frequent, and the resVira- taon accelerated. The conjunctiva is greatly congested and there is a shght serous discharge from the eyes and nose A day or two later, red spots and subsequently red pimples appear m rapid succession on those parts of the skin which are free from wool, or which are only slightly covered with it. especiaUy the head, neighbourhood of the eyes, nostrils, mouth, inner surface of the fore-hmbs and hmd-quarters. chest, abdomen, and lower surface of the taU. Less frequently the exanthema appears on VARIOLA. »3 the wooUy parts of the body, and in some rare cases on the mucous membrane of the mouth and pharynx. As a rule, the eruption is not simultaneous ; consequently different stages of the process may be seen close together on the same animal. On the fifth day after the eruption, the pimples become pale on their summits and surrounded with a red areola. When the pocks lie in great numbers close to one another, as on the head and about the eyes, the neighbouring skin becomes greatly swoUen. At this time the temperature falls, and a few days afterwards the vesicles increase in size ; being sometimes raised at other tunes flat. They then contain a limpid, colourless, or orange-coloured fluid. On the sixth or seventh day after the eruption, the pocks become ripe. From this period the contents of the pocks become more and more turbid, and the vesicles turn into pustules; this change being accompanied by severe general catarrhal fever. The temperature again rises; the mucous membrane of the eyes, nasal cavity, pharynx, larynx and bronchi becomes catarrhally inflamed ; a muco-purulent secretion flows from the eyes and nostrils; the animal slavers, regurgitates, coughs, and suffers from difficulty in swallowing and breathing; diarrhoea sometimes appears; the head becomes greatly swollen ; and the exhalations from the skin have a very bad odour. The pustules wither and dry up. the epidermis con- tracts, and the crust, which was at first yellow, assumes a dark- brown colour, and finally faUs off. leaving a small depression in the skin, or a cicatrix, on which little or no wool will grow. Under these normal circumstances the course of the disease lasts for about 4 weeks. CtouTM and Prognosis.— The course of variola may present many departures from the normal type just described. In some cases we find a very mild or even abortive form, in which the pocks are few and discrete, and the fever is slight. In other cases the morbid process does not go beyond the development of pimples, which peel off after a few days. Lastly, the eruption is confined to vesicles, with only a slight effusion of lymph and without the formation of pustules. In variola confluens, which is a severe variety of the disease, several of the pocks run together so as to produce large pustules that give rise to extensive suppuration, great inflammation, swelling, and even gangrene of the skin, from which a foetid odour is often exhaled. There is at the same time high fever • 394 INFECTIVE DISEASES. pocks are seen on the mucous membrane of the mouth, pharynx, larynx, bronchi, and even on that of the cornea ; the respective lymph glands are considerably swollen and sometimes suppurate ; the inflammation of the mucous membrane may sometimes assume a croupy character; and croupy pneumonia becomes occasionally developed. In unfavourable cases, sjonptoms of septicaemia or pyaemia with metastases in the articulations, serous membranes oi the brain, etc., may appear. Or the patients may die from pneumonic sequelae or from asphyxia, caused by laryngeal croup. Sheep take a long time to recover from an attack of this kind of variola, which gives rise to great exhaustion and cachexia. They sometimes lose their entire fleece, and often become chronically lame or blind. The pustules leave behind deep-seated scars. In variola hamorrhagica, simultaneously with the appearance of the eruption, hemorrhages break out everywhere on the skin, mucous membranes, and especially in the pocks themselves. This haemorrhagic infiltration of the pocks leads to thefr gan- grenous disintegration {variola diphtheritica). Among other sjnnptoms, haematuria is also observed. The duration of variola in a herd may be very short, or may be prolonged for months. The course of the complaint varies greatly in intensity. Only 2 or 3 per cent, escape infection, the mortality from which amounts to from 10 to 20 per cent, under ordinary drcumstances, and to 50 per cent, or more under un- favourable ones. The prognosis is particularly unfavourable in cases of variola confluens and variola haemorrhagica, and when the animals are either very old and weak or very young (sucking lambs). The percentage of losses may then be as high as from 80 to 90 per cent. Very hot or damp cold weather, bad food and unsanitary housing exercise an unfavourable influence on the course of the disease. Freshly-imported sheep become more severely infected than home-bred sheep, acclimatised sheep, and those which have been previously attacked and are consequently immune. Not counting the direct losses from death, we find that there is a fairly large indirect loss from reduced production of wool, decrease in bodily weight, frequent abortion, and chronic morbid sequelae. Differential Diagnoeia.— Sheep-pox may be confused with pustular eczema and urticaria of the head, especially when they are produced by certain fungi, such as rust-fungi and mould- VARIOLA. 395 fungi. If sheep-pox has not been observed for some years in a district, we may conclude that such sporadic pustular exan- themata are not variola. ThcrapeutiM.— The treatment of sheep-pox, like that of all other acute exanthemata, is purely expectant and dietetic In compUcated cases it may be necessary to apply a symptomatic treatment which can be carried out only with difficulty, or not at all, when a whole herd has become infected. Inoculation and veterinary police measures are the most impoivjit factors in prophylaxis. Inoonlatlon of BhMp-poz (OYinctlon).— 7noc«Ai<»<»i against sheep-pox, which, during the first hal f last century and up to the end of the sixties, was practised as a prophylactic measure, even when no outbreak was threatening, has been found to be in every way objectionable. It not only artificially mamtains permanent centres of the disease, but also spreads Ki, as has been well proved, from these fod to neighbouring healt^ districts. In several countries, such as Prussia and Austria, the dissemination of sheep-pox went hand in hand with inocu- lation. Inoculation is, however, to be recommended when the disease has ahready broken out in a herd ; for it not only shortens the stay of the epizootic, but also produces, as a rule, -« milder and more local affection than ordinary sheep-pox. The mortality is often nil, and is usually not more than 2 per cent. Only exceptionally, and under very unfavourable conditions, does it amount to 10 per cent. Inoculation may be practised in healthy sheep which are in the neighbourhood of a severely infected flock, and are in great danger of catching the disease. Taohnlqa* of laooolation.— The inoculation material, or " ovine," most be taken only from those sheep in which the course of the disease is benign, and the pocks fully ripe. The lymph should be as bright and clear as water, without any trace of turbidity or purulence. Consequently it is usually taken from the inoculated sheep 10 or 13 days after the inoculation, or 6 or 8 days after the eruption has appeared. The inoculated sheep should be segregated, and the sheep which are to be inoculated should not come into direct contact with the sheep from which the inoculation material is to be obtained, lest natural infection may take {dace simultaneously with artificial (inoculated) infection. The site of the inoculation is either on the inner surface of the ear, about 4 cm. from the tip (which position is not without danger owing to the proximity of the eyes), or, better still, on the lower surface of the tail, at about 10 to la cm. from the anus. In' the latter caae^tEe 196 INFECTIVE DISEASES. Mimal must be put down in order to perform the operation, which may be done with either a narrow and pointed inoculaUon needle, having a apoon-hke hollow, or with an inocnlaUon lancet. If time be not pressing when moculating a whole herd, it is well to perform an experimenttd inoculation with from 6 to la sheep. The symptoms in inoculated Sheep are those of a mild and regular attack of variola, with local mani- fesUtions restricted to the site of the inoculation and very slight general disturbance. The pocka become ripe on the tenth day after the inocula- tion. In exceptional cases the pocks do not appear on the site of the inocuhition itself, but on the parts adjoining it. The eruption caused by the moculation is foUowed, only in very rare cases, by a gener-' eruption (secondary pocks). The after-treatment of inoculated shee^j consists m protection against unfavourable conditions of weatiier and attention to diet. After lo or 13 days tiie flock should be examined and tiiose animals which have not " taken " should be inoculated a second time. In recent times several experiments have been made with attenuated (mitigated) mocuUtion material. Peudh attempted this by diluting the lymph wiUi water (i to 50-150) ; Nocard and MoUereau, by dilut^g it with water containing oxygen ; Semmer-Raupach, by heating it to 55" C. ; and Tonssaint and Haut. by cultivating it in nutrient solutions, rourqmer has found that inoculation with a pustule which has become developed from a previous inoculation with the ordinary virus of sheep- pox on tiie eleventh or twelfth day, confers immunity without giving nse to the eruption. He recommends the inoculation to be made at the end of the tail. Cow-Pox. BtioloCy.— Tenner's original idea that cow-pox sprang from horse-pox is nowadays held by very few. Even in fonner tunes, Turner, Leroy, Ceeley, Sunderland, Thide and others, pointed to the connection between small-pox and cow-pox' According to Bollinger, however, the source of cow-pox is not smaU-pox, as was formerly supposed, but human cow-pox (variola vaccina). Tnis view is strengthened by the fact that enzootics of cow-pox often occur at the time (spring) when children are vaccinated ; that cows have frequently been infected by human beings, especially by milkmaids who were recently vaccinated ; and that human vaccinia can be easily transmitted to cattle. The contagium of cow-pox differs from that of sheep-pox, by being fixed and not also volatile ; consequently, direct contact of the contagium, as in milking, with the injured skin is always necessary for the infection. According to Chauveau, Warlomont, Hugues, Straus and other French investigators, intravenous,' mtraocular, and subcutaneous inoculations confer immunity without pr jducing either a local or a general attack of varioU. VARIOLA. 397 The transfusion of vaccine blood from calf to calf gives im- munity without any visible affection (Reynaud). Cow-pox can be transmitted to sheep, goats, horses and men ; and human variola and vaccinia to cattle. According to Sunderland, Dinter, and Woodville, the direct inoculation of human variola or vaccinia generally confers immunity, and is accompanied only on rare occasions by an eruption. ■tatiatlos^From 1835-1868. 341 cas« of cow-pox, and from 1873-78, 100 caaes were reported in Wflrttemberg. In 1874, 374 cases • in 1877-78, 1,037 cases; and in 1888-89. 878 cases occurred in Denmark! As a rule, cow-pox is a rather rare disease. Symptoms.— Cow-pox is chiefly found in young cows which have been recently put to milk. The eruption is generally confined to the teats and to the adjacent parts of the udder. Fever is either absent or only slightly marked. The develop- ment of the pocks takes place in characteristic and well-marked stages. There is sometimes a slight disturbance of the general health of the animal, which is best shown by decrease in tbs quantity of the milk. The milk is thinner and of lighter specific gravity than usual. The impUcated teats are somewhat sensitive, slightly swollen, and show, particularly at their base, isolated pink pimples, which subsequently change into vesicles! These pimples number as a maximum from 20 to 30, and vary in size from a lentil to a pea. The colour of these small and large vesicles varies according to the condition of the skin. They are bluish-white and nacreous when the skin is white and very fine ; red and have a metallic lustre when the skin is light-coloured and thin; leaden-coloured and possessed of a metallic sheen when the skin is dark and thin ; and cream-coloured and lustreless when the skin is thick and free from pigment. The vesicles have a depression in their centre ; they are elliptical in form on the teats, and circular on the udder ; and are sur- rounded by a red ring if the skin is not pigmented, and by a tumid, swollen and firm margin. They become matured about the tenth day, and are then the size of a bean. From that time they quickly become purulent, pointed, and dry up into a dark- brown, shining crust, which falls off in about 4 days and leaves a cicatrix. The pocks are frequently torn off during the process of milking. The duration of the eruption is about 21 days. Prognosis is so favourable that treatment is superfluous. Only in rare cases the eruption spreads over the whole body, and may then be found also on the head, inner 39* INFECTIVE DISEASES. surface of the thighs, buttocks, back, throat, chest, etc. In bulls It has sometiines been se^ on the scrotum. The course of the disease in the same animal is characterised by successive attacks, so that the respective pocks show different degrees of development. The affection spreads slowly from ammal to animal in a shed, until aU the cows, with very few tttceptions, become attacked. Bulls, oxen, and young cattle become less frequently affected than cows. They sometimes receive the infection from the litter. Cow-pox usually lasts for several weeks in a shed. DliltoMiitUl ptaBJ^y^^^^ of cow-pox or " vaccine " h« been used for the vaccination of S^ A». however, cow-pox Ja comparatively rare, and as, its vaccm« ^m therefore be obtained only with difficulty. " iumani^ ^ ,^^ ^ » ;?«^t»o».f«» "T to man, was employed Uter on. On J^^t of the possibdity of the simultaneous transmission of human «H^ such as syphd» animal vaccination has been recenUy re-iat«dncS' esUbhshed m Milan then in Paris (1864), Brussels (1868), and Utter on Z ^JT"^:" "** ^«? *'*^- ^*" >^ cultivation calv« 7 to JH^^ °l** «e generally used. The technique of the va<^ti^ J'kT^ T^^ ^t 'f"*^ are fixed in tiie left lateral poS^H UWe wiUi tiie right hind leg drawn perpendiculariy umwjX Th! rian fromthe symphysis pubis up to Uie umbiUcus, and lateraUy'to the fold of 8km at the stifle, is shaved and carefully disinf«c^^ ?h« «ther" motion "inoculation or "surface" inocltion T^^^^: namdy. we make either cross incisions about 2 cm. loVT we in«:ulate the «,tire surface by means of from 50 to 200 pticLT and place on Uie mcisions or on the punctures mature lymph from a previously moculated calf. The vesicle, become maturVta T^ \ days, and tiie lymph contained in them is used for the vaccination of human bemgs and for furtiier inoculation of calves. Th^SSS™ nmtenal is obtained by means of a damp forceps. wiSi wStS VARIOLA. 399 lymph can be easily squeezed out of the ^vesicle. One calf yields from 1,000 to 3,000 doses. The vaccine may be preserved in wions ways. Capillary tubes are not to be recommend'td, because the vaccine, when kept in them. frequenUy becomes inert in as short a time as a week. A better plan is to keep the vaccine in a dry condition which we may do by scraping ofi the lymph and crusU, drying them' and idacing them between two glass pUtes, which are closed up with paraffin. In this way the lymph keeps weU for months, and even years ; or the lymph may be rubbed down in glycerine with the addiUon of an antiseptic, and is then kept in capillary tubes. As an antisepUc, RApke recommends: thymol, 0.1 ; spiritus. 0.5 ; glycerine, 100 grammes, or acid saUcyl, o-as ; aqu. destill. glycerine ii, 50 grammes. Animal vaccine gives quite as good results, as regaitls the effect and development of the exanthema, as human vaccine, to which it is greaUy to be preferred. Animal vaccine can be produced in any desired quantity, and its use is free from the danger of transmitting human diseases. The chance of transmitting tuberculosis by its employment need hardly be considered ; for tuberculosis is very rarely met with in young calves, and no proof has yet been given that it can be transmitted by vaccination. Besides, we can obviate any such risk by a previous veterinary examina- tion, and by the employment of tubercuUn. We need hardly say that only healthy and perfectiy unsuspected animab should be selected lor the inoculation. HORSB-POX. Btiology.— Fomerly horse-pox was much more common than at present, and is now exc^dingly rare. It occurs appa- rently only in certain districts, for instance that of Paris ac- cording to Bouley. It is probable that smaU-pox is the true ongm of horse-pox, which is consequently identical with cow- pox and which can be transmitted to cattle and mankind. Inoculations of horse-pox in cows produces pocks similar to those of cow-pox and capable of producing the same protective effect m men. According to Hertwig and Pingaud, artificial as wdU as natural transmission of horse-pox to men (shoe ^-smiths and grooms) produces in them an exanthema similar to that set up by cow-pox. Bollinger considers that the predUection shown by the exanthema of horse-pox to attack the skin behind the pastern is due to the fact that that part is peculiarly Uable to the fissures and other lesions of cracked heels and grease. In our opinion this Uability may be more justly ascribed to the fact that that site is frequently touched by recently vaccinated shoeing-smiths and grooms, who probably often act as inter- mediate bearers of the infection. With respect to this mode of transmission, the skin *t the back of the pastern of the horse is analogous to the udder of the cow. Horse-pox rarely becomes general, a fact which Chauvcau 400 INFECTIVE DISEASES. otearved when he made his inoculation experiments with vaccine wSlZ?^ a«d subcutaneou^y. by inhSTon an^by I^*! Warlomont and Pfeiffer obtained similar results ^^ tn.,^*;JJ?°l* K "^^P' *»^' and man can be respectively transmitted to horses. Berger observed on two oSuifflM natural infection of horses by sheep-pox. occasions t,J£r*^?T*"~'^^.^*x'y"P*°°" "« »n"«««d tern- perature, debihty. and loss of appetite. We then notice on the flexor surface of the pasterns, fast of aU. an erythemtous e«inthema which consists of congestion aid sweK TjSe Stan and may spread upwards to a greater or teJ extent At the same time the animal becomes iame. and. if nSe to move^stumbi^ aU ov«. the place, and hfts his feet ^ off the ground. On the mflamed pa^ we find vesicles and pStute t?'^.T°K ""* ^^ ^!?^* ^'^ ''^ ^"y congested.^fS iLS^on '^~°!!f*~"7r°"^' *"'* covered with a%S seoeton. The surface of the affected part graduaUy dries up or becomes covered with a scab, and the lesions hei in a f Jw weeks. In rare cases the exanthema attacks other parts ^.aUy those portions of the sWn of the head in the ndgh-' bourhood of the hps and nostrils which are only thinly cov,^ with hair ; and the mucous membrane of the nose, mouth, and conjunctiva. DUBmnttel piagiiori«.-Although the occurrence of horsebox as a distmct disease is well established, its eruption has been frequently confused with that of other diseases, especi- ally with the exanth-ema of stomatitis pustulosa conta«i«a which closely rubles it, except as regards the site of the aS ck! In France the two diseases are regarded as being identical. Tie fact that the eruption of stomatitis pustulosa can be readUv transmitted by inoculation, even to cattle, makes a mistake all the easier. In our opinion, the two diseases have, etiologicallv nothing m common. Grease and cracked heels may be confused r * *5°r!?°'''?"* *^ ^ "^^y differentiated from it by the fact that they do not manifest the t>-pical course of variola, and that they cannot be transmitted by inoculation. The vesicular eruption on the genitals may possibly be mistaken for horse-pox. Swine-Pox. Btirfogy.— Swine-pox seems to be obtained chiefly from human beings (by means of bed straw), or from sheep, as for VARIOLA. ^, ^^Z*^ .T""*^' *^* ""^^ occupying the same staU m f^Jri v^'^*;P*"' *=*° ^ transmitted experimentallylo goalj (Gerlach). and back from them to pigs. iTc^ abo ^ m the ordinary way to men. In Hungary 517 pia became affected with variohi during 1891. *^^ ^^ ♦h»*^'1?T~iJ'"*"y * «*°«"^ eruption breaks out over the enure body. There is fever, debility" loss of appetite ^ congestion of the mucous membranes. Red spoti. (liSflea biS appear on the head, throat, back, chest, imier surfa^ ofThe S arms and thighs, abdomen, etc. These spots change succ^vdy mto punples. vesides and pustules, which finallyd^ up.^^vi black, concave, circular crusts. In exceptiond^ we mv comS*^ r^*'"" °° *'* °"^ ""^^"^ membrane!Tnj^cSS^ ^T'f^T^- """**" ."»«°»brane of the stomach and i^testin« Often the disease vanes greatly in intensity. In a few cases the eruption j accompanied by lobular, catiirrhal broncho-pneu ^T.L5*^'"*^^***<^^">- Swine-pox has been frequently confused with urticaria, pustiilar eczemaVand other di*^.^ Variola of Goats. fi^T*** '!f *^ ? *^P^* ^*"°'* accountis for the fact that we find mention of only a few cases in veterinary literatiire fe t^!'rL^H*^^'T^'*"^'«90. Brtoond stiites'thit tiie vanola of goats is a disease peculiar to these animals, because ;L^?k ♦ *'r°*i**?* to »heep by inoculation. It is dso stoted that goats are unmune to u.3 variola of sheep. The course of the eruption in goats may be the same as in sheep or may be similar to the pustiilar udder affection of cows. Herhvie states that goat-pox is characterised by its course being marked by successive attacks. ^^ "»«trKea Variola of Dogs. Dog.pox can be transmitted experimentally from man to dog (Dupuis and otiiers). In rare cases this may also occur accidentiUly (Weiskopf). We must view witii suspicion ^ of tiie cases mentioned in veterinary Htijratiire; because thu disease may have been confused with the pustiilar exanthema of distemper or perhaps with mange and epizootic aphtha In any case, dogs are very slightly predisposed to variola. The supposed cases ol variola in bird* were probably those of gre- gwmoM epitheboma. Even experimentaUy. variola cannot be tran.. mitted to birds (Gtether. Hfltrel. d'Arboval. Rayer. Plant, and oth™ 26 403 INFECTIVE DISEASES. RINDERPEST {Cattit Piagut). ^ .^— Although rinderpest was not known in classical Omes, It has probably existed tor ages in the steppes of Eastern Europe and Central Asia. Its history is as ancient as that of the inhabitants of those regions. Rinderpest was brought for the first tune to Western Europe by the migration of nations in the fourth century, and by the migration of the Huns from Central Asia, of the Alans from the Volga, of the East Goths from Southern Russia, and of the West Goths from Northern Hungary. Smce then it has remained as a permanent resident in Western Eur^. After its first appearance it was continually dissemi- nated afresh over the countries of Europe by the many wars which took place. espedaUy in fhe ninth century during the reign of Charlemagne, when Germany, in particular, suffered great losses in catUe. At the commencement of the thirteenth century, rmderpest devastated Eastern and Central Europe dunng the invasion of the Moguls. Rinderpest caused great havoc through Europe during the NoHhem War. the War of Succ«»ion. and the Seven Years' War in the eighteenth century. The first great epizootic took place in the years 1709 to 1717 and spread from Tartary over the regions of the Don and Volga' to Moscow, Poland. Hungary, Prussia, Austria, Southern Ger- many, Switzerland, Italy. France, Holland, and England. It is stated that one and a half million of cattle perished during the years 1711 to 1714. Ranuuzini was the first to give an exact description of the disease, which he compared to variola. During his tune veterinary poUce regulations were first instituted against rmderpest. Another epizootic, which was described by Buniva occurred during the years 1726 to 1734. From the middle of the eighteenth century to the commence- ment of the nineteenth century, rinderpest was a permanent resident m aU the countries of Europe, with the exception of Spam and Sweden, into neither of which any cattle were im- ported. During the years i74<>-i75o, the toss of cattle was estmiated at 3,000,000 head. From 1745-1752, it amounted, m Denmark alone, to 2,000,000. The total loss in Germany up to the end of the eighteenth century was reckoned at 30,000,000 head ; and m Europe, at 200,000,000 head. The ravages of rinderpest were the chief reason for the founding of veterinary colleges, which began to spring up at that period. Many of the descriptions made at that time by BouigeUt, Boerhave, Wolstein» MNDBRPEST. ^^ year 1783 about i.ooo pubUcations on rinderpest h^ been ri^^ilr*- ^* *!"* P^*^ P"*«=«^« i«MKSation1L.S,t nnderpest was practised for the first time. Inoculation was introduced into England by Dodson in 1744 • wunSS*"* Courtivron in 1743 ; and after that into aU oth*; r^f^i^^L^^^^^ ******" ^^^ ""^ fo-r miUions of catUe during the year 1793 in Italy, into which country it had been intooduced by oxen which were intended to be used as food S™!n "*5 *™^- . ^""^ '795 to 1801 it raged in Southern S^rSL. ^I!* "^^^^y "P"*** ^y *»>« *»» o' Napoleon (1805-1809), and by the wars of Uberation (1813-1816). If invaded Europe from Moldavia and Wallachia during 1827- llZl B fn ? J"*^*' ^°^**' *°** **»« Baltic provinces during 1830-1831 (Pohsh revolution). In 1844 rinderpest was intro- K „ »nto Egypt from Roumania and Anatolia with a loss of half a mUhon cattle. Russia lost one miUion catUe in 1844- 1845. Prussia, and particularly Austria, both of which couu- tnes are on the frontiers of Russia, were visited by rinderpest neary every year For instance, RoU states that Austria Iwt nearly half a milhon cattie during the years 1847-1864. The wars of 1866 and 1870-1871 caused a wide dissemination of the "i» ««I!f !!!?* ^^^ «»* '*"«»«P«» » «»» of South Africa, where it has caused immense kisses.— Ti.] a6» 404 INFECTIVE DISEASES. » ■••J?'*;*^'— SMdenon. Briatow*, MarctaiMii. Bwto, Smbibot Mttoehnikoil, G«n«lrt.. Sitcharow, ToktoWfe. * nuny otto S! vwUgaton have occupied th«nMlv« in th* Ucteriologiaa itody of tlM infective material of rinderpeet. which, acconling to SeBuner CAaaot be demonstrated by the preMnt methods of e taininf and cnltiva^ tiOB. Semmer i* of opinion that the only bodiea which can be rMardad aa the canse of the diaeaM are very smaU corpuKlee, in the condition of sporM. which can be diatingnished only with dUBculty. i.ud which MMot be cultivated. He say. that they exiat in numben from i to 6 in ^enlarged ceU nuclei, and that they are freqrenUy anrronndad ^ !u^.' u"!?^ Sawdjefl cultivated aa infecUve matter spondatia* t»cm. «iUch break up into micrococci and atreptococr'. The coloniw **^"*^**!' "•" ** *"' gwyuh-white, then lemon-yeUow, and flaally red. The baciUi could be stained with methjdene violet. InocnUtiona With theae cnlturea produced rinderpest. The bacilli themaelvaa an very moUle, and have rounded enda. When found in the blood thmr may be •tnight or curved, and can be seen only with difficulty when uaatained. Saweljeff beUevea that former inveetigaton have aeen the aame bacteria T-^.^'^ were in a different form of development. Uetschnikofl deacribea a abort bacillua of rinderpeat with rounder i aos which some- tunea aaaumea the form of cocci, and which giowa out into leptothiix-lika ^eada. Theae bacilli are found chiefly in the ulcera of the abomaanm but are alao met with in the blood. The culturea do not Uquefy gelatiBfc' ^a>^ ivoduced with pure culturea rinderpeat in calvea and guinea- piga, but not in rabbiU. Sacharow deacribea cm apecifically pathocenic a atout baciUus i to li ^ long; and ToUahige, a very amall and abort bacillus, the pure cultivations of which are aUted to have produced the aymptoma of rinderpeat in experimental cattle. PMhogWiMia.— Senuner assumes, probably with justice, that emigration of the infective matter, which has not yet been positively identified, into the body takes place through Ott respiratory apparatus, from whence it gains entrance into the blood, and sets up a general infection in it, only after seccmdaiy changes have become developed in the digestive apparatus. The infective matter is both fixed and volatile. It is con- tained in the secretions and excretions, namely in faces, urine, saliva, tears, and milk ; mucous membranes of the nose, mouth,' and eyes ; sweat ; expired air ; blood ; and various organs of the body. The infection may take place either directly through affected animals, or indirectly by intermediate bearers, such as manure. Btter, straw, hay. soil, skins, wool, flesh, clothes, rail- way-trucks, ships, butchers, cattle-dealers, smugglers, dogs, sheep, birds, etc. It is characteristic of the contagium of rinder- pest that it can be carried only for a short distance by the air, and that this distance varies inversely with the dryness of the atmosphere, and is omsequently sbwtest in summer RINDERPEST. 405 The average distiince i* probably 25 paces. It has often happened that in sammer the transmission of the infection has been prevented by a ditch which separat'^d the infected animals from the healthy. It thus appears that the contagium is rapidly destroyed in air, and especially in dry air. On the other hand, it remains virulent for a comparatively long time in fluids, and in the soUd tissues of the body. If the nasal mucus which is used for inoculation be hermetically sealed up, it will remain virulent for 6 weeks, and in a few cases even' for 9 months. The infective matter remains active in sheds for 4 months and in hay for as long as 5 months. Flesh retains its virulence after it has been buried for 3 months, and manure which con- tinued in a frozen condition throughout the winter, proved effective after it was dug up in the spring. The intensity of the infective matter is severest at the conmiencement of an epi- footic. The virus is destroyed by desiccation, heating to a tem- perature of over 60° C , cooling it down to a temperature of - 15° C., putrefaction, and vario'is duinfectants such as chlorine, sulphurous acid, carbolic acid, etc. It is easily destroyed by disinfectants. Ooonnuio*. — Rinderpest is an infective disease peculiar to ruminants. Besides cattle, it can be transmitted to sheep, goats, deer, buffaloes, yaks, antelopes, camels, gazelles, aurochs, etc., and also to pigs according to Penning and Pluning. As a rule, one pttack confers life-long immunity. Opinions vary as to the original home of rinderpest, which according to Seigejew and Semmer is the black earth district of Eumnean Russia (Southern Russia, neighbourhood of the Black bea, and the country of the Don Cossacks). This district has a layer of humus a foot deep and luxuriant vegetation. Other investigators state that it originated in Asia, Siberia, the Kirghiz steppes, T'j ary, China, Persia, India, etc., and consequently outside of E : vjean Russia. We at least know for certain that rinderpest never becomes independently developed outside the Russian or Asiatic steppes, and that every epizootic of it in Europe has proceeded from those districts. Thus it was proved that the outbreak of rinderpest which took place in England in 1865, was caused by Russian oxen which had been imported by sea ; and the Pj;'- zootic in Switzerland in 1866, by Austrian oxen, the infection oi which was traced to the introduction of the dis^ise from Russia. For this reason, Germany and Austria, which are on the frontiers of Russia, are continually threatened with rinderpest. Formerly 406 INFECTIVE DISEASES. Ifm^aT^bSTno^'^S""*^ ^*r^ '" «^*"8»>*«^ during Bymptoiiia.-The symptoms of rinderpest are those of HsX sttel^'11 '**"?• ^« P^"''^ °' '°^^^n IS usually stated to be from 6 to o days. Roloff and othpr« to"i hr"";/'"7^** ' "^ of%e4raf^ in Lm 36 to 48 hours after mfection. Raupach Sd Ravitsch found m theu- moculation experiments!^ pronounced patolS ^Z "''^^r7'''/'J'''^ '^^ 33 hours'^after ?nt Md Ts.1 ^ *°'"''* ,*^' micro-organism in the blood andnas^ mucus as early as, 7 hours after inoculati^ thafS,"" Jr.fr^/^ '° 4'°-*'° C. and remataa near inat neight with but slight mnisrions, until other svnmtoms the ST' T? P"^"* ** ""*" *°** '^^t* fro™ 60 to 120 in iSjk^H f /" ** ^^^ ^^^^y' <*«*=«^ i» the yield of ^L'^^^ ?*.'"'"*'* ***fry- The function of rumination be- c^mes du^turbed. and the animal may have slight Xer^ on .^If .**^^'"1^^ symptoms, well marked rigors come on the superficial heat is unequaUy distributed ; the breatWng f^ -n^i 1* T' °^°«^*««t ^"let spots on their sur- r^mina? ^Il *"** ^°^ °^ *PP**^*« = a"«»t of the hmction of mmmation ; thi«t ; constipation, with the faces dryandco^^ri w^h atlr^t*?^ sometimes slight colic. Late^ L disch^ from tht ,?^ '^'""^ *"^ subsequently se;. mucous, i^e^ Z^S* •?'/*i*' «^**"*"y »^«»n« thinner and tl.mn2 „nS finaUy violent diarrhoea, accompanied by colic sets in ^ SSlven S^ ^1 *^*^ T f*^ "^'^ considerable tenesmus. S^eTtr P"^P^ °^ *»»« »»i«"y congested mucous mem- brane of the rectum. The animal becomes rapidly emaciated. RINDERPEST. 4P7 staggeis when walking, is very sensitive to pressure on the loins, and lies down a gf.:at deal. In exceptional cases the patient becomes highly excited, and even mad (congestion of the brain ; the so-called nervous form of rinderpest). Others exhibit violent dyspnoea, and symptoms of severe inflammation of the lungs (coughing, rhonchi, and dulness on percussion ; the so-called pneumonic form). In the further progress of the disease, characteristic changes are to be seen en the mucous membranes. Red patches which may be flat or in the form of wheals, and quickly become covered with a greyish-white loose crust, appear on the mucous membrane of the lip, tongue, cheeks, gums, nostrils and vagina. The uppermost epithelial layer consequently becomes opaque, and yellowish-grey spots develop on it. Less frequently the crusts are formed from the tumours by their pulpy, caseous dis- integration. The crusts on being shed, leave dark-red, hollow places (the so-called erosion ulcers), which readily bleed. In slight cases of the disease there may be no crusts or erosions. We may sometimes notice a similar eruption in the form of very minute pimples and pustules (which form an eschar) on the abdomen, inner surface of the thighs, perineum and udder, in which case it may be confused with that of variola. Pregnant animals frequently abort. If the disease takes an unfavourable course, the emaciation and loss of strength become more and more increased; the animal keeps continuously lying down, grinds its teeth, and shivers. Discoloured, purulent, and foetid discharges flow from the mouth, nose, vagina, and anus. The vagina and anus remain open ; the temperature falls below normal ; and the animal may die in convulsions, or may pass away very quietly. In some cases bloody froth is discharged from the mouth and nose before death. Ooon* and Prognoaia. — In imfavourable cases, which are by far the most common, death usually takes place between the fourth and seventh day after the appearance of the first symptoms ; and in particularly severe attacks as early as the fourth or fifth day. In the few favourable cases, recovery takes place slowly with a gradual decline in the intensity of the symp- toms, so that the period of convalescence is somewhat prolonged. The progress of the disease in a herd or shed is rather slow and proceeds in successive attacks, but increases in speed as it goes on. At the commencement, only a few neighbouring animals I 408 INFECTIVE DISEASES. II li are attacked and then greater numbers, so that several weeks S^ *''" '°*^ ^^'^ *" ^ *^* "^"^ ^ * *hed becM^ .K»^! *'°*f!t °* ^^^ *"^*^ ^*"«* S^eatiy according to the Zn !? °f^a" eP"oot,c the disease runs a much severer course than towards the end. The grey cattle * of the steppes fof Southern Russia. Hungary. Roumania. Moldavia and SeivS take rinderpest m a much milder form than other breeds : for they possess, to some extent, hereditary immmiity. As they often mamfest the symptoms of the disease in a mLner which IS by no means well marked ; it is not always easy to recognise o< trT\ ^l\"^°^^y »n ordinary cattle varies from 90 to frn^o * ' "* '° *^* ^*y steppe-cattle it is not more than from 30 to 50 per cent. [A« a result of his researches during the years i8qo to ioo» Dr r^Sf. '-T^^ V^' '""P""** Bacteriololist of taSa sUtel h^t -In' India and the East, rinderpest has been existent probably for hiSdris o tS;,^** ? i' "'^'*"''r '^«=»»' to ascertain ^iS'^^^^t'xt^t oJ t^Si. ^Ik""""""^ '*•*'* "*y •"^ «*« ««l"«d by some 2strictsXL«.i^ country It is probable, howevei? that i^ ^me tSde^t ?h^ K^''' "^"^ * '^'"^ *^'>°' o* protection against .^no«SSl » "!^ their progenitors, but up to the pre^nt this hJb«m impossible to estimate." We learn from him that the catUein ih« SrSi? ^^r^ " f**'"'''' "^^ amount^*iiSy buTtia^ ^tS^ i^^'T^ ?"'• "• °"«* ««»" susceptible. He also tSs ^S. ^*^f •''^ °* '*"*• "» «'«» »»ceV^ible to riXpSr probably as much so as Hill animals, on account of ?he isoUted p^n jinSV^SlJ^'^rr "' *'• ^""*""' •** '^""^ <^-rth°at In sA««^ and gooto the disease is milder, and its infectiousness IS less than m cattle, although the symptoms are essentially the s^e. Among 4.000 affected sheep in Austria. during the years 1861 to 1863, there . as a mortality of 66 per cent. ; and one of 00 per cent, among 30,000 in Russia during 1878. Differing • The«| Russian cattle vwy in colmir from dark iron grey to a lisht nev c«jm or dirty white. .They «>mewhat resemble the My«„e'b^ of S*S buUoclc, of which we largely used throughout India for d«ught pun««0 «^pt that .hey have no hump. .«i ^iTThick curly hair onTi f^Ki' They are capital beef producers, but are poor millcei».-Tt. devoid 5faSt-?l''""'*° '^'^''''" "^ '"* '•™' '• - ""«'"•'•'«' P^in. RINDERPEST. 409 from cattle, sheep often suffer from pneumonic affections when attacked by rinderpest. Blad«vpMt of Pl<».— Pluning states that he saw pigs in Sumatra suSering from rinderpest. The symptoms and conrse of the iuseaae are said to have been the same as in catt!?. DiffarantUl Diagnosis.— The correct diagnosis of rinder- pest IS often a matter of considerable difficulty at the first appear- ance of an outbreak, especially in cases which occur sporadically and in an unexpected manner ; because rinderpest exhibits no symptom that cannot be found in other diseases. Consec -itly our diagnostic deduction must be made from the combine ji- formation obtained from symptoms, autopsy, progress of the epizootic, and history of the particular case under consideration. The chief diagnostic symptoms are: high temperatire; red spots and yellowish-grey coating of the mucous membranes, with subsequent formation of erosion ulcers, especially on the vaginal mucous membrane ; mucous discharge from the mouth, nose, eyes, and vagina ; grave intestinal symptoms ; and ex- cessive emaciation. The proof or the possibility of an infection is of the greatest importance. We should be careful not to con- fuse rinderpest with diseases which resemble it, especially with the following : — 1. The maligHant catarrhal fever of cattle, which, however, is only very 8%htly contagious. It is generally stationary, runs a slower course, and is localised chiefly on the head and resjaratory apparatus. Here the severe affection of the eyes must be care- fully considered. 2. Foot and mouth disease shows a certain resemblance to rinderpest in the ulcerous changes in the oral cavity, in gastric attacks, and in the exanthema on the udder. The eruption on the buccal membrane is, however, very characteristic, and the exanthema is also found on the skin of the digits. The process is usually benign, and the disease spreads rapidly. 3. In dysentery, the diarrhoea appears earUer and contains more blood. The intestine only is implicated, and the affections of other mucous membranes (mouth, eyes, nasal cavities, and vagina), are absent. The post mortem appearances are also different. ^ 4. Mycotic inflammation of the intestines, caused by various fungi, q)oilt distillers' wash, etc., may possess great similarity to rinderpest in consequence of its severe course, and, at times, enxootic appearance. Here, also, intestinal troubles and certain 4ie INFECTIVE DISEASES. nervous affections are more prominent than in rinderpest. Be- sides, it is not contagious. ,. 5- ^"^osive agents and scalds, caused by the partaking of hot distillers wash, give rise to symptoms of corrosive gastro- enteritis, stomatitis, and pharyngitis. The resulting affections are, however, not contagious. 6. Anthrax, the gastric form of which may be confused with nadeipest. It runs a much more stormy course, and is not directly mfectious. Its presence can be positively proved by Postmort^examimHon and by the microscopic demonstration of the bacilh. 7' Pleuro-pneumonia, with which rinderpest is sometimes comphcated, can in most cases be distinguished with certainty by physical examination of the thoracic cavity. 8. Rabies, which might have td be considered in the nervous form of rinderpest, and cow-pox are easUy recognised. 9. Infectious hamaturia (hamoglobinuria) of cattle may, according to Babes, be sometimes confused with rinderpest. It IS, however, not contagious. Janson states that in Japan the so^alled cattle influenza " may be mistaken for rinderpest. Anatwny.—The pathological-anatomical changes in rinder- pest essentiaUy implicate the mucous membrane of the aboma- sum, small mtestine, oral cavity, rectum, and vagina. The general changes which are also common to other infectious diseases are of less importance. The cadaver is greatly emaciated, the thighs are soiled with faeces, and the neighbourhood of the mouth, nostrils, eyes, anus and vagina is covered with a yellowish or discoloured muco- pundent discharge. Nodules and pustules are sometimes found on the skm, and especiaUy on the udder. The mucous membrane ^LlL"**"! ,*"*^ ^l P^***^ ^ congested in spots, swoUen, covered with lumps of mucus, and exhibits rounded yellowish- grey caseous plates or deposits, which may be seen with the microscope to consist of detritus, cells, nuclei, and micrococci, and are caused by a superficial diphtheritic inflammation. The removal of the plates discloses ulcerous and highly-con- gested depressions in the mucous membrane ; the so-caUed erosion ulcers. TTiese changes are best marked on the inner surface of the lips, lower surface of the tongue, buccal mucous membrane, and gums of the inferior maxilla. In the first three stomachs the mucous membrane is congested ii RINDERPEST. 4" I in spots, and the epithelium is so loose that it can be easily de- tached. The contents of the rumen and reticulum are soft, and those of the omasum are often dried up, which is, however, a condition that is also met with in many other diseases. In some cases the contents of the omasum are fluid. Generally the abomasum is empty, and contains only a small quantity of a tough, muco-purulent, yellow, or sanious material. Its mucous membrane is highly congested, especially in the neighbourhood of the pyloric orifice. The congestion is partly diffuse, partly in spots, in the form of points or in streaks ; and its colour may be purple, cerise, or reddish-brown, with a tinge of slate-grey. The epithelium exfoliates. On the mucous membrane we may find small, brown-yellow caseous deposits, in the form of plates, which become detached in shreds, and leave behind indented, highly-reddened places, which are studded with blood points (erosions). The glands (peptic and mucous fglands) of the stomach are swollen, and show considerable cellular hypertrophy.- Exactly the same changes are present in the small intestine, in which we find a good deal of swelling and congestion of the mucous membrane, with insulated, scab-like caseous deposits and erosions. In very severe cases these deposits form tube- like casts of the intestinal canal. At the same time there is considerable infiltration of the solitary glands and of Peyer's patches, which are swollen and prominent, and either undergo a purulent disintegration, in which case their contents will be dis- charged in the form of a plug if pressure be exerted on them, or they become covered wth caseous or frequently purulent deposits, which are surrounded by a hypersemic ring, and which, on becoming detached, leave ulcers behind. Peyer's patches often assume a sieve-like appearance, that is to say, they become areolated. Lieberkiibn's glands are considerably swollen, and the intestinal villi cellularly infiltrated. According to Klebs, the entire mucous membrane is infiltrated with micrococci, which accumulate chiefly in the neighbourhood of the vessels, and sometimes occlude the lumen of the vessels. In the large intestine the inflammatory changes are much less pronounced, and are greatest in the cscum. Generally the mucous membrane is merely swollen, congested in spots, is of the colour of slate or of the skin of an eel, and is covered with mucus. Sometimes the changes in the small intestine may be only of this nature, although in severe cases the entire mucous mem- l»^ne of the small intestine down to the muscularis may become necrotic. 4M INFECTIVE DISEASES. Frequently the mesenteric glands are greatly swoUen and in- filtrated, so that they resemble in consistency the medullary substMce of the brain. In other cases these changes are absent. The Uver has the appearance of clay, is discoloured, and soft. TT»e gaU-blttJder is filled with thin gall in consequence of stenosis of the orifice of the biliary duct. The mucous membrane of the gall-bladder is swollen, congested, and may even be covered with grey-yellow [buff] plates of exudate. The kidneys show parenchymatous changes, are yellow-brown in colour, and abnormally soft. The mucous membrane of the urinary bladder IS congested, and covered with mucus. Similar, and usually severer changes are seen in the mucous membrane of the uterus, vagina, and rectum. The nasal mucous membrane is of a dark-red colour, and covered with grey-yellow soft scalJs, after the removal of which the true tissue of the mucous membrane lies bare. Similar changes are found in the larynx and trachea, where the deposited masses are frequently purulent and of a creamy consistence. The lungs are sometimes hyperaemic and reddened in spots ; K>metimes oedematous and even hepatised, or emphysematous. Even pneumothorax and subcutaneous emphysema may be present. The heart is flabby, relaxed, and infiltrated with ecchymoses. The endocardium assumes at an early period a duty purple colour. Hemorrhages are found under the endo- cardium and epicardium ; and a yellowish transudate in the pericardium. The Nood is dark in colour, and coagulates with difficulty. There is a large increase in the number of the leu- cocytes, and the red blood corpuscles show various changes in form (poikilocytosis). Frequently the nervous central organs and their membranes are highly hyperaemic. An accumulation of red transudate is sometimes found in the cerebral ventricles and under the arachnoid. The anatomical changes jus, described may greatly vary according to the character and the degree of the disease, and age, breed, and state of nutrition of the infected animal. In ordinary cattie the changes are always better marked than in cattle of the steppes, and in sheep. Thttrapautim and Inooolation of RindaipMi.— The treatment of rinderpest is qyite as unsuccessful as that of many other infective diseases which have a typical course. Besides, It IS forbidden by the regulations for epizootics on account of the danger of infection. Hence, affected animals must be imme- RINDERPEST. 4«J diately killed. For certain districts, as the steppes of Russia, inoculation may, however, be regarded as an important prophy- lactic agent, though only after an outbreak has occurred. Pro- tective inoculation should never be practised, as it m very liable to spread the disease. The laws of all the European States, with the exception of Russia, forbid inociilation, even after the disease has broken out; because pole-axing is much more effective, and because the mortality (about 36 per cent.) caused by the inoculation of ordinary cattle is extremely high. In the cattle of the steppes it amounts only to about 10 per cent. Favourable results of inoculation are most frequent towards the end of the epizootic. The technique of the inoculation is very simple. A clean sponge is introduced into one of the nostrils of an affected animal, and is rJlowed to remain until it is saturated with nasal mucus. It is then removed, and its contents are squeezed out into a small glass, which is closed up. A drop of this inocula- tion material is then injected subcutaneously on the neck by means of a Sticker's syringe. Even in Russia, where there were four inoculation institutes, inoculation has fallen more or less into disrepute. It is possible that, later on, inoculation of attenuated material will give more favoniTble results. [Dr. Lingard has had admirable reanlts with the inocnlation of anti- rinderpest seram dating the year 1903-1903. In Bengal, the death rate from inoculation with serum was 109 per cent. (lis in 10,190); in the Punjab, 0-0019 percent. (4 in 33,861); in the provinces of Agra and Oudh, o-ois per cent, (a in 1,353) ; «wl in Burma, o percent, (o in 4,006). As there was an outbreak of rinderpest in Bengal at the time of the inoculation, "the total deaths of 113 in 10,190 aninmiff injected with serum, instead of being an argument against the utility of the protective serum, is strongly in favour of the good work accomplished by it, for in any outbreak of the disease, iHiatever moment may be selected for the injection of the animals, a certain number must always have the con- tagium of the disease incubating in their systems" (Lingard). Dr. Lingard points out that the cattle of the Punjab and Burma have a high degree of natural or acquired immunity. During 1897, Koch and Edington have, more or less successfully, carried out extensive protective inoculation experiments against rinder- pest with infected bile. The most hopeful results, however, appear to be obtainable from the method of Danysz, Bordet, and TheUer, a transUtion of whose Report on Rindnpest to the Transvaal Govemnunt may be seen in the Veterinary Record of the 36tb February, 1898, to which number of that periodical I beg to refer my readers for full details. These ofaserven at first confer comparative immunity, by the injection of immune Uood, on experimental cattle, to which they then tranamit rinderpest by natural infection, with the result that these partiaUy protected catUe INFECTIVE DISEASES. the ramamdar of their Uvai. In thta, Uwm iwtholoBtat. Mt cm^ w-JT wcovwKl from linderpcat, rmdm the experimental ottUe canahta fa! STiZSir^rz*' • :^^r^^ " *»- ~» p"^» ">«» tern ^ tJ«tafccU«n. In thl. method, defibrinated blood » need in prefewnceto 4«5 CHAPTER II. MISCELLANEOUS INFECTIVE DISEASES. Texas Fevik — Caeciao — iNTiiuiirraNT Fevbe— Scaelet Fever — Choleea-Febeis Recoeeens-Yellow Fevee-Measles-Cadeieai DiSEASE-BEEI M«I-BEADSOT-Pe«M^,_MiLK SlCKSElS-ArEICAI. HoESE Plaooe-Afeican Hoese Death-Kaeassan-Akpaipak- Black Death. North Amenca, and which in 1894 became known in Q^^^ xZ Sl^^ P«««»ce having been proved in American catUe that had been imported 1 to Hamburg dunng that year. Smith and Kilbome have far- mshed ns with a good deal of exact knowledge concerning its patholoBy. According to them, Texas fever is an infective h«mogiobLmU Su caused by the presence of blood parante. in the red%orpn«d«e. Tt^ hsematozoa have received the name of " pyrosoma bigeminnm."* and are earned by atUe-ticks (Ixodes or boophilus bovis) that act as intermediate bweiB. The disease occurs in two forms, one acute (midsummer) the othwchronic (autumn). The most important symptolns of^hedLa!^ •re fever, hemoglobinuria. alteraUon in the form of the red corZ^ hydremia. an«nua. loss of appeUte. stoppage of ruminatfon^««^ in the seoetion of milk, constipation altemauJg with diarrh«i dyj^ and rapid emaciation. The disease sometimes runs a fatal t^nS^ from exhaustion in 4 or j days; in other cases, not tiTT^ or even Uter. ReUpses are so frequent that the disease nuy l^t for months. The mortaUty is high. especiaUy in summer ; but is tossin ccisw of the autumnal chronic form. The anatomical chances are • the presence of pyrosonue in the red blood corpuscles ; pi^Uocvtosis • anwnia ; a thin and watery condition of the blood ; haeniMtobinuria ■ and hyperajmic swelling of the spleen. Besides this, we findwchymose^ in the heart : geUtinous swelling of the connective tissue in the neiah- bonrhood of the kidneys and portal vein ; enlargement of the Uvm • •nwnia and biliary engorgement in the brown-yeUow Uver; and diffuse reddening of the gastro-intestinal mucous membrane. •The pntaiite fy»fMUan^ It U £««n aTto 4 « ia SS! 4.ndfiamito3fiinwidth.— Te. *p-«»B»n, 4i6 MISCELLANEOUS INFECTIVE DISEASES. The microKopical demonitration of the blood ) tnuitw k conducted iccording to Kitt. in the foUowing way : Make i preparation of the Wood or of the organic jnice in the uanal way adopted for the staininc of bacteria. The drop of Mood moat be {daced aa quickly aa ponitde on the cover-g^aM, and spread out at once into a thin film by meana of the edge of a second cover-glass. After allowing the preparation to dry in the air, we draw it through the flame. According to Smith, it is better to expose the cover-glass for i to a hours to the effect of dry air at a tonperature of iio« to i30« C. After this, the Uyer of blood is stained with a scdution of Ldffler's meth>lene blue either by putting a fewdropa of the solution on it or by floating the preparation for | to a minutea, on thia solution in a glass capsule. We can also simply use a watery soluUon of methylene blue ; but this method wiU take more time. The iveparation is then washed in water, dipped for one moment into a i per cent. .~)lution of acetic acid, and washed again with distilled water. The cover-slas* can then be placed with the adhering drop of water on the object b-e-.jrer for examination, or it may be mounted in Canada ^ai***" [Lingard terms Texas fever Hamoglobinuria or Red Water in cattle and buffaloes, and gives the foUowing synomyms: Triste*a (Argentina), Tick ftvtr (Australia), Lot ptskab (Urdu). Rokto mootra (BengaU), and Rodsyge (Norway). For further remarks on diBftaaci conveyed by ticks, see p. 475 «/««?.] ^^^ ^iMOMtf of sheep is an epixootic hemoglobinuria allied to Texas fever. It occurs chiefly in the ddu of the Danube, and is caused, according to Babes and Starcovici, by a blood parasite (hsematococcua)! It is also supposed to give rise to hemoglobinuria in catUe in Roumania. The symptoms consist of rigors, fever, colic, hard bloody faecca. anemia, and in rare cases to hematuria. By post morUm »i«mi«^tion we find the hematococd in the red blood corpuscles, hemogtobinuria, swelling of the sideen, intestinal hemorrhage, an anemic condition of the muscles, and a yellow gdatinous oedema in the subcutis. It is sUted that laUnntitoBt Uiwrnr (malaria, febris intermittens) has been occasionally observed in domestic animals.* In men it is a Dure miasmatic infective disease which occurs everywhere except in the T©olar regions, and particularly in swampy regions (Roman Campagna, Pontine Marshes, Sicily, Hungary, the countries of the Lower Danube, and the tropics). Laveran attributes ite occurrence to the presr- e of protozoa (malaria amcebe). lu chief symptom is an attack ot ever vdiich generally lasts for only a short time, and possesses a strik- ingly regular type (daily, every second, every third, or every fourth day, etc. ; febris quotidiana, tertiana. quartana, quintana, etc.). The spleen. as a rule, becomes considerably swollen. The fever varies greatly in type, and may take the form of ponicious. intermittent fever, remittent and continuous 'malarial fever, chronic malarial cachexia, or masked intermittent fever with neuralgia. The chief remedy for malaria is quinine. « Lingsid Mates that the majority of horses in the Kamsl Remount DepAt (India) inffer from fever of an intermittent type.— Tx. INTERMITTENT FEVER. 417 #^Pi* !?"°'?"K remark, on malarial fever of man have been tak.. from the TransUtor-s VtUrinary NoUs ■ ™» mvb oeen taken ent«I!i" :p'*'°J«4"™ «« Laveraa,' which occur, in different form. nin. -««a. Wethu,.eethatthe.eoini«n,areSt^r£emr^tt ^Zt^L^ "^' * •'Tf" »*^ -l"* « »»flering from SSi ^ W 't^ ^ • nioeqwtoe. of a place which had hhherto b^nfiS from that diMase. In thi. way. one human being can indirecuTinfc^ r^™"^.^-. ^~»^«-^«»onelnto^r4f^* ^ commumcated only by inoculation. Moaquitoes have their^X f^ri^", **'«'.™"™ ««i *f ter SMset. which are consequenUy the^ for qwctally avoiding thew insect.. ««qucnuy tne umes " The coMtituUMial diaturbance ia chiefly due to the destruction of th« red corpuscle, and to to«n. elaborated by thwe paSS^^S •^rvattons by Koch, confirms! by Stephens ^d "^Stophe^TTvt r«:ently shown Uut in intently malarial districU. pracSFylillSI young children have malaria parasites in their blo^ SThe nat,^ ^l^J^'i "'*;'• '^l'.'"*^ " Pn^ressively less liabte to tS i^ faction, and m naUve adulu the parasites are rarely found. ImmnmTv from malana can therefore be acquired ' {Manson) i'nmnmty 37 4iS MISCELLANEOUS INFECTIVE DISEASES. " TlMra m Mvanl forms of maUrial few, of which inUnnittuit favtr (H**) aad ranitttat or coatinued fever are the most common. " Dr. lUason poiiiu out that the successive geaentions of the parasites of iatermittent fever tend to become simoltaneously mature ia the blood of their hnaiaa host, about the same time every day, every second day, or every third day, accordiag to their spedee. Thus, those which Uve for a4 hours, produce quotidiaa (daily) fever; those which exist for 48 hoan, tertiaa fever; and thoee whoee cycle of development is 73 hours, quartaa fever. I have aot seea similar paroxysnu aad remissioas ia Ih . Bialaiial fever of horses. _:ilhe bilious symptoms of tea seea ia cases of malarial fever an chiefly due to the bile of the patieat coataiaing aa abaormally large amonat of Wimbin, «iiich is the bile pigaieat that gives a yellow colour to the sUa and other tissues ia jauudice. As biUrubia is produced by the decompoei- Uoa of hcmogloUa, it follows that the more free hxmoglobiB there is ia the blood, the greater will be the quaatityof bilimbia ia the bile. Ia malarial fever, the Wood becomes loaded with free hxaioglobia, owiag to the destructioa of red corpuscles by the aialaiial parasites. " The chief breeding places of moequitoes are shallow pools which ar« aot large eaou^ to coataia fish, aad which do aot dry up betweea showen. Heace the best way to rid a district of mosquitoes is to draia or fill up these pools, or to destroy the moequito larvae by pouriag iato these pools a sufficient quaatity of paraffia oil to cover their surface ; aad to kill all the mosquitoes withia rsach. A large aumber of the mosquitoee which iafest houses, caa geaeraUy be fouad resUag oa the walls ia the iaterior of these bnildiags duriag the day. " Coloael A. H. Monis, who is ia charge of the Northern Territories of the Gold Coast, reporto : ' I caused all holes ndiich atight coataia puddles, and so become breediag-grouads for the aaopheles mosquito, to be filled up. Some hollows ia rocks containing about 18 inches of water, were dis- covered filled with thousands of larvse. The Hausas' aad Carriers' lines were inspected twice a week in order to insure no stagnaat water beiag allowed to reaiaia ia old pots or tins. The general result has been an immense reducti« in India a disease in which he found in the blood motUe spirilla.* The disease was trans- mitted to monkeys and dogs by inoculation. Tallow- SicUy. -fliw** is stated to attack horses and dogs in America and [In Th* Lanut. 19th SJarch, 1904, Sir Patrick Manson states : •• As regards yellow-fever, although we do not know the germ of the disease, we know how the disease is acquired. The germ is so minute that it passes through the closest filter and seems to be ultra-microscoi»c, but we know that it exists, and that, like the germ of malaria, it is trans- ferred from one victim to another by a certain kind of mosquito, the common West Indian tigc- mosquito {Stegomyia fasciata)." Sir W. R. Rynsey (Th« Lancet, 9th August, 1902) tells us that '• in Havana, yellow- fever was endemic for a century and a half. During the past year it has been freed from the scourge by kilUng the mosquitoes in the ndghbonr- hood of each focus of disease as discovered, and by carefully disinfecting every house that had lodged a yeUow-fever patient, in order to destroy the mosquitoes that had bitten a sick person."— Tr.] It is not certain that domestic animals suffer from «"tnTlf • Steel mistook an infusmian for a spirillum (see p. 455 4t stq.).—'T%. 27* 4*0 MISCELLANEOUS INFECTIVE DISEASES. Amch states that be hu seen a case ia a dog. The supposed cases of measles in pigs were really those of erysipdas. or of some other disease. OadalMM PI——. Reboargeon has described nnder this name an equine disease which is met with in the equatorial provinces of Braiil. The symptoms are : stiffness in the hind-quarters, petechiae on the con- jaactiva, trismus, increased reflex exciubility, etc. On post morttm examination the psoas muscles look as if boiled, and the pia mater is serously infiltrated. The nature of the disease has not yet been inves- tigated. [Under the name of mat de cadmras (disease of the haunches), Dr. KImassian describes a disease 'trtiich occurs among horses in Paniguay, and wUch is due to an organism similar to the trypanosoma of Surra (P- 456)- "The symptoms — ^remittent fever, oedema, wasting — resemble those of Ngana and Surra. Most characteristic is the paralysis of the hind legs, from which the disease takes its name. It runs a chronic coursers to 6 months. In donkeys 6 1(} 13 months. There is occasionally haemogtobinuria" (SUphens and CMstopHers).—TiL.] l-Baii, which attacks mankind in the Dutch East Indies, is an infective neuritis multiidex peripherica. Eyckmann states that it is found in monkeys and hens with symptoms of paralysis in consequence of degeneration of the peripheral nerves. Lacerda reports that it is also met with in pigs and horses. Glogner attributes the disease to amoebae vrtiich he says he has found in the red blood corpuscles. t* (the quick disease) of sheep is an epizootic which occurs in the North (Iceland and FarOe Islands), especially in one-year-old lambs during autumn. It is a highly malignant epizootic disease and generally runs a very acute course with symptoms of colic. It was formerly mis- taken for anthrax, but appears according to the recent investigations of Nidsen to be a miasmatic infective gastro-enteritis. It is caused by an ovoid batcterium (the bacillus gastromycocis ovis) 3 to 6 ^ long and i n thick. The disease sometimes appears as a gastromycocis ; at other times as a general infection. * Bnubot, which is an Infectious disease, is well known in Norway and Scotkad. In North Britain it is termed "bmxy." It occurs only during aatunm and winter ; is peculiar to sheep ; and is confined almost entirely to sheep not over 3 years of age. It is almost always fatal, and runs iu course in a few hourk The chief symptoms are : great deprenion ; unwillingness to move ; desire to remain recumbent ; swelling of the hind.quarters ; tympanites ; and sometimes frothing from the mouth. We find, /tut nurttm, a dark purple discoloration of the abomasum from hamorrhag^ infiltration ; more or less congestion and degeneration of the abdominal organs ; dark colour of the blood ; and rapid decomposition of the dead body, accompanied by a considemble evolution (A gas. The flesh can be used with safety as human food. For a summary of C O. Jensen's article on this subject, see Via$rinariaH, September, 1896. It is probable that ovine anthrax is not unfreqnently mistaken for faraxy in Scotland.— Ta. PROTEOSI. 431 PMtaoaL — ^Perroncito states that this is an anthncoid disease which is met with in Sardinia, and which is produced by a microbe (protens vimlentiasimns). Milk slekiMfls. — Kimmel describes under this name a ' milk disease " which occurs in the centre of the United States of America in cattle, sheep, goats and horses, and which lasts 2 to 8 days, with loss of appetite, constipation, excitement, rigors, etc. It is stated that human beings who drink the milk of such infected animaia suffer from a similar disease. AfHoan hovsa-platfiu, which raged in Syria and Egypt in 1876 among horses, mules and asses, is a very malignant disease. It has been described by Villoresi, Apostolides, and others. The symptoms are : high fever, severe oppression of the brain, swelling and orange discoloration of the conjunctiva, petechise on the oral mucous membrane, great debility, and rapid death, frequently after only a few hours. The maximum dura- tion is 3 or 3 days. The post morUm examination shows the presence of septicaemia with general hsemorrhages and degeneration of the great parenchyma. Plassio described a similar disease under the name of " typhus of horses." AlMoan hona-daath. — ^According to Sander, who investigated it in German South- West Africa, this disease in its two forms (Dnnpaarden ziekte and Dikkoppaarden ziekte) is identical with anthrax. Theiler investigated both forms in the South African Republic, and described them as different diseases. [Sander's conclusion with respect to the nature of this disease is wrong. See p. 467 »t seq. — ^Ts.] u — This name has been given to a disease which, flrrrording to Wediomikoff, occurs among the steppe cattle in Russia, and which is probably identical with anthrax. Akpalpak is a disease which is seen in the steppes of the Kirghiz among cattle and sheep, and which was supposed to be scarlet fever (?) by Petrowsld. The blAOk death (the bubonic plague) is stated to pass to domestic animals and even to rats in China and Hong-Kong. [Bubonic plague is an infective disease which is caused by the bac- terium of Kitasato and Yersin. It is common to man and many of the lower animals, including pigeons and even flies. Rats are particulariy susceptible. The chief symptoms are the formation of buboes and the occurrence of fever. Bubonic plague is characterised by the fact that its virulence is capable of great modification, according to, apparently, the conditions under which the bacteria are cultivated. Thus its course may be very severe and accompanied by a high mortality in one place, and mild in another locality. The specific micro-organisms, which ckisely resemUe those of chicken cholera (p. 98), are chiefly found in the lymphatic gjands and intomal organs, and in fewer nnmben in the Mood. They are also present in the teces, urine, and saliva. 4»» MISCELLANEOUS INFECTIVE DISEASES. The oonUgium is fixed, or at Iea«t it caa be carried only in the form of duet or along with dust by the agency of cnrzents of air. The chief gates of infection are the alimentary canal and wounds of the skin and mucous membrane. Persons who Uve under good sanitary conditions, •ven If they go freely among plague^tricken patienu. enjoy immnnitv to a very great extent. In the eariy part of 1904. plague wL causing • great number of deaths in the Bombay Presidency (India) .- and it Ud ■Iso broken out in Johannesburg. ," ^«I^' Calmette. and Borrel have shown that intravenous, intra- peritoneal and subcutaneous injections of gelatine cultures of pburae UciUns. mixed with a UtUe bouillon and heated for one hour at sS^C If employed in doses just short of producing a fatal issue, and rmeated 3 or 4 times at intervals of 15 days, render rabUte immtuT to plague baciUus. They further found that the serum of such an im- munised animal injected into an unprotected rabbit exercised both an unmunising and a therapeutic influence. They also immunised a borse by mtravenous injections of Uving virulent cultures, and the serum of this animal was both preventive and curative of inoculated laague in rabbits, guinea-pigs, and mice. The next step was to test tiie value^this serum on man. Recent accounts lead us to infer that this has been done, wjd with the most signal success" (Th0 Practitioner. 483 CHAPTER III. CHRONIC CONSTITUTIO AL DISEASES. Anamia and Chlokosis— Pernicious ANiBMiA— General Dropsy— Leuccmia ANb PsEUDO-LEUceMiA—HiCMOPHiLiA— Scurvy— Gout- Diabetes Mbllitus— Diabetes Insipidus— Obesity— SARcoMAitMis, r>RCINOMAT08I8, AND SCROFULA. ANEMIA AND CHLOROSIS. Genenl remukt on aiuemia — ^Ansemim oi sucking-pigs and young pigs— Poljraemif (plethom). Daflnitloii. — ^The term ansemia means decrease in the total quantity of the blood and consequent diminution in the number of the red and white corpuscles, and in the amount of the haemoglobin, albumincus bodies of the plasma, salts, and water. The expression chlorosis signifies decrease only in the quantity of the haemoglobin ; the respective proportions of the blood mass, albuminous bodies, leucocytes and frequently of the red blood corpuscles being often normal. Although in mankind this condition of the blood is common, and affects only females at the time of their sexual development ; we have no positive proof that it occurs in our domestic animals. The word " chlorosis " is frequently used as equivalent to " anaemia " by persons who base their definition on the principal symptom instead of on the principal cause. The practice can be accepted only on the understanding that ordinary anaemia of animals is not the same disease as human chlorosis. ■tlology. — ^Anaemia is often congenital, and is chiefly found in puppies, Idttena, foals, calves, cattle that are specially bred for early slaughter, too finely-bred pigs, young pigs, and particularly in fancy breeds of dogs. It may appear in fat 4** CHRONIC CONSTITUTIONAL DISEASES. ammab, and in animals which have lost a considerable quantitv of Wood at one time or on different occasions. We may mention that m certam districts, animals are bled on several occasions before iattenmg them. A permanently bad system of feeding. wpeoally on potatoes and food poor in iron, is a orolific cau^ of ttus disease (the so-caUed anaemia of inanition). We often meet wth a secondary, symptomatic anaemia after many acute and chrome di»>ases, exhausting exertion, parturition and abnormal loss of fluid. We may here refer to the remarks made on progressive pernicious anasmia (p. 426). We shaU dacuss the anaama of sheep in a separate section (p. 430) on account of its great importance. ^ ' .iHw.*f?****"^~'^T^ ^ recognised by the paleness of the skin and mucous membrane ; the tolour of the latter appearimj as If washed out to ahnost a milky-white. There is^S debihty; the patient becomes fatigued by slight ex^on • tte action of the heart and lungs is accelerated ; the pulse smaU '; frequently the temperature is low; the cardiac sounds are somebmes masked by bruits de diabU ; the appetite is poor ; and disturbances of digestion appear, with the frequent iSult m newly-born animals, of death from exhaustion after a few' da3«. The tone of the muscles becomes lowered, and the Jjnobs show a tendency to sweU. The course of an«nia is chronic, and not unfrequently ends in recovery. Pernicious ansenua (p. 426) usuaUy terminates in death. Chronic anaemia of sheep IS, as a rule, complicated with hydremia, which we shall discuss later on. AnaWmy.— Besides the deficiency of blood in aU the organs, the blood itself in anaemia is pale, it resembles the }^f^^\^^ shows Uttle or no tendency to coagulate. I:li**^u*°**, *^* ^* ^*^^ *« sometimes greatiy con- tracted (phyoplasia) ; and the principal organs, such as the ZE?" **!?"*/* '^^ ^'^' ^^*"^' *^^ ^^^y^' frequently undeigo fatty degeneration, if excessive amemia has been present for a considerable time. '^^•<»»««*«-— The most important diagnostic appearance of anaama 18 the paleness of the visible mucous membranes. We also find by physical examination, deficiency of haemoglobin m the blood. Zschokke recommends for this purpose Gower-s nsemoglobmometer (colour method). ANXMIA AND CHLOROSIS. 425 Thwapautios.— Next to good, digestible, nitrogenous food, such as milk diet with horses, and a rational system of hygiene, the pnnapal remedy for anaemia is iron. It is best to give It m a form that can be easUy absorbed, and in small doses along with the food, or subcutaneously, when the digestion IS very weak. The simplest preparation is ferrum pulveratum,* wluch IS prescribed with common salt in gramme doses for horses and cattle, and in decigramme doses for dogs. To smaUer ammals we give tincture of iron, such as tinctura ferripomata,t in drops diluted with a sufficiency of water. For instance • tincture ferri pomatas 5 ; aqua destillata 250 ; M. Of this we may give one teaspoonful twice a day to a dog. Besides iron, arsenic may be exhibited as an alterative. For young animals, especially pigs, we recommend phosphate of lime in the form of soluble, ground-up bones. .u ^^T"*** "* ■aokliig.pl<» and Toontf M^fc-Braasch states that there occurs among young pigs in Schleswig-HoUtein a widely- spread anaemia, which yearly causes the death of hundreds o£ sucking-pigs on some farms, so as to endanger the entire brveding of pigs in that province The ammals are perfecUy healthy and fat up to about 14 days after birth, from which Ume they assume a pale appearance and manifest signs of chlorosis. The anaemia is so great that t- lung pigs can be castrated without losing any blood. They also show eU-marked symptoms of perverted appetite, general debility, dyspnoea, and palpitation of the heart. The animals quickly die if no remedies be appUed, or they faU into a chronic sUte of ill-health, which is accompanied by eczema, cough, diarrhoea, sweUing of the glands, etc. The disease is caused by excessive stimolation of the reproductive function of the sows, and by want of variety in their food. As the disease very rarely occurs, except in winter. It seems that the cold to which young pigs are often exposed in badly- managed piggeries (cemented floors without any Utter) most have some etiological effect. PoljamiA (Plcthom) is the opposite to anaemia. Formerly, plethora was frequentiy mentioned in text-books of pathology ; but now it is rarely alluded to, and even iU existence has frequentiy been denied. Mailer and Cohnheim in particular have called attention to the fact that even a 50 to 80 per cent, addition to the blood mass by transfusions of homogeneous blood will not produce plethora. On the other hand, Bollinger pointed to the diversity in the percentage of blood in various kinds of animals. Thus, in a fat pig the percentage of blood as compared with the weight of the body amounted to only a-2, and in a working horse to 13- 5. These extraordinary diversities are arguments in favour of the possibility of plethora, which seems to occur most commonly at the commencement of fattening young, strong animals which have been well fed, but which have had no exercise for a long time ; and perhaps • Pure powdered iron. It nearly corresponds to/ertum redaetMm.—TM.. t Tincture of malate of iron.— Tk. 436 CHRONIC CONSTITUTIONAL DISEASES. in caaM of sadden stoppage of the secretion of milk. This plethora is characterised by hypenemia of the mucous membranes, a full and strong pulse and heart-beat, and tendency to congestion of the brain and lungs. In human beings, plethora most frequently occurs from irregularities in living. On post morUm examinations in such cases we find hypertrophy and diUUtion of the heart, large vessels, and capillaries of the large glands, associated with well-marked hypertemia. PERNICIOUS ANiEMIA. Pernicious anaemia of animals— Pernicious anaemia of men. Btlology.— Pemidotis anaemia is a particularly malignant, primary or essential, and usually fatal form of anxmia in full- grown animals. Nothing positive is known as to its cause, although certain facts point to its infective or toxic origin. Zschokke having observed in horses several cases of it in one and the same stable, regards it as a stable epizootic. Over- exertion, long-continued standing in the stable, and a previous attack of inflammation of the lungs, may be regarded as pre- disposing causes. Up to the present time, about a dozen authentic cases have been seen in horses. Imminger states that he has observed the disease as an enzootic among cattie, and Friedberger has described a case in a mule. Severe anaemia may become secondarily developed as a consequence of illness caused by worms, chronic suppuration, etc. Under this heading we may appropriately place the ovile disease due to distoma hepaticum (liver flukes) and the dochmiasis* of dogs and cats. The strongylus contortus in sheep, and, in a few cases, the strongylus tetracanthus in foals (after immigration into the caecum) may also cause per- nicious ansmia. Anatomj. — By fost mortem examination we find, just as in ordinary anaemia, a general bloodless condition of the tissues and a watery state of the blood. The blood shows characteristic changes, which are absent in ordinary anaemia; namely, great paleness ,of the red blood corpuscles and alteration in * A disease due to ttrongyli in the intestines. In man the parasite is the itfongylus duodenalis ; in dogs, the dochmius trigonocephalus, which takes up iu abode generally in the small intestine and caecum ; and in caU, the dochmius Baliami feiis. In all these cases, the presence of the parasite seu up amemia and various disturbances of the alimentaiy canaL— Tm. PERNICIOUS ANEMIA. 4*7 their form (poikilocytosis). They may be increased in length, may beocnne angular, dub-shaped, or biscuit-shaped, or may assume the form of a drum-stick. Abo very small (microcytes) and very large (macrocytes) blood corpuscles appear in the blood On a luemoglobinometric examination of the blood, the proportion of the hsmoglobin is found to have decreased very considerably. Among other important changes we may mention : fatty degenenition of the vessels, muscular tissue of the heart and skeleton, and cells of the liver and kidnejrs ; extensive hemorrhages in almost all the internal organs, especially under the serous membrane, in the muscles, large glands of the body, etc ; swelling of the liver and spleen ; cellular infiltration of the medulla of the bones ; and haemoglobin infarcts in the kidneys. No one particular organ or tissue, with the exception of the blood, is affected to any great extent. Symptoms. — ^The disease usually commences with symptoms of increasing debility so gradually, that its earliest stage is usually overlooked. In other cases, respiratory catarrh with cough and nasal discharge may be the primary symptom. It also appears that the disease may begin in an acute form with high fever. Sometimes the mucous membranes are at first jrellow; but they soon become more and more pale. It is a striking fact that often, even in far advanced stages of the disease, the appetite and state of nutrition continue fairly good. On the other hand, debiUty, incapacity to bear fatigue, and tendency to sweat may appear at an early period. A character- istic symptom of the disease is the presence of obstinate high temperature, which frequently continues intermittent for days, and which generally defies treatment. This fever is accom- panied by a very considerable increase in the frequency of the pube. The heart sounds are sometimes complicated with secondary murmurs. The blood shows the symptoms, aheady described, of poikilocytosis, macrocytes and microcjrtes. During the further course of the disease, the animal gradually loses condition, and sometimes shows signs of dropsy; emaciation increases ; and death may take place with great increase of temperature, after the disease has lasted for months, and even for years. Ostertag saw a case of death in a horse with sjrmptoms of paralysis (hydrorachis and hydrocephalus). Dlfljunmtlal Diagnosis.— An exact diagnosis can be arrived at only by an examination of the blood, which should 4S* CHRONIC CONSTITUTIONAL DISEASES, be nude inunediately after the blood has left its vesMb; because changes sinular to those met with in the disease may be pro- duced in the blood by the addition of different fluids (as for instance, distilled water) and by the blood being kept for some time. The absence of a primary affection of any particular organ, excessive anaemia, and presence of persistent inter- mittent fever, the causes of w*ich cannot be found out, are important points for consideration. In contrast to leuctemia, in which the number of leucocytes is increased, while that of the red corpuscles remains normal, we find in pernicious anaemia no essential increase in the number of the leucocytes, no swelling of the lymph glands, and no leuctemic infarcts. The presence of haemorrhages is common to both. Therapautios.— Here, as in otrdinary anaemia, the principal object of our treatment should be the r^eneration of the blood by preparations of iron. The results, however, are generally 'ery unfavourable. To full-grown horses we give ferrum puhreratum in doses of 2 to 5 grammes in combination with common salt and aromatic powders, or sulphate of iron in similar doses with small quantities of carbonate of potash and aromatic vegetable powders. We may also try arsenic With horses we conunence by giving 10 grammes of liquor arsenicalis, and gradually increase it up to 50 grammes. We may combat the fever by antipyrin, antifebrin, quinine, etc. Unfotunately, however, all these antipyretic agents, even in- very lai^ doses, are only too frequently found to be useless. The affected animal should not be worked during treatment PWaioioiw Azunmia of M«ii.— Biermer in 1868 was the first to fuUy investigate this disease, which consists of an atypical formation of Wood, and which by its symptoms and /»«< mortem appearances is evidently Identical with the pernicious anaemia of the domestic animals. We possess no exact knowledge respecting its origin ; but may hazard the conjecture that It IS an infective disease. We must consider as secondary forms, but aot as essential pernicious anaemia, those cases in human medicine in which the disease was due to ankylostoma [strongyli duodenalis], found by Perron- ato m the workmen in the St. Gothard tunnel, miners, and brickfield Ubourers. or to bothriocephali. Fonfick made experimental researches respecting the pathogenesis of pernicious anemia and succeeded in pro- ducing It artificiaUy in animab by repeated intravenous injections of blood- dissolving agents (glycerine, pyrogallic acid, and solution of haemoriobin) Consequentiy. the essence of the disease seems to be a chronic hcmo- ^buianua in which the described changes of the red Wood corpuscles Mmirfy signify a separation of the colouring matter of the Wood from these corpnsdea. This view is strongly supported by Ui»- proof of the GENERAL DROPSY. 4*9 pretence of iafuctt of hwnoglobin in the Udneyi, u we have seen in the case of a hone. In the procaee of chronic hsmo^binnnia we find interference with the elaboration of the blood, and deficiency of oxygen, with consequent fatty degeneration of the organs of the body and mptare of the veasels. Fnrther reaearch into the cause of the hamoglofaincmia of pemidoos anwmia is desiraUe. Possibly the disease is due to bacteria or toxins. GENERAL DROPSY {Hydtetmid). General lemsiks— Hydnemia of sheep— Hydnemia of cattle. 0«B«nd Remarks.— There are three forms of hydiseinia.- (i) A mechanical form caused by engorgement of blood due to heart failure, and to disease of the lungs, kidneys and liver; (2) an inflammatory form ; (3) and an hydraemic form caused by a serous condition of the blood, and by alteration of the vessels. The last-mentioned form occurs most frequently in sheep with accompanying symptoms of distomatosis [disease caused \yf flukes]. Hydraemia develops in pigs and sheep daring the course of anaemia without parasitic agency, as will be discussed later on. Apart from this hyperaemia of sheep, the so-called " general oedema of cellular tissue " is another hydraemia of practical clinical importance. It occurs as an independent disease in draught-oxen in sugar factories, and in other cattle, from exclusive feeding on distillers' wash, and in horses that work in sugar factories. The causes of hydnemia are on the whole the same as those of anaemia; hereditary predisposition and bad feeding being the most important factors. The disease is divided into varieties corresponding to the respective localisation of the accumulated water, as, for instance, anasarca (water in the skin) ; ascites (water in the abdomen) ; hydrothorax (water in Ule chest) ; and h3rdro- pericardium (water in the covering membrane of the heart). Anasarca is found at first on the lower parts of the body, as on the legs, hypogastrium, inferior surface of the chest, and scrotum. In sheep, on the contrary, it is seen on the head, which is kept low down while grazing. The skin is swollen and dou^y to the touch, and retains the impression of the fingers; but is neither painful nor of abnomudly high tem- perature. Animals affected with hydraemia suffer from debility, shortness of breath, and indigestion ; the mucous membranes 430 CHRONIC CONSTITUTIONAL DISEASES. are pale and sometimes oedematoosly swollen ; and the poise is very weak. Besides the watery, thin condition of the blood, we find in all the cavities of the body and under the skin, accumulations of hydrsemic fluid, which is clear, colourless, or yellow, free from coagula, and po(M«r in albumen than the blood or inflammatory lymph. It coagulates only after it has been kept a considerable time. This watery transudate contaiiis a small number of the component parts of cells, especially of endothelial cells, and a few leucocytes. HvDitxiiiA OF Shbbp (chlorosis, dropsy, cacktxia aquosa). "■at" la BhMp.— The term "rot " wu formerly apidied to any disease which was eharacteijaed by emaciation, weaknen, poverty of Mood, and drapty. Tubercnloais oi cattle was iJao called " rot " under which heading recent writers have sometimes placed distomatosis [the morbid condition set np by the preseiice of flukes], and diseases arising respectively from strongyli in the stomach and from taenia ; and at other times, only non-parasitic ovile chronic anaemia (chlorosis) and dropsy. As we shall later on discuss the diseases just mentioned, we shall here confine our attention to the non-parasitic constitutional disease which occurs epizootically among sheep, and which manifests itself chiefly by chronic anamia and general dropsy. Etiology.— The causes of dropsy or chronic anaemia (chlorosis) of sheep, which is a grave disease that attacks whole flocks, may be placed under the following two headings : (z) Insufficient and damaged food, swampy, sandy or boggy pasture land, unsanitary abodes, and bad management; and (2) un- favourable climatic conditions, such as long continued wet and cold weather, badly situated grazing land, and penning the sheep on wet, cold soil. Consequently the disease is more frequent after very bad and wet seasons and inundations, than at other times. Anatomy.— The extraordinary poverty of blood is the first thing that strikes one on viewing the dead body. The blood resembles the juice of meat. The subcutaneous tissue of the neck, abdomen, and lower surface of the chest, and the inter-muscular connective tissue are oedematously infiltrated. The affected connective tissue seems, when it has not entirely disappeared, to .be gelatinous ; the muscular system is relaxed and pale ; the abdominal viscera are shrunken and pale ; the lungs are inflated and pale ; and the heart is relaxed and flabby. A dear, light yellow transudate is found in the thoracic and abdominal cavities, pericardium, ventricles of the brain, between the cerebral membranes, and in the spinal canal. "-vf GENERAL DROPSY. 431 Symptoma.— The ^>petite greatly varies, being some- times good for a long period, and at other times bad from the commencement. The animal is depressed and weak; drags its 1^; gives way in the Imns; and becomes gradually emaciated. All the mucous membranes are very pale and finaUy become quite white; the conjunctiva is frequently oedematously swollen; the sclerotic has a blue tinge; and a mucous discharge from the eyes is frequently present. The skin is pale, greasy, and inflated ; and the wool is lustreless, brittie, and easily falls out. The frequency of the heart and pulse is increased. (Edematous swellings develop in the inter- maxillary space, on the throat, inferior surface of the chest, and hypogastrium. The abdomen increases in sixe and becomes fluctuating (ascites). Later on, persistent exhausting diarrhoea appears ; the animal becomes so weak that it is unable to move, and continually remains recumbent. Usually the patient lingers on for several months, and sometimes for even a year. Th«rap«atioa. — ^The only remedial means which is of any use is attention to hygiene and to feeding. In the first stage of the disease a cure is always possible if we can put the animal on nutritious food which, like hay and com, contains a large proportion of nitrogen. A great number of medicines have been recommended, the most effective of which are prepara- tions of iron, common salt, lime and aromatic stomachics. From ancient times, gentian, sweet flag [acorns calamus], worm- wood, and juniper berries have been given to sheep as stomachics for the object in question. For a flock of 100 sheep we may for instance prescribe the following mixture: Sodii chhridum 500 grammes ; gerUianfg rod. pulv. ; calami rhizomai ftdv. ad 250 grammes ; ferri sulphas, pulv. 100 grammes ; Af., to be made up with ground barley-malt into a mass which the sheep will lick up. Hydraiha of Cattle ((Edema of cellular tissue). Etiology.— Chronic hydraemia of cattie, which is frequentiy observed in abattoirs as an oedema of ceUular tissue, is caused by long-continued feeding with food which contains too much water, such as distillers' wash and beetroot residue. A general hydraemia which occurs in oxen and horses, and less frequentiy in cows, and which sometimes assumes an enzootic type, is of great practical interest to owners of sugar factories. This disease is chiefly caused by exclusive feeding on beetroot residue. 43* CHRONIC CONSTITUTIONAL DISEASES. which, tince the introduction of the new method of manufacture Z^J?^*T\^ ^ "°^ °' •*»«'* "'«•'• withTi; cent of water. As the proportion of albuminoid! in the solid ^ K^*"^^ **^* I to 10 ; the beetroot residue contains Sh *^ * ^u*^*' °' ^•^•"•"inoJd*- The consumption of sudi food, combmed with hard work. finaUy brings on hydrwnia^ which occurs far less frequently in cows; ^«» ^ZZ tT;fZ •"• r'1' '°^* l«Ke amount of X^ removed out of their system along with the milk. AaaioiBy.— A post mortem examination of oxen which have died of general dropsy reveals, in a marked manner, the pale and flacad condition of the entire muscular system, and the absence of ngor mortis. The subcutaneous and inter- muscular connective tissue is infiltrated with serous fluid • the flesh M cowequently watery ; the cavities of the body are more or less filled with transudate ; the viscera are shrivelled up. nale and devoid of fat ; and the brain is oedematous. We almost always observe signs of chronic intestinal catarrh. •ymptoma.— The disease in oxen of sugar factories becomes gradually developed. The animal shows general debihty and paleness of the mucous membranes; becomes thinner and thinner m spite of the possession of an excellent appetite- passes a laige amount of urine the colour of water- and the coat is rough and stands on end. Uter on. increasiiily severe di^tive troubte set in. with alternating periods of constipation and foetid diarrhoea. The patient is salivated and ma^ests on the hmbs dropsical Swellings which impede progression and render the gait awkward and clumsy. (Edematous swellin« soon appear on the hypogastrium. dewUp. and inferior surfaoi of the chest ; and dropsical effusions form in the cavities of the body, particularly in the abdominal cavity, so that the sue of the belly is greatly increased. FinaUy. the animal IS unable to keep on its legs ; it remains persistently recumbent and dies from exhaustion, after the disease has lasted from 3 to 6 months. Thttrap«ati(w.— The treatment consists essentially in the removal of the causes that produce the disease, which can be cured only, as we have already said, by giving a suflident quantity of dry fr k? ; supposing, of course, that the change in the sy t. vf fe, '^ng has not been undertaken too late. LEVCMMIA AND PSEVDO-LEVCJEMtA. 433 Dimetics and aperients have been used symptomaUcaUy to combat the dropsical swellings and effusions. Compare here the^pective methods of treatment of ascites and hydro- LEUCiCMIA AND PSEUDO-LEUCiBMlA. *f*J^— ^""™»ia » a changed condition of the blood in whi-of STwound^yligati^d^Lg. png. If this does not avail, we may employ styptics such L hquor fern perchloridi. tamiin, aluii, cLK^v^n t^ ^tuaJ cautery. We might also administer i^te^d st^^Jcs for instance, ergot of rye or extract of hydrastis ^ SCURVY. SSJd^o^T^'T^? ^'™*° "^<=^« the tenn scurvy is nJfii * J«°»oirhagic affection which was formerlvverv jrti:"at'*^es^?' '"h'i;^^' *°^' etc..":^d':^ hZn^^A ". *Pora^caUy in prisons and barracks iSs atSr°i*°7 «*°^ 'Wtoms. such asSty.' ^^T' ^'**°"*' and rheumatic pains ; scurvy manifests itJi •curvy. Alnct all thecals of scurvy in dog, which tav,btS SCURVY. 439 orSi" ^Jn*"*^ "^ ''^'"^ *° ^^Pl« 'J<^«™'» stomatitis. thnSf^rf' . '*''^ instances, to septic and toxic affections • m Sheep and goats, to anaemia or rachitis. Very few of these tT^'^rJ"'' ™f ' r'"" ^y ^PP™*<=^ t° Sentific exa^ B^^^al''"**'""^ '"! ? ^°^ = '°' *« "«* ^th only 3 cases of it among 70.000 sick dogs. exdW**!?^'"'*" P'^ **"* '^^'^^ predisposing, if not actuaUy dweS ^^ °1 ""."^ "'^ "^"^^^^ ~°^<"« o* food and thTS'rlT '*''"''• Nothing positive is known about oth^ J^cT °^P°f 'T «^"^ • ^though Comevin, Hess, and vln^T^tL'* *1^ P"^"*=*^ ^y ^^« erysipelas. We Sr .*^^^<=« *»»« supposition that scurvy is probably of nuences which produce scurvy in man. Symptoms.— The first symptoms are debility and a caori- X^fdr *^^!,PP*****- TheiLsassumeavioL^d!^^" Sn ^J^^^^l'^^fd appearance, and bleed from sUght p Sta- tion. The teeth become loose and finaUy fall out Ld the mo*^ ''^.tT^^' ^^^"^ * ^«^ *«*i<^ odo- fr"m tf d^ «;h ™*^f '*" ""'* '^^^ '^°* ^Jood 0° tl^eir roots. L ^c^^r^l P"^^* 'P?*" ^'^ '*"*^ (ecchymoses and vibices). Swet^^th "^^ '^ S«' ^"*° ^^P "^«'^' *PP«ar on the skin frii^iSl "*'?^*'°"'"^'°***^*^i°afewcases. Besides t^ spotted hamorrhages of the gums, we notice in dogs epistaS? h^norrhages into the anterior chamber of the e^. ZTon t£?tt"*^Z' r™°'?T' "^-"^^^ into the'retin'a oi ^T'T^T°"\Tf ?' '*°"**^^ *"** ^t««tines may also S"tv ^h-vT ^^y ,<««* fro'n increasing emaciation and debihty. which are generally compUcated with diarrhoea, if no early amelioration in the external conditions takes pla^e in ^\^^ *^°?*^ ^"'^ "^"^ appearances are hemorrhages 2r^ men,h« *''' T""! '"^'^^ranes. brain, and under Uie seroiB membranes ; and a discoloured condition of the blood which coagulates with difficulty. ' «.mT^T^^"**"f "^^^ '"°** important remedial means is the removal of unsamtary conditions of feeding and dwelling. As Lh"«T 'T' ^' '"^y administer bitters, astringen^Cradix gentians, cortex quercus, and quinine), and preparations of 440 CHRONIC CONSTITUTIONAL DISEASES. ro^ *^ ** * °* "*** in wine to dogs with apparent occlT^-"' ^f^r* •■* I*ml».-Lowak stetes that this diaeu. b^Z ^° .h 1^ *-»°°«t<»i» •"«! d«>I»y and that it maaitotaTS £™JL »^°>«K very loose and Uable to iaU onTt^dut^yZ t^„-i^ J " obeerven have noted the occnmnce of con- ^L"^,"f^l^^ '^'^' ^^y- perforation of ihT^late ^d tooe«ung of the bones of the face, which ronsequently erfubitM Lt^ £othertt^^°;t^'^j:s° •^ '**•''' ^« e2:Sti"r:L^ht ll^th t™.^ .?• .'*'"**^' ""Widen that it has nothing in common «d tw -^^ '• *'"*'*»«^y»t«»'»««««Pe»icio»aofSu"iS^ di-^arTof SLT^; f. '?~'»='«°fe'»«t of gnuing, the disease al^^tSi Sals Lve C f^ tl^^^'SLf'*'' J^ '-^"» «.h .«« »»» Wdneys. Su>i^? '*"'***"*" *° •* P^"*^ for "« ««»t part by hirH^^S^i"" •***""*'*'*' *°*°**^' 8°"* ^*» be«n Observed only in bir*, (fowls p^:eons, geese, turkeys, ostriches, etc.), with the exception of one case in a dog. The older the ^nima^^^ Jhe more pred^posed «, it to gout. The susceptibihty of birds to goS 44* CHRONIC CONSTITUTIONAL DISEASES. is maxle apparent by the fact that their excrements normaUy contain a iMge quantity of uric add, the elimination of which may suffer decrease in certain cases. Anyhow, it is possible to P^JjI^gout artificiaUy in birds by ligaturing the ureters ,^*^- °fil!?i *" °'^" *"^ *° *•» "«^ o< ^^- mMiinab or •»p«.t. (Sir AUred G«nxi, Dr. Luff and other.), th. production of gout Wdif»^ "^^ •""*'" °* "^' P~^- »»«** "»*« «idli; lonned in th. ^T2Lk?*' "'■'^ excrement of birds and serpento is composed of !^^^^2;!!S^T.!'^* "«"*""» ''°"~- "H-vefon^durea pre^t m the blood of aU the birds I examined, via., the turkey coose o?tr*'H^*'"- The urine of mammal. con^;£'^;^i tah^; *'^"*"*'^'^''- Thus the average percentages^ in human unne is 1.43 ; and of vric acid, 0037 (Bloxam).-T«^ Symptoma.— In birds the' metatarsal, phalangeal, and tarsal articulations are the parts wUch are most frequently and most severely affected ; but the metacarpal, carpal, and elbow joints may also suffer. The implicated articulations show at first a soft, pamful, and diffuse swelling, which becomes gradually laiTger and more circumscribed. Often, especiaUy on the lower portion of the metatarsal articulations, we find nodular yellow tumours, which vary in size from a pea to a hazel-nut, and which are usiwUy hard, but may sometimes be fluctuating. They are hot and pamful to the touch, and are frequentiy surrounded by a red area. The epidermis over the tophi (" chalk stones "> becomes greatiy thickened and exfoliates off in thick layers These tumours often burst and discharge a giay-yellow [buff- coloured], crumbling or soap-stone looking material, which con- sists chiefly of uric acid crystals, ammonium urate and calcium urate. These tumours leave ulcers which have edges that readily bleed ^d a ^y-white base, and which penetrate to the bones, llierads a the bones that form the joints exfoliate from necrosis or become anchylosed, on account of which the toes often become crooked and considerably thickened. Sinular swellings, which give the feehng of concretions of lime when felt with the hand may sometimes be found in the tendons. The general health i^ usuaJly disturbed. At first the bird can use the affected limb for standmg and walking only with difficulty or not at all, on which account it avoids movement as much as possible. Later on gradual emaciation, debility, poverty of blood, marked paleness of the corpora cavernosa, and exhausting diarrhoea become manifested ; and in severe cases the sufferer finaUy dies. In visceral gout, the existence of which can be proved only GOUT ' 443 lIl'^hT??*' ''* ^^ calcareous nodules and incrustations chiefly Dody. coats of the vessels, pericardium, intestines, Uver soleen and ,mder the skin. The kidney, show signs of nepSto £' ^ often greatly enlarged, and their sXe is cov^r^^^' white dots, as if sprinkled with plaster of Paris. The^Tm sometimes contain chalky deposits (Kitt) Bruckmiiller met with a case in a dog of nodes on several of cxammation, these nodes were found to consist of urate of soda. ptafaori«.-Gouty inflammation of the joints may verv arthntis, which often occurs in fowls. An exact diamosirof gout can be obtained only by the microsc^?^ or^^rSc^ demo.«tration of urates. If we examine und£ XiiiS^^ the sphencal masses of concrete, we shaU find thS t^y 3 of a regular felt work " of very fine needles, and that th^S parts are composed of radiating dusters of cryst^ AeV^ sence of uiic acid is chemicaUy proved by pkcS^tte concretk»" on a porcekm dish or watch-glass. moistLnHhem mth a^ mZ.^ir*"^*'^*' ^^ «-^PO"«°« the mixfure to ^^Z S^t^r^L'r*- « «»« "•PP^'-coloured S^ S &S.t n,Z£ L?^P, "^"^^ an«nom«, it changes into a magni- SronlST "^ '°^°'"' °' ^*° P-nJle-blue bytiie additionTa dro^ of hquor potass,. The course of gouty arthritis Tvl^ Th«r»p«iitlOB.— The treatment of gout in poultrvis chieflv surgical, and comrists in opening the fuppuratiSts We Zvfii'SlT'"iX'**"*'<*P^^^ of ar^cial*5fSd Jte dady) m the dnnkmg water. These salts, in combination vriS nhwf ?^°™,* °* "^t^^' "^ Siven in hmnan medicine forT object of dissolving the uric acid. •ion of sodiiun qnadriurate into the hin«f- T^ ^'^ "*" conver- 444 CHRONIC CONSTITUTIONAL DISEASES. •olubility of •odium Uuntte. Hence, theee vegeUUei and many kinds of !^1*" !S J!l?^"* ""^ ^ '^•'^ •"'•^ «~» ««>»»• Strange tojay. artifidaUy prepared aah does not produce any good eflect to DIABETES MELLITUS. Ckin«ml Ramarka on th« natOM of DUbotos M olUtva. —The term "glycosuria," or " mellituria," is appUed to a condi- tion m which there is a temporary excretion of grape-sugar in the urine ; and that of " diabetes meUitus." to a disease charac- terised by the continued presence of a large amount of sugar in that fluid. Sugar in very miaute quantities also occurs, as It IS well known, in normal urine, especially in that of cattle and sheep. Besides, we find under normal conditions a small amount of sugar in the urine of female animals that are bringing up their young, as for instance, in bitches after their milk has dried up, in which case milk sugar (lactosuria), not giape-sugar, is excreted with the urine. The nature of diabetes mellitus is not fully known. This disease, like albuminuria, is probably only a symptom which is common to several diseases. We may, however, safely say that it is due to some defect in metabolism, in which the sugar, instead of being broken up, is excreted in an unchanged condition from the blood. Consequently, diabetes mellitus is equivalent to glycaemia (increased amount of sugar in the blood). The sugar appears to be derived partly from the hydro-carbons in the food, and partly from increased disintegration of albumen. It seems that the increased sugar-forming activity of the liver plays a great part in the pathogenesis of diabetes. In man, the normal amount of sugar in the blood remains constant at about 0.05 per cent. ; but in diabetes mellitus it may rise to i per cent. Ooouravnoo.— Various authors have met with true diabetes mellitus in dogs. We have seen 7 cases ; and Schindelka and Eichhom 3 each. Heiss saw 2 cases of it in horses ; and Rueff and Dieckerhoff, 1 case each. It seems rarer in other animals. Leblanc found it in a monkey. Thamrtas on Pl»h«t— .— The most important theoretical divisiona of diabetes whicti find acceptance at the present time are as follows :— I. Neurogtnous dittbeUs.—ln 1849 CI. Bernard, as we aU know, expert- DIABETES MELLITUS. ^5 by dmdin, th. .yn.p.thrtic. the inferior cerWaH g««lW ihe X» •tc CUnical experience with hunum beinn mlL rfio«rJh!* . ^' found in the urine after cert«n inlnrieeT^thetat^ncSoiTthe M^ciLrr.e^rcr^r£"1^^^^^ o*rti::.S'Jl" r ne„rogeno«X^tri, a'^Sti^^l.'ZS S.t^ " •''*•"■ "''•^'' °* ""• v«o-motor and ,y«paSS" o^itt^tJit^^r/K^^^ SS' i. 21^ ZS^^^r,?,""**"' •>yP««^ the glycogen TZ iiZi^^t^^l and in Urge quanUtiee into the blood, and that IdiLTn *° •"*" ; « that no formation of glycogen take. STtil ^.iTTifr"' °* "" "cderation of the bloS"^^^" that the ragar derived from the food i. p.«ed directty into the Mo^T caoL^t^*^"*'"^ ***^' «**»*»« to BonchJdat andoS^ i. to^Jj^r^/*'*"^'*^*"'*"*^ *"»»'««5«tn>-int«.tin.lcM^Sj to the abeen^ of certain femwnt. in that tube. Thi. theorybfoS on the poeaibility of diet exerd«ng an influence on diabetaT 4. fancreatic iiab*Us is said to have its origin in char «e of the ^^^LjTf^ *S '"^ ^^'^^ "^ pancr^juice!!. £.1^ wliS.31^^'"' "h^*? **^ hydKM^rbons of the food into pSK rZ?J^ ^"'' °"*^ *° *• •"«»«*• ^^^»«» the pancreas b^« affected ta such a manner that diabetes is set up. the panoptic i^to " <^^anged that iu acUon on the hydro^arboL of S^^ diS^*! SnSie "" "^ "^""^ "^ ««P«ugar. which I SSefr^ c.nL/irir**'^ fi"*^' """"^i"* to Voit, Mialhe, and othen. is c*»ed by decreased absorpUon of oxygen, or diminished alkalinity ^tlw t^od^ con«Kiu«nce of which the oxidation of the grape^ugar 2^,^ 6.Myoggnic diabetes is said to have its origin in abnormal conditions of muscular activity. Glycogen, which is essentially a nourishing ag^f„ Itt^ r- "^^''*^«* » completely oxidised uider normal LStioM^ «r^; "k ' u "^«>«»"« quantities as grape-sugar in tiie bkxx^ » favouraUy uflnenced by muscular exertion and massage 7. ConsHtuHonat diabetes, in contrast with accidentia diabetes, is 446 CHRONIC CONSTITUTIONAL DISEASES. •nppriMd to apriof from iMnditary pndtopoaition wUlch it iairiy wM ourlradianMn. S. Gouty Htbtlu, syfkiiiHe iith*U*. iimbttu of obo*Uy. ii«M«« o/ food (phloriiia)* and Habttu from eonfiutrntnt ia dop and caU, an other foma ol diabatw m^tna. 9. Soma anthon bdieva that betca ia producwl by more canaaa than one. According to Stokvia, the . rWd proceaa in diabet':a conaiaU in the diatnrbance of aeveral fanctiona ; tor inatance, the formation of augar in the inteatinal canal, the formaUon of augar and glycogen in the liver, and the conanmption of augar in the mnadea. Symptoma. — i. In dogs the first symptoms of diabetes mellitus are dulness, weakness, inability to bear fatigue, and gradual emaciation. If the disease be not too far advanced, the appetite is usually remarkably voracious and the thirst exces- sive. The urine is very abundant and is more frequently voided than in health. Its specific gravity is generally increased (1-040 to i-o6o). The amount of grape-sugar in the urine varies, and may be as high as 12 per cent., which was the proportion found by Haltenhoff in one case. V. . have observed in dogs, respec- tively, 4, 5, 7, and 8 per cent. Wolfi met with cases showing from 7 to 8 per cent. In such severe instances, the presence of sugar in the urine maybe recognised by the sweet taste of that fluid. A grey cataract (cataracta diabetica) may become deve- loped in both eyes, which may finally become completely blind (Wolfi, Haltenhoff and Ourselves). Schub and Striibing found bilateral detachment of the retina in a dog which was suffering from mellituria produced experimentally by feeding on sugar. The animals are often affected with vomiting, cough, diarrhoea, hemorrhages of the mucous membranes {Tkiernesse), and ulcers of the cornea. The debility becomes excessive towards the end of the disease. The course of the disease is always slow and extends over several months. Although recoveries may occur, as we have seen in our own practice, the prognosis is on the whole very un- favourable. Death sometimes takes place very rapidly with stupor (coma diabeticum). The only anatomical change which we found in one case, post mortem, was well-marked fatty dege- neration of the liver, with a clay-coloured appearance of the tissues of the liver, and considerable enlargement of the whole organ. Similar changes were observed by Heiss in two horses. We were able to demonstrate enlargement of the liver in a dog [* nilorizin is a ^ucoside, the consnmpticHi of which atatet diabetes, Villaret states that it is foand in the bark of the roota (rf apple tieca, pear trees, plum trees, and cherry trees.— Tn.] DIABETES MELLITVS. ^ by palpation during life. 'VcHh -felka anH w^i« t j . manifested by the unti;rittin.ss .f tJ.e n als^^^ *^hl ^^^ sumption of water rose fnm . *■ " ~ <^<>*"- Thecon- and^he ap^titeX iV " '^T '^l "«™»^ nsumption ustyoats. l^amp oats havmg been kept for a considerable 29 4SO CHRONIC CONSTITUTIONAL DISEASES. time without being turned over, as for instance on board ship foment probably, from the action of mould fungi. Dammaim observed that musty peas also produce this polyuria. This toxic polyuna has just as little in common with true diabetes msipdius as the polyuria of contracted kidneys. The nearest approach m horses to human diabetes insipidus is found in those casM of polyuria which have no apparent cause, and Sll ««^b.t no characteristic changes on post mortem exami- nation. Stockflett states that he fomid true diabetes in a hone ^w ! ?^i *"1P"^' a*ter a kick on the region of the Uver. Schindelka descnbes, in a dog, one case which was distinguished by Its rapid progress, and by complications (cataract and abscess) pecuhar to diabetes mellitus. »"»«=»; ™„f ^i""!^^**'*"^^ *^* ^"*°« ^°"° of Poly^a due to musty fodder differs as to cause from human diabetes insipidus It presents sumlar syr^iptoms. The digestion becomes impaired a few days after the consumption of the musty oats, and <»lickv pams may also ensue. Attention is soon attracted to tte abnormal frequency of the act of micturition, and to the large quantity of excreted urine, which in severe cases may amount, daily, to 25 and even to 50 Utres. The urine is pale very watCTy poor in soUd constituents, and of the low spedfic gravity of fr^m i-ooi to 1015. It contains neither albi^ nor sugju-. and often has an acid reaction, probably on account of simultaneous mtestinal disturbances. The increased secretion of unne is accompanied by increase of thirst, which often becomes very exceaive. Horses have been known to consume in one day froni 80 to 100 litres of water. The temperature is usuaUy normal, but may become considerably heightened during severe gastric attacks. Marked debility is generally present In the majority of cases the symptoms just described dis- appear after the supply of the injurious oats has been stopped. It seems that neither recovery nor improvement is possibleif the system has been under the influence of the toxic matter for a long tune. In such cases the animal becomes more and more emaciated, and finally dies from cachexia after the disease nas lasted for months or even for years. ,. ^'^•^^•^"•^--Removal of the cause, namely, stopping the mjunous food, is the best treatment. If this cannot b! (lone the oats may be improved by washing, cleaning. OBESITY. Sl^°,^"IIS!L" 5? ""^ l*™ «>« custom to .d. «» thdr vahM iSriihS l^if^ "^bte to express our opiniM. OBESITY, tissue w» «w7^' ^'P^^'^^y >° the subcutaneous connective kept for hi«diii md in^^ ^^'^ " ™°^ «*»' "« S trS^Ld"^ and ho,«.dogs, and stud ami! Jnorbidm.teri.1 from the tyrtem IVt "* ""* ""«''«» »' 29* 45* CHRONIC CONSTITUTIONAL DISEASES. appetite becomes capricious, digestion disturbed and the procreative faculty impaired or even destroyed. In cases -of long continued and excessive obesity, dyspnoea becomes com- plicated with acceleration of the pulse, palpitation of the heart, and disturbances of the circulation, such as hypertrophy of the heart, fatty infiltration of the heart, and finaUy fatty degener- ation of the heart. *«.T^*^^'**'*'*'~^''*^*y ™*y ^ treated by giving less food, by reducing the quantity of some of the component parts of the food, or by iuvreasing the decomposition of the adipose tissue. I. Decrease in the total amount of the food is the simplest and most reliable remedial means. In our clinic we have always succeeded in making fat dogs lean in a comparatively short time by a simple reduction of the diet. This plan is not always practicable ; for owners cannot be reUed on to enforce the necessary regimen. 2. A decrease or withdrawn! of food constituents, such as lat and hydro-carbons, which tend to form adipose tissue, has been tried in man with various modifications, the oldest of which is that of Banting. His " cure " consisted in the almost entire ehmination of hydro-carbons and fat, so that the diet was practically restricted to lean meat. Good results may be expected from this method, if it be judiciously apphed for moderate periods of time. Its too strict and lonf continued employment gives rise to aversion from albuminous food, and indigestion, followed by catarrh of the stomach and intestines general weakness, and exhaustion. On account of the absence' from the food of fat and hydro-carbons, which, when digested protect the albumen of the tissues from disintegration, the body consumes a portion of its own albumen, which, in any case IS not very abundant in obesity. Elbstein's method excluded hydro-carbons, except fat, which may be taken m small quantities. It appears to reduce the feeling of hunger and thirst, and to favour the deposition of albumen in the body. [In man the only dietetic method for checking obesity which can as a rale be permanenUy adopted with good results, is the exclusion of starch (bread, biscuite, cakes, pastry, macaroni, vermicelli, rice, sago, cornflour tapioca, arrowroot, etc.), and a liberal supply of those fraits (apples, pears grapes, pine-apples, oranges, strawberries, raspberries, plums, peaches' greengages, cherries, etc.) and vegetables (cabbages, cauliflowers, tomatoes! celery, spinach, etc.) which are poor in starch.— Tk.] SARCOMATOSIS, CARCINOMATOSIS, SCROFULA. 453 «ri;»?* ''■ ^^ "^"**** ^y ***^*^' "^^"^ accelerates the S^^^^'^'^KJ^'^if ^"r • ^^'^ s*^gthens the action *r»i!SL TI* ^* ^"^^ °' **^<=^ «" ^ shown in the training of horses. hv rtil5^"?*^**° ?u '?*'*• '^"^Wy to the method introduced o?h^ • ^*'''' **** ^**^ °* ^'•^ ^y decreasing the amount of blood, and consequently increjises metaboUsm. This method may be utihsed in the severe affections of the heart which occ^^u^ the later stages Of obesity. It can be combin:^ often foUowed by rheumatic affecUona brought on by undue ret^ti^n 0I effet^e and deleterious material in the system 'and by c^l^: St'Cce »lVo^i;J^^ °^ • "'"edif, ?«ai^t obesity, such as salts of bromine, alkahes aperients and diaphoretics, have fallen more or less into tr^nSl ; ^^'^'' ^T "^^ *° *^« P"«^y <*iete«c method of treatment ; because they operate too violently, and when successful they obtain their effect partly by the ^dal pro ducbon of a catarrh of the stomach or intestines. The alkah« which increase metabolism, such as Karlsbad salt are the least injurious medical agents for the reduction of ODcsity* SARCOMATOSIS, CARCINOMATOSIS, AND SCROFULA. The formation of sarcoma and carcinoma comes into the province of mediane when theyoccur in the internal organs, such as the stomach, hver. intestines, kidneys, uterus, lungs, brain, etc.. or when they spread through the whole body. Sarcomatosis and carcmomatosis often assume in horses, and especiaUy in dogs the aspect of chronic peritonitis or pleuritis with abundSt serous or hemorrhagic exudations ; as extensive new-growths of a sarcomatous or cancerous nature may become localised in the pleura- and peritoneum. The sarcomata of the abomasum give rise in cattle to chronic indigestion and loss of condition. With the frequent cardnomata of the mamma of bitches, we sometimes observe metastatic formations in the internal organs such as the hver, uterus (with a foetid, sanious discharge from' the vagina), and lungs (with symptoms of puhnonary con- 4J4 CHRONIC CONSTITUTIONAL DISEASES. wmptkm). Periosteal generalised sarcomata in dogs may the lungs and carcmomata in cattle and horses, of tuberculosis • ete^If »«ch processes tot a considerable time, the animate become greatly emaaated. Ulcerations of the new gro^ are comphcated with continued septic fever ®^^ to J^^r* ^ °°* °* *^* '1"«»**°°' ^« ««» only attempt to^««gth« the system by good feeding and to dieck?he ^TiLZ.ZZ^ '' '-^ doses Of arsenic in the Scrofula. diJ^^jL^ W»toriad coUective definition, and not an independent «•«••«. According to old clinical text-book« fh« nrj./.i«.i '""~*'*"»'™' wuwu opmoia caued attention even in hia time. Other caam mrm *h»^ «« ~^ (Papally in pig.)..wine fever. par..it« Si:^;;^,:; S5I^r«i?"' Py*«^^.P<"y«tJ«itis in foals, and metMStic^SSS (strangles was formerly caUed " scrohda eauorum "\ t« .™^ •^™n«»« 4S5 CHAPTER IV. ADDENDA TO INFECTIVE DISEASES. By M. H. Hayes, F.R.C.V.S. SnK«A-TsiTSK-FLY DisEASB-SouTH Afeican Horse-Sicknks-Diseases CONVKYK, BY T.CKS-UlCKRAT.VE LyUPHANGITIS-NotES ON ErT zooTic Lymphangitis. SURRA. ■ GeneiEl lemukt on «irra-Sum in the horse-Surm in the dog-Sumi in nf- Sum in cattle. Bibliography.— The chief publications on surra are : Report on Surra disease in the Dera IsmaU Khan District, 13th November 1880, by Inspecting Veterinary-Surgeon G. Evans, M.D. ; Report on an obscure and fatal Disease among Transport Mules in British Burma, 1885, by J. H. Steel, V.S., A.V.D. ; Bacteriology, by E. Crookshank, M.B. ; Report on Horse Surra. 1893, by Alfred Ungard, M.B. ; Summary of further Report on Surra, 1894, by Lingard; Annual Report of the Imperial Bacteriologist for 1895-1903, by Lingard ; and Report of an outbreak of Surra and Filanasis at Kumal Depst, 1896, by Lingard. In compiling the following notes on surra, I have made use, chiefly, of the exhaustive researches of Lingard, who has been engaged in the investigation of this disease for several years in India. D«llnition.— Surra is a continuous fever which is charac- terised by alternate paroxysms and intermissions, and is caused by a specific hcmatosoon (Trypanmoma Evansi). History a&a DiAt^llratioti. — This dlaeaae, under the name of " surra " {Hind, rotten), appeus to have been known i«i 456 ADDENDA TO INFECTIVE DISEASES. ^Z^^rr}"* ^ °f *^''*' *** ^ ^-^y^ «>«»tn' on both Tn^^^^J °**11°° ^ north-west frontiS of InSa. Swg «pp«irs to have observed It in Persia during 1876. Evans found •evi^d cases of it in the Dera Ismail K^nlountry Md ^ ^e first, m 1880. to describe it. and to attri^te S'c^Z hf J«Zli ^ .* ?"*** "°°°« ""*« i° B^nna which he regarded as identical with Evans's surra, and which he beheved to be relapsing fever. Gunn observed TouTSc S 8urra among grass-cutters' ponies at Kohat in 1886 ; and NuttalL Tt^n^'r ?*^ *" *° °"*'''"«^ »°»°o« the Bombay Tramway Company horses. Since then. surrThas become STi: Z ^f?'^^' .A* ««f^a^ body and in a dry state. ^ are lolled or rendered inert by prolonged atmospheric Pathotf«nMis.~Surra is an ectogenous and also an endogenous disease. Its contagium is fixed and can be conveyed only by moculation or ingestion. Hence, in the ordinary •cceptaton of theseterms.it is neither contagious nor infectious. Stagnant water and grass growing on lately inundated knd form favourable resting-places for this oiganism. It is probable 2^™***ir Tl^ *'".*^*; '^'***-*y' P- 464) act as carriers Of surra from infected animals to sound ones, especially if the totter have open wounds. Surra'appears to be a purely enzootic disease. Lingard states that there are no records of its becoming rarootic m a country by its having been imported by sumj stncken animals. Although the disease may appear any time dunng the year, it usuaUy commences its invasion soon after the rams, and attains its greatest ascendency from September to December, both months inclusive. _- _ — -The clinical aspect of surra is essentiaUy one Of progressive anaania. accompanied by paroxysms and inter- ini««ons. during both of which there is a gradual decrease m the number of the red corpuscles and in the amount of haemoglobm m the blood, with consequent ansmia of the visible mucous membranes. Surra in the Horse. From an economical point of view, surra is essentiaUy an equme disease. ^ »hhS^^***?!1" ?* "*• Howe.-" The chief symptoms in addition to the fever are the occasional appearance of an urticarial eruption, general or localised, closely foUowing the first nse m temperature, but which may make its appearance at any time durjng the course of the disease ; then the presence of petechia on the mucous membranes, chiefly that covering themembrananictitans; lachrymation ; and the exudationTf a yellow semi-gelatinous material into the subcutaneous and other connective tissues. There is a rapid wasting and great weakness, although in tiie great majority of cases tiie apatite SURRA. 459 retaaha good throughout, no matter how high the fever. There 18 extreme pallor of the visible mucous membranes, and this w foUowed at a later period by yellowness. Fit>m first to last there IS progressive anaemia; the blood at first presents a normal character, but after a varying period of time undergoes mwked changes. The white corpuscles are increased in number and the red corpuscles usually cease to form normal rouleaux, lose their mdividuality, and run together, forming irregular masses, which are at first dark, but gradually, as the disease advances, ahnost entirely lose their colouring matter and become pale' (Lingard). The respective duration of the paroxysms and intermissions IS very irregular. Lingard puts it down at from i to 6 days. He states that in a few experimental horses the paroxysms lasted from i8 to 22 days. Anatomy.— As a rule, there is, post mortem, great emacia- tion, enlargement of the liver and spleen, petechias on various mternal organs, and a yeUow or an amber-coloured jeUy-like exudation m the connective tissue of the throat, chest, and abdomen, about the muscles and other tissues, and especially round the base of the heart. The lungs often show signs of umammation. The mucous membranes and other tissues are frequently tinged yellow by the colouring matter of the bUe. Steel noticed, post mortem, ulceration of the stomach which was not brought on by the administration of drugs or irritating food, m about two-thirds of his cases among mules in Burma. In India, this ulceration has not been observed among horses as a sequence of surra. Manner and Time of Invarion.— Lingard considers that surra is conveyed to horses in water and herbage, and in grain containing the faeces of rats and bandicoots affected with the disease. The Period of Inoubation seems to be liable to great variations. It may be put at 6 or 8 days after inoculation or ingestion of blood taken from an animal suffering from surra. It appears from Lingard's investigations that the period of latency may be prolonged to 13 days, if the blood used for moculation has been taken from a dead animal. When the parasites kave been given in water by the mouth, symptoms of surra may not appear for even 75 days. We have no ^ A^, .tS- yi' ^ ^ v^ IMAGE EVALUATION TEST TARGET (MT-3) 1.0 1.1 ■M 1^ 12.2 ■40 L25 1 1.4 120 1.8 1.6 F — ISOmin /APPLIED J \t\MGB . Inc iaS3EaMMirin8ii». nodmHr. NY 14600 USA Ptwna: 718M82-0300 Fax: 7ia/2ae-ssaB e lan. A(WIM klNgs. me.. M RIgMi ItaMnrt 4^ i 4^ o ^ 4to ADDENDA TO INFECTIVE DISEASES. •xact data for detennining the time required for the disease to become manifeit from driaJdng, mider uttural conditioiis, surra- contaminated water. DoMtioii off th« DiMMM.— Gnnn states that the aver- age duration of the disease is about 5a days. Surra is invariably fatal to horses, unless when treated with arsenic according to Lingard's method. Immniiltjr.— Lingard has proved that one attack of surra does not protect a horse from a second attack. PiftmnttoJ DIagnoria —Surra has often been confounded with kumree (paralysis of the Ibins) ; although the weakness from the general exhaustion of the one is entirely difioent from that due to the local paralysis of the other. The chronic course of surra and the manner in which the internal temperature varies serve to distinguish it from anthrax. 9fVghjlmM!UL—Tht best way to prevent the occurrence of surra among horses in countries in which it exists is : (i) to see that thefr water supply is pure ; (2) to avoid giving them grass or hay taken from marshy or inundated ground; and (3) to exclude the excrements of rats, bandicoots, and mice imm the grain, which, if this precaution cannot be carried out, should be parched. I may point out in passing that the fact of mice being immune to the effects of this disease is no proof that their feces might not contain the surra parasite. Besides, it would not be always possible to distinguish their dung from that of susceptible animals. There is some reason to suppose that exposure to cold and draughts predisposes a horse to surra. During an outbreak of this disease in the Parel stables of the Bombay Tramway Company during November and December, x888, the horses were exposed to cold night winds, and xo out of X74 died from surra. When means were taken to exclude these chilling winds, no fresh cases took place. The question with regard to the administration of arsenic to animals at the commencement of the rains, as a preventive, in districts where surra is epuootic, is one worthy of trial A dose of 5 grains of arsenic in the form of Uquor arsenicalis (10 drachms), given once a day in the drinking water to each animal, could not fail to produce a beneficial effect, and could with safety SURRA. 461 be continued for a month at a time. The doae of aiwnic should then be;'gradually reduced every three days by half a grain at a time until it is discontinued altogether. An interval of seven days should then be allowed to elapse, and again the same process persevered in with intervals, until the termination of the rains, or end of October " (LtHgari). L— Lingard having made very elaborate ex- periments with many different drugs (quinine, the double iodide of mercury and potassium, santonin, mercuric perchloride, car- bolic add, iodine, bichromate of potassium, etc), proved that the best medicinal agent for surra is arsenic, which has a well- marked effect in diminishing the number of the surra-oiganisms in the blood of affected animals. Great credit is due to him for having devised the foUowing method of treatment by which horses suffering from this hitherto invariably fatal disease have recovered: — " I. Only animals in good or in fairiy good condition an aniuble to ondogo treatment lor surra. It wiU be foond impnusticable to attempt to cure iU-preaerved animals, snch as Tonga* ponies, towards the end of a heavy and hard-worked season. " 2. It is of the ntmost importance for the soccessfnl treatment of snrra that the disease be recognised, and the animal subjected to the dnw with the least potsiUedeUy. »b ".« " 3- The weight of the animal shonld be ascertained frequently when pcacticabie, so that the nutTimnm dose of arsenic to be administered during the treatment may be regulated. " 4. Arsenic should be given in the form of liquor araenicalis. " 5. In most cases of snrra in equines. a dose of 5 grains may be commenced with, and given twice daily for 48 hours, the quantity being increased by half a grain after every 4 doses have been ad- ministered, until 7 grains are reached. The latter amount should be continued twice daily for 7 days in the case of an animal bdow 800 lbs. in weight ; but in Australians 1,000 lbs. in weight and upwards, the dose may be increased by the addition of half a grain up to 9 or even 10 grains, twice daily lor the same period. The dose should then be grsduaUy reduced by half a grain or one grain according to the condition of the patient, until a four-grain dose has been reached. Again, if possible, after a period of two days, repeat the treat- ment, increasing and decreasing the dose of arsenic as above described. But dke fact must never be lost sight of, that if arsenic be administered to an animal for a prolonged period, symptoms of gastric irritation will supervene sooner or later. It has been found that by giving kaunji [water in which rice has been boiled] to the animal, morning and evening directly after the medicine, the above-menticmed symptoms have not made their appearance; consequently it will be advisable to give kaunji to the animals from the commencement of the arsenical treatment. * A fonn of curricle used in the Bombay Presidency for poetii^ etc. 462 ADDENDA TO INFECTIVE DISEASES. " 6. Daily microwopic observation of the bk>od shonld be made, and th« number of organisms recorded on a chart for ready reference, together with the temperature, pulse, and respirations of the patient, which shonld be taken three times daily, viz. 8 a.m., i p.m., and 5 p.m. " 7. Most animals will take the drug in one or two pints of water from a bucket, without any trouble. If this be found occasionally impracticable, the arsenic can be mixed with the com and bfan in the form of liquor arsenicalu ; but in obstinate cases the medicine will have to be administered to the animal in the form of a bolus or in a draught. " 8. Acute desquamative nephritis is a common complication of surra, but it must not contra-indicate the administration of anenic, although the maximum doses cannot be Maintained, otherwise the animal will have a relapse, and ultimately snccumb to the disease. " 9. Animals suffering from surra, as a general rule, have voracious appetites. It has been found by practical experience that the following amounts of hay, com, etc., are necessary for an Australian hone weighing 1,000 lbs. and over; for on this the animal keeps in fair condition and during convalescence puts on flesh ra^dly : — Hay, 15 to 3o lbs. Lnceme (fresh), 10 lbs. Barley, 8 to 14 lbs. or Gram [an Indian pea], 6 to 10 lbs. Bran, i| to 3 lbs. Salt, li oz. i Daily. " 10. When once the organism of surra has vanished for some days from the circulation of the animal under treatment, gentle exercise, com- mencing with five hundred yards, and gradually increasing to one mile, morning and evening, may be allowed. But if the temperature becomes elevated, all exercise must be stopped, until the former again registers within normal limits. " II. The exudation of semi-solid material (oedema) into the subcu- taneous tissues, notably that of the lower extremities, sheath and under surface of the abdomen, generally becomes absorbed after a time under the influence of arsenic and exercise, but this may be accelerated by daily ' massage ' of the body and limbs. " la. Surra horses, under treatment with arsenic for long periods, and which eventually die, at their autopsies firequently present some atrophy of the spleen. Consequently subcutaneous injections of infusion of spleens have been made in order to ascertain whether the material injected would perform the function of the atrophied organ. Encouraging results have been obtained. " 13. Certain of the horse surra cases under treatment somewhat suddenly developed symptoms of chronic arsenical poisoning. These, which include partial loss of power over the hind-quarters, crossing of the hinj limbs when inking, and general unsteadiness, and nervous tremors, usually proved fatal within forty-eight hours, although the further admin- istration of the drug was immediately discontinued on their recognition. In some of the later cases under our treatment, these fatal symptoms have been successfully combated by the subcutaneous injection of infusions of spleen and testicle (sheep) " (Lingard). • SURRA. Surra in the Dog. 463 Since 1891, several cases of surra have been observed among imported fox-hounds and fox-terriers in the presidencies of Bombay (Bombay and Bandora) and Madras (Ootacamund) On exammation. in some of the cases, the surra infusorian wa^ found m the blood during the paroxysms. The symptoms were more or less, as foUows : " Paroxysmal fever, anorexia, at a later date swelling of the integument about the head and throat mjection of the conjunctival membranes, increased lacfaryma- tion effusion into the joints in some cases, and marked oedema of the hmbs and under surface of the abdomen, extravasations of blood mto one or both anterior chambers of the eyes, foUowed by opacity of the cornea, and later on total blindness "(Lingard) It seems not unlikely that foxes, jackals, and hyanas in India sometimes suffer from surra ; and that, when caught and worried by hounds, they are capable of transmitting the contagium to their camne pursuers. Lingard calls attention to the instructive fact that surra occurs among hounds during the hunting months (January to the end of March) ; but among the majority of other ammals, from June to December. Surra appears, in the large majority of ca««es, if not always, to be fatal to dogs. Surra in Rats. Lewis (Calcutta and Simla) found this or a similar organism in the blood of rats (mus decumanus and mus rufescens) ; Van- dyke Carter, in that of mus decumanus and mx 5 raUus ; Crook- shank, in that of London sewer-rats ; and Wittich and Kock, in that of the German marmot {cricetus frumehtarius) ; Lingard (Bombay Presidency) has demonstrated the surra infusorian in the blood of rats and bandicoots (mus giganteus of Hardwicke), " The blood of rats from certain localities was almost always free from the haematozoon, while that of the majority of rats from other localities was affected. The haematozoon of the rats appears in and disappears from the circulation at irr^ular in- tervals, thus producing paroxysms and intermissions, as in the case of surra in the horse. The presence, in varying numbers, of the haematozoon in the circulation of rats does not appear to produce any noticeable symptoms in the great majority of them. But some few rats whose blood swarmed with the hsmatozoon have succumbed to leucocytosis, with extravasations of blood, containing the organism, into the anterior chamber and vitreous humour of the eye, opacity of the cornea, enlarged spleen, and 464 ADDENDA TO INFECTIVE DISEASES. extravasations of blood, or in some cases ulceration of the mucous membrane of the stomach " {LiHgari). SURKA IN CATTUE. As already mentioned (p. 456), surra in India is a rare and benign disease among cattle. " Although during the paroxysms of the disease the blood of the bovine species teems with the h«- matozoon, and their bodies become extremely emaciated, never- theless ultimately they recover and in time become fat and sleek again " {Lingard). TSETSE-FLY DISEASE OR TRYPANOSOMATOSIS {Nagana). The so-called true Tsetse-fly (Gfosstiw morsHam) is the carrier of a hsematozoon (Trypanosoma bntcei) which produces this disease. It belongs to the diptera, and is somewhat larger than the true house-fly. " The brownish wings lie closed flat over one another down the back, Uke the blades of a pair of scissors, while the proboscis (».«. the proboscis ensheathed in the palpi) projects horiamtally in front of the head. As pointed out by Col. Bruce, the dosed wings thus give the fly 'an ekngated appearance.' Measured from the tip of the proboscis to the end of the ckned wings, the length of the Giosstna moraitans is about half an inch" (Austen). Tsetse-flies are confined to Africa, and have been found in various districts 9n the eastern coast, from Zululand to Somali- land, inclusive ; on the western coast, from the Congo river to the Senegal river; south of lake Chad; and elsewhere. "As a general rule it may be said that the Tsetse is confined to damp, hot, k>w-lying k>calities, either on the borders of rivers or lakes, or at any rate not far from water. Cover in the shape of more or less thick bush or forest is essential, and the fly is not found on open grass plains " (Ausien). There are various kinds of Tsetse-flies, all of which have a prominent proboscis, and both sexes are blood-suckers. Owing to their bkiod-sucking habits, Tsetse-flies greatly torment domestic animals which are in their haunts. "The fly makes a bud buuing sound when flying, but after its feed and at rest, it emits a peculiar sharp, shriU note " (Bmct). "During the hottest hours of the day they are most TSETSE-FLY DISEASE. 465 aggTMBve, but they bite at any time, even at hight. when it is a bnght moonlight. Their flight is powerful and noisy; the buTz is fun-toned and somewhat highly pitched-not dull and dronrng Uke the buzz of the ordinary horse-fly; they do not settle as slowly as the horse-fly, but land with a bump, standing weU up on their legs. . . . He inserts his proboscis, lowers his hesui, and raises his abdomen untU it is ahnost vertical. When domg this, and for some Uttle time after he has com- menced sucking, he works his wings, buzzing in a minor key. rather like a bee when held forcibly, though not so powerfully. When the keenness of his appetite has been somewhat appeased he stops working his wings and sucks in silence. If left to himself, he wifl suck until his originally skinny barred abdomen become a large crimson bead. He is then ahnost helpless; if touched he will not fly, and if brushed off, he wiD only go a yard or two. to settle heavily on a bush, or gradually sink down to the ground " (Cramskmy). "It is astonishing with what rapidity the flies fill them- selves; m as smaU a space of time as twenty or thirty seconds a fly will become swoUen out like a baDoon with bright red bk)od" (Bmee). The blood-patasite of this disease lives in the btood of many lands of wild animals in Africa, apparently without injuring them m any way. but when the Tsetse-fly takes it up in its proboscis and injects it into one of the domestic animals death soon follows as a rule. Usually the bite of the Tsetse is harm- less to man, although trypanosomatosis in man has lately been observed in Africa. Thdler states that the Tsetse-fly is dependent for its exis- tence 00 big game, in the bkwd of which. Brace frequently found trypanosomata ; and that the more big game are pressed back by the advance of white men, the more the disease disappears. The Tsetse-fly shows great dislike to the smell of excrement, which, on that account, has often been used as a preventive, by smearing it over animals which have to pass through a Tsetse- fly ances somewhat similar to those of surra. This observer, fcrs' Club Committee " {Meek and Greig Smith)i Sheep bred on infected pastures acquire a certain amount of immunity. Symptoms. — Reflex irritability is greatly increased; the temperature is raised ; rate of pulse ana re« piration accelerated ; and the patient exhibits various forms of nervous disturbance, such as convulsions, spasms, paralysis, trembling, squinting, and wry neck. The spasms in some of the muscles are tonic, in others, clonic. The more or less characteristic trembling is due to clonic spasms. " The disease can be recognised by the more or less complete paralysis of the body and limbs. Symptoms may succeed one another very rapidly, or may spread over some length of time. The animal at first loses control over the muscles, which are seen to twitch convulsively. It may fall down and struggle on the ground, sometimes jumping up again, often to some height. Between the fits it is often seen to stand trembling. These symptoms are frequently accompanied by frothing at the mouth. Some such appearances are the usual outset to the disease, and are followed by a paralysis which usually affects the hind limbs, but may also include more or less of the body and head and neck. The feoe limbs are oftoi similarly paralysed. The affected limbs become cold to the touch. The paralysis neces- DISEASES CONVEYED BY TICKS. 479 •arily brings the animal to the ground, though it may be able to crawl about by the aid of the unaffected legs. When the head and neck are affected, the former is usuaUy drawo to one Mde. and the eyes often become obUque. Excitement is greatiy mcreased when the animal is disturbed. The symptoms then, in a few words, are more or less complete paralysis, pre- ceded as a rule by fits and trembling. "The small number which recover present a ' wry neck, stiff jomt, high back, or other deformity ' (Hawick Express). During recovery, swellings occur at the joints ; these may be pierced with good results, giving a large discharge of pus. According to Fair (Veterinanan, vol. viii.), ' these abscesses usuaUy appear in the neighbourhood of the joints, but sometimes above the arms the brisket, or any neighbouring part of the body ' " {Meek and Gretg Smith). ■tlolotfy and P»4hog«ii6«l«.— Williams, who has done much good work in the investigation of this disease, has formed the weU-reasoned-out opmion that ticks are the vehicles of the virus. The conclusions at which he has arrived on this subject are as foUows : " (i) That where louping-ill existed, there the tick was sure to be. (2) That where the parasites were absent there was no louping-ill ; and it is a remarkable fact that upon ground having a westerly or southern aspect ticks and louping- ill prevail, whilst on adjoining grounds with easterly or northerly aspects, upon which the grasses are short, thus providing no cover for the ticks, the disease is rare. (3) That the appearance of the parasites on the sheep in April and early summer was con- comitant with the annual outbreak of the disease. (4) That in Skye, where it is said the disease appears both in spring and autumn, the tick being also there in autumn as well as in spring " Although the connection of ticks with louping-ill appears to be absolute, the fact of ticks being found aU over the world on land, free from louping-ill, is a strong reason for thinking that the ticks are only a vehicle for the virus. Williams further notes the mteresting circumstance that the destruction of the natural cover of the ticks by ploughing up and liming the old grasses is followed by the eradication of louping-ill. The following experiment, conducted by Meek and Greig Smith {Veimnarian, December, 1897), supports to a certain extent the conclusions of Williams as to the pathogenesis of the disease. These two observers turned out on louping-ill infected gpround ao sheep, 6 being muzzled so as to prevent them 4«o ADDENDA TO INFECTIVE DISEASES. from feeding on the grass of that land, 7 beng dressed mitb a composition (sweet oil, 2 quarts ; castor oil, x quart ; train oil, I quart ; pitch oil, | pint ; and cade oil, i pint) calculated to keep off ticks, and 7 being aUowed to grase without being either muzsled or dressed. Of the 6 muszled ones — w^ch were fed night and morning on hay and turnips obtained from farms which never had the disease— 2 died of loupmg- ill ; there was one casualty from this disease among the 7 wUch were neither muzzled nor dressed; but all the 7 dressed sheep remained healthy. Meek and Greig Smith have found that the tick inoculates two pathogenic genms : one a pas organism ; the other, a bacterium wiaxii produces in rabbits tetanic spasms and post mortem appear- ances, similar to those of Umping-iU. DiflJurantlal DI»gno^is.— Anthrax and braxy are often mistaken for louping-ilL I would suggest the same possibility with regard to tetanus, which may be distinguished by the freedom from cerebral disturbance and the tonic character of the spasms of particular groups of mnades. The altermtions due to cerebral and qnnal congestion found, fost mortem, in lonping-ill cases, are absent in those of tetanus, in which there axe littk or no pathogenic changes. In both anthrax and braxy there is rapid decompodtioa of the cadaver, contnuy to what occurs m louping-ill. Iwatiwr-y — The pathological changes are chiefly limited to the brain and spinal cord, and generally consist in congestion and inflammation of the meninges, and increase in the amount of the ceiebro-spinal fluid. The pleune and pericardium are often affected with renilting serous effusion. Williams states that the flesh is usually pale, and that as a rule no really charac- teristic lesions are to be found. The cadaver resists decomposi- tion for a comparatively long time. Prophylaxia.— Meek and Greig Smith, agreeably to the observations of Williams, point out that as the larvae of the ticks die if they do not find a suitable host in eariy sununer, the farmer would do well to bum down the old withered grass on infected lands during the autumn, and to ke^ sheep off such pastures as long as the lotqnng-ill season continues. The advisability oi breaking up and liming the land, as reconunended by Williams, or dressing it w^ salt, is sdf-suggestive after we ULCERATIVE LYMPHANGITIS. ' 48, have grasped the fact that the tick requiret an animal host in at least one period of its development The length of time necessary for an application to remain effective, militates against the benefit to be obtained from dippmg and dressing as means for destroying the ticks on the >heq), or for preventing these parasites from lodging on the skin of these ruminants. Pw» ass, mule and the bovidc are susceptible to this disease ; but the dog, cat, calf and pig are immune " lCagi$v andGobert). ^ ' Episootic lymphangitis is easUy transmitted from one horse to another. 31' CHAPTER V. NOTES ON BACTERIOLOGY. By George Newman, M.D., D.P.H., F.R.S.E., etc. Fomurly Demonstrator of BacUrMogy in Kin^s College, London, Joint- Author of {' BacUriology of MUk" and Author of " Bacteriology and the Public Health," etc. These Not« are intended to awitt those readers of this book who are not convsriMit with bacteriological methods, to imder* stand tht bacteriological p(»tion of the text. They are in no sense intended to be a detailed statement on the modem methods of bacteriology.* 01«Mlfloatlc purposes, bacteria are usuaUy classified as Rods {BacUH) whose length is greater than their breadth and whose sides are parallel. Round cells (Micrococci). Spiral forms {Spirilla, Vibrones, or spirochata). which are curved rods that, on uniting, form wavy S-shaped chain-hke, or spiral threads (filaments). ' The tenn bactmum (Gr. /S«T,Jp«»,, a smaU rod) is now used. espeoaUy m the plural, as a generic name to cover all the miCTo-oiganisms, whether rods or round cells, and the term bactUus is confined to those which are strictly rods. Bacteria may be divided according to a variety of characters °J !!^u°"- " *^*y ^ *=^'"^«* according to their condition of growth m respect of oxygen, the classification would be as loliows : — 1. Probes, which, like BaciUus subtilis, require air (oxvirenl for the maintenance of their hfe. «r loxygen) 2. Anarobes. which, iike the bacilli of tetanus, malignant oedema and symptomatic anthrax, cannot live in the presence ot oxygen. *^ Facultative anarobes grow moderately well under a free supply of air. or when oxygen is entirely excluded. To this group belong most pathogenic organisms. Obligatory taohea z. 2. 3- 4M NOTES ON BACTERIOLOGY. cannot, or can only to a very slight extent, grow without oxygen. Obligatory anaerobes are unable to grow, or only feebly, unless oxygen is excluded. If, on the other hand, bacteria be divided according to their method of nutrition, the classification would be as follows : — 1. Parasites, which feed on, or at the expense of, another Uving organism (animal or v^etable), and whidh may be divided into (a) obligate parasites, and (b) facultative parasites. The former, Uke the bacillus of leprosy, can grow only in their animal host. The latter, like the badUus of anthrax, are able to vegetate both in the animal budy and apart from it. Most pathogenic bacteria are more or less true parasites. 2. Saprophytes, which obtain their nutriment from dead organic matter, play an important part in the economy of nature in breaking down complex substances into simpler com- pounds, which may again be taken up and assimilated. Thus carbon and nitrogen are supplied to the higher vegetation which is necessary . jr life in the animal kingdom. Hence the majority of bacteria, being saprophytes, must be looked upon as essential to Ufe. In a limited sense all the parasitic bacteria which can be subcultured outside the body are saprophj^c. Blicro-organisms may also be divided into path(^;enic (or disease producers) and non-pathogenic; or according as to whether they liquefy gelatine or not ; or by their products ; or by their behaviour in artificial media ; or according to the method by which they are stained ; etc. Further, it has been observed that bacteria may be classified not only by the form of the individual elements but also by their respective mode of arrangement to each other. These different arrangements and groupings are respectively peculiar to different species. For example, a diplobacillus is formed by the trans- verse division of a bacillus into two parts which continue to remain together ; leptothrix consists of long rods or threads which have no branches; and cladotkrix, of long rods or threads which have branches. Amicrococcus is a single small round cell ; the diplococcus, two divisions of a single coccus with or without a capsule (as in Diplococci of Pneumonia and Gonorrhoea) ; a streptococcus is a chain of cocci each more or less a part of its neighbour, in longer or shorter chains, and sometimes in rosaries, as in Streptococcus of Pus and Erysipelas. The Staphylococcus (Gr. ora^vAtt, a bunch of grapes) is a mass of round cells as occurs in the various Staphylococci of Suppuration. Sardnce BIOLOGY. 487 are packets of cocci in one plane, and tetrads are small square masses of cocci produced by division into four parts in two planes at right angles to each other. Again, we have different elements, or different arrangements of elements, having further characteristics— «.g., many of the bacilli have terminal or lateral flageUa, which are long or short threads of protoplasm, not staining readily, and by their vibration causing progressive movemeqt of the bacillus {e.g., Bacillus Typhosus). There is another marked difference which must always be borne in mind, namely, that due to polymorphism, which, amongst other things, gives rise, under abnormal conditions, to involution forms. These are degenerate forms and assume various shapes and sizes, diverging in a high degree from the normal. All these characters and modifications may and do serve as bases for classification. A convenient general classification is into the Lower Bacteria (cocci, bacilli, and spirilla), and Higher Bacteria (Leptothrix, Cladothrix and Streptothrix— one of the most important of which group is the Streptothrix Actinomyces). Biology. — Bacteria are composed of a body of more or less homc^eneous protoplasm, though many substances may be found therein. Sulphur, starch, and, in some organisms, pigment have been observed. Amongst the last-mentioned may be dted Spirillum rubrum (which is exceptional in not requiring free oxygen for its pigmentation), M. prodigiosus, B. pyocyaneus (except when cultured at 44° C), and B. violaceus. In addition, we may frequently detect in the body of a bacillus small granules which, owing to their staining pro- pensities, are called meta-chromatic granules. They should not be confovmded wth polar bodies, which are occasionally found at the extremities of bacilli or spirilla, and which, in their turn, should not be mistaken for spores. Nencki has pointed out that 85 per cent, of the substance of the body of a bacillus is composed of albuminous matter which he termed mycoprotein. Around this there is frequently a capsule of cellulose. Bacteria are reproduced by fission or spore formation. The micrococci multiply by simple division, and, generally speaking, bacilli do the same, though they never divide longitudinally. The method of fission is simply that a slight indentation occurs which becomes a more and more marked constriction up to the point of separation. " Spore Formation " may be either inside the cap- sule of the bacillus — endospore — or onteide as part of the chain of cells — arihrospore. Endospore formation is well seen in the 4M NOTES ON BACTERIOLOGY. bacillus of Anthrax. The protoplasm becomes granular and the small specks enlarge into encapsuled, oval, sharply-defined bodies growing at the expense of the protoplasm of the bacillus. Eventually, either by exhausting the bacillus or bursting its capsule, the spore escapes. It fulfils its function like a seed, not producing other spores but germinating into a sma'I bacillus. The capsule or the concentrated protoplasm of the spore, or both, afford it a very high degree of protection from inimical influences, such as desiccation, heat, or chemicals ; especially is this the case with the spores of Anthrax, which can retain life and virulence in a dried condition for weeks and even months. Spores may occupy different positions in the bacillus in different species— for example, in the bacillus of Malignant (Edema or of Quarter Evil, the spore is generally situated nearer the end of the rod than the middle. We have also truly Urminal spores in the bacillus of Tetanus, which then simulates a dnmi'Stick or tin-tack. Again, though bacilli of which Anthrax is the type, have spores of a less diameter than themselves, the bacillus of Malignant (Edema produces a spore which is of greater diameter than itself and which bulges out the badllary capsule. It is important to note that spore formation is not so much a multiplying stage as a resting one. One individual does not produce more than one spore and that spore only produces one bacterium. Bacteria are motile or non-motile. The motility may be considered as progressive or non-progressive. The former is due to flagella either lateral, or terminal, or both, as in bacillus typhosus. The non-progressive is undulatory or rotatory, but without any advance being made. All movement is accelerated by heat, and inhibited by cold or colouring reagents. PvodttOto of Baotarla. — ^The following are among the chief products of bacterial life :— z. PigmttU. — ^These chromogenic organisms as a general rule possess little or no pathogenic action. Light and oxygen are generally necessary for the production of pigment. 2. Ftrmmta, such as the peptic ferment, or that which splits up sugar, or that which coagulates casein in milk. 3. Gaset, such as carbonic acid or methan. 4. PhosphorisctHce, which occurs mostiy in sea-water organismsi PRODUCTS OF BACTERIA. 489 5. Chemical Products of the nature of Toxins : soluble substances produced by the bacteria and gaining access to the blood or Ijmaph stream. In the causation of disease by micro-organisms there are thCTefore these two mai' actors : the living organisms, multiplying and passmg in many cases throughout the body ; and the chemical poisons produced by them and which act locaUy and generally and react again upon the organisms which have been their source. In some cases the organism remains more or less local as m the diseases of Tetanus or Diphtheria, and from its local situation produces its toxins, which by means of the circulation are carried throughout the body, bringing about the clinical symptoms and signs of the specific disease they represent. In other cases, hke Anthrax, the baciUi themselves pass to all parte of the body and are found even at its peripheral portions producing their poisons. It is true the organisms and poisons either separately or together, may and do cause tissue change But It must not necessarily be supposed that the poisons are merely secretions of the living bacteria and would occur in the same way outside the body ; for in many cases they are formed mdirectly by the medium of ferments, and are always influenced by, even as they influence, the living tissues of the body which is invaded. As bacteriology has advanced emphasis has in a marked manner been placed less upon the organisms per se, and more upon their products. The action of bacteria, as mechanical irritants, plays a very smaU part in the processes of disease. Muir and Ritchie have pointed out the two-fold effect of bactena in the tissues :— (i) the effects of the bacteria them- selves resulting in two characteristics, viz. : tissue change and symptoms. The former occurs locally at the seat of inocula- tion, and is of the nature of inflammatory reaction, acute or diromc. Sometimes the lesion has a special site, as in Typhoid Fever or Diphtheria ; in other cases, like Tubercle or Anthrax, It depends upon the point of inoculation. The final result in the tissue change wiU of course depend upon the dose of bacteria as regards quantity, quality and specificity, and also upon the resistance or otherwise of the tissues ; it may be a com- paratively transient inflammation or actual degeneration and necrosis. (2) The toxins produced by pathogenic bacteria bnng about the specific characteristics of the disease, e.g., in Diphtheria or Tetanus. These toxins are, as has been pointed II 490 NOTES ON BACTERIOLOGY. out, not) necessarily mere secretions of the bacteria ; but are the result of the effect of ferments produced by the bacteria. It may be well here to remark that the association of germs with disease is not of recent origin. Long ago they were found to be present in anthrax and other diseases, but their mere presence in the blood or tissues is not of course sufficient evidence of their being the actual cause of disease. It is now generally agreed amongst bacteriologists that the following conditions (Koch's postulates) must be fulfilled before any micro-organism is held to be the specific cause of any par- ticular disease : — 1. It must always be found when the disease is present. 2. It must be isolate^, and cultivated outside the animal body. 3. It must, on inoculation, produce the disease. 4. The same micro-organism must be separated from the newly infected animal. Latterly, the plan of obtaining the toxin and producing the disease by its means, is coming to the front as an additional test of the specificity of an organism. Ghannels of Infeotion.— The possible modes of infection are as follows : — 1. Hereditary transmission, by which organismal diseass* are conveyed to the foetus from the maternal circulation, is on record, but it is obviously a channel in which there is little or no possioility of investigation. 2. Inoculation. Many diseases are artificially inoculable, but few are spread by this means. One of the best examples is malignant pustule (Anthrax). The commoner methods of experimental inoculation adopted in bacteriol<^cal investiga- tion are the following : (a) intravenous ; (b) intraperitoneal ; (c) intra-octdar ; and (d) si^utaneous, generally in the groin, and used in tuberculosis as a test of the presence of the bacilli in milk, etc. Spraying fine solutions of organismal culture into the trachea or nostrils and ingestion of food contaminated with bacteria or their toxins are methods which are adopted occa- sionally. 3. By contagion-or entrance through an unbroken surface of skin. This is open to question, ans/ probably further know- ledge respecting the propagation of disease will diminish the number of those spread in this manner. CHANNELS OF INFECTION. 491 4. By the respiratory trad: this channel of infection is supposed to be frequently the means of spreading anthrax, tuWde, diphtheria, scarlet fever, and similar diseases. Its consideiation opens up the large question of micro-organic life in the air. We can only mention one or two of the outstanding facts respecting this wider question. Tyndall* was one of the first to record the common existence of bacteria in the air and their 1. tion to wet and dry surfaces. Dr. Russell of Glasgowf applied Tyndall's researches to practical sanitation. He pointed out that moist surfaces do not give off soUd bodies " either by evaporation or under the influence of air currents " ; that the locomotion of micro-organisms in the air is passive, not active ; and that all organisms, even those which are microscopic, obey the law of gravitation. If these three axioms are true, it is obvious that in still air surrounded by damp surfaces we have, practically speaking, no organisms at all. And approximately this is so. Applying these facts to infectivity through the air we may understand that mucus, discharges, wet excreta, wet sputum, and all other similar vehicles of bacteria will not, so long as they are moist, part with any virus to the surrounding air, If the air is periodically or habitually infective, it is made so by desiccated hquid discharges or cutaneous exfolia- tion. But so long as the vehicle of micro-organisms is moist, it will not disseminate germs in the air. Msmufacturers act upon this principle in their treatment of anthrax-loaded material. Before being disturbed, a bale of infected hair is immersed in water and allowed to soak, and the bale loosened in order that the water may gala access to every part. The workers are not allowed to touch the hau: until the badllary dust becomes wet, and they are required to sort out the hair while it is in that condition. Thus a dangerous process may be conducted in comparative f afety. When infective dust be- comes turned into mud, it will not spread disease. Further than this, even supposing the air to be heavily iaden with germs, it does not necessarily follow that they will obtain entrance to the human tissues. Professor Sims Woodhead has pointed out that adenoid tissue, if its cells are active, whatever its situation, is a means of protection, for the reason that it contains an enormous number of active cells which are capable of taking up large numbers of micro-organisms and destroying them. • The Seating AfatUr tftlU Air. ijmr. tfHtjnU Institut* »fP»MU Health, Sept 1896, p. 407. 493 NOTES ON BACTERIOLOGY. There is, as is well known, a ring of such lymphoid tissue sur- roonding the entrance to the trachea, and another round the entrance of the oesophagus in man and other mixed-feeding animals. Yet, as Woodhead has further pointed out, it is possible— especially perhaps in pigs — that this lymphoid tissue may act as a medium for the conveyance of the disease from the outer surfaces to the tissues beneath. However that may be, it is now accepted as an estabUshed fact, that the contained air within a moist perimeter is practically free from organisms and non-injurious as far as infection is concerned. But when discharges, etc., become dry, then the respiratory tract is the common channel of infection. 5. By the alimentary canal. — Water, milk, and foods are three of the commonest vehicles for bacteria. Typhoid, cholera, epidemic diarrhoea, tuberculosis, suppuration, actinomycosis, anthrax and many other diseases have at different times been conveyed in the food of man or animals. Probably the com- monest habitant in the alimentary canal is the almost ubiquitous B. coli communis, which in man must be differentiated from B. typhosus. It need scarcely be pointed out that although pabulum for organismal life is abundant in organically pol- luted water and milk, it is practically non-existent in the air. In all bacterial diseases it is desirable to detect if possible the locality and mode of entrance of the specific organism to the tissues. Mathoda of Baotorlologioal Examination.— Broadly speaking there are three chief means by which knowledge is guned respecting bacteria, viz.: (a) Examination by the microscope ; (&) Cultivation on artificial media, and (c) Inocula- tion of animals. By the first means, morphological facts are obtained ; by the second, something is learned of the biology of the organism ; and by the third, facts are elicited respecting its pathogenesis. A few notes will be added on each of these lines of investigation. I. EXAMINATIO.^r BY THE MICROSCOPE. Micro-oiganisms may be examined under the microscope* in their natural unstained condition, or stained in such manner as to demonstrate their form, etc. * A good microscope is essential. It should have objectives of i inch, h and -ff (oil immersion). A white light, and proper adjustment of the sufastage condenser and dww-tube are also necessary. A lens ai ^th inch focal depth is the nsual power required for the stutothrix * Aniline gentian violet is made bjr adding one part of a latuimted solution of gentian violet in alcohol to ten parts of aniline oil water. The iodine or Gram's s«l$itim has the following composition :— Iodine one part, potaiaium iodide two parts, distilled water 300 parts. Eoain may be used in strength of y^s of water. EXAMINATION BY THE MICROSCOPE. 495 actinomyces, or s^eptococcus ffyogtnes bovis, are generaUy stained by Gram's method. It wiU be understood that the above is the method of Gram adapted to the staining of tissues. It is, however, still more used m general practice in the staining of sUde specimens. The method for this purpose is as follows : Place a small droplet of distilled water in the centre of a thoroughly clean sUde. With the point of a fine platinum needle take up a trace of the culture under examination and inoculate with it the water on the slide. Spread the droplet which now ought to have a cloudy appearance, in a thin even film by genUy moving the needle in a circular direction. Dry by waving the slide to and fro in the heated air above a Bunsen burner or spirit lamp. A weU spread film should have the appearance of a thin opaque cloud of even density, just visible on the surface of the sUde. The staining procedure is then as follows : — 1. Allow two or three drops of the gentian-violet stain to fall upon the slide and remain in contact with the fihn for five seconds. 2. Wash off the stain vrith the iodine solution appUed from a drop bottle for five or six seconds. The fihn should then be black or dark brown. 3. Wash off the iodine solution with a mixture of i part acetone and 2 parts alcohol absolute, but allow to remain in contact for two or three seconds only. 4. Wash off with absolute aloAol, applied until no more stain comes away. f Wash in water, blot off superfluous water, and set aside to dry. If thought desirable, the preparation may be counter- stained by the application of a very weak solution of Ziehl- Neelsen. Gram's method of staining has been used as a means of classification of organisms into two groups, those which stain (e.g., B. antkracis) and those which do not stain by this method {e.g., B. typhosus). ' Ziehl-Neelsen's method is used chiefly for the bacilli of tubercle and leprosy, and for staining spores in bacilli. The carbol-fachsin solution employed in this method is prepared by mixing *^ *^ 100 parts of a 5 per cent, solution of carbolic add. I part of fuchsin. zo parts of absolute alcohol. 496 NOTES OS BACTERIOLOGY. The various stages of this process for staining a tiMoe secHoH may be described as follows : — 1. Heat slowly the carbol-fuchsin solution (with the specimen in it) in a glass capsule on a sand-bath, in order to distribute the heat evenly. When the solution begins to give off steam, remove the capsule to the side of the bath, and allow the section to remain for five or ten minutes. 2. Remove the section from the carbol-fuchsin and place it in a capsule containing a 33 per cent, solution of sulphuric add or of nitric acid, to decolourise it. In the acid the tissue loses its bright red colour and turns a pale yellow. Alternately remove it from the acid to the plain water and back again until it is of a faint pink colour. 3. Wash well to remove any of th« superfluous stain.' 4. Place in a capstile rontai^ng a saturated aqueous solution of methylene blue for one to two minutes. 5. Wash with water. 6. Pass through a 60 per cent, solution of alcohol in order to dehydrate. 7. Place in dove-oil to dear. 8. Mount in Canada balsam. For staining by the Ziehl-Neelsen method an ordinary film proceed as follows : — The film is prepared in the usual manner, dther, for ex- ample, from the particulate matter of milk after centrifugalisa- tion or from the lesions of an experimental animal, and fixed with alcohol and ether. Then stain as follows : — 1. Allow two or thrse drops of Ziehl's carbol-fuchsin to fall upon the film, and heat dther over the flame or upon a warm stage. 2. Allow to act for three minutes, replacing with fresh stain any loss by evaporation. 3. Wash well in water, and treat with 25 per cent, sulphuric add, or 33 per cent, nitric add, until the film remains de- colourised when washed with water. 4. Dry between layers of fine filter paper, and counter-stain with Leer's alkaline blue. 5. Wash thoroughly, dry, and examine. If nulk is tmder examination it should first be centri- fugalised.* The centrifuge tubes must be thoroughly deaned * If no centrifuge is avaihble the milk most be placed in a sterilised conical flask in the following manner: to 50 cc. of milk set for sedimentation, 10 c.c. of liquefied carbolic acid crystals are added. The mixture is thoron^ly ACID-FAST BACILLI. 0» with wato-, followed by soaking for tome minutes in strong sulphuric add or nitric add, then riuaed in tap water, distilled water, and finally rectified spirit. It is better not to place mon than about an inch depth of milk in the tube. The centrifiige should be whirled for at least two minutes. In the case of milk stained by this method, the bacilli of tuberde or other "add-fast" organisms will be stained red, and the milk or casein cells blue. It is important to recognise that the non-pathogenic " add- fast" bacilli will be stained by this process as well as the pathogenic tuberde-bacillus. Some twenty different add-fast Mganisms have now been isolated from milk, butter, grass, soil, dust, manure, etc. As this point is of great importance in differential diagnosis, it may be desirable to refer briefly to the subject of these "add-fast" baciUi. The chief points for differential diagnosis between this group and the true tuberde bacillus are five:— {i) The tuberde badUus shows a fairly uniform manner of growth; (2). it requires in- cubation temperature for growth in culture media ; (3) it is unique with respect to its excessivdy slow growth ; (4) it is as regards growth and propagation a parasite ; and (5) on inocula- tion it produces pathological cellular changes distinct from the nodular new growths following inoculation of add-fast bacilli. In particular this is true» as far as is known at present, in regard to the human organism. In a sentence, the add-fast bacilli differ from the tubercle bacillus in three main particulars, viz. : morphology, conditions of devdopment (chromogenidty, rapidity of growth, and wide range of temperature within which they flourish), and their feebler pathogenic properties. From these facts it follows that however great the degree of similarity between these various add-fast bacilli, and however much it is possible by artifidal cultivation to modify the morphology of the various forms, there is suffident difference to enable a differential diagnosis to be made if all the biological characters are ascertained, and most of ali the pathogenic properties. Hence the importance of the ma . ation test b^ig i4>plied to all add-fast and tuberde-like (»ganisms detected in millr or butter. The pathological differetices from Koch's badlhis are that inocu- lati(Hi with add-fast bacilli gives rise to no " giant cells," no epithelioid cell dusters, and no tuberculous caseation. Nodular shaken and poured into a tall conical glass. After standing for twenty-four hours a little of the sediment is taken fay means of a sterilised pipette and the film made. 3» 491 NOTES ON BACTERIOLOGY. kmont occur luggestive of tubercle, but according to Potet, and Abbot and Gildertleive : («) they constitute a localised lesion ^'^y* luving no tendency to dissemination, metastasis, or pro- grease destruction of tissue by caseation ; (6) they tend to terminate in suppuration like wdinary abscoses; (et when occurring as result of intravenous inoculation they appear in tlM kidney, rarely in the lung and other organs; (d) the form of granukmu set up is similar to actinomyces. This group of ocganisms is one of considerable importance to the milk bacteri- ologist, and in all investigations dealing with the tubercle bacillus, or with milk and its p.'oducU, it is essential that the add-fast badUi met with should be clearly differentiated from the tubercle badlhis. Not sufficient care has been taken in this respect up to the present. Any such organism found should be compared in cultural and pathqgenic properties with the human tubercle badUus, the bovine bacillus of pseudo-tuberculosis and the various add-fast organisms, and not simply accepted on tmctorial properties as tubercle badUus. TlM StolBliig of ■p«rM.-The foUowing are the methods commonly adopted: Mmtr's mttkod. (•) Prepare the fihn as usual, fix and dry, observing the precautions taken in preparing milk specimens. (*) Treat with alcohol for two minutes, and then with chloroform for two minutes ; wash in water. (c) Treat with chromic add, 5 per cent, aqueous sohition, for frcMn one to two minutes ; wash and dry. (d) Pour on freshly filtered carbol-fuchsin and warm gently till it steams ; allow it to act for ten minutes and wash off with water. («) Decolourise with sulphuric add (5 per cent.) and water alternately, to remove the carbol-fuchsin from the bacilli but not the spores. (/) Dry and counter-stain with Laffler's blue until the fihn is of a faint bluish tint. Wash off stain, dry and examine. The spores will be stained red and the bacilli blue. ZiM-Nedsm method. (a) Stain the film as for tuberde bacilli. (6) Decolourise with i per cent, aqueous solution of sulphuric add, or alcohol 2 parts, acetic add i per cent., i part. CAPSULE STAINING. (e) Coanter-ttain with UMBer't blue. (i) Wtih, dry, and examine. 0»pral« MUining.-MtKC tained in a test tube, and which has been sterilised and allowed to cool into a solid state while the tube was placed in a slanting position, in order to afford a large inoculation surface. Stab cultures are made in solid nutrient media contained in test tubes. The inoculation is effected with a sterilised platinum needle on the end of which a minute portion of the cokmy is taken up, and the needle is inserted for about an inch or more in depth into the nutrient medium along the middle axis of the tube, under the usual precautions against contamination. If the organism under examination is an aerobe, it will grow only on the surface of the medium ; if an anaerobe, only in the track of the needle ; and if a facultative anaerobe, it will grow both on the surface and in the track. We may obtain valuable diagnostic information from the presence or absence of liquefac- tion, gas-formation, rapidity of growth, or pigment production ; and especially from the appearance of the colony in the track and on the surface. Moreover, when the oiganism is thus isolated in pure culture its further study is practicable. The badlhis of Diphtheria grows very rapidly (i2 to 24 hours), and appears as small scattered white colonies having a darker centre. Non-liquefying. The badUus of Anthrax pro- duces an arborescent growtii of fine branching threads running out horizontally from the track of the needle. Liquefying gelatine. The Cholera badllus has a characteristic mode of liquefaction. Koch's comma bacillus produces one large bubble at the point of inoculation which slowly increases in size. Finkler-Prior's bacillus liquefies rapidly and results in a tube of fluid with the organisms collected in a mass at the bottom. The stieptothrix of ecHnomyces produces a dry, rough, raised, crinkled growth having a more or less Inight yellow colour. INOCULATION OF ANIMALS. SOI The bacillus of Glanders on glycerine agar has a uniform streak of grey-white colour of a shiny consistence. On potato it shows a characteristic growth of a brown-yellow tint on the third day and a reddish brown on the eighth. The Tubercle bacillus produces on glycerine agar in ten or fourteen days (it is one of the slowest growing of pathogenic germs) a raised, smooth, confluent growth which later becomes tors which then occur in increased numbers in the blood, not combined with toxin celb, but as free receptors constituting antitoxin molecules. The exact hypothesis accepted is of less importance than the recognition of the broad fact that toxins in the blood and tissues sHmidaU a production of anti-toxic bodies in the body ceUs arising as far as is known from the body cells, and these anti- toxic cells protect the individual from the injurious effects of the toxiiM with which they unite, producing inert compounds resulting in immunity, As an illustration of the practical working of the antitoxin theory, we may consider the position in Diphtheria as far as the somewhat confusing nomenclature in vogue will permit us to understand it. Diphtheria is a severe inflammation and fibrinous mfiltration of the mucous membrane of the fauces, larynx, and trachea, leading to a necrosis of the superficial part rf the mucous membrane, which it thereby changes into a tenaciouo, greyish-white, pseudo-membrane. This membrane is not necessarily limited to the throat, but may occur in the stomach, intestine, external generative organs or wounds. The mem- brane consists of an infiltration of the submucosa with round cells and fibrine. The badlU of Klebs-Ldffler are held to be responsible for the production of the pseudo-membrane on the surface of the mucous membrane, and the bacilli are found, with many others (streptococci, etc.), in the supei«cial and deep layers of the membrane. The badlli exude a poison \rtiich is of the nature of a proteolytic ferment. This ferment is absorbed, and by digesting the proteids of the body, chitjily those of the spleen, produces albumoses and an organic add, which are the toxins or specific agents in prtxiucing the signs and symptoms which clinically constitute the disease known as Diphtheria (Martin). The albumoses are always associated with an organic add, and are much greater in amount than the add. Both add and albumoses are what are called Nerve Poisons, and bring about the degeneration of nerves, etc., which characterise Diphtheria. The albumoses, howevw-, when injected into rabbits, produce a high temperature and diarrhoea as well as paralysis, which affects first the posterior limbs, afterwards the respiratory musdes, and finally the heart. The changes in the nerves, according to Martin, are So8 NOTES ON BACTERIOLOGY. well marked. The axis cylinders break up into segments, and the medullary sheaths become ultimately affected. Fatty degeneration takes place in the muscle fibres. The organic add has practically the same action as the albumoses, but in a less degree. Now these changes and the theories explaining them may be graphically represented in a sort of scheme :— KleU-Lofller Bacillus - Mmmy Inftttivt Agtnt. F»l»e Membnme of Fibrin in the tubctance of which is fonned a Fennient — S*cmdary Inftctiv* Agtnt. [An EiujrBewith proteolytic action, produced locally, but disseminated generdly from its local butoiy thioa^raut the body.] By Digestion of Proteids produces { /albumosbs am okoanic acid 1- Ttxims. Which by th*ur presence' and action thiou^iout d>e body produce The signs and symp- r I. J2. Fever. I^airhoea. tonisa{Di|ditberia.l3. EoMciation and loss of body weight (4. Degeneration s cases in point, the dried sputum of tuberculosis, or the' dneu baalh of tetanus, may. on being carried by the air in the form of dust, set up their respective diseases in a manner which might appear to an unscientific observer as " infectious " • although the transference of the virus is as mechanical a^ that by the lancet or inoculation syringe. With advance of knowledge, so many of these so^alled contagious and infectious diseases were proved to be caused by special micro-organisms, that pathologists felt justified in including among them a W number of similarly behaving diseases (such as distemper and vanoja). the exciting causes of which remain still unlmown As these microbic and supposed-to-be-microbic diseases had s«« INFECTION AND CONTAGWM. the comnum property of poMwring a contagitun, or virtu, by means of which all these diseases had been proved to be, or were supposed to be, propagated, whether from outside or fnm (me animal to another, a classification founded on this property seemed to be as reasonable as it was convenient. The q>ecial meaning attached to the word "virulent" pre- cluded the use of the adjective derived from " virus." The. necessity of avoiding ambiguity prevented their being termed "infectious diseases," than which "contagious diseases" was a still mort objectionable dengnation. The net very happy escape out of this difficulty has been to give them the name of "itiftetive iiaeaatt." An infective disease, taking for granted its microbic origin, may be defined as uue that is caused by a living micro-oiganism which is capable of becoming developed in the animal body. , Although the condition of minuteness is purely arlntrary, it is weU recognised in practice : for example, we withold the term " infective " ftoia. mange, which is set up by an acanis ; but we omcede it to surra, vdiich is caused by an infusorian. The tendency to become general is in most cases considered to be a characteristic of infective diseases; parasitic ring- worm, which is due to a microscopic mould, being classed as a skin disease. The words "voUOiU" and " fixed " are emptoyed with reference to the capacity the ocmtagium or virus has or has not of being carried to a distance from its place of development, whether such place is outside ctt inside the animal body, and independently of the mode of disease trans- ference from one anipol to another. Hhis the virus of that mm-contagious disease. South African Horse Sickness, is fixed ; and that of malarial fever, which is a non-infectious Hif«tflff^ is volatile. ' When the exciting cause of a disease can, like that of anthrax ot tetanus, exist independently of the animal body, we apply the expi^ession edogenom to it. The cause of an trnhgetums disease, on the other hand, is one which, like that of glanders, can fulfil its life mission only in its animal host. Hence, in the case of an endogenous disease, the destruction of all infected animals, with the allowance of a reasonable length of time for the death of the special organisms, would prevent its further occurrence ; but sach action would have no such result with an ectogenons disease. A miasmaiic disease is an ectogenous disease, the contagium of which is volatile. INDEX. ACID-FAST BACILLI, 497. Acquired immmiity, 504. /^ActinomycMifl, 304, 215. •• in pigi, hones, and iheep, 215. II muacttloram suit, 314, II of man, 315. II , Mreptothrix of, joa /Erobcs,485. II , obligatoiy, 485. AfricM hone-dcMh, 431. African hone-plague, 431, Akptdpak, 431. Anaemia, 433, 436. ,1 of tucking pigs, 434. Anaerobes, 485. „ faculative, 485. ,1 obligatory, 486 Anasarca, 9, 439. Animals, inoculation '"y. S3. 6«-67. 409. „ epizootic, 105. „ 0^ adult animals, 65. „ of man, 61. „ ot sucklings, 61. ECTOGENOUS. 512. Endogenous, 513. Endospore, 487. Endocarditis of eiysipelas, 76. / Entootic abortion, 56-60. Epizootic dysentery, 105. „ inflammation of the lungs in American oxen, 305. „ lymphangitis, 288, 482. Equine contagious pleuro-pneumonia, 136-151. Equine influenza, 137. „ (deuro-poeumonia, 3. „ tuberculosis, I9i>i95. Erysipelas, 17. „ , endocarditis of, 76. „ of the skin, diff'use necrotic, 76. „ , s(denic, 68. „ , strepococctts of, 509. „ , swine, i, 68-85. „ , true cutaneous, 80. „ without redness of the skin, 76. Erysipelatous diseases of pigs, 68-70. FACULATIVE AN/EROBES, 485. / Farcy, 357. F*bns rtcurrens, 419. Pehling's test, 448. Ferments, 488. Finkler's bacillus of cholera, 501. Finkler-Prior's bacillus, 500. Fixed, 513. FlageUa,489. J Foot and mouth disease, 375-387, 409. » •• in pigs, 385. Fowl, septicaemia of, 5. „ typhoid, 98. „ , vibrio-choleni of, ico. GEESE, SEPTICAEMIA OF, 5. General dropsy, 439-433. Glanders, 5, 17, 39, 318, 357-389, 4^6, 449- / Glanders, bacillus of, 501. „ in cats and beasts of prey, 388. „ in man, 388. „ , staining the bacilli of, 378. Glycaemia, 444. Glycosuria, 444. Goats, anthrax in, 348. „ , rabies in, 374. „ , tetanus in, 351. „ , tuberculosis of, 300. „ , variola of, 401. Gout, 441-444. Gower's hxmoglobinometer, 434. Gram's method, 494. Grape disease, 175. Grouse disease, 105. H/EMATURIA, 15, 475. Hsemoglobinometer, Gower's, 434. Hsemoglobinuria, 410, 416. Haemophilia, 437-438. Heat ^.poplexy, 80. Hereditary transmission, 490. Hog cholera, 85, 86. „ fever, 86. „ plague, 86. Uoltmnge, 309. Horses, actinomycosis in, 314. „ , anthrax in, 346. „ , botryomycosis in, 315. „ . infectious aphthae of, 385. „ , malignant catarrhal fever of,55. Horse-pox, 319, 399^400. Horses, quarter>ill in, 137. „ stomatitis pustulosa conta- giosa of, 315-330. Horse-sickness, 348, 467-474. It , surra in the, 458-462. n typhus, 9. II •I 5*^ ' ! INDEX. HoiwildnwM, tMum in the, ayi. ■ Hmnu'talMKalaiii, 163. Hydnimia, 4«9^33> • •I ai ctttlt, 431.' ,, afihMp,43e. rfytkt^f/nffOlMif, 4J9. Hydwphobto, 353-374. IMMUNITY, 504.510. InfKtion, 511.51a. InfMtioaa i^tlut of birds, 385. II II II nu and rabbits, 385. II M dogs, 385. •I ,1 hofscs, 385k pnnnnoimteritis, 86. ,► ' sntutl disMsct in imbbits, .31;. . Infection, duumlspf, 49a ' Infective dlsMues, 1^14. InflusnsB, ia7>i36. II iautlr,'4ia II , diseases of catiie. bling, 135. II , equine, is;. II of nuui, 136. Inoculation, 490. II of animals, 501. Intermittent fever, 416. Iodide of potassium, aij. I»>dieanmiia,475. II II I in Jamaica, 477. KARA88AN, 4ai. Klein's fowl disease, 105. Kodi's comma bacillus, 50a Kumice, 46a Lonping-UI, 477. Logol's solution, 19. Lyons' method, 123. Lymphangitis, 384. epispotica, 388, 48a. -, ulcerative, 481. i> £M GRIPPE, 136. Itmgm AMifHoq. L««mi«i •83, 433-4371 449> LvVi 495' II I bacillus of, 5ot, Liptothris, 4t6. Uver inkes, 4a& Lobolar-pneoaMmlc form of equine pImiO'pnettmonia, 143. Lonns'B protaetiva ' inoculsltion ma- terial, I5. 'Stt^' MAcCQNKEy'S METftOD, 499, / Mai de eaderas, ^ad. Mahdit tb «nt, 305. ". j ''J- MUadit Anommeil, 105. Malaria, 416. Malarial fevers of man, 476. Malignant catarrhal fever of cattle, 47-55- Malignant catarrhal fever of horses, ■' 55- ,•••.-- '• Malignant eedema, ^-8, 17, 112, 116. . ..Msllein, 267, 272, 179, 280, 281, 287. •■ Malkosation, 27 j. Man, actinanyooais in, 215. I, , anthrax in, 352. „ , diphtheria of, 321, A^.. „ , ganders in, 288. >. , inflnenat of, 136. >■ , malarial fevers of, 476, I, , pernicious amemia of, 428. ., , rabies in, 37a „ , typhus of, 19. „ ,'variolaaf, 391. Measles, 419. ' . \_ ^ ,, , swine, 69. Meat, inspection of, 213.' » , official inspection of, 185. Meltitnria, 444. • Meningitis, 53. Miasmatic disease, 312. Micrococci, 485. • Micrococcus, 486. Microecope, 492. „ , examination by the, 493. Milk, 179, 5<»> „ hygiene, i8j. „ sickness, 421. Miscelhneous infective diseases, 415* 422. Moller's method, 498. Mtmilia cnukda, 338. A/Mwr maenUsm ofman, 9. •I „ Wrr/W^9. • -1' f V. f ( 'i i "i. i \i r> ■r . t* ? *■(• n: Ji I" ■ V l' I'n INDEX. 5»7 MotqwioM, 417. Moaid%485. A^KMrimm ram, ajS. M^eo-phybuuns, 510. M)reo«xiD«, 51a Mjrood* of pwfiou, 106. Mycotic inftuBnution of the inteMinei. f>9. WOTES ON BACTERIOLOGY, OBESITY, 4SI.4S3. Obligatoiy aerbbet, 485. „ uuerobet, 486. Oedema, nwlignant, 5^ i^, 112, 116. OuUmm afbitans, 338. Okt^nmia, 116. , Ruaiitic ttomatitit, 338. Parrots, mycbuf of, 106. .. , tuberculosis of, ao3. Puasitet, 486. Pasttuntttt* Oh pert, 85. Periodicsl inflammation of the eyeii, 53. Pernicious anaemia, 436-439. » » of man, 438. AfC^dkt/ffr, 85. Petediial fever, 68, 385. >i ,, in cattle, aa Phagocytosis, theory of,.505. Pharyngitis, 15. ndorisin, 15; PhosphoKscenoe, 488. Phylasins, 510. Pica, 366. Pig typhoid, 86. 'f^^ anthrax in, 349. u , diphtheria in, 337. K , foot and month disease in, 385. t, , rinderpest of, 409. „ , raUes in, 373. „ , tetanus in, 351. . «T > tubetcttloais of, 187. Pigment, 488. J Pink-cye, 137. Plethora, 435. ' Pleuro>pneumonia, 144, 410. ' » II I bonne, 389>305. ■^ Pleuro-pneumonia contagiosa, III. II ■■ contagious aqaine, «36-"5«i449. II Ml equine, 3. II 11 I infectious in goats, 305. „ » I inoculationngainst, 300. ' II ' I, , lobular- pneumonic form of equine, «43- II I, , septic in calves, 304- PntMtnotntfrite inftctitmt, 85. Pneumonia, 473.- Polygrgria, 435. Polyu.ia, 449h45i. Possibility of transmittinit hiflnan syphilis to animals by inocuhuion, ■• 3ia-" ProducU of bacteria, 488. Proltm, 431. Psendo4eucmia, 433;437. ^^ Pteudo-malignant catarriMi f)>ver of sheq),S4. Pseudo-strangles of dogs, 31. S^Pmfmra kamerrhagita, 9. Pyaemia, I, 5, 17. Pyaemic polyarthritis, 61. QUARTER-ILL, i, 8, 17, iia, 114. 137. •I I, in horses, 137. RABIES. 353-374, 410. • „ of birds, 374. „ , bovine, 37a „ , canine, 365. „ in cats, 373. II , equine, 37X » in man, 37*'' .1 >npigii373- •I of sheep and goats, 374. ' Rabbits, infections aphthae of, 385. „ , sexual disease in, 317, Bats, surra in, 463. Ray fungi, 304. ReceptotSi 5^6. Red water, 416. Red Water disease, 475. 33* ' 'fhi sii INDEX. XJUmMtJUrim»$m, S3. KhiBOHope, 374. of pip, 409. "Rot"iiiihw|>.43a A!n«»/. «7. AWyar Mmt, 76. Kwitgit mH ftrt, 70^5* "Sklted"boiMt,474. •*'***«'«'«i 453^54. Sa^rttmia, a. St^n^fytts, 486. / 'S«nM«a,436i Jlrwter, 486. • Sc■rktiIH^ 9. y Saurlet fe*cr, 418. Sctmn'mumeit, 85. 5ifAw«ii»a. 391, 394. Side-dmin theoiy. 506. SMmm, 151. Smallpox, 391. Sodium Uniate, 441. . Sodinrn qnadrnriate, 441. Soath African hone-iicknas, 348, 4«7'474. Soiina, 51a * Spirilla. 485. SpirocMtUm, 485. , Splenic.eiyiipelaa, 68 , Spore formation, 487. Spore*, staining of, 49& S/omtuJUt, 116. Stab cultures, 500 Staining, capsule, 499. St. Anthony's £re, 68. Stapfylitoccus, 486. Stap^lococau fytgtnts, 501. Stomatitis pusttUosa emtagiosa of horses, ais^aaa „ , parasitic, 338. Strangles, a, 17, at-3i, a83. Strtptocoetus bevis, 501. » 486. „ (rf erysipelas, 501. I „ ,suppttnUion,5oi. Streptothris of actinomycosis, soa Stroke cultures, soo. Suppuration, 501. ,, , streptococcus of, 501. Surra, 455-464- „ in cattle, 464. „ „ the dog, 463. » I, „ hotae, 458. „ „ rats, 463. Swine erysipelas, i, 68^5. „ fever, 81^98. „ measles, 69. ., typhus, 68. „ urticaria, 75. Swine-pox, 40a Symptomatic anthrax, 114. Syphilis in apes, 313. „ to animals, transmitting, 31a. TABES MESBNTERICA, 159. Tetanus, 139, UP-HJ, 480, 508. in cattle, 350. „ dop, asi. „ birds, asi. „ goats, a5i. „ the horse, asa „ iMgs, asi. „ sheep, 351. , immunity againrt, aj6. , rheumatic, 346. . toxic, 346. SI9 .; !. Tctiads, 487. '• T«M fcwr, 475, 487. INDEX. ' TuberenlMU of the terow membnuef. TheDfjr of phagoqrtoris, 505. TTA few, 416. 475- II II , Awtmliui 475. Ticks, dueaie* convqred l)y, 75, 481. Tophi, 44a. Toxins, chemical ptoducU of the MUoieof, 488. Tom-phyUsins, 51a Toso-sosins, 51a Tnmmuic eiythenwta, 81. Trembling, 477.481. Trammer's test, 447, 448. True cntaneous erysipelas, 80. Trypanoaomatosis, 464. y Tsetse-fly disease, ^. Tubercle, 495. ,1 badllns, 501. Tnbercnlin, 182. 1/ Tuberculosis, 153-303, 449. , canine, 191-195. , equine, 191-195. in cattle, 160-187. „ wild mammalia, aoa I general, 177. of birds, 300-303. parrots, 303. |Mgs, 187-191. sheep, 199. the brain, 176, 178. „ cat, 198-199. „ lungs, 177. of the mediastinal glands, 178. ipaeudo, 203. »77. II „ the odder, 176, 178. Typhoid fever, 8. „ , fowl, 98. Typhis, 8. „ , horse, 9. ,1 of nuUi 19. II I swine, 68. UDDER, TUBERCULOSIS OF THE, 176. Ulcerative lymphangitis, 481. Urticaria, 17, 385. ,1 , swinci 75. VARIOLAi 3P7.401. ■I confluens, 393. „ in birds, 401. ,1 . of dogs, 401. „ „ man, 391. Vesicular exanthema, 311. ■I ' -II of cattle, 316-318. " •• II hones, 313-315. Vibrio-choleta of fowl, 106. Vibrones, 485. Volatile, 513. ly/LD UND RI/fDEKSEUCHE, 106. Wooden tongue, 309. YEASTS, 485. Yellow fever, 419. ■•,51 ZIEHL-NEELSEN'S 49S>498. METHOD, FBIXTID BT noxT^ nnooTOMM vn. umvoK AHB Knatrmi. \ List of Books on Horses By CAPT. N. HORACE HAYES, F.R.C.V.S. Tta PI»U. — "As trainer, owner and rider of bones on the flat and over a ooontry, the author has had a wide experience, and when to this is added competent veterinary knowledge, it is dear that Captain Havbs is entitled to attention when he rpeaks." O PablUhed 1^ HURST AND BLACKBTT, LTD. ■3, QrMt Maribonwck Stnttt, Loadoa, W. And can be procniwd throoth any BookMller la the UaHed States. VBTBRIM ART MOTBl for HORBB-OWMBRl. An IlluMimted Manual of Hone Medicine and Suioerjr, written in limple Ungnage, with 367 Illuitimtioni. Suth Edition. Reviicd thioi^iaai, oooaidenbly enlaiged, and lai new and original Photogiaphi added. Large crown 8n>, buckram. "A. utemmtj gnid* lor howi owa»i, wpaolaUy thow who an te imamtd tnm I— iillili pnUooai imUaam."-ni ftau*. 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FuU^ lUustrated with upwards of 3ot|itioaoU7 ewpttwt MrthorttfiWbe thamaghlr oadi mblMiud li abto to ntk* tho MoHi of hk jnoHod kBowMn otau to JmwMIm Jf«0tteto#. ULU8TRATBD and Cheaper Edition. Second LMi^ crown oTO. TAit Bdititm kat tun luHnfy rtwrittiH, tkt amommt ^tki Utttrfrtu tian dtuiled, ami jj r^nductiomi tf Phatogr^kt ham turn addtd. I Um pramt ao* ii no • telat ffer aad swi; ijatm wo h»*« ma."— n« PtM, ' Tho work U (mlMBtlr pnettal and nUaU*."- FtTfrtaarp Jnrmt. "It li • ohfetartttto o< all Oaptaia Bajn' booki ao homa that thar art am ■raotioal,andUMpniaBtaaaitnotMtpttOBtotbtnlt, A work wbkh ia tatl Ufh pralta aa balat ffer aad awaj tha Dtat i«aaontd-ont out oa tnaUag oaitar a aaw BtitM t* HORSBS ON BOARD IHIP. A Guide to their Management. By M. H. Haybi. In t voL, crown 8to, widi numerous Ulustratioos from Photographs taken by the Autiior dnriag two voyages to South Africa with horses. ■Tha hook attaatthar la Uka tha ittt of Oaptala Hajta' worka, writttn oa toad, ■noMoal Uan, ud ta an tha maia wdoooM la tha* It dtala with a aobjaet OB whlth wt hava Trt a fiaa diBt to Uan."— n* /Md. ■ Aa ha hw bad two Toyadta to loath AMaa la ohaigt of teg* ooaatgaBtati, bla anBtaaea la ■aianUy jnMUoal, aad Ua book ooalaiaa maoh valaaMa laforaatloD, aad OMhttoaaaUathaWarOaaatoaToid la tha fatara aaoa of tho amta of tba patt." —Mondng Put. "Wa an Bon that tha book wUl ba foaad oatfol aafl inatmotlTo to thon who aia aaw to tba work of oaBT«jing tithar larp or aaaU nombtn of hi— a aonaa tha Has."— Cttmlr OnllMMm. TRAIHIMO AND HORBB MANAOBMBNT IN INDIA. Crown 8to. New Edition in the Press. •*Wt antataia a vocy high opialoe of Oapt Baji*' book an 'Bant TMaiac aad HaatctiMut in India,' aad *n of opiaion that no bottir gaida ooold ba niaatd m tha haadi ct tlthtr aaiataar lienanaa or iilailMiy aoigtaa aawly airiTao In that iai- partaat diTlaion of oar Brnpirt.?— FMtfiaarp /mniaJ. INFBCTIVB DISBABBB OF ANIMALS. Being the Translation of Friedbeifer and Frohner's Pathology of the Domestic Animals. Translated and Edited by the Author. With a Chillier on Bacteriology by Dr. G. Nbwm an, D. P. H. New and en- larged Edition. In 2 vols., demy Svo, each volume sold separately. "Vhtthtrooaddatdaaawortaf rtfwtnatfor bai^ irattltisam, aa a tazt-boA tar ttadtnta, or /m a tnatlta oo patboloay la Ita widtat tlfuflotaoa, thia Totaiaa atttt trtry rtqniitnaal^ aad la aa iaTalaablt adotiaa to oar Utaratait."— VtOrbmrt Xtcird. X "jSffL^""* '" ■^■■^ With 53 IIIu*,.. "Th* book li tnMdlafl/ wril 1 "TbtaotharhMi AMOHO ROHm IN SOUTH AVRIOA. In I W.I., crown »»o. '^auMM. In "Xhi book h my TmUtihr—t^mtaitr. 4> ^^— •I