PAN OATH anit tales rare? ‘ate fe ia ete ees LIBRARY NEW YORK STATE COLLEGE OF VETERINARY MEDICINE ITHACA, N.Y. Digitized by Microsoft® Cornell University Library SF 951.U58 1907 Speci il il DATE DUE _ GAYLORD Digitized by Microsoft® PRINTED INYU.S.A This book was digitized by Microsoft Corporation in cooperation with Cornell University Libraries, 2007. You may use and print this copy in limited quantity for your personal purposes, but may not distribute or provide access fo it (or modified or partial versions of if) for revenue-generating or other commercial purposes. Digitized by Microsoft® Digitized by Microsoft® Digitized by Microsoft® U. S. DEPARTMENT OF AGRICULTURE. BUREAU OF ANIMAL INDUSTRY. A. D. MELVIN, CHIEF OF BUREAU. SPECIAL REPORT ON DISEASES OF THE HORSE. BY Drs. PEARSON, MICHENER, LAW, HARBAUGH, TRUMBOWER, LIAUTARD, HOLCOMBE, HUIDEKOPER, STILES, MOHLER, AND ADAMS. « REVISED EDITION. WASHINGTON: GOVERNMENT PRINTING OFFICE, 1907. 2 Digitized by Microsoft® Digitized by Microsoft® CONTENTS The examination of a sick horse, By Leonarp Prarson, B.8., V. M. D_...- Methods of administering medicines, By Cn. B. Micnengr, V.8 ............... Diseases of the digestive organs, By Ca. B. Micnener, V.S .__..__-...2---- Diseases of the urinary organs, By James Law, F. R. C. V. S_..2..222 2... Diseases of the respiratory organs, By W. H. Harpavan, V.S8.......--...--- Diseases of the generative organs, By James Law, F. R. ©. V. 8.- 22-22-2222... Diseases of the nervous system, : By M. R. TrumsBower, V.8.........-..--- Diseases of the heart, blood vessels, and lymphatics, By M. R. Trumpower, V. 8..-..---------- Diseases of the eye, By James Law,.F. R. C. V. §.-----.------ Lameness, By A. Liautarp, M. D., V.8..-.-.------- Diseases of the fetlock, ankle, and foot, By A. A. Hotcomss, D. V. 8 ..-.---.----- Diseases of the skin, By Jamzs Law, F. R. C. V. 8..-...------- Wounds and their treatment, By Cu. B. Micnenmr, V.§ ...-----.------ General diseases, By Rusu Saippen HuipeKorgr, M. D., Vet Surra, By Ca. WarpDELL Stites, Ph. D..-....---- Osteoporosis or bighead, By Joun R. Mouter, V. M. D.---..-.---- Shoeing, By Joun W. Apams, A. B., V. M.D .-..-- Digitized by.Microso ft® 104 Fia. ILLUSTRATIONS. TEXT FIGURES. . Ground surface of a right fore hoof of the ‘‘ regular” form--...-.---- . Pair of fore feet of regular form in regular standing position......-..- . Pair of fore feet of base-wide form in toe-wide standing position --..--- . Pair of fore feet of base-narrow form in toe-narrow standing position. . Side view of an acute-angled fore foot, of a regular fore foot, and of a siumpy tote fodtes. <-: qzsssstemers sswannete tenets samemsceke ycisen . Side view of foot with the foot-axis broken backward asa result of too LOnP A. LOS Se. creransi desis sewiaysieS ia a spemidcuceeeie e sidiemuais sie 6 Sage eekiniece . Left fore hoof of a regular form, shod with a plain fullered shoe... -- . Side view of hoof and fullered shoe.............-------------+------- . An acute-angled left fore hoof shod with a bar shoe..........---.---- . A fairly formed right fore ice shoe for a roadster...-....---...------ Left fore hoof of regular form shod with a rubber pad and ‘‘three- quarter” Sho iacssiewssees esamssystecse dees jan ceakicewa se oneeseeee . A narrow right fore hoof of the base-wide standing position shod with a plain ‘‘ dropped crease’”’ shoe...--.---..----------------------- . Hoof surface of a right hind shoe to prevent interfering....-.....---. . Ground surface of shoe shown in fig. 18.........-.-.-----.---------- . Side view of a fore hoof shod so as tc quicken the ‘‘ breaking over’”’ AN, TORGEL en sted eeeds bac galcawcsicees temas ceesees ecdeses . Side view of a short-toed hind hoof of a forger...-....-.-.---------- . A toe-weight shoe to increase the length of stride of fore feet......... . Most common form of punched heel-weight shoe to induce high action insOreteet 22 sis soe te eyatajrs a tetera es Seecieeye ate nae atene Sates s Digitized by Microsoft® SPECIAL REPORT ON DISHASES OF THE HORSE. THE EXAMINATION OF A SICK HORSE. By LEONARD Pearson, B. S., V. M. D., Dean of the Veterinary Department, University of Pennsylvania, and State Veterinarian of Pennsylvania. In the examination of a sick horse it is important to have a method, or system. Ifa definite plan of examination is followed one may feel reasonably sure when the examination is finished that no important point has been overlooked and that the examiner is in a position to arrive at an opinion that is as accurate as is possible for him. Of course, an experienced eye can see, and a trained hand can feel, slight alterations or variations from the normal that are not perceptible to the unskilled observer. A thorough knowledge of the conditions that exist in health is of the highest importance, because it is only by a knowledge of what is right that one can surely detect a condition that is wrong. A knowledge of anatomy, or of the structure of the body, and of physiology, or the functions and activities of the body, le at the bottom of accuracy of diagnosis. It is important to remember that animals of different races or families deport themselves differ- ently under the influence of the same disease or pathological process. The sensitive and highly organized Thoroughbred resists cerebral depression more than does the lymphatic draft horse. Hence a de- gree of fever that does not produce marked dullness in a Thorough- bred may cause the most abject dejection in a coarsely bred heavy draft horse. This and similar facts are of vast importance in the diagnosis of disease and in the recognition of its significance. The order of examination, as given below, is one that has proved to be comparatively easy of application and sufficiently thorough for the purpose of the readers of this work. It is recommended by several writers. 9 Digitized by Microsoft® 10 DISEASES OF THE HORSE. HISTORY. It is important to know, first of all, something of the origin and development of the disease, therefore the cause should be looked for. The cause of a disease is important, not only in connection with diag- nosis, but also in connection with treatment. The character of food that the horse has, had, the use to which he has been put, and the kind of care he has received should all be inquired into closely. It may be found by this investigation that the horse has been fed on damaged food, such as brewer’s grains or moldy silage, and this may be suffi- cient to explain the profound depression and weakness that are char- acteristic of forage poisoning. If it is learned that the horse has been kept in the stable without exercise for several days and upon full rations, and that he became suddenly lame in his back and hind legs, and finally fell to the ground from what appeared to be partial paralysis, this knowledge, taken in connection with a few evident symptoms, will be enough to establish a diagnosis of azoturia. If it is learned that the horse has been recently shipped in the cars or has been through a dealer’s stable, we have knowledge of significance in connection with the causation of a possible febrile disease, which is, under these conditions, likely to prove to be influenza, or edematous pneumonia. It is also important to know whether the particular horse that is under examination is the only one in the stable or on the premises that is similarly afflicted. If it is found that several horses are afflicted much in the same way, we have evidence here of a common cause of disease which may prove to be of an infectious nature. Another item of importance in connection with the history of the case relates to the treatment that the horse may have had before he is examined. It sometimes happens that medicine given in excessive quantities produces symptoms resembling those of disease, so it is important that the examiner shall be fully informed as to the medica- tion that has been employed. ATTITUDE AND GENERAL CONDITION. Before beginning the special examination attention should be paid to the attitude and general condition of the animal. Sometimes horses assume positions that are characteristic of a certain disease. For example, in tetanus, or lockjaw, the muscles of the face, neck, and shoulders are stiff and rigid, as well as the muscles of the jaw. This condition produces a peculiar attitude, that once seen is subse- quently recognized as rather characteristic of this disease. A horse with tetanus stands with his muscles tense and his legs in a somewhat bracing position, as though he were gathered to repel a shock. The neck is stiff and hard, the head is slightly extended upon it, the face is drawn, and the nostrils are dilated. The tail is usually held up a little, and when pressed dayayagaimst the saighs it springs back to its EXAMINATION OF A SICK HORSE. 11 previous position. In inflammation of the throat, as in pharyngo- laryngitis, the head is extended upon the neck, and the angle between the jaw and the lower border of the neck is opened as far as possible to relieve the pressure that otherwise would: fall upon the throat. In dumminess, or immobility, the hanging position of the head and the stupid expression are rather characteristic. In pleurisy, perito- nitis, and some other painful diseases of the internal organs, the rigid position of the body denotes an effort of the animal to avoid pressure upon and to protect the inflamed sensitive region. The horse may be down in the stall and unable to rise. This condi- tion may result from paraplegia, from azoturia, from forage poison- ing, from tetanus, or from painful conditions of the bones or feet, such as osteoporosis or founder. Lying down at unusual times or in unusual positions may indicate disease. The first symptom of colic may be a desire on the part of the horse to lie down at a time or place that is unusual or inappropriate. Sometimes disinclination to lie down is an indication of disease. Where there is difficulty in breath- ing, the horse knows that he can manage himself better upon his feet than upon his breast or his side. It happens, therefore, that in nearly all serious diseases of the respiratory tract the horse stands persist- ently, day and night, until recovery has commenced and breathing is easier, or until the animal falls from sheer exhaustion. Where there is stiffness and soreness of the muscles, as in rheumatism, inflamma- tion of the muscles from overwork, or of the bones in osteoporosis, or of the feet in founder, or where the muscles are stiff and beyond con- trol of the animal, as in tetanus, a standing position is maintained, - because the horse seems to realize that when he lies down he will be unable to arise. Abnormal attitudes are assumed in painful diseases of the digestive organs (colic). A horse with colic may sit upon his haunches, like a dog, or may stand upon his hind feet and rest upon his knees in front, or may endeavor to balance himself upon his back, with all four feet in the air. These positions are assumed because they give relief from pain by lessening pressure, or tension, upon the sensitive structures. Under the general condition of the animal it is necessary to observe the condition, or state, of nutrition; the conformation, so far as it may indicate the constitution; and the temperament. By observing the condition of nutrition one may be able to determine to a certain extent the effect that the disease has already had upon the animal and to esti- mate the amount of strength that remains and that will be available for the repair of the diseased tissues. A good condition of nutrition is shown by the rotundity of the body, the pliability and softness of the skin, and the tone of the hair. If the subcutaneous fat has disap- peared and the muscles are wasted, allowing the bony prominences to stand out; if the skin is tight and inelastic and the coat dry and harsh, we have evidence of a low state of nutrition. This may have resulted Digitized by Microsoft® x 12 DISEASES OF THE HORSE. from a severe and long-continued disease or from lack of proper food and care. Where an animal is emaciated—that is, becomes thin— there is first a loss of fat and later the muscles shrink. By observing the amount of shrinkage in the muscles one has some indication as to the duration of the unfavorable conditions that the animal has lived under. By constitution we understand the innate ability of the animal to withstand disease or unfavorable conditions of life. The constitution depends largely upon the conformation. The type of construction that usually accompanies the best constitution is deep, broad chest, allowing plenty of room for the lungs and heart, indicating that these vital organs are well developed; capacious abdomen, allowing sufficient space for well-developed organs of digestion; the loins should be short—that is, the space should be short between the last rib and the point of the hip; the head and neck should be well molded, without superfluous or useless tissue; this gives a clear-cut throat. The ears, eyes, and face should have an expression of alertness and good breeding. The muscular development should be good; the shoulders, forearms, croup, and thighs must have the appearance of strength. The withers are sharp, which means that they are not loaded with useless, superfluous tissue; the legs are straight. and their axes are parallel; the knees and hocks are low, which means that the forearms and thighs are long and the cannons relatively short. The cannons are broad from in front to behind and relatively thin from side to side. This means that the bony and tendinous structures of the legs are well developed and well placed. The hoofs are compact, tense, firm structures, and their soles are concave and frogs large. Such a horse is likely to have a good constitution and to be able to resist hard work, fatigue, and disease to a maximum degree. On the other hand, a poor constitution is indicated by a shallow, narrow chest, small bones, long loins, coarse neck and head, with thick throat, small, bony, and muscular development, short thighs and forearms, small joints, long, round cannons, and hoofs of open texture with flat soles. The temperament is indicated by the manner in which the horse responds to external stimuli. When the horse is spoken to, or when he sees or feels anything that stimulates or gives alarm, if he responds actively, quickly, and intelligently, he is said to be of lively, or nerv- ous, temperament. On the other hand, if he responds in a slow, sluggish manner, he is said to have a sluggish, or lymphatic, tempera- ment. The temperament is indicated by the gait, by the expression of the face, and by the carriage of the head and ears. The nature of the temperament should be taken into consideration in an endeavor to ascertain the severity of a given case of illness, because the general expression of an animal in disease as well as in health depends to a large extent on the tenipetaamenty Microsoft® EXAMINATION OF A SICK HORSE. 13 THE SKIN AND THE VISIBLE MUCOUS MEMBRANES. The condition of the skin is a fair index to the condition of the animal. The effect of disease and emaciation upon the pliability of the skin have been referred to above. There is no part of the body that loses its elasticity and tone as a result of disease sooner than the skin. The practical herdsman or flockmaster can gain a great deal of information as to the condition of an animal merely by grasping the coat and looking at and feeling the skin. Similarly, the condition of the animal is shown to a certain extent by the appearance of the mucous membranes. For example, when the horse is anemic as a result of disease or of inappropriate food the mucous membranes become pale. This change in the mucous membranes can be seen inost readily in the lining of the eyelids and in the lining of the nostril. For convenience of examination the eyelids can readily be everted. Paleness means weak circulation or poor blood. Increased redness occurs physiologically in painful conditions, excitement, and follow- ing severe exertion. Under such conditions the increase of circula- tion is transitory. In fevers there is an increased redness in the mucous membrane, and this continues so long as the fever lasts. In some diseases red spots or streaks form in the mucous membrane. This usually indicates an infectious disease of considerable severity, and occurs in blood poisoning, purpura hemorrhagica, hemorrhagic septicemia, and in urticaria. When the liver is deranged and does not operate, or when the red-blood corpuscles are broken down, as in serious cases of influenza, there is a yellowish discoloration of the mucous membrane. The mucous membranes become bluish or blue when the blood is imperfectly oxidized and contains an excess of carbon dioxide. This condition exists in any serious disease of the respiratory tract, as pneumonia, and in heart failure. The temperature of the skin varies with the temperature of the body. If there is fever the temperature of the skin is likely to be increased. Sometimes, however, as a result of poor circulation and irregular distribution of the blood, the body may be warmer than normal, while the extremities (the legs and ears) may be cold. Where the general surface of the body becomes cold it is evident that the small blood vessels in the skin have contracted and are keeping the blood away, as during a chill, or that the heart is weak and is unable to pump the blood to the surface, and that the animal is on the verge of collapse. » The skin is moist, to a certain degree, at all times in a healthy horse. This moisture is not in the form of a perceptible sweat, but it is enough to keep the skin pliable and to cause the hair to have a soft, healthy feel. In some chronic diseased conditions and in fever, the skin becomes dry. In this case the hair has a harsh feel that is quite different from the condition observed in health, and from the fact of Digitized by Microsoft® 14 DISEASES OF THE HORSE. its being so dry the individual hairs do not adhere to one another, they stand apart, and the animal has what is known as “a staring coat.” When, during a fever, sweating occurs, it is usually an indi- cation that the crisis is passed. Sometimes sweating is an indication of pain. A horse with tetanus or azoturia sweats profusely. Horses sweat freely when there is a serious impediment to respiration; they sweat under excitement, and, of course, from the well-known physio- logical causes of heat and work. Local sweating, or sweating of a restricted area of the body, denotes some kind of nerve interference. Swellings of the skin usually come from wounds or other external causes and have no special connection with the diagnosis of internal diseases. There are, however, a number of conditions in which the swelling of the skin is a symptom of a derangement of some other part of the body. For example, there is the well-known “ stocking,” or swelling of the legs about the fetlock joints, in influenza. There is the soft swelling of the hind legs that occurs so often in draft horses when standing still and that comes from previous inflammation (lym- phangitis) or from insufficient heart power. Dropsy, or edema of the skin, may occur beneath the chest or abdomen from heart insuffi- ciency or from chronic collection of fluid in the chest or abdomen (hydrothorax, ascites, or anemia). In anasarca or purpura hemor- rhagica large soft swellings appear on any part of the skin, but usually on the legs, side of the body, and about the head. Gas collects under the skin in some instances. This comes from a local inoculation with an organism which produces a fermentation beneath the skin and causes the liberation of gas which inflates. the skin, or the gas may be air that enters through a wound penetrating some air-containing organ, as the lungs. The condition here de- scribed is known as emphysema. Emphysema may follow the frac- ture of a rib when the end of a bone is forced inward and caused to penetrate the lung, or it may occur, when, as a result of an ulcerat- ing process, an organ containing air is perforated. This accident is more common in cattle than it is in horses. Emphysema is recog- nized by the fact that the swelling that it causes is not hot or sensi- tive on pressure. It emits a peculiar crackling sound when it is stroked or pressed upon. Wounds of the skin may be of importance in the diagnosis of internal disease. Wounds over the bony prominence, as the point of the hip, the point of the shoulder, and the greatest convexity of the ribs, occurs when a horse is unable to stand for a long time and, through continually lying upon his side, has shut off the circulation to the portion of the skin that covers parts of the body that carry the greatest weight, and in this way has caused them to mortify. Little, round, soft, doughlike swellings occur on the skin and may be scattered freely over the surface of the body when the horse is Digitized by Microsoft® EXAMINATION OF A SICK HORSE. 15 afflicted with urticaria. Similar eruptions, but distributed less gen- erally, about the size of a silver dollar, may occur as a symptom of dourine, or colt distemper. Hard lumps, from which radiate welt- like swellings of the lymphatics, occur in glanders, and blisterlike eruptions occur around the mouth and pasterns in horsepox. THE ORGANS OF CIRCULATION. The first item in this portion of the examination consists in taking the pulse. The pulse may be counted and its character may be de- termined at any point where a large artery occupies a situation close to the skin and above a hard tissue, such as a bone, cartilage, or tendon. The most convenient place for taking the pulse of the horse is at the jaw. The external maxillary artery runs from between the jaws, around the lower border of the jawbone and up on the outside of the jawbone to the face. It is located immediately in front of the heavy muscles of the cheek. Its throb can be felt most distinctly just before it turns around the lower border of the jawbone. The balls of the first and second or of the second and third fingers should be pressed lightly on the skin over this artery when its pulsations are to be studied. The normal pulse of the healthy horse varies in frequency as follows: Stallion... 22.3252 5 ee ee oe ies, 28 to 32 beats per minute. Geldingts212 setae se oe eb cec se sseoe ss 33 to 38 beats per minute. RG oo eae eRe awa ese 34 to 40 beats per minute, Foal 2 to 3 years old___--------------- 40 to 50 beats per minute. Foal 6 to 12 months old____-___--_---- 45 to 60 beats per minute. Foal 2 to 4 weeks old_---_------------- 70 to 90 beats per minute. The pulse is accelerated by the digestion of rich food, by hot weather, exercise, excitement, and alarm. It is slightly more rapid in the evening than it is in the morning. Well-bred horses have a slightly more rapid pulse than sluggish, cold-blooded horses. The pulse should be regular ; that is, the separate beats should follow each other after intervals of equal length, and the beats should be of equal fullness, or volume. In disease, the pulse may become slower or more rapid than in health. Slowing of the pulse may be caused by old age, great exhaus- tion, or excessive cold. It may be due to depression of the central nervous system, as in dumminess, or be the result of the administra- tion of drugs, such as digitalis or strophantus. A rapid pulse is almost always found in fever, and the more severe the infection and the weaker the heart the more rapid is the pulse. Under these con- ditions, the beats may rise to 80, 90, or even 120 per minute. When the pulse is above 100 per minute the outlook for recovery is not promising, and especially if this symptom accompanies high tempera- Digitized by Microsoft® 16 DISEASES OF THE HORSE. ture or occurs late in an infectious disease. In nearly all of the dis- eases of the heart and in anemia the pulse becomes rapid. The pulse is irregular in diseases of the heart, and especially where the valves are affected. The irregularity may consist in varying inter- vals between the beats or the dropping of one or more beats at regu- lar or irregular intervals. The latter condition sometimes occurs in chronic diseases of the brain. The pulse is said to be weak, or soft, when the beats are indistinct, because little blood is forced through the artery by each contraction of the heart. This condition occurs when there is a constriction of the vessels leading from the heart and it occurs in certain infectious and febrile diseases, and is an indication of heart weakness. In examining the heart itself it is necessary to recall that it lies in the anterior portion of the chest slightly to the left of the median line and that it extends from the third to the sixth rib. It exends almost to the breastbone, and a little more than half of the distance between the breastbone and the backbone. In contracting, it rotates slightly on its axis, so that the point of the heart, which lies below, is pressed against the left chest wall at a place immediately above the point of the elbow. The heart has in it four chambers—two in the left and two in the right side. The upper chamber of the left side (left auri- cle) receives the blood as it comes from the lungs, passes it to the ‘ lower chamber of the left side (left ventricle), and from here it is sent with great force (for this chamber has very strong, thick walls) through the aorta and its branches (the arteries) to all parts of the body. The blood returns through the veins to the upper chamber of the right side (right auricle), passes then to the lower chamber of the right side (right ventricle), and from this chamber is forced into the lungs to be oxidized. The openings between the chambers of each side and into the aorta are guarded by valves. If the horse is not too fat, one may feel the impact of the apex of the heart against the chest wall with each contraction of the heart by placing the hand on the left side back of the fifth rib and above the point of the elbow. The thinner and the better bred the horse is the more distinctly this impact is felt. If the animal is excited, or if he has just been exercised, the impact is stronger than when the horse is at rest. If the horse is weak, the impact is reduced in force. The examination of the heart with the ear is an important matter in this connection. Certain sounds are produced by each contraction of the normal heart. It is customary to divide these into two, and to call them the first and second sounds. These two sounds are heard during each pulsation, and any deviation of the normal indicates some alteration in the structure or the functions of the heart. In making this examination, one may apply the left ear over the heavy muscles of the shoulder back of the shoulder joint, and just above the point of Digitized by Microsoft® EXAMINATION OF A SICK HORSE. 17 the elbow, or, if the sounds are not heard distinctly, the left fore leg may be drawn forward by an assistant and the right ear placed against the lower portion of the chest wall that is exposed in this manner. The first sound of the heart occurs while the heart muscle is con- tracting and while the blood is being forced from the heart and the valves are rendered taut to prevent the return of the blood from the lower to the upper chambers. The second sound follows quickly after the first and occurs during rebound of blood in the arteries, caus- ing pressure in the aorta and tensions of the valves guarding its open- ing into the left ventricle. The first sound is of a high pitch and is longer and more distinct than the second. Under the influence of disease these sounds may be altered in various ways. It is not profit- able, in a work such as this, to describe the details of these alterations. Those who are interested will find this subject fully discussed in the veterinary text-books. TEMPERATURE. The temperature of the horse is determined roughly by placing the fingers in the mouth or between the thighs or by allowing the horse to exhale against the cheek or back of the hand. In accurate examina- tion, however, these means of determining temperature are not relied upon, but recourse is had to the use of the thermometer. The ther- mometer used for taking the temperature of a horse is a self-register- ing clinical thermometer, similar to that used by physicians, but larger, being from 5 to 6 inches long. The temperature of the animal is measured in the rectum. The normal temperature of the horse varies somewhat under differ- ent conditions. It is higher in the young animal than in the old, and is higher in hot weather than in cold. The weather and exercise de- cidedly influence the temperature physiologically. The normal tem- perature varies from 99.5° to 101° F. If the temperature rises to 102.5° the horse is said to have a low fever; if the temperature reaches 104° the fever is moderate; if it reaches 106° it is high, and above this point it is regarded as very high. In some diseases, such as tetanus or sunstroke, the temperature goes as high as 108° or 110°. In the ordinary infectious diseases it does not often exceed 106°. A tem- perature of 107.5° and above is very dangerous and must be reduced promptly if the horse is to be saved. THE ORGANS OF RESPIRATION. Tn examining this system of organs and their functions it is custom- ary to begin by noting the frequency of the respiratory movements. This point can be determined by observing the motions of the nostrils or of the flanks; on a cold day one can see the condensation of the moisture of the warm air as it comes from the lungs. The normal H. Doce. 795, 59-2——_2 2 Digitized by Microsoft® 18 DISEASES OF .THE HORSE. rate of respiration for a healthy horse at rest is from 8 to 16 per min- ute. The rate is faster in young animals than in old, and ts increased by work, hot weather, overfilling of the stomach, pregnancy, lying upon the side, etc. Acceleration of the respiratory rate where no physiological cause operates is due to a variety of conditions. Among these is fever; restricted area of active lung tissue, from filling of por- tions of the lungs with inflammatory exudate, as in pneumonia; com- pression of the lungs or loss of elasticity; pain in the muscles con- irolling the respiratory movements; excess of carbon dioxide in the blood; and constriction of the air passages leading to the lungs. Difficult or labored respiration is known as dyspnea. It occurs when it is difficult, for any reason, for the animal to obtain the amount of oxygen that it requires. This may be due to filling of the lungs, as in pneumonia; to painful movements of the chest, as in rheu- matism or pleurisy; to tumors of the nose and paralysis of the throat, swellings of the throat, foreign bodies, or weakness of the respiratory passages, fluid in the chest cavity, adhesions between the lungs and chest walls, loss of elasticity of the lungs, etc. Where the difficulty is great the accessory muscles of respiration are brought into play. In great dyspnea the horse stands with his front feet apart, with his neck straight out, and his head extended upon his neck. The nostrils are widely dilated, the face has an anxious expression, the eyeballs protrude, the up-and-down motion of the larynx is aggravated, the amplitude of the movement of the chest walls increased, and the flanks heave. The expired air is of about the temperature of the body. It con- tains considerable moisture, and it should come with equal force from each nostril and should not have an unpleasant odor. If the stream of air from one nostril is stronger than from the other, there is an in- dication of an obstruction in a nasal chamber. If the air possesses a bad odor, it is usually an indication of putrefaction of a tissue or secretion in some part of the respiratory tract. A bad odor is found where there is necrosis of the bone in the nasal passages or in chronic catarrh. An ulcerating tumor of the nose or throat may cause the breath to have an offensive odor. The most offensive breath occurs where there is necrosis, or gangrene, of the lungs. In some diseases there is a discharge from the nose. In order to determine the significance of the discharge it should be examined closely. One should ascertain whether it comes from one or both nostrils. If but from one nostril, it probably originates in the head. The color should be noted. A thin, watery discharge may be com-_ posed of serum, and it occurs in the earlier stages of coryza, or nasal catarrh. An opalescent, slightly tinted discharge is composed of mucus and indicates a little more severe irritation. If the discharge is sticky and pus-like, a deeper difficulty or more advanced irritation Digitized by Microsoft® EXAMINATION OF A SICK HORSE. 19 is indicated. If the discharge contains flakes and clumps of more or less dried, agglutinated particles, it is probable that it originates within a cavity of the head, as the sinuses or guttural pouches. The discharge of glanders is of a peculiar sticky nature and adheres tenaciously to the wings of the nostrils. The discharge of pneumonia is of a somewhat red or reddish brown color, and, on this account, has been described as a prune-juice discharge. The discharge may contain blood. If the blood appears as clots or as streaks in the dis- charge, it probably originates at some point in the upper part of the respiratory tract. If the blood is in the form of a fine froth, it comes from the lungs. In examining the interior of the nasal passage one should remem- ber that the normal color of the mucous membrane is a rosy pink and that its surface is smooth. If ulcers, nodules, swellings, or tumors are found, these indicate disease. The ulcer that is characteristic of glanders is described fully in connection with the discussion of that disease. Between the lower jaws there are several clusters of lympathic glands. These glands are so small and so soft that it is difficult to find them by feeling through the skin, but when a suppurative dis- ease exists in the upper part of the respiratory tract these glands become swollen and easy to feel. They may become soft and break down and discharge as abscesses; this is seen constantly in strangles. On the other hand, they may become indurated and hard from the ‘proliferation of connective tissue and attach themselves to the jaw- bone, to the tongue, or to the skin. This is seen in chronic glanders._ If the glands are swollen and tender to pressure, it indicates that the disease causing the enlargement is acute; if they are hard and insen- sitive, the disease causing the enlargement is chronic. The manner in which the horse coughs is of importance in diagno- sis. The cough is a forced expiration, following immediately upon a forcible separation of the vocal cords. The purpose of the cough is to remove some irritant substance from the respiratory passages, and it occurs when irritant gases, such as smoke, ammonia, sulphur vapor, or dust, have been inhaled. It occurs from inhalation of cold air if the respiratory passages are sensitive from disease. In laryngitis, bronchitis, and pneumonia, cough is very easily excited and occurs merely from accumulation of mucus and inflammatory product upon the irritated respiratory mucous membrane. If one wishes to deter- mine the character of the cough, it can easily be excited by pressing upon the larynx with the thumb and finger. The larynx should be pressed from side to side and the pressure removed the moment the horse commences to cough. A painful cough occurs in pleurisy, also in laryngitis, bronchitis, and bronchial pneumonia. Pain is shown by the effort the animal exerts to repress the cough. The cough is not painful, as a rule, in the chronic diseases of the respiratory tract. Digitized by Microsoft® 20 DISEASES OF THE HORSE. The force of the cough is considerable when it is not especially pain- ful and when the lungs are not seriously involved. When the lungs are so diseased that they can not be filled with a large volume of air, and in heaves, the cough is weak, as it is also in weak, debilitated animals. If mucus or pus is coughed out, or if the cough is accom- panied by a gurgling sound, it is said to be moist; it is dry when these characteristics are not present—that is, when the air in passing out passes. over surface not loaded with secretion. In the examination of the chest we resort to percussion and aus- cultation. When a cask or other structure containing air is tapped upon, or percussed, a hollow sound is given forth. If the cask con- tains fluid, the sound is of a dull and of quite a different character. Similarly, the amount of air contained in the lungs can be estimated by tapping upon, or percussing, the walls of the chest. Percussion is practiced with the fingers alone or with the aid of a special percussion hammer and an object to strike upon known as a pleximeter. If the fingers are used, the middle finger of the left hand should be pressed firmly against the side of the horse and should be struck with the ends of the fingers of the right hand bent at a right angle so as to form a hammer. The percussion hammer sold by instrument makers is made of rubber or has a rubber tip, so that when the pleximeter, which is placed against the side, is struck the impact will not be accompanied by a noise. After experience in this method of exami- nation one can determine with a considerable degree of accuracy. whether the lung contains a normal amount of air or not. If, as in pneumonia, air has been displaced by inflammatory product occupy- ing the air space, or if fluid collects in the lower part of the chest, the percussion sound becomes dull. If, as in emphysema or in pneu- mothorax, there is an excess of air in the chest cavity, the percussion sound becomes abnormally loud and clear. Auscultation consists in the examination of the lungs with the ear applied closely to the chest wall. As the air goes in and out of the lungs a certain soft sound is made which can be heard distinctly, especially upon inspiration. This sound is intensified by anything that accelerates the rate of respiration, such as exercise. This soft, rustling sound is known as vesicular murmur, and wherever it is heard it signifies that the lung contains air and is functionally active. The vesicular murmur is weakened when there is an inflammatory infiltration of the lung tissue or when the lungs are compressed by fluid in the chest cavity. The vesicular murmur disappears when air is excluded by the accumulation of inflammatory product, as in pneu- monia, and when the lungs are compressed by fluid in the chest cavity. The vesicular murmur becomes rough and harsh in the early stages of inflammation of the lungs, and this is often the first sign of the beginning of pneumonia. Digitized by Microsoft® EXAMINATION OF A SICK HORSE. 21 By applying the ear over the lower part of the windpipe in front of the breastbone a somewhat harsh, blowing sound may be heard. This is known as the bronchial murmur and is heard in normal conditions near the lower part of the trachea and to a limited extent in the ante- rior portions of the lungs after sharp exercise. When the bronchial murmur is heard over other portions of the lungs, it may signify that the lungs are more or less solidified by disease and the blowing bron- chial murmur is transmitted through this solid lung to the ear from a distant part of the chest. The bronchial murmur in an abnormal place signifies that there exists pneumonia or that the lungs are com- pressed by fluid in the chest cavity. Additional sounds are heard in the lungs in some diseased condi- tions. For example, when fluid collects in the air passages and the air is forced through it or is caused to pass through tubes containing secretions or pus. Such sounds are of a gurgling or bubbling nature and are known as mucous rales. Mucous rales are spoken of as being large or small as they are distinct or indistinct, depending upon the quantity of fluid that is present and the size of the tube in which this sound is produced. Mucous rales occur in pneumonia after the solid- ified parts begin to break down at the end of the disease. They occur in bronchitis and in tuberculosis, where there is an excess of secretion. Sometimes a shrill sound is heard, like the note of a whistle, fife, or flute. This is due to a dry constriction of the bronchial tubes and it is heard in chronic bronchitis and in tuberculosis. A friction sound is heard in pleurisy. This is due to the rubbing together of ‘roughened surfaces, and the sound produced is similar to a dry rubbing sound that is caused by rubbing the hands together or by rubbing upon each other two dry, rough pieces of leather. THE EXAMINATION OF THE DIGESTIVE TRACT. The first point in connection with the examination of the organs of digestion is the appetite and the manner of taking food and drink. A healthy animal has a good appetite. Loss of appetite does not point to a special diseased condition, but comes from a variety of causes. Some of these causes, indeed, may be looked upon as being physio- logical. Excitement, strange surroundings, fatigue, and hot weather may all cause loss of appetite. Where there is cerebral depression, fever, profound weakness, disorder of the stomach, or mechanical difficulty in chewing or swallowing, the appetite is diminished or destroyed. Sometimes there is an appetite or desire to eat abnormal things, such as dirty bedding, roots of grass, soil, etc. This desire usually comes from a chronic disturbance of nutter. Thirst is diminished in a good many mild diseases unaccompanied by distinct fever. It is seen where there is great exhaustion or depres- sion or profound brain disturbance. Thirst is increased after pro- Digitized by Microsoft® 22 DISEASES OF THE HORSE. fuse sweating, in diabetes, diarrhea, in fever, at the crisis of infec- tious diseases, and when the mouth is dry and hot. Some diseases of the mouth or throat make it difficult for the horse to chew or swallow his food. Where difficulty in this respect is expe- rienced, the following-named conditions should be borne in mind and carefully looked for: Diseases of the teeth, consisting in decay, frac- ture, abscess formation, or overgrowth; inflammatory conditions, or wounds or tumors of the tongue, cheeks, or lips; paralysis of the mus- cles of chewing or swallowing; foreign bodies in upper part of the mouth between the molar teeth; inflammation of throat. Difficulty in swallowing is sometimes shown by the symptom known as “ quid- ding.” Quidding consists in dropping from the mouth well-chewed and insalivated boluses of food. A mouthful of hay, for example, after being ground and masticated, is carried to the back part of the mouth. The horse then finds that from tenderness of the throat, or from some other cause, swallowing is difficult or painful, and the bolus is then dropped from the mouth. Another quantity of hay is similarly prepared, only to be dropped in turn. Sometimes quidding is due to a painful tooth, the bolus being dropped from the mouth when the tooth is struck and during the pang that follows. Quid- ding may be practiced so persistently that a considerable pile of boluses of food accumulate in the manger or on the floor of the stall. In pharyngitis one of the symptoms is a return through the nose of fluid that the horse attempts to swallow. In some brain diseases, and particularly in chronic internal hydro- cephalus, the horse has a most peculiar manner of swallowing and of taking food. . — ae cael ae an LE YS 4/ Sen V7 Ascaris eguoerium Haines: de Digitized by Microsoft® Hus BEN 860 INTE STINAL WORMS. Digitized by Microsoft® DISEASES OF THE URINARY ORGANS. By James Law, F. R. C. V. &., Professor of Veterinary Science, etc., in Cornell University. [Revised in 1903 by the author. ] USES OF THE URINARY ORGANS. The urinary organs constitute the main channel through which are excreted the nitrogenous or albuminoid principles, whether derived directly from the food or from the muscular and other nitrogenized tissues of the body. They constitute, besides, the channel through which are thrown out most of the poisons, whether taken in by the mouth or skin or developed in connection with faulty or natural digestion, blood-forming, nutrition, or tissue destruction; or, finally, poisons that are developed within the body, as the result of normal cell life or of the life of bacteria or other germs that have entered the body from without. Bacteria themselves largely escape from the body through the kidneys. To a large extent, therefore, these organs are the sanitary scavengers and purifiers of the system, and when their functions are impaired or arrested the retained poisons quickly show their presence in resulting disorders of the skin and connective tissue beneath it, of the nervous system, or other organs. Nor is this influence one-sided. Scarcely an important organ of the body can suffer derangement without entailing a corresponding disorder of the urinary system. Nothing can be more striking than the mutual bal- " ance maintained between the liquid secretions of the skin and kidneys during hot and cold weather. In summer, when so much liquid ex- hales through the skin as sweat, comparatively little urine is passed, whereas in winter, when the skin is inactive, the urine is correspond- ingly increased. This vicarious action of skin and kidneys is usually kept within the limits of health, but at times the draining off of the water by the skin leaves too little to keep the solids of the urine safely in solution, and these are liable to crystallize out and form stone and gravel. Similarly the passage in the sweat of some of the solids that normally leave the body, dissolved in the urine, serves to irritate the skin and produce troublesome eruptions, PROMINENT CAUSES OF URINARY DISORDERS. A disordered liver contributes to the production, under different circumstances, of an excess of biliary coloring matter, which stains Digitized by Microsoft® " 76 DISEASES OF THE HORSE. the urine; of an excess of hippuric acid and allied products, which being less soluble than urea (the normal product of tissue change), favor the formation of stone, of taurocholic acid, and other bodies that tend, when in excess, to destroy the blood globules and to cause irritation of the kidneys by the resulting hemoglobin excreted in the urine, and of glycogen too abundant to be burned up in the system, which induces saccharine urine (diabetes). Any disorder leading to impaired functional activity of the lungs is causative of an excess of hippuric acid and allied bodies, of oxalic acid, of sugar, etc., in the urine, which irritate the kidneys even if they do not produce solid deposits in the urinary passages. Diseases of the nervous system, and notably of the base of the brain and of the spinal cord, induce various urinary disorders, prominent among which are diabetes, chylous urine, and albuminuria. Certain affections, with imperfect nutrition or destructive waste of the bony tissues, tend to charge the urine with phosphates of lime and magnesia, and endanger the forma- tion of stone and gravel. In all extensive inflammations and acute fevers the liquids of the urine are diminished, while the solids (waste products), which should form the urinary secretion, are increased, and the surcharged urine proves irritant to the urinary organs or the retained waste products poison the system at large. Diseases of the heart and lungs, by interfering with the free onward flow of the blood from the right side of the heart, tend to throw that liquid back on the veins, and this backward pressure of venous blood strongly tends to disorders of the kidneys. Certain poisons taken with the food and water, notably that found in magnesian limestone and those found in irritant diuretic plants, are especially injurious to the kidneys, as are also various cryptogams, whether present in musty hay or oats. The kidneys may be irritated by feeding green vege- tables covered with hoar frost or by furnishing an excess of food rich - in phosphates (wheat bran, beans, pease, vetches, lentils, rape cake, ° cotton-seed cake) or by a privation of water, which entails a concen- trated condition and high density of the urine. Exposure in cold rain or snow storms, cold drafts of air, and damp beds are liable to further disorder an already overworked or irritable kidney. Finally, sprains of the back and loins may cause bleeding from the kidneys or inflammation. The right kidney, weighing 234 ounces, is shaped like a French bean, and extends from the loins forward to beneath the heads of the last two ribs. The left kidney (Plate IV) resembles a heart of cards, and extends from the loins forward beneath the head of the last rib only. Each consists of three distinct parts—(a) the external (corti- cal), or vascular part, in which the blood vessels form elaborate capillary networks within the dilated globular sacs which form the beginnings of the secreting (uriniferous) tubes and on the surface Digitized by Microsoft® PEAS i IV; a,Cortical (or vascular) portion; b, Medullary (or tabular) portion ; vu, Peripheral portion of the latter, d,lntertor of the pelvis; aid; Arms of the pelvis; e, Border of the crest; tIntiundibulum, g, Creter Geo. Marx.del,atter D Arboval p 669 JULIUS BIEN & CONY LONGITUDI Digitized By Michdso nw? ERD NERY Digitized by Microsoft® DISEASES OF THE URINARY ORGANS. 77 of the sinuous secreting tubes leading from the sacs inward toward the second, or medullary, part of the organ; (b) the internal (medul- lary) part, made up in the main of blood vessels, lymphatics, and nerves extending between the notch on the inner border of the kid- ney to and from the outer vascular portion, in which the secretion of urine is almost exclusively carried on; and (d) a large saccular reservoir in the center of the kidney, into which all uriniferous tubes pour their secretions and from which the urine is carried away through a tube g (ureter), which passes out of the notch at the inner border of the kidney and which opens by a valve-closed orifice into the roof of the bladder just in front of its neck. The bladder is a dilatable reservoir for the retention of the urine until the discomfort of its presence causes its voluntary discharge. It is kept closed by circu- lar muscular fibers surrounding its neck or orifice, and is emptied by looped muscular fibers extending in all directions forward from the neck around the blind anterior end of the sac. From the bladder the urine escapes through a dilatable tube (urethra) which extends from the neck of the bladder backward on the floor of the pelvis, and in the male through the penis to its free end, where it opens through a pink conical papilla. In the mare the,urethra is not more than an inch in length, and is surrounded by the circular muscular fibers closing the neck of the bladder. Its opening may be found directly in the median line of the floor of the vulva, about 44 inches from its external opening. GENERAL SYMPTOMS OF DISEASE, These apply especially to acute inflammations and the irritation caused by stone. The animal moves stiffly on the hind limbs, strad- dles, and makes frequent attempts to pass urine, which may be in excess, deficient in amount, liable to sudden arrest in spite of the straining, passed in driblets, or entirely suppressed. ‘Again, it may be modified in density or constituents. Difficulty in making a sharp turn, or in lying down and rising with or without groaning, drop- ping the back when mounted or when pinched on the loins is sugges- tive of kidney disease, and so to a less extent are swelled legs, dropsy, and diseases of the skin and nervous system. The oiled hand intro- duced through the rectum may feel the bladder beneath and detect any overdistention, swelling, tenderness, or stone. In ponies the kid- neys even may be reached. = EXAMINATION OF THE URINE. Jn some cases the changes in the urine are the sole sign of disease. In health the horse’s urine is of a deep amber color and has a strong odor. On a feed of grain and hay it may show a uniform transpar- Digitized by Microsoft® 78 DISEASES OF THE HORSE. ency, while on a green ration there is an abundant white deposit of carbonate of lime. Of its morbid changes the following are to be looked for: (1) Color: White from deposited salts of lime; brown or red from blood clots or coloring matter; yellow or orange from bile or blood pigment; pale from excess of water; or variously colored from vegetable ingredients (santonin makes it red; rhubarb or senna, brown; tar or carbolic acid, green). (2) Density: The horse’s urine may be 1.030 to 1.050, but it may greatly exceed this in diabetes and may sink to 1.007 in diuresis. (3) Chemical reaction, as ascertained by blue litmus or red test papers. The horse on vegetable diet has alkaline urine turning red test papers blue, while in the sucking colt and the horse fed on flesh or on his own tissues (in starvation or ab- stinence during disease) it is acid, turning blue litmus red. (4) Organic constituents, as when glairy from albumen coagulable by strong nitric acid and boiling, when charged with microscopic casts of the uriniferous tubes, with the eggs or bodies of worms, with sugar, blood, or bile. (5) Jn tts salts, which may crystallize out spontane- ously, or on boiling, or on the addition of chemical reagents. Albuminous urine in the horse is usually glairy, so that it may be drawn out in threads, but itg presence can always be tested as follows: If the liquid is opaque, it may be first passed through filter paper; if very dense and already precipitating its salts, it may be diluted with distilled water; add to the suspected liquid acetic acid drop by drop until it reddens the blue litmus paper; then boil gently in a test tube; if a precipitate is thrown down, set the tube aside to cool and then add strong nitric acid. If the precipitate is not dissolved, it is albumen; if dissolved it was probably urate or hippurate of ammonia. Albu- men is normally present in advanced gestation; abnormally it is seen in diseases in which there occurs destruction of blood globules (anthrax, low fevers, watery states of the blood, dropsies), in diseases of the heart and liver which prevent the free escape of blood from the veins and throw back venous pressure on the kidneys, in inflamma- tion of the lungs and pleure, and even tympany (bloating), doubtless from the same cause, and in all congestive or inflammatory diseases of the kidneys, acute or chronic. Casts of the uriniferous tubes can only be seen by placing the sus- pected urine under the microscope. They are usually very elastic and mobile, waving about in the liquid when the cover-glass is touched, and showing a uniform clear transparency (waxy) or entan- gled circular epithelial cells or opaque granules or flattened red-blood globules or clear refrangent oil globules. They may be even densely opaque from crystals of earthy salts. Pus cells may be found in the urine associated with albumen, and are recognized by clearing up, when treated with acetic acid, so that each cell shows two or three nuclei. Digitized by Microsoft® DISEASES OF THE URINARY ORGANS. 79 DIURESIS (POLYURIA, DIABETES INSIPIDUS, OR EXCESSIVE SECRETION OF URINE). This consists in an excessive secretion of a clear, watery urine of a low specific gravity (1.007) with a correspondingly ardent thirst, a rapidly advancing emaciation, and great loss of strength and spirit. Causes.—Its causes may be any agent—medicinal, alimentary, or poisonous—which unduly stimulate the kidneys; the reckless admin- istration of diuretics, which form such a common constituent of quack horse powders; acrid diuretic plants in grass or hay; new oats still imperfectly cured; an excess of roots or other very watery food; a full allowance of salt to animals that have become inordinately fond of it; but, above all, feeding on hay, grain, or bran which has not been properly dried and has become musty and permeated by fungi. Thus hay, straw, or oats secured in wet seasons and heating in the rick or stack is especially injurious. Hence this malady, like coma som- nolentum (sleepy staggers), is widespread in wet seasons, and espe- cially in rainy districts. Symptoms.—The horse drinks deep at every opportunity and passes urine on every occasion when stopped, the discharge ‘being pale, watery, of a low density, and inodorous; in short, it contains a great excess of water and a deficiency of the solid excretions. So great is the quantity passed, however, that the small amount of solids in any given specimen amounts in twenty-four hours to far more than the normal—a fact in keeping with the rapid wasting of the tissues and extreme emaciation. The flanks become tucked up, the fat disappears, the bones and muscles stand out prominently, the skin becomes tense and hidebound, and the hair erect, scurfy, and deficient in luster. The eye becomes dull and sunken, the spirits are depressed, the animal is weak and sluggish, sweats on the slightest exertion, and can endure little. The subject may survive for months, or he may die early of exhaustion. In the slighter cases, or when the cause ceases to-operate, he may make a somewhat tardy recovery. Treatment.—This consists in stopping the ingestion of the faulty drugs, poisons, or food, and supplying sound hay and grain free from all taint of heating or mustiness. A liberal supply of boiled flaxseed in the drinking water at once serves to eliminate the poison and to sheath and protect the irritated kidneys. Tonics like sulphate or phosphate of iron (2 drams morning and evening) and powdered gentian or Peruvian bark (4 drams) help greatly by bracing the system and hastening repair. To these may be added agents calcu- lated to destroy the fungus and eliminate its poisonous products. In that form which depends on musty food nothing acts better than large doses of iodide of potassium (2 drams), while in other cases creosote, carbolic acid (1 dram), or oil of turpentine (4 drams) properly diluted, may be resorted to. Digitized by Microsoft® 80 DISEASES OF THE HORSE. SACCHARINE DIABETES (DIABETES MELLITUS, GLYCOSURIA, OR INOSURIA). This is primarily a disease of the nervous system or liver rather than of the kidneys, yet, as the most prominent symptom is the sweet urine, it may be treated here. Causes.—Its causes are varied, but resolve themselves largely into disorder of the liver or disorder of the brain. One of the most prominent functions of the liver is the formation of glycogen, a prin- ciple allied to grape sugar, and passing into it by further oxidation in the blood. This is a constant function of the liver, but in health the resulting sugar is burned up in the circulation and does not appear in the urine. On the contrary, when the supply of oxygen is defective, as in certain diseases of the lungs, the whole of the sugar does not undergo combustion and the excess is excreted by the kidneys. Also in certain forms of enlarged liver the amount of sugar produced is more than can be disposed of in the natural way, and it appears in the urine. A temporary sweetness of the urine often occurs after a hearty meal on starchy food, but this is due altogether to the super- abundant supply of the sugar-forming food, lasts for a few hours only; and has no pathological significance. In many cases of fatal glycosuria the liver is found to be enlarged, or at least congested, and it is found that the disorder can be produced experimentally by agencies which produce an increased circulation through the liver. Thus Bernard produced glycosuria by pricking the oblong medulla at the base of the brain close to the roots of the pneumogastric nerve, which happens to be also the nerve center (vaso-motor) which presides over the contractions of the minute blood vessels. The pricking and irritation of this center leads to congestion of the liver and the exces- sive production of sugar. Irritation carried to this point through the pheumogastric nerve causes saccharine urine, and, in keeping with this, disease of the pancreas has been found in this malady. The com- plete removal of the pancreas, however, determines glycosuria, the organ having in health an inhibitive action on sugar production by the liver. The same result follows the reflection of irritation from other sources, as from different ganglia (corpora striata, optic thalami, pons, cerebellum, cerebrum) of the brain. Similarly it is induced by interruption of the nervous control along the vaso-motor tracts, as in destruction of the upper or lower cervical sympathetic ganglion, by cutting the nervous branch connecting these two, in injury to the spinal marrow in the interval between the brain and the second or fourth dorsal vertebra, or in disease of the celiac plexus, which directly presides over the liver. Certain chemical poisons also cause saccharine urine, notably woorara, strychnia, morphia, phosphoric acid, alcohol, ether, quinia, chloroform, ammonia, arsenic, and phlorizin. Symptoms.—The symptoms are ardent thirst and profuse secretion Digitized by Microsoft® SACCHARINE DIABETES (SWEET URINE). 81 of a pale urine of a high density (1.060 and upward), rapid loss of condition, scurfy, unthrifty skin, costiveness or irregularity of the bowels, indigestion, and the presénce in the urine of a sweet princi- ple—grape-sugar or inosite, or both. This may be most promptly de- tected by touching the tip of the tongue with a drop. Sugar may be detected simply by adding a teaspoonful of liquid yeast to 4 ounces of the urine and keeping it lightly stopped at a temperature of 70° to 80° F. for twelve hours, when the sugar will be found to have been changed into alcohol and carbon dioxide. The loss of density will give indication of the amount of sugar transformed; thus a density of 1.035 in a urine which was formerly 1.060 would indicate about 15 grains of sugar to the fluid ounce. Inosite, or muscle sugar, frequently present in the horse’s urine, and even replacing the glucose, is not fermentable. Its presence may be indicated by its sweetness and the absence of fermentation or by Gal- lois’s test. vaporate the suspected urine at a gentle heat almost to dryness, then add a drop of a solution of mercuric nitrate and evapo- rate carefully to dryness, when a yellowish residue is left that is changed on further cautious heating to a deep rose color, which dis- appears on cooling and reappears on heating. In advanced diabetes, dropsies in the limbs and under the chest and belly, puffy, swollen eyelids, cataracts, catarrhal inflammation of the lungs, weak, uncertain gait, and drowsiness may be noted. Treatment is most satisfactory in cases dependent on some curable disease of liver, pancreas, lungs, or brain. Thus, in liver diseases, a - run at pasture in warm weather, or in winter a warm, sunny, well- aired stable, with sufficient clothing and laxatives (sulphate of soda, 1 ounce daily) and alkalies (carbonate of potassium, one-fourth ounce) may benefit. To this may be added mild blistering, cupping, or even leeching over the last ribs. Diseases of the brain or pancreas may be treated according to their indications. The diet should be mainly albuminous, such as wheat bran or middlings, pease, beans, vetches, and milk. Indeed, an exclusive milk diet is one of the very best remedial agencies. It may be given as skimmed milk or butter- milk, and in the last case combines an antidiabetic remedy in the lactic acid. Under such an exclusive diet recent and mild cases are often entirely restored, though at the expense of an attack of rheumatism. Codeia, one of the alkaloids of opium, is strongly recommended by Doctor Tyson. The dose for the horse would be 10 to 15 grains thrice daily. In cases in which there is manifest irritation of the brain, bromide of potassium, 4 drams, or ergot one-half ounce, may be re- sorted to. Salicylic acid and salicylate of sodium have proved useful in certain cases; also phosphate of sodium. Bitter tonics (especially nux vomica one-half dram) are useful in improving the digestion and general health. H. Doe. 795, 59-2 2 Digitized by Microsoft® 82 DISEASES OF THE HORSE. BLOODY URINE, OR HEMATURIA. Cause-—As seen in the horse, bloody urine is usually the direct result of mechanical injuries, as sprains and fractures of the loins, lacerations of the sublumbar muscles (psoas), irritation caused by stone in the kidney, ureter, bladder, or urethra. It may, however, occur with acute congestion of the kidney, with tumors in its sub- stance, or with papilloma or other diseased growth in the bladder. Acrid diuretic plants present in the food may also lead to the escape of blood from the kidney. The predisposition to this affection is, however, incomparably less than in the case of the ox or the sheep, the difference being attributed to the greater plasticity of the horse’s blood in connection with the larger quantity of fibrin. The blood may be present in small clots or in more or less intimate admixture with the urine. Its condition may furnish some indication as to its source; thus, if from the kidneys it is more likely to be uni- formly diffused through the urine, while as furnished by the bladder or passages clots are more likely to be present. Again, in bleeding from the kidney, minute cylindrical clots inclosing blood globules and formed in the uriniferous tubes can be detected under the micro- scope. Precision also may be approximated by observing whether there is coexisting fracture, sprain of the loins, or stone or tumor in the bladder or urethra. Treatment.—The disease being mainly due to direct injury, treat- ment will consist, first, in removing such cause whenever possible, and then in applying general and local styptics. Irritants in food must be avoided, sprains appropriately treated, and stone in bladder or urethra removed. Then give mucilaginous drinks (slippery elm, lin- seed tea) freely, and styptics (tincture of chloride of iron 8 drams, acetate of lead one-half dram, tannic acid one-half dram, or oil of turpentine 1 ounce). If the discharge is abundant, apply cold water to the loins and keep the animal perfectly still. HEMOGLOBINURIA (AZOTURIA, AZOTEMIA, POISONING BY ALBUMINOIDS). Like diabetes, this is rather a disease of the liver and blood-form- ing functions than of the kidney, but as prominent symptoms are loss of control over the hind limbs and the passage of ropy and. dark- colored urine, the vulgar idea is that it is a disorder of the urinary organs. It is a complex affection directly connected with a plethora in the blood of nitrogenized constituents, with extreme nervous and muscular disorder and the excretion of a dense reddish or brownish urine. It is directly connected with high feeding, especially on highly nitrogenized food (oats, beans, pease, vetches, cotton-seed meal), and with a period of idleness in the stall under full rations. The disease is never seen at pasture, rarely under constant daily work, Digitized by Microsoft® BLOODY URINE, OR HEMATURIA. 83 even though the feeding be high, and the attack is usually precipi- tated by taking the horse from the stable and subjecting it to exercise or work. The poisoning is not present when taken from the stable, as the horse is likely to be noticeably lively and spirited, but he will usually succumb under the first hundred yards or half mile of exer- cise. It seems as if the aspiratory power of the chest under the sudden exertion and accelerated breathing speedily drew from the gorged liver and abdominal veins (portal) the accumulated store of nitrogenous matter in an imperfectly oxidized or elaborated condi- tion, and as if the blood, surcharged with these materials, was unable to maintain the healthy functions of the nerve centers and muscles. It has been noticed rather more frequently in mares than horses, attributable, perhaps, to the nervous excitement attendant on heat, and to the fact that the unmutilated mare is naturally more excitable than the docile gelding. Lignieres has found in hemoglobinuria a streptococcus which pro- duced nephritis, bloody urine, and paraplegia in experimental ani- mals, including horses. Symptoms.—tin the milder forms this affection may appear as a lameness in one limb, from indefinite cause, succeeding to some sud- den exertion and attended by a dusky-brown color of the membranes of the eye and nose and some wincing when the last ribs are struck. The severe forms come on after one or two days of rest on a full ration, when the animal has been taken out and driven one hundred paces or more. The fire and life with which he had left the stable suddenly give place to dullness and oppression, as shown in heaving flanks, dilated nostrils, pinched face, perspiring skin, and trembling body. The muscles of the loins or haunch become swelled and rigid, the subject moves stiffly or unsteadily, crouches behind, the limbs being carried semiflexed, and he soon drops, unable to support him- self. When down, the body and limbs are moved convulsively, but there is no power of coordination of movement in the muscles. The pulse and breathing are accelerated, the eyes red with a tinge of brown, and the urine, if passed, is seen to be highly colored, dark brown, red, or black, but it contains neither blood clots nor globules. The color is mainly due to hemoglobin and other imperfectly elabo- rated constituents of the blood. It may end fatally in a few hours or days, or a recovery may ensue, which is usually more speedy and perfect if it has set in at an early stage. In the late and tardy recoveries a partial paralysis of the hind limbs may last for months. A frequent sequel of these tardy cases is an extensive wasting of the muscles leading up from the front of the stifle (those supplied by the crural nerve) and a complete inability to stand. Prevention.—The prevention of this serious affection lies in re- Digitized by Microsoft® 84 DISEASES OF THE HORSE. stricting the diet and giving daily exercise when the animal is not at work. A horse that has had one attack should never be left idle for a single day in the stall or barnyard. When a horse has been con- demned to absolute repose on good feeding he may have a laxative (one-half to 1 pound Glauber’s salts), and have graduated exercise, beginning with a short walk and increasing day by day. Treatment.—The treatment of the mild cases may consist in a laxa- tive, graduated daily exercise, and a daily dose of saltpeter (1 ounce). Sudden attacks will sometimes promptly subside if taken on the in- stant and the subject kept still and calmed by a dose of bromide of potassium (4 drams) and sweet spirits of niter (1 ounce). The latter has the advantage of increasing the secretion of the kidneys. Iodide of potassium in one-half ounce doses every four hours has succeeded well in some hands. In severe cases, as a rule, it is desira- ble to begin treatment by a dose of aloes (4 to 6 drams) with the above-named dose of bromide of potassium, and this latter may be continued at intervals of four or six hours, as may be requisite to calm the nervous excitement. Fomentations with warm water over the loins are always useful in calming the excitable conditions of the spinal cord, muscles, liver, and kidneys, and also in favoring secre- tion from the two latter. On the second day diuretics may be re- sorted to, such as saltpeter one-half ounce, and powdered colchicum one-half dram, to be repeated twice daily. A laxative may be re- peated in three or four days should the bowels seem to demand it, and as the nervous excitement disappears any remaining muscular weakness or paralysis may be treated by one-half dram doses of nux vomica twice a day and a stimulating liniment (aqua ammonia and sweet oil in equal proportions) rubbed on the torpid muscles. During the course of the disease friction to the limbs is useful, and in the advanced paralytic stage the application of electricity along the line of the affected muscles. When the patient can not stand he must have a thick, soft bed, and should be turned from side to side at least every twelve hours. As soon as he can be made to stand he may be helped up and even supported in a sling. ACUTE INFLAMMATION OF THE KIDNEYS, OR ACUTE NEPHRITIS. Inflammations of the kidneys have been differentiated widely, ac- cording as they were acute or chronic, parenchymatous or tubal, sup- purative or not, with increased or shrunken kidney, ete.; but in a work like the present utility will be consulted by classing all under acute or chronic inflammation. Causes.—The causes of inflammation of the kidneys are extremely varied. Congestion occurs from the altered and irritant products passed through these organs during recovery from inflammations of other organs and during fevers. This may last only during the exist- Digitized by Microsoft® INFLAMMATION OF THE KIDNEYS. 85 ence of its cause, or may persist and become aggravated. Heart dis- ease, throwing the blood pressure back on the veins and kidneys, is another cause. Disease of the ureter or bladder, preventing the escape of urine from the kidney and causing increased fullness and tension in its pelvis and tubes, will determine inflammation. Decom- position of the detained urine in such cases and the production of ammonia and other irritants must also be named. In elimination of bacteria through the kidney, the latter is liable to infection with con- sequent inflammation. The advance of bacteria upward from the bladder to the kidneys is another cause. The consumption in hay or other fodder of acrid or irritant plants, including fungi, the absorp- tion of cantharidine from a surface blistered by Spanish flies, the reckless administration of diuretics, the presence of stones in the kidney, exposure of the surface to cold and wet, and the infliction of blows or sprains on the loins, may contribute to its production. Liver disorders which throw on the kidneys the work of excreting irritant products, diseases of the lungs and heart from which clots are car- ried, to be arrested in the small blood vessels of the kidney, and injuries and paralysis of the spinal cord, are additional causes. Symptoms.—The symptoms are more or less fever, manifest stiff- ness of the back and straddling gait with the hind limbs, difficulty in lying down and rising, or in walking in a circle, the animal sometimes groaning under the effort, arching of the loins and tucking up of the flank, looking back at the abdomen as if from colicky pain, and ten- derness of the loins to pinching, especially just beneath the bony processes 6 inches to one side of the median line. Urine is passed frequently, a small quantity at a time, of a high color, and sometimes mixed with blood or even pus. Under the microscope it shows the microscopic casts referred to under general symptoms. If treated by acetic acid, boiling, and subsequent addition of strong nitric acid, the resulting and persistent precipitate indicates the amount of albumen. The legs tend to swell from the foot up, also the dependent parts beneath the belly and chest, and effusions of liquid may occur within the chest or abdomen. In the male animal the alternate drawing up and relaxation of the testicles in the scrotum are suggestive, and in small horses the oiled hand introduced into the rectum may reach the kidney and ascertain its sensitiveness. Treatment demands, first, the removal of any recognized cause. Then, if the suffering and fever are high, 2 to 4 quarts of blood may be abstracted from the jugular vein; in weak subjects or unless in high fever this should be omitted. Next relieve the kidneys so far as possible by throwing their work on the bowels and skin. A pint of castor oil is less likely than either aloes or salts to act on the kid- neys. To affect the skin a warm stall and heavy clothing may be supplemented by dram doses of Dover’s powder. Pain may be Digitized by Microsoft® 86 DISEASES OF. THE HORSE. soothed by dram doses of bromide of potassium. Boiled flaxseed may be added to the drinking water, and also thrown into the rectum as an injection, and blankets saturated with hot water should be per- sistently applied to the loins. This may be followed by a very thin pulp of the best ground mustard made with tepid water, rubbed in against the direction of the hair and covered up with paper and a blanket. This may be kept on for an hour, or until the skin thickens and the hair stands erect. It may then be rubbed or sponged off and the blanket reapplied. When the action of the bowels has been started it may be kept up by a daily dose of 2 or 3 ounces of Glauber’s salts. During recovery a course of bitter tonics (nux vomica 1 scruple, ground gentian root 4 drams) should be given. The patient should also be guarded against cold, wet, and any active exertion for some time after all active symptoms have subsided. CHRONIC INFLAMMATION OF THE KIDNEYS. Causes.—-Chronic inflammation of the kidneys is more commonly associated with albumen and casts in the urine than the acute form, and in some instances these conditions of the urine may be-the only prominent symptoms of the disease. Though it may supervene on blows, injuries, and exposures, it is much more commonly connected with faulty conditions of the system—as indigestion, heart disease, lung or liver disease, imperfect blood formation, or assimilation; in short, it is rather the attendant on a constitutional infirmity than on a simple local injury. It may be associated with various forms of diseased kidneys, as shrinkage (atrophy), increase (hypertrophy), softening, red conges- tion, white enlargement, etc., so that it forms a group of diseases rather than a disease by itself. Symptoms.—The symptoms may include stiffness, weakness, and increased sensibility of the loins, and modified secretion of urine (increase or suppression), or the flow may be natural. Usually it contains albumen, the amount furnishing a fair criterion of the grav- ity of the affection, and microscopic casts, also most abundant in bad cases. Dropsy, manifested in swelled legs, is a significant symptom, and if the effusion takes place along the lower line of the body or in chest or abdomen, the significance is increased. A scurfy, unthrifty skin, lack-luster hair, inability to sustain severe or continued exer- tion, poor or irregular appetite, loss of fat and flesh, softness of the muscles, and pallor of the eyes and nose are equally suggestive. So are skin eruptions of various kinds. Any one or more of these symp- toms would warrant an examination of the urine for albumen and casts, the finding of which signifies renal inflammation. Treatment of these cases is not always satisfactory, as the cause is Digitized by Microsoft® DISEASES OF THE KIDNEYS AND BLADDER. 87 liable to be maintained in the disorders of important organs else- where. If any such coincident disease of another organ or function can be detected, that should be treated first or simultaneously with this affection of the kidneys. In all cases the building up of the general health is important. Hence a course of tonics may be given (phosphate of iron 2 drams, nux vomica 20 grains, powdered gentian root 4 drams, daily) or 60 drops of sulphuric acid or nitromuriatic acid may be given daily in the drinking water. If there is any ele- vated temperature of the body and tenderness of the loins, fomenta- tions may be applied, followed by a mustard pulp, as for acute inflammation, and even in the absence of these indications the mus- tard may be resorted to with advantage at intervals of a few days. In suppression of urine, fomentations with warm water or with infu- sion of digitalis leaves is a safer resort than diuretics, and cupping over the loins may also benefit. To apply a cup, shave the skin and oil it; then take a narrow-mouthed glass, rarify the air within it by introducing a taper in full flame for a second, withdraw the taper and instantly apply the mouth of the glass to the skin and hold it closely applied till the cooling tends to form a vacuum in the glass and to draw up the skin, like a sucker. As in the acute inflammation, every attention must be given to secure warm clothing, a warm stall, and pure air. TUMORS OF THE KIDNEYS. Tumors, whether malignant or simple, would give rise to symptoms resembling some form of inflammation, and are not likely to be recog- nized during life. PARASITES. To parasites of the kidney belong the echénococcus, the larval, or bladder worm, stage of the small echinococcus tapeworm of the dog; also the Cysticercus fistularis, another bladder worm of an unknown tapeworm; in these there is the possibility of the passage with the urine of a detached head of the bladder worm or of some of its micro- scopic hooklets, which might be found in the sediment of the urine and thus establish a diagnosis. Dioctophyme renale, the largest of roundworms, has been found in the kidney of the horse. Its presence can only be certified by the passage of its microscopic eggs or of the entire worm. Immature stages of roundworms, either Strongylus equinus or a related species, may be found in the renal artery or in the kidney itself. SPASM OF THE NECK OF THE BLADDER. This affection consists in spasmodic closure of the outlet from the bladder by tonic contraction of the circular muscular fibers. It may be accompanied by a painful contraction of the muscles on the body Digitized by Microsoft® 88 DISEASES OF THE HORSE. of the bladder; or, if the organ is already unduly distended, these will be affected with temporary paralysis. It is most frequent in the horse, but by no means unknown in the mare. Causes.—The causes are usually hard and continuous driving with- out opportunity for passing urine, cold rainstorms, drafts of cold air when perspiring and fatigued, the administration of Spanish fly or the application of extensive blisters of the same, abuse of diuretics, the presence of acrid diuretic plants in the fodder, and the presence of stone in the bladder. As most mares refuse to urinate while in harness, they should be unhitched at suitable times for urination. Spasms of the bowels are always attended by spasm of the bladder, hence the free passage of water is usually a symptom of relief. . Symptoms.—The symptoms are frequent stretching and straining to urinate, with no result or a slight dribbling only. These vain efforts are attended by pain and groaning. On resuming his natural position the animal is not freed from the pain, but moves uneasily, paws, shakes the tail, kicks at the abdomen with his hind feet, looks back to the flank, lies down and rises, arches the back, and attempts to urinate as before. If the oiled hand is introduced into the rectum the greatly distended bladder may be felt beneath, and the patient will often shrink when it is handled. It is important to notice that irritation of the urinary organs is often present in impaction of the colon with solid matters, because the impacted intestine under the straining of the patient is forced backward into the pelvis and presses upon and irritates the bladder. In such cages the horse stands with his fore limbs advanced and the hind ones stretched back beyond the natural posture, and makes fre- quent efforts to urinate, with varying success. Unpracticed observers naturally conclude that the secondary urinary trouble is the main and only one, and the intestinal impaction and obstruction is too often neglected until it is irremediable. In cases where the irritation has caused spasm of the neck of the bladder and overdistention of that organ, the mistake is still more easily made; hence it is important in ~ all cases to examine for the impacted bowel, forming a bend, or loop, at the entrance of the pelvis and usually toward the left side. The impacted intestine feels soft and doughy, and is easily indented with the knuckles, forming a marked contrast with the tense, elastic, resil- ient, overdistended bladder. It remains to be noted that similar symptoms may be determined by a stone or sebaceous mass, or stricture obstructing the urethra, or in the newborn by thickened mucus in that duct and by the pressure of hardened, impacted feces in the rectum. In obstruction, the hard, impacted body can usually be felt by tracing the urethra along the lower and posterior surface of the penis and forward to the median line of the floor of the pelvis to the neck of the bladder. That part Digitized by Microsoft® Ned Miyata IES : i | C 5 ce | 5 I ee i E i B 8|| H i 5 | Ere i el | i a HE g | i ¢ i: a i iN : UH | & B f\ Hh | a i 4 a zany \F i i | H 10 | i oa | H #7 We | i i ft +) | aos = ——— a SS a re ee coer init) ee i i ve yal pe iS A = as ——— = oo Structure of the Kidney. Diagranunatic a, Medillary laver; b, Boundary xane,; ¢, Cortical layer, 1, Fecretors tube; 2,Open ing on the summil of renal papilla; 3,lirst branch of bifurcation, % Second brancn of bitiircation; 5,Third branch of bifurcation ;, 6, Straight collecting tube; 7, June tonal tcbiile; &, Ascending portion of Hentes loop, 9, Descending portion of Henle s loop; 10, Loop of Henle: Il, Convolited tubule; 12, Malpighian corpuscte ;l3,Renal ar tery; 14 Branch supplying the glomeruli, 13, Afferent vessel of the glomeriilt » 16, Branch going directly: to the capillaries, li, Straight arterioles coming directly from the renal artery, 18, Straight arteriole coming trom the atterent vessel of the glomerulus, 19, Straight artertole coming trom the capillary placius, 20, Vascilar loop of the pyramids, CL Efferent vessel of the glomerulus going to the capillary pleas, 22,Capittary plexus of the glomerular part of the cortical substance ; 23,Capitlary plecus of the pyramids of Ferre, <4 Cortical plexus of the kidney, 25,Venae stetlatae ; 26,Vein coming trom the captllartes of the cortesc , 27, Inter lobular veut, 28, Ven recening the veriae rectie; 29, Venae rectae Note . The shaded part of the urinary ALCS represent the part in which the epithelium us rodded and of a granitar appearance Geo. Marx,after D'Arboval . p 372 shyfll JULIUS BIEN 8 CON ¥ MICOS Digitized By Microsoft® ID N bY Vv Digitized by Microsoft® ANNE Ds Renal Glomerulus. a“ Artery of the glomerulus, b, Branch supplying the atterent vessel of the Glomeruliis, c, Afferent vessel of the glomerite ; d, Artery gowg directly to the capillary plexus of the cortical SUOSTAILCE > C, capllary plexus ; Lh Clomerulins Renal Glomerulus with its wferentvessels and efferents . a, Branch of renal artery; b, Afferent vessel of the glomerulus; ¢, Gloneriulits ; A, Afferent vessel go- ing into corpuscle eet Matpighi b 372 7 JULIUS BIEN & CO. Geo. Marx,afier D Arboval. p 372 371 MICR ¢ Diditize'd by Microsone KIDNE Digitized by Microsoft® PIA Vit, Phosphatic cateadus, urte acid nucleus. X 215 Calculus of ovalate of line Siaight Lorceps used mremnovtry CUA, Fieral casts. Some deprived of epithelium. lwo are decper colored trom the presence of urate of soda Haines.del after Hurtrel DArboval JULIUS BIEN 8 CO.N 4 cALcuLiDigitized byrlisrosoff® oR REMOVAL. Digitized by Microsoft® PARALYSIS OF THE BLADDER. 89 of the urethra between the seat of obstruction and the bladder is usually distended with urine, and feels enlarged, elastic, and fluctu- ating. Treatment.—Treatment may be begun by taking the animal out of harness. This failing, spread clean litter beneath the belly or turn the patient out on the dung heap. Some seek to establish sympa- thetic action by pouring water from one vessel into another with dribbling noise. Others soothe and distract the attention by slow whistling. Friction of the abdomen with wisps of straw may suc- ceed, or it may be rubbed with ammonia and oil. These failing, an injection of 2 ounces of laudanum or of an infusion of 1 ounce of tobacco in water may be tried. In the mare the neck of the bladder is easily dilated by inserting two oiled fingers and slightly parting them. In the horse the oiled hand introduced into the rectum may press trom before backward on the anterior or blind end of the bladder. Finally, a well-oiled gum-elastic catheter may be entered into the urethra through the papilla at the end of the penis and pushed on carefully until it has entered the bladder. To effect this the penis must first be withdrawn from its sheath, and when the advancing end of the catheter has reached the bend of the urethra beneath the anus it must be guided forward by pressure with the hand, which guidance must be continued onward into the bladder, the oiled hand being introduced into the rectum for this purpose. The horse catheter, 34 feet long and one-third inch in diameter, may be bought of a surgical instrument maker. PARALYSIS OF THE BLADDER. Paralysis of the body of the bladder with spasm of the neck has been described under the last heading, and may occur in the same way from overdistention in tetanus, acute rheumatism, paraplegia, and hemiplegia, in which the animal can not stretch himself to stale, and in cystitis, affecting the body of the bladder but not the neck. In all these cases the urine is suppressed. It also occurs as a result of disease of the posterior end of the spinal marrow and with broken back, and is then associated with palsy of the tail, and, it may be, of the hind limbs. Symptoms.—The symptoms are a constant dribbling of urine when the neck is involved, the liquid running down the inside of the thighs and irritating the skin. When the neck is unaffected the urine is retained until the bladder is greatly overdistended, when it may be expelled in a gush by the active contraction of the muscular walls of the abdomen; but this never empties the bladder, and the oiled hand introduced through the rectum may feel the soft, flabby organ still half full of urine. This retained urine is lable to decompose and give off ammonia, which dissolves the epithelial cells, exposing the Digitized by Microsoft® 90 DISEASES OF THE HORSE. raw mucous membrane and causing the worst type of cystitis. Sup- pression and incontinence of urine are common also to obstruction of the urethra by stone or otherwise; hence this source of fallacy should be excluded by manual examination along the whole course of that duct. Treatment.—Treatment is only applicable in cases in which the de- termining cause can be abated. In remedial sprains of the back or disease of the spinal cord these must have appropriate treatment, and the urine must be drawn off frequently with a catheter to prevent overdistention and injury to the bladder. If the paralysis persists after recovery of the spinal cord, or if it continues after relief of spasm of the neck of the bladder, apply a pulp of mustard and water over the back part of the belly in front of the udder, and cover with a rug until the hair stands erect. In the male the mustard may be applied between the thighs from near the anus downward. Daily doses of 2 drams extract of belladonna or of 2 grains powdered Spanish fly may serve to rouse the lost tone. These failing, a mild current of electricity daily may succeed. INFLAMMATION OF THE BLADDER (CYSTITIS, OR UROCYSTITIS). Cystitis may be slight or severe, acute or chronic, partial or general. It may be caused by abuse of diuretics, especially such as are irritat- ing (cantharides, turpentine, copaiba, resin, etc.), by the presence of a stone or gravel in the bladder, the irritation of a catheter or other foreign body introduced from without, the septic ferment (bac- terium) introduced on a filthy catheter, the overdistention of the bladder by retained urine, the extrication of ammonia from retained decomposing urine, resulting in destruction of the epithelial cells and irritation of the raw surface, and a too concentrated and irritating urine. The application of Spanish flies or turpentine over a too ex- tensive surface, sudden exposure of a perspiring and tired horse to cold or wet, and the presence of acrid plants in the fodder may cause cystitis, as they may nephritis. Finally, inflammation may extend from a diseased vagina or urethra to the bladder. Symptoms.—The symptoms are slight or severe colicky pains; the animal moves his hind feet uneasily or even kicks at the abdomen, looks around at his flank, and may even lie down and rise frequently. More characteristic are frequently repeated efforts to urinate, result- ing in the discharge of a little clear, or red, or more commonly floc- culent urine, always in jets, and accompanied by signs of pain, which persist after the discharge, as shown in continued straining, groan- ing, and perhaps in movements of the feet and tail. The penis hangs from the sheath, or in the mare the vulva is frequently opened and closed, as after urination. The animal winces when the abdomen is pressed in the region of the sheath or udder, and the bladder is found Digitized by Microsoft® DISEASES OF THE BLADDER. 91 to be sensitive and tender when pressed with the oiled hand intro- duced through the rectum or vagina. In the mare the thickening of the walls of the bladder may be felt by introducing one finger through the urethra. The discharged urine, which may be turbid or even oily, contains an excess of mucus, with flat shreds of membrane, with scaly epithelial cells, and pus corpuscles, each showing two or more nuclei when treated with acetic acid, but there are no microscopic tubular casts, as in nephritis. If ue to stone in the bladder, that will be found on examination through rectum or vagina. Treatment implies, first, the removal of the cause, whether poisons in food or as medicine, the removal of Spanish flies or other blistering agents from the skin, or the extraction of stone or gravel. If the urine has been retained and decomposed it must be completely evac- uated through a clean catheter, and the bladder thoroughly washed out with a solution of 1 dram of borax in a quart of water. This must be repeated twice daily until the urine no longer decomposes, because so long as ammonia is developed in the bladder the protecting layer of epithelial cells will be dissolved and the surface kept raw and irritable. The diet must be light (bran mashes, roots, fresh grass), and the drink impregnated with linseed tea, or solution of slippery elm or marsh mallow. The same agents may be used to inject into the rectum, or they may even be used along with borax and opium to inject into bladder (gum arabic 1 dram, opium 1 dram, tepid water 1 pint). Fomentations over the loins are often of great advantage, and these may be followed or alternated with the appli- cation of mustard, as in paralysis; or the mustard may be applied on the back part of the abdomen below or between the thighs from the anus downward. Finally, when the acute symptoms have subsided, a daily dose of buchu 1 dram and nux vomica one-half dram will serve to restore lost tone. IRRITABLE BLADDER. Some horses, and especially mares, show an irritability of the blad- der and nerve centers presiding over it by frequent urination in small quantities, though the urine is not manifestly changed in character and no more than the natural amount is passed in the twenty-four hours. The disorder appears to have its source quite as frequently in the generative or nervous system as in the urinary. A troublesome and dangerous form is seen in mares, which dash off and refuse all control by the rein if driven with a full bladder, but usually prove docile if the bladder has been emptied before hitching. In other cases the excitement connected with getting the tail over the reins is a pow- erful determining cause. The condition is marked in many mares during the period of “ heat.” An oleaginous laxative (castor oil 1 pint) will serve to remove any Digitized by Microsoft® 92 DISEASES OF THE HORSE. cause of irritation in the digestive organs, and a careful dieting will avoid continued irritation by acrid vegetable agents. The bladder should be examined to see that there is ‘no stone or other cause of irri- tation, and the sheath and penis should be washed with soapsuds, any sebaceous matter removed from the bilocular cavity at the end of the penis, and the whole lubricated with sweet oil. Irritable mares should be induced to urinate before they are harnessed, and those that clutch the lines under the tail may have the tail set high by cutting the cords on its lower surface, or it may be’ prevented getting over the reins by having a strap carried from its free end to the breeching. Those proving troublesome when “ in heat ” may have 4-dram doses of bro- mide of potassium, or they may be served by the male or castrated. Sometimes irritability may be lessened by daily doses of belladonna extract (1 dram), or a better tone may be given to the parts by balsam copaiba (1 dram). DISEASED GROWTHS IN THE BLADDER. These may be of various kinds, malignant or simple. In the horse I have found villous growths from the mucous membrane especially troublesome. They may be attached to the mucous membrane by a narrow neck or by a broad base covering a great part of the organ. Symptoms.—The symptoms are frequent straining, passing of urine and blood with occasionally gravel. An examination of the bladder with the hand in the rectum will detect the new growth, which may be distinguished from a hard resistant stone. In mares, in which the finger can be inserted into the bladder, the recognition is still more satisfactory. The polypi attached by narrow necks may be removed by surgical operation, but for those with broad attachments treatment is eminently unsatisfactory. DISCHARGE OF URINE BY THE NAVEL, OR PERSISTENT URACHUS. This occurs only in the newborn, and consists in the nonclosure of the natural channel (urachus), through which the urine is discharged into the outer water bag (allantois) in fetal life. At that early stage of the animal existence the bladder resembles a long tube, which is prolonged through the navel string and opens into the outermost of the two water bags in which the fetus floats. In this way the urine is prevented from entering the inner water bag (amnion), where it would mingle with the liquids, bathing the skin of the fetus and cause irritation. At birth this channel closes up, and the urine takes the course normal to extra-uterine life. Imperfect closure is more fre- quent in males than in females, because of the great length and small caliber of the male urethra and its consequent tendency to obstruction. In the female there may be a discharge of a few drops only at a time, while in the male the urine will be expelled in strong jets coincidently with the contractions of the bladder and walls of the abdomen. Digitized by Microsoft® DISEASES OF THE BLADDER. 93 The first care is to ascertain if the urethra is pervious by passing a human catheter. This determined, the open urachus may be firmly closed by a stout waxed thread, carried with a needle through the tis- sues back of the opening and tied in front of it so as to inclose as little skin as possible. If a portion of the navel string remains, the tying of that may be all sufficient. It is important to tie as early as possible so as to avoid inflammation of the navel from contact with the urine. In summer a little carbolic-acid water or tar water may be applied to keep off the flies. EVERSION OF THE BLADDER. This can only occur’in the female. It consists in the turning of the organ outside in through the channel of the urethra, so that it appears as a red, pear-shaped mass hanging from the floor of the vulva and protruding externally between its lips. It may be a mass like the fist, or it may swell up to the size of an infant’s head. On examining its upper surface the orifices of the urethra may be seen, one on each side, a short distance behind the neck. with the urine oozing from them drop by drop. ‘This displacement usually supervenes on a flaccid condition of the bladder, the result of paralysis, overdistention, or severe compression during a difficult, parturition. The protruding organ may be washed with a solution of 1 ounce of laudanum and a teaspoonful of carbolic acid in a quart of water, and returned by pressing a smooth, rounded object into the fundus and directing it into the urethra, while careful pressure is made on the surrounding parts with the other hand. If too large and resistant it may be wound tightly in a strip of bandage about 2 inches broad to express the great mass of blood and exudate and diminish the bulk of the protruded organ so that it can be easily pushed back. This method has the additional advantage of protecting the organ against bruises and lacerations in the effort made to return it. After the return, straining may be kept in check by giving laudanum (1 to 2 ounces) and by applying a truss to press upon the lips of the vulva. (See Eversion of the womb.) The patient should be kept in a stall a few inches lower in front than behind, so that the action of gravity will favor retention. INFLAMMATION OF THE URETHRA (URETHRITIS, OR GLEET). This affection belongs quite as much to the generative organs, yet it can not be entirely overlooked in a treatise on urinary disorders. It may be induced by the same causes as cystitis (which see); by the passage and temporary arrest of small stones, or gravel; by the irri- tation caused by foreign bodies introduced from without; by blows on the penis by sticks, stones, or by the feet of a mare that kicks while being served; by an infecting inflammation contracted from a mare Digitized by Microsoft® 94 DISEASES OF THE HORSE. served in the first few days after parturition or one suffering from leucorrhea; by infecting matter introduced on a dirty catheter, or by the extension of inflammation from an irritated bilocular cavity filled with hardened sebaceous matter, or from an uncleansed sheath. Symptoms.—The symptoms are swelling, heat, and tenderness of the sheath and penis; difficulty, pain, and groaning in passing urine, which is liable to sudden temporary arrests in the course of micturi- tion, and later a whitish mucopurulent oozing from the papilla on the end of the penis. There is a tendency to erection of the penis, and in cases contracted from a mare the outer surface of that organ will show more or less extensive sores and ulcers. Stallions suffering in this way will refuse to mount, or having mounted will fail to com- plete the act of coition. If an entrance is effected infection of the mare is liable to follow. Treatment in the early stages consists in a dose of physic (aloes 6 drams) and fomentations of warm water to the sheath and penis. If there is reason to suspect the presence of infection, inject the urethra twice daily with borax 1 dram, water 1 quart, using it tepid. Where the mucopurulent discharge indicates the supervention of the second stage, a more astringent injection may be employed (nitrate of silver 20 grains, water 1 quart), and the same may be applied to the surface of the penis and inside the sheath. Balsam of copaiba (1 dram daily) may also be given with advantage after the purulent discharge has appeared. Every stallion suffering from urethritis should be withheld from service, as should mares with leucorrhea. STRICTURE OF THE URETHRA. This is a permanent narrowing of the urethra at a given point, the result of previous inflammation, caused by the passage or arrest of a stone, or gravel, by strong astringent injections in the early nonsecret- ing stages of urethritis, or by contraction of the lining membrane occurring during the healing of ulcers in neglected inflammations of that canal. The trouble is shown by the passage of urine in a fine stream, with straining, pain, and groaning, and by frequent painful erections. It must be remedied by mechanical dilatation, with cathe- ters just large enough to pass with gentle force, to be inserted once a day, and to be used of larger size as the passage will admit them. The catheter should be kept perfectly clean, and washed in a borax solution and well oiled before it is introduced. URINARY CALCULI (STONE, OR GRAVEL). These consist in some of the solids of the urine that have been pre- cipitated from the urine in the form of crystals, which remain apart as a fine powdery mass, or magma, or aggregate into calculi, or stones, of varying size. Their composition is therefore determined in differ- Digitized by Microsoft® STONE, OR GRAVEL. 95 ent animals by the salts or other constituents found dissolved in the healthy urine, and by the additional constituents which may be thrown off in solution in the urine in disease. In this connection it is important to observe the following analysis of the horse’s urine in health: Wale ris os 56 ee ON a fe i Eos 918. 5 WGA ots aS 8 eet oS Se ee Sa en ae 13.4 Urie acid and urates__________________ ie ee ne St 1 Hippuric! acids. 22 8 nt ee ee ee tee 26. 4 Lactic acid and lactates___._______.-_-_-__-__ ee 1.2 Mucus and organic matter_____________________---___-_____ 22.0 Sulphates (alkaline) __.-_____-.--_-________ ee 1.2 Phosphates (lime and soda) --___________________- 2 Chlorides (sodium) -—----_--_-__________----__---___-_____- 1.0 Carbonates (potash, magnesia, lime)______________________ 16.0 1000. 0 The carbonate of lime, which is present in large amount in the urine of horses fed on green fodder, is practically insoluble, and therefore forms in the passages after secretion, and its microscopic rounded crystals give the urine of such horses a milky whiteness. It is this material which constitutes the soft, white, pultaceous mass that some- times fills the bladder to repletion and requires to be washed out. In hay-fed horses carbonates are still abundant, while in those mainly grain-fed they are replaced by hippurates and phosphates—the prod- ucts of the wear of tissues—the carbonates being the result of oxida- tion of the vegetable acids in the food. Carbonate of lime, therefore, is a very common constituent of urinary calculi in herbivora, and in many cases is the most abundant constituent. Oxalate of lime, like carbonate of lime, is derived from the burning up of the carbonaceous matter of the food in the system, one impor- tant factor being the less perfect oxidation of the carbon. Indeed, Fiistenberg and Schmidt have demonstrated on man, horse, ox, and rabbit that, under the full play of the breathing (oxidizing) forces, oxalic acid, like other organic acids, is resolved into carbonic acid. In keeping with this is the observation of Lehmann, that in all cases in which man suffered from interference with the breathing oxalate of lime appeared in the urine. An excess of oxalate of lime in the urine may, however, claim a different origin. Uric and hippuric acids are found in the urine of carnivora and herbivora, respectively, as the result of the healthy wear (disassimilation) of nitrogenous tis- sues. But if these products are fully oxidized, they are thrown out in the form of the more soluble urea rather than as these acids. When uric acid out of the body is treated with peroxide of lead it is resolved into urea, allantoin, and oxalic acid, and Weehler and Frer- richs found that the administration of uric acid not only increased Digitized by Microsoft® 96 DISEASES OF THE HORSE. the excretion of urea, but also of oxalic acid. It may therefore be inferred that oxalic acid is not produced from the carbonaceous food alone, but also from the disintegration of the nitrogenous tissues of the body. An important element of its production is, however, the imperfect performance of the breathing functions, and hence it is liable to result from diseases of the chest (heaves, chronic bronchitis, etc.). This is, above all, likely to prove the case if the subject is fed to excess on highly carbonaceous foods (grass and green food gener- ally, potatoes, etc.). Carbonate of magnesia, another almost constant ingredient of the urinary calculi of the horse, is formed the same way as the carbon- ate of lime—from the excess of carbonaceous food (organic acids) becoming oxidized into carbon dioxide, which unites with the mag- nesia derived from the food. The phosphates of lime and magnesia are not abundant in urinary calculi of the horse, the phosphates being only present to excess in the urine in two conditions—(a) when the ration is excessive and specially rich in phosphorus (wheat bran, beans, pease, vetches, rape cake, oil cake, cotton-seed cake) ; and (b) when, through the morbid destructive changes in the living tissues, and especially of the bones, a great amount of phosphorus is given off as a waste product. Under these conditions, however, the phosphates may contribute to the for- mation of calculi, and this is, above all, likely if the urine is retained in the bladder until it has undergone decomposition and given off ammonia. The ammonia at once unites with the phosphate of mag- nesia to form a double salt—phosphate of ammonia and magnesia— which, being insoluble, is at once precipitated. The precipitation of this salt is, however, rare in the urine of the horse, though much more frequent in that of man and sheep. These are the chief mineral constituents of the urine which form ingredients in the horse’s calculi, for though iron and manganese are usually present it is only in minute quantities. The excess of mineral matter in a specimen of urine unquestion- ably contributes to the formation of calculi, just as a solution of such matters out of the body is increasingly disposed to throw them down in the form of crystals as it becomes more concentrated and ap- proaches nearer to the condition of saturation. Hence, in consider- ing the causes of calculi we can not ignore the factor of an excessive ration, rich in mineral matters and in carbonaceous matters (the source of carbonates and much of the oxalates), nor can we overlook the concentration of the urine that comes from dry food and priva- tion of water, or from the existence of fever which causes suspension of the secretion of water. In these cases, at least the usual amount of solids is thrown off by the kidneys, and as the water is diminished there is danger of its approaching the point of supersaturation, when Digitized by Microsoft® STONE, OR GRAVEL. 97 the dissolved solids must necessarily be thrown down. Hence, calculi are more common_in stabled horses fed on dry grain and hay, in those denied a sufficiency of water or that have water supplied irregularly, in those subjected to profuse perspiration (as in summer), and in those suffering from a watery diarrhea. On the whole, calculi are most commonly found in winter, because the horses are then on dry feeding, but such dry feeding is even more conducive to them in summer when the condition is aggravated by the abundant loss of water by the skin. In the same way the extreme hardness of the water in certain dis- tricts must be looked upon as contributing to the concentration of the urine and correspondingly to the production of stone. The carbon- ates, sulphates, etc., of lime and magnesia taken in the water must be again thrown out, and just in proportion as these add to the solids of the urine they dispose it to precipitate its least soluble constituents. Thus, the horse is very obnoxious to calculi on certain limestone soils, as over the calcareous formations of central and western New York, Pennsylvania, and Ohio, in America; of Norfolk, Suffolk, Derbyshire, Shropshire, and Gloucestershire, in England; of Poitou and Landes, in France; and Munich, in Bavaria. But the saturation of the urine from any or all of these conditions can only be looked on as an auxiliary cause, and not as in itself an efficient one, except on the rarest occasions. For a more direct and immediate cause we must look to the organic matter which forms a large proportion of all urinary calculi. This consists of mucus, albu- men, pus, hyaline casts of the uriniferous tubes, epithelial cells, blood, etc., mainly agents that belong to the class of colloid or noncrystalline bodies. A horse may live for months and years with the urine habit- ually of a high density and having the mineral constituents in excess without the formation of stone or gravel; and again ope with dilute urine of low specific gravity will have a calculus. Rainey, Ord, and others furnish the explanation. They not only show that a colloid body, like mucus, albumen, pus, or blood, deter- mined the precipitation or the crystalline salts in the solution, but they determined the precipitation in the form of globules, or spheres, capable of developing by further deposits into calculi. Heat intensi- fies this action of the colloids, and a colloid in a state of decomposition is specially active. The presence, therefore, of developing fungi and bacteria must be looked upon as active factors in causing calculi. In looking, therefore, for the immediate causes of calculi we must consider especially all those conditions which determine the presence of albumen, blood, and excess of mucus, pus, etc., in the urine. Thus diseases of distant organs leading to albuminuria, diseases of the kid- neys and urinary passages causing the escape of blood or the forma- H. Doe. 795, 59-2——T 2 Digitized by Microsoft® 98 DISEASES OF THE HORSE. tion of mucus or pus, become direct causes of calculi. Foreign bodies of all kinds in the bladder or kidney have long been known as deter- mining causes of calculi and as forming the central nucleus. This is now explained by the fact that these bodies are liable to carry bacte- ria into the passages and thus determine decomposition, and they are further liable to irritate the mucous membrane and become enveloped in a coating of mucus, pus, and perhaps blood. The fact that horses appear to suffer from calculi, especially on the magnesian limestones, the same districts in which they suffer from goiter, may be similarly explained. The unknown poison which pro- duces goiter presumably leads to such changes in the blood and urine as will furnish the colloid necessary for precipitation of the urinary salts in the form of calculi. CLASSIFICATION OF URINARY CALCULI. These have been named according to the place where they are found, renal (kidney), wretral (ureter), vesical (bladder), urethral (urethra), and preputial (sheath, or prepuce). They have been otherwise named according to their most abundant chemical constit- uent, carbonate of lime, owalate of lime, and phosphate of lime calculi. The stones formed of carbonates or phosphates are usually smooth on the surface, though they may be molded into the shape of the cavity in which they have been formed; thus those in the pelvis of the kidney may have two or three short branchlike prolongations, while those in the bladder are round, oval, or slightly flattened upon each other. Calculi containing oxalate of lime, on the other hand, have a rough, open, crystalline surface, which has gained for them the name of mulberry calculi, from a supposed resemblance to that fruit. These are usually covered with more or less mucus or blood, produced by the irritation of the mucous membrane by their rough surfaces. The color of calculi varies from white to yellow and deep brown, the shades depending mainly on the amount of the coloring matter of blood, bile, or urine which they may contain. Renal caleuli—These may consist of minute, almost microscopic, deposits in the uriniferous tubes in the substance of the kidney, but more commonly they are large masses and lodged in the pelvis. The larger calculi, sometimes weighing 12 to 24 ounces, are molded in the pelvis of the kidney into a cylindroid mass, with irregular rounded swellings at intervals. Some have a deep brown, rough, crystalline surface of oxalate of lime, while others have a smooth, pearly white aspect from carbonate of lime. ) providing for the application of an antiseptic to the cord. For this purpose a dram of sulphate of copper may be mixed with an ounce of vaseline and Digitized by Microsoft® 148 DISEASES OF THE HORSE. pressed into the groove in the face of each clamp. In applying the clamp over the cord it should be drawn so close with pincers as to press out all blood from the compressed cord and destroy its vitality, and the cord applied upon the compressing clamps should be so hard- twined that it will not stretch later and slacken the hold. When the clamp has been fixed the testicle is cut off one-half to 1 inch below it, and the clamp may be left thus for twenty-four hours; then, by cut- ting the cord around one end of the clamp, the latter may be opened and the stump liberated without any danger of bleeding. Should the stump hang out of the wound it should be pushed inside with the finger and left there. The wound should begin to discharge white matter on the second day in hot weather or the third in cold, and from that time a good recovery may be expected. CONDITIONS FAVORABLE TO SUCCESSFUL CASTRATION. The young horse suffers less from castration than the old, and very varely perishes. Good health in the subject is all important. Castra- tion should never be attempted during the prevalence of strangles, influenza, catarrhal fever, contagious pleurisy, bronchitis, pneumonia, purpura hemorrhagica, or other specific disease, nor on subjects that have been kept in close, ill ventilated, filthy buildings, where the system is liable to have been charged with putrid bacteria or other products. Warm weather is to be preferred to cold, but the fly time should be avoided or the flies kept at a distance by the application of a watery solution of tar, carbolic acid, or camphor to the wound. CASTRATION OF CRYPTORCHIDS (RIDGLINGS). This is the removal of a testicle or testicles that have failed to descend- into the scrotum, but have been detained in the inguinal canal or inside the abdomen. The manipulation requires an accurate anatomical knowledge of the parts, and special skill, experience, and manual dexterity, and can not be made clear to the unprofessional mind in a short notice. It consists, however, in the discovery and removal of the missing gland by exploring through the natural chan- nel (the inguinal canal), or, in case it is absent, through the inguinal ring or through an artificial opening made in front and above that channel between the abdominal muscles and the strong fascia on the inner side of the thigh (Poupart’s ligament). Whatever method is used, the skin, hands, and instruments should be rendered aseptic with a solution of mercuric chloride 1 part, water 2,000 parts (a car- bolic acid lotion for the instruments), and the spermatic cord is best torn through by the écraseur. In many such cases, too, it is desirable to sew up the external wound and keep the animal still, to favor healing of the wound by adhesion. Digitized by Microsoft® CASTRATION OF STALLIONS. 149 PAIN AFTER CASTRATION. Some horses are pained and very restless for some hours after cas- tration,and this may extend to cramps of the bowels and violent colic. This is best kept in check by carefully rubbing the patient dry when he rises from the operation, and then leading him in hand for some time. If the pain still persists a dose of laudanum (1 ounce for an adult) may be given. BLEEDING AFTER CASTRATION. Bleeding from the wound in the scrotum and from the little artery in the posterior portion of the spermatic cord always occurs, and in warm weather may appear to be quite free. It scarcely ever lasts, however, over fifteen minutes, and is easily checked by dashing cold water against the part. Bleeding from the spermatic artery in the anterior part of the cord may be dangerous when due precaution has not been taken to prevent it. In such case the stump of the cord should be sought for and the artery twisted with artery forceps or tied with a silk thread. If the stump can not be found, pledgets of tow wet with tincture of muriate of iron may be stuffed into the canal to favor the formation of clot and the closure of the artery. STRANGULATED SPERMATIC CORD. If in castration the cord is left too long, so as to hang out of the wound, the skin wound in contracting grasps and strangles it, pre- venting the free return of blood and causing a steadily advancing swelling. In addition the cord becomes adherent to the lips of the wound in the skin, whence it derives an increased supply of blood, and is thereby stimulated to more rapid swelling. The subject walks stiffly, with straddling gait, loses appetite, and has a rapid pulse and high fever. Examination of the wound discloses the partial closure - of the skin wound and the protrusion from its lips of the end of the cord, red, tense, and varying in size from a hazelnut upward. If there is no material swelling and little protrusion, the wound may be enlarged with the knife and the end of the cord broken loose from any connection with the skin and pushed up inside. If the swelling is larger, the mass constitutes a tumor and must be removed. (See below.) SWELLING OF THE SHEATH, PENIS, AND ABDOMEN. This occurs in certain unhealthy states of the system, in unhealthy seasons, as the result of operating without cleansing the sheath and penis, or of keeping the subject in a filthy, impure building, as the result of infecting the wound by hands or instruments bearing sceptic Digitized by Microsoft® 150 DISEASES OF THE HORSE. bacteria, or as the result of premature closure of the wound, and imprisonment of matter. Pure air and cleanliness of groin and wound are to be secured. Antiseptics, like the mercuric chloride lotion (1 part to 2,000): are to be applied to the parts; the wound, if closed, is to be opened anew, any accumulated matter or blood washed out, and the antiseptic liquid freely applied. The most tense or dependent parts of the swelling in sheath or penis, or beneath the belly, should be pricked at intervals of 3 or 4 inches, and to a depth of half an inch, and anti- septics freely used to the surface. Fomentations with warm water may also be used to favor oozing from the incisions and to encourage the formation of white matter in the original wounds, which must not be allowed to close again at once. A free, creamlike discharge im- plies a healthy action in the sore, and is the precursor of recovery. ’ PHYMOSIS AND PARAPHYMOSIS. In cases of swelling, as above, the penis may be imprisoned within the sheath (phymosis) or protruded and swollen so that it can not be retracted into it (paraphymosis). In these cases the treatment indi- cated above, and especially the scarifications, will prove a useful pre- liminary resort. The use of astringent lotions is always desirable, and in case of the protruded penis the application of an elastic or simple linen bandage, so as to press out the blood and accumulated fluid, will enable the operator to return it. TUMORS ON THE SPERMATIC CORD. These are due to rough handling or dragging upon the cord in castration, to strangulation of unduly long cords in the external wound, to adhesion of the end of the cord to the skin, to inflammation of the cord succeeding exposure to cold or wet, or to the presence of infection (Staphylococcus botriomyces). These tumors give rise to a stiff, straddling gait, and may be felt as hard masses in the groin connected above with the cord. They may continue to grow slowly for many years until they reach a weight of 15 or 20 pounds, and contract adhesions to all surrounding parts. If disconnected from the skin and inguinal canal they may be removed in the same manner as the testicle, while if larger and firmly adherent to the skin and surrounding parts generally, they must be carefully dissected from the parts, the arteries being tied as they are reached and the cord finally torn through with an écraseur. When the cord has become swollen and indurated up into the abdomen such removal is impos- sible, though a partial destruction of the mass may still be attempted by passing white-hot pointed irons upward toward the inguinal ring in the center of the thickened and indurated cord. Digitized by Microsoft® CASTRATION OF THE MARE. 151 CASTRATION BY THE COVERED OPERATION. This is only required in case of hernia or protrusion of bowels or omentum into the sack of the scrotum, and consists in the return of the hernia and the application of the caustic clamps over the cord and inner walls of the inguinal canal, so that the walls of the latter become adherent above the clamps, the canal is obliterated, and further pro- trusion is hindered. For the full description of this and of the opera- tion for hernia in geldings, see remarks on hernia. CASTRATION OF THE MARE. Castration is a much more dangerous operation in the mare than in the females of other domesticated quadrupeds and should never be resorted to except in animals that become unmanageable on the recur- rence of heat and that will not breed or that are utterly unsuited to breeding. Formerly the operation was extensively practiced in Europe, the incision being made through the flank, and a large pro- portion of the subjects perished. By operating through the vagina the risk can be largely obviated, as the danger of unhealthy inflam- mation in the wound is greatly lessened. The animal should be fixed in a trevis, with each foot fixed to a post and a sling placed under the body, or it may be thrown and put under chloroform. The manual operation demands special professional knowledge and skill, but it consists essentially in making an opening through the roof of the vagina just above the neck of the womb, then following with the hand each horn of the womb until the ovary on that side is reached and grasped between the lips of forceps and twisted off. It might be torn off by an écraseur especially constructed -for the purpose. The straining that follows the operation may be checked by ounce doses of laudanum, and any risk of protrusion of the bowels may be obviated by applying the truss advised to prevent eversion of the womb. ‘To further prevent the pressure of the abdominal con- tents against the vaginal wound the mare should be tied short and high for twenty-four or forty-eight hours, after which I have found it best to remove the truss and allow the privilege of lying down. Another important point is to give bran mashes and other laxative diet only, and in moderate quantity, for a fortnight, and to unload the rectum by copious injections of warm water in case it should threaten to become impacted. * STERILITY. Sterility may be in the male or in the female. If due to the stal- lion, then all the mares put to him remain barren; if due to the mare, she alone fails to conceive. Digitized by Microsoft® 152 DISEASES OF THE HORSE. In the stallion sterility may be due to the following causes: (a) Imperfect development of the testicles, as in cases in which they are retained within the abdomen; (0) inflammation of the testicles, re- sulting in induration; (c) fatty degeneration of the testicles, in stal- lions liberally fed on starchy food and not sufficiently exercised; (d) fatty degeneration of the excretory ducts of the testicles (vasa defe- rentia) ; (é) inflammation or ulceration of these ducts; (f) inflam- mation or ulceration of the mucous membrane covering the penis; (g) injuries to the penis from blows (often causing paralysis) ; (/) warty growths on the end of the penis; (/) tumors of other kinds (largely pigmentary), affecting the testicles or penis; (/) nervous diseases which abolish the sexual appetite or that control the muscles which are essential to the act of coition; (%) azoturia with resulting weakness or paralysis of the muscles of the loins or the front of the thigh (above the stifle); (2) ossification (anchylosis) of the joints of the back or loins, which render the animal unable to rear, or mount; (m) spavins, ringbones, or other painful affections of the hind limbs, the pain of which in mounting causes the animal to suddenly stop short in the act. In the first three of these only (a, 6, and ¢) is there real sterility in the sense of the nondevelopment or imperfect devel- opment of the male vivifying element (spermatozoa). In the other examples the secretion may be perfect in kind and amount, but as copulation is prevented it can not reach and impregnate the ovum. In the mare barrenness is equally due to a variety of causes. Ina number of breeding studs the proportion of sterile mares has varied from 20 to 40 per cent. It may be due to: (a) Imperfect develop- ment of the ovary and nonmaturation of ova; (0) cystic or other tumors of the ovary; (c) fatty degeneration of the ovary in very obese, pampered mares; (d) fatty degeneration of the excretory tubes of the ovaries (Fallopian tubes); (e) catarrh of the womb, with mucopurulent discharge; (f) irritable condition of the womb, with profuse secretion, straining, and ejection of the semen; (gq) nervous irritability, leading to the same expulsion of the male ele- ment; (A) high condition (plethora), with profuse secretion and excitement; (¢) low condition, with imperfect maturation of the ova and lack of sexual desire; (j) poor feeding, overwork, and chronic debilitating diseases, as leading to the condition just named; (/) closure of the neck of the womb, temporarily by spasm or perma- nently by inflammation and induration; (/) closure of the entrance to the vagina through imperforate hymen, a rare, though not un- known, condition in the mare; (mm) acquired indisposition to breed, seen in old, hard-worked mares which are first put to the stallion when aged; (n) change of climate has repeatedly been followed by barrenness; (0) hybridity, which in male and female alike usually entails sterility. Digitized by Microsoft® STERILITY. 153. Treatment.—The treatment of the majority of these conditions will be found dealt with in other parts of this work, so that it is only necessary here to name them as causes. Some, however, must be specially referred to in this place. Stallions with undescended testicles are beyond the reach of medicine, and should be castrated and devoted to other uses. Indurated testicles may sometimes be remedied in the early stages by smearing with a weak iodine ointment daily for a length of time, and at the same time invigorating the system by liberal feeding and judicious work. Fatty degeneration is best met by an albuminoid diet (wheat bran, cotton-seed meal, rape cake) and constant well-regulated work. Saccharine, starchy, and fatty food (potatoes, wheat, corn, etc.) are to be specially. avoided. In the mare one diseased and irritable ovary should be removed, to do away with the resulting excitability of the remainder of the generative organs. An irritable womb, with frequent strain- ing and the ejection of a profuse secretion, may sometimes be cor- rected by a restricted diet and full but well-regulated work. Even fatigue will act beneficially in some such cases, hence the practice of the Arab riding his mare to exhaustion just before service. The perspiration in such a case, like the action of a purgative or the abstraction of blood just before service, benefits, by rendering the: blood vessels less full, by lessening secretion in the womb and else- where, and thus counteracting the tendency to the ejection and loss of semen. If these means-are ineffectual, a full dose of camphor (2 drams) or of salacin may at times assist. Low condition and anemia demand just the opposite kind of treatment—rich, nourishing, albumi- noid food, bitter tonics (gentian), sunshine, gentle exercise, liberal grooming, and supporting treatment generally are here in order. Spasmodic closure of the neck of the womb is common and is easily remedied in the mare by dilatation with the fingers. The hand, smeared with belladonna ointment and with the fingers drawn into the form of a cone, is introduced through the vagina until the projecting, rounded neck of the womb is felt at its anterior end. This is opened by the careful insertion of one finger at a time, until the fingers have been passed through the constricted neck into the open cavity of the womb. The introduction is made with a gentle, rotary motion, and all precipitate violence is avoided, as abrasion, laceration, or other cause of irritation is likely to interfere with the retention of the semen and with impregnation. If the neck of the womb is rigid and unyielding from the induration which follows in- flammation—a rare condition in the mare, though common in the cow—more force will be requisite, and it may even be needful to in- cise the neck to the depth of one-sixth of an inch in four or more opposite directions prior to forcible dilatation. The incision may be. made with a probe-pointed knife, and should be done by a profes- Digitized by Microsoft® 154 DISEASES OF THE HORSE. sional man if possible. The subsequent dilatation may be best effected by the slow expansion of sponge or seaweed tents inserted into the narrow canal. In such cases it is best to let the wounds of the neck heal before putting to horse. An imperforate hymen may be freely incised in a crucial manner until the passage will admit the human hand. An ordinary knife may be used for this purpose, and after the operation the stallion may be admitted at once or only after the wounds have healed. INDICATIONS OF PREGNANCY. As the mere fact of service by the stallion does not insure preg- nancy, it is important that the result should be determined, to save the mare from unnecessary and dangerous work or medication when actually in foal and to obviate wasteful and needless precautions when she is not. The cessation and nonrecurrence of the symptoms of heat (horsing) are most significant though not an infallible sign of conception. If the sexual excitement speedily subsides and the mare persistently refuses the stallion for a month, she is probably pregnant. In very exceptional cases a mare will accept a second or third service after weeks or months, though pregnant, and some mares will refuse the horse persistently, though conception has not taken place, and this in spite of warm weather, good condition of the mare, and liberal feed- ing. The recurrence of heat in the pregnant mare is most likely to take place in hot weather. If heat merely persists an undue length of time after service, or if it reappears shortly after, in warm weather and in a comparatively idle mare, on good feeding, it is less signifi- cant, while the persistent absence of heat under such conditions may be usually accepted as proof of conception. An unwonted gentleness and docility on the part of a previously irritable or vicious mare, and supervening on service, is an excellent indication of pregnancy, the generative instinct which caused the excitement having been satisfied. An increase of fat, with softness and flabbiness of muscle, a loss of energy, indisposition for active work, a manifestation of laziness, indeed, and of fatigue early and easily induced, when preceded by service, will usually imply conception. Enlargement of the abdomen, especially in its lower third, with slight falling in beneath the loins and hollowness of the back are sig- nificant symptoms, though they may be entirely absent. Swelling and firmness of the udder, with the smoothing out of its wrinkles, is a suggestive sign, even though it appears.only at intervals during ges- tation. A steady increase in weight (14 pounds daily) about the fourth or fifth month is a useful indication of pregnancy. So is a swollen and red or bluish-red appearance, he eas kaa gmucous membrane. PREGNANCY. 155 From the seventh or eighth month onward the foal may be felt by the hand (palm or knuckles) pressed into the abdomen in front of the left stifle. The sudden push displaces the foal toward the opposite side of the womb, and as it floats back its hard body is felt to strike against the hand. If the pressure is maintained the movements of the live foal are felt, and especially in the morning and after a drink of cold water or during feeding. ppay Dur. ©) = —/ EERE esate at SPIO T POYIQOL) Duoy adiuns: > a ©) = =o sere "] —— oO) I ee S27}. AO PU} PPIPJOL OP PIS JllPULI71). Uy Set 227IOY « ¢ h DS" St ———— . B SS x = — arr G Y =F) Gey MOPDPPNG PPAL Pir1ds? ae EFI, 2 ty P1LOD YPM LILA) PIAL I eS < SE es = ae a ee LOI = a cis > g go | < ae = JULIUS BIEN & CO.N.Y Haines,del after Flenung Digitized by Microsoft® INSTRUMENTS USED IN DIFFICULT LABOR. Digitized by Microsoft® JEN EVAN O.4 after Fleming Vertebro- Sacral presentation Lumbe-Sacral presentation Haines del JULIUS BIEN & CON Y NOR BAT HEMET? Digitized by Microsoft® ii >.g +N 05 9 N3IG SNIIN “YONDIAIP YOY PUY ANOL) uorUwasald AOWUASOY Yyesyt uo juaqg Gx VYPray UO1NDIUASASA LO1LIISOF SINIOUL Vale IAS AUd “IVINHUONAV Hsp UO pueQ 2 Ya] FURS Voypuesasd |VS1OP PUD pup YOOU IY) UO SQUiVT uonpyUacas1d puyr PPAoGty G tere fap sor MAIULOPQD UO DUM SUNT MONPYMIS ILA PLE PSVISG uo PUIG SQUNT UOMD]UISILA AOMLIT UY f Digitized by Microsoft® Digitized by Microsoft® LS Airs ee U Neh wLarel Transverse presentation -Cpper view. atter Fleming. [ot Sterno-abdominal presentation —Head and Feet: engaged . Haines, afler Flemung. JULIUS BIEN & CO NY Digitized by Microsoft® ABNORMAL PRESENTATIONS. Digitized by Microsoft® DISEASES OF THE GENERATIVE ORGANS. 167 seen in the mare. This is not the rule, however, as the foal up to birth usually accommodates itself to the size of the dam, as illustrated in the successful crossing of Percheron stallions on mustang mares. If the disproportion is too great the only resort is embryotomy. FRACTURED HIP BONES. More commonly the obstruction comes from distortion and narrow- ing of the pelvis as the result of fractures. (Plate XV, fig. 2.) Fractures at any point of the lateral wall or floor of the pelvis are repaired with the formation of an extensive bony deposit bulging into the passage of the pelvis. The displacement of the ends of the broken bone is another cause of constriction, and between the two con- ditions the passage of the fetus may be rendered impossible without embryotomy. Fracture of the sacrum (the continuation of the back- bone forming the croup) leads to the depression of the posterior part of that bone in the roof of the pelvis and the narrowing of the pas- sage from above downward by a bony ridge presenting its sharp edge forward. In all cases in which there has been injury to the bones of the pelvis the obvious precaution is to withhold the mare from breeding and to use her for work only. If a mare with a pelvis thus narrowed has got in foal inadvertently, abortion may be induced in the early months of gestation by slowly introducing the oiled finger through the neck of the womb and fol- lowing this by the other fingers until the whole hand has been intro- duced. Then the water bags may be broken, and with the escape of the liquid the womb will contract on the solid fetus and labor pains will ensue. The fetus being small will pass easily. TUMORS IN THE VAGINA AND PELVIS. Tumors of various kinds may form in the vagina or elsewhere within the pelvis, and when large enough will obstruct or prevent the passage of the fetus. Gray mares, which are so subject to black pig- ment tumors (melanosis) on the tail, anus, and vulva, are the most likely to suffer from this. Still more rarely the wall of the vagina becomes relaxed, and being pressed by a mass of intestines will pro- trude through the lips of the vulva as a hernial sac, containing a part of the bowels. Where a tumor is small it may only retard and not absolutely prevent parturition. A hernial protrusion of the wall of the vagina may be pressed back and emptied, so that the body of the fetus engaging in the passage may find no further obstacle. When a tumor is too large to allow delivery the only resort is to remove it, but before proceeding it must be clearly made out that the obstruc- tion is a mass of diseased tissue, and not a sac containing intestines. Digitized by Microsoft® 168 DISEASES OF THE HORSE. If the tumor hangs by a neck it can usually be most safely removed by the écraseur, the chain being passed around the pedicel and gradu- ally tightened until that is torn through. HERNIA OF THE WOMB. The rupture of the musculo-fibrous floor of the belly and the escape of the gravid womb into a sac formed by the peritoneum and skin hanging toward the ground, is described by all veterinary obstetri- cians, yet it is very rarely seen in the mare. The form of the fetus can be felt through the walls of the sac, so that it is easy to recognize the condition. Its cause is usually external violence, though it may start from an umbilical hernia. When the period of parturition arrives, the first effort should be to return the fetus within the proper abdominal cavity, and this can sometimes be accomplished with the aid of a stout blanket gradually tightened around the belly. This failing, the mare may be placed on her side or back and gravitation brought to the aid of manipulation in securing the return. Even after the hernia has been reduced the relaxed state of the womb and abdominal walls may serve to hinder parturition, in which case the oiled hand must be introduced through the vagina, the fetus brought into position, and traction coincident with the labor pains employed to secure delivery. TWISTING OF THE NECK OF THE WOMB. This condition is very uncommon in the mare, though occasionally seen in the cow, owing to the greater laxity of the broad ligaments of the womb in that animal. It consists in a revolution of the womb on its own axis, so that its right or left side will be turned upward (quarter revolution), or the lower surface may be turned upward and the upper surface downward (half revolution). The effect is to throw the narrow neck of the womb into a series of spiral folds, turn- ing in the direction in which the womb has revolved, closing the neck and rendering distention and dilatation impossible. The period and pains of parturition arrive, but in spite of contin- ued efforts no progress is made, neither water bags nor liquids appear- ing. The oiled hand introduced into the closed neck of the womb will readily detect the spiral direction of the folds on its inner surface. The method of relief which I have successfully adopted in the cow may be equally happy in the mare. The dam is placed (with her head uphill) on her right side if the upper folds of the spiral turn toward the right, and on her left side if they turn toward the left, and the oiled hand is introduced through the neck of the womb and a limb or other part of the body of the fetus is seized and pressed against the wall of the womb, while two or three assistants turn the Digitized by Microsoft® DISEASES OF THE GENERATIVE ORGANS. 169 animal over on her back toward the other side. The object is to keep the womb stationary while the animal is rolling. If success attends the effort, the constriction around the arm is suddenly relaxed, the spiral folds are effaced, and the water bags and fetus press forward into the passage. If the first attempt does not succeed it may be repeated again and again until success crowns the effort. Among my occasional causes of failure have been the prior death and decompo- sition of the fetus, with the extrication of gas and overdistention of the womb, and the supervention of inflammation and inflammatory exudation around the neck of the womb, which hinders untwisting. The first of these conditions occurs early in the horse from the detach- ment of the fetal membranes from the wall of the womb, and as the mare is more subject to fatal peritonitis than the cow, it may be con- cluded that both these sources of failure are more probable in the equine subject. When the case is intractable, though the hand may be easily intro- duced, the instrument shown in Plate IX, figure 7, may be used. Fach hole at the small end of the instrument has passed through it a stout cord with a running noose, to be passed around two feet or other portion of the fetus which it may be possible to reach. The cords are then drawn tight and fixed around the handle of the instru- ment; then, by using the cross handle as a lever, the fetus and womb may be rotated in a direction opposite to that causing the obstruction. During this process the hand must be introduced to feel when the twist has been undone. This method may be supplemented, if neces- sary, by rolling the mare as described above. EFFUSION OF BLOOD IN THE VAGINAL WALLS. This is common as a result of difficult parturition, but it may occur from local injury before that act, and may seriously interfere with it. This condition is easily recognized by the soft, doughy swelling so characteristic of blood clots, and by the dark-red color of the mucous membrane. I have laid open such swellings with the knife as late as ten days before parturition, evacuated the clots, and dressed the wound daily with an astringent lotion (sulphate of zinc 1 dram, carbolic acid 1 dram, water 1 quart). A similar resort might be had, if necessary, during parturition. CALCULUS (STONE) AND TUMOR IN THE BLADDER. The pressure upon the bladder containing a stone or a tumor may prove so painful that the mare will voluntarily suppress the labor pains. Examination of the bladder with the finger introduced through the urethra will detect the offending agent. A stone should be extracted with forceps. (See “ Lithotomy.”) The large papillary Digitized by Microsoft® 170 DISEASES OF THE HORSE. tumors which I have met with in the mare’s bladder have been inva- riably delicate in texture and could be removed piecemeal by forceps. Fortunately, mares affected in this way rarely breed. IMPACTION OF THE RECTUM WITH FECES. In some animals, with more or less paralysis or weakness of the tail and rectum, the rectum may become so impacted with solid feces that the mare is unable to discharge them, and the accumulation both by reason of the mechanical obstruction and the pain caused by pressure upon it will impel the animal te cut short all labor pains. The rounded swelling surrounding the anus will at once suggest the con- dition, when the obstruction may be removed by the well-oiled or well-soaped hand. SPASM OF THE NECK OF THE WOMB. This occurs in the mare of specially excitable temperament, or under particular causes of irritation, local or general. Labor pains, though continuing for some time, produce no dilatation of the ne $ the womb, which will be found firmly closed so as to admit but one or two fingers, and this, although the projection at the mouth of the womb may have been entirely effaced, so that a simple round opening is left, with rigid margins. Freatment.—The simplest treatment consists in smearing this part with solid extract of belladonna, and after an interval inserting the hand with fingers and thumb drawn into the form of a cone, ruptur- ing the membranes and bringing the fetus into position for extrac- tion, as advised under “ Prolonged retention of the fetus.” Another mode is to insert through the neck of the womb an ovoid caoutchouc bag, empty, and furnished with an elastic tube 12 feet loug. Carry the free end of this tube upward to a height of 8, 10, or 12 test, insert a filler into it, and proceed to distend the bag with tepid or warm water. FIBROUS BANDS CONSTRICTING OR CROSSING THE NECK OF THE WOMB. These, occurring as the result of disease, have been several times observed in the mare. They may exist in the cavity of the abdomen and compress and obstruct the neck of the womb, or they may extend from side to side of the vagina across and just behind the neck of the womb. In the latter position they may be felt and quickly remedied by cutting them across. In the abdomen they can only be reached by incision, and two alternatives are presented: (1) To perform embry- otomy and extract the fetus piecemeal and (2) to make an incision into the abdomen and extract by the Cesarean operation, or simply to cut the constricting band and attempt delivery by the usual channel. Digitized by Microsoft® DIFFICULT PARTURITION. 171 FIBROUS CONSTRICTION OF VAGINA OR VULVA. This is probably always the result of direct mechanical injury and the formation of rigid cicatrices which fail to dilate with the re- mainder of the passages at the approach of parturition. The pre- sentation of the fetus in the natural way and the occurrence of suc- cessive and active labor pains without any favorable result will direct attention to the rigid and unyielding cicatrices which may be incised at one, two, or more points to a depth of half an inch or more, after which the natural expulsive efforts will usually prove effective. The resulting wounds may be washed frequently with a solution of 1 part of carbolic acid to 50 parts of water, or of 1 part of mercuric chloride ts 1,000 parts of water. FETUS ADHERENT TO THE WALLS OF THE WOMB. In inflammation of the mucous membrane lining the cavity of the womb and implicating the fetal membranes, the resulting embryonic tisswe sometimes establishes a medium of direct continuity between -av ‘vomb and fetal membranes; the blood vessels of the one commu- nicate freely with those of the other and the fibers of the one are prolonged into the other. This causes retention of the membranes after birth, and a special risk of bleeding from the womb, and of septic poisoning. In exceptional cases the adhesion is more extensive and binds a portion of the body of the foal firmly to the womb. In such cases it has repeatedly been found impossible to extract the foal until such adhesions were broken down. If they can be reached with the hand and recognized, they may be torn through with the fingers or with a blunt hook, after which delivery may be attempted with hope of success. i. EXCESSIVE SIZE OF THE FETUS. It would seem that a small mare may usually be safely bred to a large stallion, yet this is not always the case, and when the small size is an individual rather than a racial characteristic or the result of being very young, the rule can not be expected to hold. There is always great danger in breeding the young, small, and undeveloped female, and the dwarfed representative of a larger breed, as the off- spring tend to partake of the large race characteristics and to show them even prior to birth. When impregnation has occurred in the very young or in the dwarfed female, there are two alternatives—to induce abortion or to wait until there are attempts at parturition and to extract by embryotomy if impracticable otherwise. / CONSTRICTION OF A MEMBER BY THE NAVEL STRING. In man and animals alike the winding of the umbilical cord around a member of the fetus sometimen leads At8 the amputation of the 172 DISEASES OF THE HORSE. ‘ Jatter. It is also known to get wound around the neck or a limb at birth, but in the mare this does not seriously impede parturition, as the loosely attached membranes are easily separated from the womb and no strangulation or retarding occurs. The foal may, however, die from the cessation of the placental circulation unless it is speedily delivered. WATER IN THE HEAD (HYDROCEPHALUS) OF THE FOAL. This consists in the excessive accumulation of liquid in the ventricles of the brain so that the cranial cavity is enlarged and constitutes a great projecting rounded mass occupying the space from the eyes upward. (See Plate XV, fig. 3.) With an anterior presentation (fore feet and nose) this presents an insuperable obstacle to progress, as the diseased cranium is too large to enter the pelvis at the same time with the forearms. With a posterior presentation (hind feet) all goes well until the body and shoulders have passed out, when progress is suddenly arrested by the great bulk of the head. In the first case, the oiled hand introduced along the face detects the enormous size of the head, which may be diminished by puncturing it with a knife or trocar and cannula in the median line, evacuating the water and pressing in the thin bony walls. With a posterior presentation, the same course must be followed; the hand passed along the neck will detect the cranial swelling, which may be punc- tured with a knife or trocar. Oftentimes with an anterior presen- tation the great size of the head leads to its displacement backward, and thus the fore limbs alone engage in the passages. Here the first object is to seek and bring up the missing head, and then puncture it as above suggested. DROPSY OF THE ABDOMEN IN THE FOAL, OR ASCITES. The accumulation of liquid in the abdominal cavity of the fetus is less frequent, but when present it may arrest parturition as com- pletely as will hydrocephalus. With an anterior presentation the foal may pass as far as the shoulders, but behind this all efforts fail to secure a further advance. With a posterior presentation the hind legs as far as the thighs may be expelled, but at this point all progress ceases. In either case the oiled hand, passed inward by the side of the foal, will detect the enormous distention of the abdomen and its soft, fluctuating contents. The only course is to puncture the cavity and evacuate the liquid. With the anterior presentation this may be done with a long trocar and cannula, introduced through the chest and diaphragm; or with a knife an incision may be made between the first two ribs and the lungs and heart cut or torn out, when the diaphragm will be felt projecting strongly forward, and may be easily punctured. Should there not be room to introduce the hand Digitized by Microsoft® DIFFICULT PARTURITION. 173 through the chest, the oiled hand may be passed along beneath the breast bone and the abdomen punctured. With a posterior presenta- tion the abdomen must be punctured in the same way, the hand, armed with a knife protected in its palm, being passed along the side of the flank or between the hind limbs. It’ should be added that moderate dropsy of the abdomen is not incompatible with natural delivery, the liquid being at first crowded back into the portion of the belly still engaged in the womb, and passing slowly from that into the ad- vanced portion as soon as that has cleared the narrow passage of the pelvis and passed out where it can expand. GENERAL DROPSY OF THE FETUS. In this case the tissues generally are distended with liquid, and the skin is found at all points tense and rounded, and pitting on pressure with the fingers. In some such cases delivery may be effected after the skin has been punctured at narrow intervals to allow the escape of the fluid and then liberally smeared with fresh lard. More com- monly, however, it can not be reached at all points to be so punctured nor sufficiently reduced to be extracted whole, and resort must be had to embryotomy. SWELLING OF THE FETUS WITH GAS, OR EMPHYSEMA. This has been described as occurring in a living fetus, but I have only met with it in the dead and decomposing foal after futile efforts have been made for several days to effect delivery. These cases are very difficult ones, as the foal is inflated to such an extent that it is impossible to advance it into the passages, and the skin of the fetus and the walls of the womb and vagina have become so dry that it is impracticable to cause the one to glide on the other. The hair comes off any part that’may be seized, and the case is rendered the more offensive and dangerous by the very fetid liquids and gases. The only resort is embryotomy, by which I have succeeded in saving a valuable mare that had cariied a colt in this condition for four days. CONTRACTIONS OF MUSCLES. The foal is not always developed symmetrically, but certain groups of muscles are liable to remain short, or to shorten because of per- sistent spasmodic contraction, so that even the bones become distorted and twisted. This is most common in the neck. The bones of this part and even of the face are drawn to one side and shortened, the head being held firmly to the flank and the jaws being twisted to the right or left. In other cases the flexor muscles of the fore limbs are contracted so that these members are strongly bent at the knee. In neither of these cases gan tbe distonterbantebe extended and straight- 174 DISEASES OF THE HORSE. ened, so that body or limbs must necessarily present double, and natural delivery is rendered impossible. The bent neck may some- times be straightened after the muscles have been cut on the side to which it is turned, and the bent limbs after the tendons on the back of the shank bone have been cut across. Failing to accomplish this, the next resort is embryotomy. TUMORS OF THE FETUS, OR INCLOSED OVUM. Tumors or diseased growths may form on any part of the foal, internal or external, and by their size impede or hinder parturition. In some cases what appears as a tumor is an imprisoned and undevel- oped ovum, which has grafted itself on the fetus. These are usually sacculated, and may contain skin, hair, muscle, bone, and other natural tissues. The only course to be pursued in such cases is to excise the tumor, or, if this is not feasible, to perform embryotomy. MONSTROSITIES. Monstrosity in the foal is an occasional cause of difficult parturi- tion, especially such monsters as show excessive development of some part of the body, a displacement or distortion of parts, or a redun- dancy of parts, as in double monsters. Monsters may be divided inte— (1) Monsters with absence of parts—absence of head, limb, or other organ. (2) Monsters with some part abnormally small—dwarfed head, limb, trunk, ete. (3) Monsters through unnatural division of parts—cleft head, trunk, limbs, etc. (4) Monsters through absence of natural divisions—absence of mouth, nose, eyes, anus, confluent digits; etc. (5) Monsters through fusion of parts—one central eye, one nasal opening, etc. (6) Monsters through abnormal position or form of parts—curved spine, face, limb, ete. (7) Monsters through excess of formation—enormous head, super- numerary digits, etc. (8) Monsters through imperfect differentiation of sexual organs— hermaphrodites. (9) Double monsters—double-headed, double-bodied, extra limbs, ete. Causes.—The causes of monstrosities appear to be very varied. Some monstrosities, like extra digits, absence of horns or tail, etc., run in families and are produced almost as certainly as color or form. Others are associated with too close breeding, the powers of symmet- Digitized by Microsoft® DIFFICULT PARTURITION. 175 rical development being interfered with, just as in other cases a sex- ual incompatibility is developed, near relatives failing to breed with each other. Mere arrest of development of a part may arise from accidental disease of the embryo; hence vital organs are left out, or portions of organs, like the dividing walls of the heart, are omitted. Sometimes an older fetus is inclosed in the body of another, each having started independently from a separate ovum, but the one having become embedded in the semifluid mass of the other and hav- ing developed there simultaneously with it, but not so largely nor perfectly. In many cases of redundance of parts, the extra part or member has manifestly developed from the same ovum and nutrient center with the normal member to which it remains adherent, just as a new tail will grow out in a newt when the former has been cut off. In the early embryo, with its great powers of development, this fac- tor can operate to far greater purpose than in the adult animal. Its influence is seen in the fact pointed out by St. Hilaire that such redundant parts are nearly always connected with the corresponding portions in the normal fetus. Thus superfluous legs or digits are attached to the normal ones, double heads or tails are connected to a common neck or rump, and double bodies are attached to each other by corresponding points, naval to naval, breast to breast, back to back. All this suggests the development of extra parts from the same primary layer of the impregnated and developing ovum. The effect. of disturbing conditions in giving such wrong directions to the developmental forces is well shown in the experiments of St. Hilaire and Valentine in varnishing, shaking, and otherwise break- ing up the natural connections in eggs, and thereby determining the formation of monstrosities at will. So, in the mammal, blows and other injuries that detach the fetal membranes from the walls of the womb or that modify their circulation by inducing inflammation are at times followed by the development of a monster. The excitement, mental and physical, attendant on fright occasionally acts in a simi- lar way,.acting probably through the same channels. The monstrous forms likely to interfere with parturition are such as, from contracted or twisted limbs or spine, must be presented double ; where supernumerary limbs, head, or body must approach the passages with the natural ones; where a head or other member has attained to an unnatural size; where the body of one fetus has become inclosed in or attached to another, etc. Extraction is sometimes possible by straightening the members and securing such a presentation as will reduce the presenting mass to its smallest and most wedgelike dimensions. To effect this it may be needful to cut the flexor tendons of bent limbs or the muscles on the side of a twisted neck or body; and one or more of the manipulations necessary to secure ang, Dring 4p, a missing member may be required. 176 DISEASES OF THE HORSE. In most cases of monstrosity by excess, however, it is needful to remove the superfluous parts, in which case the general principles employed for embryotomy must be followed. The Cesarean section, by which the fetus is extracted through an incision in the walls of the abdomen and womb, is inadmissible, as it practically entails the sacrifice of the mare, which should never be done for the sake of a monster. (See “ Embryotomy,” p. 182.) ENTRANCE OF TWINS INTO THE PASSAGE AT ONCE. Twins are rare in the mare, and still more rare is the impaction of both at once into the pelvis. The condition would be easily recog- nized by the fact that two fore limbs and two hind would occupy the passage at once, the front of the hoofs of the fore feet being turned upward and those of the hind feet downward. If both belonged to one foal they would be turned in the same direction. Once recog- nized, the condition is easily remedied by passing a rope with a run- ning noose round each foot of the foal that is farthest advanced or that promises to be most easily extracted, and to push the members of the other fetus back into the depth of the womb. As soon as the one fetus is fully engaged in the passage it will hold its place and its delivery will proceed in the natural way. TABLE OF WRONG PRESENTATIONS. Tnsomipletly extended. Flexor tendons short- ened. Fore limbs........ Crossed over the neck. Bent back at the knee. Bent back from the shoulder. Bent downward on the neck. Anterior pres-Jtyoaq Head and neck turned back beneath the breast. entations, jo CTT TT TTT Turned to one side. Turned upward and backward on the back. Hind limbs -....-- Hind feet engaged in the pelvis. Transverse......-- Back of foal to side of pelvis. Inverted ....---.- har of ie Hone of pelvis. : : ent on itself at the hock. Posterior pres- Hind limbs ----.- Bent at the hip. entations. | Transverse..-..-.. Back of foal to side of pelvis. Inverted ...---.-- Back of foal to floor of pelvis. Transverse presentation of body-. {Rin Lead gis Fei amerers a. FORE LIMBS INCOMPLETELY EXTENDED. In cases of this kind, not only are the back tendons behind the knee and shank bone unduly short, but the sinew extending from the front of the shoulder blade over the front of the elbow and down to the head of the shank bone is also shortened. The result is that the fore limb is bent at the knee and the elbow is also rigidly bent. The condition obstructs parturition by the feet becoming pressed against the floor of the pelvis or by the elbow pressing on its anterior brim. Relief is to be obtained_by forcible extension. A aa : Digitized by Microson® ~~ ~°P° Wir) @ running PML ATE Ted, SAN thigh and croup PTESERAALLOM, i) | } after Fleming. ) / Anterior presentation Mind -limb deviation. Haines del. JULIUS BIEN & Co.N.Y ABN OR MpjditizdBY Midi GSOH®T 10 Ns Digitized by Microsoft® PUVA XN, Anterior presentation. Head turnect On stde Antervor presentation. Head turned on back. Haines de} JULIUS BIEN & CO.NY ABNORMAL PRESEN-BATIONS. igitized by Micrésorte Digitized by Microsoft® HOEWT LTAOWAIG 40 St AVO SNOTMIWA :stonenreserg 1onienny ANOS -@ N3IS SAMAr Jap sourey ‘Saanaia ious “F109 JO PO2Y 2DYAIIO.LP AL Suu Old aqye ‘sTAQad Pa ULsOf9 EAE ALE | Sunurapq Taye (PTIIY IU) JO UONDIAIP PLVMUMOGT UORDYUASIAA LO VLA PUP < Digitized by Microsoft® (1PUTS1IG ) (NWLOJONLQUI LOf ayriLyg Wie tov Del Digitized by Microsoft® DIFFICULT PARTURITION. 177 noose is passed around each fetlock and a repeller (see Plate IX) planted in the breast is pressed in a direction upward and backward while active traction is made on the ropes. If the feet are not thereby raised from the floor of the pelvis the palm of the hand may be placed beneath them to protect the mucous membrane until they have advanced sufficiently to obviate this danger. In the absence of a repeller, a smooth rounded fork handle may be employed. If the shortening is too great to allow of the extension of the limbs in this way, the tense tendons may be cut across behind the shank bone and in front of the elbow, and the limb will be easily straightened out. This is most easily done with an embryotomy knife furnished with a ring for the middle finger, so that the blade may be protected in the palm of the hand. (See Plate XV, fig. 4.) ONE FORE LIMB CROSSED OVER THE BACK OF THE NECK, With the long fore limbs of the foal this readily occurs, and the resulting increase in thickness, both at the head and shoulder, offers a serious obstacle to progress. (See Plate XI, fig. 2.) The hand introduced into the passage detects the head and one- fore foot, and farther back on the same side of the head the second foot, from which the limb may be traced obliquely across the back of the neck. If parturition continues to make progress the displaced foot may ‘bruise and lacerate the vagina. By siezing the limb above the fetlock it may be easily pushed over the head to the proper side, when partu- rition will proceed normally. FORE LIMB BENT AT THE KNEE. The nose and one fore foot present, and on examination the knee o. the missing fore limb is found farther back. (Plate XI, fig.1.) First place a noose each on the presenting pastern and lower jaw, and push back the body of the fetus with a repeller, while the operator seizing the shank of the bent limb extends it so as to press back the knee and bring forward the fetlock and foot. As progress is made little by little the hand is slid down from the region of the knee to the fetlock, and finally that is secured and brought up into the passage, when parturition will proceed without hindrance. If both fore limbs are bent back the head must be noosed and the limbs brought up as above, one after the other. It is usually best to employ the left hand for the right fore limb, and the right hand for the left fore limb. FORE LIMB TURNED BACK FROM THE SHOULDER. In this case, on exploration by the side of the head and presenting limb, the shoulder only can be reached at first. (Plate XI, fig. 4.) By noosing the head and presenting fore limb, these may be drawn forward into the pelvis, and the oiled hand being carried along the H. Doe. 795. 59-2__Digitized by Microsoft® ; 178 DISEASES OF THE HORSE. shoulder in the direction of the missing limb is enabled to reach and seize the forearm just below the elbow. The body is now pushed back by the assistants pressing on the head and presenting limb or on a repeller planted in the breast until the knee can be brought up into the pelvis, after which the procedure is the same as described in the last paragraph. HEAD BENT DOWN BETWEEN THE FORE LIMBS. This may be so that the poll or nape of the neck, with the ears, can be felt. far back between the fore limbs, or so that only. the upper border of the neck can be reached, head and neck being bent back beneath the body. With the head only bent on the neck, noose the two presenting limbs, then introduce the hand between them until the nose can be seized in the palm of the hand. Next have the assist- ants push back the presenting limbs, while the nose is strongly lifted upward over the brim of the pelvis. This accomplished, it assumes the natural position and parturition is easy. When both head and neck are bent downward it may be impossible to reach the nose. If, however, the labor has only commenced, the limbs may be drawn upon until the operator can reach the ear, by dragging on which the head may be so far advanced that the fingers may reach the orbit; traction upon this while the limbs are being pushed back may bring the head up so that it bends on the neck only, and the further procedure will be as described in the last paragraph. If the labor has been long in progress and the fetus is jammed into the pelvis, the womb emptied of the waters and firmly contracted on its solid contents, the case is incomparably more difficult. The mare may be chloroformed and turned on her back with hind parts ele- vated, and the womb may be injected with sweet oil. Then, if the ear can be reached, the correction of the malpresentation may be at- tempted as above described. Should this fail, one or more sharp hooks may be inserted in the neck as near the head as can be reached, and ropes attached to these may be dragged on, while the body of the foal is pushed back by the fore limbs or by a repeller. Such repul- sion should be made in a direction obliquely upward toward the loins of the mother, so as to rotate the fetus in such a way as to bring the head up. As this is accomplished a hold should be secured nearer and nearer to the nose, with hand or hook, until the head can be straightened out on the neck. All means failing, it becomes necessary to remove the fore limbs (embryotomy) so as to make more space for bringing up the head. If, even then, this can not be accomplished, it may be possible to push the body backward and upward with the repeller until the hind limbs are brought to the passage, when they may be noosed and delivery effected with the posterior presentation. Digitized by Microsoft® DIFFICULT PARTURITION. 179 HEAD TURNED BACK ON THE SHOULDER. In this case the fore feet present, and the oiled hand passed along the forearms in search of the missing head finds the side of the neck turned to one side, the head being perhaps entirely out of reach. (Plate XIV, fig. 1.) To bring forward the head it may be desirable to lay the mare on the opposite side to that to which the head is turned, and even to give chloroform or ether. Then the feet being noosed, the body of the fetus is pushed by the hand or repeller for- ward and to the side opposite to that occupied by the head until the head comes within reach, near the entrance of the pelvis. If such displacement of the fetus is difficult, it may be facilitated by a free use of oil or lard. When the nose can be seized it can be brought into the passage, as when the head is turned down. If it can not be reached, the orbit may be availed of to draw the head forward until the nose can be seized or the lower jaw noosed. In very difficult cases a rope may be passed around the neck by the hand or with the aid of a curved carrier (Plate IX), and traction may be made upon this while the body is being rotated to the other side. In the same way in bad cases a hook may be fixed in the orbit or even between the bones of the lower jaw to assist in bringing the head up into position. Should all fail, the amputation of the fore limbs may be resorted to as advised under the last heading. HEAD TURNED UPWARD ON THE BACK. This differs from the last malpresentation only in the direction of the head, which has to be sought above rather than at one side, and is to be secured and brought forward in a similar manner. (Plate XIV, fig. 2.) Ifa rope can be passed around the neck it will prove most effectual, as it naturally slides nearer to the head as the neck is straightened and ends by bringing the head within easy reach. HIND FEET ENGAGED IN THE PELVIS. In this case fore limbs and head present naturally, but the hind limbs bent forward from the hip and the loins arched allow the hind feet also to enter the passages, and the further labor advances the more firmly does the body of the foal become wedged into the pelvis. (Plate XIII, fig. 2.) The condition is to be recognized by introduc- ing the oiled hand along the belly of the fetus, when the hind feet will be felt advancing. An attempt should at once be made to push them back, one after the other, over the brim of the pelvis. Failing’ in this, the mare may be turned on her back, head downhill, and the attempt renewed. If it is possible to introduce a straight rope car- rier, a noose passed through this may be put on the fetlock and the repulsion thereby toads rr scree of continued failure 180 DISEASES OF THE HORSE. the anterior presenting part of the body may be skinned and cut off as far back toward the pelvis as possible (see “ Embryotomy ”) ; then nooses are placed on the hind fetlocks and traction is made upon these while the quarters are pushed back into the womb. Then the re- maining portion is brought away by the posterior presentation. ANTERIOR PRESENTATION WITH BACK TURNED TO ONE SIDE. The greatest diameter of the axis of the foal, like that of the pelvic passages, is from above downward, and when the fetus enters the pelvis with this greatest diameter engaged transversely or in the nar- row diameter of the pelvis, parturition is rendered difficult or impos- sible. In such a case the pasterns and head may be noosed, and the passages and engaged portion of the foal freely lubricated with lard, the limbs may be crossed over each other and the head, and a move- ment of rotation effected in the fetus until its face and back are turned up toward the croup of the mother; then parturition becomes natural. BACK OF THE FOAL TURNED TO THE FLOOR OF THE PELVIS. In a roomy mare this is not an insuperable obstacle to parturi- tion, yet it may seriously impede it, by reason of the curvature of the body of the foal being opposite to that of the passages, and the head and withers being liable to arrest against the border of the pelvis. Lubrication of the passage with lard and traction of the limbs and head will usually suffice with or without the turning of the mare on her back. In obstinate cases two other resorts are open: First, to turn the foal, pushing back the fore parts and bringing up the hind so as to make a posterior presentation, and, second, the amputation of the fore limbs, after which extraction will usually bea easy. HIND PRESENTATION WITH LEG BENT AT HOCK. In this form the quarters of the foal with the hind legs bent up beneath them present, but can not advance through the pelvis by reason of their bulk. (Plate XI, fig. 3.) The oiled hand introduced can recognize the outline of the buttocks, with the tail and anus in the center and the sharp points of the hocks beneath. First pass a rope around each limb at the hock, then with hand or repeller push the buttocks backward and upward, until the feet can be brought up ‘into the passages. The great length of the shank and pastern in the foal is a serious obstacle to this, and in all cases the foot should be protected in the palm of the hand while being brought up over the brim of the pelvis. Otherwise the womb may be torn. When the pains are too violent and constant to allow effective manipulation, Digitized by Microsoft® DIFFICULT PARTURITION; 181 some respite may be obtained by the use of chloroform or morphia and by turning the mare on her back, but too often the operator fails and the foal must be sacrificed. Two courses are still open: First, to cut through the cords behind and above the hock and extend the upper part of the limb, leaving the hock bent, and extract in this way, and, second, to amputate the hind limbs at the hip joint and remove them separately, after which the body may be extracted. HIND PRESENTATION WITH LEGS BENT FORWARD FROM THE HIP. This is merely an aggravated form of the presentation last de- scribed. (Plate XIII, fig. 1.) If the mare is roomy, a rope may be passed around each thigh and the body pushed upward and forward, so as to bring the hocks and heels upward. If this can be accom- plished, nooses are placed,on the limb farther and farther down until the fetlock is reached and brought into position. If failure is met with, then amputation at the hips is the last resort. HIND PRESENTATIONS WITH THE BACK TURNED SIDEWAYS OR DOWNWARD. These are the counterparts of similar anterior presentations and are to be managed in the same way. PRESENTATION OF THE BACK. This is rare, yet not unknown, the foal being bent upon itself with the back, recognizable by its sharp row of spines, presented at the entrance of the pelvis and the head and all four feet turned back into the womb. (Plate XII, fig. 1.) The body of the fetus may be ox- tended across the opening transversely, so that the head corresponds to one side (right or left), or it may be vertical, with the head above or below. In any such position the object should be to push the body of the fetus forward and upward or to one side, as may best promise to bring up the fore or hind extremities, and bring the latter into the passage so as to constitute a normal anterior or posterior presentation. This turning of the fetus may be favored by a given position of the mother, by the free use of oil or lard on the surface of the fetus, and by the use of a propeller. PRESENTATION OF BREAST AND ABDOMEN. This is the reverse of the back presentation, the foal being extended across in front of the pelvic opening, but with the belly turned toward the passages and with all four feet engaged in the passage. (Plate XII, fig. 2.) The most promising course is to secure the hind feet i t f d into th b. Al with nooses and then push ithe one ee t forwar into the wom s 182 DISEASES OF THE HORSE. goon as the fore feet are pushed forward clear of the brim of the pelvis, traction is made on the hind feet so as to bring the thighs into the passage and prevent the reentrance of the fore limbs. If it prove difficult to push back the fore limbs a noose may be passed around the fetlock of each and the cord drawn through the eye of a rope carrier, by means of which the members may be easily pushed back. EMBRYOTOMY. This consists in the dissection of the fetus, so as to reduce its bulk and allow of its exit through the pelvis. The indications for its adop- tion have been furnished in the foregoing pages. The operation will vary in different cases according to the necessity for the removal of one or more parts in order to secure the requisite reduction in size. Thus it may be needful to remove head and neck, one fore limb or both, one hind limb or both, to remove different parts of the trunk, or to remove superfluous Lincrinirous parts. Some of the simplest opera- tions in embryotomy (incision of the head in hydrocephalus, incision _ of the belly in dropsy) have already been described. It remains to notice the more difficult procedures which can be best undertaken by the skilled anatomist. Amputation of the head.—This is easy when both fore limbs are turned back and the head alone has made its exit in part. It is more difficult when the head is still retained in the passages or womb, as in double-headed monsters. The head is secured by a hook in the lower jaw, or in the orbit, or by a halter, and the skin is divided circularly around the lower part of the face or at the front of the ears, according to the amount of head protruding. Then an incision is made backward along the line of the throat, and the skin dissected from the neck as far back as possible. Then the muscles and other soft parts of the neck are cut across, and the bodies of two vertebre (neck bones) are severed by cutting completely across the cartilage of the joint. The bulging of the ends of the bones will serve to indi- cate the seat of the joint. The head and detached portion of the neck may now be removed by steady pulling. If there is still an obstacle, the knife may be again used to sever any obstinate connections. In the case of a double-headed monster, the whole of the second neck must be removed with the head. When the head has been detached, a rope should be passed through the eyeholes, or through an artificial opening in the skin, and tied firmly around the skin, to be employed as a means of traction when the missing limbs or the second head have been brought up into position. Amputation of the hind limb.—This may be required when there are extra hind limbs or when the hind limbs are bent forward at hock or hip joint. In the former condition the procedure resembles that for removal of a fore Brab, but, ropes Fore anatomical knowledge. DIFFICULT PARTURITION. 183 Having noosed the pastern, a circular incision is made through the skin around the fetlock, and a longitudinal one from that up to the groin, and the skin is dissected from the limb as high up as can be reached, over the croup, if possible. Then cut through the muscles around the hip joint, and, if possible, the two interarticular ligaments of the joint (pubio-femoral and round), and extract the limb by strong dragging. Amputation of the fore limbs.—This may usually be begun on the fetlock of the limb projecting from the vulva. An embryotomy knife is desirable. This knife consists of a blade with a sharp, slightly hooked point, and one or two rings in the back of the blade large enough to fit on the middle finger, while the blade is protected in the palm of the hand. (See Plate XV, fig. 4.) Another form has the blade inserted-in a mortise in the handle, from which it is pushed out by a movable button when wanted. First place a noose around the fetlock of the limb to be amputated, cut the skin circularly en- tirely around the fetlock, then make an incision on the inner side of the limb from the fetlock up to the breastbone. Next dissect the skin from the limb, from the fetlock up to the breastbone on the inner side, and as far up on the shoulder blade as possible on the outer side. Finally, cut through the muscles attaching the limb to the breast- bone, and employ strong traction on the limb, so as to drag out the whole limb, shoulder blade included. The muscles around the upper part of the shoulder blade are easily torn through and need not be cut, even if that were possible. In no case should the fore limb be removed unless the shoulder blade is taken with it, as that furnishes the greatest obstruction to delivery, above all when it is no longer advanced by the extension of the fore limb, but is pressed back so as to increase the already thickest posterior portion of the chest. The preservation of the skin from the whole limb is advantageous in various ways; it is easier to cut it circularly at the fetlock than at the shoulder; it covers the hand and knife in making the needful - incisions, thus acting as a protection to the womb; and it affords a means of traction on the body after the limb has been removed. In dissecting the skin from the limb the knife is not needful at all points; much of it may be stripped off with the fingers or knuckles, or by a blunt iron spud pushed up inside the hide, which is mean- while held tense to render the spud effective. In case the limb is bent forward at the hock, a rope is passed round that and pulled so as to bring the point of the hock between the lips of the vulva. The hamstring and the lateral ligaments of the hock are now cut through, and the limbs extended by a rope tied round the lower end of the long bone above (tibia). In case it is still needful to remove the upper part of the limb, the further procedure is the ‘Lod 4 last raph. same as described in ihe ast iy Wher Bson® 184 DISEASES OF THE HORSE. In case the limb is turned forward from the hip, and the fetus so wedged into the passage that turning is impossible, the case is very. difficult. I have repeatedly succeeded by cutting in on the hip joint and disarticulating it, then dissecting the muscles back from the upper end of the thigh bone. A noose was placed around the neck of the bone and pulled on forcibly, while any unduly resisting struc- tures were cut with the knife. Cartwright recommends to make free incisions round the hip joints and tear through the muscles when they can not be cut; then with cords round the pelvic bones, and hooks inserted in the openings in the floor of the pelvis to drag out the pelvic bones; then put cords around the heads of the thigh bones and extract them; then remove the intestines; and finally, by means of the loose, detached skin, draw out the body with the remainder of the hind limbs bent forward beneath it. Reuff cuts his way into the pelvis of the foal, and with a knife separates the pelvic bones from the loins, then skinning the quarter draws out these pelvic bones by means of ropes and hooks, and along with them the hind limbs. The hind limbs having been removed by one or the other of these procedures, the loose skin detached from the pelvis is used as a means of traction and delivery is effected. If it has been a monstrosity with extra hind limbs, it may be possible to bring these up into the passage and utilize them for traction. Removal of the abdominal viscera.—In case the belly is unduly large, from decomposition, tumors, or otherwise, it may be needful to lay it open with the knife and cut or tear out the contents. Removal of the thoracic viscera—To diminish the bulk of the chest it has been found advisable to cut out the breastbone, remove the heart and lungs, and allow the ribs to collapse with the lower free ends overlapping each other. Dissection of the trunk.—In case it becomes necessary to remove other portions of the trunk, the general rule should be followed of preserving the skin so that all manipulations can be made inside this as a protector, that it may remain available as a means of exercising traction on the remaining part of the body, and as a covering to protect the vaginal walls against injuries fror: bones while such part is passing. FLOODING, OR BLEEDING FROM THE WOMB. This is rare in the mare, but not unknown, in connection with a failure of the womb to contract on itself after parturition, or with eversion of the womb (casting the withers), and congestion or lacera- tion. If the blood acctmulates in the flaccid womb, the condition may only be suspected by reason of the rapidly advancing weakness Diver eee “Digitized by Microson® > & DIFFICULT PARTURITION. 185 swaying, unsteady gait, hanging head, paleness of the eyes and other mucous membranes, and weak, small, failing pulse. The hand in- troduced into the womb detects the presence of the blood partly clotted. If the blood escapes by the vulva, the condition is evident. Treatment consists in evacuating the womb of its blood clots, giv- ing a large dose of powdered ergot of rye, and in the application of cold water or ice to the loins and external generative organs. Besides this, a sponge impregnated with a strong solution of alum, or, still better, with tincture of muriate of iron, may be introduced into the womb and squeezed so as to bring the liquid in contact with the walls generally. EVERSION OF THE WOMB. If the womb fails to contract after difficult parturition, the after- pains will sometimes lead to the fundus passing into the body of the organ and passing through that and the vagina until the whole inverted organ appears externally and hangs down on the thighs. The result is rapid engorgement and swelling of the organ, impaction of the rectum with feces, and distention of the bladder with urine, all of which conditions seriously interfere with the return of the mass. In returning the womb the standing is preferable to the recumbent position, as the abdomen is more pendent and there is less obstruc- tion to the return. It may, however, be necessary to put hobbles on the hind limbs to prevent the mare from kicking. A clean sheet should be held beneath the womb, and all filth, straw, and foreign bodies washed from its surface. Then with a broad, elastic (india rubber) band, or in default of that a long strip of calico 4 or 5 inches wide, wind the womb as tightly as possible, beginning at its most dependent part (the extremity of the horn). This serves two good ends. It squeezes out into the general circulation the enormous mass of blood which engorged and enlarged the organ, and it furnishes a strong protective covering for the now delicate friable organ, through which it may be safely manipulated without danger of laceration. , The next step may be the pressure on the general mass while those portions next the vulva are gradually pushed in with the hands; or the extreme lowest point (the end of the horn) may be turned within itself and pushed forward into the vagina by the closed fist, the return being assisted by manipulations by the other hand, and even by those of assistants. By either mode the manipulations may be made with almost perfect safety so long as the organ is closely wrapped in the bandage. Once a portion has been introduced into the vagina the rest will usually follow with increasing ease, and the operation should be completed with the hand and arm extended the full length within the womb and moved from point to point so as to straighten out all parts of the organ and insure that no portion still Digitized by Microsoft® 186 DISEASES OF THE HORSE. remains inverted within another portion. Should any such partial inversion be left it will give rise to straining, under the force of which it will gradually increase until the whole mass will be protruded as before. The next step is to apply a truss as an effectual me- chanical barrier to further escape of the womb through the vulva. The simplest is made with two inch ropes, each about 18 feet long. These are each doubled and interwoven at the bend, as seen in Plate IX, figure 4. The ring formed by the interlacing of the two ropes is adjusted around the vulva, the two ends of the one rope are carried up on the right and left of the tail and along the spine, being wound round each other in their course, and are finally tied to the upper part of the collar encircling the neck. The remaining two ends, belonging to the other rope, are carried downward and forward between the thighs and thence forward and upward on the sides of the belly and chest to be attached to the right and left sides of the col- lar. These ropes are drawn tightly enough to keep closely applied to the opening without chafing, and will fit still more securely when the mare raises her back to strain. It is desirable to tie the mare short so that she may be unable to lie down for a day or two, and she should be kept in a stall with the hind parts higher than the fore. Violent straining may be checked by full doses of opium (one-half dram), and any costiveness or diarrhea should be obviated by a suitable laxa- tive or binding diet. Tn some mares the contractions are too violent to allow of the return of the womb, and full doses of opium one-half dram, laudanum 2 ounces, or chloral hydrate 1 ounce, may be demanded, or the mare must be rendered insensible by ether or chloroform. RUPTURE, OR LACERATION, OF THE WOMB. This may occur from the feet of the foal during parturition, or from ill-directed efforts to assist, but it is especially liable to take place in the everted, congested, and friable organ. The resultant dangers are bleeding from the wound, escape of the bowels through the opening and their fatal injury by the mare’s feet or otherwise, and peritonitis from the extension of inflammation from the wound and from the poisonous action of the septic liquids of the womb escaping into the abdominal cavity. The first object is to close the wound, but unless in eversion of the womb this is practically impossible. In the last-named condition the wound must be carefully and accurately sewed up before the womb is returned. After its return, the womb must be injected daily with an antiseptic solution (borax, one-half ounce, or carbolic acid, 8 drams to a quart of tepid water). If in- flammation threatens, the abdomen may be bathed ‘continuously with hot water by means of a heavy woolen rag, and large doses of opium (one-half dram) may be given twice or thrice daily. Digitized by Microsoft® DIFFICULT PARTURITION. 187 RUPTURES OF THE VAGINA. These are attended by dangers similar to those belonging to rup- ture of the womb, and in addition by the risk of protrusion of the bladder, which appears through the lips of the vulva as a red pyri- form mass. Sometimes such lacerations extend downward into the bladder, and in others upward into the terminal gut (rectum). In still other cases the anus is torn so that it forms one common orifice with the vulva. Too often such cases prove fatal, or at least a recovery is not at- tained, and urine or feces or both escape freely into the vagina. The simple laceration of the anus is easily sewed up, but the ends of the muscular fibers do not reunite and the control over the lower bowel is never fully reacquired. The successful stitching up of the wound communicating with the bladder or the rectum requires unusual skill and care, and though I have succeeded in a case of the latter kind, I can not advise the attempt by unprofessional persons. BLOOD CLOTS IN THE WALLS OF THE VAGINA. (See “ Effusion of blood in the vaginal walls,” p. 169.) INFLAMMATION OF THE WOMB AND PERITONEUM. These may result from injuries sustained by the womb during or after parturition, from exposure to cold or wet, or from the irritant infective action of putrid products within the womb. Under the inflammation the womb remains dilated and flaccid, and decomposi- tion of its secretions almost always occurs, so that the inflammation tends to assume a putrid character and general septic infection is likely to occur. Symptoms.—The symptoms are ushered in by shivering, staring coat, small rapid pulse, elevated temperature, accelerated breathing, inappetence, with arched back, stiff movement of the body, looking back at the flanks, and uneasy motions of the hind limbs, discharge from the vulva of a liquid at first watery, reddish, or yellowish, and later it may be whitish or glairy, and fetid or not in different cases. Tenderness of the abdomen shown on pressure is especially character- istic of cases affecting the peritoneum or lining of the belly, and is more marked lower down. If the animal survives, the inflammation tends to become chronic and attended by a whitish muco-purulent discharge. If, on the contrary, it proves fatal, death is preceded by extreme prostration and weakness from the general septic poisoning. Treatment.—In treatment the first thing to be sought is the removal of all offensive and irritant matters from the womb through a caout- chouc tube introduced into the womb, and into which a funnel is fitted. W water should be passed until it comes away clear. To e aa Digitized By Microsoh® i 188 DISEASES OF THE HORSE. insure that all of the womb has been washed out, the oiled hand may be introduced to carry the end of the tube into the two horns . successively. When the offensive contents have been thus removed, the womb should be injected with a quart of water holding in solu- tion 1 dram permanganate of potash, or, in the absence of the latter, 2 teaspoonfuls of carbolic acid. Repeat twice daily. Ffomentation of the abdomen, or the application of a warm flaxseed poultice, may greatly relieve. Acetanilid, in doses of half an ounce, repeated twice or thrice a day, or sulphate of quinia in doses of one-third ounce, may be employed to reduce the fever. If the great prostration indi- cates septic poisoning, large doses (one-half ounce) bisulphite of soda, or salicylate of soda, or sulphate of quinine may be resorted to. LEUCORRHEA. This is a white, glutinous, chronic discharge, the result of a contin- ued subacute inflammation of the mucous membrane of the womb. Like the discharge of acute inflammation, it contains many forms of bacteria, by some of which it is manifestly inoculable on the penis of the stallion, producing ulcers and a specific gonorrheal discharge. Treatment may consist in the internal use of tonics (sulphate of iron, 3 drams, daily) and the washing out of the womb, as described under the last heading, followed by an astringent antiseptic injection (carbolic acid 2 teaspoonfuls; tannic acid one-half dram, water 1 quart). This may be repeated two or three times a day. LAMINITIS, OR FOUNDER, FOLLOWING PARTURITION. This sometimes follows on inflammation of the womb, as it fre- quently does on disorder of the stomach. Its symptoms agree with those of the common form of founder, and treatment need not differ. DISEASES OF THE UDDER AND TEATS, CONGESTION AND INFLAMMATION OF THE UDDER. This is comparatively rare in the mare, though in some cases the udder becomes painfully engorged before parturition, and a doughy swelling, pitting on pressure, extends forward on the lower surface of the abdomen. When this goes on to active inflammation, one or both of the glands become enlarged, hot, tense, and painful; the milk is dried up or replaced by a watery or reddish serous fluid, which at times becomes fetid ; the animal walks lame, loses appetite, and shows general disorder and fever. The condition may end in recovery, in abscess, induration, or gangrene, and in some cases may lay the foun- dation for a tumor of the gland. Treatment.—The treatment is simple so long as there is only con- gestion. Active rubbing with lard or oil, or, better, camphorated Digitized by Microsoft® DISEASES OF THE UDDER AND TEATS. 189 oil, and the frequent drawing off of the milk, by the foal or with the hand, will usually bring about a rapid improvement. When active inflammation is present, fomentation with warm water may be kept up for an hour and followed by the application of the cam- phorated oil, to which has been added some carbonate of soda and extract of Selladonne. A dose of laxative medicine (4 drams Bar- bados aloes) will be of service reducing fever, and one-half ounce saltpeter daily will serve a similar end. In case the milk coagulates in the udder and can not be withdrawn, or when the liquid becomes fetid, a solution of 20 grains carbonate of soda and 10 drops carbolic ° acid dissolved in an ounce of water should be injected into the teat. In doing this it must be noted that the mare has three separate ducts opening on the summit of each teat and each must be carefully in- jected. To draw off the fetid product it may be needful to use a small milking tube, or spring teat dilator designed by the writer. (Plate VIII, figs. 2 and 3.) When pus forms and points externally and can not find a free escape by the teat, the spot where it fluctu- ates must be opened freely with the knife and the cavity injected daily with the carbolic-acid lotion. When the gland becomes hard and indolent, it may be rubbed daily with iodine ointment 1 part, vaseline 6 parts. TUMORS OF THE UDDER. a As the result of inflammation of the udder it may become the seat of an indurated diseased growth, which may go on growing and seri- ously interfere with the movement of the hind limbs. If such swell- ings will not give way in their early stages to treatment by iodine, the only resort is to cut them out with a knife. As the gland is often implicated and has to 32 removed, such mares can not in the future suckle their colts and therefore should not be bred. SORE TEATS, SCABS, CRACKS, WARTS. By the act of sucking, especially in cold weather, the teats are sub- ject to abrasions, cracks, and scabs, and as the result of such irrita- tion, or independently, warts sometimes grow and prove troublesome. The warts should be clipped off with sharp scissors and their roots burned with a solid pencil of lunar caustic. This is best done before parturition to secure healing before suckling begins. For sore teats use an ointment of vaseline 1 ounce, balsam of tolu 5 grains, and sulphate of zine 5 grains. Digitized by Microsoft® DISEASES OF THE NERVOUS SYSTEM. By M. R. TRuMBowER, V. S. [Revised in 1903 by Leonard Pearson, B. S., V. M. D.J THE ANATOMY AND PHYSIOLOGY OF THE BRAIN AND NERVOUS SYSTEM. The nervous system may be regarded as consisting of two sets of organs, peripheral and central, the function of one being to establish a communication between the centers and the different parts of the body, and that of the other to generate nervous force. The whole may be arranged under two divisions: First, the cerebro-spinal system; second, the sympathetic, or ganglionic system. Each is possessed of its own central and peripheral organs. In the first, the center is made up of two portions—one large and expanded (the brain) placed in the cranial cavity; the other elon- gated (spinal cord), continuous with the brain, and lodged in the canal of the vertebral column. The peripheral portion of this sys- tem consists of the cerebro-spinal nerves, which leave the axis in symmetrical pairs, and are distributed to the skin, the voluntary muscles, and the organs. In the second, the central organ consists of a chain of ganglia con- nected by nerve cords which extends from the head to the rump on each side of the spine. The nerves of this system are distributed to the involuntary muscles, mucous membrane, viscera, and blood vessels. The two systems have free intercommunication, ganglia being at the junctions. - Two substances, distinguishable by their color, enter into the forma- tion of nervous matter, namely, the white or medullary, and the gray or cortical substance. Both are soft, fragile, and easily injured, in consequence of which the principal nervous centers are well protected by bony coverings. The nervous substances present two distinct forms—nerve fibers and nerve cells. An aggregation of nerve cells constitutes a nerve ganglion. The nerve fibers represent a conducting apparatus, and serve to place the central nervous organs in connection with peripheral end organs. The nerve cells, however, besides transmitting impulses, act as physiological centers for automatic, or reflex, movements, and also 190 Digitized by Microsoft® DISEASES OF THE NERVOUS SYSTEM. 191 for the sensory, perceptive, trophic, and secretory functions. A nerve consists of a bundle of tubular fibers, held together by a dense areolar tissue, and inclosed in a membranous sheath—the neurilemma. Nerve fibers possess no elasticity, but are very strong: Divided nerves do not retract. . Nerves are thrown into a state of excitement when stimulated, and are, therefore, said to possess excitable or irritable properties. The stimuli may be applied to, or may act upon, any part of the nerve. Nerves may be paralyzed by continuous pressure being applied. ‘When the nerves divide into branches, there is never any splitting up of their ultimate fibers, nor yet is there ever any coalescing of them; they retain their individuality from their source to their termination. Nerves which convey impressions to the centers are termed sensory, or centripetal, and those which transmit stimulus from the centers to organs of motion are termed motor, or centrifugal. The function of the nervous system may, therefore, be defined in the simplest terms, as follows: It is intended to associate the different parts of the body in such a manner that stimulus applied to one organ may excite or depress the activity of another. The brain is that portion of the cerebro-spinal axis within the cra- nium, which may be divided into four parts—the medulla oblongata, the cerebellum, the pons Varolii, and the cerebrum—and it is cov- ered by three membranes, called the meninges. The outer of these membranes, the dura mater, is a thick, white, fibrous membrane which lines the cavity of the cranium, forming the internal periosteum of the bones; it is continuous with the spinal cord to the extremity of the canal. The second, the arachnoid, is a delicate serous membrane, and loosely envelops the brain and spinal cord; it forms two layers, leav- ing between them the arachnoid space which contains the cerebro- spinal fiuid, the use of which is to protect the spinal cord and brain from pressure. The third, or inner, the pia mater, is closely adher- ent to the entire surface of the brain, but is much thinner and more vascular than when it reaches the spinal cord, which it also envelops, and is continued to form the sheaths of the spinal nerves. The medulla oblongata is the prolongation of the spinal cord, extending to the pons Varolii. This portion of the brain is very large in the horse; it is pyramidal in shape, the narrowest part join- ing the cord. The pons Varolit is the transverse projection on the base of the brain, between the medulla oblongata and the peduncles of the cerebrum. ‘The cerebellum is lodged in the posterior part of the cranial cavity, immediately above the medulla oblongata; it is globular or elliptical Digitized by Microsoft® 192 DISEASES OF THE HORSE. in shape, the transverse diameter being greatest. The body of the cerebellum is composed of gray matter externally and of white matter in the center. The cerebellum has the function of coordinating move- meuts; that is, of-so associating them as to cause them to accomplish a definite purpose. Injuries to the cerebellum cause “isturbances of the equilibrium, but do not interfere with the will power or intelligence. The ceredrum, or brain proper, occupies the anterior portion of the cranial cavity. It is ovoid in shape, with an irregular flattened base, and consists of lateral halves or hemispheres. The greater part of the cerebrum is composed of white matter. The hemispheres of the cerebrum are usually said to be the seat of all psychical activities. Only when they are intact are the process of feeling, thinking, and willing possible. After they are destroyed, the organism comes to be like a complicated machine, and its activity is only the expression of the internal and external stimuli which act upon it. The spinal cord, or spinal marrow, is that part of the cerebro- spinal system which is contained in the spinal canal of the backbone, and extends from the medulla oblongata to a short distance behind the loins. It is an irregularly cylindrical structure, divided into two lateral symmetrical halves by fissures. The spinal cord terminates ‘posteriorly in a pointed extremity, which is continued by a mass of nerve trunks—cauda equine. A transverse section of the cord reveals that it is composed of white matter externally and of gray matter internally. The spinal cord does not fill up the whole spinal canal. The latter contains, besides, a large venous sinus, fatty matter, the membranes of the cord, and the cerebro-spinal fluid. The spinal nerves, forty-two or forty-three in number, arise each by two roots, a superior, or sensory, and an inferior, or motor. The nerves originating from the brain are twenty-four in number, and arranged in pairs, which are named first, second, third, etc., counting from before backward. They also receive special names, according to their functions, or the parts to which they are distributed, viz: 1. Olfactory. 7 Facial. 2. Optic. 8. Auditory. 3. Oculo-motor. 9. Glosso-pharyngeal. 4, Pathetic. 10. Pneumogastrie. 5. Trifacial. 11. Spinal-accessory. 6. Abducens. 12. Hypoglossal. INFLAMMATION OF THE BRAIN AND ITS MEMBRANES. Inflammation may attack these membranes singly, or any one of the anatomical divisions of the nerve matter, or it may invade the whole at once, Practical experience, however, teaches us that primary inflammation of the dura mater is of rare occurrence, except in direct mechanical injuries to the head or diseases of the bo f th - : Digitized by Microsoft®. WARIS ZES SOUS GENS STE ANOO 8 Nata SNIINE uruseyy deye jap saureyy snxayd 177]05 WAVSAG PHOYPDAUAS onvIwS |@ ‘DILISD DOUNIAUT S719) A LD FULT OLPDS Fe SNLAL PAAUIDL DLO2 FDUAS ADA Digitized by Microsoft® AX TLV id Digitized by Microsoft® DISEASES OF THE BRAIN. 193 nium. Neither is the arachnoid often affected with acute inflamma- tion, except as a secondary result. The pia mater is most commonly the seat of inflammation, acute and subacute, but from its intimate relation with the surface of the brain the latter very soon becomes involved in the morbid changes. Practically, we can not separate in- flammation of the pia mater from that of the brain proper. Inflam- mation may, however, exist in the center of the great nerve masses— the cerebrum, cerebellum, pons Varolii, or medulla at the base of the brain—without involving the surface. When, therefore, inflamma- tion invades the brain and its enveloping membranes it is properly called encephalitis; when the membranes alone are affected, it is called meningitis; or the brain substance alone, cerebritis. Since all of the conditions merge into each other and can scarcely be recognized separately during the life of the animal, they may here be considered together. ENCEPHALITIS, MENINGITIS, AND CEREBRITIS (INFLAMMATION OF THE BRAIN AND ITS MEMBRANES). Causes.—Exposure to extreme heat or cold, sudden and extreme changes of temperature, excessive continued cerebral excitement, over- feeding with nitrogenous foods, direct injuries to the brain, such as concussion, or from fracture of the cranium, overexertion, sometimes as sequelee to influenza, pyemia, poisons having a direct influence upon the encephalic mass, extension of inflammation: from neighboring structures, food poisoning, tumors, parasites, metastatic abscesses, etc. Symptoms.—The diseases here grouped together are accompanied by a variety of symptoms almost none of which, however, are asso- ciated so definitely with a special pathological process as to point unmistakably to a given lesion. Usually the first symptoms indicate mental excitement, and these are followed by symptoms indicating depression. Acute encephalitis may be ushered in by an increased sensibility to noises, with more or less nervous excitability, contrac- tion of the pupils of the eyes, and a quick, hard pulse. In very acute attacks these symptoms, however, are not always noted. This condi- tion will soon be followed by muscular twitchings, convulsive or spasmodic movements, eyes wide open with shortness of sight. The animal becomes afraid to have his head handled. Convulsions and delirium will develop, with inability of muscular control, or stupor and coma may supervene. Where the membranes are greatly implicated, convulsions and delirium with violence may be expected, but where the brain substances are principally affected stupor and coma will be ‘the prominent symptoms. In the former condition the pulse will be quick and hard; in the latter, soft or depressed with often a dila- tation of the pupils, and deep, slow, stertorous breathing. The H. Doe. 795, 59-2—13 2 Digitized by Microsoft® 194 DISEASES OF THE HORSE. symptoms may follow one another in rapid succession, and the disease approach a fatal termination in less than twelve hours. In subacute attacks the symptoms are better defined, and the animal seldom dies before the third day. Within three or four days gradual improve- ment may become manifest, or cerebral softening with partial paral- ysis may occur. In all cases of encephalitis there is a marked rise in temperature from the very onset of the disease, with a tendency to increase until the most alarming symptoms develop, succeeded by a decrease when coma becomes manifest. The violence and character of the symptoms greatly depend upon the extent and location of the structures involved. Thus, in some cases there may be marked paral- ysis of certain muscles, while in others there may be spasmodic rigidity of muscles in a certain region. Very rarely the animal be- comes extremely violent early in the attack, and by rearing up, strik- ing with the fore feet, or falling over, may do himself great injury. Usually, however, the animal maintains the standing position, prop- ping himself against the manger or wall, until he falls from inability of muscular control or unconsciousness. Occasionally he may -go through a series of automatic movements in his delirium, such as trotting or walking, and, if loose in a stall, will move around in a circle persistently. Early and persistent constipation of the bowels is a marked symptom in nearly all acute affections of the brain; re- tention of the urine, also, is frequently observed. Following these symptoms there are depression, loss of power and consciousness, lack of ability or desire to move, and usually fall of temperature. At this stage the horse stands with legs propped, the head hanging or resting on the manger, the eyes partly closed, and does not respond when spoken to or when struck with a whip. Chronic encephalitis or meningitis may succeed the acute stage, or may be due to stable miasma, blood poison, narcotism, lead poison- ing, etc. This form may not be characterized in its initial stages by excitability, quick and hard pulse, and high fever. The animal usually appears at first stupid; eats slowly; the pupil of the eye does not respond to light quickly; the animal often throws up his head or shakes it as if suffering sudden twinges of pain. He is slow and sluggish in his movements, or there may be partial paralysis of one limb, one side of the face, neck, or body. These symptoms, with some variations, may be present for several days and then subside, or the disease may pass into the acute stage and terminate fatally. Chronic encephalitis may affect an animal for ten days or two weeks without much variation in the symptoms before the crisis is reached. If im- provement commences, the symptoms usually disappear in the reverse order in which they developed, with the exception of the paralytic effects, which remain intractable or permanent. Paralysis of certain sets of muscles is a very common result of chronic, subacute, and Digitized by Microsoft® DISEASES OF THE BRAIN. 195 acute encephalitis, and is due to softening of the brain or to exuda- tion into the cavities of the brain or arachnoid space. Softening and abscess of the brain is one of the terminations of cerebritis. It may also be due to an insufficient supply of blood as a result of diseased cerebral arteries and of apoplexy. The symptoms are drowsiness, vertigo, or attacks of giddiness, increased timidity, or fear of familiar objects, paralysis of one limb, hemiplegia, imperfect control of the limbs, and usually a weak, intermittent pulse. In some cases the symptoms are analogous to those of apoplexy. The char- acter of the symptoms depends upon the seat of the softening or abscess within the brain. Cerebral sclerosis sometimes follows inflammation in the struct- ure of the brain affecting the connective tissues, which eventually become hypertrophied and press upon nerve cells and fibers, causing their ultimate disappearance, leaving the parts hard and indurated. This condition gives rise to a progressive paralysis and may extend along a certain bundle of fibers into the spinal cord. Complete paralysis almost invariably supervenes and causes death. Lesions.—On making post-mortem examinations of horses which have died in the first stages of either of these diseases we will find an excessive engorgement of the capillaries and small blood vessels, with correspondingly increased redness and changes in both the contents and the walls of the vessels. If death has occurred at a later period of the disease it will be found that, in addition to the redness and en- gorgement, an exudation of the contents of the blood vessels into the tissues and upon the surfaces of the inflamed parts has supervened. If the case has been one of encephalitis, there will usually be found more or less watery fluid in the ventricles (natural cavities in the brain), in the subarachnoid space, and a serous exudation between the convolutions and interstitial spaces of the gray matter under the membranes of the brain. The amount of fluid varies in different cases. Exudations of a membranous character may be present and are found attached to the surface of the pia mater. In meningitis, especially in chronic cases, in addition to the serous effusion, there are changes which may be regarded as characteristic in the formation of a delicate and highly vascular layer or layers of membrane or organized structure on the surface of the dura mater, and also indications of hemorrhages in connection with the membra- nous formations. Hematoma, or blood tumors, may be found em- bedded in this membrane. In some cases the hemorrhages are copious, causing paralysis or apoplexy, followed by speedy death. The menin- gitis may be suppurative. In this case, a puslike exudate is found between the membranes covering the brain. In cerebritis, or inflammation of the interior of the brain, there is a tendency ta softening and suppuration and the formation of Digitized by Microsoft® 196 DISEASES OF THE HORSE. abscesses. In some cases the abscesses are small and numerous, sur- rounded with a softened condition of the brain matter, and some- times we may find one large abscess. In cases of recent development the walls of the abscesses are fringed and ragged and have no lining membrane. In older or chronic cases, the walls of the abscesses are generally lined with a strong membrane, often having the appearance of a sac, or cyst, and the contents have a very offensive odor. Treatment.—In all acute attacks of inflammation involving the membranes or cerebral masses, it is the pressure from the distended and engorged blood vessels and the rapid accumulation of inflamma- tory products that endangers the life of the animal in even the very early stage of the disease. The earlier the treatment is commenced to lessen the danger of fatal pressure from the engorged blood vessels, the less amount of inflammatory products and effusion we have to contend with later on. The leading object, then, to be accomplished in the treatment of the first stages of encephalitis, meningitis, or cere- britis is to relieve the engorgement of the blood vessels before a dan- gerous degree of effusion or exudation has taken place, and thereby lessen the irritation or excitability of the affected structures. If the attempt to relieve the engorgement in the first stage has been only partially successful, and the second stage with its inflammatory prod- ucts and exudations, whether serous or plastic, has set in, then the main objects in further treatment are to keep up the strength of the animal and hasten the absorption of the exudative products as much as possible. To obtain these results, when the animal is found in the initial stage of the disease, where there is unnatural excitability or stupor with increase of temperature and quickened pulse, we should apply cold to the head in the form of cold water or ice. For this pur- pose cloths or bags may be used, and they should be renewed as often as necessary. If the disease is still in its early stages and the animal is strong, bleeding from the jugular vein may be beneficial. Good results are to be expected only during the stage of excitement, while there is a strong, full pulse and the mucous membranes of the head are red from a plentiful supply of blood. The finger should be kept on the pulse and the blood allowed to flow until there is distinct softening of the pulse. As soon as the animal recovers somewhat from the shock of the bleeding, the following medicine should be made into a ball or dissolved in a pint of warm water and be given at one dose: Barbados aloes, 7 drams; calomel, 2 drams; powdered ginger, 1 dram; tincture of aconite, 20 drops. The.animal should be placed in a cool, dark place, as free from noise as possible. When the animal becomes, thirsty half an ounce of bromide of potash may be dissolved in his drinking water every six hours. Injections of warm water into the rectum may facilitate the action of the purgative. Norwood’s tincture of veratrum viride, in Digitized by Microsoft® DISEASES OF THE BRAIN.. 197 20-drop doses, should be given every hour and 1 dram of solid extract of belladonna every four hours until the symptoms become modified and the pulse regular and full. If this treatment fails to give relief, the disease will pass into the advanced stages, or, if the animal has been neglected in the early stages, the treatment must be supplanted with the hypodermic injec- tion of ergotin, in 5-grain doses, dissolved in 1 dram of water, every six hours. The limbs may be poulticed above the fetlocks with mus- tard. Warm blanketing, to promote perspiration, is to be observed in all cases in which there is no excessive perspiration. If the disease becomes chronic (encephalitis or meningitis), we must place our reliance upon alteratives and tonics, with such incidental treatment as special symptoms may demand. Jodide of potassium in 2-dram doses should be given three times a day and 1 dram of calo- mel once a day to induce absorption of effusions or thickened mem- branes. Tonics, in the form of iodide of iron in 1-dram doses, to which is added 2 drams of powdered hydrastis, may also be given every six or eight hours, as soon as the active fever has abated. After the disappearance of the acute symptoms, blisters (cantharides cintment) may be applied behind the poll. When paralytic effects remain after the disappearance of all other symptoms, sulphate of strychnia in 2-grain doses, in combination with the other tonics, may be given twice a day, and be continued until it produces muscular twitching. In some cases of paralysis, as of the lips or throat, bene- fit may be derived from the moderate use of the electric battery. Many of the recoveries will, however, under the most active and early treatment, be but partial, and in all cases the animals become predis- posed to subsequent attacks. A long period of time should be allowed to pass before the animal is exposed to severe work or great heat. When the disease depends upon mechanical injuries, they have to be treated and all causes of irritation to the brain removed. If it is due to stable miasma, uremic poisoning, pyemia, influenza, rheumatism, toxic agents, etc., they should receive prompt attention for their removal or mitigation. Cerebral softening, abscess, and sclerosis are practically inaccess- ible to treatment, otherwise than such relief as may be afforded by the administration of opiates and general tonics, and, in fact, the diagnosis is largely presumptive. CONGESTION OF THE BRAIN, OR MEGRIMS. Congestion of the brain consists in an accumulation of blood in the vessels, also called hyperemia, or engorgement. It may be active or passive—active when there is an undue determination of blood or diminished arterial resistance, and passive when it accumulates in the vessels of the brain, owing to some obstacle to its return by the veins. Digitized by Microsoft® 198 DISEASES OF THE HORSE. Causes.—Active cerebral congestion may be due to hypertrophy of the left ventricle of the heart, excessive exertion, the influence of extreme heat, sudden and great excitement, artificial stimulants, etc. Passive congestion may be produced by any mechanical obstruction which prevents the proper return of blood through the veins to the heart, such as a small or ill-fitting collar, which often impedes the blood current, tumors or abscesses pressing on the vein in its course, and organic lesions of the heart with regurgitation. Extremely fat animals with short thick necks are peculiarly subject to attacks of cerebral congestion. Simple congestion, however, is merely a functional affection, and in a slight or moderate degree involves no immediate danger. Extreme engorgement, on the con- trary, may be followed by rupture of previously weakened arteries and capillaries and cause immediate death, designated then as a stroke of apoplexy. Symptoms.—Congestion of the brain is usually sudden in its mani- festation and of short duration. The animal may stop very suddenly and shake his head or stand quietly braced on his legs, then stagger, make a plunge, and fall. The eyes are staring, breathing hurried and stertorous, and the nostrils widely dilated. This may be followed by coma, violent convulsive movements, and death. Generally, however, the animal gains relief in a short time, but he may remain weak and giddy for several days. If it is due to organic change of the heart or to disease of the blood vessels in the brain, then the symptoms may be of slow development manifested by drowsiness, dimness or im- perfect vision, difficulty in voluntary movements, diminished sensi- bility of the skin, loss of consciousness, delirium, and death. In milder cases effusion may take place in the arachnoid spaces and ventricles of the brain, followed by paralysis and other complications. Pathology.—In congestion of the brain the cerebral vessels are loaded with blood, and the venous sinuses distended to an extreme degree, and the pressure exerted upon the brain constitutes actual compression, giving rise to the symptoms just mentioned. On post- mortem examinations this engorgement is found universal through- out the brain and its membranes, which serves to distinguish it from inflammations of these structures, in which the engorgements are confined more or less to circumscribed portions. A prolonged con- gestion may, however, lead to active inflammation, and in that case we will find serous and plastic exudations in the cavities of the brain. In addition to the intensely engorged condition of the vessels we find the gray matter of the brain redder in color than natural. In cases where several attacks have occurred the blood vessels are often found permanently dilated. Treatment.—Prompt removal of all mechanical obstructions to the circulation. If it is due to venous obstruction by too tight a collar, Digitized by Microsoft® SUNSTROKE. 199 the loosening of the collar will give immediate relief. The horse should be bled freely from the jugular vein. If due to tumors or abscesses, a surgical operation becomes necessary to afford relief. To revive the animal if he becomes partially or totally unconscious, cold water should be dashed on the head. Give a purge of Glauber’s salts. If the limbs are cold, tincture of capsicum or strong mustard water should be applied to them. If symptoms of paralysis remain after two or three days, an active cathartic and iodide of potassa will be indicated, to be given as prescribed for inflammation of the brain. Prevention.—Well-adjusted collar, with strap running from the collar to the girth, to hold down the collar when pulling upgrade; regular feed and exercise, without allowing the animal to become ex- cessively plethoric; moderate checking, allowing a free-and-easy movement of the head; well-ventilated stabling, proper cleanliness, pure water, etc. SUNSTROKE, HEAT STROKE, OR HEAT EXHAUSTION. The term sunstroke is applied to affections occasioned not exclu- sively by exposure to the sun’s rays, as the word signifies, but by the action of great heat combined generally with humid atmosphere. Exhaustion produced by a long-continued heat is often the essential factor, and is called heat exhaustion. Horses on the race track un- dergoing protracted and severe work in hot weather often succumb to heat exhaustion. Draft horses exposed to the direct rays of the sun for many hours, which do not receive proper care in watering, feeding, and rest in shady places, suffer very frequently from sun- stroke. Symptoms.—Sunstroke is manifested suddenly. The animal stops, drops his head, begins to stagger, and soon falls to the ground uncon- scious. The breathing is marked with great stertor, the pulse is very slow and irregular, cold sweats break out in patches on the surface of the body, and the animal often dies without recovering consciousness. The temperature becomes very high, reaching 105° to 109° F. In heat exhaustion the animal usually requires urging for some time previous to the appearance of any other symptoms, generally perspiration is checked, and then he becomes weak in his gait, the breathing hurried or panting, eyes watery or bloodshot, nostrils dilated and highly reddened, assuming a dark, purple color; the pulse is rapid and weak, the heart bounding, followed by unconsciousness and -death. If recovery takes place, convalescence extends over a long period of time, during which incoordination of movement may persist. Pathology.—Sunstroke, virtually active congestion of the brain, often accompanied by effusion and blood extravasation, characterizes this condition, with often rapid and fatal lowering of all the vital Digitized by Microsoft® 200 DISEASES OF THE HORSE. functions. The death may be due in many instances to the complete stagnation in the circulation of the brain, inducing anemia, or want of nourishment of that organ. In other cases it may be directly due to the excessive compression of the nerve matter controlling the heart’s action, and cause paralysis of that organ. There are also changes in the composition of the blood. Treatment.—Under no circumstances is bloodletting permissible in sunstroke. Ice or very cold water should be applied to the head and along the spine, and half an ounce of carbonate of ammonia or 6 ounces of whisky should be given in 1 pint of water. Cold water should be showered upon the body of the horse from the hose or otherwise. This should be continued until the temperature is down to 108° F. Brisk friction of the limbs and the application of spirits of camphor often yield good results. The administration of the stim- ulants should be repeated in one hour if the pulse has not become stronger and slower. In either case, when reaction has occurred, preparations of iron and general tonics may be given during conva- lescence: Sulphate of iron, 1 dram; gentian, 3 drams; red cinchona bark, 2 drams; mix and give in the feed morning and evening. Prevention.—In very hot weather horses should have wet sponges or light sunshades on the head when at work, or the head may be sponged with cold water as many times a day as possible. Proper attention should be given to feeding and watering, never in excess. During the warm months all stables should be cool and well ven- tiated, and if an animal is debilitated from exhaustive work or disease he should receive such treatment as will tend to build up the system. Horses should be permitted to drink as much water as they want while they are at work during hot weather. An animal which has been affected with sunstroke is very liable to have subsequent attacks when exposed to the necessary exciting causes. . APOPLEXY, OR CEREBRAL HEMORRHAGE. Apoplexy is often confounded with cerebral congestion, but true apoplexy always consists in rupture of cerebral blood vessels, with blood extravasation and formation of blood clot. Causes——Two causes are involved in the production of apoplexy, the predisposing and the exciting. The predisposing cause is degen- eration, or disease which weakens the blood vessel; the exciting cause is any one which tends to induce cerebral congestion. Symptoms.—Apoplexy is characterized by a sudden loss of sensa- tion and motion, profound coma, and stertorous and difficult breath- ing. The action of the heart is little disturbed at first, but soon be- comes slower, then quicker and feebler, and after a little time ceases. If the rupture is one of a small artery and the extravasation limited, Digitized by Microsoft® DISEASES OF THE BRAIN. - 201 sudden paralysis of some part of the body is the result. The extent and location of the paralysis depend upon the location within the brain which is functionally deranged by the pressure of the extrava- sated blood; hence these conditions are very variable. In the absence of any premonitory symptoms or an increase of tem- perature in the early stage of the attack, we may be reasonably certain in making the distinction between this disease and congestion of the brain, or sunstroke. Pathology.—In apoplexy there is generally found an atheromatous condition of the cerebral vessels, with weakening and degeneration of their walls. When a large artery has been ruptured it is usually fol- lowed by immediate death, and large rents may be found in the cere- brum, with great destruction of brain tissue, induced by the forcible pressure of the liberated blood. In small extravasations producing local paralysis without marked general disturbance, the animal may recover after a time; in such cases gradual absorption of the clot takes place. In large clots atrophy of the brain substances may follow, or softening and abscess from want of nutrition may result, and render the animal worthless, ultimately resulting in death. Treatment.—Place the animal in a quiet, cool place and avoid all stimulating food. Administer, in his drinking water or feed, 2 drams of the iodide of potassa twice a day for several weeks if necessary. Medical interference with sedatives or stimulants is more apt to be harmful than of benefit, and bloodletting in an apoplectic fit is extremely hazardous. From the fact that cerebral apoplexy is due to diseased or weakened blood vessels, the animal remains subject to subsequent attacks. COMPRESSION OF THE BRAIN. Causes.—In injuries from direct violence a piece of broken bone may press upon the brain, and, according to its size, the brain is robbed of its normal space within the cranium. It may also be due to an extravasation of blood or to exudation in the subdural or arach- noid spaces. Death from active cerebral congestion results through compression. The occurrence may sometimes be traced to the direct cause, which will give assurance for the correct diagnosis. Symptoms.—Impairment of all the special senses and localized paralysis. All the symptoms of lessened functional activity of the brain are manifested to some degree. The paralysis remains to be our guide for the location of the cause, for it will be found that the paralysis occurs on the opposite side of the body from the location of the injury, and the parts suffering paralysis will denote, to an expert veterinarian or physician, the part of the brain which is suffering compression. Treatment.—Trephining, by a skillful operator, for the removal of Digitized by Microsoft® 202 . DISEASES OF THE HORSE. the cause when due to depressed bone or the presence of foreign bodies. When the symptoms of compression follow other acute diseases of the brain, apoplectic fits, etc., the treatment must be such as the exigencies of the case demands. CONCUSSION OF THE BRAIN. Causes.—This is generally caused by an animal falling over back- ward and striking his poll, or perhaps falling forward on his nose; by a blow on the head, ete. Train accidents during shipping often cause concussion of the brain. Symptoms.—Concussion of the brain is characterized by giddiness, stupor, insensibility, or loss of muscular power, succeeding imme- diately upon a blow or severe injury involving the cranium. The animal may rally quickly or not for hours; death may occur on the spot or after a few days. When there is only slight concussion or stunning, the animal soon recovers from the shock. When more severe, insensibility may be complete and continue for a considerable time; the animal lies as if in a deep sleep; the pupils are insensible to light; the pulse fluttering or feeble; the surface of the body cold, muscles relaxed, and the breathing scarcely perceptible. After a variable interval partial recovery may take place, which is marked by paralysis of some parts of the body, often of a limb, the lips, ear, etc. Convalescence is usually tedious, and frequently permanent im- pairment of some organs remains. Pathology.—Concussion produces laceration of the brain, or at least a jarring of the nervous elements, which, if not sufficiently severe to produce sudden death, may lead to softening or inflammation, with their respective symptoms of functional derangement. Treatment.—The first object in treatment will be to establish reac- tion or to arouse the feeble and weakening heart. This can often be accomplished by dashing cold water on the head and body of the ani- mal; frequent injections of weak ammonia water, ginger tea, or oil and turpentine should be given per rectum. In the majority of cases this will soon bring the horse to a state of consciousness. In more severe cases mustard poultices should be applied along the spine and above the fetlocks. As soon as the animal gains partial consciousness stimulants, in the form of whisky or capsicum tea, should be given. Owing to severity of the structural injury to the brain or the pos- sible rupture of blood vessels and blood extravasation, the reaction may often be followed by encephalitis or cerebritis, and will then have to be treated accordingly. For this reason the stimulants should not be administered too freely, and they must be abandoned as soon as reaction is established. There is no need for further treatment unless complications develop as a secondary result. Bleed- ing, which is so often practiced, proves almost invariably fatal in Digitized by Microsoft® DISEASES OF THE BRAIN. 2038 this form of brain affection. We should also remember that it is never safe to drench a horse with large quantities of medicine when he is unconscious, for he is very liable to draw the medicine into the lungs in inspiration. Prevention.— Young horses, when harnessed or bitted for the first few times, should not have their heads checked up high, for it fre- quently causes them to rear up, and, being unable to control their balance, they are liable to fall over sideways or backwards, thus causing brain concussion when they strike the ground. ANEMIA OF THE BRAIN. This is a physiological condition in sleep. Causes.—It is considered a disease or may give rise to disease when the circulation and blood supply of the brain are interfered with. In some diseases of the heart the brain becomes anemic, and fainting fits occur, with temporary loss of consciousness. Tumors growing within the cranium may press upon one or more arteries and stop the supply of blood to certain parts of the brain, thus inducing anemia, ultimately atrophy, softening, or suppuration. Probably the most frequent cause is found in plugging, or occlusion, of the arteries by a blood clot. Symptoms.—Imperfect vision, constantly dilated pupils, frequently a feeble and staggering gait, and occasionally cramps, convulsions, or epileptic fits occur. Pathology.—The exact opposite of cerebral hyperemia. The blood vessels are found empty, the membranes blanched, and the brain sub- stance softened. ; Treatment.—Removal of the remote cause when possible. General tonics, nutritious food, rest, and removal from all causes of nervous excitement. HYDROCEPHALUS, OR DROPSY OF THE BRAIN. This condition consists in an unnatural collection of fluid about or in the brain. Depending upon the location of the fluid, we speak of external and internal hydrocephalus. External hydrocephalus is seen chiefly in young animals. It con- sists in a collection of fluid under the meninges, but outside of the brain proper. This defect is usually congenital. It is accompanied by an enlargement of the skull, especially in the region of the fore- head. The pressure of the fluid may cause the bones to soften. The disease is incurable and usually fatal. Internal hydrocephalus is a disease of mature horses, and consists in the accumulation of an excessive quantity of fluid in the cavities or ventricles of the cerebrum. The cause of this accumulation may be a previous inflammation, a defect in the circulation of blood Digitized by Microsoft® 204 DISEASES OF THE HORSE. through the brain, heat stroke, overwork, excessive nutrition, or long- continued indigestion. Common, heavy-headed draft horses are pre- disposed to this condition. The symptoms are an expression of dullness and stupidity, and from their nature this disease is sometimes known as.“ dumminess ” or “immobility.” A horse so afflicted is called a‘ dummy.” Among the symptoms are loss of intelligence, stupid expression, poor mem- ory, etc. The appetite is irregular; the horse may stop chewing with a wisp of hay protruding from his lips; he seems to forget that it is there. Unnatural positions are sometimes assumed, the legs being placed in clumsy and unusual attitudes. Such horses are difficult to drive, as they do not respond readily to the word, to pressure of the bit, or to the whip. Gradually the pulse becomes weaker, respiration becomes faster, and the subject loses weight. Occasionally there are periods of great excitement due to temporary congestion of the brain. At such times the horse becomes quite uncontrollable. A horse so afflicted is said to have “staggers.” The outlook for recovery is not good. Treatment is merely palliative. Regular work or exercise and nutri- tious food easy of digestion, with plenty of fresh water, are strongly indicated. Intensive feeding should not be practiced. The bowels should be kept open by the use of appropriate diet or by the use of small regular doses of Glauber’s salts. TUMORS WITHIN THE CRANIUM. Tumors within the cranial cavity and the brain occur not infre- quently, and give rise to a variety of symptoms, imperfect control of voluntary movement, local paralysis, epilepsy, etc. Among the more common tumors are the following: Osseous tumors, growing from the walls of the cranium, are not very uncommon. Dentigerous cysts, containing a formation identical to that of a tooth, growing from the temporal bone, sometimes are found lying loose within the cranium. Tumors of the choroid plexus, known as brain sand, are frequently met with on post-mortem examinations, but seldom give rise to any appreciable symptoms during life. They are found in horses at all ages, and are of slow development. They are found in one or both of the lateral ventricles, enveloped in the folds of the choroid plexus. Melanotie tumors have been found in the brain and meninges in the form of small, black nodules in gray horses, and in one instance are believed to have induced the condition known as stringhalt. Fibrous tumors may develop within or from the meningeal struc- tures of the brain. Digitized by Microsoft® DISEASES OF THE BRAIN. 205 Gliomatous tumor is a variety of sarcoma very rarely found in the structure of the cerebellum. Treatment for tumors of the brain is impossible. SPASMS, OR CRAMPS. Causes.—Spasm is a marked symptom in many diseases of the brain and of the spinal cord. Spasms may result from irritation of the motor nerves as conductors, or may result from irritation of any part of the sympathetic nervous system, and they usually indicate an excessive action of the reflex motor centers. Spasms may be induced by various medicinal agents given in poisonous doses, or by effete materials in the circulation, such as nux vomica or its alkaloid strychnia, lead preparations, or an excess of the urea products in the circulatiom, etc. Spasms may be divided into two classes: Tonite spasm, when the cramp is continuous or results in persistent rigidity, as in tetanus; clonic spasm, when the cramping is of short duration, or is alternated with relaxations. Spasms may affect involuntary as well as the voluntary muscles, the muscles of the glottis, intestines, and even the heart. They are always sudden in their development. Spasm of the glottis —This is manifested by a strangling respira- tion; a wheezing noise is produced in the act of inspiration; extreme anxiety and suffering for want of air. The head is extended, the body profusely perspiring; pulse very rapid; soon great exhaustion becomes manifest; the mucous membranes become turgid and very dark colored, and the animal thus may suffocate in a short time. Spasms of the intestines.—(See “ Cramp colic,” p. 58.) Spasms of the neck of the bladder—This may be due to spinal irri- tation or a reflex from intestinal irritation, and is manifested by fre- quent but ineffectual attempts to urinate. Spasm of the diaphragm, or thumps.—Spasmodic contraction of the diaphragm, the principal muscle used in respiration, is generally occasioned by extreme and prolonged speeding on the race track or road. The severe strain thus put upon this muscle finally induces irritation of the nerves controlling it, and the contractions become very forcible and violent, giving the jerking character known among horsemen as “thumps.” This condition may be distinguished from violent beating of the heart by feeling the pulse beat at the angle of the jaw, and at the same time watching the jerking movement of the body, when it will be discovered that the two bear no relation to each other. (See “ Palpitation of the heart,” p. 236.) Spasm of the thigh, or cramp of a hind limb.—This is frequently witnessed in horses that stand on sloping plank floors—generally in cold weather—or it may come on soon after severe exercise. It is probably due to an irritation of the nerves of the thigh. In cramps of the hind leg the limb becomes perfectly rigid, and attempts to flex Digitized by Microsoft® 206 DISEASES OF THE HORSE. the leg are unsuccessful; the animal stands on the affected limb, but is unable to move it; it is unnaturally cold; it does not, however, appear to cause much suffering unless attempts are made to change position. This cramp may be of short duration—a few minutes—or _it may persist for several days. This condition is often taken for a dislocation of the stifle joint. In the latter the foot is extended back- ward, and the horse is unable to advance it, but drags the limb after him. An examination of the joint also reveals a change in form. Spasms may affect the eyelids, by closure or by retraction. Spasm of the sterno-maxillaris muscle has been witnessed, and the animal was unable to close the jaws until the muscle became relaxed. Treatment of spasms.—An anodyne liniment, composed of chloro- form 1 part and soap liniment 4 parts, applied to cramped muscles will usually cause relaxation. This may be used where simgle exter- nal muscles are affected. In spasms of the glottis, inhalation of sul- phuric ether will give quick relief. In spasm of the diaphragm, rest and the administration of half an ounce of chloroform in 3 ounces of whisky, with a pint of water added, will generally suffice to bring relief, or if this fails give 5 grains of sulphate of morphia by hypo- dermic injection. If spasms result from organic disease of the nerv- ous system, the latter should receive such treatment as its character demands. In cramp of the leg compulsory movement usually causes relaxation very quickly; therefore the animal should be led out of the stable and be forced to run or trot. Sudden nervous excitement caused by a crack of the whip or smart blow, will often bring about immediate-relief. Should this fail, the anodyne liniment may be used along the inside of the thigh, and chloroform, ether, or lauda- num given internally. An ounce of the chloral hydrate will cer- tainly relieve the spasm when given internally, but the cramp may return soon after the effect has passed off, which in many cases it does very quickly. Convulsions.—Although there is no disease of the nervous system which can be properly termed convulsive, or justify the use of the word convulsion to indicate any particular disease, yet it is often such a prominent symptom that a few words may not be out of place. General, irregular muscular contractions of various parts of the body, with unconsciousness, characterize what we regard as convulsions, and like ordinary spasms are dependent upon some disease or irrita- tion of the nervous structures, chiefly of the brain. No treatment is required; in fact, a general convulsion must necessarily be self- limited in its duration. Suspending, as it does, respiratory move- ments, checking the oxygenation and decarbonization of the blood, the rapid accumulation of carbonic-acid gas in the blood and the exclusion of oxygen quickly puts the blood in a condition to produce the most reliable and speedy. sedative effect upon the nerve excitabil- Digitized by Microsoft® DISEASES OF THE BRAIN. 207 ity that could be found, and consequently furnishes its own remedy so far as the continuance of the convulsive paroxysm is concerned. Whatever treatment is instituted must be directed toward a removal of the cause of the convulsive paroxysm. CHOREA, OR ST. VITUS DANCE. Chorea is characterized by involuntary contractions of voluntary muscles. This disease is an obscure disorder, which may be due to pressure upon a nerve, cerebral, or spinal sclerosis, small aneurisms in the brain, etc. Choreic symptoms have been produced by injecting granules of starch into the arteries entering the brain. Epilepsy and other forms of convulsions simulate chorea in appearance. Stringhalt is by some termed chorea. This is manifested by a sud- den jerking up of one or both hind legs when the animal is walking. This symptom may be very slight in some horses, but has a tendency to increase with the age of the animal. In some the catching up of the affected leg is very violent, and when it is lowered to the ground the motion is equally sudden and forcible, striking the foot to the ground like a pile driver. Very rarely chorea may be found to affect one of the fore legs, cr the muscles of one side of the neck or the upper part of the neck. Involuntary jerking of the muscles of the hip or thigh is seen occasionally. and is termed “shivering” by horsemen. Chorea is often associated with a nervous disposition, and is not so frequent in animals with a sluggish temperament. The involuntary muscular contractions cause no pain, and do not appear to produce much exhaustion of the affected muscles, although the jerking may be regular and persistent whenever the animal is in motion. Treatment.—In a few cases, early in the appearance of this affec- tion, general nerve tonics may be of benefit, viz, iodide of iron, 1 dram; pulverized nux vomica, 1 dram; pulverized scutellaria, 1 ounce. Mix and give in the feed once a day for two weeks. Arsenic in the form of Fowler’s solution is often beneficial. If the cause is con- nected with organic brain lesions, treatment is usually unsuccessful. EPILEPSY, OR FALLING FITS. The cause of epilepsy is seldom traceable to any special brain lesions. In a few cases it accompanies disease of the pituitary body, which is located in the under surface of the brain. Softening of the brain may give rise to this affection. Attacks may occur only once or twice a year or they may be of frequent recurrence. Symptoms.—No premonitory symptoms precede an epileptic fit. The animal suddenly staggers; the muscles become cramped; the jaws may be spasmodically opened and closed, and the tongue be- Digitized by Microsoft® 208 DISEASES OF THE HORSE. come lacerated between the teeth; he foams at the mouth and falls down in a spasm. The urine flows away involuntarily, and the breathing may be temporarily arrested. The paroxysm soon passes off, and the animal gets on his feet in a few minutes after the return of consciousness. Treatment.—Dashing cold water on the head during the paroxysm. After the recovery, 1 dram of oxide of zinc may be given in his feed twice a day for several weeks, or benefit may be derived from the tonic prescribed for chorea. PARALYSIS, OR PALSY. Paralysis is a weakness or cessation of the muscular contraction. by diminution of loss of the conducting power or stimulation’ of the motor nerves. Paralytic affections are of two kinds, the complete and the éncomplete. The former includes those in which both motion and sensibility are affected; the latter those in which only one or the other is lost or diminished. Paralysis may be general or partial. The latter is divided into hemiplegia and paraplegia. When only a small portion of the body is affected, as the face, a limb, the tail, it is desig- nated by the term local paralysis. When the irritation extends from the periphery of the center it is termed reflex paralysis. Causes.—They are very varied. Most of the acute affections of the brain and spinal cord may lead to paralysis. Injuries, tumors, disease of the blood vessels of the brain, etc., all have a tendency to produce suspension of the conducting motive power to the muscular structures. Pressure upon, or the severing of, a nerve causes a paralysis of the parts to which such a nerve is distributed. Apoplexy may be termed a general paralysis, and in nonfatal attacks is a frequent cause of the various forms of palsy. General paralysis——This can not take place without producing immediate death. The term is, however, usually applied to paralysis of the four extremities, whether any other portions of the body are involved or not. This form of palsy is due to compression of the brain by congestion of its vessels, large clot formation in apoplexy, concussion, or shock, or any disease in which the whole brain structure is involved in functional disturbance. Hemiplegia, or paralysis of one side, or half, of the body.—Hemi- plegia is frequently the result of a tumor in the lateral ventricles of the brain, softening of one hemisphere of the cerebrum, pressure from extravasated blood, fracture of the cranium, or it may be due to poi- sons in the blood or to reflex origin. When hemiplegia is due to or the result of a prior disease of the brain, especially of an inflamma- tory character, it is seldom complete; it may affect only one limb and one side of the head, neck, or muscles along the back, and may pass off in a few days after the disappearance of all the other evidences of the Digitized by Microsoft® PARALYSIS. 209 primary affection. In the majority of cases, however, hemiplegia arises from emboli obstructing one or more blood vessels of the brain, or the rupture of some vessel the wall of which had become weakened by degeneration and the extravasation of blood. Sensibility in most cases is not impaired, but in some there is a loss of sensibility as well as of motion. In some cases the bladder and rectum are involved in the paralysis. Symptoms.—tIn hemiplegia the attack may be very sudden, and the animal fall down powerless to move one side of the body, one side of the lips will be relaxed; the tongue may hang out on one side of the mouth; the tail curved around sideways; an inability to swallow food or water may be present, and often the urine dribbles away as fast as it collects in the bladder. Sensibility of the affected side may be entirely lost or only partial; the limbs may be cold and sometimes unnaturally warm. in cases wherein the attack is not so severe the animal may be able to maintain the standing position, but will have great difficulty in moving the affected side. In such cases the animal may recover from the disability. In the more severe, where there is complete loss of power of movement, recoveries are rare. Paraplegia, or transverse paralysis of the hind extremities —Pa- ralysis of the hind extremities is usually due to some injury or inflam- mation affecting the spinal cord. (See “ Spinal meningitis,” p. 211, and “ Myelitis, p. 213.) It may also be due to a reflex irrigation from disease of peripheral nerves, to spinal. irritation or congestion caused by blood poisons, etc. Symptoms.—When due to mechanical injury of the spinal cord, from a broken back or spinal hemorrhage, it is generally progressive in its character, although it may be sudden. When it is caused by agents in the blood, it may be intermittent or recurrent. Paraplegia is not difficult to recognize, for it is characterized by a weakness and imperfect control of the hind legs and powerless tail. The urine usually dribbles away as it is formed and the manure is pushed out, ball by ball, without any voluntary effort, or the passages may cease entirely. When paraplegia is complete, large and ill- conditioned sores soon form on the hips and thighs from chafing and bruising, which have a tendency to quickly weaken the animal and necessitate his destruction. Locomotor atauia, or incoordination of movement.—This is charac- terized by an inability to control properly the movement of the limbs. The animal appears usually perfectly healthy, but when he is led out of his stall his legs have a wobbly movement, and he will stumble or stagger, especially in turning. When this is confined to the hind parts it may be termed a modified form of paraplegia, but often it may be seen to affect nearly all the voluntary muscles when they are H. Doce. 795, 59-2. 14 2 Digitized by Microsoft® 210 DISEASES OF THE HORSE. called into play, and must be attributed to some pressure exerted on | the base of the brain. Local paralysis ——This is frequently met with in horses. It may affect many parts of the body, even vital organs, and it is very frequently overlooked in diagnosis. Facial paralysis—This is a frequent type of local paralysis, and is due to impairment of function of the motor nerve of the facial muscles, the portio dura. The cause may exist at the base of the brain, compression along its course after it leaves the medulla oblon- gata, or to a bruise after it spreads out on the great masseter muscle. Symptoms.—aA. flaccid condition of the cheek muscles, pendulous lips, inability to grasp the food, often a slow and weak movement in chewing, and difficulty and slowness in drinking. Laryngismus paralyticus, or roaring.—This condition is character- ized by roaring, and is usually caused by an inflamed or hypertro- phied bronchial gland pressing against the left recurrent laryngeal nerve, which interferes with its conducting power. A similar con- dition is occasionally induced in acute pleurisy, where the recurrent nerve becomes involved in the diseased process or compressed by plastic exudation. Paralysis of the rectum and tail_—This is generally the result of a blow or fall on the rump, which causes a fracture of the sacrum bone and injury to the nerves supplying the tail and part of the rectum and muscles belonging thereto. This facture would not be suspected were it not for the loss of motion of the tail. Intestinal paralysis—Characterized by persistent constipation; frequently the strongest purgatives have no effect whatever on the movement of the bowels. In the absence of symptoms of indigestion, or special diseases implicating the intestinal canal, torpor of the bowels must be attributed to deficient innervation. This condition may depend upon brain affections or be due to reflex paralysis. Sud- den checks of perspiration may induce excessive action of the bowels or paralysis. Paralysis of the bladder.—This usually affects the neck of the blad- der, and is characterized by incontinence of urine; the urine dribbles away as fast as it is secreted. The cause may be of reflex origin, disease of the rectum, tumors growing within the pelvic cavity, injury to the spinal cord, ete. Paralysis of the optic nerve, or amaurosis.—A paralysis of eyesight may occur very suddenly from rupture of a blood vessel in the brain, acute local congestion of the brain, the administration of excessive doses of belladonna or its alkaloid atropia, etc. In amaurosis the pupil is dilated to its full extent, the eye looks clear, but. does not respond to light. Digitized by Microsoft® SPINAL MENINGITIS. 211 Paralysis of hearing, of the external ear, of the eyelid, partial paralysis of the heart and organs of respiration, of the blood vessels from injury to the vaso-motor nerves of the esophagus, or loss of deglutition, palsy of the stomach, all may be manifested when the supply of nervous influence is impaired or suspended. Treatment for paralysis.—In all paralytic affections there may be anesthesia, or impairm.cnt of sensibility, in addition to the loss of motion, or there may be Ayperesthesia, or increased sensibility, in connection with the loss of motion. These conditions may call for special treatment in addition to that for loss of motion. Where hyperesthesia is well marked local anodynes may be needed to relieve suffering. Chloroform lniment or hypodermic injections of from 3 to 5 grains of sulphate of morphia will allay local pain. If there is marked anesthesia, or loss of sensibility, it may become necessary to secure the animal in such a way that he can not ‘suffer serious injury from accidents which he can not avoid or feel. In the treat- ment of any form of paralysis we must always refer to the cause, and attempt its removal if it can be discovered. In cases where the cause can not be determined we have to rely solely upon a general external and internal treatment. Externally, fly blisters or strong irritant liniments may be applied to the paralyzed parts. In hemi- plegia they should be applied along the bony part of the side of the neck; in paraplegia, across the loins. In some cases hot-water cloths will be beneficial. Internally, it is well to administer 1 dram of powdered nux vomica or 2 grains of sulphate of strychnia twice a day until twitching of some of the voluntary muscles occurs; then discontinue it for several days, and then commence again with a smaller dose, gradually increasing it until twitching recurs. Iodide of potash in 1 to 2 dram doses two or three times daily may be em- ployed with the hope that it will favor the absorption of the clot or obstruction to the nervous current. In some cases Fowler’s solution of arsenic in teaspoonful doses twice a day in the drinking water proves beneficial. Occasionally benefit may be derived from the application of the electric current, especially in cases of roaring, facial paralysis, paralysis of the eyelid, etc. Nutritious but not too bulky food, good ventilation, clean stabling, moderate exercise if the animal is capable of taking it, good grooming, etc., should be observed in all cases. SPINAL MENINGITIS, OR INFLAMMATION OF THE MEMBRANES ENVELOPING THE SPINAL CORD. Causes——This may be induced by the irritant properties of blood poisons, exhaustion and exposure, spinal concussion, all forms of injury to the spine, tumors, caries of the vertebra, rheumatism, etc. Symptoms.—A chill may be the precursor, a rise in temperature, or Digitized by Microsoft® 212 DISEASES OF THE HORSE. a general weakness and shifting of the legs. Soon a painful, convul- sive twitching of the muscles sets in, followed by muscular rigidity along the spine, in which condition the animal will move very stiffly and evince great pain in turning. Evidences of paralysis or para- plegia develop, retention or incontinence of urine, and oftentimes sexual excitement is present. The presence of marked fever at the beginning of the attack, associated with spinal symptoms, should lead us to suspect spinal meningitis or myelitis. These two conditions usually appear together, or myelitis follows inflammation of the meninges so closely that it is almost impossible to separate the two; practically it does not matter much, for the treatment will be about the same in both cases. Spinal meningitis generally becomes chronic, and is then marked principally by paralysis of that portion, or parts of it, posterior to the seat of the disease. Pathology.—In spinal meningitis we will find essentially the same condition as in cerebral meningitis; there will be an effusion of serum between the membranes, and often a plastic exudation firmly adherent to the pia mater serves to maintain a state of paralysis for a long time after the acute symptoms have disappeared by compressing the cord. Finally, atrophy, softening, and even abscess may develop within the cord. Unlike in man, it is usually found localized in horses.. Treatment.—Bags filled with ice should be applied along the spine, to be followed later on by strong blisters. The fever should be con- trolled as early as possible by giving 20 drops of Norwood’s tincture of veratrum viride every hour until the desired result is obtained. One dram of the fluid extract of belladonna, to control pain and vas- cular excitement of the spinal cord, may be given every five or six hours until the pupils of the eyes become pretty well dilated. If the pain is very intense 5 grains of sulphate of morphia should be injected hypodermically. The animal must be kept as free from excitement as possible. If the urine is retained in the bladder it must be drawn off every four or six hours. In very acute attacks the disease gener- ally proves fatal in a few days. If, however, the animal grows better some form of paralysis is apt to remain for a long time, and the treatment will have to be directed then toward a removal of the exuda- tive products and a strengthening of the system and stimulation of the nervous functions. To induce absorption, iodide of potassa in 2-dram doses may be given, dissolved in the drinking water, twice a day. To strengthen the system, iodide of iron 1 dram twice a day and 1 dram of nux vomica once a day may be given in the feed. Electricity to the paralyzed and weakened museles is advisable; the current should be weak, but be continued for half an hour two or three times daily. If the disease is due to a broken back, caries of ‘the vertebrae, or some other irremediable cause, the animal should be destroyed at once. Digitized by Microsoft® DISEASES OF THE SPINAL CORD. 213 MYELITIS, OR INFLAMMATION OF THE SUBSTANCE OF THE SPINAL CORD. This is a rare disease, except as a secondary result of spinal menin- gitis or ‘njuries to the spine. Poisoning by lead, arsenic, mercury, phosphorus, carbonic-acid gas, etc., has been known to produce it. Myelitis may be confined to a small spot in the cord or may invoive the whole for a variable distance. It may lead to softening, abscess, or degeneration. Symptoms.—The attack may begin with a chill or convulsions; the muscles twitch or become cramped very early in the disease, and the bladder usually is affected at the outset, in which there may be either retention or incontinence of urine. These conditions are followed by complete or partial paralysis of the muscles posterior to the locality of the inflamed cord, and the muscles begin to waste away rapidly. The paralyzed limb becomes cold and dry, due to the suspension of proper circulation; the joints may swell and become edematous; vesicular eruptions appear on the skin; and frequently gangrenous sloughs form on the paralyzed parts. It is exceedingly seldom that recovery takes place. In a few instances it may assume a chronic type, when all the symptoms become mitigated, and thus continue for some time, until septicemia, pyemia, or exhaustion causes death. Pathology.—The inflammation may involve nearly the whole length of the cord, but generally it is more intense in some places than others; when due to mechanical injury, the inflammation may remain con- fined to a small section. The cord is swollen and congested, reddened, often softened and infiltrated with pus cells, and the nerve elements are degenerated. Treatment.—Similar to that of spinal meningitis. SPINAL CONGESTION. This condition consists in an excess of blood. As the blood vessels of the pia mater are the principal source of supply to the spinal cord, peremia of the cord and of the meninges usually go together. The symptoms are, therefore, closely allied to those of spinal meningitis and congestion. When the pia mater is diseased, the spinal cord is almost invariably affected also. Cause.—Sudden checking of the perspiration, violent exercise, blows, and falls. Symptoms.—The symptoms may vary somewhat with each case, and closely resemble the first symptoms of spinal meningitis, spinal tumors, and myelitis. First, some disturbance in movement, lower- ing of the temperature, and partial loss of sensibility posterior to the seat of the congestion. If in the cervical region, it may cause inter- ference in breathing and'the action of the heart. When in the region of the loins, there may be loss of control of the bladder. When the Digitized by Microsoft® 214 DISEASES OF THE HORSE. congestion is sufficient to produce compression of the cord, paraplegia may be complete. Usually fever, spasms, muscular twitching, or muscular rigidity are absent, which will serve to distinguish spinal congestion from spinal meningitis. Treatment.—Hot-water applications to the spine, 1-dram doses fluid extract of belladonna repeated every four hours, and tincture of aconite root 20 drops every hour until the symptoms become amel- iorated. If no inflammatory products occur, the animal is likely to recover. SPINAL ANEMIA. This may be caused by extreme cold, exhausting diseases, spinal embolism or plugging of a spinal blood vessel, an interference with the circulation through the abdominal aorta, from compression, thrombosis, or aneurism of that vessel; the spinal vessels may be caused to contract through vaso-motor influence, a result of periph- eral irritation of some nerve. Symptoms.—Spinal anemia causes paralysis of the muscles used in extending the limbs. When the bladder is affected, it precedes the weakness of motion, while in spinal congestion it follows, and in- creased sensibility, in place of diminished sensibility, as in spinal con- gestion, is observed. Pressure along the spine causes excessive pain. Treatment.—If the exciting cause can be removed, the animal re- covers; if this fails, the spinal cord may undergo softening. SPINAL COMPRESSION. When caused by tumors or otherwise, when pressure is slight, it produces a paralysis of the muscles used in extending a limb and con- traction of those which flex it. When compression is great it causes complete loss of sensibility and motion posterior to the compressed part of the cord. Compression of a lateral half of the cord produces motor paralysis, disturbance of the circulation, and difficulty of movement, an in- creased sensibility on the side corresponding to the compressed sec- tion, and a diminished sensibility and some paralysis on the opposite side. Treatment.—When it occurs as a sequence of a preceding inflam- matory disease, iodide of potassa and general tonics are indicated. When due to tumors growing within the spinal canal, or to pressure from displaced bone, no form of treatment will result in any benefit. SPINAL HEMORRHAGE. This may occur from changes in the wall of the blood vessels, in connection with tumors, acute myelitis, traumatic injuries, etc. The blood may escape through the pia mater into the subarachnoid cavity, and large clots be formed. Digitized by Microsoft® DISEASES OF THE SPINAL CORD. 215 Symptoms.—The symptoms are largely dependent upon the seat and extent of the hemorrhage, as they are principally due to the com- pression of the cord. A large clot may produce sudden paraplegia, accompanied by severe pain along the spine; usually, however, the paralysis of both motion and sensation is not very marked at first; on the second or third day fever is apt to appear, and increased or diminished sensibility along the spine posterior to the seat of the clot. When the bladder and rectum are involved in the symptoms it indi- cates that the spinal cord is compressed. Treatment.—In the occurrence of injuries to the back of a horse, whenever there is any evidence of paralysis, it is always advisable to apply bags of ice along the spine to check or prevent hemorrhage or congestion, and 2 drams of the fluid extract of ergot and 20 drops of tincture of digitalis may be given every hour until three doses have been taken. Subsequently tincture of belladonna in half-ounce doses may be given three times a day. If there is much pain, 5 grains of sulphate of morphia, injected under the skin, will afford relief and lessen the excitability of the animal. In all cases the animal should be kept perfectly quiet. SPINAL CONCUSSION. This is rarely observed in the horse, and unless it is sufficiently severe to produce well-marked symptoms it would not be suspected. It may occur in saddle horses from jumping, or it may be produced by falling over an embankment, or a violent fall upon the haunches may produce it. Concussion may be followed by partial paralysis or spinal hemorrhage; generally, however, it is confined to a jarring and some disturbance of the nerve elements of the cord, and the paralytic effect which ensues soon passes off. Treatment consists in rest until the animal has completely recovered from the shock. If secondary effects follow from hemorrhage or compression, they have to be treated as heretofore directed. SPINAL TUMORS. Within the substance of the cord glioma or the mixed gliosarco- mata are found to be the most frequent, tumors may form from the meninges and the vertebra, being of a fibrous or bony nature, and affect the spinal cord indirectly by compression. In the meninges we may find glioma, cancers, and psammoma, fibromata; and aneurisms of the spinal arteries have been discovered in the spinal canal. Symptoms.—Tumors of the spinal canal cause symptoms of spinal irritation or compression of the cord. The gradual and slow develop- ment of symptoms of paralysis of one or both hind limbs or certain muscles may lead to a suspicion of spinal tumors. The paralysis induced is progressive, but not usually marked with atrophy of the Digitized by Microsoft® 216 DISEASES OF THE HORSE. muscles or increased sensibility along the spine. When the tumor is within the spinal cord itself all the symptoms of myelitis may be present. Treatment.—General tonics and 1-dram doses of nux vomica may be given; iodide of iron or iodide of potassa in 1-dram doses, three times a day in feed, may, in a very few cases, give some temporary benefit. Usually the disease progresses steadily until it proves fatal. NEURITIS, OR INFLAMMATION OF A NERVE. This is caused by a bruise or wound of a nerve or by strangulation in a ligature when the nerve is included in the ligation of an artery. The changes in an inflamed nerve are an enlargement, reddening of the nerve sheath, spots of extravasated blood, and sometimes an infil- tration of serum mixed with pus. Symptoms.—Acute pain of the parts supplied by the nerve and absence of swelling or increased heat of the part. Treatment.—Hypodermic injections of from 3 to 5 grains of mor- phia to relieve pain, hot fomentations, and rest. If it is due to an inclusion of a ligature, the nerve should be divided above and below the ligature. NEUROMA, OR TUMOR OF A NERVE. Neuroma may be from enlargement of the end of a divided nerve or due to fibrous degeneration of a nerve which has been bruised or wounded. Its most frequent occurrence is found after the operation of neurotomy for foot lameness, and it may appear after the lapse of months or even years. Neuroma usually develops within the sheath of the nerve with or without implicating the nerve fibers. It is oval, running lengthwise with the direction of the nerve. Symptoms.—Pain of the affected limb or part is manifested, more especially after resting a while, and when pressure is made upon the tumor it causes extreme suffering. Treatment—Excision of the tumor, including part of the nerve above and below, and then treat it like any other simple wound. INJURIES TO NERVES. These may consist in wounding, bruising, laceration, stretching, compression, etc. The symptoms which are produced will depend upon the extent, seat, and character of the injury. Recovery may quickly take place, or it may lead to neuritis, neuroma, or spinal or cerebral irritation, which may result in tetanus, paralysis, and other serious derangements. In all diseases, whether produced by some form of external violence or intrinsic causes, the nerves are necessa- rily involved, and sometimes it is to a primary injury of them that the principal fault in movement or change of nutrition of a nart is due. Digitized by Microsoft® FORAGE POISONING. 217 It is often difficult or impossible to discover that an injury to a nerve has been inflicted, but whenever this is possible it may enable us to remedy that which otherwise would result in permanent evil. Treat- ment should consist in relieving compression, in hot fomentations, the application of anodyne liniments, excision of the injured part, and rest. FORAGE POISONING, OR SO-CALLED CEREBRO-SPINAL MENINGITIS. This disease prevails among horses in nearly all parts of the United States. It is most common in Maryland, Delaware, Virginia, North Carolina, New Jersey, Pennsylvania, New York, Kansas, Missouri, Illinois, Indiana, and Ohio. Certain localities are visited by it almost every year. This condition consists in a poisoning and de- pression of the nervous system from eating or drinking food or water containing poison generated by mold or bacteria. It has been shown to be due to eating damaged ensilage, corn, brewers’ grains, oats, etc., or to drinking stagnant pond water or water from a well contami- nated by surface drainage. Horses at pasture may contract this dis- ease when the growth of grass is so profuse that it mats together and the lower part dies and ferments or becomes moldy. In England a similar disease has been called “ grass staggers,” due to eating rye grass when it is ripening or when it is cut and eaten while it is heating and undergoing fermentation. In eastern Penn- sylvania it was formerly known by the name of “ putrid sore throat ” and “ choking distemper.” A disease similar in many respects, which is very prevalent in Virginia, especially along the eastern border, is commonly known by the name of “ blind staggers,” and in many of the Southern States this has been attributed to the consumption of worm-eaten corn. Horses of all ages and mules are subject to this disease. Symptoms.—The symptoms which typify sporadic, or epidemic, cerebro-spinal meningitis in man are not witnessed among horses, namely, excessive pain, high fever, and early muscular rigidity. In the recognition of the severity of the attack we may divide the symp- toms into three grades. In the most rapidly fatal attacks the animal may first indicate it by weak, staggering gait, partial or total inabil- ity to swallow solids or liquids, impairment of eyesight; twitching of the muscles, and slight cramps may be observed. Asa rule, the tem- perature is not elevated—indeed, it is sometimes below normal. This is soon followed by a paralysis of the whole body, inability to stand, delirium in which the animal sometimes goes through a series of auto- matic movements as if trotting or running; the delirium may become very violent and the animal in his unconsciousness may bruise his head in his struggles very seriously, but usually a deep coma renders him quiet until he expires. Death in these cases usually takes place in Digitized by Microsoft® 218 DISEASES OF THE HORSE. from four to twenty-four hours from the time the first symptoms be- come manifest. The pulse is variable during the progress of the dis- ease; it may be almost imperceptible at times, and then again very rapid and irregular; the respirations generally are quick and catch- ing. In the next form in which this disease may develop it first be- comes manifest by a difficulty in swallowing and slowness in mastica- tion, and a weakness which may be first noticed in the strength of the tail; the animal will be unable to switch it or to offer resistance when we bend it up over the croup. The pulse is often a little slower than normal. There is no eyidence of pain; the respirations are unchanged, and the temperature little less than normal; the bowels may be some- what constipated. These symptoms may remain unchanged for two or three days and then gradual improvement take place, or the power to swallow may become entirely lost and the weakness and uncertainty in gait more and more perceptible; then sleepiness or coma may ap- pear; the pulse becomes depressed, slow, and weak, the breathing stertorous, and paroxysms of delirium develop, with inability to stand, and some rigidity of the spinal muscles or partial cramp of the neck and jaws. In such cases death may occur in from six to ten days from the commencement of the attack. In many cases there is no evidence of pain, spasm, or fever at any time during the progress of the disease, and finally profound coma develops and death fol- lows, painless and without a struggle. In the last or mildest form the inability of voluntary control of the limbs becomes but slightly marked, the power of swallowing never entirely lost, and the animal has no fever, pain, or unconscious move- ments. Generally the animal will begin to improve about the fourth day and recovers. In a few cases the spinal symptoms, manifested by paraplegia, may be the most prominent symptoms; in others they may be altogether absent and the main symptoms be difficulty in mastication and swal- lowing; rarely it may affect one limb only. In all cases where coma remains absent for six or seven days the animal is likely to recover. When changes toward recovery take place, the symptoms usually leave in the reverse order in which they developed, but local paralysis may remain for some time, rarely persistent. One attack does not give immunity, for it may recur at some later time and prove fatal. Horses have been known to pass through three attacks, being affected for a week or longer each time. Treatment.—In the worst class of cases treatment is very seldom successful, and it is dangerous to attempt the administration of medi- cine by the mouth, on account of the inability of the animal to swal- low. If the condition of the animal will admit of a drench, give 4 to 6 ounces of whisky in 2 pints of milk; the inhalation of ammonia Digitized by Microsoft® TETANUS, OR LOCKJAW. 219 vapor from a sponge saturated with dilute aqua ammonia may arouse consciousness. In the second class of cases a purge should always be given, and the further treatment recommended is to give strychnia in 2-grain doses twice or three times daily. If there is twitching of the shoulder muscles or gnashing of the teeth, this should be discontinued. The strength of the heart should be kept up with carbonate of ammonia or whisky. When the animal is unable to swallow, one-fourth-grain doses of sulphate of atropia may be injected under the skin every four, six, or eight hours, as the case may demand. The atropia is a heart stimulant, increases capillary circulation, and quiets pain and excitability. When the most prominent symptoms abate give such food as they may be able to eat, and keep fresh, cool water constantly before them, supporting them in slings if necessary; clean stabling and plenty of fresh air are of the utmost importance. Pathology.—Post-mortem examination reveals, in some cases, more or less congestion of the blood vessels at the base of the brain and effusion in the ventricles and in the subarachnoid space, both in the cranial and the spinal cavities. The brain and cord appear softened in some cases where the greatest evidence of inflammatory action existed. In other cases the post-mortem examination is entirely negative, no gross lesions being visible. Hygienic measures needful—Whenever this disease appears in a stable all the animals should be removed as soon as possible. They should be provided with clean, well-ventilated, and well-drained stables, and each animal should receive a laxative and be fed food and given water from a new, clean source. The abandoned stable should be thoroughly cleansed from all waste matters, receive a coat of whitewash containing 4 ounces of carbolic acid to the gallon of water, and should have time to dry thoroughly before the horses are replaced. A complete change of food is of the very greatest im- portance, on account of the belief that the cause resides in diseased grain, hay, and grass. TETANUS, OR LOCKJAW. _ This disease is characterized by spasms affecting the muscles of the face, neck, body, and limbs, and of all the muscles supplied by the cerebro-spinal nerves. The spasms or muscular contractions are rigid and persistent, yet mixed with occasional more intense con- tractions of convulsive violence. Causes.—This disease is caused by a bacillus that is often found in the soil, in manure and in dust. This germ grows only in the ab- sence of oxygen. It produces a powerful nerve poison, which causes the symptoms of tetanus. The germ itself multiplies at the point © Digitized by Microsoft® 220 DISEASES OF THE HORSE. where it is introduced, but its poison is absorbed, and is carried by the blood to all parts of the body, and thus the nervous system is poisoned. Deep wounds infected by this germ are more dangerous than superficial wounds, because in them the germ is more remote from the oxygen of the air. Hence, nail pricks, etc., are especially dangerous. In the majority of instances the cause of tetanus can be traced to wounds, especially pricks and wounds of the feet or of tendinous structures. It sometimes follows castration, docking, the introduction of setons, inclusion of a nerve in a ligature, etc. It may come on a long time after the wound is healed—three or four months. In some countries where tetanus appears to be enzootic the presump- tion is that it is due to a specific germ. Horses with a nervous, ex- citable disposition are more predisposed than those of a more slug- gish nature. Stallions are more subject to develop tetanus as the result of wounds than geldings, and geldings more than mares. Symptoms.—tThe attacks may be acute or subacute. In an acute attack the animal usually dies within four days. The first symptoms which attract the attention of the owner is difficulty in chewing and swallowing, an extension of the head and protrusion over the inner part of the eye of the membrana nictitans, or haw. An examination of the mouth will reveal an inability to open the jaws to their full extent, and the endeavor to do so will produce great nervous excita- bility and increased spasm of the muscles of the jaw and neck. The muscles of the neck and along the spine become rigid and the legs are moved in a stiff manner. The slightest noise or disturbance throws the animal into increased spasm of all the affected muscles. The tail is usually elevated and held immovable; the bowels become consti- pated early in the attack. The temperature and pulse are not much changed. These symptoms in the acute type become rapidly aggra- vated until all the muscles are rigid—in a state of tonic spasm—with a continuous tremor running through them; a cold perspiration breaks out on the body; the breathing becomes painful from the spasm of the muscles used in respiration; the jaws are completely set, eyeballs retracted, lips drawn tightly over the teeth, nostrils di- lated, and the animal presents a picture of the most extreme agony until death relieves him. The pulse, which at first was not much affected, will become quick and hard, or small and thready when the spasm affects the muscles of the heart. In the subacute cases the jaws may never become entirely locked; the nervous excitability and rigid- ity of the muscles are not so great. There is, however, always some stiffness of the neck or spine manifest in turning; the haw is turned over the eyeball when the nose is elevated. It is not uncommon for owners to continue such animals at their work for several days after the first symptoms have been observed. All the symptoms may grad- ually increase in severity for a period of ten days, and then gradually Digitized by Microsoft® TETANUS, OR LOCKJAW. 22 diminish under judicious treatment, or they may reach the stage wherein all the characteristics of acute tetanus become developed. In some cases, however, we find the muscular cramps almost solely con- fined to the head or face, perhaps involving those of the neck. In such cases we have complete trismus (lockjaw), and all the head symptoms are acutely developed. On the contrary, we may find the head almost exempt in some cases, and have the body and limbs per- fectly rigid and incapable of movement without falling. Tetanus may possibly be confounded with spinal meningitis, but the character of the spasm-locked jaw, retraction of the eyeballs, the difficulty in swallowing due to spasms of the muscles of the pharynx, and above all, the absence of paralysis, should serve to make the distinction. Prevention. Where a valuable horse has sustained a wound that it is feared may be followed by tetanus, it is well to administer a dose of tetanus antitoxin. This is injected beneath the skin with a hypoder- mic syringe.