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TEXT BOOK

OF

\

VETERINARY MEDICINE ~

BY

JAMES LAW, F.R.C.V.S.

Director of the New York State Veterinary College
Cornell University, Ithaca, N. Y.

VOL. III

SECOND EDITION

REVISED AND ENLARGED

DISEASES OF THE NERVOUS SYSTEM—GENITO-
URINARY ORGANS—EVE—SKIN: CONSTI-
TUTIONAL DISEASES

ITHACA
PUBLISHED BY THE AUTHOR
7905

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Copyright by
JAMES LAW
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PRESS OF
ANDRUS & CHURCH
ITHACA, N. ¥.

VETERINARY MEDICINE.

DISEASES OF THE NERVOUS SYSTEM.

Nervous control of bodily flnetions : affected through disease of nerve
centres or nerve trunks, sensory, motor, vaso-motor, etc. Modes of im-
paired nervous function : objective ; subjective. Nervous characteristics
in different breeds, individuals, sexes, castratedanimals. Nervous disorder
from microbian toxins, narcotics, nervous stimulants, etc.

All bodily functions are more or less directly controlled by the
nervous system, hefice nervous troubles are interwoven with the
diseases of all other organs. Disorder of the nerve centres or
nerve trunks affects the most distant parts over which these pre-
side, or to and from which they convey nervous impulse. In
different cases we see this operating through the sensory or
motor functions, through lack of codrdination: or of balance,
through modification of the circulation, respiration, secretion,
absorption, nutrition, metabolism, special sensation, intellection,
emotion, etc. ‘These manifestations are less evident or less diag-
nostic in the lower animal, because we cannot fully avail of the
subjective symptoms. While the human patient can tell us his
feelings and experience in their regular order and succession, we
can only infer most of these in the animal, through dependent
objective symptoms. In many cases we cannot even infer for
lack of dependent symptoms.

The practitioner must carefully watch for and accurately ob-
serve all objective symptoms, and seek to rightly interpret them.
Among other things he must note the nervous conformation, or-
ganization and susceptibility ; the hereditary nervous characteris-
tics as séen in breeds, temperament, habit, aptitude to learn,
docility, instinct, intelligence, emotions and affections, and judge
the case in the light of these. Similarly he must take into ac-
count the hereditary, racial and individual irritability, obstinacy,
restiveness, vice, alertness, sluggishness, stupidity, moroseness,
and diagnose accordingly. Congestion, anemia, coma, paresis,
paralysis, may result from the nervous disorder and offer valu-

2 Veterinary Medicine.

able concurrent testimony tothe same. Allowance must always
be made for the use to which the animal has been put, thus sexw-
ality tells strongly in the horse, bull, boar, or ram which has
been used for breeding and has become relatively indocile and
even dangerous ; food tells ina horse that ‘‘shows his corn’’,
and in the dog fed on flesh ; the comparatively untrained English
race horse is far less docile than the one inured to saddle or har-
ness and the horse fresh from the range, though previously
trained, is far less tractable than the one in steady work. ‘The
sexual products are especially liable to modify the temper, hence
the docility of the gelding, and castrated mare, and the undis-
turbed life and steady growth and fattening of castrated animals
from cattle to capons.

The products of certain diseases and many drugs derange the in-
nervation and intellection. Of this we have examples in the
hebetude of the victims of milk sickness and dourine, in the wild
delirium of rabies, in the varied nervous disorders that attend on
the use of narcotics, essential oils, alcohol, chloral, sulphonal,
trional, strychnia, lead, phosphorus, arsenic, etc.

GENERAL SYMPTOMATOLOGY AND DIAGNOSIS.

Motor disorders : paralysis, paresis, hemiplegia, crossed hemiplegia, spinal
hemiplegia, paraplegia, monoplegia, local palsy, pseudo-paralysis, spasm,—
tonic, clonic, tremor, hemispasm, monospasm, spasm of eyeball, spasm of
head, paraplegic spasm, general spasms—convulsions, local spasms. Inco-
ordination. Staggering. Reflex action. Morbid reflex: increased reflex,
reflex tonic spasm.

It seems desirable to note specially some of the more prominent
morbid nervous phenomena and conditions, with lesions or other
conditions which cause them, before considering what are usually
recognized as special diseases. ’

MOTOR DISORDERS.

Paralysis (Akinesis) is loss of voluntary or involuntary
muscular movement through defective inervation..

Paresis is a paralysis which is partial in degree; power of
motion is impaired but not completely lost.

General Symtomatology and Diagnosis. 3

Hemiplegia is the loss of voluntary motion in many muscles
on one side of the face or body. In general hemiplegia, the fol-
lowing muscles are usually excepted :—muscles of the tongue, of
mastication, of the eye, of respiration, of the neck and trunk
generally and of the proximal part of thelimbs. ‘The hind limbs
are usually most affected, and muscles that are most exclusively
under the control of the will—those dominated by the cortical
centres of the brain. When due toa clot on the brain or de-
generation it occurs on the side opposite to that occupied by the
clot, on account of the motor fibres crossing at the anterior pyra-
mids of the medulla. Hemianzsthesia is a rare attendant and
when present is often on the side opposite to the hemiplegia.
Sensory fibres cross in the spinal cord, and the lesion is, probably
spinal.

Crossed Hemiplegia is motor paralysis of certain cephalic
nerves (3d, 7th, 5th, 6th, and 8th, ) on the same side with the clot
or lesion, and of the muscles of the trunk on the other side. The
cranial nerves proceed to muscles on the same side as their
origin, while filaments going to the trunk through the spinal
cord, cross in the pyramids (motor), or spinal cord (sensory).
In crossed hemiplegia, hemianzsthesia is common with both
forms of paralysis on one side.

Spinal Hemiplegia has the face and head sound (except
sometimes the iris), and half the body paralyzed on the side on
which the spinal lesion (clot) exists. If anzesthesia exists it is on
the side opposite to the lesion and posterior to it—-the sensory
filaments crossing just before leaving the cord.

Paraplegia is loss of voluntary power of one transverse half
of the body ; usually the posterior, and affects the tail, and has
coincident anzesthesia, being due to a spinal lesion. Anal and
vesical sphincters may or may not be paralyzed according as the
lesions implicate their respective spinal centres or not. If there
is neither anzesthesia nor vesical paralysis the lesion may be cere-
bral, in the paracentral lobes of both hemispheres (meso-vertix
at the fissure of Rolando.)

Monoplegia is a circumscribed paralysis, as of one limb, or on
one side of the face, one group of muscles or a single muscle.
It may be due to cerebral, spinal or nervous lesion. Cerebral
monoplegias ate distinguished by: 1st, initial spasm; 2nd, ab-

4 Veterinary Medicine.

sence of anesthesia ; 3d, persistence of nutrition ; 4th, paralysis
greatest in the distal portion of the member.

Localized Paralysis is usually due to the lesion ofa nerve, and
is both motor and sensory. If due to a spinal lesion it usually
affects one or more groups of muscles. In case the lesion is in
the nerve, be guided, in investigating it, by Van der Kolk’s law,
that the sensory fibres are usually distributed in the skin corre-
sponding to the muscles which receive the motor fibres.

Pseudo-paralysis occurs from muscular diseasé, injury, in-
flammation or degeneration, and has no appreciable central nor
nervous lesion nor anzesthesia.

Spasm (Ayperkinesis) ; abnormal violent muscular contrac-
tions with or without loss of consciousness.

Tonic (¢e¢anic) Spasm is violent and continuous.

Clonic Spasm is rapidly intermittent :—Contractions and re-
laxations.

Tremor (¢vemdling) consists in small, intermittent, involun-
tary contraction.

Hemispasm affects the face, or limbs, or both, on one side of
the body and may precede hemiplegia.

Monospasm affects one limb, one group of muscles or a
single muscle. It may be due to lesion of the brain, of the
spinal cord or of the nerves. Thus it may imply commencing
disease of the moter centres or tracts.

Spasms of the Eyeballs (rolling of globe to one side) and
Spasms of the Eyeballs and Head, are important indications
of apoplexy. They imply disorder (commencing irritation) of
the cerebral motor areas. Advanced disease would probably de-
termine hebetude, coma, drowsiness, or palsy. If epileptiform
it turns away from the lesion. If hemiplegic it turns toward the
lesion and away from the paralysis. If lesion of the pons it
turns away from the lesion.

Paraplegic Spasm is a tonic spasm, partial in degree, caus-
ing stiff, tetanoid (spastic) walk. In all four extremities there
may be mixed paresis and contraction. This often attends on
hemorrhage into the meninges.

General Spasms, convulsions as in Eclampsia, Epilepsy,
Chorea, Tetanus.

Local Spasms may be rhythmic or not, in slight cases to be

General Symtomatology and Diagnosis. 5

seen only in the eyelids or superficial muscles as twitching, and
occur in neurasthenia, or in poisoning by strychnia, brucia and
other motor nerve poisons.

Incodrdination (Dyskinesis) is the lack of the harmonious
balanced movement of the various groups of muscles. Codrdina-
tion of movement is due to aspecial mechanismin the spinal cord,
and extending forward through thesmedulla oblongata, pons, and
crura cerebri to the floor of the third ventricle. In the form of
ataxta (lack of power of muscular control) it is usually the result
of degeneration (sclerosis) of the superior columns of the cord,
of the medulla, pons or crura. It may occur from degeneration
or destructive change in the cerebellum, or from disease or sec-
tion of the posterior roots of spinal nerves, or finally from the
action of certain narcotic poisons (ptomaines, toxins).

Staggering (¢tubation) occurs from lesions of the cerebellum,
medulla or pons; also from alcohol, opium, and other narcotics.

Reflex Action. ‘The normal stimulation of different functions,
motor, secretory, circulatory, etc., depends on the nerve centres
in the spinal cord, which are roused into action’by a centripetal
impulse derived from a distant part. Thus the balanced contrac-
tion of the different muscles which preserves the equilibrium of
the body, depends on the apprehension by the nerve centres, con-
sciously or subconsciously, of such contractions (muscular sense),
and it is largely under the control of the will. Here three im-
pulses act codrdinately : 1st, the afferent impulse from the mus-
cle to the nerve centre ; 2d, the efferent impulse from the nerve
centre to the muscle ; and 3d, the inhibitory or controlling, vol-
untary impulse from the sensorium to the nerve centre involved.
In another case, savory odors, sapid flavors and masticatory move-
ments cause a free secretion from the salivary glands. Again,
the scratching of a dog’s breast causes him to move his hind limb
as if he were himself doing the scratching. Again, the pricking
of a limb causes the prompt, even if involuntary, contraction of
its muscles to withdraw it from the source of irritation.

Morbid Reflex. Reflex action may be modified in various
ways as the result of disease or injury. It may becomeexcessive
from irritability of the organ from which the centripetal impulse
starts, or of the reflex centre in the spinal cord, or of the muscle
or other organ to which the centrifugal impulse is directed, or

6 Veterinary Medicine.

finally, from impairment of, or separation from the inhibitory
centre in the cerebrum. It may be impaired or abolished from
degeneration or destruction of any of the tissues just named, or
of the conducting nerves which connect them to each other.

The contraction and closure of the pupil under light is a reflex
act from the retina on the optic lobes, etc., and from these
through the motor oculi to the iris. This reflex is lost and the
iris fails to contract in: anesthesia of the retina ; atrophy of the
optic nerve ; disease of the optic lobe ; superior (posterior) spinal
sclerosis ; disease of the motor oculi ; or disease of the iris.

The lumbar. reflex is lost in many febrile states in the horse, so
that pinching of the loins fails to produce wincing, and this be-
comes a test of the active persistence of the disorder.

Increased Reflex is often noticed when the parts, including
the spinal reflex centre, are disconnected from the brain: as in
lesions or disease of the cord infront (cephalad) of its reflex cen-
tre. Here the cerebral or voluntary inhibition is lost.

Reflex Tonic Spasm of muscles around a diseased or dislo-
cated joint, or of those controlling its action, often affords a val-
uable means of diagnosis, the possibility of nervous, muscular
and tendinous disease being excluded.

TROPHIC SYMPTOMS AND DISORDERS.

Degenerative atrophy, in hemoglobinuria, laryngeal hemiplegia, neurec-
tomy, nerve lesion, brain or cord lesion, lead poisoning, disuse. Dermatitis,
ulceration, morbid secretion, polyuria, mellituria, albuminuria, poisonous
milk,

Degenerative Atrophy. From section, disease, atrophy or
degeneration of nerves or nerve centres, the muscles, which they
normally innervate, waste, often to an extreme degree. As ex-
amples of this we see the atrophy of the triceps extensor cruris
and other groups in hemoglobinuria, of the intrinsic laryngeal
muscles in voaving, of the muscles supplied in neurectomy, and of
groups of muscles in myelitis, broken back, lead paralysis, and
scapular muscular atrophy. ‘True to the law of wasting of physi-
ologically inert organs, the nerves are atrophied and degenerated,
and often also the bones, joints and skin.

Trophic Symptoms and Disorders. 7

The degeneration of an inactive organ applies to the nervous tis-
sues themselves. According to the law of Waller, the nerve fibre
(axis cylinder), when cut off from its nutritive center (cell body
with nucleus) degenerates and ultimately perishes. The axis
cylinder is a component part of the neurou, which includes also
its continuation in the cell and nucleus, and when the latter,
which is the source and origin of both nerve impulse and trophic
control, is lost, the inactive axis of the nerve fibre degenerates.
This law is now availed of in tracing the distribution of nerve fila-
ments, the degefieration being found in those that have been cut
off from their nerve cells while those that come into the nerve
trunk from other sources, distal of the injury, maintain their
integrity.

In addition to this peripheral atrophy, a degeneration centrad
of the injury to the nerve is seen under certain conditions, but
especially in intrauterine life. In such cases the atrophy may ex-
tend up to and include the central nerve cells, causing a secondary
central nervous lesion from an initial peripheral one.

By bearing these laws of nerve atrophy in mind, lesions that
would otherwise be obscure, may be satisfactorily accounted for.

Eruptions and Ulcerations of a Nervous Origin. Herpes
or shingles in man is now recognized as a nervous disease, cir-
cumscribed to the distribution of given nerves and occurring
unilaterally or bilaterally. Deep-seated dermatitis, vesicles, neu-
ralgia, pain, itching and formication are common accompaniments.
The whole is traced to disease of the ganglion on the posterior
(superior) root of the spinal nerve distributed to the part. This
establishes a principle, and in inscrutable and obstinate, circum-
scribed skin disease the veterinarian should see if it coincides
with the distribution of one or more sensory spinal nerves.

Ulcerations are often caused by the lack of protection of a part
after paralysis, thus perforation of the cornea will follow section
or disease of the trigeminus. These may be prevented by care-
fully covering the part, and even cured by a fine protective cover-
ing like collodion.

Alterations of the Secretions often follow on section of the
sympathetic trunks, that of the cervical sympathetic in rabbits
causing excessive congestion of the facial skin, with exudation
and scabby product, also profuse secretion of sweat, tears, and ear
cerumen and dry, scaly skin.

8 Veterinary Medicine.

Polyuria is determined by section of one point of the medulla
behind the root of the vagus, medlituria by puncture between the
vagus and auditory nerves (the hepatic vaso-motor centre), and
albuminuria by a puncture in front of the latter. Impairment of
the hepatic vaso-motor tracts in the spinal cord, or of the anterior
or posterior cervical sympathetic ganglia, or of the first thoracic
ganglion equally determines nervous mellituria.

Poisonous milk produced in hard worked mares, or over-ex-
cited dams of other species, causing dyspepsia, diarrheea, arthritis
or other trouble in the suckling, must be in part attributed to
nervous disorder.

Practically all secretions and nutrition are largely under nerv-
ous control, so that modifications in quantity or quality can often
-be attributed to nervous influence.

SENSORY SYMPTOMS AND DISORDERS.

Hypereesthesia, cutaneous, thermic, muscular, visceral. Parzesthesia,
pressure on nerve. Anzesthesia, partial, drug. Analgesia. Hyperalgesia.

‘These are necessarily much less obvious to the veterinarian
than to the physician of man. _ Yet in certain cases they may be
observed directly, and in others deduced from dependent symp-
toms.

Hyperesthesia is a state of exalted excitability of any part of
the sensory nervous apparatus.

Cutaneous hyperesthesia is that condition in which the
slightest touch gives rise to an instant and extreme response.
Some nervously organized mares which are dangerously ticklish
and irritable, afford physiological examples. The surface sore-
ness and sensitiveness which exist in the febrile chill, in wounds,
dermatitis and neuralgia give pathological examples. It is further
seen in certain cases of meningitis (cerebral and spinal), spinal
irritations, rabies, tetanus and neuritis.

Hypereesthesia in cold is seen in neuralgia, rhéumatism, the
early stages of many fevers (chill), in myelitis, neuritis, nerve
injuries, and in posterior (superior) spinal sclerosis. ..

Hypereesthesia of the muscles may be noted in tetanus,
muscular rheumatism and neuralgia.

Sensory Symptoms and Disorders. 9

Visceral hyperesthesia is shown in many cases of spasms of in-
voluntary muscles (colic, arrest of intestinal calculi, gall stones or
urinary concretions), and in inflammation of serous membranes
(pleurisy, peritonitis). ‘

Paresthesia. This is a painfulor morbid sensation caused
-by a lesion in the central nervous structures or in the nerves, but
referred by the sufferer to some peripheral organ over which such
centre presides. It may even be referred to an organ or part that
has been amputated or otherwise removed. ‘This may cause lame-
ness of a kind to indicate suffering in a given muscle, tendon or
joint, when the cause is purely central. In dourine, sexual acts
are excited which have their real source in the nerve centres.
The rabid dog snaps at imaginary flies in mid-winter, when such
insects are only phantoms of his brain.

Pressure on a nerve trunk induces sensations of tingling,
vibration, formication, heat, cold, and paresis, referred by the
mind to the part to which that nerve is distributed, and when the
pressure is removed these sensations recede in the order in which
they came. ‘This may explain some occult cases of lameness.

Itching may be a pure, persistent neurosis without any skin
lesion. ‘Treatment should then be addressed to the nervous sys-
tem.

Anesthesia, or absence of sensation, is in its degree partial or
complete. The latter is familiar as occurring in parts the sensory
nerves of which have been cut across, also in parts the sensory
nerve or nerve centres of which have become completely degene-
rated. ‘I‘here is no response to the prick of a needle, the touch
of a hot wire, to pinching or cutting. If the nerve remains intact
as far as the spinal centres, reflex action may still occur, but the
patient himself has no consciousness of this nor of the injury
causing it. Accordingly, he makes no movement of head, ears,
eyes, or other parts still dominated by the brain.

In partial or imperfect anesthesia, the response to irritation
is less marked and may be even delayed. In some forms of cen-
tral lesions the response to a prick may be delayed two, five, or
ten seconds, or even more.

Anesthesia causes awkwardness or uncertainty of movement,
especially if the subject is blindfolded.

Anesthesia may be induced by medicine, as in the general

10 Veterinary Medicine.

anesthesia of etherisation, or the local anzesthesia caused by the
topical applicatton of cocaine or carbolic acid.

Analgesia, or insensibility to pain, may be present in cases in
which ordinary sensations are still felt. It may be caused by co-
caine, alcohol, and to some extent by carbolic acid.

Hyperalgesia is the opposite of this condition, and may be
seen in certain irritable conditions of the nerve centres.

PSYCHIC SYMPTOMS AND DISORDERS.

Limitation in lower animals. Effects of age, training, race heredity, in-
dividual and racial peculiarities, exhaustion, prostration, dementia, cerebral
congestion, compression, degeneration, narcotics, ptomaines, toxins. Con-
trolling absorption in another trouble. Delusions, hallucinations, vice,
violence, cestrum, fatigue. Cerebral source of motions.

These have a much more restricted field in the lower animals
than in man in keeping with the limitation of the mental facul-
ties, and they may often be traced to demonstrated structural dis-
order. Vet some emotions of joy, fear or rage run very high
and are comparatively unchecked -by high mental development or
mental training. The effect of training is, however, very
marked in the more educated animals.

Age modifies by the sobering that come from experience and
habit. The frolics of puppies, kittens, lambs, foals and calves
are in marked contrast with the sedateness and stolidity of old
dogs, cats, sheep or cattle.

Training is seen in the educated horse which would have
been panic stricken at sight of a locomotive, flag or floating
paper, at the smell of a lion or bear, at the sound of a gun or
drum, and which will now boldly face any one of these with no
manifest tremor. The emotional puppy can be trained to
soberly fetch and carry, to drive sheep or cattle without biting,
to lie sentinel by his master’s property, to point at birds without
seeking to catch them, or to carry shot birds without devouring
them.

Race heredity comes from the training along the same lines
in many successive generations. Thus the more domesticated
breeds of dogs (shepherd, poodle, and greyhound) are very af-

Psychic Symptoms and Disorders. II

fectionate ; other breeds (bull, mastiff, bloodhound) are lacking
in this character. All trained races take naturally to the occu-
pations of their ancestors. Some (horses, cattle and sheep) are
easily panic-stricken, (stampeded). Some (turkeys, roosters)
are not easily stampeded. Some (skunks), having effective
sources of defense, have little fear of man.

Individual and racial mental dullness and torpor must
also be recognized. Some are stupid and slow, others alert and
quickly responsive. Some horses are not Jdevel-headed and be-
come uncontrollable in difficult situations. Some dogs are so
emotional as to endanger their lives from sudden heart trouble.
Some horses, dogs and cats will pine and die when separated
from their fellows or human friends. Extreme timidity, or
sudden rage may be so marked as to constitute a virtual morbid
phenomenon. Sluggish cerebral and mental action may result
from exhaustion, prostration, or dementia ; also from cerebral con-
gestion, pressure and degeneration ; or from poisoning by nar-
‘cotics, ptomaines or toxins (opium, hyoscyamus, Indian hemp,
dourine, milk sickness, etc. It may come from profound ab-
sorption in another object, as when the rabid dog bears whipping
without a howl.

Delusions or hallucinations are shown in the rabid dog
snapping at flies, or attacking his friend or master as ‘an enemy,
as well as in other forms of delirium. Narcotics, such as opium,
Indian hemp, etc., ptomaines, toxins, and (in dogs) essential
oils cause delirium by acting on the nerve centres.

Vice in its various forms may become a genuine neurosis, the
animal losing control of its actions.

Violence in the form of self-defense or aggression is seen in
mares in feat, in bulls or stallions under sexual excitement, in
animals roused by inconsiderate whipping, or in bulls looking on
scarlet clothing.

Some high-spirited animals, under extreme fatigue from over-
work, sometimes become violent but resume their docility under
rest and food.

In all cases we must know the soaial of an individual animal
to enable usto properly appreciate any apparent deviation from
the psychic form. No less essential is it to take into account
the environment and treatment of the patient.

N

.

12 Veterinary Medicine.

With regard to localization of cerebral lesions, Sequin thinks
emotions are probably generated in the basal ganglia such as
those of the pons and thalami, while inhibition depends on the
anterior cerebral cortical convolutions.

DIAGNOSIS, SYMPTOMS AND THEIR IMMEDIATE
CAUSES. LOCALIZATION OF LESION IN
SPECIAL SYMPTOMS.

Spasm, pain, numbness—irritation. Paresis, paralysis, anzesthesia (con-
stant), destructive lesions. Both combined—variable symptoms, recurrent.
Definite, fixed symptoms—structural lesions, usually progressive. Symp-
toms, variable as to place, time, subsidence and recurrence—functional
lesions. Brain lesions. Pressure on brain—pain, spasm, nausea, dullness,
blindness, stupor, coma, palsy. Congestion and anzmia synchronous.
Lesions of cortex. Encephalic lesions—hemiplegia, with spasms, increased
reflexes, spasms follow cranial nerves, vertigo, apoplexy, epilepsy, dementia,
coma, little muscular atrophy, or dermal sloughing. Spinal lesions, para-
.plegia, without spasm, reflex reduced or nil, follow spinal nerves, head
symptoms less, much muscular atrophy, bed sores. Sensory and motor
tracts, in crus cerebri, respiratory centres—inspiratory, expiratory, inhibi-
tion. Salivation, sneezing, coughing, sucking, chewing, swallowing, vomit-
ing. Cardiac centres, accelerating and inhibitory. Vaso-motor centre.
Spasm centre. Perspiratory centre. Pons. Corpora quadrigemini, crura
cerebri. Thalamus, corpus striatum. Cerebellum. Cerebral cortex: in
ass; in dog. Spinal lesions: lateral half section : central anteroposterior,
vertical section: superior columns; inferior columns; cervical lateral
columns ; respiratory tract ; glycogenic centre; pupillary dilator; cardiac
accelerator ; vaso-motor, sudoriparons ; centre for anal sphincter; for vesi-
cal sphincter ; genital centre ; vaso-motor and trophic centres ; muscular
sense tract ; superior column and Goll’s. Table of phenomena from cord
lesions.

In Irritation of nervous organs the symptoms. (spasm, pain,
numbness) are usually zztermittent.

In Destructive Lesions of nervous organs the symptoms,
(paresis, paralysis, aneesthesia) are usually constant.

When irritation and destruction are associated the symp-
toms are variable and frequent. he characteristic symptoms of
the two may coexist or succeed each other.

Structural Nervous Lesions have symptoms that are definite

Localization of Lesion in Special Symptoms. 13

in their area of distribution, nature, (spasm, paralysis) and per-
manency. Objective Symptoms predominate and the case is likely
to be progressive and fatal.

Functional Nervous Diseases have symptoms of indefinite
distribution, variabie in character, with intermissions and spon-
taneous disappearances (as under marked excitement) and sub-
jective symptoms predominate. They may, however, last for a
length of time without change.

Localization of Brain Lesions.

Lesions of the cranial nerves and their superficial and deep
centres of origin need not here occupy attention. ‘These may be
studied in works on anatomy and physiology. Attention may be
drawn rather to the remoter effects of ganglia which effect or
control distant action, and to general pressure on the encephalon.

General Pressure on the Encephalon, whether through
fracture of the cranium and depression of bone, by acute conges-
tion, by blood extravasation, by inflammatory exudation, or by
acute abscess, will cause pain, spasms, nausea, dullness, blind-
ness, stupor and coma. After expulsion of the cerebrospinal
fluid from cranial cavity, the increasing pressure compresses
the blood vessels, reduces or interrupts the circulation and
abolishes the functions in the parts deprived of blood. Thus
congestion of one portion of the encephalon is usually associated
with diminished circulation in another portion. Disorder in the
first may occur from hyperemia and irritation and in another
part from a consequent anemia.

Destructive Lesions of Cortex of One Cerebral Hemi-
sphere may or may not cause permanent symptoms, as shown
by the passage of a crowbar through the front of the left hemi-
sphere, yet the man survived for 13 years and showed no loss of
intelligence, his disposition and character alone having changed
for the worse. ‘The one hemisphere may by itself sufficiently
control mental acts, while the other lies dormant or may even
have undergone degeneration.

Diagnosis of Encephalic and Spinal Lesions. The fol-
lowing may be taken as guiding principles :

Encephalic: Hemiplegic or bilaterally hemiplegic grouping
of symptoms.

14 Veterinary Medicine.

Spinal: Paraplegic grouping of symptoms.

Encephalic: Frequent contracture or spasms of paretic
muscles.

Spinal: Paralysis more perfect and continuous.

Encephalic: Reflexes in affected muscles increased : Cerebral
inhibition absent.

Spinal: Reflex abolished or reduced in parts the seat of the
lesion.

Encephalic: Spasms in areas of distribution of cranial nerves
(not spinal.)

Spinal: Spasms and paralysis follow distribution of spinal
nerves.

Encephalic: Head symptoms frequent (vertigo, apoplexy,
epilepsy, dementia, coma).

Spinal: Relative absence of head symptoms.

Encephalic: Comparative absence of marked muscle atrophy.

Spinal: Atrophy in special muscular groups.

Encephalic: Little tendency to form bed sores.

Spinal: Tendency to form sloughs and bed sores.

t

Sensory (A¢sthesodic) and Motor (Kinesodic) Tracts in
Encephalon.

In the crus and above, the sensory tract lies dorso-laterad of the
motor tract, forming about one-fifth of the crus, and extending
upward through a white layer bending inward to form an angle
and finally diverging to the different cortical convolutions. The
motor tract is mainly contained in the inferior pyramids of the
bulb, and constitutes the median two fifths and basal two fifths of
the crus. Without entering farther into this subject it will be
observed that lesions of the outer layer of the crus and its radi-
ating fibres may cause hemianzesthesia of body or head, includ-
ing the eye, while lesions of the median and basal layers and
- radiating fibres induce hemiplegia of the head, tongue, fore
limb, hind limb, trunk, etc.

Respiratory Centres, Inspiratory and Expiratory are in
the floor of the fourth ventricle between the centres for the vagus
and accessory nerves, and are directly stimulated by the CO, in
the blood. Secondary subsidiary centres are in the optic thala-
mus, in the corpora quadrigemini both anterior and posterior

Sensory and Motor Tracts in Encephaton, 15

pairs, and finally in the cervical spinal cord, so that disorder of
respiration may occur from lesions in these points as well as in
the main oblongata centre.

Respiratory Inhibition and arrest depend on the vagus, the
superior and inferior laryngeal nerves.

The Salivation Centre also lies in the floor of the fourth
ventricle and stimulation of the medulla causes free secretion.

The Centres for Sneezing, Coughing, Sucking, Chewing,
Swallowing and Vomiting are also seated in the oblongata, so
that any one of these phenomena may come from a central irrita-
tion. In bulbar paralysis the loss of power usually extends from
the tongue through the lips, cheeks, jaws, pharynx, larynx, to
the respiratory muscles and heart. Coughing may be roused by
irritation of the external auditory meatus, liver, stomach, bowels,
or generative organs as well as from the air passages.

Cardiac Accelerating and Inhibiting Centres are both
present in the bulb, the latter receiving its afferent impulse main-
ly through the vagus nerve. Stimulation of the vagi, aneemia of
the bulb through decapitation or through tying both carotids,
hyperemia through tying of the jugulars, a venous state of the

_ blood, and blows on the abdomen all slow or arrest the heart
action. Digitalis or muscarin has a similar efféct. The heart
action is accelerated by febrile and inflammatory affections, by
a high or low temperature by section of the vagi, by sipping
of cold water, by atropine or curari, and by saltsofsoda. Potash
salts on the other hand restore the inhibitory action of the vagi
and lower the heart’s action.

The Vaso Motor Centre is also in the oblongata and the
contraction of the vessels with increase of arterial pressure. may
ensue from afferent currents in the sympathetic nerve and many
sensory trunks. ‘The varying activity is seen in blushing, in the
congestion of mucous membranes under rage or excitement, in the
capillary contraction in the early stage of inflammation, in the
second stage of capillary dilation, in angioma, or nevus, and in
extensive congestions and hemorrhages in different organs. The
arrest of bleeding under fainting is due largely to the anzemia of
this centre. ‘

A Spasm Centre the pricking of which causes general con-
vulsions lies in the medulla oblongata at its junction with the

16 Veterinary Medicine.

pons. This is excited by excess of carbon dioxide in the blood,
by suffocation, drowning, by anzemia of the bulb from bleeding
or ligature of the carotids, by venous congestion after ligature of
the jugulars, or by the direct application to the part of ammonia
carbonate, or salts of potash or soda. It may also be aroused by
afferent nervous currents from different peripheral parts (spinal
cord, sciatic nerve, etc. ).

A Perspiratory Centre is found in the medulla, on each side,

which may be roused into action by diaphoretics (opium, ipeca-
cuan, tartar emetic, Calabar bean, nicotin, picrotoxin, camphor,
pilocarpin, ammonia acetate, etc. ).
’ The Pons like the medulla is at once a ganglionic and con-
ducting organ, and its lesions may lead to arrest of nerve currents
generated above or below it, or to the failure to develop currents
in its own centres. Stimulation of its superficial layers may be
without effect, but if this is carried into the centre epileptiform
convulsions ensue. Lesions of one side of its posterior half cause
facial paralysis the same side and motor and sensory paralysis on
the opposite side of the body (crossed hemiplegia). Lesions of one
side of its anterior half cause paralysis in both face and body on
the same side. ‘This depends on the crossing of the fibres mid-
way back in the pons, which cross again in the medulla (motor
fibres) and in the spinal cord (sensory fibres). Lesions of the
pons are liable to interfere with the functions of the trigemini,
the oculo motor, and the superior oplique, and to determine
epileptic movements and loss of codrdination of sensorio-motor
movements. Lesions of the superficial transverse fibres (median
cerebellar peduncles) tend to cause involuntary movements to
one side.

Lesions of the Corpora Quadrigemina cause dictaeoutite of
vision, failure of the pupil to contract to light, blindness, paralysis
of the oculo-motor nerves, and lack of codrdination of move-
ments. Stimulation of one anterior corpus causes rolling of
both eyes to the opposite side, with, if continued, a similar move-
ment of the head and even of the body (horse in mill, or index
motion, or rolling on its axis).

The Crura Cerebri are conducting bodies but contain also
different nerve centres. Lesions of one crus cause violent pain
and spasm on the opposite side of the body, followed by paralysis.

Sensory and Motor Tracts in Encephalon. 17

The oculo motor may be paralyzed on the same side, but the face

‘and tongue on the opposite side, owing to the fibres crossing in

the pons. There may be turning movements.

The Optic Thalamus transmits sensory currents to the cere-
bral cortex. Lesions in this organ cause sensory paralysis on the
opposite side of the body. Afferent currents that do not traverse
the thalamus cause reflexes only. It contains one of the roots of
the optic nerve and its destruction will impair vision. Its in-
juries may also produce turning movements.

The Corpus Striatum transmits motor currents originating
in the cerebral cortex. Lesions of its interior (lenticular nucleus)
cause motor paralysis and sometimes anesthesia on the opposite
side of the body. Electrical stimulation of this nucleus causes
general muscular contractions of the opposite side of the body.
Irritation of the surface layers is painless and symptomless.

The Cerebellum has been long credited with codrdination,
and Flourens, after its removal from a pigeon, found an utter lack
of harmonized movement in walking, springing or balancing.
Luciani removed the organ from a bitch and, after full healing of
the part, found a lack of muscular tone (a cerebellar ataxy), so
that no great muscular effort could be satisfactorily accomplished.
After months, marasmus set in and proved fatal. The lack of
codrdination is especially connected with lesions of the vermiform
process, those of the posterior portion causing falling forward and
those of the anterior portion, falling backward. Injury to the
middle peduncle on one side causes turning or rolling to the
opposite side. Under slighter injuries they may be only un-
steadiness and staggering like a drunken man. Nausea and
vomiting, with more or less stiffness of the neck or oposthotonos,
may be present. Rolling of the eyes or squinting may occur.

Focal Cortical Centers of the Cerebrum. Cortical
Localization. Much has been done experimentally and by
observation of morbid lesions to locate functions in the different
convolutions, and though the subsidiary implication of adjacent
and interdependent parts interferes with a perfectly confident
diagnosis, yet certain fundamental facts may be borne in mind as
contributing to a satisfactory diagnosis.

Arloing, on the basis of his own experiments and those of his

2

18 Veterinary Medicine.

predecessors, gives the following as applicable to the equine (ass)
eat ;

. Stimulation of the origin’of the front part of the first frontal
eee ice or of the anterior part of the pre-Sylvian convolu-
tion, causes approximation of the feet on the opposite side of the
body.

2. Stimulation of the superior part of the first frontal convolu-
tion or of the superior part of the post- Rolandic convolution
causes closure of the jaws and diduction.

3. Stimulation of the anterior end of the upper orbital convo-
lution, or of the anterior part of the pre-Rolandic convolution,
leads to movements of the nose and upper lip.

4. Stimulation of the antero-superior patt of the lower frontal —
convolution, or the union of the post-Rolandic with the Sylvian
convolution causes movement of tongue and jaws.

5. Stimulation of the union of the vertical and horizontal parts
of the orbital convolution or frontal lobe, causes opening of the
jaws and bending of head and neck.

6. Stimulation in the front of the union of the frontal and
longitudinal convolutions, or at the union of the Sylvian and sec-
ond parietal convolution causes rolling of the opposite eye.

7. Stimulation of union of the frontal and parietal parts of sec-
ond parietal convolution leads to closure of both eyelids or, with
a strong current, of lids on both sides.

8. Stimulation of the second parietal convolution, above and a
little behind the extremity of the Sylvian fissure, causes opening
of the eye and adduction of the ear on the opposite side, or, if a
very strong current, on both sides.

g. Strong stimulation of the posterior part of the first and sec-
ond parietal convolutions causes tonic convulsions.

1o. Currents through the posterior parts of the third and fourth
parietal convolutions give similar convulsions with violent trem-
bling of the trunk and members.

In the Dog’s Brain localization is easily made by reference to
the crucial fissure which passes outward, right and left, at right
angles with the longitudinal fissure about the junction of its
anterior withits middlethird. Also by four parietal convolutions
which run backward from near the crucial fissure, parallel with the
longitudinal fissure. They are counted from without inward.

Sensory and Motor Tracts in Encephalon. 19

Fritsch, Hitzig and Ferrier have mapped out the followlng motor
areas :

1. The convolution in front of the outer end of the crucial sul-
cus controls the muscles of the neck.

2. The bend of the same convolution backward, opposite the
outer extremity of the crucial sulcus, controls the extensors and
adductors of.the fore limb.

3. The convolution just behind the outer end of the crucial
‘sulcus controls the muscles which flex and rotate the fore limb.

4. The same convolution behind the middle of the crucial fis-
ure controls the movements of the hind limb.

5. The second convolution back of the crucial fissure controls
the muscles of the face.

_ 6, The anterior part of the internal (4th) parietal convolution,
just back of the crucial fissure, controls the lateral switching
movements of the tail. :

7. The posterior angle of the first post-crucial convolution
causes retraction and abduction of the fore limb.

8. The outer end of the first post-crucial convolution, directly
behind the outer end of the sulcus, causes raising of the shoulder
and extension of the fore limb.

g. ‘The anterior end of the third parietal convolution (the
second from the longitudinal fissure) controls closure of the eye-
lids, the rolling of the eyeball upward, and narrowing of the
pupil.

10. Stimulation of the anterior end of the second parietal con-
volution causes partial opening of the mouth with retraction and
elevation of its angle.

1r. Stimulation of the point of union of the first and second
parietal convolutions anteriorly causes opening of the mouth
with protrusion and retraction of the tongue.

12. Stimulation of the median part of the second parietal con-
volution, causes retraction and elevation of the angle of the mouth.

13. Stimulation of the convolution directly in front of the
outer end of the crucial sulcus causes dilatation of the eyelids
and pupil while the eyes and head are turned toward the oppo-
site side.

14. Stimulation of the convolution behind the crucial fissure
causes contraction of the muscles of the perineum.

20. Veterinary Medicine.

15. Stimulation of the convolution in front of the crucial fis-
sure, on its anterior and sloping portion, causes movements of
the pharynx and larynx (swallowing).

16. Stimulation of motor areas of the cortex, by scraping, irri-
tation, or disease tends to produce spasmodic contractions of cer-
tain groups of muscles (Jacksonian Epilepsy). Strong stimula-
tion may cause general epileptiform spasms, which are at first
tonic, then clonic. One such seizure strongly predisposes to a
second. If, during an attack, the cortical centres presiding over
a special group of muscles were sliced off, such muscles relaxed,
though the general spasms in the other muscles continued.

Localizations of Spinal Lesions.

Being at once a conductor between the brain and nerves, and a
reflex nerve centre, we must consider both roles in seeking to
locate lesions from symptoms. In passing from the nerves to
and from the sensorium both sensory and motor currents cross so
that one side of the brain presides over the other side of trunk
and limbs. This crossing of the motor fibres takes place in the
medulla oblongata, while that of the sensory fibres occurs in the
spinal cord close in front of the nerve from. which they have
entered.

Cross-Section of one lateral half of the spinal cord:
therefore causes motor paralysis and rise of temperature of the
whole of that side of the body posterior to the lesion, while it in-
duces sensory paralysis and cooling on the opposite side of the
body up to the same point. A very limited sensory paralysis on
the same side occurs corresponding to the few sensory fibres pass-
ing outward obliquely through the portion injured by the cross-
section.

A vertical section of the cord separating the one lateral
half from the other does not necessarily affect the motor cur-
rents, while it produces a limited anzesthesia on each side in the
area of distribution of the nerves, the sensory fibres of which
crossed in the seat of the lesion.

Transverse section of the superior columns causes hyper-
zesthesia and lack of codrdination.

Transverse section of inferior columns, or of the in-
ferior horn of gray matter, if close behind the medulla, causes no

*

Localization of Spinal Lesions. 21

motor paralysis, but if farther back induces motor paralysis on
the same side of the body.

Transverse section of the cervical lateral columns causes
motor paralysis of the lateral walls of the chest (respiratory
tract). If the section is made in the dorsal or lumbar region it
is the same as lesion of the superior columns.

Among reflex centres in the cord the following may be named :

The Respiratory Tract in the cervical lateral columns just
referred to. ;

A Glycogenic Centre in the anterior cervical section be-
tween the bulb and the fourth cervical nerve.

Centres which Dilate the Pupil between the fifth cervical
and the sixth dorsal nerve.

Cardiac Accelerator Centres between the three last cervical
and the five first dorsal nerves.

Vaso-Motor Sudoriparous Centres in the central gray
matter.

Centre for Anal Sphincter between the sixth and seventh
dorsal nerves.

Centre for Vesical Sphincter between the third and fifth
lumbar nerves.

Genital Centre, opposite the first lumbar nerve.

Vaso-motor and Trophic Centres are found in the inferior
horns of gray matter, and their degeneration causes progressive
muscular atrophy.

The Muscular Sense Tract is located near the surface of
the superior columns, so that a certain amount of incodrdination
and unsteadiness of progression follows its destruction.

The Deeper Part of the Superior Columns and the Column
of Goll which bounds the superior median fissure control mus-
cular sense and coordination, and their disease (posterior lateral
sclerosis) entails locomotor ataxy.

e

Veterinary Medicine.

TABLE SHOWING PROMINENT PHENOMENA FROM LESIONS
OF THE CORD.

LESIONS IN

Cervical Reaion.

Dorsal Region

Lumbar Region

Paralysis in

Sensation

Atrophy

Electric reaction

Neck muscles; dia-
phragm; trunk;
limbs.

Local hypereesthesia in
fore limbs. Anzesthe-
sia in rest of limbs
and trunk,

Rarein neck; common
in fore legs.

Lessened in atrophied
muscles,

Dorsal,abdominal and
intercostal muscles.
Paraplegia.

Hy peresthesiaiu low-
er part of abdominal
wall.

Slight in muscles be-

. hind lesion.

Lessened in dorsal
and abdominal mus-
cles; slightly in
wasted leg.

Paraplegia.

Hyperesthesia in
zone around loins:
anesthesia in hind
limbs.

In hind limbs.

Lessened in atrophied
muscles ; in ratio.

Bladder Retention or intermit-|Same as cervical. Incontinence from
tent ‘incontinence re- palsy of sphincter.
flex, or (later) from
overflow Cystitis oh
common,

Bowels Involuntary evacuation|Same as Cervical. Paralysis of sphincter
(reflex spasm) or con- with incontinence ;
stipation, : costiveness.

Superficial reflex |Temporary loss; then|Same as cervical, Lost.
rapid increase.

Deep reflex Temporary loss ; then/Same as cervical. Lost.
slow increase.

Priapism Often present. Often present, Absent.

HALLUCINATIONS.
Subjective cerebral impressions projected as real. Rabies. Toxins.

Poisons.

Essential oils.

Chloroform.

Hallucinations are subjective impressions which the animal

supposes to be real.

The disorders in his brain are projected out-

ward and become to him real objects and occurrences.

They may arise from the presence of proliferation of microbes
in the brain asin rabiesin animals. They may proceed from poi-
soning of the brain by toxins as in anthrax.

They may be developed, in dogs especially, by the action of cer-

tain essential oils on the cerebral cortex.

will be considered with those special diseases.
orders from drugs have been studied experimentally by Cadeac
and Mennier, and may be noticed in this place.

The first two classes

The mental dis-

Timidity. Panic. Stampede. 23

Lavander, fennel and angelica produce in the dog a condition
of extreme terror, and overcome all disposition to exercise self-
defense.

Mints and origanum induce hallucinations of odor. ‘The dog
seeks around with head and nose elevated, sniffs the air, moves
cautiously, fixes his eye on some phantom object, and starts to
hunt imaginary game. The love of catmint seems to amount toa
mania in the feline animal. ;

Kidney vetch evidently causes a sensation of itching or formi-
cation ; the dog bites the hair of the tail, the hind Jimbs or the
flank as if to destroy fleas or other vermin.

Dogs under chloroform have sought to hunt, and stallions un-
der ether have shown generative excitement with erection of the
penis and movements of coition.

TIMIDITY. PANIC. STAMPEDE.

Timidity. Panic. Timid driver. Impaired vision. Nervous. Irritability.
Gadding. Gregarious habit. Absence of natural weapons. ‘Treatment.
Habit. Substitution. Absolute constraint. Kindness. Boldness. Work.
Moderate diet. .

An animal is naturally nervous, and by habit has become timid
untilit is virtually impossible to utilize it. In a body of animals,
fear is quickly transferred from one to the other until all join in
a wild panic and stampede. This is common in range cattle or
horses, but is found in army horses as well, anda whole regiment
will sometimes refuse to longer face the enemy and flee in spite of
every effort of the rider. On a smaller scale, two timid horses in
a team, scared by some unusual sight, add each to the sense of
fear of the other, as they try to escape, until they gallop blindly
into any danger. ‘This sense of terror is often fostered by the
timid rider or driver, every feeling of apprehension conveyed
through the trembling or uncertain hand, or the voice which has
lost the element of confiderice, tending to undermine the last ves-
tige ofj;trust on the part of the horse. Imperfect sight is one
cause of panic, as the perception of common objects in distorted

24 Veterinary Medicine.

form or unwonted situations strikes terror to the timid animal,
causing shying or bolting. Better absolute blindness than such
imperfect vision.

A constitutional timidity tends constantly to increase unless the
animal is judiciously accustomed to the object of terror. The
horse once scared, seems to become more and more watchful for
other objects of dread, and even inclined to bolt from such as are
common and of every day occurrence.

Cattle and sheep attacked by the gadfly (cestrus) flee in great
terror, and this dread is communicated from animal to animal so
that the whole herd or flock is suddenly panic-stricken. The bel-
low of the ox attacked and the erection of its tail is the signal for
every other within reach to join the stampede.

These panics are associated with the instinct of these races to-
ward a gregarious life; they mass together for protection and
they learn to heed the slightest indication of approaching danger.
This instinct grows more powerful by constant exercise, and is
* most marked in those genera which have the least natural means
of protection. Hence, of all animals sheep are most easily panic-
stricken, and once affected, they move in mass, one following its
fellow, without object, without definite direction or destination,
and without consideration of the other dangers they are to meet.
Hence, if one sheep jumps over the parapet of a bridge to certain
destruction, the whole flock speedily follows. If one leaps overa
fallen tree into a snow bank, all at once follow suit and pile above
each other in one suffocating, perishing mass.

While this condition is hereditary in, gregarious families, it is
essentially a psychosis in those animals that have been often
scared until they are continually on the watch foi objects of fear.

Treatment. In the case of horses, the best course is to make
the animal familiar with the object of dread ; let him look at it,
approach it siowly, smell it, feel it with his lips. Never turn
away his eyes from it and drive him off, as that confirms the im-
pression of dread, and the object retains ever after its dreaded
appearance. In this way timid colts become gradually fearless of
umbrellas, city sights, street cars, large vans, flags, music, loco-
motives and the like,—they become, in the expressive language of
the horseman, voad-wise. A paddock or yard beside a railroad
will soon accustom a timid horse tothe cars, and so with other
things, experience will remove apprehension.

Timidity. Panic. Stampede. 25

A more speedy removal of the habit of dread may often be
secured by the principle of substitution. The mind of the animal
does not readily attend to more than one matter at a time ; if,
therefore, we can distract the attention in another direction, the
object of fear may be virtually ignored until the eye has become
habituated to it, and it will be recognized as harmless. Thus it is
that a twitch on the upper or lower lip, a binding of the chin in
upon the breast by a Yankee bridle may make the horse tempo-
rarily heedless of the object of terror. So also in the bolting
horse, the obstruction of the breath by a cord with a running
noose around the neck, or the sending of an electric current
through wire reins and bit will promptly check him in his wild
career.

The result is still better when the animal is made to feel his
utter helplessness in the hands of man and the futility of any at-
tempt to escape. On this are based the method of Rarey and of
his various successors. With fore limbs strapped up, the animal
soon exhausts himself in his efforts to disengage them and escape,
and lies down completely reconciled to his fate. He may now be
accustomed to his objects of terror—the opening and closing of
an umbrella, or the waving of a flag over his head, the discharge
of a gun close to his ear, the passing of car or locomotive, or any
other object of his dread. When allowed to get up he will usu-
ally pay no further attention to these things, especially if patted
and spoken to encouragingly, and perhaps fed apple or sugar, or
something of which he is fond. As far as is consistent with the °
thoroughness of the subjection, the animal should be treated
throughout with the greatest kindness, so as to retain and even
increase his trust in man and sense of dependence, while at the
same time he is strongly impressed with the futility of resistance
to his will. After the animal has been thus taught to bear with
equanimity his former objects of terror, he should not be at once
allowed to forget them, but by daily experience he should be con-
firmed in the conviction that they are harmless, and may be met
with safety. This should be carried out, if possible, in the hands
of the bold and kind operator who has trained him, as, if returned
to a timid driver or rider, he may be easily lead back into his for-
mer habits of blind terror. A similar and even easier resort is the
process of turning as given under balking.

26 Veterinary Medicine.

Constant hard work, for a time, is an excellent form of acces-
sory treatment, as the plethora developed by over-feeding and
temporary idleness begets an irritability and impatience of control
which is quite likely to beguile him into his old habits.

In case of runaway, beside the electric and asphyxiating treat-
ment already referred to, the animal may be blinded and quickly
brought to a stand-still. Movable blinds may be used which
habitually stand well out from the eyes, but which may be instant-
ly drawn closely over them by the simple pulling of a cord. The
sudden darkness and the impossibility of directing his course,
brings an instant realization of the existence of other dangers be-
side the original bugbear.

BALKING. RESTIVENESS.

Definition. Common in assand mule. Causes: low condition ; overload-
ing ; nervousness ; sluggish nature ; irritable driver ; shoulder sores ; poor
collar ; hard bit : sharp or sore maxilla ; sores in angle of mouth; mares ;
racial tendency: going fromstable: a psychosis. Symptoms: stands stock
still ; plunges, but won’t draw; will stamp, bite, kick, rear, buck, crowd on
wall: liedown. Breach of warranty ; sound price ; willfulness ; balking of
raw horse ; diagnosis from nervous disorders ; sores, etc. Time in which re-
turnable. Treatment : preventive, curative ; distract attention ; cord on ear :
whiff of ammonia or capsicum ; closing nostrils ; blindfolding ; tying up the
fore leg ; stroking nose, eyes orears; tapping flexors or metacarpus ; move
in circle with head tied to tail ; coax to go.

In general terms this has been defined as a refusal to obey.
Usually in solipeds it is a refusal to move as directed with a load,
under the saddle, or in hand. Though essentially a vice, it may
become such a fixed habit that it appears to dominate the will of
the animal and may thus be called a psychosis—a mental infirm-
ity.

It is much more common in asses and mules than in horses, in
keeping with their more obstinate disposition and too often
harsher treatment.

There may be simple refusal to pull. This often comes from
overloading, and especially when the animal has been sick or
idle, and comes back to work with soft flabby muscles unequal to

Balking. Restiveness. 27

any violent exertion. After one or two ineffective efforts he sets
himself back in the harness refusing to try again and the vice is
started. Ordinary loads on bad roads full of holes from which it
is impossible to drag the wheels have a similar effect. ‘The dan-
ger is greater if the animal is naturally of a nervous or impatient
disposition, and if he makes a desperate plunge forward and fails
at once to move the load. Such a horse hitched with a slow
steady mate is liable to have expended his effort before the latter
has had time to join him in the pull, and it becomes impossible to
move the load because the two cannot be started simultaneously.
The conditions are aggravated if the driver is irritable and by
voice and acts further excites the already too excitable animal.

Lesions of various kinds, such as shoulder bruises, abscesses,
abrasions and callouses, saddle bruises, callouses, abscesses or fist-
ulze cause acute pain whenever the effort is made, and render the
animal more impatient and indisposed to try again.

Too small a collar or one that fits: badly (too narrow, uneven)
has often a similar effect.

Among other causes may be named a hard bit harshly used, a
sharp edge of the lower jaw bone where the bit rests in theinter-
dental space, sores of the buccal mucous membrane in this situ-
ation, and caries or necrosis of the superficial layer of the bone.
Also chaps, ulcers, or cancroid of the angle of the mouth.

Young horses, that are as yet imperfectly trained, are more
readily driven to balk than old trained animals.

Mares are more subject to the vice than geldings, by reason
apparently of a more nervous disposition, but much more because
of the excitement to which they are subjected, under the periodic
returns of heat.

Peuch speaks of rare hereditary cases in which the habit is
uncontrollable and the animal incurable.

Friedberger and Frohner accuse chestnut and sorrel horses as
being especially liable to balk.

However started the continued exercise of the act fixes it
as an incurable habit a virtual psychosis. Yet the inclination
of the animal, his likes and dislikes to a certain extent con-
trol its manifestations, thus a horse rarely balks in going home,
and shows it mostly in going in the opposite direction, and
above all on a new or unknown road.

28 Veterinary Medicine,

The Symptoms vary greatly in different cases. One animal
stands stock-still propping his legs outward and absolutely re-
fusing to budge. ‘This may occur even in the stall when it is
attempted to take the animal out. When on the road he is
usually willing to turn and go back, but no persuasion by voice
or whip can force him forward. -

Other horses make ineffective plunges forward but never throw
weight enough into the collar to overcome any resistance.

Still others stamp, bite, throw themselves to- one side rather
than forward, rear up, strike with the fore feet, and if whipped
kick with the hind. Some will throw themselves down and
struggle in this condition.

Under the saddle the animal may crowd against a wall, rear,
kick, buck or even throw himself down in his efforts to dis-
lodge the rider. ‘These violent manifestations however rather
belong to vice than mere balking. Trembling, perspiration,
frequent rejection of urine, and general acceleration of pulse
and breathing may manifest a severe nervous disorder.

Diagnosis. It is often important to pronounce upon the exact
nature of this trouble so as to determine whether the seller is
responsible for a breach of warranty given or implied. As regards
implied warranty a sound price for au animal sold to do a given
kind of work implies a mutual understanding that the animal is
not physically or psychically incapacitated for such work.

The balking horse is one that obstinately refuses to perform
a piece of work for which his physical condition seems to he well
adapted. The w7/Jfulness of the refusal is the important feature.
In case of such a serious drawback to the value of a horse, the
presumption of fraud on the part of the seller is unavoidable, in
case he failed to mention the habit to the purchaser, but of course
this is even more emphatically certified if he has warranted the
animal as a good worker, or kind, or true in work.

On the other hand he cannot be held responsible for the fail-
ure to perform an act in case the horse has been overloaded when
fat or out of condition, or if he has sores on back, withers or
shoulders, a badly fitting collar, a severe or large clumsy bit, or
sores on the lower jaw, or indeed any temporary physical in-
firmity, to which the balking can be fairly attributed.

Balking is not to be confounded with nervous affections

Balking, Restiveness. 29

(paretic, spasmodic, congestion) in which the failure to obey is
not due to lack of will, but to lack of power. Nor must it
be confounded with the inability of the paralysis of lead pois-
oning. It is perhaps most likely to be confounded with that
lack of both sensory and motor power which attends on ven-
tricular dropsy and other chronic affections of the brain. Insuch
cases (immobility, coma) the habitual dullness, drowsiness, gen-
eral hebetude, and lack of energy contrasts strongly, with the
strength, vigor and general life of the animal which suddenly,
willfully and incorrigibly balks.

The.balky horse which has no such nervous disorder as an ex-
cuse, no badly fitting harness, no lesion on shoulder, back, limbs
nor mouth, no unsuitable bit, no special softness nor poverty of
condition, no slow, ill-adjusted mate, no impatient driver, and no
excessive load, nor impassable road, but which jibs without ex-
cuse, as a willful disobedience, may well be cause for annulling
asale. In most European countries such a horse can be returned’
to the seller and the sale set aside within 3 days (Austria), 4
days (Prussia), 5 days (Saxony), 9 days (Hesse).

Treatment. This should be preventive by avoiding the
various causes above enumerated, for if the habit is once con-
tracted it is too often impossible to establish a permanent cure.
The horse is largely a bundle of habits and the first act of dis-
obedience has given a bias to the nerve cells of the cortex cerebri
which like a planted seed tends to reproduce itself whenever an
opportunity offers. With every successive act of the kind, the
impression on the nerve cells becomes deeper and more indelible
and the habit fixed the more firmly.

In slight recent cases in the milder dispositions the vice may
be overcome by some resort which engages and engrosses the
animal’s attention. Among these may be named tying a cord
round the root of the ear and tying it down; giving an inhala-
tion of ammonia or a sniff of powdered capsicum ; closing the
nostrils until the horse struggles to breathe ; blindfolding for a
few minutes; tying up one fore leg until thoroughly tired ; even
stroking the nose or ears until the fret is overcome. Immedi-
ately following on any one of these methods, move the horse
gently to the right and left and call him confidently to get up.
Some will start if gently tapped with the toe below the knee

30 Veterinary Medicine.

until the foot is lifted and repeating this a few times in succes-
sion, then, after a few steps, reward with an apple, sugar or
piece of bread, and don’t push too far at a time but repeat the
lesson often. If among the first exhibitions of the vice it
may be met by occupying the time in a make-believe fixing of
the harness until the animal ceases to fret, then standing by his
head, tap him on the croup with a whip and call him to go on.
Or he may first be moved to the right and left and then ordered
to move. A rather wearisome treatment is to place in the stall
with a man behind him who taps him on the rump every few
minutes, preventing composure, rest, or sleep, and keeping this
up without interval for twenty-four hours or even double that
time if necessary. If he goes well when hitched, he is driven
but if he balks, he is returned to the stall and the treatment con-
tinued. :

Magner, who mentions all these methods, reserves his highest
‘commendation for the method of tying the horse’s head round to
his tail and letting him turn in a circle until he is giddy and falls
over. Some stubborn cases get -habituated to turning in one
direction and continue obdurate until the head and tail are tied
around on the other side and the rotary motion reversed.
When thoroughly dazed by this treatment, the animal is hitched
up and will usually move on. If there is still an indisposition,
stand by his head and tap the croup with a whip, calling on him
to start. Or subject him to further rotary treatment.

, DELIRIUM.

A phenomenon in different morbid states ; cerebral hypereemia, aneemia,
congestion, inflammation, intoxication, toxin poisoning. Symptoms : horse,
ox, sheep, swine, dog. Treatment: adapted to primary disease present,
narcotic, poison, and to degree of violence. Anzesthetics, soporifics, cerebral
sedations, cold to head, eliminants, depletion or tonics and nutritious food.

Delirium or derangement of emotional or mental functions is
usually the result of organic disease of the brain and especially of
the cortical gray matter of the cerebrum. It is seen in hyperze-
mia, anemia, faults of nutrition, intoxications and variations of

Delirium. 31

temperature. The derangements of circulation may be in the
meninges or in the nervous substance. ‘The intoxications may
be with mineral (lead, mercury), vegetable (opium, Indian hemp,
belladonna, -hyoscyamus, stramonium, strychnia), or other
poisons, including the toxic products of microbes (as in pneu-
monia, scalma, rabies, influenza, Rinderpest, milk sickness,
Texas fever, etc. ).

Symptoms. ‘These are usually an extraordinary and disorderly
nervous excitement. Horses take expectant or ready positions
of the limbs, plunge with feet in rack or manger, rear, turn, kick,
bite, spring violently, neigh, and push or knock the head against
the wall. Cattle bellow in a loud or frightened manner, attempt
to kick and gore, grind the teeth and make movements of the
jaws, froth at the mouth, dash themselves in any direction heed-
less of obstacles, push the head against the wall breaking teeth or
horns, and moving heedlessly against fences, or trees, or into
water or pits even to their own destruction. Sheep stamp the
feet, butt, bleat, work the jaws, grind the teeth, leap, and move in
a given direction regardless of obstacles. Pigs grunt, tremble,
champ the jaws, run against obstacles, scratch the ground with
their feet or snout and creep under the litter. They may even
attempt to bite. Dogs are restless, whine, moveina circle, snap
at straw, bars, doors, and other objects, and may show a disposi-
tion to bite. In all the domestic animals these delirious symp-
toms may closely resemble those of rabies. This has been par-
ticularly noticed in certain forms of poisoning. Pascault has
found this in cattle that had eaten garlic and Cadeac in dogs that
had eaten tansy.

The animals in such cases become morbid, dull, taciturn, they
become usually hypersensitive, sometimes hyposensitive, have a
change of voice, and show a readiness to resent and bite if inter-
fered with, and even to wander away by themselves as in rabies.
On the other hand they may be siezed with lethargy and torpor
as in dumb rabies, and with or without access of convulsions may
pass away in a condition of paralysis.

Among other conditions these symptoms have been found to be
associated with epilepsy, foreign bodies in the pharynx, gullet,
stomach or bowels, with intestinal parasites, or with mycotic
poisoning (ergotism, smut, the fungus of coniferous trees, etc. ).

32 Veterinary Medicine.

The lack of the extreme hyperesthesia and excitability of
rabies, and usually of the mischievous disposition to bite, the
presence of foreign bodies in the mouth or gullet, and the evi-
dence of disorder of digestion, with costiveness, tympany, and
tenderness, and the history of the case may serve to differentiate.
In cases of doubt the innoculation of a rabbit on the brain should
demonstrate the absence of rabies by the absence of the charac-
teristic symptoms after sixteen days.

Treatment. As delirium in animals is a deranged innervation
from congestion, narcotic drugs, ptomaines, etc., it must be
looked on as in most cases a mere phenomenon, pointing to a
definite disease, or to a particular intoxication, and treatment
must be directed toward the removal of the primary cause. Thus
the remedial measures must be directed in the different cases to
the encephalitis, meningitis, digestive disorders, contagious dis-
ease, or drug to which the affection may be traced. ‘The patient
must be put in a strong inclosure or securely tied so that he can
do no harm: it will often be desirable to secure shade or cool air,
or to apply cold water or ice to the head, and to quiet the nervous:
excitement by inhalations of chloroform, or ether, rectal injec-
tions of chloral, or bromides, or full doses of hyoscine, sulphonal,
trional or tetronal. These may be pushed to the extent of induc-
ting anzesthesia, sleepor quiet, as the case may be, and meanwhile
other measures should be taken to eliminate the poisons, correct
the congestion, or remove the source of irritation. Anemic
cases may demand iron and bitters, with an aliment rich and
easily assimilated, while plethoric cases may require purgation,
diuresis or even bloodletting. All noise and any cause of excite-
ment must be carefully guarded against.

VICIOUSNESS. AGRESSIVE VICE.

Subject maliciously using its natural weapons. Horse kicks, bites, crowds
against wall, rears, bucks, plunges, treads upon. Cattle use horns or fore-
head, or kick. Dog bites. Cats scratch and bite. Ticklishness different,
Developed or inherited. Revenge. Desperation in pain. Sexual. A
psychosis. Responsibility of owner, in selling, toward employe, in exposing
in a public place. Treatment: remove source of suffering, treat kindly,
secure confidence, castrate, place under absolute constraint, throw a la
Rarey, Comanche bridle, tie head to tail and circle, etc.

This word is employed to cover only those forms of vice in
which the animal shows a malignant disposition to attack or in-
jure man or beast. Each animal usesits natural weapons accord-
ing to the occasion.

The horse strikes with his fore feet, kicks with his hind, bites,
crowds his rider’s legs against a wall, or his attendants’ body against
the side of the stall, rears; bucks, plunges, or treads his victim
under his feet.

The ruminants, large and small, use their horns, and cattle
their feet as well. In the absence of horns they still use the fore-
head, but much less effectively and usually only with the purpose
of defence.

The dog attacks with his teeth and the cat with her claws by

* preference, and uses the teeth as a secondary weapon.

Swine use their tusks to rip or disembowel their adversary or
victim.

A very ticklish horse cannot bear to be touched on the flank or
hind parts, without throwing the ear backward, glancing back,
showing the white of the eye, and lifting the foot. But if this
is mere excess of sensitiveness and begets no disposition to kick
it is not viciousness.

The vicious horse will in such cases bite or kick repeatedly and
with well directed purpose. He will moreover show the move-
ments of ears and eyes and attack his victim in the absence of
any such excuse, the simple approach being a sufficient occasion.
He will bite and strike with the fore feet at the same time, or he
may strike out with one hind foot or with bothat once. Hemay

3 33

34 Veterinary Medicine.

attack indiscriminately all who approach him, or reserve his ill-
will for particular individuals, and then he often acts under a
feeling of revenge for ill-usage from this individual or some one
he conceives him to represent.

In some cases viciousness is inherited and certain families have
a bad reputation in this respect. It may be either a survival of
the: ancestral disposition of the wild horse, or it may be a trait
developed by ill-usage of a team of more immediate ancestors.

In other cases the habit is acquired by the individual himself,
and in such cases it may be due to brutal treatment at the ‘hands
of man; to a continuous punishment of a high-spitited horse
leading to resentment and retaliation; to acute pain in boils,
abrasions or other sores in the root of the mane, or the shoulder,
or the back, where pressed on by the collar or saddle; or to the
generative excitement of mares in feat. In many such cases the
vice lasts only during the persistence of the cause, in others it
becomes permanent. ‘The stallion is much more disposed to
aggressive vice than the gelding.

Whether we may consider the vice a disease or not, it becomes
a habit engrained in the nature, the nerve centres tending to re-
produce their habitual acts indefinitely, so that we may look on
the condition as a psychosis which is too often incurable.

Responsibility of the owner. Dangerous aggressive vice is
too self-evident to the buyer to constitute a good cause for an-
nulling a sale, but it has this legal bearing, that the owner who
keeps an animal known to be vicious, renders himself responsible
for whatever injury to man or beast he may perpetrate. Thus
the vicious stallion, bull or dog in a public place which damages
person or property, renders his owner liable to the extent of such
damages. This, of course, must be largely qualified by the at-
tendant circumstances. The man employed to take care of a
horse, knows his babits as fully as the owner, takes his chances
and should exercise due precautions to avoid danger. TYhe per-
son who enters a stall carelessly without speaking to the horse,
seeing that he stands over, or otherwise responds to his call, is
himself to blame if he gets kicked. The attendant who does
things to a dangerous or questionable horse for mere bravado
cannot blame the owner if he gets himself injured. If a person
teases a horse so as to tempt him to retaliate, not only is he re-

Victousness. Aggressive Vice. 35

sponsible for his own consequent injuries, but largely also for
the habits of the horse and for such injuries as others may sub-
sequently sustain from him.

A dog or a bull shown in a public place, and which breaks
loose and injures spéctators or others, manifestly renders his
master responsible for all such damage.

Treatment of aggressive vice. In mild dispositions in which
the vice is roused by temporary suffering, it may often be cured
by removal of the cause of such suffering. Indeed, without the
healing of sores under the collar or saddle the vice cannot be ar-
rested. Considerate and gentle treatment, too, will go far to re-
store confidence and to gradually do away with the aggressive
disposition.

In wicked stallions castration will usually restore to a good
measure of docility. The exceptional cases appear to be those
that are hereditarily and constitutionally vicious, or in which the
habit has been thoroughly developed and firmly fixed by long
practice.

Mares, too, which become vicious and dangerous at each re-
currence of cestrum, can usually be completely cured by the re-
moval of the ovaries especially if this is done early in the disease.

The inveterate cases may usually be subdued and rendered
controllable for a time by one of the methods of subjugation em-
ployed by the professional tamers, but unless they are thereafter
kept in good hands they are liable to relapse into the old habit.
Among the more effective methods are the Rarey mode of throw-
ing which may be repeated again and again until the animal is
thoroughly impressed with a sense of the domination of man and
the futility of resistance ; the resort of tying the head and tail
closely together and letting the animal weary and daze himself
by turning in a circle, first to one side and then to the other;
the application of the Comanche bridle made of a small rope, one
loop of which is passed through the mouth and back of the ears
and drawn tightly, then another loop is made to encircle the
lower jaw, and the chin is drawn in against the trachea by
passing the free end of the rope round the upper part of the neck
and again through the loop encircling the lower jaw and draw-
ing it tight ; or a similar small rope is passed a number of times
through the mouth and back of the ears and drawn tightly so as

36 Veterinary Medicine.

to compress the medulla and stupefy the animal. This is supposed .
to be rendered more effective by passing one turn each between.
the upper lip and gums and between the lower lip and the gums.

CATALEPSY.

Definition. Tetanic and paralytic forms. Balance of flexors and extensors

Cataleptoid. No constant lesion. Hysterical. Hypnotic. Subjects ; horse, ox,
wolf, cat, chicken, Guineapig, snake, frog, crayfish. Causcs: strong mental
impression, Indigestion, etc, in susceptible system. Lesion : inconstant,
muscular degeneration, etc. Symptoms: wax like retention of position
given, voluntary movement in abeyance, mental functions impaired, secre-
tions altered. Duration andfrequency variable. Treatment: shock ; cold ;
‘ammonia, pepper, snuff, electricity, amyle nitrite, nitro-glycerine, apomor-
phine, bromides, purgatives, bitters, iron, zinc, silver, open air exercise.

Definition. Thisis a functional nervous disorder, characterized
by paroxysms of impaired or perverted consciousness, diminished
sensibility, and above all a condition of muscular rigidity, by
means of which the whole body, or it may be but one or more
limbs retain any position in which they may be placed.

Laycock describes two forms in man—the catochus or tetanic
form, and the paralytic form. Mills would restrict the name cat-
alepsy to cases in which the muscular tone is such that the affect-
ed part may be bent or moulded like wax or a leaden pipe, and
will not vary from this.when left alone. Other forms in which
this waxen flexibility (flexibilitas cerea) is absent or imperfect
he would designate as catalepoid.

The disease is not associated with any constant cerebral lesion,
though it may supervene in the course of other nervous disorders,
and therefore may own an exciting cause in existing lesions of
the brain. The immediate cause must however be held to be
functional, and this is in keeping with its most common form in
man (hysterical), and with the hypnotic form which is observed
both in man and animals. This latter may be looked on as
a form of induced or hypnotic sleep, in which the retention of the
position given toa limb or part is the most prominent symptom.
In all cases there is an impaired condition of the sensory func-
tions of the cerebral convolutions, and an insusceptibility of the
motor centres to the control of the will, or the reflex stimulus.

F Catalepsy. ae

Hering has recorded the disease in the horse, Landel in the ox,
and Leisering in the prairie wolf. The hypnotic form has been
shown in cats, chickens, and Guinea pigs. The serpent charm-
ing of the Indian dervishes and similar effects on frogs and cray-
fish have been attributed to hypnotic catalepsy.

Causes. Strong mental emotions and diseases which pro-
foundly affect the nervous system have been adduced as causes
(fear, excitement, chills). Indigestible food has even been
charged with causing it. There is undoubtedly, to begin with
a specially susceptible nervous system, and hence it is liable to-
prove hereditary, and in man to appear as a form of hysteria, or
to alternate in the same family with epilepsy, chorea, alcoholism,
opium addiction and other neurosis.

Hypnotism as a cause is claimed by various writers. Azam
says that in the fairs in the South of France, jugglers hypnotize
cocks by placing the bill on a board, on which they trace a black
line passing between the two feet of the bird. Cadeac adds that
Father Kircher, in the 17th century, employed a similar method
to put fowls to sleep. Alix put cats to sleep by securing them
firmly, and then looking steadily into their eyes. ‘The condition
attained varies according to the degree of the sleep, the will being
dominated first, and later, consciousness of external objects is
lost. Hypnotism, however, appears to be difficult and uncertain
in the lower animals, in keeping with the limited development of
intelligence and will, as compared with the human being. Cadeac
states that the very old and the very young are completely refrac-
tory to hypnotizing influences. P ,

Lesions. No constant pathological changes are found, though
different nervous lesions may serve to rouse the disease in a pre-
disposed subject. Frohner found in the affected muscles granu-
lar swelling, fatty degeneration, haemorrhages, and waxy (amy-
loid) degeneration of the cardiac muscles, corresponding to what
has been found in tetanus ; also haemorrhages on the stomach.
and intestines.

Symptoms. The leading objective symptom is the tonic con-
dition of the muscles by which a perfect balance is established and
maintained between the flexors and extensors so that the affected
part maintains the same position which it had when the attack.
began, or any other position which may be given to it during the

38 : Veterinary Medicine.

progress of the paroxysm. The position is only changed when
the muscles involved have become completely exhausted. Dur-
ing the attack the affected muscles are swollen and firm, so that
their outline may often be traced through the skin, later as the
attack subsides they become soft and flaccid. Voluntary move-
ment of .the affected muscles is impossible until after the
paroxysm. ‘The attack usually comes on suddenly and in this
respect resembles epilepsy ; at other times there are premonitory
symptoms of nervous anxiety, excitement or irritability. There
is-usually considerable impairment of consciousness, intelligence,
common sensation, and even of the special senses. Ina cataleptic
dog Frohner noted mental and motor troubles, considerable
anzesthesia, and loss of sight, smell, and hearing. ‘The eyes are
fixed, the pupils either contracted or dilated, and the urine
passed may be albuminous or even icteric.

Course, Duration. WLike other functional nervous disorders
this is extremely uncertain in its progress. There may be but
one attack or a succession ; they may last from a few minutes,
to 7 days (Frohner), or even several weeks (Hertwig); they
may end in recovery or less frequently they may prove fatal
usually by inanition.

Treatment. During a seizure a sudden shock will sometimes
cut short the attack, douching with cold water, an inhalation of
ammonia, of capsicum or of snuff, or the application of electricity
in an interrupted current through the spine and affected muscles.
Ether anzesthesia will not always relax (Sinkler). Inhalation
of a few drops of nitrite of amyle has proved effective in man, as
has also the injection subcutem of three drops of a 1 per cent.
solution of nitro-glycerine; apomorphine hypodermically is
usually effective (Sinkler). Bromide of potassium has also been.
advised, and in case of coldness of the surface, a warm bath.

When there is overloaded stomach and gastric indigestion an
emetic is indicated, and in constipation a purgative (for speedy
action chloride of barium or physostigma subcutem).

In the intervals between attacks tonics and general hygiene
should be invoked to build up the weakened nervous system.
Quinine, and salts of iron, zinc or silver with a nourishing diet
and out door exercise are especially indicated.

INSOLATION. HEAT EXHAUSTION. SUNSTROKE.
THERMIC FEVER.

Definition : two forms. Heat exhaustion. Causes: prolonged heat.
and moisture, overexertion. Impaired vaso-motor centre. Failing heart,
Carbon dioxide poisoning. Symptoms : weak, fluttering pulse, perspiration,
muscles flaccid, prostration, no hyperthermia. Treatment: stimulant, digi-
talis, digitalin, subcutem, nitroglycerine, warm baths. Thermic fever.
Hyperthermiaexcessive. Causes : insolation, prolonged heat and impure air,
furnace heat, moist and dry heat, electric tension, overwork, muscular ex-
haustion, coagulation of myosin, constant heat on one part (head), excess of
carbon dioxide, stiffening of bodies when killed in hot weather, debility,
weakness, fatigue, chest constriction, tight girths or collars, short bearing
reins, plethora, obesity, open cars and yards, fever, privation of water, heavy
fleece. Lesions: right heart and systemic veins full, blood black fluid or
diffluent, left ventricle empty, congested meninges, effusions in or on brain,
or hemorrhages. Symptoms: horse: dull, stupid, stubs toes, sways quar-
ters, droops head, hangs on bit, props on feet, breathes rapidly, pants, stertor,
dilated nostrils, gasping, fixed eyes, dilated pupils, tumultuous heartbeats:
gorged veins, epistaxis, perspiration, convulsions ; ox: parallel symptoms ;
sheep : open mouth, stertor, fixed eyes, pupils dilated, panting, swaying,
fall, convulsions ; dog : dull, prostrate, pants, congested veins and mucose,.
weakness, spasms, syncope, speedy rigor mortis. Overheating. Diagnosis :
early excessive hyperthermia, venous congestion, shallow panting breathing,
violent heart action, loss of sensory and motor functions, convulsions.
Prevention : avoid violent, prolonged heat, and exertion, especially in case
of fat animals or those new to hot climate, keep emunctories acting, shade
head, water on head and to drink, protect fat cattle, shear sheep, water.
Treatment : shade and laxatives ; if severe, cold water from hose, ice bags
to poll, rub legs, acetanilid subcutem, stimulant enemata, later mineral
tonics, iron or zinc.

Definition. A morbid condition produced by the exposure to
extreme heat, and marked by profound disorder of the vaso-
motor and heat centres.

The single term of sun-stroke or heat-stroke has been replaced
by two,—heat exhaustion and sun-stroke, indicating two dis-
tinct conditions, brought about by exposure to heat and mani-
fested by different states of the body and distinctive symptoms.

Heat Exhaustion.

This appears as an exaggerated form of the general sense of
relaxation, weakness and languor which follows on prolonged

39

40 Veterinary Medicine.

violent exertion in a hot atmosphere. ‘There is more or less im-
pairment of the vaso-motor nerve centre in the medulla, relaxa-
tion of the capillary system, and flagging of the heart’s action,
which loses its customary stimulus, by reason of the defective
supply of blood-returned by the veins. This may become so ex-
treme that the patient dies by syncope. In other cases the
paresis is mainly shown in the vaso-motor system, and its centres
in the medulla, the blood is delayed in the distended capillaries
and veins, it becomes overcharged with carbon dioxide, the
heart’s action is accelerated and feeble, the pulse rapid, weak
and fluttering, perspiration breaks out on the skin, and the tem-
perature is normal or subnormal. ‘The muscular weakness, the
flaccid condition of the facial muscles, and general depression
suggest a state of collapse. This condition is not necessarily due
to exposure to the intensity of the sun’s rays, but may come on
in animals subjected for a length of time to artificial heat, and
especially if the air is impure, and if the subject has to undergo
severe physical exertion. :

Treatment, In slight cases of this kind a stimulant is usually
desired and ammonium carbonate in bolus or solution will
usually serve a good purpose. In its absence alcohol or spirits
of nitrous ether may be given. Digitalis is of great value in
sustaining the flagging action of the heart and has the advantage
that as digitalin it can be given hypodermically when it is im-
possible to give ammonia, alcohol or ether by the mouth. For
the same reason nitro-glycerine may be resorted to, or even
atropia as a vaso-motor stimulant. Active friction of the body
and limbs will aid circulation and indirectly stimulate the heart,
and in case of subnormal temperature it may be supplemented
by a warm bath in the smaller animals, kept up until the normal
temperature in the rectum has been restored.

Thermic Fever. Sun-stroke,

This is readily distinguished from heat exhaustion by the pre-
dominance of the hyperthermia. While in heat exhaustion
the temperature is usually subnormal, in sun-stroke it is exces-
sive, (108°-—113° F.). |

Causes, The immediate cause of sunstroke is exposure to
undue heat, but this need not be the heat of the sun’s rays direct.

Insolation. Sun-stroke. Thermic Fever. 4I

A large proportion of cases in the human subject are attacked
during the night, and again at sea where an attack in a passenger
is practically unknown, it is terribly common among stokers
working in a close atmosphere of 100° to 150° F.

The attendant conditions have much influence in determining
an attack, thus it is generally held that heat with excess of moist-
ure is the most injurious, yet in Cincinnati, statistics showed a
greater number of cases in man when the air was dry. The sup-
pression of perspiration and the arrest of cooling by evaporation
in the latter case would tend to a rapid increase of the body tem-
perature, and the condition would be aggravated by the electric
tension usually present with the dry air. With the hot, moist air,
perspiration might continue, but evaporation would be hindered,
and there would be arrest of the cooling process and an extreme
relaxation of the system. ,

Again, it is usually found that seizures take place during or
after hard muscular exertion in a hot period, and much importance
is attached to the attendant exhaustion, the excess of muscular
waste, and the alteration of the myosin, which latter coagulates
at a lower temperature in the over-worked animal. But on the
other hand, experiment shows that the animal confined to abso-
lute inactivity in the hot sunshine or in a high temperature (at
go0°), dies in a few hours, whereas another animal left at liberty
in the same temperature does not suffer materially. The explana-
tion appears to be that the dog, kept absolutely still, has the contin-
uous action of the heat on the same parts and on the same blood,
for the capillaries dilate, and the blood is delayed, overheated,
and surcharged with carbon dioxide, and the result is either syn-
cope from heart failure, or asphyxia from excessive carbonization
ofthe blood. Back of these and concurring with them is the par-
alysis of the vaso-motor and heat generating nerve centres, from
the high temperature or the condition of the blood.

The excessive carbonization of the blood deserves another word.
The prolonged contact of the blood and air in the lungs is essen-
tial to the free interchange of oxygen and carbon dioxide. Vie-
rordt showed that with sixty respirations per minute the expired
air became charged with but 2.4 per cent. of this gas, whereas
with fourteen respirations it contained 4.34 per cent. Therefore,
with violent muscular work (which charges the blood with carbon

42 Veterinary Medicine.

dioxide) and rapid breathing (which fails to secure its elimina-
tion), the over-driven animal soon perishes from asphyxia. Un-
der a high temperature of the external air, this condition is aggra-
vated since the rarified air contains just so much the less oxygen,
the absorption of which is the measure of the exhalation of car-
bon dioxide. .

Dr. H. C. Wood, who has experimented largely on the subject
in animals, finds the cause of heart failure in the coagulation of
the myosin, which takes place under ordinary circumstances at
115° F., but at a much lower temperature when a muscle has been
in great activity immediately beforedeath. As the temperature
of thermic fever frequently reaches 113°, or even higher, he easily
accounts for the sudden syncope occurring during active. work in
a high temperature. As an example of such sudden rigor, he ad-
duces the sudden stiffening of the bodies of some soldiers killed
in battle during hot weather.

Wood further shows that all the symptoms of thermic fever can
be produced in the rabbit by concentrating the temperature onits
head, which seems to imply a direct action on the brain and in par-
ticular on the heat producing and vaso-motor centres. This becomes
the more reasonable that the temperature attained does not im-
pair the vitality of the blood but, leaves the leucocytes possessed
of their amceboid motion. He found, moreover, that if the heat
were withdrawn before it has produced permanent injury to the
nervous system, blood or other tissues, the convulsions and un-
cousciousness are immediately relieved and the animal recovers.

Other conditions may be adduced as predisposing or concurrent
causes of thermic fever. Whatever impairs the animal vigor has
this effect. Fatigue, as already noticed, is a potent factor, in
man a drinking habit; in all animals a long persistence of the
heat during the night as well as the day ; impure air in badly
ventilated buildings ; and mechanical restriction on the freedom
ofbreathing. Inmilitary barracks with the daily temperature at
118° F. and the night temperature 105, the mortality became ex-
treme, and in close city car stables the proportion of sun-strokesis
enhanced. Inall such cases, the air becomes necessarily more
and more impure continually. The atmosphere has the same
heat as the animal body, so that no upward current from the lat-
ter can be established, to create a diffusion. ‘The carbon dioxide

Insolation. Sun-stroke. Thermic Fever. 43

and other emanations from the lungs, the exhalations from the
skin, dung and urine, accumulate in the air immediately sur-
rounding the animal and respiration becomes increasingly imper-
fect and difficult. This condition is further aggravated by the
accumulation of the animal heat in the body. ‘The blood circu-
lating in the skin can no longer be cooled, to return with refrig-
erating effect on the interior of the body, the cooling that would
come from the evaporation of sweat is obviated by the suppres-
sion of that secretion, as well as by the saturation of the zone of
air immediately surrounding the body, and thus the tendency is
to a steady increase of the body temperature until the limit of
viability has been passed.

‘The mechanical restriction of respiration should not be over-
looked. In European soldiers landed in India and marched in
the tight woolen clothing and close stocks a high mortality has
been induced and in horses with tight girths or collars and short °
bearing reins, and oxen working in collars a similar result is ob-
served. Any condition of fever is a potent predisposing factor.

Horses or cattle that are put to violent or continued exertion
when too fat or out of condition are especially subject to sun-
stroke. Fat cattle driven to market under a hot sun, or shipped
by rail, crowded in a car and delayed on a siding under a hot sun,
with no circulation of air, often have insolation in its most violent
form. ‘The same may be seen ‘in the hot stockyard, with a still
atmosphere and the fat animals subjected to the fnll blaze of a
July sun. The chafed feet caused by travel, and the muscular
weariness caused by standing in the moving car are material ad-
ditions to the danger.

Similarly horses suffer on the race track when subjected to
protracted and severe work in hot weather, or again dragging
loads in a heated street under a vertical sun, or on a side hill,
with the sun’s rays striking perpendicularly to its surface.

A change in latitude has a decided effect, the Northern horse
suffering much more frequently than the one which is native to
the Southern States and which has inherited the habit of heat
endurance.

Finally faults in feeding and above all watering are appreciable
factors. ‘The privation of water in particular is to be dreaded.
Tracy in his experience with American soldiers in Arizona found

44 Veterinary Medicine.

that the command could usually be guarded against sun stroke
when a supply of water was kept on hand. It should be used
guardedly, but nothing would act better in obviating an attack.
On the other hand, when the canteens were empty, under the
hot sun the seizures increased disastrously.

Sheep are especially liable to suffer from-heat by reason of
their dense fleece, which hinders the evaporation of perspira-
tion, and the cooling effect of air on the skin. When the
temperature rises, respiration is accelerated and panting, the
lungs seeking to supplement the work of the skin. When
traveling in a heavy fleece, or in the hot sunshine in July or
August sun stroke is not uncommon among them.

Lesions, Among the lesions may be named, vacuity of the
left ventricle and fullness of the right ventricle and veins with
fluid blood or a diffluent clot; congestion of the pia or dura
‘ mater, effusion into the ventricles, hemorrhages into the sub-
serous tissues, and degeneration of the muscles.

Symptoms. Worse. When premonitory symptoms are ob-
served the animal fails to respond to whip or voice, lessens his
pace, stubs with his fore feet and sways with the hind, depresses
his head and hangs heavily on the bit.

Too often these are omitted or overlooked, and the horse sud-
denly stops, props himself on his four limbs, drops and extends
the head, breathes with great rapidity, panting and even stertor,
dilates the nostrils widely, retracts the angle of the mouth and
even gapes, has the eyes fixed, the pupils dilated and the beats
of the heart tumultuous. The superficial veins are distended, the
visible mucosze congested with dark blood, and blood may escape
from the nose. Perspiration usually sets in.

_ The animal may fall and die in a few minutes in convulsions,
or, if stopped sufficiently early and suitably treated, he may in a’
measure recover in 15 to 20 minutes.

Symptoms. Ox. The premonitory symptoms are like those
in the horse: dullness, rapid panting, breathing, the mouth is
opened and the pendent tongue is covered with frothy saliva, a
frothy mucus escapes from the nose, the eyes are congested and
fixed, the pupils dilated, the nostrils and flanks work laboriously,
the heart palpitates, the animal sways or staggers and falls.
Death follows in convulsions, or it may be delayed, the animal

Lnsolation. Sun-stroke. Thermic Fever. 45-

struggling ineffectually to rise, or having periods of comparative
quiet. The rectal temperature is very high, 107° to 114° F. If
able to stand, there is usually blindness and heedlessness of sur-
rounding objects.

Symptoms. Sheep. The open mouth, protruding tongue,
frothy saliva, reddened fixed eyes, rapid breathing, beating
flanks, stertor, and unsteady gait are characteristic when taken
along with the manifest causes. Swaying movements followed
by a sudden fall and death in convulsions form the usual termina-
tion of the disease.

Symptoms. Dog. These have been mainly produced experi-
mentally and consisted in hyperthermia, dullness, prostration,
accelerated breathing and heart action, congested veins, and
mucosz, muscular weakness, convulsions, and syncope or as-
phyxia. After death the muscles became speedily rigid, and
the blood accumulated in the venous system, was fluid or only
loosely coagulated. In these animals, if the experiment were
stopped in time the animal could be restored to health.

Slighter cases may occur in the different animals, more partic-.
ularly from overdriving in hot weather, and in such cases the
overheated animal recovers, but there is liable to remain a special
sensitiveness to excessive heat and a tendency to be dull, sluggish
and short winded, to hang the head in hot weather, and to seek
shelter from the direct rays of the sun.

Diagnosis is largely based on the suddeness of the attack, on
the occurrence of high temperature before the seizure, not after as
it is liable to be, if at all, in apoplexy, on the dark congestion of
the mucosze, and of the venous system, on the rapidity and shal-
Jowness of the respirations, on the tumultous action of the heart,
and on the general loss of sensory and especially of motor func-
tion, in circumstances calculated to induce sunstroke. Localized
paralysis or spasm would suggest the formation of a cerebral ef-
fusion or clot.

Prevention. ‘This will depend on the class of animal and its
conditions of life and work. In horses care should be taken
to regulate the work by the heat of the season and condition of
the animal. When the temperature ranges from 80° to 100° F.
the work should be lessened and every attention should be given
to maintain the healthy functions (bowels, kidneys, skin) in good

46 Veterinary Medicine.

working condition. If the horse is young, fat, or out of condi-
tion from idleness or accumulation of fat he must have the
greater consideration. So it is with a horse recently come froma
colder latitude, and with a heavy draught horse that may be
called on to do rapid work. Some protection is secured by wear-
ing a sunshade or wet sponge over the poll, and much may be
expected from an occasional rest in the shade, a swallow of cool
water and sponging of the head. :

Very heavy fat cattle should not be driven far nor shipped on
the hottest days, and the packed car should not be left in the
full sunshine in a still atmosphere. Yards with sheds under
which they can retreat must be secured if possible.

The heavily fleeced sheep must have equal care and the pastures
for fat sheep and cattle should have available shade in form of
trees, walls or sheds. Access to water is an important condition.

Treatment. In slight cases (overheated) a few days of rest,
under an awning rather than in a close stable, with a restricted
and laxative diet.

In severe thermic fever the first consideration is to lower tem-
perature. If available turn a hose on the head, neck and entire
body for five or ten miautes, or until the rectal temperature ap-
proaches the normal. In the absence of such a water supply,
dash cold water from a well on the body but especially the head
and neck, and if available tie a bag of ice around the poll. Active
friction to the legs and body is often of great advantage. A large
dose of antipyrin or acetanilid may be given hypodermically. On
the other hand stimulants, and especially carbonate of ammonia,
or sweet spirits of nitre may be given as an enema. This may
be repeated in an hour in case the pulse fails to acquire force and
tone.

Should the temperature rise again later it may often be kept in
check by cold sponging and scraping followed by rubbing till
dry.

In case of continued elevation of temperature, with heat of the
head, and perversion of sensory or motor functions, meningitis
may be suspected and appropriate treatment adopted.

For the prostration and weakness that is liable to follow therm-
ic fever, mineral tonics such as the salts of iron or zinc may be
resorted to.

EPILEPSY. FALLING SICKNESS.

Definition. Frequency. Susceptibility: dogs, pigs, cattle, horses, par-
rots, sparrows. Divisions: slight and severe ; Jacksonian (partial) ; sympto-
matic ; idiopathic. Lesions ; inconstant ; of brain, cranium, cerebral circu-
lation, myelon, poisons in blood, dentition, cortical and ganglionic lesions,
cerebral asymmetry, stenosis of vertebral canal. Medullar asymmetry.
traumas of cranium, anzemia, bleeding, carotid ligation, spinal reflexes,
irritation of the skin, creatinin, cinchonoidin, lead, ergot, nitropentan,
nitro-benzo], ptomaines, toxins, parasites, nerve lesions, local hyperzesthesia
(withers of horse, recurrent ophthalmia), indigestion, constipation, sciatic’
neuritis. Causes: nervous predisposition, heredity (man, cat, dog, ox),
sexual excitement, fear, sudden strong, visual impression, uric acid in
blood, meat diet. Symptoms: horse, sudden seizure, bracing feet and
limbs, swaying, fall, convulsive rigidity, jaws working or clenched, eyes
rolling, salivation, stertor, dyspnoea, sensation absent. Duration. Symp-
toms of localized epilepsy. Cattle, bellow, stertor, rolling eyes, jerking
rigidity, fall. Sheep. Swine. Premonitory malaise, jerking, champing
jaws, fall, trembling, rigidity, involuntary discharges. Dog: trembles,
cries, falls, rigidity, clonic contractions, stertor, sequele. Diagnosis:
sudden attack, unconsciousness, spasms, quick recovery, no spasms in
syncope, vertigo has no spasms, thrombosis has symptoms developed by ex-
ercise. Jurisprudence : animal returnable after twenty-eight days (Wurten-
berg, etc.), thirty days (France). Treatment: of susceptible brain, and
peripheral irritant. Correct all irritation or disease, or expel parasites.
Nerve sedations : bromides, opium, valerian, belladonna, hyoscine, duboi-
sine. Tonics: zinc, arsenic, silver, baths, electricity. Borax. Vegetable
diet. Castration. Avoidance of excitement. Surgical operations. Tre-
phining. Excision of cortex. Outdoor life. During a fit: amyle nitrite,
chloroform, ether, chloral, warm hath, cold or warmth to head, quiet se-
cluded place.

Epilepsy is the name given to a class of cases characterized by
a sudden and transient loss of consciousness with a convulsive
seizure, partial or general. It appears to be due to a sudden ex-
plosive discharge of convulsive nervous energy, which may be
generated by a great number of causes of morbid irritation—
pathological, traumatic, or toxic. As a rule the epileptic seizure
is but the symptomatic expression of a complex derangement
which may be extremely varied as to its nature and origin.

Frequency in different animals. ‘The affection is far less fre-
quent in the domestic animals than in man, doubtless because of

47

48 Veterinary Medicine.

the absence of the special susceptibility which attends on the
more highly specialized brain, the disturbing conditions of civ-
ilization, and the attendant vices.

Among domestic animals, dogs are the most frequent victims
in keeping with their relatively large cerebral development, their
emotional and impressionable nature and the unnatural and arti-
ficial conditions in which as house pets they are often kept.
Their animal food and the consequent uric acid diathesis is a
probable cause, as it isin man. In ten years of the dog clinic at
Alfort they made an average of 3 per cent. of all cases. Next to
the dog the pig kept in confinement is the most frequent victim,
while cattle and horses come last. At the Alfort clinic epileptic
horses were not more than I per 1000 patients. It is not at all °
unfrequent in birds, especially canaries and parrots. Reynal
has seen it in sparrows.

Divisions, The disease has long been divided into petit mal
and grand mal (haut mal). The petit mal (slight attack) is
usually a transient seizure affecting a group of muscles only and
associated with only a momentary or very transient loss of con-
sciousness. The loss of consciousness is uncertain in many
cases. Under partial epilepsies must be included the hemi-
epilepsy, or Jacksonian epilepsy, which is confined to one side of
the body.

The grand mal (severe attack) is one in which the loss of
consciousness is complete, and the convulsions are general in the
muscles of animal life.

Another division is into symptomatic and idiopathic cases,
and if this distinction could always be made it would be of im-
mense value in the matters of prognosis and treatment as the re-
moval of the morbid state of which epilepsy is the symptom will
usually restore the patient to health. Thus the removal of
worms from the alimentary canal, of indigestible matters from
the stomach, of a depressed bone or tumor from the surface of
the brain may in different cases be the essential condition of a
successful treatment.

Morbid Anatomy and Pathology. ‘The literature of epilepsy is
very rich and extensive and yet no constant lesions of the ner-
vous system can be fixed on as the local cause of the disease. A
review of the whole literature leads rather to the conclusion that

Epilepsy. Falling Sickness. 49

irritations coming from lesions of the most varied kind, acting on
a specially susceptible brain will rouse the cerebral centres to an
epileptic explosion. Thus epilepsy has been found to be asso-
ciated with lesions of the following kinds :

1st. Brain lesions of almost every kind, including malformations.

2nd. Lesions of the walls of the cranium.

3d. Disorders of the cerebral circulation.

4th. Lesions of the spinal cord.

5th. Morbid states of the circulating blood (excess of urea,
uric acid, creatinin, lead poisoning. )

6th. Reflected irritation, as from dentition, worms, sexual ex-
cesses, injuries to certain nerves, notably the sciatic, or to par-
ticular parts of the skin.

ist. Brain lesions. Those which affect the medulla and the
cortical convolutions around the fissure of Rolando would be ex-
pected to be implicated because these centres preside over the
principal motor actions of the body and limbs. Vet though
these parts are found to be affected with various morbid lesions
in a certain number of cases of epilepsy, such lesions are ex-
ceptional, rather than the rule. In 20 cases of epilepsy in man,
15 showed no lesion whatever of the brain. Blocq and Marinesco,
pupils of Charcot, recently made a critical examination of the
medulla and Rolandic cortex in nine cases that died during the
fit. All showed granular bodies (degenerated myelin or blood
pigment) in the perivascular sheaths but they found these in dis-
seminated sclerosis and even in healthy brainsas well. ‘T‘he neuro-
glia cells of the first cortical layer contained black granules.
Otherwise four cases had no change, while five showed sclerosis of
the cortex. ‘The medulla was sound in all cases excepting one
which showed punctiform hemorrhages. Visible lesions may be
present in other parts of the brain ; Wenzel long ago claimed
constant lesion of the pituitary body. Beside the cerebral cortex,
lesions have been found in the bulb, the hypoglossal nucleus,
the olivary body, the hippocampi, the thalamus, the corpus
striatum, the quadrigemini, the cerebellum, etc. Hughlings-
Jackson who made an extended investigation of the subject con-
cludes that any part of the gray matter of the encephalon may
become over-excitable and give rise to a convulsive attack. Not

4

50 Veterinary Medicine.

only may the lesion be in any part of the brain, but it may be of
any kind : meningitis, cerebritis, softening, tubercle, tumor, hy-
datid, embolism, or dropsy. Marie Bra found an extreme asym-
metry of the cerebral lobes in epileptics. Kussmaul and others
found stenosis of the vertebral canal and asymmetry of the two
lateral halves of the medulla.

and. Cranial lesions. These consist largely in blows or
falls upon the head, with ostitis, periostitis, fractures. with de-
pressions, fibrous neoplasia implicating or not the meninges and
pressing on the brain, hemorrhages from minute arteries, etc.
The diagnosis of such lesions will often open a way to a success-
ful treatment. Baker found most of the severe cases from head
injuries.

3d. Disorders of the cerebral circulation. Burrows,
Kussmaul and Turner showed that in animals, loss of conscious-
ness and epileptiform convulsions followed on cerebral anzemia
caused by profuse bleeding or by compression of the carotids.
The same has been observed in surgical cases after ligation of
one common carotid. Hermann caused convulsions in a rabbit
by ligating both anterior and posterior vene cave.

4th. Lesions ofthe Spinal Cord. Brown-Sequard determined
epileptiform convulsions by transverse section of one half of the
spinal cord, or of its superior, lateral or inferior columns. The
later development of the doctrine of interrupted spinal inhibition,
suggests that, many of the seizures in question are but exaggera-
ted spinal reflexes, which are no longer restrained by cerebral in-
hibition. ‘That all are not of this spurious kind may be fairly
inferred from his further demonstration that bruising of the great
sciatic in animals tended to produce epilepsy. In such cases the
irritation of certain areas by pinching the skin, served to produce
a seizure. Not only so, but the animals in which such artificial
epilepsy had been induced tended to transmit the infirmity to
their progeny. The prevailing view of epilepsy however, would
consider such lesions as sources of peripheral irritation by which
the brain is affected sympathetically, while the real explosion is
the result of the sudden discharge of the pent up excitement
caused in the encephalic centres by the irritation at such distant
points.

Epilepsy. Falling Sickness. 51

5th. Morbid States of the Circulating Blood. Certain
poisons, when brought in contact with encephalic nerve centres

produce epileptic seizures. Gallerani and Lussana applied
creatinin directly to the cerebral cortex and quickly induced
epileptiform convulsions and choreiform movements. Injected
subcutaneously it failed to produce the same effect. Cinchonoidin
acted on the basal ganglia of the brain producing convulsions
but no choreiform movement. Poisoning with lead, ergot, nitro-
pentan, nitro-benzol and a number of other poisons brings about
intermittent convulsive seizures. The same may be inferred of
ptomaines and toxins, in the convulsions that appear in the ad-
vanced stages of infectious diseases (canine distemper, hog
cholera, etc. ).

6th. Reflex Irritation. Perhaps no peripheral irritation
more frequently causes epilepsy, than parasites. In young dogs
worms in the intestines (teenia coenurus, teenia tenuicollis, tenia
serrata, taenia echinococcus, and ascarides) have been especially
incriminated. Also linguatula teenioides in the nasal sinuses. In
young pigs the echinorrhynchus gigas, ascarides and trichocepha-
lus. In horses ascarides havé been principally blamed.

Wounds implicating nerves, and tumors pressing on nerves,
have served as sources of nervous excitement which accumulates
in the cerebral ganglia and bursts forth as an epileptic explosion.
Bourgelat mentions the case of a horse which fell in a fit the
moment he was touched on his tender withers, also a case in
which a seizure coincided with an attack of recurrent ophthalmia.
Gerlach saw a horse which had an epileptic fit the instant he.was
touched on his sensitive withers. In kittens and puppies the
irritation attendant on dentition is a common cause of attacks. In
nervous dogs and pigs indigestion or constipation may serve as
the occasion of an explosion. In the experimental cases of
Brown-Sequard, not only did the injury to the sciatic nerve de-
velop in the brain a latent tendency to epilepsy, but the subse-
quent pinching of the skin in certain areas (epileptigenous zones)
promptly brought about a seizure.

Causes. Most of the causes of epilepsy have been given
above under the head of pathology and morbid anatomy. The
nervous predisposition may, like any other peculiarity or function,
become hereditary. In the hnman race nothing is more certain

52 Veterinary Medicine.

than the tendency to some form of nervous disorder (insanity,
dementia, alcoholism, morphinism, epilepsy, chorea, etc.) in a
special family line. Reynal records the case of an epileptic cat
(belonging to an employe of the Alfort veterinary school) the
progeny of which for three generations, became affected with
epilepsy and mostly died before they were a year old. Also four
epileptic dogs (3 males and 1 female) which produced a num-
ber of epileptic puppies. LaNotte records the cases of two bulls
affected with epilepsy, in the progeny of which numerous cases of
epilepsy appeared ; the cows being attacked after the first calving,
and the oxen soon after they were first put to work. Breeding
stallions are particularly liable to attacks, the high feeding, lack
of muscular work in the open air, and above all the oft repeated
nervous excitement attendant on copulation being directly ex-
citing causes. The heredity of the artificial epilepsy induced by
Brown-Sequard in Guinea pigs, serves to strengthen the doctrine
of heredity in ordinary forms.

Among emotional causes fear easily heads the list. Bernard
states that a horse became epileptic in connection with the terror
caused by the giving way of a wooden bridge over which he was
passing. Bourgelat and Reynal adduce instances, in cavalry
horses when first put under fire. Reynal records the case of an-
other which had his first attack when facing a moving locomo-
tive, and which never again could see an engine in motion
without suffering another attack. La Notte mentions the case of
a horse attacked when frightened by a sky rocket ; Romer, the
case of a horse scared by the sudden display of a white sheet in
front of him, and Friedberger and Frohner relate cases of attacks
caused by intense rays of light, as in racing toward the declining
sun, or the dazzling reflection from the surface of the water.
Liedesdorf saw it in a dog scared by a locomotive.

A strong impression like that caused by transition from bright
light into darkness, by seeing shadows of trees crossing the road,
or violent suffering caused by severe forms of constraint have
been named as causes.

Speaking in ‘‘ Brain,’’ of epilepsy in man, Alexander Haig at-
tributes the fits tothe fluctuations of uric acid in the blood.
Headache (migraine) he finds to be very closely allied to epi-
lepsy and convulsions and to be a result in a susceptible system

Epilespy. Falling Sickness. 53

of a liberal flesh diet. By a vegetable and fruit diet he reduces
the ingestion and formation of uric acid, so that the largest
quantity which a patient is likely to get into his blood, shall
never or only very rarely, affect the blood pressure and increase
the intra-cranial circulation to a dangerous extent. In predis-
posed subjects, all flesh food, soup, and meat extracts must be
avoided, while even tea, coffee, cocoa and other vegetable arti-
cles containing zanthin compounds are to be regarded as pro-
ducing uric acid, and to be denied, or employed only as the
merest flavoring.

This position is greatly strengthened by the fact that epilepsy
is so much more frequent in the carnivora (dog, cat, bird) than
in the herbivora. It also suggests very strongly a light vege-
table diet for both prophylactic and curative purposes in our
domestic animals. In the same line the frequent and liberal
drinking of warm, water, the use of diuretics and the flushing of
the large intestine are indicated.

For other causes see under pathology.

Symptoms in the Horse. It has been claimed that premoni-
tory symptoms, stich as dullness, lack of energy and quick, ner-
vous or startled movements herald an attack, but in animals as
in man, the disease usually attacks suddenly without any ante-
cedent indication.

If at work the horse stops suddenly, or if in the stable he
ceases eating, seems frightened, stands for an instant immovable,
braces his feet, sways, trembles, and falls heavily to the ground.
_Or he may remain for an instant supported on his rigid limbs,
the jaws moving or firmly closed, the eyes rolling, and ‘the facial
muscles drawn or twitching. When down there are convulsive
movements of the limbs, so that the animal may kick out violent-
ly, and tense contractions or twitchings may occur in the muscles
of the croup, chest and abdomen. There is usually an increase
of the salivary secretion with frothy accumulation about the
angles of the mouth. The respiration is stertorous, dyspneeic,
and interrupted, the nostrils widely dilated, the nasal mucosa of
a dark brownish red, and the superficial veins distended. The
pulse is weak, slow, irregular, intermittent and sometimes im-
perceptible. Sensation seems to be in abeyance. No attention

54 Veterinary Medicine.

is paid to loud sounds, nor to pinching, pricking, or even cauter-
izing the skin. Perspirations may break out on the flank or
over the whole surface of the body.

The duration of the attack may be from one to four minutes,
or exceptionally ten or fifteen, after which the muscles relax, the
twitching ceases, the horse raises his head, extends his fore
limbs and finally rises.

After rising some are dull and stupid for an hour or so, and
may continue to perspire, some move the limbs, jaws or head
automatically, turn in a circle, or seek seclusion and darkness,
while some take at once to eating and seem as if nothing had
happened.

In partial or localized epilepsy the spasms are confined to a
limited group of muscles like those of the jaws, neck, or fore litnbs.
These may alternately contract and relax, or they may remain rigid
for a minute or less, the mouth being held open or firmly closed
with grinding of the teeth, the eyes rolled backward and upward,
or affected with strabismus, the face drawn and distorted, the
head turned to one side or downward, or the limbs fixed and
immovable.

* At the conclusion of an attack it is not uncommon to see a dis-
charge of urine or fzeces, or in stallions, of semen.

The horse often contracts a fear of the place where the attack
occurred, and this contributes, with the re-appearance of the
former object of dread (car, locomotive, rifles, cannon, etc.) to
precipitate a new attack if he is compelled to go to such a place.

Symptoms in Cattle. In cattle the animal is attacked without
premonition, bellows, breathes hard and with effort, has dilata-
tion of the nostrils, and squinting or rolling upward and back-
ward of the eyes and falls to the ground rigid and trembling.
There may be violent succussions of the limbs, head or neck,
movements of the jaws, grinding of the teeth, and the appearance
of frothy saliva and elements of food about the lips. The beats
of the heart are violent, the pulse slow and small, and sometimes
intermittent. Involuntary micturition, defecation, or discharge
of semen may occur. In slight cases one or more of these symp-
toms may be absent, and the victim may not even fall to the
ground but support himself against a wall or other object.

aM

Lpilepsy. Falling Sickness. 55

The duration of the attack may be from one to five minutes,

rarely more, and there is often a slow and progressive subsidence

-of the spasms. When recovered the animal may get up and go
to eating or rumination as in health.

Symptoms in Sheep. In sheep the attack is sudden. The
animal ceases eating or stops in its walking, and after turning or
other voluntary movement falls to the ground, head extended,
mouth open, eyes rolling or squinting, and with rigidity or
twitching of the muscles of the neck or limbs. There is the
same loss of sensation, frothing from the mouth, and grinding of
the teeth as in the larger animals. The attack may last 40 to 50
seconds.

Symptoms in Swine. In pigs a state of discomfort and rest-
lessness often marks the approach of an attack, referable probably
to the digestive disturbance or to parasites which furnish the oc-
casion of the disease. Uneasy, wandering movements, jerkings
of head or limbs, rolling of the eyes, champing of the jaws
may first appear. Then the animal falls, extending its limbs
and head, with open mouth, retracted lips, and a free flow of
saliva. ‘Trembling and jerking of the head, neck and limbs,
hurried, short, difficult breathing, and complete loss of sensation
may be noted. Discharges of urine, semen, and prostatic fluid
are not uncommon. ‘The attack usually lasts 2 or 3 minutes,
and exceptionally 1o to15. In the shorter seizures, frequent
repetition is not uncommon, Delafond having observed 5 or 6
attacks in the course of an hour.

Symptoms in Dogs. ‘The attack is sudden and unheralded by
prodromata. The animal stops, trembles, cries plaintively and
falls ; he may manage to rise or to doso in part but instantly falls
anew. ‘Ihe limbs stiffen, tremble or twitch, the head is extended
or flexed, or jerked, violently striking the ground, the mouth
open, with abundant saliva, or firmly closed though the tongue
may be between the teeth. The trunk may be firm and rigid or
alternately twisted in one direction or the other. The eyes roll
or squint, and the breathing ig stertorous and ‘difficult. Insensi-
bility is complete. ‘Toward the end of the attack there may be
a discharge of urine, feeces or semen, the stools often containing
worms. ‘The body is often wet with perspiration during or after
an attack.

56 Veterinary Medicine.

The attack usually lasts for two or three minutes, then the
convulsions gradually lessen in intensity and finally cease, the
dog raises his head, opens his eyes, and gazes inquiringly around.
Then he gets on his feet, shakes himself and may at once resume
his customary habits. In other cases the restoration is less sud-
den. ‘The dog remains for 30 to 60 minutes dull and stupid, or
seems to have little power of control over its muscles and stag-
gers as if intoxicated, or as if the muscles were benumbed. It
may drop on its knees and then fall with the head on the ground
and repeat this several times. In other cases the dog wanders
around, or trots off and may snap at any one interfering with
him, so that the case is often mistaken for one of rabies. Fiaally
the animal may remain prostrate and fall into a deep sleep marked
by stertorous breathing.

Diagnosis. ‘The diagnosis of epilepsy is usually easy. The
suddenness of the attack, the loss of consciousness, the muscular
spasms, the complete temporary recovery and the tendency to
recur, forma Zoute ensemble, which is pathognomonic. The danger
of confounding this with other nervous disorders is on the whole
greatest in the slight cases in which the symptoms are less typical.

From Syncope it is easily distinguished by the spasms which
are not present in syncope.

From eclampsia it is not so easy to diagnose, but the line be-
tween eclampsia and epilepsy has not been accurately drawn,
and some have even shown a disposition to drop eclampsia from
medical nomenclature. Eclampsia may be defined as general
convulsions dependent on some eccentric irritation, and which do
not recur after such irritation has been removed. This would
remove from the category of epileptic attacks the cases of convul-
sions in which the attacks were due to intestinal or nasal parasites,
dentition, irritation, tumors pressing on nerves, canine distemper
and other infectious diseases. So far the distinction might be
made by the diagnosis of the particular disease on which the
convulsions depend. ‘There remains however a class of cases in
which the centric nervous disorder on which the epileptic seizure
depends is present, and also the peripheral source of irritation
(worms, etc.). In such a case the presence of the worms or
other eccentric source of irritation, even if added to the fact that
this was the immediate exciting cause of the epileptic explosion,

Epilepsy. Falling Sickness. 57

could not do away with the fact that the essential conditions of
epilepsy are permanently present in the nervous centres. The
difficulty therefore of making an accurate differential diagnosis,
resides largely in the impossibility of drawing a definite line of
pathological separation between eclampsia and epilepsy.

From Vertigo epilepsy is distinguished by the absence in the
former of marked spasmodic contractions. It is only in the mild-
er forms of epilepsy those in which the spasmodic action is so
slight as to be overlooked, that this disease can be confounded
with vertigo.

From Thrombosis or embolism of the iliac or femoral arteries
epilepsy is easily distinguished by the absence of exercise as the
essential cause in the development of the latter. In thrombosis
on the other hand, the loss of control over the hind limbs is de-
veloped at will by active motion (walking, trotting). In throm-
bosis too the absence of pulsation at the fetlocks or at any point
below the seat of obstruction is conclusive.

Question of Soundness and Jurisprudence. Manifestly a
horse or bull subject to attacks of epilepsy is ot sound. It is
moreover a disease, the symptoms of which are only shown for a
very short period at one time, after a long interval of apparently
perfect health. Itis, therefore, a disease against which a purchas-
er cannot be expected to protect himself and he should have the
right to annul the sale and return the animal in case the infirmity
should appear within a reasonable period after purchase. This
is provided for in the laws of different countries of Europe, thus
in Wurtenberg, Baden and Hesse, a purchased animal may
be returned within 28 days; in France within 30 days, and in
Bavaria within 4o days. The greatest difficulty arises from the
frequent impossibility of obtaining expert testimony on a seizure
which is likely to occur at any moment, without premonition,
and in which the testimony of a non-expert may easily be mis-
leading. It seems as if complaint having been made within the
specified legal time, an extension of guarantee should be given
by the court, the animal to be meanwhile kept under the super-
vision of a veterinarian.

Another question has arisen as to the position of an animal
suffering from reflex epilepsy. If the attacks are caused by in-
testinal worms or nasal acarina which are easily removed, it is

58 Veterinary Medicine.

quite evident that this cannot be considered as a permanent un-
soundness, and one for which a contract of sale can be justly
annulled. But on the other hand, while the eccentric source of
irritation which is easily curable may have been the active agent
in developing the seizures, it may bé none the less true that the
central infirmity which determines the abnormal susceptibility, to
excessive generation and epileptic explosion of nervous force,
may also be present and the animal cannot be considered as
sound until a sufficient length of time has elapsed after the re-
moval of the peripheral irritation and no new seizure has taken
place.

Treatment of Symptomatic Epilepsy. In cases due to an ec-
centric irritant the first step must be the removal of such irritant.
In case of intestinal worms the various vermicides and teeniacides
must be resorted to. (See Intestinal Parasites). For the
linguatula teenioides the injection of benzine or tobacco water
into the nose, or into the sinuses, with or without trephining may
be resorted to. In diseased teeth extraction or filling may be
demanded. In dentition-irritation, lancing of the gums. In all
other cases in which a peripheral nervous irritation can be traced
every available means should be taken to remove it.

Treatment of Central Epilepsy. Bearing in mind that peri-
pheral irritation is a frequent exciting cause of a seizure, too
much care cannot be given to the conservation of the general
health and especially to make the diet wholesome in quantity,
quality and time of feeding and watering, and to guard against
constipation and indigestion. In dogs a too stimulating meat
diet is to be avoided.

“The medicinal agents employed have been mainly such as are
sedative, or tonic to the nervous system. Valerian was long ex-
tolled as a valuable remedy (Gohier, Delafond, Delwart), and
this has been improved upon more lately by substituting valerian-
ate of zinc. Belladonna and its alkaloid atropia have been
strongly advocated (Tisserant, Bernard, Williams, Friedberger)
and it has the recommendation that it causes vaso-motor contrac-
tion and tends to lessen cerebral congestion. Hyoscine or du-
boisine may be used as a substitute. Cyanide of iron has been
lauded by Jourdier and Tabourin, as far superior to valerian. Of
late years the nerve tonics, zinc compounds (oxide, sulphate,

Epilepsy. Falling Sickness. 59

chloride) and silver salts (nitrate) and arsenic have been used,
often with excellent results. Borax strongly recommended for
man (1 to 134 drachm daily) by Pastena is worthy of a trial for
dogs. It is given largely diluted in syrup to avoid gastric irri-
tation.

Of all agents employed up to the present the bromides still
.Claim a foremost place. They should be given in a large dose, ,
on an empty stomach and at such a time as to occupy the system
at the hour when the seizure is expected to recur. Thus for
morning attacks the dose may be given at night, while for night
attacks it may be given in the afternoon. Miiller uses sodium
bromide inthe dog as least liable to disturb the stomach, while
Peterson for man, advises the potassium salt for the same reason.
For man, McLane Hamilton advocates a combination of the
sodium and ammonium salts, Eulenberg adds the potassium com-
pound, while Berkley uses strontium bromide, and Bourneville

camphor monobromide.

Given at night in full dose (30 grs. for dog) the bromides tend
to secure a quiet sleep, with brain rest and recuperation. If
beneficial they should be repeated daily until a cure or other sign
of bromism appears. This may be somewhat checked by arsenic
or chloral hydrate.

Wesley Mills finds potassium iodide nseful in some dogs when
bromides fail. Bromohydrate is advocated by Miiller.
Flechsig and others have had excellent resultsin man from the
opium bromide treatment. Full doses of opium given three
times a day for six weeks, when they are replaced by full doses
of bromides four times a day.

Improvement should be shown in the shortening of the con-
vulsions and the lengthening of the intervals between them.
Should the bromides fail in this, resort may be had to other treat-
ment.

Toulouse, Clark and others find that privation of salt, in man,
allows the bromine salt to replace the chlorine one in the tissues,
and the hydrobromic acid the hydrochloric in the gastric juice,
and in this way the bromine can be introduced safely in larger
amount into the tissues and is longer retained, though given in
half the doses.

60 Veterinary Medicine.

A most important element in the treatment is a vegetable diet
with or without milk, to obviate excessive production of uric acid.
Anything which will disagree and produce gastric or intestinal
fermentations with toxins must be carefully guarded against and
these will differ in different individuals.

Stallions and other excitable males, and females may often be
cured by castration. Patients should be very carefully guarded
against all sources or excitement, reports of guns, sight of loco-
motives or automobiles, waving flags, instrumental music,
sudden exposure to sunshine or other bright light, reflection
from water, snow, or ice, the contrast of dark shadows, as of
trees, alternating with bright light, etc. Dogs, becoming ex-
cited at a show, may have a convulsion if not removed, and
much more so in presence of another dog in a fit.

A surgical operation often places the disease in abeyance for
many months, but, unlessin the case of the removal of a dis-
eased organ which has acted as a factor, this is not permanent.
Hence in man transient benefit has been secured from operations
on the eyes, the bfain, the testicles, the ovaries, etc. In local
(Jacksonian) epilepsy, which can be traced to a definite cortical
area in the brain, the trephining of the skull and the excision of
the cortex at that point, has given temporary relief, with a local
palsy, but too often the irritation from the resulting cicatrix has
in time aroused the disorder anew. Even independently of the
removal of the cortex, the trephining has been successfully re-
sorted to, by savage as well as civilized peoples, securing a tem-
porary relief. Though not in practice in veterinary medicine it
seems as if this were even more applicable than in man. It
would be fully justified if it preserved for a year or more an
animal in usefulness which must otherwise be destroyed, even if
the disease should return at the end of this time.

Plunge or douche baths (60° to 70° F.) and rubbing dry will
often tone. up the nervous system, and a course of bitters, or iron,
or both, may prove valuable. An out-door life and moderate
muscular exercise are important.

During a convulsion the animal should be freed from all
harness, halters, girths, etc., that would impair respiration, the
jaws must be kept apart with a cloth to prevent biting the tongue,
and the animal held with head and neck in natural position.

'

Eclampsia. Convulsions. Spasms. 61

To arrest the spasms the best agent is amyle nitrite inhaled from
a handkerchief. It may be replaced by a mixture in equal parts
of chloroform and ether. Or rectal injections may be given
of chloral. Nitro-glycerine will sometimes cut short an attack or
prevent it. Small animals may have the body immersed in a
warm bath, and cold applied to the head. Congested buccal and
conjunctival mucosze would indicate cold to the head, while
pallor would suggest warm fomentations.

When the fit is over the animal should be kept in a quiet,
dark place until the excitement or stupor has completely passed.

ECLAMPSIA. CONVULSIONS. SPASMS.

Definition : functional convulsions from peripheral irritation. From den-
tition, helminths, uterine disease, nursing (anemia). Treatment. Injuries
to cranial bone.

Eclampsia (convulsions) is difficult to define as distinct from
epilepsy, the present tendency however appears to be to apply
this term to cases in which the spasms are of a purely
functional nature as far as the brain is concerned and
caused by peripheral nervous irritation. Whereas in epilepsy
there is some organic disease or disorder of the brain itself.
Therefore the convulsions of anemia, of teething, and of
parasitism, would come under this heading being curable by
the removal of the distant source of irritation, while the spas-
modic seizures, that are due to central nervous lesions and are
not exclusively dependent on peripheral irritation would be
classed as epilepsy. In other words reflex epilepsies with no
central brain disorganization would be classed as convulsions.

Edampsia from Dentition is seen especially in young cats,
dogs and pigs when cutting-teeth, and may be obviated by
lancing the gums, extracting diseased or milk teeth entangled on
the crowns of their successors, and by a slight laxative with
bromides.

Eclampsia from Helminthiasis has been already referred to
under epilepsy. The main object is the expulsion of the worms,
after which nerve sedatives and tonics will be valuable.

62 Veterinary Medicine.

Eclampsia'from Uterine Disease has been noticed by Al-
brecht, in cows shortly after calving, the symptoms being spasms
of the neck, persistent extension or turning of the head, grind-
ing of the teeth, loss of consciousness, convulsive movements of
the legs, rolling of the eyes, and slow recovery. The same
symptoms have been observed in goats and have been sup-
posed to depend on a reflex from the irritated womb. Another
supposable cause is the absorption of toxic products from the
womb and vagina. Manifestly the removal of the after birth
and the disinfection of the womb, should be here employed
along with the ordinary nerve sedatives.

Eclampsia in Nursing Female Dogs has long been attributed
to anzemia by English veterinarians. It occurs especiallyin high .
bred bitches, when nursing a large litter and some weeks after
parturition when the puppies have grown large and .vigorous,
with proportionately increased demands on the maternal source of
supply. The dam shows an emaciated aspect, with restless anx-
ious eyes, a wearied expression, and a generally exhausted ap-
pearance. ‘There is weakness and swaying behind, or complete
inability to use the limbs, the animal goes down, trembles vio-
lently and shows clonic spasms of the extensors of the legs, the
neck, the back, the face and the eye. Breathing is accelerated,
stertorous and labored, the heart beats violently, the mucous mem-
branes are congested, and the mouth is opened with convulsive
movements of the jaws and throat. The attack is readily dis-
tinguished from epilepsy, by the retention of sensation, and by
* the absence of involuntary passages from the bowels, or kidneys.
Recovery is likely to be secured if the puppies or most of them
are removed early enough and the bitch sustained by nourishing
food, and tonics. The spasms may be combated by the anti-
spasmodics and nerve sedatives employed in epilepsy. Chloroform,
morphia, phenacetin, acetanilid, urethane have been especially
commended. Beef teas, cod-liver oil, and iron may be resorted
to and free outdoor exercise and sunshine should be secured.

General convulsions are common in connection with direct in-
jury to the brain and more particularly of its coverings, (cranial
bones, meninges). In such cases the irritation which otherwise
starts at a distance and reaches the brain through the afferent
nerves, or the modification of the circulation acts directly on the

Chorea. St. Vitus Dance. 63

gray matter. It is interesting to note in this connection that the
evacuation of the cerebral fluid, which removes the soft support
of the water cushion and allows the brain to come in contact with
the hard bony walls, determines an access of convulsions. In
cases of convulsions attendant or mechanical injury to the cra-
nium surgical interference will be in order.

CHOREA. ST. VITUS DANCE.

Definition. Susceptible animal. Causes: nervous leisons inconstant,
youth, debility, anzemia, microbian toxins, cerebral embolism, rheumatism,
trophic alterations in nerve cells, fright. Lesions: variable in seat and
character, congestion of perforated space, corpus striatum, Sylvian convolu-
tions, gray matter at root of posterior horn of spinal cord, etc., experi-
ments of Chauveau and Wood. Symptoms : dog, local twitching, fore limb,
one or both, neck, head, maxilla, eyelids, eyeballs, hind limbs, trunk,
thythmic, less when recumbent, usually absent in sleep, roused by excite-
ment ; horse, head, neck, fore limb, trunk: cattle, head, neck, limbs;
swine, hind limbs, neck, head ; severe cases lead to exhaustion, emaciation,
marasmus, paralysis. Duration: weeks, months, years. Treatment: laxa-
tive, tonic, hygienic, arsenic, zinc sulphate, strychnia, sedative, belladonna,
conium, cannabis Indica, chloral, acetanilid, trional, etc., icebags or ether
spray to spine, cold douches, outdoor life..

Definition. A neurosis characterized by constant twitching of
muscles or of groups of muscles, and which usually ceases during
sleep. :

Animals Susceptible, ‘This disease is especially common in the
dog, but has been recognized also in the horse, ox, cat and pig.
Causes. Much difference of opinion exists as to the true cause.
of chorea. In many cases no nervous lesion has been found and
therefore the disease has been pronounced purely functional.
The victims are as a rule the young, weak and debilitated so that
anzemia has been held to be the main causative factor. Then in
dogs the affection is a common sequel of distemper and hence it
has been attributed to toxic matters (microbian, etc. ) in the blood.
It should be added that European writers attribute the rhythmic
spasms which follow distemper to eclampsia, epilepsy or tic, and
claim that the contractions must be irregular or arhythmic in order

64 Veterinary Medicine.

to constitute chorea. English and American writers, however,
have attributed less importance to this point and consider that
the constancy and persistency of the contractions in the dog,
differentiate an affection from both eclampsia and the epilepsy and
relate it rather to chorea. Ticas illustrated in crib-biting is cer-
tainly not constant nor rhythmical nor is it a habit beyond the
control of the will.

Among other alleged causes of chorea is embolism of the ar-
teries of the brain or spinal cord. Angel Money went so faras
to inject a fluid containing arrowroot, starch granules and car-
mine into the carotids of animals, and produced movements
closely resembling those of chorea. Another theory connects
chorea with the rheumatic poisons. Some English writers find
more than 80 per cent. of all cases in man associated in some way
with rheumatism, but in Philadelphia, Sinkler found that not more
than 15 per cent. showed such a relation. D. C. Wood as the
result of necropsies of a number of choreic dogs reached this
conclusion : ‘‘ Owing to emotional disturbance, sometimes stopping
of various vessels of the brain, or sometimes the presence of
organic disease, there is an altered condition of the ganglionic
cells throughout the nerve centres. If the cause is removed and
the altered condition of the nerve cells goes only so far, it re-
mains what we call a functional disease. If it goes so far that
the cells show alteration, we have an organic disease of the
nervous system. ’’

In man the element of sudden fright is awarded a high position
in the list of causes.

Lesions. Constant morbid changes of structure have not been
established in chorea. On the contrary in the many careful ne-
cropsies of choreic subjects some lesions of brain or spinal cord
has been almost always found. Dickinson always found con-
gestion of some part of the brain or spinal cord, but most con-
stantly of the substantia perforata, the corpora striata and the
beginning of the Sylvian fissure. In the cord the cervical and
dorsal regions were the most commonly affected, and preéminently
the gray matter at the root of the posterior horn. The bilateral
symmetry of the contractions in cases of unilateral lesions, has.
been held to discredit the theory of embolic origin, yet this may

Chorea. St. Vitus Dance. 65

be explained by mutual relation of the ganglia of the two sides
and their codrdination of function.

The question of the relative importance of the encephalic and
spinal lesions has been also debated. Chauveau believed that by
section of the cord in choreic dogs, he had proved that the spasms
were of medullary origin. Wood on the other hand found that
the choreic movements persisted after section of the cord, and
seemed warranted in the conclusion that the movements origin-
ated in the cord. The probability is, that with the cord intact,
the primary source of the morbid movement may reside either in
the encephalon or the cord. In chorea, following distemper, I
have found marked congestion of the encephalon and its men-
inges.

Symptoms. In the dog the twitching may be confined to one
fore leg, or it may extend to both and then usually implicates the
neck and head. In other cases the lower jaw, the head, the eye-
lids or even the eyeballs may be the séat of the twitching motions
and in still others the hind limbs and trunk are also implicated.
In nearly all cases the tendency is to a continuous rhythmic
action, which may moderate without actually ceasing while
the animal lies down, but which usually stops altogether during
deep sleep. When it intermits at other times it can commonly
be roused into activity by exciting the animal in any way.

In the horse the muscles affected may be those of the head
and neck, of the fore limb (Hering), of head, limbs and trunk
(Leblanc). :

In cattle the movements have affected the neck and head and
the fore or hind limbs (Anacker, Schleg).

In young pigs the hind limbs, the neck and head have been
chiefly involved in the spasms (Hess, Vervey).

If the affection is slight it may not seriously impair the general
health, but in proportion to its severity and the constancy and
generalization of the spasms and the consequent muscular waste
and exhaustion, the animal becomes gradually worn out and
emaciated and dies of paralysis and marasmus.

Duration. In favorable cases recovery may ensue in a few
weeks; in others the disease becomes chronic and will last for
months or years.

5

66 Veterinary Medicine.

Treatment. Among the first indications are fresh air and
wholesome easily digestible food. The removal of any source of
intestinal irritation should be sought by bland laxatives. As
the health is usually low, a course of iron tonics is nearly always
in order.

Special nervous tonics are next demanded. No agent has a
better reputation than arsenious acid. Ten drops of a 1 per cent.
solution of arsenite of soda may be given daily to the dog or one
ounce to the horse. If gastric irritation forbids the use of this
agent, sulphate of zinc may be given in 1 to 3 grain doses twice
a day to the dog. In other cases strychnine #5 to 5 of a grain
may be given in the same manner.

Nerve sedatives often have a good effect in calming the nerv-
ous irritability and in this way belladonna, conium, canabis
Indica, chloral, chloroform, acetanilid, trional, etc., have been
employed.

In the same line are ice bags or ether spray applied to
the spine for ten minutes at a time, and douche baths of cold
water, the animal being afterward rubbed dry. This last par-
takes of the nature of a stimulant and may be classed with gentle
exercise which at once distracts the patients’ attention from the
nervous infirmity, trains him to control the muscles, gives nor-
mal exercise and tone to the enfeebled organs and improves the
general health.

CONVULSIVE TWITCHING OF THE FACE.

Nature of phenomenon, arhythmic, hyperexcitability of nerve centres or
skin. Nerve section. Head jerking: horse, hard bit, severe check, inter-
nal pain, exertion, hypersensitiveness. Treatment: nervesection. Tongue
lolling, etc. Flapping of lower lip. Nasal rhythmic movements. Weav-
ing, from impatience, rhythmic. Rocking on hind limbs. Resting foot on
coronet. Pawing. Treatment : eliminate irritation, nerve tonics, sedatives,
hygienic measures.

This has been observed especially in the dog and may be
easily confounded with chorea. The muscles on one side of the
face are twitched at more or less regular intervals, or in other
cases there are sudden opening and closing of the lower jaw.

Convulsive Twitching of the Face. 67

The affection has not been satisfactorily connected with any
special brain lesion, though as in chorea proper and epilepsy, we
must invoke a special disorder or hyper-excitability of the nerve
centres presiding over the affected muscles. The clonic spasm
may in some cases be due only to a motor impulse from such ex-
cited nerve centre, while in others it may be traced backward
along the afferent nerves to an oversensitive part of the skin or
other organ. In these last purely reflex forms of the trouble it
may be possible to correct it by section of the sensory nerves
involved.

Convulsive Movements of the Head.

Convulsive movements of the head as a whole constitute a fre-
quent form of chorea in the dog. It is especially common in
horses and shows itself in different forms. A horse with a
tender mouth, or which has been used with a hard bit, or with a
heavy hand on the reins, or which has been driven with a check
rein so short as to be unsuited to its conformation, is liable to in-
dulge in annoying elevation and depression of the head when
under the saddle or in harness. ‘The same phenomenon may be
shown in connection with violent internal pains, as in strangu-
lated hernia, intussception, or twisting of the bowels. The
habit once formed is not easily corrected, so that careful treat-
ment with the view of prevention is especially to be given.

Another more objectionable, dangerous, and less voluntary
motion is the sudden jerking of the head upward, or to one side
when excited under the saddle or in harness. The disorderly
movements are not, as a rule, seen while the animal is at rest,
but seem to be produced under the stimulus of exertion. They
appear to be quite involuntary, and suggest the dread caused by
the settling or buzzing of an insect about the nose or ears, but
occur in the depth of winter in the absence of insect life, as well
asin midsummer. ‘The suddenness and involuntary nature of
the movement is suggestive of epilepsy, but there is no indica-
tion of attendant unconsciousness. From choreic movements it
is apparently distinguished, by its presence only when ridden or
driven. It is unquestionably associated with hypersensitiveness
of the nerve centres, and yet in many cases it appears to be a
reflex originating in a specially tender or sensitive part of the

68 Veterinary Medicine.

skin or mucous membrane. In more than one instance in this
college clinic the trouble was corrected by the section of both
facial branches of the 5th cranial nerves as they emerged from
the infra-orbital foramina.

Abnormal Movements of the Tongue.

Some horses double the tongue downward, others upward of
‘the bit ; others protrude the tongue and give it a sinuous, ser-
pentine motion. which causes alternate protrusion and retraction.

Flapping of the Lower Lip.

This habit of rapid opening and closing of the lower lip so as
to produce a disagreeable flapping noise by striking it agaiust
the upper, isseen in many horses and proves a most objection-
able trait in harness or saddle animals.

Rhythmical Movements of the Nose.

Certain horses apply the protractile end of the nose against the
lower lip and spend hours in succession in moving it rhythmic-
ally forward and backward, or from side to side.

Weaving. Movement like a Bear in a Cage.

This consists in a lateral rocking of the head and neck, and
sometimes of the chest as well with alternate stepping on the
right and left fore feet. It has been supposed to represent the
movement of the weaver in working a hand loom, or still better
. the movement of a caged wild beast in constant turning toward
the right and left of the front of his cage. The motions are as
regular as a pendulum, and involve the contraction of corre-
sponding groups of muscles on the two sides of .the body.

They seem, in some cases, to begin in impatience in waiting
for the feed, while other horses in the same row are being at-
tended to first, but when the habit has been formed it may be
continued most of the time in the intervals between feeds as well.
Nervous horses and those that are hearty feeders are the most
subject to this infirmity.

Vertigo. Megrims. Blind Staggers. 69
Disorderly Movements of the Limbs.

Some horses have a habit of continuously raising one hind
limb, others raise the right and left alternately, rocking the hind
quarters from side to side, others stand with the heel of one hind
foot resting on the front of the coronet of the other, while still
others paw continuously with the fore feet while standing in the
stall. |

Zreatment. ‘These various conditions even when begun as an
expression of impatience, soon become fixed habits, that prove in
the end virtually uncontrollable by an animal, which has no
strong will and no consciousness of anything to be gained by re-
sisting the impulse. They become virtual psychoses. In cases
in which the habit can be traced to a peripheral irritation, the
cutting off of this by complete section of the afferent nerves
leading to the irritable nerve centre will sometimes succeed in ef-
fecting a cure. In other cases in which the source of the dis-
order is probably largely central in the cerebral ganglia, nerve
tonics, and sedatives, and generally corroborative treatment are
the most obvious means of palliation. Such measures are, how-
ever, rarely successful. Nourishing-food and invigorating out-
door exercise are useful auxiliaries.

VERTIGO. MEGRIMS. BLIND STAGGERS.

Disadvantage of lack of subjective symptoms. Causes, varied, narcotics,
overloaded stomach, cerebral anzemia or hypereemia, degeneration, parasites,
tumors, jugular obstruction, valvular heart disease, disease of internal ear,
plethora. Susceptible animals : horse, ox, dog, pig, sheep Direct causes:
tight collar, or throat-latch, flexion of head, heart desease, pulmonary disease,
embolisms, gastric distention, hepatic disorder, optic vertigo, aural vertigo,
injections into ear, rhigolene, chloral, acariasis, seasickness, railroad sick-
ness, cholesteatoma, coenurus, concussion, degeneration, softening, oestrus,
linguatula, narcotics, essential oils, essential vertigo. Symptoms: in irrit-
able animal, highly fed, and without exercise, crowds pole, his mate or,a
wall, shakes or jerks head, staggers, trembles, rears, plunges, falls, struggles,
sweats, rolls eyes, recovers. In gastric or hepatic cases, dullness, pendent
head, swaying gait, dull eye, dilated pupil, pendent lids and lips, leans on
adjacent object, staggers, falls. In optic cases are obvious causes in transi-
tion to light, etc., and palliation by covering the eyes. In aural cases, roll-

70 Veterinary Medicine.

ing eyes, constrained position of ear, deafness, pharyngeal or Eustachian
trouble, wax or acari in ear, tender or itchy ear. Plethoric cases in spring,
in overfed, etc. Brain lesions may have fever and disordered innervation,
but retained consciousness, and nomarked spasm. Duration. Sheep: para-
sitic vertigo. Turning. Rotation. Treatment according to cause: restrict
ration, give exercise, purgative, adjust collar, breast strap, check, avoid
sudden transitions of light, overdraw check, blinds ; treat nasal, pharangeal,
ocular or aural trouble ; during attack, stop in shade, cold to head, deplete,
bleed, purge, shady pasture or light work, bromides, blisters, etc.

In dealing with vertigo or giddiness in animals we are con-
fronted by the impossibility of realizing the subjective feelings
of the animal, as we can so easily ascertain by interrogation in
the case of man, and thus our conclusions are largely inferences
drawn from certain unsteady, reckless or uncontrollable move-
ments, or from an apparent inability to maintain a stable equi-
librium. The condition is rather a symptom of a variety of
morbid conditions, functional and structural, than a disease
sut generis. It may be due to alcoholic or other narcotic intoxi-
cation, to an overloaded or otherwise deranged stomach, to shock,
to a stroke of lightning, to disturbances—anzemic or hypereemic—
in the circulation in the encephalon, to degenerations, parasites
or tumors in the brain, to compression of the jugular veins, to
valvular or other disease of the heart, to disease of the internal
ear, to the plethora of spring or early summer, to the qualms of
sea sickness, to insolation.

The purely toxic cases are more clearly defined and temporary
so that they may be eliminated from consideration at present, yet
their possible occurrence must always be borne in mind by the
practitioner especially when called to pronounce upon cases of
vertigo in connection with veterinary legal questions. The
cases that are due to a persistent neurosis, or to circulatory troubles
may well be placed in a list by themselves, yet in their legal re-
lations it is highly important. that the practitioner should as far
as possible discriminate among these as well.

Susceptible Animals. Vertigo undoubtedly exists among all
domestic animals. The symptoms by which it is recognized
have been noted especially in the horse and much less frequently
in ox, dog, pig and sheep.

Vertigo. Megrims. Blind Staggers. 71

Among horses it especially attacks the mature or aged, and
family harness horses, pampered and irregularly exercised ; (sad-
dle horses rarely suffer) ; it is more likely to appear for the first
time in spring though when established it happens at all seasons ;
it may come on when a horse is driven in blinders and fail to ap-
pear in the absence of these. :

Causes. 1st. Compression of the jugular veins by a too tight
collar is the cause of one of the simplest forms of vertigo and is
observed, in growing or fattening animals in which the neck has
become gradually too large for the collar. The supply of a larger
and well fitting collar will soon confirm the diagnosis by a com-
plete and permanent removal of the trouble. In other cases the
veins may be compressed by undue flexion of the head, the chin
being drawn toward the breast, or by a throat latch buckled too
tightly. The substitution of an overdraw check rein, or a loose
throat latch will show the true source of the trouble.

2nd. Disease of the valves ofthe heart or their insufficiency
from cardiac dilatation is a common cause of vertigo, and may be
recognized by auscultation and by the general symptoms OF
chronic heart disease.

3d. Disease of the lungs interfering with the flow of blood
through the right heart and more distantly with the return of
blood from the brain. It further effects the brain functions
through the circulation of a highly carbonized blood, which fails
to maintain the normal functions of the ganglia.

4th. Disease of the blood vessels, it may be by emboli
washed on from clots in the pulmonary veins or the left heart
and arrested in the vessels of the brain ; it may be by aneurism
of the anterior aorta as reported ofa ieee (Lustig) ; it may be by
phlebitis and thrombosis of the jugulars ; it may be by adjacent
tumors pressing on the vessels.

5th. Gastric Vertigo, Abdominal Vertigo, is a complica-
tion of gastric or hepatic disorder with giddiness and unsteady
movement. ‘The abdominal disorder may be at once a cause and
result of the vertigo and it is not always easy to decide which
predominates. The unsteady movements in certain cases of over-
loaded stomach in the horse are illustrations of purely abdomi-
nal vertigo, while on the other hand in vomiting animals nausea,
retching, emesis, and other gastric disorders promptly attend on

72 Veterinary Medicine.

the primary cerebral disorder. ‘There is also a special tendency
to vertigo in the fat, idle, gorged horse and in those with torpor
or other disorder of the liver occurring in pampered horses in
spring and early summer.

6th. Optic vertigo is a reflex disorder, détenmined i in the ex-
citable nerve centres by the visual influence. Thus it has been
seen in horses and sheep from the intense glare of the sun’s rays,
reflected from a lake or river or from white snow or ice, or even
from the glistening inner surface of the blinds. The effect is in-
tensified if the animal has just emerged from a dark stable or a
darker mine. ‘The overdraw check may bea factor by reason ofits
turning the eyes upward and exposing them continuously to the
full glare of the sun. ‘The sense of motion conveyed through the
eyes contributes to bring on giddiness and a sense of swimming.
In man this is notorious, the sense of nausea and vertigo being
precipitated by looking at the nearby, moving objects in cabin
or on deck, while it may be retarded by directing the eyes to
steady distant objects. As dogs, horses and other animals suffer
from seasickness, and even railroad sickness, this attendant fac-
tor may be logically accepted. The mere limitation of the field
of vision, by the use of blinds, and the disappearance in rapid
succession of near objects behind this narrow screen probably has
an influence similar to the visible motions in the ship between
decks, in cases in which these portions of the harness are mani-
fest factors.

7th. Aural Vertigo is determined by irritations of different
kinds affecting the external, middle or internal ear. Experi-
mental sections show that this is especially due to injuries of the
semicircular canals. If the horizontal canal is divided there are
pendulum-like movements of the head alternately to the right
and left, also lateral rolling of the eyes. If the posterior canal is
cut there is a vertical movement, or nodding of the head and
vertical rolling of the eyes. If the superior vertical canals are
injured there are pendulum-like vertical movements of the head
and the animal tends to fall forward. Injury to the anterior
canal causes diagonal rolling of the eyeball. In destruction of
all the canals various pendulum-like movements are performed,
and standing often becomes impossible. Stimulation of one
auditory nerve is followed by rotation of the eye and rotation

Vertigo. Megrims. Blind Staggers 73

of the body on its axis toward the injured side. The passage of
a galvanic current through the head between the mastoid pro-
cesses, or from one external auditory meatus to the other, causes
rolling of the eyeballs. Jnjection of water violently into a rabbit’ s
ear, ot of iced water or of a rhigolene jet, causes rolling of the
eyes, and rotation of the hody toward the side operated on. Dr.
Wier Mitchell hada similar experience in his own person. If
the injections are repeated a permanent vertiginous condition is
induced, and the rabbit or Guinea pig, which has been kept
in darkness for a few hours and is then suddenly exposed to sun-
light, is unstable on its limbs for a few seconds. Lucz found
that with perforation of the membrana tympani, an ear air
douche, at 0.1 atmospheres caused, abduction of the eyeball,
dyplopia, giddiness, sense of darkness, and disturbed respiration.
Vulpain found that a 25 per cent. solution of chloral hydrate
dropped into the ear of a rabbit caused vertiginous movements.
McVey records the case of a music teacher who had intense ver-
tigo induced by the dow bass notes of a piano. Crum Brown
noticed that if a person with bandaged eyes, is rotated for some
time as ona potter’s wheel, he can at first estimate the degree of
rotation, but after a time he fails to do so, and the rotation may
be stopped, without checking his sense of whirling. The
familiar method of subduing an intractable or vicious horse by
running him rapidly around iz a@ very narrow circular course,
or by tying head and tail together and letting him circle around
until he staggers or falls, is another manifest example of this
aural vertigo. Rabbits and dogs suffering from acariasis of the
external ear move around in a circle, or even turn somersaults
tending toward the affected side. Trasbot has found larve of
insects (simulium cinereum ?) in the ears of vertiginous horses,
which he successfully treated with injection of chloroform. Even
hard pellets of wax pressing on the tympanic membrane have
been found to give rise to vertigo.

The explanation of cases of aural vertigo, has been sought in
the physiological action of the endolymph and perilymph on the
end filaments of the nerve in the membranous labyrinth, the
turning of the head from one side to the other having the effect
of changing the pressure in different parts and establishing cur-
rents by which the change of position is recognized; on the

74 Veterinary Medicine.

other hand any injury to the canals, by disturbing the pressure
of the perilymph andinterfering with the relative position of the
canals, and the direction and force of the currents of the endo-
lymph and perilymph, destroys all proper sense of balance.
The rotation of the subject as on a wheel or in turning in a
narrow circle, is held to cause circular currents in and around
the membranous labyrinth which temporarily destroy all sense of
equilibrium. Seasickness and railroad sickness are doubtless in
part due to the swaying motions causing disturbance in the
canals. ‘The intimate relation between the root of the auditory
nerve and that of the vagus in the medulla, may serve to explain
the mutual interdependence of derangement of the stomach and
liver on the one hand and the occurrence of vertigo on the other.
Again the relation of vertigo to visual troubles, both as to cause
and effect, has been attributed to the close relations of the
ganglia presiding over the 3d, 4th, 5th and 6th nerves and those
of the nerve of hearing.

There is a degree of deafness in nearly all cases of aural verti-
go, a circumstance which may be utilized in the diagnosis of. such
cases, the presence of disease of the guttural pouch, or Eusta-
chian tube, and evidence of deafness on one side, rather than the
other, may be taken as corroborative evidence of the affection.
On the other hand James shows that the stone deaf are much
less subject to both seasickness and vertigo than those that hear.
The disorder that leads to vertigo implies a retention of a meas-
ure of the normal function of the internal ear, and therefore of
hearing, whereas the disease that has caused complete destruction
of the internal ear and consequent loss of hearing has equally
destroyed the function of the labyrinth in maintaining a sense of
balance, and has obviated the aural sensations of equilibrium and
loss of balance.

8th. Cerebral Vertigo may be associated with derangement
of the circulation, or disease in the brain or its meninges.
Anzmias and congestions resulting from disease or impaired
function of heart, lungs, arteries or veins have been already
noticed. It remains to note the presence of cholesteatomata and
other tumors, and of parasites (cysticercus cellulosa in pig ;
coenurus cerebralis in sheep) in the encephalon, and of injuries
from concussion, degeneration and softening of the brain sub-
stance.

Vertigo. Megrims. Blind Staggers. 75

oth. Nasal Vertigo has been noted by Cadeac in connection
with irritation in the nose and especially by the larva of oestrus
ovis (sheep), and the linguatula (dog, horse). In certain of the
cases manifested by jerking of the head and diverging to one
side, the recovery after section of the pes anserina indicates a
nasal origin.

1oth. Vertigo from Narcotics (alcohol, lolium temulentum,
belladonna, solanum, various essential oils, carbon monoxide,
etc)., have been already referred to.

11th. There remains to be noted cases in which no narcotic
poison, no mechanical disturbance of the circulation, no visual,
aural nor nasal trouble, no gastric nor hepatic disorder, and not
even a distant nervous lesion can be found; the disease may in
such cases be ranked for the present as essential vertigo.

Symptoms. As usually seen in the horse, vertigo often attacks
the nervous, irritable animal in which the slightest occasion of
irritation or disturbance causes intense suffering and quick re-
sponse. This is often aggravated by the plethoric condition of
the animal, kept on a liberal ration of grain and having little
exercise. In some forms of the affection, however, and especial-
ly the gastric and hepatic, the subject is dull, carries the head
low, and lacks vivacity and energy.

In the first form (the most common in the horse) the animal
which has been full of life and vigor, slackens his pace and the
tension on the reins, or stops suddenly, shakes the head, vertical-
ly or horizontally, or jerks it to one side, trembles, staggers,
props his legs outward for more stable support, presses against
the pole, or the other horse, or a wall, leans on the breeching or
hangs on the breast strap, plunges forward, or to one side, or
rears up and even, falls backward, and comes to the ground.
Profuse perspiration ensues, the eyes roll, the face is pinched and
drawn, the prostrate animal may struggle in a helpless way, and,
if the harness is loosened, he may get up in a few seconds and
slowly recover. Often, however, he remains for an hour or,
more, nervous, sensitive, bedewed with sweat, trembling and
with anxious expression. Such are the more common. manifes-
tations of what is familiarly known as blind staggers. The
symptoms will vary however, with the cause.

In gastric or hepatic cases there may be more particularly

76 Veterinary Medicine.

dullness and lack of energy, low carriage of the head, unsteadi-
ness of gait, lack of lustre in the eye, pupils dilated, semi-closed
eyelids, pendent lips, a tendency to lean onthe stall or hang on
the harness, and though the animal may stagger and fall, there is
not the abrupt transition from life and energy to the active excite-
ment and uncontrollable movements. Thesame remarks apply in
a measure to narcotic vertigo.

With optic vertigo, the attendant conditions will help to a
diagnosis. ‘The animal has come from darkness to full sunshine ;
there is the white, icy or snowy reflection everywhere which the
animal was facing when attacked, or the glistening lake or river,
the overdraw check rein, or the blind with perhaps a shining inner
surface. The pupil is closed, and the eye is rolled back or oscil-
lates in one direction or another. The symptoms are checked by
covering the eyes or removing the subject into a dark building or
even into the shade of a tree or shed.

With aural vertigo there may be similar rolling of the eyes,
without the pupillary closure, the ear may be drawn down or
back, and the shaking or jerking of the head is likely to be a
marked feature. If there is more motion of one ear than the
other, if the head is jerked to the one side, if there is a measure
of deafness in the one ear (to be ascertained rather in the inter-
vals between attacks), if there is disease of the pharynx, the Eu-
stachian tube or pouch, or swelling about the root of the ear, if
there is wax, scurf, or acarus in the ear, if the animal rubs it fre-
quently, aural vertigo may be suspected.

Nasal vertigo. T’hose forms in which the head is jerked hor-
izontally, vertically, or diagonally, the animal pressing against-its
mate or the pole, or outward in the harness, and getting out of its
track, even if it should stcp short of falling, and which appear
only during work, or are aggravated by exertion, have been
attributed to lesions of the ear (Fleming), but in some cases they
can be warded off by wearing a net over the nostril, and can be
entirely stopped by complete transverse section of the pes anse-
rina, so that in a certain number at least they must be accounted
nasal. These are not usually attended by sneezing. The simple
expedient of driving with a rather close net over the nostril may
enable one to diagnose many of the purely nasal forms.

Plethoric vertigo may be suspected when the attack comes on

Vertigo. Megrims. Blind Staggers. 77

in spring, in a fleshy or fat horse, over-fed and little exercised,
when there is dark red congestion of the nasal mucosa and con-
junctiva, and a subsidence with rest.

In the vertigo of brain lesions, the acute forms are attended by
fever and marked signs of delirium or disordered nervous func-
tions, while in the chronic forms there may be permanent hyper-
zesthesia, or anzesthesia, general or with rather diffuse limits, and
the vertiginous attacks repeat themselves frequently irrespective
of weather, though they may be precipitated by faults of feeding,
indigestion, severe exertion, or some of the other exciting causes
above mentioned.

These cases are to be distinguished from epilepsy by the ab-
sence of any spasmodic contraction, aside from the jerking of the
head and rolling of the eyes, and by the fact that consciousness is
retained throughout. During the attack the animal may fail to
respond to irritation of the nasal mucosa, but this appears to be
due to the fact that his whole attention isengaged with a more
serious trouble.

The duration of an attack is from one to two, or exceptionally
five minutes. The form which is represented by jerking of the
head and deviation from the direct line of motion may continue
so long as exercise is kept up.

In the nasal vertigo of sheep and dogs, due to parasites,
sneezing, and congestion of the mucosa are to be looked for.

In the cerebral parasitic vertigo of sheep and pigs, the

.symptoms vary according to the seatofthe parasite. ‘These may
be blindness, turning in a circle, moving straight ahead regard-
less of obstacles, jerking upward of the head with nose protruded,
hemiplegia, hemianzesthesia, cross hemiplegia, cross hemianzes-
thesia, and any one of the many forms of paralysis, or exagge-
rated nervous action. The animal usually turns to the side on
which the parasite lies and is paralyzed on the opposite side of
the trunk. A peculiarity of these cases is that while the symp-
toms are continuous, yet.there are periodic aggravations which
bear no relation to feeding, exertion or excitement, but depend
on the protrusion at intervals of the heads of the parasites into
the brain substance. If there are several parasites in the brain
and they do this at different times the symptoms are liable to
vary according to their seat, and the special organ which is irri-

78 Veterinary Medicine.

tated. ‘This variability of symptoms is suggestive of parasitism.
While turning around in a circle has been already noticed
there remains, in certain cerebral forms, the peculiar phenome-
non of the animal rotating rapidly on its longitudinal axis. The
patient falls on its side and rolls over and over. Among the
brain lesions with which it has been experimentally identified are
injuries tothe mzddle peduncles.of the cerebellum, or of the supero-
external portion of the cerebral peduncles, or of the posterior part
of the encephalon, or of different parts of the hemispheres.

Cases of vertigo that occur without any appreciable lesions have
been named essential vertigo. Guibert has attributed some cases
to irritation of the lower part of the limbs by contact with the
litter but this could only occur in an animal in which the nervous
system was in a morbidly excitable condition.

Treatment. 'The prophylactics and therapeutics of vertigo
will vary with the cause. The diagnosis of the cause is there-
fore the most important step. In pampered, overfed, idle horses
a reduced ration and daily exercise or work will often suffice.
It is usually desirable, however, to remove intestinal irritants
and deplete the vascular system by an active purgative. If the
attacks appear only in Spring this care should be especially given
at such seasons. A tight or badly fitting collar should be cor-
rected, also a position of the breast strap which causes it to press
on the jugular veins. A short bearing rein causing undue
flexion of the head must be lengthened or abandoned. A too
dark stable should be avoided, also the sudden exposure to white,
dusty roads and, still more so, to the glare of snow, ice, or
water. A short, overdraw check rein, turning the eyes up
directly into the sun’s rays, or blinds with a glistening inner sur-
face may require correction. It may be better to abandon blinds
altogether, or to cover the eyes by a piece of leather, 2 to 4
inches wide, extending across the forehead from one eye to the
other ; or a sunshade attached to the headstall may be worn so
as to protect the eyes. Horses which become seasick or carsick
may sometimes be helped by covering the eyes. Other indica-
tions would be to treat any existing trouble which interferes with
a normal circulation in the brain (pulmonary congestion, aneu-
risms, tumors pressing on carotids or jugulars, phlebitis, etc. ),
and such as affect the ear (disease of the pharynx, guttural

Vertigo, Megrims. Blind Staggers. 79

pouches, adjacent glands, petrous temporal bone, membrana
tympani, external ear). Indurated wax, insects or insect larvee
may be removed by careful irrigation with warm water, and per-
haps by chloroform. Nasal parasites must be washed out or de-
stroyed by benzine, and any hyperzesthesia of the nasal mucosa
may be met by covering the nostril with a net, or radically by
cutting the facial branch of the 5th nerve as it emerges from the
infra-orbital foramen.

When attacked the horse should be at once stopped and put
under the shadow of aroof or tree, or in their absence a blanket
or lap robe may be used to cover his eyes. If there is danger of
falling remove the harness, and secure a soft piece of ground,
free from stones or other hard bodies. Cold water applied to the
head will sometimes check. A common practice is to bleed from
the palate, and in plethoric cases especially, and in such as are
dependent on congestion, tumors or other lesion of the brain it is
to be commended. ‘The action will be rendered more prompt and
effective if the blood is taken from the jugular. A laxative diet,
and carefully regulated work are desirable to obviate the tendency
to the affection, and this may often be accomplished by a run at
pasture. Otherwise daily small doses of Glauber salts in the feed
may suffice. Bromides may be used to calm nervous excitement.

In cases of gastric vertigo an active cathartic, followed by
smaller laxative doses or a laxative diet and a course of bitters
may prove useful. Such cases should never be worked ona full
stomach but should be left at rest at least for an hour after a meal.

In aural vertigo special attention must be given to the throat,
and external ear. Bromides may often be useful, and sometimes
benefit may be derived from an occasional blister or light firing
back of the ear.

In ccenurus cerebralis in sheep the only resort is to trephine
and remove the parasite.

CONCUSSION OF THE BRAIN.

Definition. Causes: leaps, trips, falls, blows. Symptoms : fall, insensi-
bility, flaccidity, suspended respiration, tumors, vomiting, recovery, signs
of cerebral congestion. Pathology : anzmia followed by congestion. Diag-
nosis: from fracture, epilepsy. Treatment: quiet, rubbing of limbs, am-
monia, cold to head, or heat ; for congestion, bromides, depletion, ice pack,
derivatives. ;

Definition. Concussion is the condition produced by mechani-
cal jar or shock of the cerebral mass, and manifested by modifi-
cation of the brain functions of any grade from a simple dazed
condition to that of complete unconsciousness.

Causes. The most familiar cause is the stroke of the butcher’s
pole ax, producing sudden and absolute insensibility. A horse
in leaping, trips and falls on his head or running against a wall
sustains a concussion, which leaves him for some seconds without
any signs of life. The same will happen to other animals, but
above all to rams which in their combats, back for a number of
yards and running together meet with a shock from the effect of
which even their thick skulls cannot save them. Other hlows
upon the head operate to the same end.

Symptoms. Concussion is manifested by different grades of
symptoms. At first there is usually a fall with complete insen-
sibility. The animal lies flaccid, utterly insensible to external
irritation and there is suspension of respiration. ‘The heart con-
tinues to beat and a frequent weak pulse may be often detected.
In'slight cases, breathing may be re-established at the end of a
minute or two, with muscular tremors and movements of the
limbs ; then the animal rises, shakes his head, neighs, and walks
at first unsteadily and afterward with greater and greater firmness.
In vomiting animals, emesis occurs.

In some cases this may be followed, after an hour or two, by
signs of congestion, heat of the head, redness of the eyes, irri-
tability, or dullness and stupor and perhaps muscular twitching.
This may improve or it may terminate in death preceded by
spasms, general convulsions, rolling of the eye balls, and stupor
or coma with general muscular relaxation.

The primary condition is usually an anemia of the cerebral

80

-Concusston of the Brain. 81

matter as seen in the brain of the animal suddenly killed by the
blow ofa hammer. The return of consciousness or semi-con-
sciousness is connected with the resumed freedom of the cerebral
circulation. The later convulsions, stupor or coma, usually imply
active congestion or the effusion of blood on the brain surface, or
in its substance. :

Diagnosis from fracture must be made mainly by manipula-
tion of the bone in the seat of the blow, and by the absence of
the increasing stupor and coma which attend on pressure from
a gradually increasing blood clot. From epilepsy it is to be dis-
tinguished by the evidence of mechanical injury, by the absence
of spasms at the first, by the suspension of breathing and the
absence of froth about the lips.

Treatment. Keep the patient still and prostrate until there are
signs of returning respiration and free cerebral circulation. This
may be hastened, however, by active rubbing of the limbs and
body, by giving guarded inhalations of ammonia, or even by
friction of the skin with ammonia and oil. Sometimes reaction
is favored by dashing cold water on the head, while in other
cases hot water to the poll will prove more effective, or the
two may be used alternately with good results.

If, after partial recovery, there is marked restlessness, or ir-
ritability it may be met with bromides. If secondary uncon-
sciousness supervenes effusion of serum or blood is to be feared,
or extreme congestion, and blood may be drawn from the jug-
ular or by cups from the cranium, and ice bags or cold water
may be applied to the head. Hot foot baths or mustard embro-
cations applied to the limbs, and even derivation toward the
bowels may be used. ‘The indications for treatment come to be
for meningo-encephalitis.

LIGHTNING STROKE. ELECTRIC SHOCK.

Fatal. Non-fatal. Herbivora at pasture under tree. Symptoms: dazed
for a few minutes, unconscious for hours, permanent paresis or paralysis-
Lesions : lines of burned hair, skin or muscles, rigor mortis slight, decompo:
sition rapid, bluish black venous and capillary congestion, extravasations,
blood fluid. Diagnosis. Treatment: ammonia, ether, alcohol, caffein,
nerve stimulants.

While a stroke of lightning is usually fatal, yet in certain cases,
the victim is but temporarily stunned and recovers with more or
less remaining paralysis. The subject has also great importance
in connection with the claim of the owner against a company which
may have insured his stock against lightning.

Any animal may be struck, but the herbivora which are futnea
out to pasture are especially liable to such injuries, because they
seek shelter under trees, which operate as lightning rods.

Symptoms. In slight cases of shock whether by lightning or
the current of a hanging live electric wire, the subject may be
simply dazed and may or may not fall to the ground, and recover
itself in a very few minutes. In other cases there is a more
violent shock which prostrates the animal to the earth, where it
may lie unconscious for some hours and yet quickly and com-
pletely recover. In still other cases after such prostration re-
covery is incomplete and the animal remains affected with pare-
sis or paralysis of one or more, commonly of both hind, or all four
limbs. In the more violent shocks death is instantaneous.

Often the impact and course of the current are marked by
visible lesions. Sometimes the skin is wounded exposing a bluish
black tissue beneath. More commonly there is an area of burnt
hair, or straight, radiating or angular lines of raised and frizzled
hair marking the course of the current. Ina horse killed by an
electric light wire in Ithaca recently the current had burned to a
depth of several inches in the muscles of the shoulder which
rested on the wire. ;

Lesions are often rather indefinite. There may be no appre-
ciable change in the nervous system. Rigor mortis is slight; it
passes off rapidly and decomposition sets inearly. The venous
system and capillaries are usually filled with liquid blood of a

82 :

Lightning Stroke. Electric Shock. 83

dark bluish black color, and at intervals are points, spots and
patches of blood extravasation. The uniformly liquid state of
the blood is one of the most marked phenomena of death from
electricity. The dark blue congestion of the radical veins is also
very pathognomonic, the part struck or traversed by the main
current, being the seat of the most elaborate arborescent network.
This arborescent appearance of the dark colored veins, and the
petechize are often marked in the internal organs (brain, kidneys
liver, lungs). ;

Diagnosis. 'The environment of the animal will often clear the
diagnosis. ‘The patient is found helpless, or dead under a tree
by a pole, or under a hanging wire, and if a tree there are evi-
dénces of the electric shock in scattered leaves and branches,
stripping off of the bark, or perhaps rending of the tree in pieces.
In case of wires attached to or passing near such a tree, the sup-
porting poles show similar splitting and rending. Add to these
the fluidity of blood in the carcase, the thickly ramifying network
of the minute dark bluish, red veins, the petechize and the com-
parative absence of cadaveric rigidity, and we have a picture very
significant of lightning stroke.

Treatment in such cases is according to the condition. The
primary unconsciousness is met by inhalations of ammonia or
ether, or the injection of brandy or alcohol subcutem. Caffein,
atropine or hyoscyamin may ‘be used as substitutes. If conscious-
ness returns recovery is usually rapid and complete. Should
paresis or paralysis remain it must be treated like any ordinary
case of these affections.

INTRACRANIAL HAMORRHAGE AND THROMBOSIS.
APOPLEXY. SOFTENING OF THE BRAIN.

Definition. Causes: Nature: intracranial rupture, with pressure, serous
effusion, excessive congestion, experimental cases, aneemia from pressure,
comparative immunity of horse, heart disease, Bright’s disease, atheroma,
degeneration, emboli, age, blood tension, severe exertion, excitement, con-
cussion, insolation, venous obstruction, toxins, neoplasms. Lesions: blood
clots, small and multiple, large and solitary, brain absorption, cavities, cysts.
Symptoms: dullness, swaying, trembling, elevation of head, tnrningin circle,
sudden fall, spasms, unequal dilated or contracted pupils, eyes turned to
affected side, congested or anzemic mucosz, stertor, puffing cheeks except
in solipeds, pulse slow, soft, full, vomiting, stupor, coma, unconsciousness,
paralysis, monoplegia, hemiplegia, sequela. Diagnosis: sudden uncon-
sciousness, with little spasm, but paralysis, history, sign of trauma, deep
coma, eyes turned to one side, pupils unequal, stertor, slow breathing and
pulse ; from urzemia, pulmonary apoplexy, cedema or anthrax. Treatment:
bleeding, ice pack, snow, cold water, rest, derivatives to limbs, later purge,
bromides, potassium iodide, tonics, open air life.

Definition. Cerebral apoplexy has been defined asa sudden
loss of sensation and voluntary motion, from pressure originating
within the cranium and followed by paralysis, often unilateral.
The definition is somewhat insufficient as regards the early symp-
toms as the same conditions attend on convulsions and epilepsy
(haut mal), and it is only by excluding these by their character-
istic features of sudden seizure with clonic spasms and théir inter-
mittent and paroxysmal habit that we reach an easy and satisfac-
tory distinction. Later the paralysis tends to identify the apo-
pletic attack.

Causes and Nature. ‘The immediate cause and essential lesion
of apoplexy has been generally held to be the rupture of an intra-
cranial artery and the formation of a considerable blood clot which
presses upon (and abolishes the functions of) the brain. ‘where
are cases, however, in which the characteristic symptoms are
present, and yet a complete recovery ensues at an early date, too
early to allow for the absorption of a considerable clot. Moreover,
in fatal cases perhaps no blood clot is to be found, but in place a
serous effusion, or an internal congestion which exercised the
fatal pressure on the brain. So far, therefore, as clinical phe-

84

Apoplexy and Softening of the Brain. 85

nomena are concerned, we must allow that apoplexy may arise
from any sudden pressure on the brainsubstance. Pagenstecher
produced the symptoms of the disease by injecting, at a regulated ,
pressure, melted wax and tallow between the skull and dura
mater in the dog. In the moderate cases there were drowsiness,
psychi¢ depression and general muscular weakness. In the more
severe ones there were added sleep and unilateral paralysis. In
the more extreme cases death followed in a few hours after coma
set in, though in some of these a partial recovery ensued if the
waxy mass was scooped out before the fatal symptoms appeared.
Cases ended fatally only when the injection pressure equalled
that of the blood, and convulsions occurred only when the pres-
sure was unsteady. ‘The temperature fell as it does in apoplexy
in man, at the outset, but it continued falling to the fatal issue
contrary to what takes place in man.

Duret injected water into the cranium of animals so as to pro-
duce great tension of the occipito-atloid membrane causing there-
by arrest of the respiration and slowing of the heart’saction. On
tearing the membrane so as to allow escape of the water, respira-
tion began anew and consciousness was gradually restored.

Edes sustains the view that apoplexy isdirectly due to anzemia
of a lesser or greater portion of the brain substance, and that this
need not be in any one particular seat nor of any definite extent.
This anzemia is usually induced by pressure and may be caused
by effused blood, or serum, or by the extreme congestion due to
narcotic poisons, or other cause. Embolism of a cerebral vessel,
however, by cutting off the blood from the part of the brain
which it supplies may give rise to the apoplectic phenomena.

Friedberger and Froéhner found apoplexy quite frequent in
sheep, ox, and dog, and rare in the horse, although more subject
to the violent exertion which they put in the front of all causes.
It is probable that the sluggish, pampered life of the first three
aniimals, and the tendency to fatty degenerations and heart disease
introduces a special predisposition as it does in man, while the
horse, inured to an open air life and a vigorous muscular condi-
tion, is comparatively immune. Bright’s disease is a common
cause in the human subject, with its resulting cardiac hypertrophy.
The degenerations attendant on these conditions and especially
fatty change (atheroma) in the walls of the cerebral arteries,

86 Veterinary Medicine.

pave the way for their rupture and for blood effusion. Emboli
also carried from the diseased heart not only cut off the blood
from the parts supplied by the plugged arteries, but increase the
blood tension on the cardiac side of the obstruction and endanger
rupture at any weak part. ‘Thus they may cause apoplexy from
anzemia without rupture or apoplexy from the pressure of effused
blood.

Age which is such a notorious factor in man is not without its
inflence in the lower animals. Itisin the old that we mostly
see disease of kidneys and heart and the degenerations of the tis-
sues, including the brain and its vessels ; in these, therefore, rupt-
ture and extravasation are the most frequent.

The other causes are mostly connected with increased blood
tension with or without a debility of the vascular walls. Violent
exertions as in racing, coursing, dragging heavy loads up hill or
on heavy ground, severe excitement, cerebral concussion, insola-
tion, and intense congestion of the brain substance have all been
recognized as causative factors. The compression of the jugulars
by a small collar, the violent straining attendant on parturition,
or constipation, and even the retrocession of blood from the sur-
face when exposed to extreme cold, may contribute to the final
rupture.

In infectious diseases in which the toxic products tend to pro-
duce profound modifications in the blood and tissues, extravasa-
tions are met with in the brain as in other organs. Thus they are
seen in anthrax, Texas fever, petechial fever, etc.

Then the formation of neoplasms in the brain may be the oc-
casion of the rupture of the vascular walls and apoplexy.
Hematoma of the dura in the dog (Friedberger and Fréhner),
cholesteatomata in the horse, and carcinoma may be apparent
causes.

.The effect of mechanical injury must be admitted, as blows
on the head, injuries from an ox yoke, and concussions during
the battles of rams and bulls.

Lesions. Blood extravasations may be found at any part of the
brain: a. into the brain substance; b. into the ventricles;
c. from the pia mater; d. into the arachnoid sac; e. between
the skull and dura mater. It is especially commonin connection
with the ganglia adjoining the ventricles ; the corpus striatum,

Apoplexy and Softening of the Brain. 87

optic thalamus, the corpora quadrigemini, the fornix. In other
cases the crus cerebri, pons, medulla oblongata, corpus calosum.
In other cases the convolutions of the cerebrum or cerebellum
suffer. The amount of effusion may be limited to a few drops or
it may cover an extensive area and cause considerable flattening
of the brain substance.

When capillary hemorrhages are present—the size of a millet
seed or a pea—Friedberger and Froéhner have usually found
them multiple, but when large enough to form distinct clots
they are usually single and confined to one side. If a clot, in-
volving the brain substance, is.small, it. merely separates the
nervous fibres, but if larger, the cerebral tissue is broken down
in the mass of clot, discolored, torn and softened. If the patient
has survived the first attack the clot passes through the different
stages of discoloration, brown, brownish yellow, yellow, and may
become fibrous forming a distinct cicatrix, with loss of brain sub-
stance. In connection with the partial absorption of the effused
blood, cavities may be filled with a serous fluid (apoplectic cysts),
and these may show multiple loculi. The nerve fibres which
lead to an old standing lesion are usually degenerated.

When effused into a ventricle, blood is less readily absorbed
and tends to remain as a flattened discolored layer.

Extravasation between the dura mater and the cranium is
probably always the result of direct mechanical violence.

Symptoms. Premonitory indications of apoplexy are less com-
monly recognized in the lower animals than in man, doubtless
largely because of the impossibility of appreciating subjective
symptoms. ‘The first observed indications are usually dullness,
some lack of codrdination of movement, swaying, unsteady gait,
trembling and a tendency to deviate to one side or to move ina
circle. In the majority of cases, however, the first symptoms
noticed are a complete loss of consciousness or nearly so, a
sudden fall and often more or less convulsive movements of the
limbs aggravated by any excitement. The eyes remain dilated,

‘the pupils enlarged or sometimes contracted, and in case of uni-
lateral effusion the axis of vision of both eyes is turned to the
affected side, right or left. The pupil of one eye is likely to be
more widely dilated than that of the other. Rolling of the eye-

88 Veterinary Medicine.

balls is not uncommon. Convulsions may occur, the head and
hind limbs being drawn back forcibly as in oposthotonos, or the
animal may lie flaccid and comatose from the first. ‘The nasal,
buccal and orbital mucous membranes are usually congested,
deep red or livid, yet sometimes they are anezemic and pale
(Shock). The breathing is usually characteristic, being deep,
slow, labored, irregular and stertorous and accompanied by
puffing out of the cheeks at each expiration (except in solipeds).
Yet there are cases in which stertor is absent. The pulse is
usually slow, full and soft, and, in the carotids, throbbing, but
it may be weak and imperceptible. There may be complete un-
consciousness, and again from the first, or nearly so, there may
be a slight response to a stimulus, which cannot be referred alto-
gether to reflex action. In vomiting animals, emesis may ensue.
Stupor and coma are more or less marked, though liable to inter-
missions under any cause of irritation.

Along with the above symptoms the spasms and sequent
paralysis, are significant. If confined to given muscles or groups
of muscles. (monoplegia) it usually implies pressure on some
special cortical convolutions presiding over these muscles, and
convulsions are to be expected. If there is hemiplegia it is sug-
gestive of implication of the medulla or pons on the opposite
side, or of a clot on the corpus striatum or extensively on one
side of the cerebrum. A clot in the lateral ventricle tends to
profound coma. So liable, however, is pressure to be extended
from one side of the brain to the other, and irritation on the one
side to rouse a corresponding condition on the opposite side, or
in related ganglia, that deductions of this kind cannot always be
implicitly relied on.

Though an animal should recover from an attack there is liable
to remain some modification of the nervous functions, partial
anesthesia, circumscribed paresis, dullness, lack of energy, irrit-
ability, or muscular atrophy. ,

‘Cerebral embolism and thrombosis and their sequelz, infarction
and softening, give rise to corresponding symptoms, according to
the seat of the lesion, and like lesions of the blood vessels pre-
dispose to subsequent attacks.

Diagnosis is based largely on the appearance, usually sudden

Apoplexy and Softening of the Brain. 89

but sometimes slow, of a more or less profound unconsciousness,
attended or followed by paralytic troubles. The history of the
case may assist, any blow on the head, or sustained by falling,
striking a wall or post, or wearing a yoke, is to be noted. Any
extraordinary exertion or excitement must be considered. Any
sign of injury about the head; the congestion of the cephalic
mucous membranes in contrast with the pallor of shock, the
onset of the attack without convulsions (or with them as in epi-
‘lepsy) ; the deep coma indicating cerebral hemorrhage or nar-
cotic poisoning ; the absence of the odor of alcohol, opium, or
other narcotic from the breath; the turning of the eyes to one
side and the inequality of the pupils on the two sides ; the turn-
ing of the head to the same side as the eyes ; the slow, labored,
usually stertorous breathing ; the slow, full, soft pulse; the oc-
.casionally rigid condition of the’muscles and finally the paralysis,
hemiplegic and less frequently monoplegic or paraplegic, make
up the diagnostic picture.

Uremia and diabetic coma may be excluded by examination of
the urine, pulmonary apoplexy or edema by the predominance of
respiratory troubles, and fulminant azthrax by the examination
of the blood and by the fact that this disease does not prevail in
the locality.

Treatment is very unsatisfactory in the lower animals, as the
disease is very fatal, and unless recoveries are complete, they are
not pecuniarily desirable. It is only in the slighter cases, there-
fore, that treatment can berecommended. At the very outset no-
thing is better than a full bleeding in a large stream from the
jugular vein or temporal artery. Ice, snow, or cold water should
meanwhile be applied to the cranial region. Absolute rest should
be given, any harness that would impede circulation or respiration
removed, and hot water or stimulating embrocations applied to
the limbs.

When consciousness returns and the patient can swallow, an
active purgative may be administered, or barium chloride or
eserine may be given subcutem. Any recurring heat of the head
may be met by renewal of cold applications, and the force of the
circulation may be kept in check by small doses of bromides or
aconite. In case of the formation of a clot, iodide of potassium
and other alkaline agents may be resorted to. Quiet and the

go Veterinary Medicine.

avoidance of all excitement together with a laxative non-stimu-
lating diet must be secured throughout. A course of vegetable
or mineral tonics and an occasional blister to the side of the neck
may prove a useful sequel.

CEREBRAL HYPERAMIA.
MENINGO—ENCEPHALIC CONGESTION.

Passive and active hyperzemia. Causes: passive: obstacles to return of
blood : anzemia : active - brain excitement, sunstroke, violent exertion, fear,
abdominal tympany, ptomaines, narcotics, lead, darnel, millet, leguminous
seeds partly ripened, tumors, parasites. Symptoms : horse ; variable, vertigo,
stupor, convulsions, apoplexy, irritability, disorderly movements, strong,
hard pulse, congested mucosz, heat of head, dullness, drowsiness, lethargy,
coma, alternating periods of violence, aggravated by what tends to increase
vascularity of brain, congested optic disc : caét/e - parallel, with special heat of
horns : dogs: similar, with desire to move, or wander, or has nausea, howls,
snaps. Treatment : cold to head, derivation to limbs and bowels, chloral,
bromides, ergot, bleeding, darkness, coolness, non-stimulating food.

Congestion of the encephalon is treated here as a pathological
entity, though it cannot always be distinguished clinically from
some forms of vertigo on the one hand and from the milder types
of apoplexy or encephalitis on the other. It has been divided
into passive or venous hyperemia and active or arterial hyperemia.

Passive hyperemia, as shown under vertigo and apoplexy is a
common result of a tight collar, a tight strap used for crib-biting, a.
too short bearing rein, dilation or valvular disease of the right
heart, or disease of the lungs, violent efforts in running, draught,
etc. It tends to be associated with arterial anzemia-on the princi-
ple that the closed cranial cavity can only admit a certain amount
of blood and if an excess accumulates in the veins and capillaries,
this must be compensated first by the movement backward to the
spinal canal of the cerebro-spinal fluid, and second by the-dimi-
nution of the blood in the cerebral arteries.

Active hyperemia, may be brought about by any excitement:
which especially affects the brain. This has been already noted
in connection with insolation (sunstroke). It may result from

‘Cerebral Hyperemia gI

severe exertion during hot weather, in a violently contested
race, in drawing a heavy load up hill, or in harsh training.
Violent exertion just after a meal is especially injurious. Also
the excitement of travelling by rail, or that caused by proximity
to locomotives, to discharges of firearms and to other causes of
great fear; encreased blood tension in the cerebral vessels in
connection with hypertrophy of the left ventricle, or obstruction
in other vessels (of the limbs) so as to direct the force of the
current into the carotids, the expulsion of blood from the
splanchnic cavities by gastric or intestinal tympany, or over-
loading of the paunch, and irritation of the brain by ptomaines
and toxins in certain infectious diseases (rabies, canine distem-
per, etc.) Inthe same way vegetable narcotics (opium, etc.)
produce congestion. Among the most common causes of con-
gestion are lead, poisoning by lolium temulentum, partially ripened
lolium perenne, millet, Hungarian grass, and partially ripened
seeds of the leguminosze (chick vetch, vicia sativa.) Other
causes are the presence of tumors (cholesteatoma) and parasites
coenurus, cysticercus) in the brain.

Symptoms. Cerebral hyperemia, like other brain disorders
may give rise‘to a great variety of symptoms, according to the
condition of the animal and the susceptibility of its nerve centres.
Sonie cases have the characteristic seizures of vertigo, others the
manifestations of heat stroke, and others, epileptic explosions or
apoplectic symptoms. For these see under their respective head-
ings. In other cases the symptons are those of encephalo-
meningitis but moderate in its type and often tending to a transient
duration, or to prompt resolution and recovery.

Horse. ‘There ismanifest change of the nervous and intellect-
ual conditions, which may show itself by irritability of restless-
ness, by pushing against the wall, by hanging back on the halter,
by trembling, shaking the head, neighing, pawing and, in ex-
ceptional cases, by rearing, biting or kicking. The pulse is hard
and full, the heart’s impulse strong, the beats in the carotids and
temporal arteries being especially forcible, and the buccal, nasal
and orbital mucosz are strongly congested. Heat of the head is
usually a marked feature. While usually very sensitive to touch,
noise or light, the animal may be dull or drowsy, and in spite of
its marked sensitiveness, it is then inert or lethargic and indis-

92 Veterinary Medicine.

posed toany active exertion. Friedberger and Frohner say that
the habitual comatose condition alternates at intervals with
periods of violent excitement during which the animal pushes or
dashes against the wall, grinds the teeth, rears, paws, kicks, bites,
etc., and then relapses into the state of coma. When the disease
reaches this stage it may be questioned whether we are not deal-
ing rather with acute encephalitis.

In active congestion the symptoms are always aggravated by
whatever tends to increase the vascular tension in the brain.
Active exertion, draught, the pendent position of the head, the
recumbent position on the side with the head as low as the body
or lower, aggravate all the phenomena and render the animal more
helpless. :

The following table slightly modified from Spitzka serves to
point out the distinctions between anzemia and hyperemia :

Symptoms. In Cerebral Anzmia. In Cerebral Hyperzmia.
Pupils. Usually dilated and mobile. | Usually small or medium.
Respiration. Often interrupted by a deep | Normal or nearly so.

breath or sigh, even when | — :
at rest.
Activity. Lassitude. Restless, but indisposed to
exertion.
Temperament. | Lethargic with exceptions. | Irritable with exceptions.
Intelligence. Senses impaired. Impaired.
Elevation ofhead| Aggravates symptoms, No effect, or improvement.
Recumbent, de- | Amelioration. Aggravation.
pendent head.
Straining. Not necessarily aggravated. | Aggravated.

Cattle show the same general congestion and heat of the head,
ears and horns, congested mucosz, fixed eyes, and pupils, indis-
position to follow the herd, irritability, and dullness with often a
disposition to lie down. This may go on to violent bellowing,
pushing against the wall, grinding of the teeth, working of the
jaws, rolling of the eyeballs, and violent dashing in different
directions regardless of obstacles.

Dogs show the same restlessness and excitability, congested
head, eyes and nose, frequent movement from place to place, a ,
desire to wander off, and it may be spasms. If there has been
any gastric disturbance vomiting usually supervenes. As in the

Cerebral Hyperemia. 93

larger animals the disease may go on to more violent symptoms,
and the animal howls, rushes in different directions, and may
snap at imaginary objects, or at any one who interferes with him.
His movements are liable to be unsteady, uncertain and swaying.

In all cases the ophthalmoscope reveals a congestion of the
optic disc. ;

In the different animals too, acute cerebral hyperzemia tends to
merge early into encephalitis with exudation and pressure, at-
tended by stupor, coma, somnolence or profound lethargy.

Treatment. In slight cases of cerebral hypereemia, it. may be

_ sufficient to apply cold to the head with a stimulating fomenta-
tion to the limbs, and an active purgative, with chloral or bro-
mides. Ergot in full doses has often an excellent effect.

In the more acute types of the disease, bleedingis the first and
most efficient measure. A full abstraction from the jugular
will relieve the vascular tension and relieve the circulation on the
brain. It has been counselled to avoid this when comatose
symptoms have set in, and in some prostrate conditions a large
and rapid abstraction of blood may fatally increase the prostra-
tion. In other cases, however, the less rapid abstraction will
improve at once the intracranial circulation and nutrition, and
solicit the reabsorption of the exudate which produces sopor and
coma.

A purgative is oue of the most efficient derivatives, the deter-
mination of an excess of blood to the bowels and of an abundant
serous discharge into their interior acting asa valuable depletion,
and abstraction of blood from the over-excited brain. At least a
half more than the usual dose must be given, and may be supple-
mented by an injection of glycerine or a hypodermic exhibition
of ‘eserine. It is best to avoid too drastic or irritant purgatives
as the cerebral congestion may be aggravated by the irritation, as
it often is induced in severe indigestions. For the horse, aloes
and podophyllin, or for ruminants, omnivora and carnivora
castor oil may be resorted to.

The patient must be placed by himself in a dark, cool, well
aired building, and when able to resume feeding must receive an
easily digested, non-stimulating diet ; for horses or cattle, gruels,
wheat bran mashes, pulped roots, or green food; for dogs and
pigs, gruels, mush or milk.

Any sequent paralysis must be treated on general principles.

MENINGO—ENCEPHALITIS. STAGGERS.

Divisons. Causes : traumas, faulty diet, highly nitrogenous, leguminous
seeds, undergoing ripening, cotton seed, gluten meal, forced feeding, buck-
wheat, rye grass, lupins, cryptogams, trefoil, equisetum, narcotics, mi-
crobian ferments, experiments with spoiled food and epizootics in wet
years, high temperature, violent exercise, railroad travel, climatic change,
complex causes, embolisms, infections, lead, phosphorus, tumors, parasites.
Symptoms: with meningitis, fever, hyperesthesia, active delirium and
convulsions predominate ; with encephalitis, dullness, stupor, somnolence,
muscular weakness, anaesthesia, paralysis, coma ; usually complex, hyper-
thermia, periods of benumbing, followed by excitement ; drowsy, stupid,
semi-closed ey elids, drooping lips, ears, and head, latter resting on manger ”
or wall, walks unsteadily, limbs out of plumb, hangs on halter, won’t back,
turns in circle, costive, indigestion, tympanies, rumbling, abnormal (often
slow) pulse and breathing, congested optic disc ; alternate with trembling,
excitement, pawing, rearing. plunging, pushing against the wall, trotting
motions, etc. ; uncontrollable violence ; severity and frequency of parox-
ysms indicate gravity: recovery sequele. Duration: death in 24 to 36
hours ; or weeks. Prognosis : one quarter recover, with increased suscepti-
bility ; nervous animals worst. Lesions : extravasation, congestion, exu-
dates, pus, thickened meninges ; choroid plexus ; brain matter gray or red,
puncta, infiltrated, softened, excess of leucocytes, red softening, yellow
softening, sclerosis, cicatrix, abscess. Diagnosis: from rabies, cerebral
congestion, immobility, influenza. Cattle, Symptoms : evidence of trauma,
indigestion, lead poisoning, narcotism, parasitism ; dullness, stupor, somno-
lence, stertor, grinding teeth, spasms, twitching, restless movements, blind-
ness, violent actions, bellowing, hebetude, palsy. Relation to causation.
Sheep: Symptoms. Swine: Symptoms. Dog: Symptoms. Diagnosis
from rabies. Treatment: quiet, darkness, coolness, restraint, ice or cold
irrigation, elimination, derivation, depletion, diuretics, potassium iodide,
antipyretics, laxative diet, cool water, evacuate abscess. Cattle, similar,
saline laxatives, for lead sulphuric acid, for ccenurus, operation, for cestrus,
benzine. Dog, parallel treatment, milk diet or gruels, for linguatula,
benzine.

The inflammatory affections in the cranial cavity have been
divided primarily into the following :

1. Meningitis. Inflammation of the coverings of the brain, and

2. Encephalitis (Cerebritis). Inflammation of the nervous sub-
stance. These are further subdivided into:

A. Pachymeningitis. Inflammation of the dura Mater.

B. Leptomeningitis. Inflammation of the pia Mater.

94

Meningo—Encephalitis. Staggers. 95

C. Purulent Meningitis,

D. Serous Meningitis.

E. Tubercular Meningitis.

I. Traumatic Meningitis, ete.

G. Cerebro-Spinal or Infective Meningitis.

HT. Acute Meningitis.

I. Chronic Meningitis.

J. Polioencephatitis Corticalis. Inflammation of the brain cortex.

K. Polioencephalitis Superior. Inflammation of convolutions
around the Sylvian fissure, palsy of the eyeball.

L. Polioencephalitis Superior. Inflammation of the Medulla,
bulbar palsy. ;

M. Interstitial Inflammation of the Brain. Resulting often in
sclerosis.

In the lower animals, however, where we cannot avail of sub-
jective symptoms, such fine distinctions can rarely be made in
diagnosis and except in case of an uncomplicated meningitis, or
a circumscribed encephalitis, which affects only a limited group
of muscles like those of the eye, arm, or leg, we have to fall
back upon a more general diagnosis. Again meningo-encepha-
litis is more common than the uncomplicated affection of the
brain, or the membranes, and therefore, we shall follow Trasbot
in dealing with the combined affection, and noting incidentally
the distinctions that can be made in the more purely limited
affections.

Causes. Mechanical Injuries. Pachymeningitis occasion-
ally results from blows or other injuries upon the head, especially
in stallions and vicious horses struck with a heavy whip or club,
cattle and sheep injured in fighting, and oxen hurt by the yoke.
These injuries may also affect the brain asin concussion, or by
the extension of the disease into the nervous tissue. In the
cranium of a stallion in the New York State Veterinary College
Museum the whole of the meninges are greatly thickened by a
traumatic meningitis of old date and the subjacent cerebral con-
-volutions of the right hemisphere are deeply encroached on, flat-
tened and absorbed over an areaof 134 inches in the longest
‘diameter. .

Diet. Among the most common causes of encephalitis in
horses is an injudicious dietary. Overfeeding with grain, but

96 Veterinary. Medicine.

especially with grain and seeds that are rich in albuminoids
deserve the first mention. The various leguminous seeds, peas,
beans, tares, vetches, and the ripened leguminous fodders, clover,
alfalfa and sainfoin, are especially to be incriminated. These
are usually most dangerous when in the stage of advanced
ripening and yet not fully matured, evidently indicating the
development of narcotic poison at this stage. Such poisons are
found habitually in certain species, like the chick vetch (vicia
cicera) which produces paralysis when fed to the extent of more
than ‘one-twelfth part of the ration. This danger is not, how-
ever, confined to the leguminosz ; an over abundant ration of
cottonseed meal has a similar effect; and indeed this rich ali-
mentary product has been practically discarded from pig feeding,
and largely as the main constituent from the ration of dairy
cows. Gluten meal, another product rich in proteids, is attended
by similar dangers. But it is not alone the seeds that are rich in
nitrogen that are to be dreaded, forced feeding even on the car-
bonaceous maize induces disorder of the digestion and brain,
especially in dairy cows. Buckwheat, also, and indeed all the
heating carbonaceous grains tend to similar disorders, and are
especially injurious in internal ophthalmia (recurring ophthal-
mia) which is so closely related to brain congestion. With
sound judgment and in well balanced rations, all such agents can
be fed to advantage ; it is only when fed exclusively or to excess
as’ the heavy ration that they are to be feared.

Narcotics. Next must be noted those alimentary matters
which are hurtful by reason of narcotic constituents. At the
head of this list may be placed the lolium temulentum or intoxi-
cating ryegrass. Like the vicia sativa or cicera, the seeds of this
are always poisonous, hence its significant name. Then the
other ryegrasses, perennial and annual (Italian), though per-
fectly safe in ordinary circumstances, develop at the period of
ripening a narcotic principle, which produces cerebral congestion
or inflammation in whole stables of horses at a time. The lolium
temulentum is poisonous to man and animals alike. Baillet and
Filhol obtained from the seeds an etherial extract containing a
bland oil to the amount of two-fifths and a yellow extract to the
extent of three-fifths. The amount of this extract derived from
three ounces of the seed often developed the most violent

Meningo—Encephalitis. Staggers: 97

symptoms in the dog, while that furnished by six pounds of the
seeds proved fatal to the horse. Pigs and cattle seemed to be
unaffected by the agent when given by the mouth. Sheep
suffered more but required large doses. Ducks and chickens
were practically immune, being affected only by very large doses.
Rabbits were not poisoned by the yellow etherial extract, but
succumbed to a watery extract. Brydon found that lambs
suffered extensively from eating the heads of the ryegrass.

Lupins on certain lands produces an icteric disorder ac-
companied by cerebral symptoms but the result is not the same
under all conditions and it has been suspected that the symptoms
were caused by cryptogams and their products. The same re-
mark applies to the brain symptoms sometimes produced by
trefoil, equisetum and other plants.

A great number of narcotic and narcotico-acrid plants pro-
duce nervous symptoms indicating cerebral congestion or inflam-
mation such as ranunculus, wild poppy, digitalis, fennel, cenanthe
crocata, hellebore, veratrum, conium, yew, tobacco, box, aconite,
cicuta virosa, even buckwheat at the time of flowering, vetch and
flax.

Fodders affected with cryptogams or bacterial ferments are
undoubtedly at times the cause of encephalitis. Veterinary
records furnish many instances of wide spread attacks of stomach
staggers, abdominal vertigo, and cerebro-spinal meningitis in
wet seasons, when the fodders have been harvested in poor con-
dition, or when from inundation or accidental exposure they have
become permeated by cryptogams and microbes. Among com-
paratively recent accounts of this are those of Martin and Var-
nell (musty oats), Lombroso, Depre, Erbe, Pellizi, and Tireli
(smuts), Bouley and Barthelemy (musty fodder), and Ray
(fermented potatoes). One of the most extended local out-
breaks of cerebro-spinal congestion I have seen, occurred in the
pit mules of the Wilkesbarre coal mines, while fed on Canadian
hay which had been soaked with rain in transit and had under-
gone extensive fermentation. It should be noted that there
were the attendant factors of overwork, in anticipation of a strike,
and a Sunday’s holiday above ground in a bright summer
sunshine.

The experimental administration of moulds, smuts and mi-

7

98 Veterinary Medicine.

crobes, have in the great majority of cases led to little or no
evil result (Gamgee, Mayo, Dinwiddie, etc.) and there is a
strong tendency to discredit the pathogenic action of these
agentsin reported outbreaks. The safer conclusion perhaps
would be, to recognize the fact that they are not equally patho-
genic under all conditions of their growth and administration.
The oft-recurring epizootics of brain disease in connection with
wide spread spoiling of the fodders in remote and recent times,
probably imply that cryptogams or microbes and their products,
plus some condition not yet fully understood are efficient con-
current factors. If we can discover this as yet unknown factor
and demonstrate that it operates with equal power in the ab-
sence of the cryptogams and ferments, as in their presence, it
will be logical to pronounce these latter as nonpathogenic under
all circumstances. Until then cryptogams and bacteria must be
held as probable factors.

' A continuance of high temperature is an undoubted factor
and becomes more potent, if conjoined with a close, damp, ill-
aired stable.

Violent exertion especially in hot weather produces active
congestion of the brain and occasionally merges into meningo-
encephalitis. Ifthe animal has been for sometime confined to
the stable on rich aliment’ the condition is aggravated.

Railroad travel is another recognized cause.

Any considerable change of the conditions of life may

operate in the same way. A sale and transport to a distance
with change of feed, water, work, stabling and even of climate
is at times a potent factor. Prietsch has seen a horse attacked
three times in a single year, and on each occasion after a change
of ownership and locality. Trasbot quotes an Algerian veteri-
narian to the effect that many of the Percheron horses imported
into the Mitidja are attacked by encephalo-meningitis during
the extreme heats of summer.

A careful observation of cases will however show that in the
majority of cases an attack comes not from one individual
factor alone but from a concurrence of several operating together.

Other cases are caused by embolisms and infections from
diseases localized in other parts of the body. Thus we have
cerebral abscess in pyzemia, stranglesand omphalitis, and cerebral

Meningo—Encephalitis. Staggers. 99

congestions and inflammation in canine distemper, equine con-
tagious pneumonia, laminitis, and angina.

Among mineral poisons, lead is notorious asa cause of acute
cerebral disorder often leading to inflammation. Other mineral
poisons like arsenic and phosphorus may lead to ‘encephalitis
symptomatic of gastro intestinal irritation, or caused by the toxic
products of indigestion.

Rapidly growing tumors, like cholesteatomata, are liable to
induce recurrent attacks of encephalitis in connection with
periodic irritation.

Finally parasites in the cranium are sufficient causes of at-
tacks. Inthe New York State Veterinary College Museum is the
brain of a cat with a nematoid wound round the hypophysis. In
equine subjects suffering from the strongylus armatus the larval
worm or clots caused by its presence in other arteries sometimes
invade the encephalic blood vessels causing disturbances of the
circulation, embolism, inflammation or degeneration. (Albrecht,
Von Heill). The larvee of the cestrus has also been found in the
brain substance producing inflammatory or degenerative foci
(Briickmiiller, Megnin, Siedamgrotzky). ‘Their presence in the
nasal sinuses at times causes encephalitis by contiguity. The ces-
toid worms, ccenurus in sheep .and other ruminants, and cysti-
cercus in swine, find their natural larval habitat in the brain and

‘by their movements produce more or less congestion and inflam-
mation. Cases of ccenurus in the horse have been described by
Rousset, Frenzel, Zundel, and Schwanefeldt.

Symptoms. The symptoms of uncomplicated meningitis on the
one hand and encephalitis on the other are rarely seen, the
disease usually implicating more or less both brain and meninges,
in a common inflammation or the symptoms of the one involving
those of the other through proximity or interdependence of func-
tion. And yet in traumatic lesions of the cranial walls, the
symptoms may be those of pure meningitis, and in thrombosis,
embolism or parasitism of the brain, and in certain tumors they
may be those of simple encephalitis. The distinction consists
largely in the predominance of fever, hyperzesthesia, active de-
lirium and convulsions in meningitis, and especially in its earlier
stages; and the prominence of dullness, stupor, somnolence, mus-
cular weakness, paralysis, anzesthesia, coma, and the clouding of
special senses, with much less pronounced febrile reaction, or
vascular excitement in encephalitis.

100 Veterinary Medicine.

There is usually, however, a mixing of symptoms so that the
benumbing or paralysis of the nervous functions alternates with
periods of their exaltation, and with both conditions hyperther-
mia exists, though usually higher with meningitis.

The manifestations of benumbing or paresis may be continu-
ous or interrupted, and are exhibited in stupor, coma, somnolence,
lethargy, paresis or paralysis. ‘The manifestations of excitement
are.not continuous but occur in paroxysms or at least exacerba-
tions, which may show in visual or mental illusions, active, vio-
lent delirium, trembling, rigors, clonic or tonic spasms. The
onset is usually abrupt, the animal passing in a few hours from
apparent health, to pronounced nervous disorder. The horse
seems drowsy and stupid, standing with semi-closed eyes, often
drooping lower lip and ears, head pendent and resting in the
manger or against the wall in front, the back arched and the
limbs drawn together. When moved, it walks unsteadily and often
the limbs are left out of plumb, one extending unduly forward,
backward or to one side, and often crossing over its fellow. Some
cannot be made to back, others back spontaneously hanging on
the halter. Turning short in a circle is difficult or impossible
and tends to throw the patient down. Yet some exceptional
cases will turn around spontaneously to the right or left, and an
animal tied to a post goes around it at the end of its halter in its
effort to pass straight forward. The circling movement may be
due to the irritation on the one side of the brain or to irritation of
particular ganglia and nervous tracts as noticed under cerebral
hyperzemia.

Appetite is usually lost, or more properly, the animal no
longer takes notice of surrounding things, not even of its food.
In some cases, however, in which stupor or coma is not extreme
the animal will eat a little during his quiescent intervals. In
ryegrass and other dietetic poisoning, the animal may still eat and
fall asleep with the mouth full. The digestion is impaired or
suspended, the bowels costive, and fermentations with tympanies
and rumbling are frequent complications. When originating from
poisonous food this often contributes to these abdominal compli-
cations.

Respirations in the comatose condition are deep and slow,
sometimes not more than four or five per minute. The heart

Meningo—Encephalitis. Staggers. 101

usually beats strongly, often tumultuosly, and the pulse varies
greatly—infrequent or frequent, strong or weak, full or small.
With cerebritis it is often abnormally slow.

Hyperthermia is always present to a greater or less extent,
being often more marked in the more violent forms or those in
which meningitis appears to predominate than in the purely cere-
bral forms. ‘The temperature may vary from 1o1° to 106°.

The optic disc is congested.

Probably in all cases or nearly all there is a preliminary stage
of excitement, in which the eye is clear, the eyelids open, the
aspect alert and the whole skin affected by a marked hyper-
zesthesia. In some cases the symptoms of excitement are much
more violent at the outset of the disease, as marked by trembling,
nervous movements, pawing, pushing the head against the wall.
while the motions of walking or trotting are performed by the
limbs, or those of plunging forward, rearing up, ‘drawing back
on the halter, etc.

But even when the disease seems to have started with stupor
and coma, these paroxysms of excitement almost invaribly ap-
pear at intervals as it advances. Some, however, plunged in
stupor or coma at the first, remain in this condition until they
end in paralysis or death, or start in convalescence.

During one of the paroxysms the trembling animal may push
his head against the wall as if pulling a heavy load ; at other
times he will plunge with his feet in the manger and recoiling,
fall to the ground, where he struggles violently in an apparent ef-
fort to rise ; others rear up, pulling on the halter or breaking it
and falling back over ; some pull back on the halter and throw
themselves down ; some grind the teeth, or seize the manger, or
strike blindly with the fore limbs. When seized out of doors
the horse may be quite uncontrollable and refuse to return to the
stable even when led by two men with double halters. In all
such cases the eye has a fixed, glaring aspect which is the more
pronounced when the pupils are dilated, the conjunctiva is
deeply congested, of a deep, brownish red with a tinge of yellow.
This is usually greatly enhanced by the bruises and extravasa-
tions caused by pushing or knocking the head against the wall.
he same violence may lead to serious bruises and injuries else-
where, even fractures of the orbital process or zigoma, of the

102 Veterinary Medicine.

ilium or ischium, of the poll or the base of the brain ; also of the
incisor teeth.

These paroxysms may be so frequent that they seem to be sub-
ject to remissions only, and not separated by complete intermis-
sions. During the paroxysms breathing and pulsations are both
greatly accelerated.

The gravity of the attack may be judged in part by the vio-
lence and frequency of the paroxysms. Yet some cases, marked
by profound coma from the first, prove the most rapidly fatal,
and the paroxysms of excitement and violence are not incompat-
ible with recovery. Improvement may usually be recognized by
the increased length of the intervals between the paroxysms, and
by the shortening and moderation of the periods of excitement.
After the paroxysms have ceased the drowsiness or stupor gradu-
ally disappears, and the hyperthermia subsides.

Even after recovery: from the acute or violent symptoms there
is liable to remain some aberration or perversion of function, due
to the persistence of some encephalic or meningeal lesion. The
general hebetude known as zmmodility may bespeak dropsy of
the ventricles, pressure of a tumor or clot, or degeneration of
ganglonic centres. Diseases of the eyes (amaurosis, glaucoma,
cataract), or of the ear (deafness, disease of the internal or
middle ear) are less frequent results.

The supervention of general or facial paralysis or of hemi-
plegia during the active progress of the malady, is an extremely
unfavorable symtom. ;

Duration. A fatal result may take place at any time by self
inflicted injuries (dashing the head against the wall, or falling
backward and striking the head on a solid body). Apart from
this, death may come within twenty-four or thirty-six hours. If
the animal survives two to seven days recovery is more probable.
Hering records a case of recovery after five weeks illness. Hot
weather hastens a fatal result, while cool, cloudy weather is
favorable.

Prognosis. Under rational treatment about one-fourth recover.
One-half of the victims make a partial recovery but remain in a
condition of dementia or hebetude, blindness, deafness, local or
general paralysis which renders them more or less useless. Not
more than one-fifth or at most one-fourth of all cases recover.

Meningo—Encephalitis. Staggers. 103

Even in these there is left an increased predisposition ‘to re-
currence. It is noted by Trasbot that the mortality is higher in
highbred, nervous, irritable animals, which show -a tendency
to greater frequency, force and duration of the paroxysms of ex-
citement. When decubitus is constant, death may take place
from septic poisoning starting from bed sores, and gangrenous
sloughing. In other cases there is fatal starvation from inability
to eat.

Lesions. In pachymeningitis due to mechanical injury there
is usually cutaneous and subcutaneous, blood extravasation, and
there may be fracture of the cranial bones. The dura matter is
dark red, hyperzemic, thickened, covered with exudation and small
blood clots mixed with pus cells, and has contracted strong ad-
hesions to the cranial bone. Bony spicula may project into the
fibrous neoplasm.

Leptomeningitis usually coexists from extension of the in-
flammation into the adjacent arachnoid and pia mater. There
is then a reddish serous effusion into the arachnoid and beneath
it, and the substance of both membranes is thickened by exudate,
and discolored by congestion and minute hemorrhages. When-
ever the pia mater is thus inflamed, the superficial layer of the
brain is implicated, oedematous, soft and doughy. The exten-
sion is also made into the ventricles and a serous effusion takes
place often to two, three or more times the normal amount
(82 grammes, Schiitz). The choroid plexus forms a yellowish
gelatinoid mass, and the ganglia (corpora striata, optic thalamus,
etc.), are flattened.

In encephalitis the affected superficial gray matter of the
ganglia or convolutions, is deepened in color, usually in limited
areas corresponding to the disease of the meninges. Sometimes
the color becomes of a distinctly reddish tinge, and, when cut into,
shows unusually prominent red points where the capillaries have
beencut. Somewhat larger areas of blood staining indicate heemor-
rhagic extravasations. The nervous substance is more or less
infiltrated with liquid and softened. The nerve cells are swollen,
and in process of granular degeneration and the same is true of
the myelin, while the axis cylinder is uneven in its outline.
Apart from the numerous minute petechial hemorrhages there is
an abundant migration of leucocytes which are found scattered in
the degenerating and softened nervous tissues.

104 Veterinary Medicine.

The softening of the nervous tissue may result in a pulpy
material, which in the comparative absence of blood is grayish
(gray softening), if abundantly infiltrated with blood is red
(red softening), if older and discolored is yellow, as in an old
extravasation (yellow softening), if thick and viscous is ge-
latinoid softening. If the exudate becomes organized into
fibrous material it is a connective tissue sclerosis or a cica-
trix. If the softening exudate becomes purulent it constitutes
a cerebral abscess. Cerebral abscess is especially common as
secondary abscess in strangles or contagious rhino-adenitis in the
horse, but may occur as the result of the presence of any pyo-
genic germ.

Diagnosis. While there is a certain similarity to rabies, the
horse with encephalo-meningitis is distinguished by the absence
of the extreme hyperzesthesia and irritability, of the persistent
neighing and squealing,, of the rapid alterations of the voice,
hoarse and shrill, of the hallucinations, as following imaginary
objects with the eyes, of the readiness to attack with teeth or
heels when in any way disturbed or excited, of the disposition to
get violently excited when a dog is brought near, or in the case
of a stallion to show generative excitement.

From cerebral congestion it is to be distinguished by the
greater severity of the paroxysms, or the deeper character of the
stupor, but above all by the presence of the hyperthermia and
other indications of fever.

Immobility which presents the symptoms of drowsiness,
stupor and hebetude, is also unattended by fever, or anorexia,
shows a healthy condition of the functions of respiration, diges-
tion and assimilation and a restful condition when left quiet
and still.

The cerebral excitement that sometimes appears in influenza is
really an encephalitis complication, but its specific cause is
recognized in the local prevalence of the infectious disorder, and
the inflammatory or catarrhal condition of the mucous membranes.

The diagnostic manifestations of meningitis and encephalitis
respectively are given under symptoms.

Symptoms in Cattle. In cattle encephalo-meningitis super-
venes on congestion, and sometimes comes on abruptly in con-
nection with traumatic injuries, acute gastric disorder, lead-

Meningo—Encephalitis. Staggers. 105

poisoning, or narcotism. The cases of cerebral parasitism are
usually slow in their onset.

Upon the preliminary dullness and somnolence there super-
venes excitement, manifested by loud bellowing, pushing the
horns, forehead or teeth against the wall, labored often stertorous
breathing, a fixed eye often with dilated pupil giving it a peculiar
glaring appearance, movements of the jaws, frothing at the lips,
tremors, muscular spasms, twitching, or a restless disposition to
move, in a circle, in a straight line or less frequently backward.
The patient seems to see nothing and is utterly regardless of ob-
stacles. Sometimes the animal plunges violently into manger
or rack, against or through the partition of his box, through
fences, into ponds, pits, quarries and other dangerous places that
may be accidentally in his way. The paroxysms may be inter-
mitted by intervals of comparative calm, and tend to merge into
a condition of dulled sensation, staggering, stupor, hebetude and
paralysis. The congested conjunctiva and, when it can be seen,
the optic disc will correspond to the cerebral congestion. These
cases usually proceed to a fatal issue in a few hours. Some
cases, however, make a good recovery after a few days of dull-
ness and prostration. In cases that are connected with lead
poisoning, or the toxic action of narcotics in the fodder, the at-
tendant circumstances will assist in the diagnosis. From malig-
nant catarrh implicating the encephalon, it may be distinguished
by the absence of the catarrhal inflammation of the conjunctiva,
pituita, sinuses, buccal mucous membrane, and genito-urinary
passages. Also of the tendency to implication of the hair follicles
and the keratogenous tissue of the frontal horns.

In the Edinburgh Veterinary Review, Dundas describes a form
of alcoholism in cows caused by feeding these animals on ‘‘ burnt
ales’’ in the vicinity of distilleries. The ale is given by steeping
straw init, and the animals will also drink it freely. They often
sleep soundly after such a beverage or give evidence of intoxica-
tion. ‘The head is turned singularly to one side and slightly ele-
vated. The pupils are'widely dilated, and the eyes have a re-
markably wild appearance. On being approached the animals
wink rapidly and tremble. There is marked heat of head, horns,
and ears. When pressed with the finger in the axilla they fall
instantly and when pulled by the head they incline to turn over.

106 Veterinary Medicine.

The pulse is 70 to 80 per minute. Delirium and loss of codrdi-
nation of the muscular movements set in, and in case of survival
various forms of chronic brain disease are manifested. In one
cow the violent symptoms came on with the near approach of
parturition. The post mortem lesions consisted in ramified red-
ness and punctiform blood extravasations in the pia mater and
meninges. ‘The brain substance was softened and clots of blood
were found in the lateral ventricles. Congestion and extravasa-
tions were also found around the cervical myelon. (See Alco-
holic Intoxication. )

Symptoms in Sheep. "The sheep is often drowsy, dull and
stupid, lying by itself with head low or laid backward. During
the periods of excitement it works the jaws, froths at the mouth,
carries the head turned in one direction, upward or lateral,
bleats piteously, pushes against the wall, has uncertain,
stiff or staggering gait, or convulsions, and finally paralysis.
The head is hot, and the eye fixed, congested or sometimes
rolled upward or squinted. Symptoms in the goat are nearly
the same. ‘The ccenurus disease is more gradual in its onset,
and produces periodic paroxysms corresponding to the activity
of the heads of the parasite when protruded into the brain
substance. It is mainly confined to sheep of one year and
under and that are kept where dogs have access.

Symptoms in Swine. Pigs may at first have a period of dull-
ness or restlessness, the latter merging into active delirium. The
patient champs his jaws, froths at the mouth and nose, some-
times vomits, squeals, raises himself with fore feet on the wall;
walks round and round, or falls and rolls over, has tremors or
convulsions.

Symptoms in the Dog. ‘There may be preliminary indications
of illness, anxiety, restlessness, irritability and a desire for seclu-
sion. Vomiting may occur. ‘This is liable to merge into pros-
tration, a dullness of the special senses, utter inattention to calls,
yet a disposition to resent any interference, a readiness to bite, at
least to howl, when handled. Some will constantly howl or
moan. The eye is fixed, the pupils dilated, the conjunctiva deep
red, the head and roots of the ear are hot. The expression of
the face is pinched and drawn, the muscles may twitch, the eyes
roll, twitching of the neck or limbs may appear, and even epilep-

. Meningo—Encephalitis. Staggers. 107

tiform attacks. In exceptional cases the symptoms approximate
to those of rabies, in the tendency to seek seclusion, to wander
off, to bite on any interference, and even to gnaw the bars of the
cage or any object within reach. After more or less of such ex-
citement, the period of stupor, coma, paresis, or paralysis comes
on, and the animal dies in a state of complete nervous prostra-
tion. In cases associated with the linguatula tznioides the
sneezing, nasal discharge and nasal congestion, even in the early
stages, betray the true character of the disorder.

The rabiform cases usually lack the intense irritability, the
deep conjunctival congestion, the depraved appetite, the al-
teration of the voice, and the mischievous desire to attack
without reason which characterize rabies.

Treatment, In all cases of phrenitis, quiet, darkness, and
coolness are especially demanded. For the horse a roomy, loose
box or a well fenced yard may be secured, and if he can be se-
cured by a halter from a point above the level of the head and in
the centre of the box it will obviate the increase of congestion by
hanging of the head. The application of cold to the cranium in
the form of wet cloths, ice bags or irrigation is always in order,
and should be continued so long as heat of the head and other
indications of cranial hypereemia last.

In the horse suffering, as is so often the case, from narcotic
poisoning an active purgative is one of the first considerations to
clear away any remains of the poison from the prima vie. An
ounce of aloes may be safely given, as there is in this case little
danger of superpurgation, and, to secure an even more prompt
response, eserine (1% grain) or barium chloride (% drachm) may
be given subcutem or intravanously. Or am ounce or two of
glycerine by the rectum might be used as a substitute for these
last. ‘The action of the purgative proves not only eliminant and
therefore antidotal, but it is a most effective derivative from the
brain. When the restlessness or excitement is very great we
may use acetanilid, trional, sulphonal or some one of the many
brain sedatives and antithermics. Sedatives, or anodynes like
opium, which tend to increase cerebral congestion are dangerous.

Bleeding from the jugular or temporal artery, has been objected
to on the ground that it tends to increase the exudate and there-
fore the pressure and cerebral anemia. On the other hand it.

108 Veterinary Medicine.

often proves of great value in vigorous, muscular and plethoric
horses in temporarily lessening the blood-pressure in the brain,
and affording the walls of the overcharged capillaries an oppor-
tunity to resume a more normal tone and to control that very
exudation which isso much dreaded. It is most effective in the
early stages when little or no exudation has taken place and may
then be pushed to the extent of producing a perceptible softening
of the pulse (4; 6 or 8 quarts). Even in the advanced stages
when exudation has led to stupor or coma a moderate and care-
fully guarded bleeding may favor reabsorption of the liquid exu-
date. In weak and anemic cases in which general bleeding ap-
pears to be contra-indicated the shaving of the cranial surface
followed by leeching or wet cupping can be safely resorted to.

Counterirritants like bleeding are denounced and advocated by
different practitioners. In cases of extreme hypereesthesia where
excitement and fever would be dangerously increased by their.
use, they must be discarded, or used only in the modified form
of soothing hot fomentations to the extremities. Where there
is less sensitiveness mustard poultices or pulp applied on the sides
of the neck, or upon the limbs, or even more energetic blisters
will be of great service.

After the action of the purgative the bowels may be kept free
by calomel in 4% drachm doses twice daily and as much sulphate
of soda as may be necessary.

Iodide of potassium (1-2 drs. twice a day) is beneficial as
an antithermic, a circulatory sedative, an eliminant, and probably
at times as an antidote but it cannot be given while calomel is
used. Certain it is that it often seems to act well in succession
to the purgative, in cases of poisoning by ryegrass and legu-
minosee.

When fever runs very high it may sometimes be admissible
to give aconite, but the coal tar products are much more prompt
and powerful, and may therefore be more hopefully employed
for a short time.

In conditions of extreme prostration, stupor, or coma, stimu-
lants are resorted to, but too often with no good effect, the
exudation and compression which many times cause such symp-
toms being rather aggravated than benefited by such agents.

During convalescence a restricted, non-stimulating laxative

Meningo—Encephalitis. Staggers 109

diet (bran mashes, gruels, apples, potatoes, carrots) is de-
manded. Pure cool water should be always accessible.

In other forms of meningo-encephalitis the same general -prin-
ciples should be applied, due attention being paid to the ‘re-
moval of the active cause when that can be discovered.

When the indications point unequivocally to abscess, and its seat
can be accurately located by a circumscribed paralysis, an
operation for its evacuation is fully warranted. Otherwise death
or permanent uselessness is almost certain.

In cattle and other ruminants the same general principles of
treatment must be applied. As a cathartic Epsom or Glauber
salts are preferred to aloes and may be supplemented by barium
chloride or eserine. Croton, sometimes useful, is liable to
dangerously increase the gastric irritation in cases in which this
is a marked determining factor. When the animal is down,
raise the head by bundles of straw, or by a halter tied to a
beam overhead. [In lead poisoning, sulphuric acid largely diluted
may be added to the sulphates so as to precipitate the insoluble
sulphate of lead. Potassium iodide is of value to dissolve the
lead in the tissues and lead to its elimination. Cases of ccenurus
require trephining and extraction ; the larve of the cestrus should
be washed out with tobacco water or destroyed by benzine.

In dogs the stomach is usually emptied spontaneously by
emesis. A purgative of castor oil, followed by daily doses of
calomel may be given, and attention given to the cooling of the
head and general system. Antipyrin or acetanilid may be use-
fully employed. The diet should be restricted to milk or thin,
well-boiled gruels. .

The linguatula in the nose must be met as are the cestride of
the sheep, and intéstinal worms must be got rid of by active
vermifuges.

CHRONIC HYDROCEPHALUS. DROPSY OF THE VEN-
TRICLES. IMMOBILITY.

Horse especially suffers. Enzootic in given Alpine Valleys, along Rhone,
in Mississippi Valley and bottom lands. Acclimatizing fever. Old,
lymphatic, large heads, narrow foreheads predisposed. Geldings. Causes,
heredity, cerebral and meningeal congestion, cranial traumas, venous ob-
struction, tumors, false membranes, fodder or water poisoning, overwork,
insolation, prolonged moist heat, hepatic, gastric, and pulmonary disorders.
Symptoms: form of head, stupid expression, irresponsive ears, pendent
lips, sluggish movements, crossed legs, slow mastication, dips face in water,
intractable by halter or rein, unable to back with rider, or wagon, drags
back fore limbs, worst in hot damp weather, in sunshine, or after work, or
with full stomach. Paroxysms of excitement. Lesions: excess of arach-
noid, subarachnoid or ventricular fluid, atrophy of ganglia and convolu-
tions, ependyma thick, opaque, sclerosis, brain anzemic. Tumors, nature.
Experimental cases. Prognosis, incurable, better in cool season. In cattle,
sheep, swine and dogs. Treatment: derivatives, nerve stimulants (nux),
puncture, pilocarpin, purgatives. Jurisprudence. Notify seller in 9 days
(France), 15 (Bavaria), 21 (Wurtenberg, Baden), 28 (Hesse, Prussia), 30
(Austria), Examination by expert. ,

Dropsy of the ventricles is common in the horse in certain
countries and districts, yet even there it is uncommon in cattle,
sheep, swine and dogs, save as a congenital affection. It is re-
ported as enzootic in some Alpine valleys and along the Rhone,
attacking especially the mares and immature horses so that breed-
ing becomes impossible. Mauener who reports this says that in
the same localities encephalic diseases are more common in man.
In America it appears to be most frequent in the rich bottom
lands of the Mississippi valley and of the Southern States.
Northern horses taken to the Gulf States though they may not
suffer to this extent, are liable in the first year to show weakness,
debility, and lack of vigor which is spoken of as the acclima-
tizing fever. Elsewhere the affection is one of the old horses in
which the vital powers begin to fail, Common breeds of horses
with lymphatic temperament, large head and narrow forehead
have been found to be especially predisposed. Geldings are said
to be most liable on account of the arrested development of the
brain, but with the great preponderance of geldings among work
horses, it is dangerous to generalize too far.

110

Chronic Hydrocephalus. Dropsy of the Ventricles. IIl

2

Causes. Acute encephalitis may lapse into the chronic form and
then assume the symptoms of this disease. Cases that come on
slowly ‘arid imperceptibly appear at times to be hereditary, as
might be expected from the fact that it usually goes with a
lymphatic temperament. The conditions which cause cerebral or
meningeal hyperzemia in chronic form conduce to the affection.
Injuries to the cranial vault from traumatism or disease are infre-
quent causes. Renault records a case associated with two bony tu-
mors, each as large as an egg, projecting inward from the frontal
bone and which had produced extensive absorption of the convolu-
tions and increase of the cerebro spinal fluid. Inacase of my
own with an abscess in the diploe above the frontal sinus, and
pressing inward on the brain a similar condition existed. In
other cases Renault noticed that the cerebro spinal fluid was
largely in excess.

Much more commonly, however, the accummuldtion of liquid
takes place in the ventricles, and is associated with different
causes : as tumors or false membranes near the base of the brain
pressing on the veins returning blood from the ependyma, tumors
in the ventricles (cholesteatomata, etc., of the ependyma or
choroid plexus) obstructing the circulation or giving rise to local
hypereemia, and chronic congestions from the other causes such
as faulty conditions of fodders, or water, exposure to undue heat,
overwork, etc. The enzootic prevalence of the disease in certain
localities, (Alps, Rhone Valley, bottom lands) would suggest that
local conditions in food or water are factors, though we cannot as
yet fully explain the mode of causation. In the same way we
must recognize the influence of hepatic and gastric disorders
which arise from such faulty regimen and affect the brain by
nervous sympathy and by the action of toxic elements thrown
into the circulation. ‘Then again we must take sufficient ac-
count of the congestions resulting from obstructions in the
fesser circulation, disease of the lungs, and of the right heart,
and compression of the jugulars by a tight or badly fitting
collar, or compulsory curving of the neck as set forth under
vertigo and cerebral congestion.

Symptoms. Among the symptoms must be recognized the
conformation with which it is usually found associated. T’he
predisposed animals are usually low bred, common horses, with

112 Veterinary Medicine.

narrowness of the cranium and space between the ears and
with a retreating of the head from the orbits to the poll. Other
horses suffer but the majority are of this conformation, and thus
the disease acquires a hereditary basis. ,

The expression of the face is characteristic. The eye is dull,
often sunken, lacking in vivacity and life, the eyelids are
semi-closed, the ears do not prick up to sounds, the muscles of
the face are relaxed, so that the lips hang flaccid, and the nostrils
fail to dilate freely and rhythmically. The animal is apparently
unconscious of all that goes on around him, and is not aroused
by the entry or exit of men or horses, by voice or slap, by
food or water. His head is probably dropped and resting in
the manger, and he raises it sluggishly when compelled ; when
moved from side to side cf the stall his legs may retain a
position turned outward or crossed one over the other ; if ener-
getjcally roused he wakes up slowly, and almost immediately
relapses into his former lethargy, without accomplishing what
was called for. When left with legs crossed he often remains so
until wearied by the constrained position, or in danger of falling
from loss of balance. Not only the legs but the head will re-
tain for a time an abnormal position given to it,—bent, dropped,
turned to one side or the other.

This same lethargy extends even to mastication, which is usu-
ally performed slowly and indifferently, and is often interrupted
in the middle of the trituration of a morsel which remains in the
cheek, on the tongue, or between the teeth, and perhaps hanging
out of the mouth. Hence the horseman’s expression, he smokes
his pipe.

His mode of drinking is no less singular. Usually the lower
part of the face is dropped deeply into the water, and he will only
withdraw it when it becomes necessary to breathe. He may con-
tinue to masticate while drinking.

When walked or trotted he may movea short distance all right ;
he may even hasten his progress for a short distance without
refusing meanwhile to respond to the rein, then he may stop
and for a short time longer resist all efforts with voice, whip, or
spur to start him anew. In other cases he will turn to one side,
getting into ditches or fences by an apparently involuntary action.
and in defiance of whip or reins.

Chronic Hydrocephalus. Dropsy of the Ventricles. 113

One of the most striking features of the disorder is the difficulty
of backing. In some cases he will back a few steps and then prove
unable to back farther ; in others he will show it best when heat-
ed with a jonrney ; in other cases still he will back well enough
under his own weight, but prove utterly unequal to the actif a
heavy man is placed on his back, or if hitched to a loaded. wagon.
In backing with or without a rider the horse, pulled back by the
reins, inclines backward with his hind limbs extended forward
beneath the abdomen, his forefeet extended in front, and his back
arched ; he extends his head or turns it to one side, and when the
change in the center of gravity endangers his equilibrium, he
draws back his forefeet without lifting them, each making a
groove in the ground, and at the same time he makes a disorderly
motion of the hind limbs to one side to restore the balance. In
default of this he may drop his quarter on the ground and perform
a back somersault on his rider. Even when he succeeds in | bal-
ancing himself after dragging the forefeet back, the difficulty of
further backing is rather increased, as the nervous irritability is
enhanced by a continuance of the excitement.

When hitched in a carriage the phenomena are virtually the
same; when backed he extends or flexes the head, inclines the
body backward, and after a tiine loses his equilibrium, sometimes
executes a few disorderly steps backward, or throws himself vio-
lently to one side, or turns over backward in the shafts.

The symptoms are always worse during hot, damp weather, and
when the animals are exposed to the full glare of the sun. The
milder cases can be worked without great inconvenience in winter,
while they become utterly useless in summer.

Active exertion and increased rapidity of the circulation has a
similarly injurious effect. After a period of rest nothing amiss
may be noticed, while after a period of work in the sunshine the
symptoms become well marked and the difficulty of backing pro-
nounced. Plethora or full feeding aggravates, while spare, laxa-
tive diet, laxatives, rest or bleeding relieves.

The affection may become complicated by more active inflam-
matory action leading to paroxysms resembling those of meningo-
encephalitis ;—pushing against the wall, rearing up with the fore
feet in the manger, acting as if walking or trotting, etc. In
other cases the paroxysmis resemble those of vertigo ; the animal

8

114 Veterinary Medicine.

plunging forward, starting to one side, or rearing up and falling
back.

Lesions. The pathological anatomy of this disease is that of
chronic hydrocephalus. Renault records cases in which the sub-
arachnoid and arachnoid fluids were under the normal while the
fluid in the ventricles was increased to a marked extent. This
accumulation is often so great that the whole of the surrounding
nervous matter is greatly attenuated, the convolutions of the
cerebral hemispheres are flattened so that the sulci are all but ef-
faced, the water may shine through at points and even bulge
after the manner of a hernia, the ganglia in the ventricle (corpus
striatum, optic thalamus, hippocampus) are flattened and atro-
phied, the base of the cerebrum is thinned and bulges downward,
and the olfactory lobes may have their internal cavity greatly
distended so that they look like little bladders of fluid. The
ependyma may have lost its normal thinness and translucency,
having become thick and opaque, and sometimes its surface is
granular and rough. The choride plexus is congested and
swollen with infiltration. The brain tissue adjacent is firmly ad-
herent and there is a hyperplasia of its connective tissue consti-
tuting a veritable sclerosis. At some points, however, the com-
pressed nervous tissue has undergone degeneration and softening.
As might be expected from the pressure of the liquid, anzemia of
the brain tissue is a marked feature of the morbid condition.

Other conditions have at times been found in chronic hydro-
cephalus.

Renault found two long tumors each as large as a hen’s egg
projecting from the dura mater into the cerebral hemisphere. In
other cases there have been fibrous thickening of the dura mater,
exudations on the pia mater, and false membranes on the arach-
noid (Roll). Chabert and more recent writers have observed
cysts and tumors of the choroid plexus in'such cases, but these
have been met with not unfrequently in the entire absence of the
characteristic symptoms of this disease.

Nature. ‘The affection before us is evidently one in which the
majority of the higher brain functions are profoundly depressed
or debilitated, and this is accounted for by the accumulating
intraventricular liquid pressing on the ganglionic centres in the
cerebral hemispheres, and in the floor of the lateral and third
ventricles.

Chronic Hydrocephalus. Dropsy of the Ventricles. 115

Experimentally an approximate loss of sensation, intelligence,
spontaniety, will, and muscular power is produced in birds or
mammals deprived of their cerebral hemispheres. Colin’s heifer,
which had been thus mutilated, would lie in torpor, and though
it could be made to get up and walk, it struck its head heedlessly -
against the wall, and retained in its mouth unchewed, the food
that had been placed there. He says of such cases: ‘‘ they live
a long time, move automatically, respire, digest, but they lose,
with the sensations, memory, judgment, will, and the most vital
instincts of their kind.’”’

In the dropsy of the ventricles the attenuation and atrophy of
the cerebral convolutions produce symptoms which approximate
closely to those resulting from their experimental ablation, so
that one may fairly attribute the general symptoms in the two
cases to the loss of their function. Many of the attendant symp-
toms, and especially the aberration of smell, sight, hearing and
taste, may be referred to the concomitant injuries of the basal
ganglia of the brain.

We need not seek in one general answer to resolve the question
whether the dropsy or inflammation is the initial lesion. For our
present purpose it must suffice, that the dropsy with aneemia and
atrophy of the cerebral convolutions and basal ganglia produce
the symptoms of immobility.

At the same time it is only logical to conclude that any morbid
condition of the cerebral circulation or of the brain or membranes
which leads to a corresponding amount of ventricular effusion, or
atrophy or destruction of the nerve centres, already designated,
will produce the symptoms characteristic of this disease. Thus
the different forms of meningitis, traumatic injuries to the
cranium, chronic encephalitis, cerebral softening or degeneration,
sclerosis, neoplasms of all kinds affecting the brain (cysts, choles-
teatoma, psammoma, melanoma, etc. ), and parasites may occasion
this disease.

Prognosis. ‘The disease is essentially incurable.. It may last
for years with little change except the winter improvement, but it
rarely subsides permanently. It is only in those cases in which
the symptoms have been determined by a transient or removable
cause, as a moderate exudation or a parasite with a short term of
life that a favorable result may be looked for. Usually the im-

116 Veterinary Medicine.

provements seen in cool seasons or stables, under good hygiene,
are not recoveries but temporary amelioration only.

Symptoms in other animals. Corresponding conditions produce
similar symptoms in cattle, sheep, swine and dogs, but the disease
receives less attention in these animals because they are not called
on for steady work. The animals are lazy, dull, insensible to
excitement, stupid, show a lack of muscular power and control,
stagger or move disorderly and show tympanies or other indica-
tions of indigestion.

Treatment. Majendie and others had a few apparent recoveries,
after violent counter-irritation over the spinal cord (cervical and
dorsal). Coculet and Lafosse claimed recoveries from the pro-
longed use of nux vomica in large doses (up to 5 drachms).
Hayne attempted evacuation of the fluid by puncture through the
perforated plate of the ethmoid bone, but had evil results from
the ensuing hamorrhage and encephalitis. Aseptic puncture
through the plate of the frontal bone would be much more prom-
ising. Klemm suggested hydrochlorate of pilocarpin (15 grains),
and this would promise better than any other measure to induce’
absorption of the liquid. The fatal drawback to this as to other
measures is that itis not applied until the slow, steady pressure
has caused such extensive cerebral atrophy that, even if the liquid
could be removed and its reproduction prevented, the lost func-
tions can never berestored. If the disease could be diagnosed
and treated before this change of structure had taken place, the
hope of recovery would be much better founded. Even in cases
which make a temporary recovery during cold weather one would
be warranted in using active derivatives toward the bowels and
kidneys, also pilocarpin, counter-irritation to the spine and even
tapping of the ventricles.

Legal Aspect of Chronic Hydrocephalus.

To claim relief in case a horse affected in this way is sold as
sound, the seller must be notified at an early date. Inthe differ-
ent countries of Europea limit is set after which such notification
will have no legal value. The seller must be notified, in France
in 9 days, in Saxony in 15 days, in Bavaria, Wurtenberg and
Baden in 21 days, in Hesse and Prussia in 28 days, and in Austria
in 30 days.

Chronic Hydrocephalus. Dropsy of the Ventricles. 117

Diagnosis. The veterinarian called to act as expert in such
cases must examine the suspected animal along the different lines
in which the cerebral aberration is manifested in the disease. He
will see the animal standing quietly in the stall apart from all
sources of excitement. See if there is a defect in the breadth of
the cranium, or a deflection backward of this region from the
straight line of the front of the face, together with a heavy clumsy
head. Is the head pendent, resting on the. manger, with dull eye,
drooping lids, lack of expression, loose hanging lower lip? Does
he hold morsels unchewed projecting from the mouth or over the
tongue, or in the cheek? Does he plunge both mouth and nose
in the water to drink, and masticate meanwhile? Are his legs
found crossed or in abnormal positions, and if put in such posi-
tions, does he fail to rectify them at once? Is the head leftin an
abnormal flexed, depressed or lateral position if placed in it?
Does the subject find it difficult or impossible to back? Does he
pay the customary attention to the going or coming of other
horses, to feeding, etc. ?

If no distinct symptoms are found he should then be examined
under other conditions. In taking out of the stable how does he
turn in the stall or back out of it, and in what way does he
approach the door, clumsily or with difficulty? When moved in
a circle, does he sway or stagger? Can he back when mounted
or attached to a heavy carriage? Can he execute all these move-
ments satisfactorily after the respiration and circulation have been
excited by walking, trotting or galloping in hand or otherwise?
In case of difficulty in backing, in the absence of the other diag-
nostic symptoms, he must see that this does. not arise from other
causes. Some untrained horses have not been taught to back and
cannot be made to do so at once. Some refuse to back from in-
docility or stubbornness, but can perform the act if induced in
other ways, asin having a narrow stall. Sometimesa sore mouth,
from a hard bit may make a hoyse nervous and obstinate so that
he will seek to escape in any other way rather than by backing
under steady pressure of the bit. Sometimes he will back all
right under the halter. In all such cases of simple obstinacy or
fear of pain, the absence of the other symptoms is strongly sug-
gestive. If the horse hasa well developed cranium, a full bright,
alert eye, firmness of lips, intelligent expression, readiness to

118 Veterinary Medicine.

appreciate and respond to all noises, words, touches or other
causes of excitement, plenty of fire and spirit, and an absence of
any apathy, dullness, awkwardness of movement or position of the
limbs, or of any other sign of failing nervous power he may be
considered free from this affection, evenif he refuses to back ina
docile manner. In other cases there is a distinct physical inca-
pacity quite apart from any brain disorder. Sprains or anchy-
losis of the back or loins or anchylosis or painful arthritis of the
hocks, may hinder backing.

‘The diagnosis from encephalitis and other inflammatory affec-
tions associated with stupor, rests on the absence of hyperthermia,
of the congestion of the orbital and nasal mucosz, of the heat of
the head and of the paroxysmal attacks of excitement which char-
acterize these diseases.

CEREBRO-SPINAL MENINGITIS.

Definition. Epizootic manifestations. Faulty hygiene, insanitary stables,
impure air, defective drainage, fermenting food, overwork, overfeeding, ex-
citement, heat exhaustion, electric tension. Probably complex. Horse,
ox, sheep, goat, dog. Microbian factors in man and rabbit. Lesions:
meningeal, brain and spinal congestion, effusion, suppuration, circumscribed
necrosis, softening, petechize. Blood dark, fluid or a diffluent clot. Symp-
toms: horse: paresis, anorexia, dysphagia, mucous congestion, reddish
brown : in severe cases, chill, stupor, apathy, debility, palsy, tonic spasms
of neck, back or loins, hyperesthesia, twitching, trismus, hyperthermia,
delirium, coma, convulsions, and early death. Duration averages 7 to 15
days. Ox, asin encephalo-meningitis. Sheep, microbes. Dog, dulled
senses, stupor, coma, palsy, hyperthermia, heat of head, spasms, etc. Diag-
nosis: by brain and spinal symptoms; cases in groups. More sudden than
tetanus, or rabies, and shows no mischievous purpose, nor depraved appe-
tite: from tubercular meningitis. Treatment: Avoid suspected stable,
food, water, or supicious environment, disinfect, correct local diseases,
unload bowels, belladonna, atropia, chloral, bromides, ergot, phenacetin,
potassium iodide. Bleeding. Cold to head or back. Derivatives. Sling.
In convalescence, regulated diet and tonics.

Definition, Concurrent inflammation of the meninges of the
brain and spinal cord..

This appears at times in many horses in the same locality, asin
New York in 1850 (Large), in Denmark since 1852 (Stockfleth,
Bagge), and in Egypt in 1876 (Apostolides). In Cairo alone

Cerebro-Spinal Meningitis 119

about 6,000 horses, mules and donkeys perished. Hence the
disease is known as epizootic cerebros pinal meningitis. Butagain
it is often seen in scattering or sporadic cases. Add to this that
no evidence has ever been adduced that the disease is communi-
cated from one animal to another, and in these days of the par-
allelism of epizootics and pathogenic microbes, we may well
hesitate about continuing to use such a qualifying term. Fried-
berger and Frohner claim ‘‘ that a large number of clinical facts
have been erroneously reported under the name of spasms of the
neck. Rabies, tubercular basilar meningitis, apoplexy, simple
encephalitis, and certain poisonings have been confounded with
that disease.’’ They assure us that ‘‘ cold, damp, chilly weather,
hot stables, clipping and overfeeding are of but secondary im-
,Portance,’’ but they fail absolutely to tell us what is of premary
importance in a causative sense. American writers who have
attempted to account for the disease have groped somewhat
blindly for causes in the idea of poison. Large charged it on in-
sanitary conditions, poisonous gases, and defective sewerage in
cities, and lack of drainage and deficient stable ventilation in the
country. J. C. Michener attributes it to foods undergoing fer-
mentation and considers it as a paralysis due totoxicfungi. W.
L. Williams, in Idaho, found the greatest number of cases in
winter had been fed hay made from alfalfa (lucerne) and
timothy, though some had small grains and native grasses. ‘The
soil was dry, porous, gravelly, devoid of humus, and lying on
lava rock. ‘The altitude and clearness of the atmosphere were
supposed to exclude the idea of cryptogams, yet the crops
generally were raised by irrigation. The water was from clear
mountain streams. Stables were generally low and full of
manure, with thatched roofs, but hardly tight enough to be
called close. In these cases the defective stable room, the irriga-
tion, the leafy hay (lucerne), and the probable presence of fer-
ments (bacteria), are the only suggestive conditions. In a fatal
outbreak which I saw among the Wilkesbarre, Pa., pit mules,
rain-soaked and badly fermented timothy hay, overwork in view
of a strike, and a Sunday’s holiday in an unshaded yard under a
hot July sun, in contrast with the previous darkness and coolness
of the pits, coincided to disturb the general health. In several of
the Southern States it is attributed to worm-eaten corn, Trum-

120 Veterinary Medicine.

bower thinks it should be traced to the parasitic fungi that grow
on plants, grains, and vegetation. In many instances the disease
has appeared simultaneously with the feeding on certain speci-
mens of brewer’s grains, oats and hay, so that: to use Trum-
bower’s words these were the carriers if not the prime factors of
the disease.

In recognizing how much cryptogams and bacteria vary under
different conditions of life, and what various products they elab-
orate at different stages of their growth, we can theoretically ex-
plain the absence of the disease at one time and its presence at
another under what seem to be identical circumstances, as also
‘the variety of symptoms shown in different outbreaks. While
this causation cannot be said to be absolutely proved, it is not
antagonistic to the facts in many of the best observed outbreaks,
and may serve as a hypothetical working theory until actual
demonstration can be furnished. ‘The affection suggests a nar-
cotic poison introduced from without, rather than a disease due
to a germ propagated in the system.

This need not, however, exclude the operation of attendant .
conditions such as over work, plethoric feeding, excitement, close
stables, heat exhaustion, etc., which tend to bring about cerebro-
spinal congestion. Even the electric tension of Idaho, of the
United States generally, and of Egypt, in connection with their
comparatively dry atmosphere, should not be overlooked in con-
sidering the possible causative factors.

In all probability as we learn more of the true pathology of the
disease, we shall come to recognize not one, but several toxic
principles, and several different affections each with its character-
istic phenomena in the somewhat indefinite affection still known
as cerebro-spinal meningitis.

The malady has been described in horses, oxen, sheep, goats
and dogs, attacking by preference the young, which are not yet
inured to the unknown poison, and by preference in winter and
spring, the periods of close stabling, dry feeding and shedding of
the coat.

In the absence of bacteriological data from the horse, it may be
noted that in man cerebro-spinal meningitis, has been commonly
found to be associated with the presence in the meningeal exudates
of the micrococtus pneumonia croupose, (Micrococcus lanceolatus

Cerebro-Spinal Meningitis : 121

encapsulatus). This is frequent in the mouths of healthy per-
sons so that some additional accessory cause must be invoked to
increase the susceptibility or lessen the protective power of the
tissues. This has been thought to be found in the concurrent
presence of other bacteria, the staphylococcus pyogenes aureus,
pueumobaccillus of Friedlander and the streptococcus pyogenes.
Mosny appears to have established this for the staphylococcus in
the case of rabbits. With a given dose of the micrococcus pneu-
monize death was always delayed fora fortnight, while with
the same dose thrown into one thigh, and the staphylococcus
aureus in the other, the rabbit died in one day. ‘This enhanced
‘potency resulting from the presence of the golden staphylococcus
has been invoked to account for the germ making its way from
the mouth to the brain in cases of otitis, suppuration of, the
Eustachian tube, tonsilitis or nasal catarrh. These remarks are
intended to be suggestive, rather than conclusive, as we have
as yet no certainty that cerebro-spinal meningitis in the horse
is caused by the same germ as it is in man.

Lesions. ‘The lesions are usually those of leptomeningitis, or
congestion of the brain and spinal cord and often effusion into
the ventricles, with a serous exudation under the pia mater or
into the arachnoid cavity. This may be transparent and yel-
lowish, or grayish and turbid, or milky. Inthe sheep, Roloff
has found purulent products under the pia mater, around the
roots of the spinal nerves, and in the’surface layers of cerebral
gray matter. The marked hypereemia on the surface of the
gray matter is a striking feature, and circumscribed areas of ne-
crotic nervous tissue and softening are not uncommon. Pete-
chiz are frequent on the meninges, the brain, heart, lungs and
kidneys. Granular and fatty degenerations are also met with in
these parenchymatous organs. ‘The blood may be dark and
liquid or diffiuent.

Symptoms in the Horse. ‘The mildest attacks are manifested
by ‘paresis, or loss of perfect control over the limbs, or loss of
power over the tail, impairment of appetite and some difficulty of
swallowing, together with some congestion or reddish brown dis-
coloration of the orbital and nasal mucosz. In other cases
paralysis of one or more limbs may supervene but without’
marked fever or coma.

122 Veterinary Medicine.

The more severe forms are ushered in by violent trembling, or
by stupor, apathy, and extreme muscular weakness, or actual
paralysis. In such cases the animal may stagger or fall. -Dys-
phagia or inability to swallow is often a marked symptom, the
saliva falling in strings from the lips. Another common phe-
nomenon is the rigid contraction of the muscles of the neck, back
and loins, the parts becoming tender to the touch and a more or
less prominent oposthotonos setting in. Twitching of the mus-
cles of the shoulders and flanks may be noticed. ‘Trismus also
is sometimes seen. The breathing is usually rapid and catch-
ing and the temperature 104° to 106°. The pulse may be ac-
celerated and hard, or weak and soft, or alternating. The eyes
are violently congested, of a brownish or yellowish red color,
and the eyeballs may be turned to one side. Paroxysms of de-
lirium may set in, when the animal will push against the wall,
or ‘perform any of the disorderly movements described under
meningo-encephalitis. Sooner or later coma and paralysis super-
vene, and death occurs in from five to forty-eight hours. In the
most acute (fulminant) cases the animal falls and dies in convul-
sions. Ou an average the disease lasts from eight to fifteen days.
In the more favorable cases, without any snpervention of coma,
recovery may begin on the third or fourth day.

Symptoms in the Ox. These are largely those of encephalo-
meningitis. If they do not come on with the customary violence,
there may be at first difficulty in prehension, mastication and
swallowing of food ; a rigid condition of the muscles of the neck,
back, and sometimes of the jaws, and twitching of the muscles of
the limbs, neck, lips, oreyes. Fora time there may be hyperzes-
thesia, restlessness and irritability, stamping of the feet or shaking
of the head, then there is liable to follow, dullness, apathy, stupor,
coma and paralysis. As in the horse, the distinction from ordi-
nary encephalo-meningitis will at times rest on the prevalence of
the epizootic disease in the locality.

Symptoms in Sheep. The attack is described as coming on
with weakness, dullness, lethargy, salivation, convulsions, opos-
thotonos, grinding of the teeth, succussions of the body and
limbs, heat of the head, and stupor or paralysis unless death
ensues during a paroxysm. ‘The congestion of the head and of
the encephalic mucous membranes, and the deviation of the eyes

Cerebro-Spinal Meningitis. 123

are constant features. Wischnikewitsch describes an extended
outbreak in sheep in which the brain lesions were complicated by
hepatization of the lungs, and bacilli were found in the various
exudates. This reminds one of the presently accepted cause in
man, which is, however, a micrococcus rather than a bacillus.

Symptoms in Dogs. ‘These are described as some aberration
of the senses, which gradually merges into stupor, coma and
paralysis. While the animal is able to keep on his feet he sways
and staggers, runs unconsciously against objects, or walks ina
circle. There is heat of the head, injected eyes, sometimes
drawn back or squinting, oposthotonos, and general spasms oc-
curring in paroxysms. The duration of the disease is about the
same as in the horse.

Differential Diagnosis. From other forms of meningitis this is
easily distinguished. Fulminant cases almost all belong to this
type, the fact of the coincident implication of brain and spinal
cord is strongly suggestive of this form, and the occurrence of
many cases at once, without any demonstrable toxic or thermic
cause, is tolerably conclusive. From tetanus there is this added
distinction, that the disease does not set in so slowly, the spasms
of the neck and.back are not so persistent, and stupor sets in
early, ina way that is unknowninlockjaw. Rabies is recognized
by the slow onset, the characteristic prodromata, the mischievous
disposition, the depraved appetite, and by the history of its local
prevalence. Tubercular meningitis in cattle has a similar asso-
ciation with tuberculous animals in the same family or herd, and
often by the local indications of tubercle elsewhere, emaciation,
unthriftiness, cough, flocculent and gritty nasal discharge, en-
larged lymph glands, pharyngitis, mammary disease.

Treatment. With a disease so fatal prevention should be the first
consideration and especially when it appears in an enzootic form.
Even in the absence of a definite knowledge of its germ or toxin, it
is logical to avoid the locality, condition, food or water by which
such germ or toxin has presumably entered the system, together
with every unhygienic condition, which may have reduced the re-
sistance of the system and laid it open to the attack. The animals
should be removed to a clean, airy, building and the old one
should be thoroughly emptied, purified and whitewashed, the
lime-wash containing 4 ozs. of chloride of lime, or 1 dr, of mer-

124 Veterinary Medicine.

curic chloride to the gallon. Drains and gutters should have
special attention and the animals should not be returned until the
stable is thoroughly dry. A change of feed is imperative when
there is any suggestion of damp, mustiness or fermentation, and
even in the absence of such indications, since the ferments and
their products may still be present in a dried condition. It should
also be an object to correct any morbid or pyogenic condition of
the pharynx, Eustachian pouch, nose or ear, by appropriate
measures and the inhalation of sulphurous acid or chlorine may be
resorted to with advantage.

As medicinal treatment, Large advises to give at the outset 1 oz.
aloes with one or two drs. of solid extract of belladonna and as an
eliminant, derivative and nervous sedative there is much to be
said for it. In case the difficulty of swallowing should prove a
serious barrier a hypodermic injection of 1% dr. barium chloride,
1% to 2grs. eserine, or 2 grs. hydrochlorate of pilocarpin to-
gether with 4% grain of atropin, may be employed. As a sub-
stitute for atropin, ergot, potassium bromide, chloral hydrate,
chloroform, or phenacetin have been tried in different cases with
varying results. Iodide of potassium has been employed with
advantage in the advanced stages and in convalescence, and may
be usefully employed in the early stages as a sedative to the nerv-
ous system, a deobstruant and an eliminant, if not as a direct
antidote, to the toxins.

Bleeding is generally condemned, yet in acute cases where there
are indications of active brain congestion, threatening convulsions
or coma it may tend to ward off a fatal result.

Cold applications to the head. are generally commended. Bags
of ice or snow, irrigation with cold water, or cooling by running
water at a low temperature, through a pipe coiled round the head
or extended along the spine, will meet the purpose. Applied con-
tinuously this constringes the bloodvessels within the cranium as
well as on its surface, lessens the exudation, and controls the pain
and spasms. ‘This may be advantageously associated with warm
fomentations to the feet and limbs, friction, or even the applica-
tion of stimulating embrocations to draw the blood to these parts.
In the smaller animals ever warm baths may be resorted to as a
derivative, cold being meanwhile applied to the head and- spine.
This not only lessens the vascular pressure within the cranium,

Abscess of the Brain. 125

but secures elimination of toxic matters by both skin and kidneys.
Cold pure water should be constantly within reach.

A most important thing in the horse is to put him in slings, if
he is at all able to stand with their assistance. In decubitus he
rests on his side, with the head on the ground, ‘and lower than
the splanchnic cavities. The result is a gravitation of blood to-
ward the head. In the sling, with the head fairly raised the
gravitation is the other way and the head is depleted. If the
patient is too ill to be maintained in the sling, he may be packed
up with bundles of straw on each side, so that his breast may lie
on a thickly littered bed, and his head may be elevated.

When convalescence sets.in care must be taken to nourish with
non-stimulating, easily digested foods, gruels, soft mashes, pulped
or finely sliced roots. In vomiting animals rectal alimentation
may become necessary. ‘The rise of cranial temperature or the
aggravation of brain symptoms should be met as needed by the
local application of cold, and potassium iodide and iron or bitter
tonics may be given if they do not interfere with digestion.

ABSCESS OF THE BRAIN.

Infection, in traumas, meningitis, encephalitis, strangles, etc. Symp-
toms: evidence of trauma, chill, hyperzesthesia, irritability, drowsiness,
giddiness, stupor, spasms, paresis, coma, dilated pupils, congested mucosa,
vomiting. Location indicated by muscular groups involved. Treatment :
As in meningitis : trephining in hopeful cases.

The formation of abscess in the cranial cavity has been re-
ferred to in connection with injuries to the cranium and meningo-
encephalitis. It may here be said in general terms that this ab-
scess is a product of infection. In the horse the most common
cause is strangles, and especially such cases as run a tardy or ir-
regular course with imperfect softening and limited suppuration
in the submaxillary or pharyngeal region. It is to be looked on
as an extension of the purulent infection so as to cause a second-.
ary abscess. ‘The same may occur in case of ordinary abscess in
any distant organ. In the brain as elsewhere suppuration may
result from direct local injury as in the case of blows by clubs,
or yokes, running against walls or posts, falls, the effects of but-

126 Veterinary Medicine.

ting, injuries by bullets and otherwise. In these cases, as
noticed under concussion, there may be two points of injury
(and two abscesses) one, in the seat of the injury, and one in
a deeper part of the brain, at the opposite wall of the cranium,
Again abscess may result in the brain from extension from a
similar process going on in the vicinity. Thus otitis extends
through the middle and internal ear to the -brain, and its start-
ing point may have been more distant, namely, in the Eustachian
tube, or pouch, or in the pharynx.

The symptoms yary according to the size of the abscess, the
rapidity of its formation and the amount of attendant congestion.
In the common cases resulting from strangles, I have usually
found the animal down, unable to rise, blind, amaurotic, with
dilated pupils, congested mucous membranes, and occasional
spasmodic movements of the limbs, neck and head. The symp-
toms may, however, vary through hypereesthesia, irritability,
drowsiness, giddiness, stupor, local or general paralysis with oc-
casional spasms or convulsions. There may be an initial shiver-
ing, and a rise of temperature, yet as pressure on the brain in-
creases it may become normal or subnormal. In circumscribed
abscess the symptoms may be much less severe, not perhaps ex-
ceeding irritability, drowsiness, and some paresis or local
paralysis.

In some such cases one can trace the connection with some pri-
mary disease, (traumatic injuries to the cranium, abscess of the
diploe or sinus, parasites in the sinus, otitis, or pharyngeal dis-
ease) which serve as an indication of the true state of things.
In others there may be circumscribed local manifestations (anzes-
thesia, hypereesthesia, hemiplegia, paralysis of special muscular
groups, or spasms of the same) which may indicate more or less
accurately the exact seat of the lesion. When well defined, this
localization of the resultant phenomena, serves to distinguish this
and other local lesions, from meningitis which is apt to be much
more general in its diffusion. In the carnivora and omnivora
vomiting is a marked symptom.

Treatment of brain abscess is usually hopeless, yet the at-
tendant inflammation may be met as in other cases of meningitis.
If the seat of abscess can be ascertained surgical interference is
fully warranted.

TUBERCULAR MENINGITIS.

Little seen in cattle. Acute and chronic cases. Miliary tubercles in pia.
Hydrocephalus. Progresses slowly. Irritability, hypereesthesia, photo-
phobia, congested conjunctiva, grinding teeth, spasms, squinting, dilated
pupils, congested disc, drowsiness, stupor, coma, palsy. ,

Tubercle of the encephalon has been little noticed in the lower
animals, partly because it is especially a disease of early life,
while animals usually contract tubercle later in life, and partly
because subjective symptoms are inappreciable, and the cranium
is seldom opened in post mortem examinations. As the af-
fection usually appears as a secondary deposit, the tubercles else-
where go along way toward identifying the nature of the disease
in the brain. It has usually been found consecutive to pulmon-
ary tuberculosis.

In a case reported by Fischceder as seen at the Bromberg
abattoir, in a 350 lbs. calf, the animal had shown weakness,
stupor and a tendency to fall toward the right. The brain lesions
consisted of small foci of tubercle on the posterior pillars of the
fornix (trigone) and adjacent parts. The left eye had on its .
inner aspect, near the junction of sclerotic and cornea, a firm mass
with tubercular centres, extending inward as far as the retina.
The bronchial mediastinal, prepectoral, brachial and precural
glands were tuberculous.

In a case in a cow reported by Lesage there were unsteady
gait, impaired vision, and great timidity. Necropsy showed a
suboccipital tubercle extending into the frontal sinus and cranium,
and invading the brain near the parietal lobe for more than an
inch. ‘There were retro-pharyngeal and pleural tubercles as well.

In a case of Routledge’s, with extensive recent exudate, the
condition advanced from apparent health to extensive paralysis
in three days, while in a case which the author obtained in
slaughtering a tuberculous herd no special nervoussymptoms had
been noticed during life. Much therefore depends on the rapidity
as well as the seat of development.

The primary lesions in the brain are of the nature of miliary
tubercles in the pia mater which becomes congested, rough, gran-

127

128 Veterinary Medicine.

ular, and throws out a free serous secretion. ‘Thus hydrocepha-
lus is a usual concomitant of the affection.

The disease is characterized by its slow advance in keeping
with gradual increase of the tubercle and is thus distinguishable
from the more acute congestions and inflammations. The earlier
stages are usually marked by nervous irritability, hypereesthesia,
intolerance of light, closed eyelids, congested conjunctiva, grind-
ing of the teeth and even spasms partial or general. The second
stage shows somnolence, deepening into stupor or coma, or there
may be going in a circle or other irregular movement. Squint-
ing usually convergent, dilated pupils and congestion of the optic
disc frequently occur. The sleep, stupor, paralysis or coma may
set in early and is usually largely due tothe amount of exudation
and the rapidity of its effusion.

TUMORS OF THE BRAIN. NEOPLASMS.

Existence inferential with similar external tumors. Cholesterine tumors
on plexus of lateral, third or fourth ventricle : pea to egg: in old; con-
centric layers with abundant exudate. Symptoms: slight, or excitability,
dullness, vertiginous paroxysms with sudden congestions, as in encepha-
litis, sopor, stupor, paresis, coma. Melanoma: mainly meningeal; pea to
walnut ; with skin melanomata in gray or white horses. Cases. Pigmented
sarcomata. Diagnosis, inferential, Psammoma: advanced cholesteatoma,
melanoma, fibroma, etc.: osteid tumors. Nervous irritation, delirium,
spasms, nervous disorder, and paroxysms. Myxoma: contains mucin;
cells (in homogeneous matrix) round, spindle-shaped or stellate. Changes
to fat (cholesterine). &dematous connective tissue, neoplasm. Myxo-
lipoma. Myxo-cystoid. Symptoms.

Tumors in the brain are not marked by distinct pathognomonic
symptoms, so that their presence is to be inferred asa probability
‘rather than pronounced upon asa certainty.

The most common forms in the horse are cholesterine (choles-
teatoma), melanotic (melanoma), sandy, gritty, (psammoma),
and fibrous (fibroma).

CHOLESTEATOMA.

These are tumors formed largely of the peculiar fat which is
found in bile and brain matter, and that crystallizes in flat oblong
scales with a notch at one corner. ‘The tumors are usually con-
nected with the choroid plexus and developed beneath the pia
mater, and may be of any size from a pea to a hen’s egg, or in
exceptional cases a sheep’skidney. As a basis there is a stroma
of connective tissue permeated by bloodvessels from the plexus.
Groups of spherical or polygonal cells fill the interstices while
fusiform cells are found in the stroma. ‘There is a variable
amount of phosphate or carbonate of lime which in oldstanding
cases may give a cretaceous character tothe mass. These consti-
tute sandy tumors (psammomata).

Cholesteatomata are especially common in old horses and are
manifestly connected with congestion of the choroid plexus and
exudation. Ina recent case or ina case which has shown a recent
cerebral hyperzemia, we may find a central mass of yellowish
‘ cholesterine, and surrounding this an abundant yellow gelatinoid
exudation. This latter is rich in cholesterine which fails to dis-
solve along with the rest of the exudate on the occurrence of
resolution, and is therefore laid up as the solid fatty material.
For the same reason the fatty element is usually laid on in layers,
one corresponding to each access of local hyperzemia and exuda-
tion. The great tendency to calcareous degeneration has been
attributed to the abundance of phosphate of lime in the cerebral
exudate.

The symptoms of these tumors are exceedingly uncertain.
Many such tumors of considerable size have been found after
death in animals in which no disease of the brain had been sus-
pected during life. In these it is to be inferred that the accretions
were slow, gradual, and without any serious congestion. In
other cases the tumor is attended by paroxysms of vertigo, or in-
dications of hyperemia or meningitis, which will last for several
days and gradually subside. It is reasonable to suppose that the
tumors are largely the result of such recurrent attacks of en-
cephalitis, and are no less the cause of their recurrence. The

9 129

130 Veterinary Medicine.

intervals of temporary recovery correspond to the subsidence of
hypereemia and the reabsorption of the liquid portion of the
exudate. ‘The manifestations during an access correspond directly
to those met with in encephalitis. As in that affection there is
usually an initial period of excitement and functional nervous dis-
order tending to more or less somnolence, stupor, paralysis or
coma, with long intermissions of apparently good health. In other
cases the stupor or. paretic symptoms may persist up to the fatal
issue.

MELANOMA OF THE ENCEPHALON.

Black pigment tumors have been found in connection with the
brain and especially the meninges, varying in size from a pea to
a walnut, and as a rule, secondary to similar formations else-
where. ‘They are most common in gray horses which have
turned white, and may give rise to gradually advancing nervous
disorder. Bouley and Goubaux record a case of this kind at-
tended with general paralysis. W. Williams reports the case of
an aged gray stallion with melanomata on the meninges and in
the brain substance which were associated with stringhalt of old
standing. Mollereau in a vertiginous horse found a pigmented
sarcoma in the right hemisphere between the gray and white
matter, and like an olive in size and shape. There were melano-
mata around the anus. (Annalesde Medecine Veterinaire, 1889).
So far as such have been examined they ‘follow the usual rule in
melanomata in having a sarcomatous structure.

While it is impossible to make a certain diagnosis without
opening the cranium, the condition may be suspected, in gray
horses, when melanotic tumors are abundant in the usual ex-
ternal situations (anus, vulva, tail, mammee, sheath, lips, eye-
lids, etc.), and when brain symptomis set in and progress slowly
in such a way as to suggest the gradual growth of a tumor.

Treatment is hopeless, since if they have invaded the brain,
the tumors are likely to be multiple in the organ, and numerous |
and widely scattered elsewhere.:

PSAMMOMATA (GRITTY TUMORS) OF THE BRAIN.

As already noted these sandy tumors are often the advanced
stage of cholesteatomata, the abundance of the phosphate of lime
leading to its precipitation in the neoplasm. The same cretaceous
deposit often takes place in old standing tumors of other kinds, as
in melanoma, and fibroma so that the sandy neoplasm may be
looked upon as a calcareous degeneration of various forms of
intracranial tumors. ‘The same tendency to calcareous deposit is
seen in the tuber cinereum (pineal body) of the healthy brain
which has taken its name from the contained gritty matter. This
tendency to the precipitation of earthy salts may be further recog-
nized in the osteid tumors which occasionally grow from the dura
mater. ‘

The gritty tumors are especially found in the older horses in
which the tendency is greatest to extension of ossification and
calcic degenerations.

Like other tumors these may attain a considerable size before
they give rise to any very appreciable symptoms, but having
attained a given development—often the size of a walnut, they
become the occasion of nervous irritation, delirium and disorder,
as indicated under encephalic hypereemia and inflammation,
cholesteatomata, etc. There may, however, be drowsiness, stupor,
coma, or paralysis as the exclusive symptom, or there may be
spasms and convulsions.

MYXOMA OF THE BRAIN.

Myxoma is a tumor in which mucoid elements or a gelatinoid
degeneration and infiltration containing mucin is a prominent
feature. The mucous tissue which constitutes the tumor may differ
little from ordinary connective tissue except that the intercellular
spaces contain mucin. Histologically the tissue consists of cells
embedded in a homogeneous matrix. The cells may be of va-
rious forms, round, in recent formations and spindle-shaped or
star-shaped, but especially the latter, in the older. When incised
a fluid containing mucus escapes in greater or less abundance.

131

132 Veterinary Medicine.

While this has properties resembling albumen it is distinguished .
by the fact that the precipitate thrown down in it by alcohol is
softened and redissolved on the addition of water. The precipi-
tate thrown down in an albuminous liquid is insoluble in water.

The formation of this mucous exudate is liable to be followed
by fat so that Virchow considered it as antecedent to fat forma-
tion. ‘This is especially noticeable in the early stages of the
cholesteatomata of the choroid plexus of the horse, in which, as
observed by Furstenberg, Lassaigne, and Verheyen, the new for-
mation is at first a myxoma, which later becomes filled up with
cholesterine.

Recent observations tend to discredit the alleged distinctive
character of myxoma. ‘The meshes of all connective tissue con-
tain a perceptible amount of mucin. CEdematous subcutaneous
connective tissue contains this mucin in greater proportion and
approximates to the condition of mucous tissue. The umbilical
cord, which has been long advanced as the physiological type of
mucous tisstie, has been shown to consist of ordinary connective
tissue with an abundance of fluid in its meshes.

Koster denies that the myxoma is a special type of tumor and
holds that it is only a condition that may arise in any tumor
which contains connective tissue. In other words, myxoma is
only an cedematous condition of the connective tissue neoplasm—
fibroma, sarcoma, carcinoma, etc.—due to passive congestion or
other circulatory disturbance.

As seen in the brain of the horse the formation is usually of the
nature of a myxo-lipoma, as the final outcome is usually the
cholesterine bearing mass. In other cases the connective tissue
spaces become further distended with the viscous, gelatinoid
liquid and form veritable cysts—myxoma-costoides.

In tumors of this kind affecting the choroid plexus the chain
of symptoms is essentially the same as given under cholesteatoma
and the prognosis is nearly equally grave. It need only be said
that in recent cases in which there is as yet little permanent
tissue, measures may sometimes be hopefully adopted, to secure
the reabsorption of liquid constituents, and even perchance to re-
move some obvious cause of passive congestion upon which the
effusion depends.

ACROMEGALY. HYPERTROPHY OF THE PITUITARY
BODY.

Like other portions of the brain the pituitary body is subject
to degenerations and diseases of various kinds. This is particu-
larly mentioned here because of the occasional association of its
hypertrophy with the trophic processes of different parts of the
body. Along with an over-development of the limbs, and less
frequently of the body, an enormous increase of the hypophysis
has been foumd, and the one condition has naturally been set
down as the result of the other. _ In some such instances, of over-
growth, however, some other blood glands, such as the thyroid
or thymus, have been found to be hypertrophied, so that at
present it is difficult to do more than notice the association ob-
served between the two conditions.

CEREBELLAR DISEASE.

Cerebellum and codrdination. Pressure on adjacent parts renders results
uncertain. Generic symptoms, ataxia, titubation. Marked symptoms with
rapid morbid progress. Treatment: tonic, hygienic.

Whatever functions are exercised by the cerebellum there is
no doubt of its control over muscular codrdination. It is quite
true that disease of any other part of the brain causing effusion,
exudation or intracranial pressure will more or less completely
arrest the functions of the cerebellum just as disease of the cere-
bellum producing intracranial pressure will derange the functions
of other parts of the encephalon. The general symptoms pro-
duced in this way cannot therefore be accepted as indicating the
precise localization of an intracranial disease. Dullness, stupor,
coma, dilated pupils, choked discs, optic neuritis, and vomiting,
are in this sense generic symptoms, which may in the absence of
fever indicate dropsy, exudation, apoplexy, tumor, concussion or
other lesion, and with hyperthermia may-indicate encephalitis or
meningitis. But if in the absence of these symptoms and of aural

133

134 Veterinary Medicine.

disease there should appear ataxia, swaying unsteady gait, and
staggering, there is a strong presumption of cerebellar disease.
This may also be manifested by the other and generic symptoms
already mentioned only the diagnosis is not then so certain.
Again cerebellar disease may exist without the ataxia and lack of
balance, but probably only in cases in which the progress is slow
and the organ has ‘had ample time to accommodate itself to the as
yet comparatively restricted lesions. The result may be a mere
defect of muscular tone, or it may extend to an almost absolute
loss of contractility, or it may be of any intermediate grade.

Treatment, which is eminently unsatisfactory, consists in im-
proving the general health and tone, by corroborant medicines
and conditions of life, and training the muscles by carefully grad-
uated exercise and even electricity.

BULBAR PARALYSIS. DISEASE OF THE MEDULLA
OBLONGATA.

Impaired innervation of bulbar nerves. Paresis of lips, tongue, and
larynx. Roaring. Rapid pulse. Glycosuria, albuminuria. Ptosis. Twitch-
ing eyelids. Dysphagia. Paralysis. Treatment, rest, cold to head, laxa-
tives, nerve stimulants, tonics, electricity.

The bulb is intimately connected with the origin of the hypo-
glossal, glosso-pharyngeal, spinal accessory, vagus, facial, and tri-
facial nerves and active disease in the bulb is therefore likely to
entail impairment of the function of several of these nerves. In
man this is recognized in chronic progressive bulbar paralysis,
which almost always affects the lips, tongue and larynx advance-
ing steadily though slowly to a fatal termination. In degenera-
tive lesions there is modified voice, difficulty of swallowing, rapid
pulse, and laryngeal paralysis (especially of the arytenoid
muscles). The implication of the root of the vagus may be in-
ferred from the arrest of inhibition of the heart, and from glyco-
suria or albuminuria. Occasionally the ocular and palpebral
muscles are involved causing ptosis, or twitching of the muscles.
When the facial (7th) nerve is implicated, paralysis of one or both
sides of the face may be marked, including often the ears. When

Loco Poisoning. Oxytropis Lamberti. 135

the glosso-pharyngeal, the difficulty of swallowing is a prominent
feature, and when the spinal accessory, spasm or paralysis of the
neck. In the worst cases death supervenes early, by reason of
interference with the respiratory and cardiac functions.

The treatment of these affections is usually very unsatisfactory,
though in meat producing animals it may sometimes be desirable
to preserve them in preparation for the butcher. Rest, in hyper-
zemic cases, cold to the head and purgatives, and in those in which
fever is absent, small doses of nerve stimulants (strychnia) and
tonics (phosphorus, phosphates, ammonia-sulphate of copper,
zinc sulphate, silver nitrate) may be tried. A course of arsenic
and earefully regulated electrical stimuli may at times give good
results.

LOCO POISONING. OXYTROPIS LAMBERTI. ASTRA-
GALUS MOLLISSIMUS.

Astragalus Hornii: A. Lentiginosus: A. Mollisimus: Oxytropis Lam-
berti: O. Multifloris : O. Deflexa: Sophora Serecia : Malvastrum Coccinium :
Corydalis Aurea. In dry regions: Cause, a psychosis. Emaciation. Lassi-
tude. Impaired sight. Illusions. Vice. Refuses other food. Contradic-
tory views. Experiments by Dr. Day.

The term Joco is of Spanish origin and has come to us through
the Spanish speaking residents on the cattle raising plains and
the Pacific Coast. The word is defined to mean mad, crazy,
foolish. It has been applied indiscriminately toa disease in stock
manifested by these symptoms, and to a variety of leguminous
plants, found growing on the western lands and supposed to cause
the disease in question. The plants complained of aré Astragalus
Hornii, and A. Lentiginosus (Griesbach) in California, A.
Mollissimus (Torrey) and Oxytropis Lamberti (Purshiana) in
Colorada and New Mexico. Other allied species, and like these
found also in the other Rocky Mountain States, Sophora Serecia,
Oxytropis Multifloris, O. Deflexa, Malvastrum Coccinum, and
Corydalis Aurea var. Occidentalis have been less confidently
charged with producing the disease.

These plants grow on poor, dry, sandy or gravelly soils, and
having great power of resisting drouth, are often in fair growth

136 Veterinary Medicine.

and present an abundant mass of leaves when surrounding
vegetation is withered up. Hence, it is alleged, the animals are
driven to use it when nothing else is obtainable and once accus-
tomed to it, the desire for more becomes a veritable craze or neu-
rosis, and the victim searches for it and devours it to the exclu-
sion of other food.

The following quotations may serve to illustrate the effects
alleged :

Among the symptoms first noticed are loss of flesh, general
lassitude and impaired vision ; later the animal’s brain seems to
be affected ; it becomes vicious and unmanageable and rapidly
loses both flesh and strength. Frequently when approaching
some small object it will leap into the air as if to clear a fence.
The patient also totters on its limbs and appears as if crazy.
After becoming affected it may linger many months, or a year,
but usually dies at last from the effects of the complaint. (Dr.
Vassey. Report of Dept. of Agriculture, 1884).

“T think very few if any animals eat the loco at first from
choice ; but as it resists the drought until other food is scarce
they are first starved to it, and after eating it a short time appear
to prefer it to anything else. Cows are poisoned by it as well as
horses, but it takes more of it to affect them. It is also said to
poison sheep. As I have seen its actions on the horse, the first
symptom apparently is hallucination. When led or ridden up to
some little obstruction, such asa bar or rail lying in the road, he
stops short, and if urged, leaps as though it were four feet high.
Next he is seized with fits of mania in which he is quite uncon-
trollable and sometimes dangerous. He rears, sometimes even
falling backwards, runs or gives several successive leaps forward,
and generally falls. His eyes are rolled upward until only the
white can be seen, which is strongly injected and as he sees
nothing, is as apt to leap against a wall or a man, asin any other
direction. Anything which excites him appears to induce the
fits, which, I think, are more apt to occur in crossing water than
elsewhere, and the animal sometimes falls so exhausted as to
drown in water not over two feet deep. Hee loses flesh from the
first, and sometimes presents the appearance of a walking skel-
eton. In the next and last stage he only goes from the loco to
water and back, his gait is feeble and uncertain, his eyes are

Loco Poisoning. Oxytropis Lamberti, 137

sunken and have a flat, glassy look, and his coat is rough and
lustreless. In general the animal appears to perish from starva-
tion and consequent excitement of the nervous system, but some-
times appears to suffer acute pain, causing him to expend his
strength in running wildly from place to place, pausing and
rolling, until he fallsand diesin a few minutes.’’ (O. B. Ormsby,
Report Dept. of Agriculture, 1874).

‘* Animals are not fond of it at first, or don’t seem to be, but
after they get accustomed to the taste they are crazy for it and
will eat little or nothing else when-loco canbehad. ‘There seems
to be little or no nutrition in it as the animal invariably loses flesh
and spirit. Even after eating of it they may live for years, if
kept entirely out of its reach, but if not, they almost invariably
eat of it until they die.’”’ (Mrs. T. S. Whipple, San Luis, Cal.,
Report Dept. of Agriculture, 1874).

‘‘Cattle, after having eaten it,’’ Oxytropis Lamberti, ‘‘ may
linger many months, or for a year or two, but invariably die at
last from the effects of it. The animal does not lose flesh appar-
ently, but totters on its limbs and becomes crazy. The sight be-
comes affected so that the animal has no knowledge of distance,
but will make an effort to step over a stream or an obstacle while
at a distance off, yet will plunge into it or walk up against it on
arriving at it.’’ - (Dr. Moffat, U. S. Army. )

‘The term doco, simply meaning foolish, is applied because of
the peculiar form of dementia induced in the animals that are in
the habit of eating the plant. Whether the animals (horses
chiefly) begin to eat the plant from necessity (which is not likely)
or from choice, I am unable to say. Certain it is, however, that
when once commenced, they continue it, passing through a tempo-
rary intoxication, toacomplete nervous and muscular wreck in the
latter stages, when it has developed into a fully marked disease,
which terminates, in death from starvation or inability to digest
more nourishing food. The animal, toward the last, becomes
stupid or wild, or even vicious, or again acting as though attacked
with blind staggers.’ (Dr. Rothrock. Report of Dept. Agri-
culture, 1884).

Dr. Isaac Ott, of Easton, Pa., gives the following as the
physiological action of the Astragalus Mollissimus ; ‘‘ It decreases
the irritability of the motor nerve, greatly affects the sensory

138 : Veterinary Medicine.

ganglia of the central nervous system, preventing them from
readily receiving impressions. Has a spinal tetanic action. It
kills mainly by arrest of the heart. Increases the callory secre-
tion. Hasa stupefying action on the brain. Reduces the cardiac
force and frequency. Temporarily increases arterial tension,
but finally decreases it. Greatly dilates the pupil.’’ (Cdmer.
Jour. of Pharmacy, 1882.

In opposition to these statements Professor Sayre, of Kansas,
after an extended observation, arrived at the conclusion that ‘‘ it
is a grave question whether loco weed is a poison at all; upon
chemical examination no poisonous principle of any kind was dis-
covered ; no toxic effect was observable when administered to
frogs, cats, dogs, or the human species, . . . . the point cannot
be accepted as a settled one whether loco is poisonous to cattle or
not.”’

Dr. G. C. Faville found in /ocoed sheep in Colorado, bunches of
tapeworms in the gall ducts. Dr. Cooper Curtice, who sub-
sequently studied the subject, found the tzenia fimbriata, and be-
lieves that to these the symptoms are exclusively due. ‘‘ The
affected lambs are large headed with undersized bodies and hide-
bound skins. Their gait is slightly like that of a rheumatic.
They seem to have difficulty in cropping the shorter grass ; they
also appear to be more foolish than the other sheep, standing
oftener to stamp at the sheep dogs or the herder than the healthier
ones. Others do not seem to see as well, or are so affected that
they seem to appreciate danger less. In driving they are to be
found at the rear of the flock.’’ (Animal Parasites of Sheep).

It is altogether probable that the teeniasis of sheep has been
mistaken for /oco, but this can hardly account for the remarkable
symptoms found in other genera of animals, as a concomitant of
an acquired and insatiable fondness for these leguminous plants.
The teenia fimbriata has been found in sheep and deer, but there
is no record of it as a parasite of cattle and horses.

Dr. Sayre’s failure to find any poisonous principle in the plants,
or any toxic action on frogs, dogs or cats, cannot be received as
conclusive in face of the result reached by others. Perhaps
Dr. Sayre’s specimens were not grown under the proper condi-
tions, or were not collected in the proper season to secure the
toxic ingredient.

Loco Poisoning. Oxytropis Lamberti. 139

Miss C. M. Watson, of Ann Arbor, Mich., succeeded in sepa-
rating a small amount of alkaloid from the root of Oxytropis
Lamberti, but did not apply the crucial test of physiological ex-
periment. In the Report of the Department of Agriculture for
1879, are given analyses of Oxytropis Lamberti, Astragalus
Mollissimus and Sophora Speciosa, in each of which a small
amount of alkaloid was found.

In 1888~9, Dr. Mary Gage Day, of Wichita, Kansas, made care-
ful experiments on cats and rabbits, under the supervison of Dr.
Vaughan in the Michigan Laboratory of Hygiene. She used a
decoction of roots, stems and leaves of plants gathered in Sep-
tember and gave 60 to 70c. c. of this toa half-grown vigorous kit-
ten daily, along with abuudance of milk and other food. In two
days the kitten became less active, showed rough coat, increased
desire for the /oco, with partial loss of appetite for other food,
diarrhoea came on, and retching and vomiting occasionally oc-
curred. The expression became peculiar and characteristic.
These symptoms increased, and emaciation advanced, and on the
18th day periods of convulsive excitement supervened. These
were sometimes tetanic, the head being thrown backward and the
mouth frothing. At other times the kitten stood on its hind
limbs and struck the air with its fore paws, then fell backward
and threw itself from side to side. There were short intervals
of quiet, life being indicated by breathing only. After 36 hours
of these intermittent convulsions paraplegia set in, and the kitten
died in two hours. There was no apparent loss of consciousness
before death.

Post mortem examination revealed gastric and duodenal ulcers,
some of which were nearly perforating. The heart was in
diastole ; brain and myel appeared normal; the entire body
anemic.

Toa vigorous adult cat 60 c.c. to 70 ¢.c. of a more concentrated
solution were given with other food. Theresults were essentially
the same. By the twelfth day the cat was wasted to a skeleton
and very weak. Paralysis of the hind limbs came on and the
cat died on the thirteenth day.

As atest experiment, two strong young cats were confined in the
same place, fed from the same dish, and treated in every way the
same, except that the one was fed daily a decoction of the /oco.

140 Veterinary Medicine.

The one fed /oco acquired the loco disease with the symptoms
described above while the other, eating ordinary food only, re-
mained healthy.

Subcutaneous injections of the concentrated decoction thrown
into frogs and chickens at the Michigan Laboratory of Hygiene,
under direction of Dr. Victor C. Vaughan, caused nervous twitch-
ing and in large doses, death in 1 or 2 hours from heart paralysis.
The same symptoms were produced in frogs by injection of an
alcoholic extract of the residue left after evaporation to dryness
of the decoction.

The loss of appetite, acquired liking for the ‘‘ /oco-weed,’’ rough
coat, emaciation, peculiar expression, rearing, plunging, and a
staggering uncertain gait are among the symptoms given in the
earliest published observation on the loco disease, and agree with
the statements universally made by ranchmen. An ulcerated
condition of the intestines was also pointed out by Professor
Sayre in a locoed cow upon which he made a necropsy (Dodge
City Times, July, 1887) : but the diarrhcea which wasso marked
a symptom in the cats experimented on, is not mentioned as a
characteristic symptom in horses and cattle.

‘‘FRrom the close agreement of the symptoms in the cats with
those universally recognized in locoed horses and cattle, I con-
clude that the cases described above were genuine cases of the
‘loco disease ’’’ and are, so far as can be ascertained, the first
that were ever experimentally produced.”’

‘The craving for the ‘‘ loco’’ is soon acquired. The kittens
would beg for it as an ordinary kitten does for milk, and when
supplied would lie down contented. ‘To determine whether a
herbivorous animal would easily acquire the ‘‘loco habit’’ a
young ‘‘ jack’’ rabbit was captured and fed a few days on milk
and grass; then fresh ‘‘loco’’ was substituted for the grass.
At first the ‘‘loco’’ was refused, but soon it was taken with as
much relish as the grass had been. After ten days of the milk
and ‘‘loco’’ diet the rabbit was found dead, with the head
drawn back and the stomach ruptured.’’

‘* With reference to the character of the plants at the different
seasons of the year, I am convinced by numerous experiments,
on material gathered in different months, that the greatest
amount of poison is present in the autumn and winter.’’ ‘The

Lead Poisoning. Plumbism. 141

scarcity of other food at that period of the year is only a partial
explanation of the number of deaths occuring at that season.

Conclusions :

“rst. There is some poison in ‘‘loco weed’’ which may cause
the illness and, if sufficient quantity is taken, the death of an
animal.’’

‘‘ad. This poison is contained in the decoction obtained from
the plants, and by systematically feeding it to healthy cats, cases
of ‘‘loco’’ disease may be produced.”

‘3d. Taste for the green “‘loco weed’’ may be experiment-
ally produced in the jack rabbit.’’

4th. From the large quantity of the plant or the decoction
required to prodnce the disease, the poison must be weak, or if
strong, it must be in very small amount.

LEAD POISONING. PLUMBISM.

Physiological action on nervous system. Sources: near smelting furnaces
on vegetation ; paints ; paint scrapings in manure and on soils ; lead pack-
ing of pumps, engines, etc. ; sheet lead; bullet spray ; wall paper lead ;
leaden water pipes or cisterns ; lead acetate ; painted buckets ; painted silo ;
lead compounds in arts. Experiments on animals. Accidental poisoning :
horse, fever, gray nasal discharge, salivation, convulsions, paralysis,
dyspnoea. Cattle, emaciation, dyspcena, palsy, tonic spasm of flexors of
limbs, swollen carpus, death in a few months. Young worst. Sheep,
lambs paretic. Swine in pens escaped, those at large suffered. Post-
mortem ; lead or lead compounds in stomach, or shown by analysis, in
gastric contents, liver, spleen, kidney, etc. Tests. Treatment; hydro-
sulphuric or sulphuric acid. sulphate of magnesia or soda, antispadmodics ;
in chronic cases, potassium iodide, bitters.

The physiological action of lead is exerted on the nervous sys-
tem, so that lead poisoning may be appropriately enough treated
of as a disease of the nervous system.

Sources. ‘The sources of lead as a poison for animals are
extremely varied. In England in the vicinity of lead mines and
smelting furnaces it is deposited from the air in a fine powder,
and consumed with the vegetation. Herapath found that the de-
posit, in dangerous amount, began half a mile from the chimney
of the smelter and extended about half a mile further.

142 Veterinary Medicine.

A second source is in lead paints used about farms and the
scrapings of paint pots thrown out with manure and spread
upon the fields. .These lead combinations will last for years in the
soil or on the surface, being plowed under one year and turned up
again the next when the occasion of their presence has been
completely forgotten. In one case I found the red lead paint
marked by the tongues of cattle at the back of an abandoned
cottage the fence around which had been broken down. In
another the scrapings were found in an orchard which had been
near and convenient for throwing them out. In the third case a
paint can hung on the branch of an apple tree, well out of the
way of the stock as the owner fondly supposed, showed in its
contents the marking of the barbed tongues of the cattle. In
a fourth case a barrel of paint was set under the barn where
there was not height enough to admit the matured cattle,
but it bore the marks of licking by the young stock, and they
alone died but in such numbers that the owner concluded
it must be the ‘‘Rinderpest.”’

The lead packing from the joints of pumps, engines and other
machinery, thrown away around works and mines, is a common
source of the trouble. I once found large quantities in the gas-
tric contents of cows that had died around a coal mine in
Ayrshire, Scotland.

Sheet lead—tea-chest lead—is another common source of the
poison. This is thrown out, scattered with the manure on the field,
and will resist the elements for years but dissolves when taken
into the acid stomach of the animal.

The spray from bullets in the vicinity of rifle butts is another
common cause of the poisoning. <

In one instance I have seen a cow poisoned by eating some lead-
impregnated wall paper which had been carelessly left in the
stable.

Less frequently the poisoning comes from drinking water car-
ried in leaden pipes, or left to stand in a leaden cistern. The
softest waters—rain, snow, distilled water—are the most liable to
this impregnation. The hard waters containing carbonates, sul-
phates or phosphates, tend to be decomposed, the acid uniting
with the lead to form comparatively insoluble carbonates, sul-
phates or phosphates of lead, which protect the subjacent lead

Lead Poisoning. Plumbism. 143

against solution. The hardness of the water is not, however, a
sufficient safeguard, as iron, solder, and other agents present in
the lead as an impurity or merely resting upon it, are sufficient to
set up a galvanic action resulting in solution.

The salts of lead may find direct access to the animal, as in the
case reported by Gamgee in which a farmer used a barrel which
had contained acetate of lead for mixing the feed given to his
stock. A somewhat similar source of poisoning is found in the
use of buckets or silos which have been painted inside, and scale
off in contact with hot water, etc.

Blythe enumerates the following compounds of lead as employed
in the arts :

1st. Hair dyes which have a basis of litharge, acetate or car-
bonate of lead in combination with lime and other agents.

2nd. White lead in its various forms is.carbonate of lead.

3rd. Newcastle white is white lead made with molasses vinegar.

4th. Notingham white is white lead made with sour ale.

5th. Miniature Painter’s white is lead sulphate.

6th. Pattison white is an oxychloride of lead.

7th. Chrome Yellow is impure chromate of lead.

8th. Turner’s Yellow, Casella Yellow, Patent Yellow is oxy-
chloride of lead.

goth. Chrome Red is a bichromate of lead.

roth. Red Lead is the red oxide of lead.

11th. Orange Red is an oxide obtained by calcining the car-
bonate.

12th. Nitrate of Lead is much used in calico printing.

13th. Pyrolignite of Lead is an impure acetate used in dyeing.

14th. Sulphate of Lead is a by product in the preparation of
acetate of aluminium for dyeing.

Forms, lead poisoning occurs in acute and chronic forms.
T’he two forms, however, merge into each other and are largely
convulsive and paralytic.

Experimentally. Harnack found that 2 to 3 mgrms. in frogs
and 40 mgrms. in rabbits caused increased intestinal peristalsis,
diarrhoea, and paralysis of the heart. Dogs had choreic symp-
toms. Gusserno gave 1.2 grm. to rabbits and dogs respectively,
and produced emaciation, shivering and paralysis of the hind
extremities. Rosenstein with 0.2 to 0.5 grm. obtained in dogs

144 Veterinary Medicine.

similar symptoms with epileptiform convulsions, and Heubel had
symptoms of colic in a few cases.

Casual or Accidental Poisoning. Metallic lead is slowly
dissolved and therefore large doses of this may be taken in with-
out visible ill effect. Shot has often been given to relieve the
symptoms of broken wind in horses, and a dog at the Lyons
Veterinary School took four ounces without visible ill effect.
When finely divided, however, as in sheet lead or the spray of
bullets it presents a much more extended surface to oxygen and
acids, and in the acid stomach of monogastric animals, or even in
the organic acids of the rumen it is dissolved in quantity sufficient
to prove poisonous.

Symptoms in Horses. Shenton thus describes his cases.
‘‘ There was a rough, staring coat, a tucked up appearance of
the abdomen, and a slightly accelerated pulse ; in fact, symptoms
of febrile excitement which usually, however, passed away in
about a week. About this time large quantities of gray colored
matter were discharged from the nostrils, and saliva from the
mouth, but at no times was there any enlargement of the sub-
maxillary, lymphatic, or salivary glands. Nor was there consti-
pation of the bowels, which appears to be nearly always present
in cases of lead poisoning in man. Fits and partial paralysis
came on at intervals ; and when the animals got down they often
struggled, for a long time ineffectually, to get up again. The
breathing up to this time was pretty tranquil, but now became so
difficult and labored that the patient appeared in danger of suffo-
cation. ‘The pulse was in no case above 60 or 70, and I ascribe
the difficulty of respiration to a paralyzed state of the respiratory
apparatus. The animals did not live more than two or three
days after these symptoms appeared. The post mortem appear-
ance varied but little. The lungs and trachea were inflamed ;
the lungs engorged with large quatities of black blood; the
trachea and bronchia filled with frothy spume. In all cases but
two the villous part of the stomach presented isolated patches of
increased vascular action, and in all cases the intestines, and
especially the large ones, were inflamed. The blind pouch of
the ceecum was nearly gangrenous. ‘There was nothing remark-
able about the liver, spleen or kidneys, except that they were of
a singularly blue appearance.’ ’

Lead Poisoning. Plumbism. 145

Symptoms in Ruminants. ‘These are described by Herapath as
following the erection of lead smelting furnaces in the Mendip
Hills in Somersetshire. There werestunted growth, emaciation,
shortness of breathing, paralysis of the extremities, particularly
the hinder ones, the flexor muscles of the fore limbs affected so
that the animals stood on their toes, swelling of the knees and
death in a few months. Even if removed to a healthy locality
the victims failed to thrive. The effects were most pronounced
in the young. Lambs were born paralytic; at three weeks
old they could not stand, and palsy of the glottis rendered it
dangerous to feed from a bottle. Twenty-one out of twenty-
three died early. The milk of cows and sheep was reduced in
quantity and quality, and: contained traces of lead. The cheese
had less fat in it. ‘The dead showed the mucous ‘surfaces paler
than natural and the lungs had large areas with abruptly circum-
scribed margins of a dark red color, surcharged with fluid. A
blue line appeared on the gum close to the teeth, and from this
a globule of lead could be melted under the blowpipe.

In the cases that have come under my observation paralysis of
the hind limbs, emaciation and low condition, have been most
prominent in the chronic forms, while these have been compli-
cated by torpor of the bowels, blindness, stupor, coma, and more
or less frequent paroxysms of delirious excitement or convulsions
in the acute. In the chronic cases the blue line on the gums is
an important symptom.

Herapath noticed that near the smelting furnaces pigs escaped
if kept in the pen but suffered if allowed to goat large. This is
explained by the presence of lead in the forms of oxide, car-
bonate and sulphate on the herbage, hay and hedge rows, andin
short on all vegetation.

In post mortem examination the stomach should be carefully
searched for lead in the metallic form as sheet lead, bullet spray,
etc., for the different forms of paint of which lead forms an in-
gredient, for the discarded white lead packing of pipes and ma-
chinery, and even for solid masses of metallic lead. This is
especially necessary in the case of cattle in which the morbid
habit of eating non-alimentary matters is so common, and for
which the sweet taste of some of the lead compounds seems to

offer an attraction. ‘The lead being long retained in the first
10

146 Veterinary Medicine.

three stomachs in contact with acetic and other organic acids is
especially liable to be dissolved and absorbed in dangerous amount.

In the chronic cases especially, the test by electric current may
furnisha valuable pointer. Inlead poisoning the muscles respond
much less actively to the stimulus than in the normal condition.

In resorting to analysis the following table from Heubel of the
amount of lead in the different organs of a dog may offer a guide
to the selection of an organ for examination :

DAaver i220). ocne eae os coe ee .03 to .1O per cent.
RAMEY 225225222225 5Sse-5s2e5 25 - .03tO .07 ‘
Brain neces cessssesocctakceucese cecns, 20240 205 ay
BONES Locos eee cee eee aceeccece, SOL TO 204; _
Muscles __._---_ ease .004 to .008 a

Professor George Wilson found the lead very abundant in the
spleen, and used it for analysis. He dissolved it in aqua regia
over a slow fire, cooled, filtered, evaporated, cleared, and boiled
with dilute nitric acid. Then filtered and dried again, dissolved
in dilute muriatic acid, and finally applied the colortests. With
hydrosulphuric acid it gives a black precipitate, with sulphuric
acid, a white, and with potassium iodide or bichromate a bright
yellow. Or from the solution of the chloride the lead may be
obtained as a metallic deposit on zinc from which it can be fused
into a minute globule on charcoal.

In the treatment of lead poisoning the first object is to prevent
the further solution of lead in the alimentary canal and to carry
it off. To fill the first indication, hydrosulphuric acid or sul-
phuric acid may be administered to form respectively the insoluble
sulphide or sulphate. Asa purgative, sulphate of magnesia or
soda should be preferred, as favoring at once elimination and the
formation of an insoluble precipitate. Large doses are usually
desirable, especially in ruminants, because of the bulky contents
of the stomach and the torpor of the alimentary canal. If grip-
ping is a prominent symptom opium or other antispasmodic must
be added. .

In chronic cases, after the evacuation of the contents of the
alimentary canal small daily doses of potassium iodide will serve
to dissolve the lead out of the tissues, while sulphates may be
given in small doses to assist in elimination from the bowels
and to prevent reabsorption. The treatment by potassium iodide
is equally applicable, to assist in the elimination of the lead that

Alcoholic Intoxication. 147

has passed into the circulation and tissues. The doses, however,
should in any case be small to avoid the sudden solution of a
large amount of lead which had been deposited in the tissues in a
comparatively insoluble form. The sudden entrance into the cir-
culation of any large amount of such lead would induce a prompt
return of the toxicsymptoms. A continuous exhibition of small
doses is the course of wisdom and safety. -The bowels should
meanwhile be kept somewhat relaxed by small doses of sodium
or magnesium sulphate. Asa general tonic a course of bitters
may be called for, especially when torpor or emaciation is pro-
nounced.

ALCOHOLIC INTOXICATION.

Beer in pigs, alcohol in dogs, absinthe in horse, alcohol and burnt ales in
cows, alcoholized grain in fowls, also fermented raisins... Symptoms, lack
of codrdination, staggering, flushed mucosz, full pulse, stertor, sopor, coma,
alcoholic breath, chill, muscular twitching, delirium. Treatment : ammonia
acetate, or carbonate, apomorphia, pilocarpin, warm water, coffee, stomach
pump, electricity.

Poisoning by alcohol is less common in the lower animals than
in man, yet the veterinary journals record a considerable number
of cases. We have seen pigs suffer from drinking soured beer ;
the smaller breeds of dogs (English terriers) which are systemat-
ically dwarfed by feeding alcohol are often kept for a length of
time in a condition of semi-intoxication. Bissauge records the
case of a horse inebriated bya glass of absinthe and a pint of
white wine, and that of a cow which died intoxicated 24 hours
after she had been given thtee quarts of pure alcohol (Rec. de
Med. Vet. 1895). Dundas records intoxication in cows fed on
burnt ales. Intoxication of barnyard fowl and wild birds from
eating grain soaked in strong alcoholic liquids has been frequent-
ly noticed, and Bissauge reports fatal drunkenness among our
domestic fowls front eating raisins and other fruits which had
undergone fermentation. :

The symptoms are too suggestive to require notice in detail.
Thereis a lack of coordination of movement, a staggering gait, a
disposition to lie, dilated pupils, dark red flushing of the visible
mucous membranes, a full pulse, stertorous respirations, drowsi-

148 Veterinary Medicine.

ness, stupor, and finally coma. The breath exhales the odor of
alcohol, and the temperature usually falls, especially if the subject
has been exposed to cold. It may rise later in connection with
inflammation of the stomach or brain. Muscular twitchings and
delirium are sometimes found, and may occur paroxysmally.

Treatment. A pint of liquor of the acetate of ammonia to
horse or ox may quickly relieve the symptoms, or 1 0z. carhon-
ate of ammonia may be given in solution ina pint of vinegar. If
more convenient the hypodermic injection of 1 or 2 grains of
apomorphia, or of 5 grains of pilocarpin may beemployed. Warm
water is of the greatest value in securing elimination. A strong
infusion of coffee is very effectual. If the patient is a vomiting
animal an emetic may be employed, and in case of coma the
stomach pump may be resorted to. Cold applied to the head or
galvanism may be used to rouse the patient.

In case of gastritis or encephalitis following the attack these
must be treated according to indication.

ANILINE POISONING.

Composition. Source. Uses. Toxic action on skin, by inhalation, and
by stomach. Symptoms: acute, chronic. Test. Treatment : emesis, pur-
gatives, stimulants, tonics, enemata, bleeding, normal salt solution.

Aniline (Amidobenzene, Phenylamine, C,H, N) is a product
of coal tar produced in the manufacture of benzole and of aniline
dyes. Being an object of large production and consumption in
the arts, its toxic action is seen not infrequently in man, and less
so inanimals. As used in confectionery it is so diluted that it is
rarely or never injurious. On textile fabrics, however, it often
causes cutaneous irritation, and when eaten by animals may be
toxic. Workmen in the factories usually suffer from its inhala-
tion.

Turnbull gave % dram sulphate of aniline toa dog, inducing
vomiting in 2% hours and purging one hour later. There were.
accelerated pulse, labored breathing and paraplegia, followed by
recovery in five hours. Other objective symptoms are coldness
of the surface, and a bluish or purple color of the visible mucosz,

Poisoning by Nitro-Benzol. 149

the blood failing to take up oxygen. In chronic aniline poisoning
in man the following symptoms have appeared : papular, vesicular
or pustular skin eruptions, or ulcers on hands, feet and scrotum ;
an odor of coal tar; anorexia, nausea and vomiting ; headache,
vertigo, stupor, ringing of the ears, amblyopia, muscular spasms,
muscular weakness, anzesthesia and motor paralysis especially of
the extremities. The fatal dose is 1% dr. and upward.

Aniline may be extracted from the tissues by petroleum ether,
and on the evaporation of the solution, it is left as an oily yellow-
ish mass which gives the following reactions :—with a few drops
of sodic hypochlorite a blue or violet blue ; with acids a rose red ;
with bromine a flesh red.

The treatment must be by elimination by emesis, or purgation,
by removal from aniline fumes or mixtures, and by stimulating
and tonicagents. In place of emesis a stomach tube and lukewarm
water in large amount may be employed to wash out the stomach.
For vomiting animals ipecacuan may be employed. Copious
enemata may be given, along with purgatives, to clear out the
bowels. As stimulants strong coffee, caffein, camphor, or strych-
nia may beemployed. In case of profound stupor, prostration, or
paresis it may be desirable to reduce the amount of aniline in the
system by free blood-letting, care being taken to inject subcutem,
or into a serous cavity, a nearly equivalent amount of normal
salt solution. .

POISONING BY NITRO-BENZOL.

Composition. Source. Uses. Characters. Toxic qualities. Convul-
sions; paralysis; cyanosis; weak pulse; bitter almond odor; dark red
urine; sopor, giddiness ; reduced size of red blood globules ; congested
brain, stomach, intestines. Treatment: emesis, purgation, stimulants,
electricity, derivatives, bleeding, normal salt solution.

Nitro-benzol (Nitro-benzine, C, H, NO, ) is a coal tar product,
formed in large quantities in the manufacture of aniline dyes
and extensively used as a flavoring agents for soaps, sweet meats,
etc. It is formed by the addition of strong nitric acid to ben-
zine, and appears as a yellow fluid with an odor resembling,
yet somewhat different from, that of prussic acid or oil of

150 Veterinary Medicine.

bitter almonds. It may prove deadly to man or dog in a
dose of fifteen drops, though most commonly it enters the system
by inhalation. In animals the prominent symptoms are convul-
sions and paralysis, supervening on a period of weak circulation
and pulse, and blueness of the visible mucous membranes. The
characteristic odor resembling the oil of bitter almonds exhales
from the lungs and skin. In man there are dilatation of the
pupils, blueness of the lips and nails, pallor of the face, weak
pulse, slow breathing (often in the end Cheyne-Stokes respira-
tion), a dark maroon or port wine color of the urine, and ambly-
opia. In the chronic cases the skin is yellowish, and there are
weariness, a dragging walk, headache, morning anorexia,
drowsiness, giddiness, numbness of the hands or other parts and
emaciation. The blood is chocolate color with red globules re-
duced in size, in number and in hemoglobin, but containing an
excess of carbon dioxide. The brain is often congested and the
gastro-intestinal mucosa like the skin may be yellow (from al-
leged formation of picric acid). In chronic cases disseminated
sclerosis may be seen.

In treatment emesis, purgation, stimulants (ammonia, cam-
phor), galvanism, sinapisms to the chest, and phlebotomy, with
injection of normal salt solution, may be resorted to, asin aniline
poisoning.

POISONING BY CARBON DISULPHIDE.

Used to kill insects in grain, etc., in barns. Locally anzesthetic, and irri-
tant. Inhaled, toxic, causing excitement; anzesthesia, collapse. Large
doses, excitement, reckless movements, incodrdination, giddiness, sleep,
stertor, paraplegia. Small doses, weakness, emaciation, tremors, paraplegia,
polyuria, mellituria ; convulsions, death. Distortion and varicosity of axis
cylinder, and unequal staining of cytoplasm. Treatment: pure air, good
diet ; massage, electricity, tonics, phosphorous.

This agent is largely used in vulcanizing and other factories
where the employes are liable to suffer, and also in granaries,
barns, etc., for the destruction of insects in grain and other
objects and where animals are liable to suffer.

Locally it acts like chloroform, when confined to the surface, as
under a glass or covering, producing very active irritation with
anesthesia.

Narcotic Potsons. 151

Inhaled it produces intoxication, excitement, general anzesthesia
and finally collapse. In rabbits it causes intense excitement,
giddiness, swaying from side to side, and reckless leaps forward,
followed by profound sleep with deep stertor, and paraplegia for
half an hour after the return of consciousness (Oliver). . When
taken fora long time in small quantity it caused weakness,
emaciation, tremors, paraplegia, and death in convulsions. There
was polyuria, with excess of sugar but neither urea nor albumin.
The large cells in the motor areas of the brain, when stained by
Golgi’s method, showed the axis cylinder distorted and varicose,
and the cytoplasm stained unequally. The action on dogs was
essentially the same, and in neither animal were changes in the
blood globules observed (Oliver).

In man slow poisoning caused headache and exhilerant intoxi-
cation, followed by depression, mental apathy, dullness, loss of
memory, impaired vision, hearing, sexual desire and muscular
power. Cramps are common (Delpech, Curtis).

Treatment consists in giving pure air, good food, massage,
galvanism, tonics, and for the persistent nervous failure phos-
phorus. :

NARCOTIC POISONS.

Among narcotics and other poisons affecting the nervous
system may be named the following :

Wild poppy which produces rabiform symptoms or coma ;
also its alkaloids, and especially opium.

Buckwheat when in flour : causes intoxication like alcohol.

Hyoscyamus, belladonna, stramonium, bittersweet, pro-
duce weakness, paresis and palsy.

Cannabis indica causes sluggishness, vertigo and staggering
in carnivora. Steeping of hemp in running streams is forbidden
in some warm climates. Even flax is claimed to have caused
staggering and convulsions.

Skunk cabbage (dracontium), causes vertigo, nausea and
vomiting.

Wild garlic produces rabiform attacks.

Valerian leads to cerebral disorder—notorious in cats.

Hellebore causes coma, stupor, weakness and convulsions.

\

152 Veterinary Medtcine.

Veratrum album, cevadilla and viride produce tremors and
spasms.

Ranunculus causes stupor, trembling, loss of lumbar reflex
and sudden death.

Digitalis paralyzes lips and hind limbs, with stupor and con-
tracted pupils.

CEnanthe crocata caused general paralysis.

Conium maculatum led to anesthesia, blindness dilated
pupil, palsy and convulsions.

Vetches, lupins, ryegrass, millet, etc., already nmed (Vol.
II. and Meningitis).

Fermented potatoes, chestnuts, beechnuts (see Vertigo).

Ergot, smut, musty fodder, mouldy meal or bread (see
poisoning by Cryptogams).

Bitter almond cake, wilted leaves of choke cherry,
hydrocyanic acid cause vertigo, tremors, paresis, epileptiform
convulsions.

Aconite leads to anesthesia, paralysis and death.

Tobacco entails nausea, vertigo, cardiac prostration, and
death.

Artemesia cinz and santonin cause in dogs epileptiform
convulsions and paraplegia.

Box leaves produced coma, vertigo and convulsions.

Cicuta virosa determines epileptiform convulsions.

Iodoform entails stupor, sopor, coma, and rabiform symptoms.

Strychnia, ergot and rhus cause tonic spasms.

Coriaria Myrtifolia of Southern Europe yields a deadly
narcotic glucoside.

Fruit of the Umgamu of S. Africa makes an intoxicating
drink acting on animals and man.

The Coca of Brazil paralyzes sensibility and is said to over-
come fatigue.

The Pareca, a species of inga of the Amazon valley acts in
the same way: a snuff by a new subject causing him to fall as if
shot, while the inured are exhilarated, and hunger, fatigue and
depression are relieved. Captain Herndon says itis made from
the ashes of a vine, the seeds of the acacia angico and the leaves
of the abuta (cocculus). When nearly dead with hunger, fatigue
and fever, a snuff made him fall drunk in the hammock, his limbs
feeling as if under an electric shock ; on rising he felt no pain and

Tetany. 153

seemed to dream, but outwalked the Indian guides for two hours
till daylight.

A dwarf bush of the mountains of Africa and a bulbous root
of Nebraska are alleged to possess similar properties.

The hydery—quill—rhay (Indian tobacco) is used in British
Columbia and Alaska for the same effect as opium.

Sleepy grass (Stipa inebrians and S. Siberica) of Texas and
New Mexico causes profound sleep or stupor for one or two days.
In horse causes diaphoresis and diuresis.

Tutu (coriaria rustifolia) of New Zealand has poisonous seeds,
acting even fatally on fatigued cattle and sheep, but not on horse,
goat or pig. The narcosis lasts but a few hours.

Treatment. Opium and some other alkaloids find an antidote
in potassium permanganate, to be supplemented by diffusible stimu-
lants. All may be counteracted by eliminants (vegetable emetics,
laxatives and diuretics), seconded by abundance of water and
other diluents. When the agent is acrid or irritant demulcents
(boiled flaxseed, raw eggs, milk, slippery elm, albumen, mallow,
gums, etc.) should be used freely, and fomentations and poultices
applied over the abdomen and loins.

TETANY.

Definition. Casual and experimental casesin animals. Causes : Excision
of the thyroid, indigestions with fermentation, rheumatism, infection, ma-
Jaria, rachitis, want of hygiene, hereditary or developmental irritability,
microbian poisons. Symptoms: intermittent spasms with semi-flexed
limbs, tremors. Diagnosis: by the complete intermissions of spasms, and
by pressure on nerve or artery, rousing them. No fever. Like spasms of
ergot. Treatment: thyroid extract, grafting thyroid; remove sources of
irritation, anti-spasmodics, warm or tepid baths, electricity.

Definition. 'Tetany is the name given to a limited contraction
of a group of muscles usually in the extremities occurring
paroxysmally with intervals, during which it may usually be
roused into activity by compression of the nerve or artery pro-
ceeding to the muscles in question.

The disease has not been accorded a place in systematic works
on veterinary medicine, though cases have been recorded which
are supposed to have been of this nature, and in cases occurring

154 Veterinary Medicine.

in man and associated with dyspepsia and gastric dilation,
Bouveret and Devic have extracted from the contents of the
stomach a toxic substance which caused tetanic convulsions in
animals. ‘The total removal of the thyroid gland, or even of
four-fifths of it (Eiselsberg), in the cat is found to be invariably
followed by tetany.

Causes. Beside the origin from the removal or general disease
or degeneration of the thyroid, it has been attributed to digestive
troubles, associated with fermentations and the production of
toxic matters, to rheumatism, infection and malaria, to rachitis
and unhygienic conditions. The systematic changes and trials of
growth and development, of pregnancy and lactation, seem to be
factors in certain cases. A peculiar irritable nervous organiza-
tion transmitted by heredity is undoubtedly a potent cause, and
upon this, bacteridian, leucocytic and other poisons operate so as
to rouse the paroxysms. :

Symptoms. There are usually prodromata in the shape of dull-
ness, prostration, weariness, and some dullness of the special
senses. Fever is commonly absent and the contractions tend to
affect both flexors and extensors, but as the force of the first
predominates, the affected member is usually held more or less
rigidly semi-flexed. The spasm appears suddenly, often taking
occasion of some voluntary movement, and may last for several
minutes or hours. It is followed by an interval of relaxation of
equally uncertain duration. ‘Though usually attacking the limbs
and causing the victim to walk on the toes, it may extend to the
face, neck or trunk, and constitute an intermittent trismus,
-oposthotonos or emprosthotonos.

Diagnosis. Tetany is to be distinguished from tetanus by the
complete intermissions of the spasms, and by the voluntary de-
velopment of these by compression of the presiding nerve or
artery. Pressure on the nerve arouses its excitability, and com-
pression of the artery shutting off the supply of blood from the
disordered and susceptible muscles, tends to increase their irrita-
bility. Ligature of an artery supplying healthy muscles causes
simple trembling of such organs. From the spasms of cerebral
spinal or meningeal inflammation tetany is distinguished by the
absence of fever, and the complete intermissions of the paroxysms.
The spasms of ergotism bear the closest relation to those of tetany

Contraction of the Spinal Cord in the Horse and Cow, 155

and in the absence of proof of the ingestion of ergot, might well
be confounded with them.

Treatment. ‘This consists mainly in doing away with the causes,
when these can be ascertained. Portions of thyroid may be
grafted if complete thyroidectomy has been performed, or thyroid
extract may be given. In the human subject recoveries have
followed the expulsion of intestinal worms, the cure of gastric
dilation, dyspepsia, fermentations, diarrhoea, rachitis, menstrual
irregularity, or auto-intoxication, Firé has seen recovery follow
the extraction of a carious tooth.

The spasms may be met by the internal administration of anti-
spasmodics (chloral, belladonna, bromides, opiates, ) and the ex-
ternal application over the affected muscles of anodynes and
anti-spasmodics (belladonna, opium, chloroform, oil of cajeput,
oil of peppermint, menthol, etc.). Warm or tepid baths are
often of great value and a mild electric current has been found
useful.

CONGESTION OF THE SPINAL CORD IN. THE HORSE
AND COW.

Under this heading Trasbot describes hemoglobinuria and par-
turition paresis, but this tends to cover up the more important
causes and phenomena of these diseases, which should be kept in
the foreground. Spinal congestion is undoubtedly a feature of
both these affections, and the sudden onset and rapid recoveries
often seen, indicate the absence of inflammatory action, yet thisis
but an accompaniment of a constitutional morbid state which we
think fully warrants a special consideration of each elsewhere
(see: Heemoglobinuria ; Parturition paresis).

Apart from these affections congestion habitually merges into
myelitis or spinal meningitis, and may be considered as the initial
stage of these disorders. It owns the same causes and is mani-
fested by closely allied symptoms, but these are less persistent,
and may subside abruptly into a condition ofhealth. The treat-
ment will be on the same general lines as for myelitis, but with
much better hope of success.

ACUTE MYELITIS. POLIOMYELITIS. INFLAMMA-
TION OF THE SPINAL CORD.

Causes : Stimulating food to excess, sexual over-stimulation, violent over-
exertion, hot sun, chill, rheumatism, traumas, injury to spinal nerves, ver-
tebral caries, microbian infection, narcotics, vegetable poisons, cryptogams,
Lesions : discoloration of white or gray matter, swelling, friability, soften-
ing, extravasations in points, leucocytes in excess, nerve cells cloudy, granu-
lar, nucleus enlarged, stain highly, chromophile granules irregular, neuro-
glia thickened. Symptoms: Hyperthermia, rigor, hyperzesthesia, tonic
contractions in neck and limbs, intense lameness. paresis, palsy, muscular
atrophy, areas of heat followed by coldness, such parts may not perspire,
palsy less complete than in broken back, circulation and breathing acceler-
ated or slow, paraplegia in large herbivora. Diagnosis: progressive onset,
hypereesthesia or rigidity merging into palsy, retention and later inconti-
neuce of urine, extreme spinal tenderness, rapid atrophy of affected mus-
cles, skin sloughing. Prognosis, always grave. Treatment: purgation,
bleeding, hot fomentations, ice bags, compresses, derivatives, bromides
chloral, potassium iodide, atropia, ergot, electricity, strychnia, soft laxative
food, bitters, phosphates.

Causes. Vike congestion this may be a result of plethora
in overfed animals, in those subjected to specially stimulating
food like gluten meal, cotton seed meal, beans, peas, vetches in
excess, animal food for herbivora (the waste of hotels and restau-
rants for cows, compressed meat products for pigs), a period of
absolute rest on full rations in horses habituated to hard work
and full feeding ; of sexual over-stimulation in males (stal-
lion, bull, ram); of violent over-exertion especially if under
a hot sun; of sudden chill when over-fatigued and perspiring ;
of cold rain storms (Freirier) ; of rheumatism (Kowalski) ;
of traumatism (fractures, sprains, slipping with over-disten-
sion) ; of falls upon the point of the ischium; of blows upon
the back (Cruzel, Trasbot) ; of tumors implicating the cord;
of too violent efforts in serving by stallions; of injuries of
the great nerve trunks passing off from the cord (Gull, Tras-
bot, etc.) ; of extensions from caries or suppurations of the
vertebrz (Decoste, Trasbot) ; of microbian infection, asin
rabies, distemper, tubercle, dourine, louping ill, milk sickness,
contagious pneumonia, influenza, and suppurations: of narcotic

156

Acute Myelitis. Poliomyelitis. 157

poisoning, as from ergot, smut, the poisons of the cryptogams
and bacteria of mouldy bread, musty fodder, spoiled meats, fish,
etc. ; also the poisons of lolium, vetch, lupin, astragalus,
oxytropis, arsenic, etc.

Lesions. These consist in a yellow or pink discoloration of
the white and especially of the gray matter, and a special prom-
inence of the puncta vasculosa in the affected part. Swelling or
distortion of the part is not usual. This may involve only a
single gray horn, the two horns on the same side, the two in-
ferior horns, or all four at once, or the white matter adjacent
may also show the rosy tint, the large puncta, and a charac-
teristic softness and friability. Minute blood extravasations are
very significant. Microscopically examined leucocytes are found
in abundance in the perivascular spaces and in the neuroglia,
The neurons (nerve ganglia cells) are degenerated, being
cloudy, swollen, with enlarged nucleus, stain highly, and show
enlargement of the chromophile granules. Ina more advanced
stage the cell has an indefinite outline and the nucleus is in-
distinct and may fail to take a stain; the chromophile granules
are irregular and do not radiate evenly from a centre and many
vacuoles appear. ‘This may lead to fatty softening, or to fibrous
increase of the neuroglia, and sclerosis.

Symptoms. ‘These vary greatly in different cases according to
the part involved, the meninges or some special region of the
cord, to the essential cause of the inflammation and its acuteness.
Usually the attack sets in slowly in contradistinction to the
abrupt attack of congestion. Hyperthermia and rigor are
usually among the first symptoms, though in many cases hyper-
zsthesia is the most markedearlysymptom. The skin covering
the muscles which derive innervation from the affected section of
the cord is the most sensitive. This is often so extreme along the
vertebral column that percussion on the spinous processes or
pinching between the fingers and thumb causes the most pro-
nounced wincing and dropping of the back. Copland and
Laposso have noticed that a sponge of hot water drawn along the
line of the vertebrze causes acute pain and contractions of the
muscles of the back and limbs, which are almost tetanic in their
force, ‘This probably implies the existence of meningitis, since
the absence of rigidity of the muscles of the neck, back and

158 Veterinary Medicine.

limbs, usually implies the absence of meningeal inflammation.
It may, however, éccur in localized or commencing myelitis.
The existence of unilateral lesions and rigidity determines intense
lameness, which is further characterized by the most marked
hypereesthesia.

The morbid phenomena of the motor system are more
characteristically paretic or paralytic than spasmodic. When
rigidity or spasm ushers in the attack it is superseded in a few
hours or in two or three days by flaccidity of the muscles of the
affected part, with imperfect control or even complete paralysis.
The muscles affected will depend on the seat of the spinal lesion.
If in the neck it may affect fore and hind limbs, and even the
chest and abdomen ; if in the back or loins it will induce para-
plegia, the anterior limit of which will correspond to the seat of
the lesion ; if near the caudal extremity of the cord, (lumbar
portion), paralysis of the tail and of the sphincters ani and
vesicze may be prominent features. Retention of urine and faeces
(spasm) may precede incontinence (palsy).

Common sensation may be dull or abolished on one or on
both sides. If on one side only, the other may show hyper-
eesthesia.

Trophic modifications are very marked though they may
not be noticeable at first. The paralytic muscles waste rapidly
and the impaired nutrition is manifested in the rapid formation of
sloughing and intractable sores where pressure comes in recum-
bency (the hips, stifles, hocks, shoulders, etc.). This is
especially noticeable on parts supplied by the cord at or behind
the seat of the lesions.

Vaso-motor changes are usually marked by a preliminary
hyperthermia of the affected parts, followed by a corresponding
hypothermia. Sometimes the affected part of the skin will re-
main quite dry while the rest of the body is covered by perspira-
tion.

Choked optic disc and retinitis are sometimes present.

The febrile reaction which is at first moderate, gradually in-
creases in force; the animals become dull, drowsy, careless of
food, and the hyperzesthesia merges into paresis or paralysis.
This is rarely so complete as in fracture of the vertebree. If the
inflammation is restricted to the lower columns only, there may be

Acute Myelitis. Poliomyelitis. 159

akinesis without change of the sensitiveness or with hypersensi-
tiveness. If restricted to the upper columns there may be sensory
paralysis on the opposite side...

The heart sounds and pulse are usually altered, palpitations
may appear early with acceleration and: sharpness of the pulse,
and this may alternate with a tardy slow pulse with intermissions.
Breathing also becomes accelerated and in violent cases with
trembling, though in moderate inflammation with effusion, soften-
ing and degeneration, it is liable like the heart beats to become
slow and tardy.

When vertigo appears it may be attributed to extension to the
bulb or cerebellum, or to the sympathetic implication of these
organs.

The frequency with which paraplegia occurs in the larger her-
bivora suggests a special susceptibility of the lumbar portion of
the cord, probably in connection with severe muscular effort, of
the hind limbs.

In protracted cases the fever may run very high, being compli-
cated by septic poisoning from the numerous cutaneous sloughs and
sores, as well as by cystitis and nephritis. .

Diagnosis. ‘This may be based on the progressive onset, unlike
the sudden attack of congestion ; on the occurrence of primary
fever with hyperesthesia or even muscular rigidity, merging into
a later paresis or paralysis ; on the retention of urine, followed by
incontinence ; on the torpor of the rectum ; on the extreme ten-
derness of the spine in the region of the inflammatory lesion ; and
on the tendency to rapid atrophy of the affected muscles, and the.
death and sloughing of.the skin under pressure over the promi-
nent parts of the body. ‘The definite localization of the muscular
symptoms, and the different temperature and secretion of the
affected part of the skin, from the unaffected, are further con-
firmatory of myelitis.

Prognosis. While always grave, myelitis induced by narcotic
elements in the food which can quickly be eliminated from the
system, and that which has not caused compulsory decubitus, or
persistent retention of urine and faeces, may be considered as
hopeful. When, on the other hand, the nature and extent of the
Jesions have entailed a prolonged paralysis, or in the large animals,
{especially solipeds), a persistently recumbent position, there is

160 Veterinary Medicine.

little to be hoped for. The degenerated myel, and the badly
wasted muscles, combine to prevent rising and the use of the
limbs, the sloughing bed sores quickly poison the blood and
general system, and the animal sinks beyond hope of remedy.
Again, if the faeces accumulate in the rectum causing general re-
tention of the bowel contents and fermentation, the shock to the
nervous system and the toxins absorbed add materially to the
prostration and danger. Finally the retained urine infected
through the blood or by a catheter, quickly passes into ammoni-
acal fermentation, with softening and detachment of the cystic
epithelium. septic infection of the mucosa, and the extension of
this infection through the ureters to the kidneys. The complica-
tion of infective inflammation of bladder and kidneys introduces
one of the most dangerous conditions possible.

Treatment, Inan acute case, at the outset, elimination of any
extraneous poison should be sought as the first step toward a
restoration of the normal spinal functions. Purgatives may be
employed to this end, and if the case is urgent and without spasms
immediate action may be sought by a hypodermic injection of
1% gr. eserine and 2 grs. of pilocarpin. Meanwhile the horse
may receive a dose of aloes, or the cow one of Epsom salts.
Abundance of watery or demulcent liquids given by the mouth or
as enemas, should not be omitted.

When plethora has been a prominent factor and symptoms are
urgent, a free bleeding (4 to 5 quarts for horse or cow) from
the jugular vein may serve to relieve the vascular tension,
dilute the vital fluid, and moderate the inflammation. Hot
fomentations or sinapisms to the limbs, and even cupping on the
neck and chest, may contribute to relieve the tension on the
spine. When the temperature is already high, bags of ice may
be applied to the tender parts of the spine or those indicated to
be the inflamed parts by the groups of rigid or paretic muscles.
Wet compresses or evaporating lotions may be substituted. In
the absence of mustard, tartar emetic, biniodide of mercury, or
euphorbium may be used, or even croton oil in a carefully
guarded manner, but cantharides, oil of turpentine, and other
agents calculated to irritate the kidneys are to be avoided.

Bromides, hydrobromic acid, potassium iodide, chloral, or bel-
ladonna may be availed of. Some prefer ergot, but this, like

Acute Myelitis. Poliomyelitis. 161

strychnia, is of doubtful effect or positively injurious in most
cases in the early stages. Even in the early stages electricity
may be used in the form of a constant current, which tends to
vaso-motor contraction and a better tone of the capillaries. The
electrodes may be applied along the affected side of the spine so
that the current may traverse the affected part. It may be kept
up for ten to twenty minutes at a time and repeated daily. Any
undue suffering under the current may be accepted as a demand
for the reduction of its force or its suspension for the time being.

When the hyperthermia has subsided and the occurrence of
paresis or paralysis demands nervous stimuli, these may be sought
in counterirritants, strychnia, and interrupted currents of elec-
tricity. The blisters already mentioned may be used. Strychnia
may be used internally (horse or ox 2 grs., sheep gr., dog 31; to
zs gr.) or hypodermically (horse 1% gr., sheep % gr., dog ,45
to sy gr.). Should this excite the animal or aggravate the symp-
toms it must be stopped and deferred until the inflammation shall
have more completely subsided. The same remark applies to
electricity which may be tried in the interrupted current, and
graduated to the endurance of the patient or entirely abandoned
for the time.

If the patient is able to support itself on its limbs, it is best
kept in a sling to avoid the formation of sloughs and sores. If
it cannot so support itself a very thick soft bed of litter is essen-
tial to avoid the sloughing and septic poisoning. Food must be
laxative and easily digestible such as mashes, hay tea, and boiled
or pulped roots. Fresh green grass may be employed when ob-
tainable.

During convalescence a course of bitters with calcium phos-
phate and carefully regulated exercise are important. In tardy
cases Trasbot especially recommends cauterization.

II

SPINAL MENINGITIS. -

Complex cases. Microbian invasion. Lowered vital tone. Traumas.
Poisons, parasites, tubercle, rheumatism, neoplasms, poisonous food. Symp-
toms: Stiffness, tonic contraction, spasms, hyperesthesia with warmth,
enuresis, paralysis later. ‘Treatment : parallel to myelitis : cold, anodynes,
nerve sedatives, and anti-spasmodics., saline purgatives, diuretics. Iodine,
electricity, cauterization.

It is often difficult to distinguish between spinal myelitis
and meningitis in the lower animals, and the danger of confusion
is greater because the two affections are often conjoined. Attacks
appear to be often associated with microbian invasion of the
membranes, but in its turn this is often favored by the lowered
tone of the membranes through mechanical injury, circulatory
disorder, trophic changes, or the action of poisons in the blood.
Thus the condition may supervene on fractures, partial disloca-
tions or sprains of the neck, back or loins, abscesses pressing on
the spine, extension of septic inflammation from poll evil, fistu-
lous withers, or arthritis of the vertebre, penetration of the mem-
branes by sharp pointed bodies (Reindl found a darning needle
in a cow’s spinal canal), invasion by microbes in influenza, brust-
seuche, dourine, rabies, milk sickness, distemper, pyeemia, sep-
ticeemia, strangles, louping ill, or Texas fever. ‘The toxins of
tetanus may start similar trouble. The larva of cysticercus
cellulosa may-cause meningitis in dogs or pigs, the sclerostoma
in the soliped, the filaria in dogs and strongle in a variety of
animals. Tubercle of the meninges is not unknown, and rheu-
matism is alleged asa cause. Neoplasms commencing 1n the cord
act in a similar way, and the poisons of rye grass, millet, loco,
lupins, tares and vetches may act on the membranes as well as
on the myel.

Symptoms. In the main these resemble those of myelitis and
are often present at the same time, and it is only necessary to
note those which are especially pathognomonic. ‘The early rigors
are followed by stiffness of the back shown in rising Or walking
and aggravated by motion. ‘There may be tonic contraction of
the dorsal and lumbar muscles amounting at times to opostho-
tonos. The muscles of the limbs, chest or abdomen or some part

162

Acute Myelitis in the Dog. Meningo-Myelitis 163

of them may be the seat of tonic or clonic spasms. The skin is
usually hypersensitive and this is aggravated by heat. The urine
is liable to be retained because of the pain of stretching to
micturate. Paralysis usually follows and implies extension to
the myel, compression of the cord by reason of exudation, or
implication of the spinal nerves at the points of exit. In myelitis
on the other hand the spasms may be entirely absent, and
paralysis sets in early and extends rapidly according to the seat
and extent of the lesion.

Treatment. ‘This will be along the same lines as in myelitis,
being aimed at elimination of toxic matters, and the counteract-
ing of the existing inflammation. Anodynes such as bromides
and chloral and cold water or ice are especially called for to alle-
viate pain and hyperzesthesia, and anti-spasmodics like ether,
chloroform, chloral, belladonna, etc,, to allay the spasm. Saline
purgatives too, and diuretics may be availed of to limit effusion
and favor reabsorption. In the advanced stages iodine may be
freely applied to the spine, and an occasional electric current, or
cauterization may be availed of.

ACUTE MYELITIS IN THE DOG. MENINGO-MYELITIS.

Causes: distemper, in long-haired pets, pyeemia, exposure to cold, vio-
lent over-exertion, traumas, vertebral caries or abscess. Lesions: in lum-
bar enlargement, horns yellowish, red, friable, pultaceous, leucocytes in ex-
cess, punctiform extravasations, neurons opaque ; granular, filaments difflu-
ent, varicose, sclerosis. Meninges congested, thickened. Symptoms: as in
horse, extreme hyperzesthesia, later anzesthesia, tremors or twitching, later
paraplegia. Treatment: Laxatives, ice bags, sedatives, later derivatives,
cauterization. During convalescence, phosphates, iron, zinc, strychnia.
Attend to bladder and rectum, light, laxative diet, pure air and water.

Causes. ‘This disease is a common result of distemper and ac-
cording to Trasbot, is much more frequent in long-haired and pet
dogs than in the short-haired and mongrels. The shelter of the
hair, like the warm indoor atmosphere, seems to contribute to a
special sensitiveness of the cutaneous and nervous tissues. The
infective inflammation of the myel is also seen in pyzemia, rabies
and milk sickness. It appears to be further induced by ex-

164. Veterinary Medicine.

posure to cold draughts when heated, or excited, by plunging
into ice cold water, by lying on cold, damp, stone pavement or
metallic plates. Violent over-exertion, excessive fatigue, and a
variety of traumatisms are further factors. Kicks, blows on the
back, concussion from falling from a window or other height,
and sprains received in fighting or otherwise, are common causes.
Disease of the vertebrz or abscesses in their vicinity will some-
times extend to the meninges and cord.

Lesions. ‘These are like those in the larger animals, being toa
large extent determined by the cause and nature of the lesion,
concussion, sprain, fracture, pyzemic, septiceemic, or other in-
fection. The implication of the myel to the exclusion of the
meninges is very frequent and the lumbar enlargement is the
most common seat of disease. Localization in the brachial en-
largement or in one lateral half of the cord is uncommon. The
gray matter towards the extremity of the horn is the most com-
monly involved, reflecting a yellowish, grayish red or deep red
color, and breaking down into a pultaceous mass on the slightest
pressure. At an advanced stage the altered coloring matter
gives to the tissue a brownish yellow color without altering its
consistency. ‘The still vital and vascular area around the centre
of softening may be slightly swollen and abnormally firm. ‘The
neuroglia is the seat of leucocytosis, and minute (usually puncti-
form) extravasations of blood. The red globules are crenated
or otherwise distorted and the white are granular and opaque.
The neurons are swollen, granular and opaque and the nerve
fibres are more or less diffluent, moniliform and in their sub-
stance show no clear outline of white substance and axis cylin-
der. Interruptions by granule masses and vacuoles are common.
In old standing or chronic cases the liquid exudate and granular
debris have been largely absorbed and the thickening of the
neuroglia by fibrous neoplasm, has restored the firmness or even
approximated the part to a condition of sclerosis.

In case the meninges are involved there is thickening by exud-
ation into their substance or on their surface, there may be ad-
hesion between the outer and inner layers of the arachnoid and a
serous fluid, red, milky or clear, distends the arachnoid or sub-
arachnoid space. The false membranes, here as elsewhere, are
usually red if recent, and increase in pallor with age.

Acute Myelitis in the Dog. Meningo-Myelitis. 165

Symptoms. ‘These are in the main the same asin the larger
animals. ‘The early excitement usually takes the form of hyper-
eesthesia. When lifted, pressed, touched or only approached
the dog may growl, howl, snap, cringe, cower or tremble, glancing
up meanwhile with anxious or pleading eyes. When later, this
gives place to aneesthesia no such interference will draw a re-
sponse. The motor disorders at the outset are mostly of the
nature of tremors or twitching of the muscles of the limbs or of
those parts of the trunk corresponding to the seat of the lesion.
In exceptional cases spasms or convulsions may be shown. ‘Tras-
bot records a case of very acute myelitis of the brachial enlarge-
ment in which there were clonic contractions of the muscles of
the neck, jaws and eyeballs, and grinding of the teeth, which
condition lasted for thirty six hours. When this motor excite-
ment merges into paralysis it usually attacks the hind limbs which
are extended backward helpless while the animal pulls himself
forward by his fore limbs. Some such cases are restless and in
continual movement while others are dull, apathetic and indis-
posed to move. ‘The precise seat of the paresis or paralysis will
be determined by the seat of the lesion as in the larger animals.
Thus paraplegia is most common, less frequently hemiplegia,
palsy of the fore limb, palsy of a single limb, and monoplegias,
about in the order named. Palsy of the tail and sphincters im-
plies a lesion of the lumbar section of the cord and is very
offensive in the incontinence of urine and fzeces especially in long-
haired subjects.

Treatment. ‘The abstraction of blood is rarely called for in
myelitis inthe dog. Ifadmissible at all it isin the case of strong,
vigorous, plethoric animals which have been attacked in connec-
tion with sudden exposure to cold or accidental concussion, and
which are presented for treatment at once. Then leeches may
be applied to the abdomen or inside of the thigh, or the jugular
may be opened with a lancet. Usually on the other hand the
patient is fat, lymphatic, and, if a few days have elapsed, even
anemic, while if he has been the victim of an accident the
shock and prostration would forbid any depressive measures.

Derivation toward the bowels may be sought by pugative doses
of calomel or jalap. In case of high fever, cold may be applied -
(in the form of icebags, evaporating lotions or wet cloths) to the

166 | Veterinary Medicine.

tender portion of the spine. Ifthe attack has followed exposure
to cold, salicylate of soda may be given, otherwise the bromide of
potassium or camphor. Acetanilid and other antithermic agents
may be used with caution. ,

With the abatement of the high fever and the supervention of
paresis, if not before, counterirritants are demanded.

Owing to the propensity to lick and the danger of absorption,
poisonous agents are virtually prescribed. Yet Moller advises
cantharides, croton oil, mercuric iodide, and oil of mustard, -and
Trasbot restricts the choice to tartar emetic one part to sixteen
parts of lard. ‘This the latter rubs softly along the spine for sev-
eral minutes. If the dog is closely watched or muzzled this or the
mustard or croton oil may be admissible. If otherwise, a long-
haired dog may be rubbed on the spine with a combination in
equal parts of strong aqua ammonia and olive oil ; or it may have
applied for some minutes wet cloths rather hotter than the hands
can bear ; or a light cauterization may be made with a Paquelin
cautery. At this stage, too, bitters and phosphate of lime may
be given. Trasbot has long'used with the best results 1 grain
doses of neutral, gelatinoid phosphate of lime, repeated two or
three times a day. Iron may also be restored to, or sulphate of
zinc. Strychnia and electricity are also of great value as soon
as the irritability of the spinal centres will allow of their safe em-
ployment. Massage and gentle exertise are important.

From the first, attention must, be given to obviate the retention
of urine and fzeces, and the strict antisepsis or asepsis of the
catheter adopted to prevent infective cystitis and nephritis.

Throughout the disease abundant nourishment of an easily
digestible quality isdemanded. Cleanliness, pure air and general
comfort must not be forgotton.

CHRONIC MYELITIS. SCLEROSIS.

Sequel to acute. Result of sprains and spinal injuries. Symptoms: pa-
resis on exertion, lameness in one or more limbs, knuckling, circumductive
movement of feet, uncertain planting, dropping, worse if blinded, phe-
nomena progressive. Lesions: sclerosis of cord; absorption of nerve cells
and fibres, in gray horns, and columns, superior, lateral and inferior, cord,
altered in color, unduly firm, in points softening. Stains deeply in car-
mine, lightly in osmic acid or hematoxylin. Meninges thickened, nerve
roots atrophied. Diagnosis : previous acute myelitis ; later muscular weak-
ness, and paresis, under exercise: from embolism. Treatment : hopeless if
advanced ; progress delayed only. Good hygiene; tonics, open air, gentle
exercise, pure water, grooming, succulent pasture, nourishing food, alka-
lines, common salt, phosphates,

.

Cases of this kind have not been satisfactorily diagnosed, and
as a rule domestic animals affected with partial paralysis are
rarely allowed to live in a condition in which they are offensive
to themselves and owners, a source of constant experise with
little or no hope of recovery nor profit. Again, in the case of
the large mammals, the prolonged recumbency and the low grade
of nutrition in the semi-paralyzed parts, usually entail unhealthy
sores and septic poisoning which sooner or later prove fatal. It
is only, therefore, in the slighter cases, in which a fair measure
of control over the limbs remains, that these cases are likely to
survive. ‘Trasbot suggests that many cases which pass for lum-
bar sprains are really chronic myelitis and on careful examination
will show spinal sclerosis.

Causes. ‘These are largely speculative, yet doubtless the same
causes which determine the acute form, will produce the chronic
when acting with less force and greater persistency. The lesions
that are left after an acute attack are calculated to keep up a
measure of vascular and trophic disorder which will be found
associated with more or less sclerosis.

Symptoms. In Weber’s case in the horse (Recueil de Med.
Vet., 1884, p. 432) the advance was slow, so that for nearly a
year the manifestations were not diagnostic. At first there was
weakness of the hind limbs when worked to fatigue. Perfect
rest led to improvement, and work, to aggravation which became
steadily worse and worse. For a length of time the horse main-

167

168 Veterinary Medicine. A

tained good condition, glossy skin, elevated head, alert expres-
sion, keen sight and hearing, and normal breathing and pulse.
Standing in the stall there was no abnormal position of the limbs,
nor evidence of lack of perfect control.

But when moved all this was changed. He showed first lame-
ness in the right fore limb and soon in all four members. The
feet were swung and planted uncertainly, the animal swayed and
staggered, the limb would knuckle over at the knee or fetlock,
or bend at the hock, and be recovered with difficulty. After
going slowly for a few steps he moved with greater freedom
though still with difficulty, and the trouble was greatly aggra-
vated when the eyes were blindfolded. Then every step threat-
ened to precipitate him to the ground. The symptoms were es-
sentially those of locomotor ataxy.

The tactile sensibility was unimpaired, the loins had the
normal sensibility, urination and defecation were natural and the
appetite remained good. After ten months he showed loss of
condition, dullness of the special senses, stupor, and a special
sensitiveness about the head, and resented its handling.

Lesions. ‘Thirteen months after the commencement of the at-
tack this horse was destroyed and the cord was found to be
profoundly altered by fibroid degeneration of the neuroglia and
absorption of the nerve elements (cells and fibres), the lesions
affecting different portions of the gray horns, and the columns—
superior, lateral and inferior. The affected portion of the cord
usually shows in man a grayish, opaque or translucent appear-
ance, with in some cases a shrunken aspect and undue firmness
of texture, and at points, centres of softening. If hardened,
the sclerosed sections take the carmine stain deeply, but the
osmic acid or hematoxylin stain very slightly, contrary to what
holds in health. In recent cases there is only slight thickening
of the neuroglia, but when the disease is advanced the trabeculz
are thick, dense, and firm, and the nerve fibres have largely dis-
appeared. The coats of the blood vessels adjacent to the sclerosis
are thickened and their lumen is narrowed. Thickening of the
meninges is not uncommon, either confined to those covering the
diseased portion of the cord or extending completely around it.
Atrophy of the nerve roots is often appreciable by the naked eye.

Diagnosis. 'This depends largely on the fact that the condition

Chronic Myelitis. Sclerosis. 169

follows an acute attack of myelitis, on the supervention of mus-
cular weakness and lack of muscular control, whenever the animal
is exercised to fatigue, the morbid symptoms subsiding promptly
when he is allowed to rest, the aggravation of these symptoms
when the patient is blindfolded and a gradual though slow ad-
vance of the symptoms with the lapse of time. From arteritis
and embolism it is to be distinguished by the absence of the local
Symptoms of pain and tenderness, and by the absence of pulsation
in the same artery distal of the obstruction and of improvement
by the lapse of time or a run at grass. :

Treatment Unless in the very early stages even a partial re-
covery is not to be looked for. By a run at grass or by gentle
well regulated exercise the impaired nerves and muscles may be
educated to a better control for a limited period but the progress
of the disease is not really arrested and the final issue is likely to
be ruinous. Even in man, where goper cent. of the cases are
connected with syphilis, the fibroid hyperplasia (sclerosis) is not
remedied as gummataare, by mercury and iodides. In the soliped,
-where no such specific disease can be charged, the repair of the
structural changes is no more hopeful. The many different
methods of treatment in man,—electricity, blisters, firing, stretch-
ing of the spine, stretching, of the sciatic and crural nerves
—though inducing transient improvement in many cases,
produce no real permanent benefit, and are to be remand-
ed to the region of psychic inferences which have little or
no place in the therapeutics of the lower animals. Strych-
nia, veratrin and other spinal stimulants are of little per-
manent value. A general hygienic and corroborative treatment
may be used with the view of retarding the progress of the dis-
ease rather than of curing it. Open air exercise, sunshine, suc-
culent pasturage, an ample supply of pure water, and active
grooming are valuable. Nourishing food is all important.
Lecithin or the hypodermic injection of spermin or other rich
albuminous animal product is useful. A course of bicarbonate of
soda and carbonate of iron with or without bitters may be tried.
When the animal must be kept on dry winter food; he should
have free access to common salt and water. This favors at once
absorption, assimilation, and elimination, and by fostering nu-
trition and the removal of waste matters, it contributes to: keep

170 Veterinary Medicine,

the disease in abeyance. Phosphoric acid and the various phos-
phates have been largely used and largely rejected, their main
value being in the tonic effect on the spinal centres. Trasbot
especially recommends the neutral gelatinoid phosphate of lime
as having proved especially valuable in his hands. He gave
from 1 grain upward to dogs twice a day.

ARTERITIS (THROMBOSIS, EMBOLISM) OF THE
SPINAL CORD AND MEMBRANES.

Conditions of spinal circulation favorable to embolism and microbian in-
vasion. Slow currents. Blood stasis. Free anastomosis a compensation.
Symptoms. Treatment.

Facts are wanting with regard to these lesions in the domestic
animals, but anatomical, physiological and pathological consider-
ation are strongly suggestive of their occurrence. The vascular
network of the spinal cord favors a tardy circulation, and this in
turn is favorable to the arrest of solid*bodies and the delay, pro-
liferation and colonization of microbes. ‘The median spinal artery
receives a supply of blood by two trunks, right and left, entering
by the intervertebral foramina at each intervertebral articulation.
It has not, therefore, one continuous, equable, onward flow, but
rather numerous independent currents corresponding to the enter-
ing vessels, and with intervening eddies or areas of. comparative
stagnation. ‘The nervous material of the cord admits no large
arteries but only capillary trunks which anastomose freely in its
substance. This would seem to entail a sluggish flow, which
would favor microbian arrest and colonization, even if the small
size of the vessels serves to shut out clots of any material size.
Finally the abundant venous plexus, and especially the two lateral
venous sinuses, communicating freely with each other and,
through each intervertebral foramen, with the extra spinal veins.
determine a similar tardy flow that should be favorable to morbid
processes. If we pass back of these vessels, we find the posterior
aorta to be at once the largest and the most direct channel for the
entrance of emboli coming from the left heart or lungs. This
danger is counteracted in greater part by the fact that the greater

Arteritis of the Spinal Cord and Membranes. 171

part of this blood passes into the large vessels which supply the
liver, spleen, kidneys, stomach, bowels, and hind limbs, and
while embolism is well known in these parts it has not been
demonstrated as yet in the spinal cord. The toxins produced in
infectious diseases and circulated in the blood can often lead to
destruction of the endothelium, and inflammation of the deeper
structures. In this way any circulating microbes find a ready in-
fection atrium. Hektoen seems to have demonstrated this in the
case of tubercular meningitis. By pressure of the neoplasm on the
vessel or by fibroid thickening and contraction of the walls of the
vessel, the subsidiary cord is denied its fullsupply, and degenera-
tion of the nervous substance is invited. In the human subject
degeneration of the cord has been shown to follow the line of
such diseased arteries. Thrombosis follows in every case in
which the serous coat is involved, and embolism can easily occur
from clots small enough to enter the capillary vessels. Lamy’s
experiment of blocking the small arteries with inert powder,
shows that this will give rise to foci of hemorrhagic softening,
which commence in the gray substance. The blocking, how-
ever, must be multiple to produce any material effect, as the free
anastomosis of the spinal capillaries otherwise secures an abund-
ant blood supply to adjacent parts. In case of an infective em-
bolism the disease will advance even if the obstruction is single.

The general symptoms of these conditions would depend on the
exact seat of the lesion, and treatment would have to proceed on
general principles, the object being to check the inflammatory
conditions, and trust to the vs medecatrix nature in connection
with rest and good hygienic conditions.

HEMORRHAGES INTO THE SPINAL MEMBRANES

MENINGEAL SPINAL APOPLEXY. H2MATORRACHIS. 2. HEM-
ORRHAGE INTO THE SPINAL CORD. SPINAL APOPLEXY.
HAMATOMYELIA.

Definition. Causes: violent exertion, blows, falls, morbid blood, frac-
ures, caries, tumors, tubercle, aneurisms. Lesions: Clot between or outside
membranes in meningeal hemorrhage, in gray matter and even in white in
myelon bleeding, Cord bulges. If survives, nervous matter absorbed.
Symptoms: Sudden stiffness or palsy of given areas ; spasms more common
in meningeal extravasation. Rapid muscular wasting. No fever at first.
Treatment: cold to part; slings ; atropia, ergot, lead acetate. Later as
for myelitis. Large clot may warrant surgical interference.

In the first of these forms the bleeding takes place between the
arachnoid and the two contiguous membranes—pia and dura, or
outside the dura. In the second it takes place into the substance
of the cord though it may encroach on the pia mater. Both con-
ditions have been attributed to violent muscular efforts or con-
tractions as in draught, racing, fighting, leaping, tetanic con-
vulsions, also to blows on the back, or falls from aheight. Mor-
bid states of the blood in which there is a hemorrhagic tendency
(scurvy, purpura, hemophilia, anthrax) may be contributory
causes. Spinal fractures, aneurisms, caries, tumors and tubercle
may be additional causes.

Lesions. In miningeal bleeding the clot is found outside the
dura, or between the dura and arachnoid which may or may not
be ruptured. A clot on the pia mater may press seriously on the
cord or may cause rupture of the arachnoid. In hemorrhage
of the cord, the effusion usually begins in the gray matter, though
it may extend far into the white. It may be circumscribed to
half an inch in diameter or affect almost the entire length of
the cord. The cord may be distinctly enlarged at the point of
effusion, and in exceptional cases the blood may have broken
through to the membranes. If the patient survives, absorption
and degenerations of the cord are inevitable.

Symptoms. In both forms there is a sudden attack, with

172

Spina Bifida. 173

stiffness or paralysis of given muscles and without hyperthermia.
Rigidity and spasms of the muscles are more characteristic of
meningeal hemorrhage, and early paralysis of the spinal. An
early hyperzesthesia is also most significant of an effusion in
the cord, Rapid muscular atrophy is also characteristic of
this. The two conditions resemble meningitis and myelitis but
come on much more suddenly and are unattended by fever.

Treatment. Such cases are not hopeful. Cold to the affected
part of the spine, keeping the patient in slings to solicit the good
effect of gravitation, and giving ergot or lead acetate internally
are among the first indications. Later, the treatment would be-
practically the same as for meningitis or myelitis. In case of
complete paralysis from a sudden formation of a large clot, it
has even been advised to cut down on the seat of the injury. and
evacuate the blood, using antiseptic precautions.

SPINA BIFIDA.

This is an elastic swelling consisting of the spinal meninges
enclosing a liquid, and in some cases the spinal cord as well,
and protruding between the unclosed laminze of the verte-
bral rings, usually in the region of the sacrum or loins. It is
essentially an arrest of development on the part of the vertebree
and enveloping muscles and skin, and an extension of the cord
and effusion of the meningeal and central spinal liquids, in the
absence of their bony and muscular support. Hydrocephalus is
no uncommon complication.

The diagnosis may be based on the presence of an elastic, some-
what transparent tumor, projecting from the vertebral spines, at
birth. Ifit contains a segment of thecord it is usually flattened,
depressed on the summit and often associated with paralysis.

As occurring in the lower animals this need not be treated. In
man, careful antisepsis and evacuation followed by injection of a
solution of iodine 10 grs., iodide of potassium 30 grs., and glyce-
rine I oz., have, in favorable cases, secured obliteration of the
sac, but even then the recovery has rarely been complete and
permanent. Paralysis and death have usually supervened.

SPINAL CARIES. TUBERCULAR OR OTHER INFEC-
TIVE DISEASE OF THE VERTEBRA.

Spinal caries in old horses, sprains, fractures, infections ; caries often
confined to articulating processes: anatomical form : Oxoido-atloid caries
from poll evil, concussions, fights, rachitis. Tubercle of bone and interver-
tebral cartilage in cattle. Symptoms: distortion, stiffness, rigidity : stands
day and night, sensory and motor paralysis: localization of lesion ; dyspnoea;
spastic palsy back of lesion; effect on tail, sphincters. Diagnosis : progres-
sive tenderness and stiffness of spine, distortion, localized exaltation or de-
pression of nervous function, osteoporosis, rachitis, caries, tubercle, mela-
noma, abscess, infectious disease. Treatment: Sling in narrow stall, good
food, pure air, sunshine, tonics, phosphates.

As seen in the human subject spinal caries is usually tubercular
and is known as ‘‘ Pott’s disease.’’ Asseen in old horsesit appears
to be rather a result of other infections, especially purulent, and
may have started in connection with traumatics or mechanical
injuries to the bones and ligaments. In such cases I have seen it
repeatedly in hollow backed horses in which the line of the spine
descended abruptly and extremely from the withers and rose
again to the sacrum. ‘The distortion was so great that the back
appeared as if it could barely sustain the weight of the animal
and yet the patients were kept at work and proved useful for
light driving. Post mortem examination showed extensive caries
and suppuration of the vertebral bodies, confined, however, to one
or two segments as if due to a mechanical lesion. In the region
of the loins it is much more likely to affect the articulations of
the vertebral rings, because of the manner in which these are
wedged into each other when the spine is pressed downward.
In the neck where the normal movement is so much freer such
injuries are much less common. Caries affecting the articular
surfaces of the axoido—atloid joint is by no means uncommon.
It may follow poll evil, or injuries sustained when a horse runs
against a wall, or in the fights of bullsor rams. Disease of the
vertebrze may be of the nature of rachitis occurring in this case
during life.

In cattle the disease is liable to be tubercular in which case, not
only is the bone invaded but the morbid process extends to the

174

Spinal Caries. Infective Diseases of the Vertebre. 175

intervertebral cartilage and projecting, presses on the spinal
meninges and cord. It may even encircle the entire spinal cavity
and strangle the cord. Ifthe pus should extend downward it
may form abscess under the spine, and rupture into an internal
cavity or externally.

Symptoms. Injuries and disease of the vertebrze may last for a
length of time without implicating the spinal cord or nerves.
They may then cause only distortion, with stiffness or ridigity of
the spinal column. When, however, the displacement of the in-
jured, carious or tubercular bones, the distension of the abscess
or the increase of the hyperplasia leads to pressure on the
nerve roots, the meninges or cord, nervous symptoms are like-
ly to be developed. Compression of the nerve roots—sensory
or motor—may cause sensory or motor paralysis or both,
limited to particular areas the outline of which will point to
the precise seat of the lesion. If in the recti of the head and
other muscles of the neck, it points to the anterior cervical
vertebree. If inthe fore limbs, it points to the posterior bones
of the neck. The implication of the diaphragm would in-
criminate the fourth and fifth cervical vertebre. If in the
crural muscles or those of the quarter and thigh, the lumbar
vertebrze must be looked to. ‘The implication of the nerves of
the back, while impairing the functions of the intercostal and
abdominal muscles, produce less marked symptoms than when
the limbs are involved.

When the disease extends deeper so as to implicate the men-
inges and especially the cord, there is evidence of impairment
or interruption of conduction in the cord in addition to the
simple involving of the nerves that emerge at that point. Thus
serious disease or pressure on the cervical part of the cord in
front of the fourth vertebra will make respiration difficult or
impossible and speedy asphyxia may ensue. The paralysis of
all parts behind the lesion is overlooked, in view of the fatal
nature of the paralysis of the intercostals and diaphragm. If
the interruption of conduction is incomplete there may be
spastic paralysis and hyperzesthesia in the limbs and trunk back
of the lesion.

If the dorsal cord is involved so as to render conduction im-
perfect there will be at first imperfect control of parts posterior to

176 Veterinary Medicine.

the lesion, and when still further implicated, flaccid or spastic
paralysis, especially of the hind limbs and tail. When it impli-
cates the lumbar region in addition to the paralysis named for
the dorsal, there will be incontinence of urine and even relaxa-
tion of the anal sphincter. Ina case of acute tuberculosis in a
cow, supervening on an ancient tuberculous lesion, as seen by
the author, there were imperfect control of the hind limbs and un-
certain gait, with tenderness of the dorsal region as if the animal.
had sprain of the back.

Diagnosis of these cases of vertebral disease may not always.
be possible in the early stages, yet the symptoms of progressive
tenderness and stiffness in the region of the spine, the distortion
in some instances of the spinal column, the subsequent appear-
ance of localized motor and sensory symptoms, and later still the
spasms or spastic paralysis in all parts behind the seat of the
lesion, will be strongly suggestive of such a disease. When in-
dications exist of osteoporosis, rachitis, or tuberculosis, of caries,
abscess, or infectious lesions of the cervical or dorsal spinal
region, the inference is still stronger. Then if reaction occurs.
under the tuberculin test, or if the urine contains an excess of
phosphates in the herbivora, the case may be diagnosed with
certainty.

Treatment, This will rarely be admissible on account of the
expense and uncertainty of result. Some meat animals may
be killed for food. If otherwise, keep in narrow stall where the
animal cannot turn even the head, feed from moderate level to
avoid movement of the spine by the upward and downward
movements of the head. Gentle brushing is useful as a means.
of cleanliness, and of toning up the muscular system. Nourish-
ing food of an easily digestible kind is essential, and pureair and
sunshine are important auxiliaries. A course of cod liver oil
with bitters may be given to improve the general health, cal-
cium sulphide may be tried in case of suppurative caries, and
calcium phosphate will usually be desirable to improve the nutri-
tion and consistency of the osseous system, In case of a valued.
patient which it is desirable to preserve for reasons of sentiment.
or affection, or for breeding purposes, one might be warranted in.
continuing a long and expensive course of treatment, but in the
regular run of cases considerations of humanity and economy
would counsel the prompt destruction of the animal.

SLOW COMPRESSION OF SPINAL CORD. PARALYSIS.

Causes : Caries, vertebral diseases and lesions, neoplasms, actinomycosis,
tubercle, abscess, organizing exndates, parasites. Melanoma, cholesteatoma,
sarcoma, papilloma, lipoma, glioma, chrondroma. Symptoms: advance
insensibly, or by sudden leap with exudate, spasm, paresis, transverse, senses
clear, muscular atrophy, advance from behind forward. Cervical, dorsal,
lumbar lesions. Bladder, sphincters, tail, Symptoms increased by move-
ment, Treatment: according to lesion. Tumors, hopeless. Blood clots.
Actinomycosis. Analgesics. Electricity.

Causes. Slowly progressive compression of the cord has been
already noted as resulting from caries and other diseases of the
vertebree. It remains to notice such as result from the growth
of tumors and other neoplasms in the spinal canal. In the horse
these are commonly melanoma (in white horses), sarcoma, en-
cephaloid, papilloma, cholesteatoma, and osteoma; in cattle,
beside tubercle and actinomycosis, have been found sarcoma,
lipoma, osteoma and glioma; and in dogs sarcoma and chon-
dro-sarcoma. Chronic abscesses may be met with in all animals
determining the same class of symptoms by slow pressure, In
the same manner exudates in process of organization contract,
and are liable to compress the myelon. Cadeac draws attention
to a calcic degeneration ‘of exudates in the dura mater of the dog,
(ossifying pachymeningitis), and of ossification of the interver-
tebrz cartilages with vegetations on their surfaces. Parasites
also exercise a growing pressure, especially echinococcus, in cat-
tle cysticercus mediocanellata, in sheep and dogs coenurus, and
in pigs and dogs cysticercus cellulosa.

Melanoma. In gray and white horses, with disseminated
melanosis, the spinal canal is often involved, the pigmentary sar-
coma appearing in small formations and sometimes large enough
to determine injurious pressure. In the early stages these may
cause stiffiness and lameness referable to particular muscles or
groups, varying in situation, even as to the limbs affected, at
successive dates, and finally merging into paraplegia.

Cholesteatoma is less common than in the encephalon, yet
one is reported by Drexler as attached to pia mater and pos-
sessed of great firmness, crisply crackling under the knife. It

12 177

178 Veterinary Medicine.

doubtless secures accretions under meningeal exudates like those
of the choroid plexus.

Sarcoma and encephaloid are usually found in connection
with the dura mater, and of small size, but numerous. They
often surround the roots of the spinal nerves, and here as on the
cord exert sufficient pressure to impair nervous function.

Papilloma has been found connected with the pia mater and
of marked vascularity. The author has found one in the ewe in
a case of the neurasthenia of advanced gestation.

Lipoma is also rare. Osseous growths are common, being
favored by sprains and injuries. All show a marked predilection
for the lumbar and last dorsal vertebrae. This may be partly ex-
plained by the liability to injury and to disease invasion through
the interlocking of the joint surfaces of the rings. Osteophytes
growing from the intervertebral cartilage are common in the dor-
sal region as well.

Glioma has been found in cattle, occupying the substance of
the cord itself and growing to the size of a hen’s egg or even of
the closed fist. ,The cord is gradually atrophied and paraplegia is.
inevitable.

Chrondro-sarcoma has been found. growing from the inter-
vertebral fibro cartilage of dogs.

Tne Symptoms may be deferred for a length of time on account
of the accommodation of the myelon to the slowly increasing
pressure. When they do become manifest, it is usually at first by
insensible gradations so that for a time their existence is question-
able. Yet a case will sometimes reach a sudden climax, by reason
of a blood extravasation or inflammatory exudate, and the signs.
of sudden pressure or acute myelitis or meningitis supervene. In
the absence of sudden access of trouble, the symptoms are those
of a slow increase of motor troubles (local, paresis, paralysis,
paraplegia), or sezsory (hypereesthesia, anzesthesia). Spasms
may occur early or even later in the disease. From disorder due
to cerebral lesions the morbid phenomena are distinguished by
being paraplegic rather than hemiplegic ; sensori-motor rather than
sensory or motor; local rather. than general; with intelligence.
and. special senses clear, rather.than dull or abolished ; associated
with marked muscular atrophy in the affected parts; advancing
from behind forward rather than uniform throughout the body.

Slow Compression of Spinal Cord. Paralysis. 179

The area of nervous disorder points more or less clearly to the
seat of the lesion. Early implication of the fore limbs, and then
later of the hind, suggests lesion of the cervical region. Dyspnea
tumultuous heart action, or vertigo may coincide. Tardy move-
ments of the hind limbs, imperfect balancing, dragging, swaying,
knuckling, involuntary flexions of stifle or hock, flexor con-
tractions, standing on toe, cramps, paraplegia, indicate lesion in
the dorsal or lumbar region. ‘There may be palsy of the rectum,
anus, bladder, sphincter vesicze, penis, and vulva. Paralysis or
other nervous disorder of the tail and sphincters ani and vesicz,
without implication « of the hind limbs or quarters, may bespeak
lesion in the terminal end of the spinal cord.

With paralysis of the bladder the penis may be pendent out of
the sheath, or being retained within it, the urine may dribble
constantly into and from that cavity, and the vulva may be soft,
and flaccid. When the anus is involved, the adjacent part of
the rectum usually participates becoming overloaded, the sphincter,
is soft and lax and allows a constant oozing, and ‘the exposure of
the mucosa. The paralytic tail hangs, between the thighs, limp
and flaccid, and becomes saturated with manure and in females
with urine.

Even in the earlier stages the symptoms are usually greatly
aggravated by compulsory. movements like turning in a.circle,
walking up hill, or (in dogs) up a stair, and the arched back, the
pendent head, and hesitating planting of the foot. suggests walk-.
ing on pins. For a more exact localization of the lesion the
reader may consult the table indicating the functions of the.
different parts of the spinal cord. ‘The early fatigue under exer-
cise grows as- in other progressive spinal lesions...

Treatment. In most cases this i is hopeless. , Tumors, bony. and,
calcic growths, tubercles, degenerations and ‘absorption of nervous
tissue. are practically beyond remedy. A blood extravasation
may ‘be largely : absorbed, leaving only. the permanent. changes in
the nervous tissue. In this, time is the main element. Actino-
mycosis may sometimes be successfully met by a course of. potas-,
sium iodide, when, if the nervous lesions are slight, a fair re-
covery may be secured. In the majority of cases, however, the
practitioner is limited to measures for palliation of suffering by
atropia, chloral, phenacetin, etc., or by nerve stimulants like

180 Veterinary Medicine.

nux in small doses, or by weak currents of electricity. In meat
producing animals, it is often the best course to fatten rapidly,
or to turn over at once to the butcher.

DILATATION OF THE CENTRAL CANAL OF THE
SPINAL CORD. SYRINGOMYELIA.

This means literally a cavity in the spinal cord but is applied
to cavities formed by dilatation of the central spinal canal, or by
an excavation in the nervous tissue immediately adjacent and
usually communicating with a dilated segment of the canal. In
man it is usually the result of an active proliferation of the
epithelial cells of the canal, blocking the same, or extending into
the adjacent nervous tissue in the form ofa glioma. Indifferent
cases in dogs it occurred asthe result of pressure. It has been
seen in dogs, cats and Guinea pigs, asa casual lesion and as the
result of experiment.

In a case reported by Lienaux it extended for practivally the
whole length of the cord, varying in form and size at different
points. In the lumbar portion it was only slightly dilated, in the
dorsal it was very irregular with prolongations into the gray mat-
ter, toward the cervical enlargement, its transverse section re-
sembled an inverted V, and in the anterior cervical part it was
unevenly rounded. Notable changes were cell proliferation and
subsequent degeneration with the formation of cavities, thicken-
ing of the neuroglia, and compression and even obliteration of
the vessels with circumscribed areas of necrosis, terminating also
in cavity formation.

Symptoms. ‘These vary with the nervous structures invaded,
atrophied or destroyed. Invasion of the anterior horns of gray
matter, causes trembling and muscular wasting. The implication
of the superior horns determines more or less marked anzesthesia.
Hyperzesthesia, spasms, paresis and paraplegia are also seen but
no symptom nor group of symptoms is diagnostic of the exact
lesion.

Treatment is manifestly hopeless.

NEURASTHENIA IN PREGNANT EWES.

Causes: inactivity, lowered muscular and nervous tone, twin pregnancy,
approach of parturition, dry (clover hay) ration, concurrent diseases. Symp-
toms: moping, anorexia, depression, stupor, blindness, paresis, lethargy.
Prevention : open air life, exercise, high muscular condition, avoidance of
debilitating and relaxing conditions. Treatment : hygienic, nerve tonics,
attend to concurrent diseases.

Neurasthenia has been defined as an incompetency of the
nervous system, leading to early fatigue, and inability to recuper-
ate from the prostrate condition. Pending a better knowledge of
the affection. I have given this name to an asthenic affection seen
in pregnant ewes when nearing the completion of the period of
gestation.

Causes. In a large number of cases I have found several con-
ditions so constant, not to say invariable, that they seem to de-
serve special attention in the list of causes:

Ist. Enforced inactivity. In every instance that has come
under my notice the ewes have been confined for several months
to a barn or at most a confined yard so that exercise became im-
possible. The muscular system was flabby and soft, although as
a rule there was abundance of fat, and the number of red globules
did not vary much fromthe normal. In an animal that is natur-
ally so active, and so accustomed to outdoor life the reduction of
tone and vigor is to be expected. The same evil shows in other
directions, thus after a snowy winter and close confinement the
crop of lambs will sometimes perish of goitre without exception,
while in subsequent years, with enforced exercise of the ewes,
practically all escape.

2d. ‘Twin lambs have been found in the womb of almost every
case examined. ‘he extra drain upon the system, and the de-
pressing action of the load on an atonic ewe together with the
symptomatic irritation are to be noted.

3d. The near approach of the completion of gestation, the
cumulative effect of along pregnancy,and perhaps the absorption of
metabolic products from the fcetal membranes in course of prepar-
tion for detachment, and of leucomaines from the physiologically

181

182 Veterinary Medicine.

active or developing mammee, doubtless have a prostrating influ-
» ence on the susceptible nervous system.

4th. All had been fed on clover hay either as an exclusive diet
or as part of their ration. This is sufficiently nutritive, as testi-
fied by the fat condition of the patients, but it may be that it was
too nitrogenous for such an inactive life. Again the clover hay
usually abounds in cryptogams and bacteria and their products,
which may have contributed somewhat to the asthenia.

5th. Concurrent diseases, in individual cases or flocks, mani-
festly contributed to the general loss of nervous power. In some
the bowels were studded with the nodules of the cesophagostoma,
in others cestrus larvee had extensively invaded the nasal sinuses,
one had congestion of the mucosa of the small intestines, some
had congestion and fatty degeneration of the liver, others had
fatty kidneys, and one had a papilloma pressing on the spinal
cord. Manifestly diseases and degenerations of various kinds
would still further undermine nervous energy and add to the
atony.

Cold and heat did not seem to dominate, as most were kept in
warm barns, and wore heavy winter fleeces, while one clipped,
early in December, and kept in an atmosphere 40° to 55°, was
attacked in the second week of January.

As this experience was had ina goitre district it may become a
question whether the poison of this disease was a causative
factor. Goitre was not a prominent feature in either ewes or
lambs.

Symptoms. Variable. * The most prominent are, leaving the
flock, moping alone, grinding the teeth, drooping and trembling
of head and ears, temperature normal or subnormal (100.5°),
respiration 24, pulse 80, feeds and ruminates sparingly, bowels
normal, buccal mucosa pale, conjunctiva hypereemic, in some
cases stupor and partial blindness, the animal walking against
racks or fences, walk is slow and unsteady, the muscles feel soft
and flabby, the abdomen may be full, but its walls are quite
flaccid so that the lambs can be easily felt. As the disease ad-
vances all symptoms are aggravated, food is no longer taken,
rumination ceases, the ewe remains recumbent, cannot be made
to rise, and when lifted and carried makes no struggle. After
24 hours of this helpless condition death supervenes. In some

Neuritis. Perineuritis. 183

instances labor pains have come on and the ewe has perished in
a vain effort at delivery. Illness lasted about a week.

Prominent /estons have been noted under causes. It need only
be added that no notable difference from the normal was found
in making a count of the red globules, and the size of the in-
dividual globule was normal or only perceptibly smaller as is to
be expected in a dense plasma. ‘In differerit cases there was
found congestion of the abomasum, small intestine, liver and
brain.

Prevention. The most important measure is to maintain a
strong, well-developed muscular system, and a vigorous nervous
tone by a sufficiency of out door exercise during the winter
months. Half a mile ora mile at least should be given daily to
the breeding ewes, no matter what the attendant difficulties. If
clover hay is musty it should be replaced in whole or in part by
another kind. Parasites and other diseases which tend to lower
the general tone should be appropriately treated.

Treatment. When once established, the disease has not been
successfully treated. Nerve tonics are indicated.

NEURITIS. PERINEURITIS.

Definition. Causes: traumas, poke, stanchions, collar, yoke, interfering,
neurectomy, fractures, tumors, callus, rheumatism, gout, violent over-dis-
tension. Lesions: nerve sheath red, swollen, exudate, leucocytesin excess,
fibroid thickening, nerve atrophy, degeneration, axis granular, myelin in
oily globules, peripheral extension. Muscular degeneration and atrophy.
Symptoms : tenderness, swelling, muscular atony, wasting, spasms, twitch-
ing, decreased excitability, paralysis, in section swelling on proximal end.
Prognosis : disability for weeks, months or year; response to electric cur-
rent, operability of tumors, curability of rheumatism or gout, hopeful con-
ditions ; long standing degeneration, etc., unpromising. Treatment : rest,
soothe, anodynes, splint with soft pad, essential oils, lead and opium lotion,
ice, snow ; derivatives ; laxatives; diuretics, anti-rheumatics, Faradisation.

Definition. Inflammation of a nerve leading to paralysis of
‘the parts to which it is distributed. .

Causes. ‘Trautiatism is the most common factor. Among the
common examples are injury of the seventh nerve above the

184 Veterinary Medicine.

angle of the lower jaw, by a poke worn in pasture by the horse,
or by stanchions in the cow. Hogs may suffer from blows of the
triangular neck gear worn to prevent them from breaking through
fences. Blows by the yoke, incised and contused wounds implicat-
ing the nerve, such as neurectomy, and the blows received in in-
terfering, and compression by tumors or bony growths, are
familiar examples. Fractures with displacement, notably those
of the sacrum and proximal end of the coccyx with caudal paraly-
sis, are not uncommon. Infractures of the limbs the pressure
upon or wounding of a nerve. Again, the callus on the seat of
fracture may induce neuritis by pressure as may also the projec-
tion of the end of a bone in luxation. Rheumatism affecting the
nerve sheaths and, in birds and swine, gout, are additional
factors. Violent overdistension, and even chronic muscular
spasm, are quoted as causes.

Lesions. ‘The early changes are mainly in the connective tissue
sheath, which becomes hyperzemic, red and swollen, with a gela-
tinoid exudate and a great multiplication of leucocytes. Later,
the interfibrillar connective tissue is involved and the nervous
substance proper undergoes hyperemia and degeneration. The
axis cylinder undergoes granular degeneration and the myelin
breaks up into oil-like globules. The lesions are at first limited
in extent, though there may be more than one focus, and the re-
sulting degeneration of the nervous filaments advances toward
the periphery in accordance with Waller’s law by which disease
changes proceed rapidly in parts cut off from their trophic cells.

The muscles supplied by the inflamed nerves also rapidly
degenerate. The fibres shrink in size, and lose their striated
appearance, becoming distinctly granular, and pale. Round cells
are formed in excess in the sarcolemma and muscular fibre, and if
the morbid condition persists there is fibroid degeneration, cir-
rhosis and contraction.

Symptoms. Inthe absence of the subjective element of pain,
which is the most constant symptom in man, we must rely mainly
on the exquisite tenderness on pressure along the line of the
nerve, but localized at some particular point, on the swelling at
such tender point and on the loss of muscular power or even of’
sensation in the tissues corresponding to its peripheral distribu-
tion. ‘The muscles may be hypersensitive and are usually flaccid

Neuritis, Perineuritis 185

if not from actual paralysis, still from the pain which attends on
their contraction. In some cases they are the seat of clonic
spasms or twitching. Under a current of electricity they show a
decreased irritability which bears a direct relation to the grade of
degeneration which has occurred in the nerve fibres. In cases of
deep-seated neuritis paralysis may be the only appreciable symp-
tom. In traumatic injuries like bruises of the seventh nerve
or fracture of the sacrum the local swelling and tenderness are
marked initial symptoms, upon which supervene the paralysis and
atrophy of the muscles cut off from full innervation. In neurec-
tomy the tender swelling in the stump which is still in connection
with the nerve centre may amount to a distinct neuroma, while
the peripheral and detatched portion of the nerve steadily loses its
irritability as shown by electric stimulus.

Prognosis. 'This will depend on the nature of the lesions. A
single transverse section of a nerve, without loss of substance may
be repaired in a few months, while with loss or degeneration of a
considerable part of its substance it may maintain a paralysis for
years or even permanently. Lesions due to slight bruises may
recover in a few weeks, while the more severe ones will persist for
months or years. The response to electric stimulus distal of the
lesions, is a guarantee of the absence of degeneration and a feature
hopeful of recovery. Pressure by bony displacement or neoplasia
must be done away with as the first condition of improvement in
such cases. Rheumatic and gouty cases will persist until these
constitutional infirmities are corrected.

If the neuritis and paralysis have lasted for any length of time,
the degeneration of the muscles will keep up a degree of muscular
weakness (and if in the limbs lameness) after the repair of the
nerve has been completed.

Treatment. Rest is the first consideration accompanied by
soothing and anodyne application to the inflamed nerve. When
neuritis exists in a limb a softly padded splint may be useful at
first. ‘The skin over the inflamed nerve may be rubbed by one
or a combination of the anodyne essential oils, (oil of cajeput, oil
of peppermint, oil of lavender). If the pain and tenderness are
extreme, a bag of ice or snow may give relief and should be kept
applied for a length of time. Or hot fomentations with a lotion
of lead and opium may be preferred especially in rheumatic cases.

186 Veterinary Medicine.

If blisters seem to be called for, aqua ammonia and oil of turpen-
tine may be added to the essential oils, or muriatic acid may be
applied with a glass rod in points along the line of nerve. A
laxative of Epsom or Glauber salts will often prove of great value
at the outset and may be followed by diuretic doses of potassium
iodide, potassium nitrate or acetate, and in rheumatic cases
sodium salicylate. In these last forms, as also in gout, the car-
bonates and acetates of the alkalies, colchicum, and salicylates are
especially to be persisted with. In these, too, rubefacients and
blisters are often of essential value and may be repeated again
and again.

Faradism is of little account during the active stage of neuritis
excepting as a test of the progress and extent of the degeneration,
but when inflammation has subsided nothing contributes more to
the restoration of the tone and healthy nutrition of both nerve
and muscle. ‘The current is to be sent along the line of the pare-
tic nerve and muscles for ten or fifteen minutes at a time and not
less than once a day.

NEURALGIA.

Intermittent or remittent pains, in line of nerve without inflammation, or
other structural lesion. Diagnosis: lameness, stiffness of particular mus-
cles having a common nerve. Unnatural position habitual. Pain of inflam-
mation and of neuralgia. No functional change. Rheumatism. Tumors.
Causes : lead, rheumatism, gout, auto-poisons, cold, aneemia, reflex. Facial
neuralgia, occipito-cervical, dorso-intercostal, lumbo-abdominal, sciatic
Treatment: elimination, of lead, etc.; intestinal antiseptics, tonics, hot
water, anodynes, arsenic

This is characterized by pain paroxysmal,, intermittent or re-
mittent situated in the course of given nerves. It must bea pure
neurosis and unaccompanied by any specific structural lesions like
. inflammation, degeneration, atrophy, hypertrophy, tumor or the
like. Itistherefore manifested subjectively and cannot be easily
identified in the lower animals. Nevertheless, Lafosse, Zundel,
Genée, and others have recorded cases, their conclusion being de-
duced from symptoms which were held to indicate nervous suffer-

Neuralgia, 187

ing in the absence of any structural lesion whatever. A priord
one can with difficulty escape the conviction that neuralgia must
exist in the lower animals as in man, and the only drawback to its
recognition is the difficulty of diagnosis.

The first step in such diagnosis must usually be the presence of
lameness, stiffness or indisposition to free movement of some par-
ticular muscle or group of muscles deriving their innervation from
a particular nerve. Or there may bea particular position habitu-
ally assumed such as semi-closed eyelids, drawn back ears, laterally
inclined neck which strongly suggests nervous suffering. Next,
there must be the exclusion of any appreciable structural cause
and especially of inflammation. The three prominent features of
the pain of inflammation is that it is aggravated by pressure, it is
heightened by movement, and it is accompanied by some decided
alteration of the function of the part. If there are at the same
time exudation and swelling, inflammation is all the more certainly
indicated. Ina neuralgic pain on the contrary pressure does not
increase the pain : it may even alleviate it : movement of the part
may be rather satisfactory to the patient than painful ; and the
disturbance of function, contractile, secretory, trophic, is not per-
ceptible. ‘There is no local exudation nor swelling to account for
the nervous disorder.

The liability to confound the affection with a neuritis more
centrally situated, but the pain of which is referred to the peri-
phery of the nerve, is to be obviated by a tracing, of the nerve
along its course to the nerve centre so as to identify any centre of
tenderness, and also by the implication of all the peripheral
branches coming off ectal of that point. *

Again, rheumatism may be easily confounded with neuralgia,
but here the affected nerve and muscle and even the skin over it
is liable to be very tender to the touch or pinch, and if at all
acute some hyperthermia is present. Like rheumatism, neuralgia
shows a tendency to shift from place to place.

Pains due to pressure on the nerves by tumors, ‘aneurisms, and
other swellings, are constant, whereas neuralgic pains are marked
by remissions and aggravations and even by intervals of complete
relief.

Causes. 'The toxic neuralgias are illustrated by chronic lead
poisoning, in which, in man, there are wandering pains like those

188 Veterinary Medicine.

of rheumatism, and in the lower animals muscular stiffness and
contractions which suggest a similar condition. In man, too,
gout is a common factor, and in pigs and birds in which this con-
dition exists, stiffness and evidence of suffering may well be at
times attributed to a similar cause. How many other forms of
chronic metallic poisoning and poisoning by morbid autochtho-
nous products of indigestion are attended by disorders of innerva-
tion and nutrition, it is as yet impossible to say. The direct
action of cold, an anzemic condition of the nerves, and reflex
action from distant sources of irritation are among the other in-
voked causes. Inflammation in the xerui nervorum is also invoked
as a factor, but in this case the symptoms would not accord with
the rule given above, since the nerve trunks would be very tender
to touch or pressure, and the suffering would be unshifting and
shown permanently in the one seat.

Facial Neuralgia. Lafosse and Zundel describe as cases of
this kind those in which periodically the horse’s eyes are fixed
and shining, the ears drawn back and depressed as in vice, the
head at intervals bent on the neck, with plaintive neighing, rub-
bing the head on the stall and pawing. ‘Those cases of twitching
of the head or rapid jerking of the ears in horses, when they
have been driven for some distance, and which are relieved by
wearing a close net over the nostril or by section of the trifacial
nerve at the infra-orbital foramen, manifestly partake of this
character.

Cervico-Occipital Neuralgia. Lafosse speaks of this as
often mistaken for torticolis, the head being turned to the af-
fected side during the paroxysms. In man this is often a result
of cold draughts on the back of the head, and associated with
tender points on the course of the nerve, between the mastoid
and the median line.

Dorso-intercostal neuralgia causes pain in deep inspiration,
and lumbo-abdominal neuralgia develops tenderness in the
loins, in one testicle, or in one lip of the vulva according to
Lafosse. Diagnosis between such cases and neuritis, spinal
disease, and other obscure nervous affections must be very
problematical.

Sciatic Neuralgia. This is described by Zundel as causing
jerking and lameness in the affected limb, sometimes aggravated

Neuralgia. 189

and sometimes improved by work and associated with muscular
weakness or paresis. Sciatica in man is, however, rarely a
simple neuralgia, but partakes rather of the nature of a neuritis,
and there is no good reason for supposing that the disease of this
nerve in the lower animals is other than an inflammatory
condition.

Leclainche after consideration of the testimony adduced, is of
the opinion that we still lack absolute evidence of uncomplicated
neuralgia in the domestic animals.

Treatment. For toxic cases elimination of the poison is the
first consideration. For /ead carefully graduated doses of iodide
of potassium to carry off the offending agent without increasing
its poisonous action must be continued as long as the metal is
passed by the urine. It may be followed by a course of strychnia,
by electricity, massage and blisters. Gouty subjects may be
treated with salicylate of soda, alkalies, or colchicum. The vic-
tims of Bright’s disease must be treated for the kidney affection.

Where there has been trouble of the digestive organs, in-
testinal antiseptics (salol, sodium salicylate, bismuth-salicylate,
beta napthol) and small doses of arsenious acid will sometimes
benefit.

In anzemic conditions a course of tonics (cod liver oil, iron,
quinine, nux vomica) are indicated, and, to improve the local
blood supply, nitro-glycerine. A rich stimulating ration, currying,
an open air life, and sunshine (in summer a run at grass) are
called for.

In man with a suspicion of traumatic origin, W. H. Thomson
strongly advocates a persevering use of the hot water douche to
the parts first affected, the hypodermic use of morphia and
atropia, and in case of local anzemia nitroglycerine every three
hours. Where there is a suspicion of inflammation he success-
fully employs absolute rest, with opium narcotism so as to abolish
the pain, for twenty days if necessary. Aconite, antipyrin,
acetanilid, phenacetin, exaglin, and gelsemium have their
advocates, and may benefit in individual cases. A course of
arsenic is often successful, and phosphorous and ergot have each
proved of value.

ATROPHY OF NERVES.

From arrest of function, from lesions, pressure, distal, but at times central
of lesion. Symptoms: Loss of function advancing to paralysis. Muscle
atrophy. Prognosis: in absence of incurable cause, is hopeful. Union of
divided ends, restoration of function. Treatment: time, ligature of divided
ends. .

This is usually the result of arrest of function. It may be due
to transverse section of the nerve, as in surgical neurectomy when
the separated peripheral'end of the nerve gradually wastes. It
may come from contused wounds implicating the nerve and caus-
ing destruction of itssubstance. It may be from tumors or other
neoplasms pressing on the trunk of the nerve and preventing the
passage of nerve currents. Or, inflammatory effusion may press
on the nerve, as happens often to the crural in hemoglobinuria.
Or the pressure may come from enlarged mediastinal glands, or
even from the distended posterior aorta under habitual violent
exertion so as to permanently incapacitate and atrophy the left re-
current laryngeal nerve as in chronic laryngeal paralysis (roaring).
Similar wasting occurs in.other nerves under corresponding con-
ditions. Atrophy may, however, extend centrally from the peri-
pheral end of a nerve when it can no longer remain functionally
active. We find an example of this in the atrophy of the optic
nerve up to the commissure when the eyeball has been excised.
A similar condition is often seen in horses in which the integrity
of the eye has been completely destroyed in connection with re-
curring ophthalmia.

The symptoms attendant on atrophy of a nerve are those of im-
paired function gradually advancing to complete paralysis of
motion or sensation. In cases of a complete breach of continuity
as in séction or severe traumatism the entire loss of function’
necessarily precedes the atrophy. Again, when it comes from
destructive changes in the coats and media of the eye, and of the
ganglionic cells of the retina, the atrophy of the nerve trunk pro-
ceeds simultaneously with the lesions of the organ of vision.

The diagnosis will in many cases be easy as deduced from the
traumatic or surgical lesion. In other cases it may be made with

190

Atropy of Nerves. Ig

certainty from the complete muscular paralysis, wasting and
degeneration of the muscles supplied by the nerve, and by the his-
tory of the case Cheemoglobinuria in atrophy of the triceps exten-
sor cruris, roaring in atrophy of the laryngeal muscles and recur-
rent nerve). In other cases, as in the eye, we have the atrophy
of the eyeball, the distortion or complete paralysis of the iris, tht
opacity of the Iens, or the exudation into the vitreous, choroid and
tetina when these can still be observed.

Prognosis will depend on the cause. Witha nerve severed with
a knife or crushed in a part of its course and atrophied, without
destructive changes in the organs in which it is distributed, repair
is possible and to be expected in time.

Treatment is expectant, yet inflammation must be subdued,
tumors removed, divided ends ligatured, etc.

DISEASES OF THE URINARY ORGANS.

Relative prevalence in man and animals. Causes of difference. Kidneys as
eliminating organs for nitrogenous material, toxins, bacteria, mineral, veg-
etable and animal poisons, diuretic drinking water, condition powders,
cantharides, urea, etc. Suppression of urine, precipitation of urine. Fil-
tration through kidney. Secretion. Urinary solids. Nervous control of
secretion. Excess.

Diseases of the urinary organs are less prevalent in the lower
animals than in man, owing largely no doubt to the greater sim-
plicity of their habits of life and. to the comparative shortness of
the lives of those that are kept for meat producing. It is a mis-
take, however, to suppose that they are so infrequent as would
appear, since the absence of subjective symptoms in the animal
allows a number of the milder forms of renal disease to be passed
over without recognition.

In man the excessive consumption of animal food, the lack of
exercise, the abuse of alcohol, the prevalence of veneral diseases,
conduce largely to renal troubles, while animals in general escspe.
Yet animals suffer much more extensively than is generally sup-
posed. The kidneys are, as in man, the eliminating organs for
superfluous and waste nitrogenous matter, and in overfed animals
may be overcharged with this work. They are the general
emunctories for the soluble poisonous products of bacteria and
plants, which may stimulate the urinary secretion, and from these
irritation may result. It is through the kidneys that the bacteria
themselves largely leave the animal body, and trouble is liable to.
come during their passage. Further, exposure to cold tends to in-
crease the urinary secretion, over-stimulating the kidneys, and
the same may come from diuretic drinking waters and condition
powders, also from cantharides and other diuretic agents applied
to the skin. Urea and many toxins are diuretic, hence the oc-
currence of polyuria at and after the crisis of fevers.

192

Diseases of the Urinary Organs. 193

On the other hand suppression of the urinary secretion
may occur in connection with profuse perspirations in hot weather,
with prolonged diarrhcea, or with privation of water, and in such
cases the liquid becomes concentrated and irritating and there
is a disposition to precipitate its solids under slight disturbing
causes. As conducive to such precipitation may be nained
foreign solid bodies, bacterial ferments and probably the goitre
poison since gravel and calculus are common in goitrous regions.

There are two forms of elimination through the kidneys.
1, filtration ; 2, secretion. :

1. Filtration is referred to the glomeruli, and is determined by
the relative blood pressure. Increase of pressure causes increase
of watery transudation. Digitalis increases heart action and
arterial pressure, and accidentally urination. Excessive consump-
tion of water and watery liquids increases intravascular ten-
sion, and the amount of urine.

2. Secretion is referred to the columnar epithelium of the
convoluted tubes. It is by the elective affinity or selective
power of this epithelium that the solids of the urine are ab-
stracted from the blood and passed into the urine. Crystals of:
uric acid have been found ‘in these cells and it is supposed
that the abundance of water furnished by the glomeruli, irri-
gating these convoluted tubes, dissolves and washes on the
various solids and other products with which the epithelial cells
are charged. The protoplasm of the cells becomes saturated
with the urea, uric acid, hippuric acid coloring matter (indican,
urochrome, etc. ), and this is washed out, passing by exosmosis
to the liquid of lesser density with which the tubes are filled.

Nervous Control of Urinary Secretion.

An electric current through the renal plexus of the sym-
pathetic (vaso-motor) lessens, or suppresses urinary secretion
(inhibition).

Cutting the nerves of this plexus causes excessive vaso- -di-
lation, renal pulsations synchronous with heart beats and arterial
pulse, and great increase of urine. A similar increase comes
from the application of cold to the surface, from fatigue, from
heat exhaustion, from irritation of the floor of the fourth ventricle

13

194 Veterinary Medicine.

just in front of the origin of the vagus and from section of the
splanchnic nerve. This last is, however, much less marked and
more transient than from section of the renal nerve noted above ;
the latter causing dilation of the renal vessels only, and increased
pressure, whereas the former causes dilation of the abdominal
organs generally, diverting the blood largely to other parts than the
kidney and preventing the same increase of pressure in the vessels
of the latter. For the same reason transverse section of the medulla
oblongata, or of the spinal cord as far back as the seventh cervical
vertebra, lessens or interrupts the urinary secretion, the pressure
in the kidney being reduced by the diversion of much of the
blood elsewhere. This influence of the nervous system on the
urinary secretion seems to be mainly or entirely one of increase
or decrease of blood pressure in the kidney. For this reason a
weak heart tends to lessen urinary secretion.

Excessive increase of urine is only important when con-
tinuous and in the absence of visible cause, such as diuretics.

PHYSICAL PROPERTIES OF THE URINE.

Color, yellow, red, brown ; horse, ox, calf, sheep, goat, dog, cat, bird.
In disease : pale yellow, with water in excess ; deep yellow, red, brown with
solids-in excess, urobiline, biliverdin, hamoglobin. Extraneous colors.
Bilharzia, Translucency : Turbidity : horse, ruminants, carnivora, pig. In
disease, horse, other animals. Consistency, viscous, stringy, tarry ; odor,
horse, dog, cat, ammoniacal, foetid, drug odor. Specific gravity, estimate of
solids ; reaction, acid, alkaline, neutral ; morbid chemical changes, sodium
chloride, phosphate, alkaline, earthy, indican, urea, uric acid, hippuric acid,
phenol, creatinin, acetone, oxalic acid, allantoin, xanthiu, hypoxanthin,
cyanuric acid, leucin, albumen, glucose, bile salts and pigments, blood,
hemoglobin, epithelium, pus, casts

Color. In estimating the color we must note the various
shades of yellow, red and brown and compare these with the
normal in different genera of animals, on different food and
water, and in different conditions of health. Grades of color
may be stated as follows :

Yellow: Pale, clear and deep yellows.

Red: Reddish yellow, yellowish red, and red.

Physical Properties of the Urine. 195

Brown : Brownish red, reddish brown and brownish black.

Color of Normal Urine. This varies with the species of
animal, food, quantity of water drunk, and time of retention in
the bladder. aa 5

Horse: Urine is normally clear yellow, brownish yellow, .or
deep citron yellow, and the color is deepened by rich and abund-
ant food (excess of solids) and- by exposure to the air (changes
in pigments). It may be sulphur white and sedimentary from
precipitation of CaCO, when on green food.

Ox, Calf, Sheep and Goat: Normal urine clear yellow to
wine yellow. In the ox especially it is a pale straw tint, but
varies to a deep brown on nitrogenous food (clover, peas, beans,
cotton seed, lentils, pea or bean straw). Color may be due to
indican and sometimes to indicanin or indigo blue, which ex-
plains the blue urine sometimes described.

Dog: Normal urine is yellow, straw-colored, aniline yellow,
honey yellow, to brownish yellow in hot season or on: dry nitro-
genous food. Is always relatively deeper than in ruminants.

Cat: Straw yellow to honey yellow, with variation asin the dog.

Pig: Very pale yellow, more highly colored on dry feeding,
nuts, peas, etc.

Birds : White or yellow, sedimentary. Mixed with feeces in
cloaca.

Color of Pathological Urine: Pale yellow with excessive
secretion glycosuria, polyuria, cryptogamic polyuria, chronic in-
terstitial nephritis, under diuretics, or after excessive drinking.
The free secretion of a crisis in a fever is pale yellow.

Deep yellow, deep red, deep brown color, indicates excess
of urinary pigment (urobiline) and is deepened by nitric acid.
This is seen in all hyperthermias with suppressed or diminished
secretion, in privation of water, or food. This urine is acid even
in herbivora.

Yellow, saffron yellow, brownish yellow, greenish, olive,
or brownish red indicate the presence of bile pigments (biliver-
din, bilirubin) as in jaundice or cholyuria. Bile salts should be
tested for. A similar coloration may come from free consump-
tion of carrots, or other yellow pigmentary matters.

Red, brownish red, blood red, or deep brown color im-
plies the presence of blood or blood coloring matter in the urine

196 Veterinary Medicine.

(hematuria, hemoglobinuria). Exposed to the air this becomes
. brown or chocolate in ratio with the amount of blood or blood pig-
ment present. Some such cases'are complicated by blood -clots.
Color due to Foreign Constituents.
Bronze or black color may come from injection of phenic
acid,
Deep green or olive green may come from tar, carbolic
acid, salol, creosote, or derivatives of benzine taken in.
Brownish green comes from thallin and reddens with iron
chloride.
Brown or blood red from rhubarb or senna.
Purple red from santonin, if alkaline (if acid, is reddish
yellow).
Red from madder (it is alleged from indigo).
Yellow from Carrots.
Blue (indigo blne) may occur in urine of horse or ox when
exposed to‘the air.
Bluish gréen will come from feeding indigo.
White or yellow color will result from the presence of pus:
White chylous urine octurs with a hematozéon (Bilharzia
Crassa) in the blood of cattle.

Translucency. Urine may be passed clear and become turbid _

by standing. The presence of colloids hinders precipitation and
prevents clearing.

Horse: Urine is generally turbid, especially what has been
long in the bladder, and that which is last passed. The turbidity
is largely due to precipitation of calcium carbonate and bicar-
bonate, and increases on green food, or if the liquid stands ex-
posed to the air and is cooled. Not unfrequently the salts are
thrown down as fine spherical granules, or there may be a white
pultaceous mass. They are sometimes entangled in extremely
mobile cylindroid masses coming from the uriniferous tubes during
convalescence from fevers or during fasting. A fine pellicle on
the surface is normal in horse’s urine left in the air.

Ox, sheep and goat: Urine is passed clear. May become

turbid through the change of lime carbonate into bicarbonate in
cattle but always more slowly than in the horse.

‘Carnivora : Urine is passed clear but becomes turbid on decom-
position, or if concentrated. With excess of fat in the food it

“ae

»

Physical Properties of the Urine. 197

may become opaque from floating ‘oil globules, apart from the
classic chyluria. N

Pig: Fed on raw fresh vegetables the urine is clear, but if on
cooked or dried vegetables, and especially if nitrogenous, it may

show opacity. baa a

Pathological; The horse’s urine -is ‘ Jimpid and acid in’,
polyuria ; limpid and alkaline or neutral. with modified phos-
phates. It may be morbidly turbid from excess of lime phosphate
or sulphate, urea or other acid salts, exudates, leucocytes or pus.
These usually indicate nephritis. Mucus and muco-purulent
exudate suggest pyelitis or pelvic nephritis. Blood elements
, indicate nephritis, cystitis or urethritis. Debris of kidney tissue
* may indicate tuberculosis,; tumors, etc.

Turbidity in other animals than solipeds is abnormal: examine

the urine.

Consistency of Urine.- Morbid urine may be gluey, sizy,
syrupy, mucous, oily. If a horse’s urine is scanty a slight
siziness may, be normal and due to tenacious mucus from the
pelvis of the kidney, and from the solution of mucin and epi-
. thelium «in the alkaline fluid. Viscous, sizy, stringy, and
tarry (pitchy) urine is found in pyelitis, pyelo-nephritis, or
cystic catarrh, but not in polyuria owing to the presence of the.
solvent acid.

Odor of Urine. ‘This is somewhat aromatic in horse and
ox, disagreeable in the dog, and repulsively heavy in the
cat. With polyuria the odor is less. Ifthe urine has been re-
tained and fermented it is ammoniacal, if there are ulcers or
tumors it is feetid, in diabetes it smells of acetone, after
taking turpentine it has a violet odor, and after phenic acid,
camphor, ether and other drugs it ‘is variously modified.

Specific Gravity of Urine in ratio to water 1000:

Horse, 1020 ~—s« to 1050 . (1040)
Ox, 1025 me 1045 (1030)
Sheep; Goat, 1015 ae 1065 (1040)
Dog, 1020 ue 1060 (1040)
* Pig, 1005 “ TOI5 (1010)
Cat, 1020 ee 1040 (1030)

In the horse the urine may be roo1 to 1010 in polyuria, in
chronic interstitial nephritis, and i ina crisis of fever attended by

*
“A

oe.

ra
f

) A

“6 a

198 Veterinary Medicine.

diuresis. It may be ros5o to 1060 in glycosuria. Undissolved
solids that are merely suspended in the urine do not affect its
density.

A rough estimate of solids may be made by multiplying the
last two figures of a specfic gravity expressed in four figures by
2.33. The result approximates to the number of grammes of
solids in 1000 cc.

Chemical Reaction of Urine. The liquid is tested by litmus
paper, red and blue, weakly impregnated. The normal reaction
is determined by the food : the urine of carnivora and sucking

-herbivora is acid turning blue litmus red: the urine of vege-
table feeders is a/kaline turning reds blue. In the horse the
alkalinity is mainly due to excess of lime bicarbonate, passing,
with standing, into lime carbonate, the carbon dioxide being de-
rived from organic acids (lactic, malic, citric, etc.), by oxidation.
The hippurates are also alkalinein reaction. In dogs the acidity
is due to lime and soda phosphates, sulphates, urates and oxalates.

Pathologically we find the urine strongly alkaline from the
evolution of ammonia from urea, in fermentations occurring with
prolonged retention in the bladder or in. cystitis. The urine
is acid even in herbivora in all fevers in which appetite is lost or
seriously impaired, and which the metabolism is excessive.

Chemical Changes in the Urine in Disease. Sodium
Chloride, is present in large amount in health (horse 25 to 35
grammes, dog 0.25 to 5 grammes daily) is diminished in fever,
anemia, visceral and exudative inflammations. It is increased
during the absorption of false membranes and exudates. It is
thrown down by adding solution of nitrate of silver, the curdy
white precipitate being insoluble in nitric acid.

Phosphates of lime, soda, potash and, scantily, of mag-
nesia are normally present (horse 0.08 to 0.60 gramme phos-
phoric acid daily) and are present in excess in digestive disorders
and in malnutrition of bones (rachitis, osteoporosis and rheuma-
toid arthritis). The alkaline phosphates are very soluble and
never precipitated. Earthy phosphates dissolve in acid urine,
but are precipitated from alkaline. To a little of the urine adda
few drops of acetic acid, followed by a few drops of uranium
acetate. A yellow precipitate of uranium and ammonium double
phosphate is thrown down.

Physical Properties of the Urine. 199

Indican (C,H,NSO,) is formed from indol which passes suc-
cessively through the forms of indoxyle and indoxylid potassio-
sulphate. This is normally present in the urine, the horse ex-
creting I to2 grammes daily, thedog 0.15 gramme. It is present .
in excess in intestinal indigestions, constituting indicanuria. It
is tested by adding a drop of muriatic acid and one of a solution
of chloride of lime to the urine, when it will show a blue ring,
the depth of which indicates the relative amount.

Urea (CON,H,) the principal waste product of nitrogenous
matter, is always present in considerable amount. The sound
horse may eliminate 100 to 200 grammes daily, the dog 5 to 180
grammes. It is present in excess in all fevers and inflammations
unless urination is suspended or impaired, in cryptogamic diuresis,
in mellituria, ureemia, nephritis and cystitis. Test : Theaddition
to a filtered solution of urine, freed from phosphates, of solution
of acid nitrate of mercury, precipitates it as nitrate of urea. A
simpler test is to add to a drop or two of urine on a glass slide a
drop of nitric acid and heat gently. The nitrate of urea is pre-
cipitated in the characteristic rhombic or hexagonal crystals as
seen under the microscope. Heat urea crystals in a test tube:
biuret is formed and ammonia escapes. Add a trace of a copper
sulphate solution and a few drops of a 20 per cent. solution of
caustic potash : a rose-red color is produced—the biuret reaction.

Uric Acid (C,H, N,O,). Traces only of this are fonnd in the
normal herbivorous urine, yet it is more abundant when on a full
dry grain diet, on milk (suckling) or on animal food. The dog
kept on animal food has a large amount.

Pathologically it is produced in the dog and even in the
horse in fever, overwork and starvation, the animal living on his
own tissues. Interference with oxidation in the lungs seems to
produce it as an arrest in the transformation of albuminoids to
urea. ‘The neutral urate of soda remains in solution: the acid
urate of soda is precipitated. Zest: To the urine add one-fourth
its volume of muriatic acid and set aside for 24 hours in a cool
place. On the bottom and sides of the glass and on the surface
of the liquid will be found the yellowish red acicular crystals of
uric acid.

Hippuric Acid (C,H,NO,) is normally present in all urine,
but is especially abundant in that of herbivora. The horse elim-

200 Veterinary Medicine.

inates 60 to 160 grammes daily. It has been found to be in-
creased by feeding on dandelion, carrots, clover, asparagus,
apples, plums, benzoic acid, oil of bitter almonds, toluol, cinna-
mic or kinic acid. It is absent in sucking calves, and horses fed
on grain devoid of husk. Pathologically it is increased in
hyperthermia, icterus, some liver diseases and diseased kidneys.
Test : Precipitate any albumen by nitric acid and boiling, then
add hydrochloric acid which precipitates the hippuric acid in long
needle-like crystals. Heated‘ina small glass tube it forms an oily
liquid, and heated to redness gives off an odor of hydrocyanic
acid (nitro-benzol) and carbon is left. This distinguishes alike
from uric acid and benzoic.

Phenol is produced by intestinal fermentation. The horse
normally excretes about 3 grammes daily. Pathologically it ap-
pears in excess in indigestions, abscesses, softened discharging
tubercle, pyzemia, and septicaemia. Test : Dilute solutions of
ferric salts give a blue coloration.

Creatinin, a product of metabolism of albuminoids, is found
especially in the urine of carnivora and omnivora in health. It is
pathologically increased when oxidation is interfered with, as in
diseases of the lungs. Test: Add to the urine a very dilute
solution of sodium nitro-prusside and then drop by drop some
solution of caustic soda, when a ruby red color is shown and dis-
appears again on boiling. Acetic acid changes to blue.

Acetone (C,H,O) is found in the urine of healthy omnivora
and carnivora and increased by excess of nitrogenous food.
Pathologically it has been found in fevers with much blood
change, in inanition, in cancer, in indigestions, and auto-intoxi-
cations. Test: To several cc. of urine add a few drops of.
iodo-potassic iodide solution and caustic potash when iodoform
will be abundantly precipitated with its characteristic color and
odor.

Oxalic Acid (C,H,O,) appears to be secreted in small
amount by healthy kidneys and it may also come from the
splitting up of uric acid after secretion. It is augmented by
feeding agents rich in oxalic acid (beets, fresh beans, asparagus,
tomatoes). Pathologically it abounds in certain indigestions,
and is associated with lameness and emaciation. Test: Add

Physical Properties of the Urine. 201

lime water to the urine, and the white oxalate of lime is precipi-
tated.

Allantoin (C, H, N, 0,) | is found in the urine of sucklings
(calves) during the ret few weeks of life, in pregnancy and
when on a meat diet. It diminishes with the increase of vege-
table food.

Xanthin (C,H,N,O,) is found in urine as a result of imperfect
oxidation of nitrogenous matters especially, which would other-
wise pass into uric or hippuric acid. Its immediate antecedents
in such transformation are guanin and hypoxanthin or sarkin.
It is a rare constituent of urinary calculus.

Hypoxanthin (C,H,N,O) is produced from fibrine in gastric
and pancreatic dizestion and in putrefaction, and is especially
abundant in leuczemic subjects.

Cyanuric Acid (C,,H,,N,O,) occurs in dog’s urine.

Leucin (C, H,, N O,) and Tyrosin (C, H,, NO,) are products of
pancreatic digestion of proteids, and the former occurs normally in
the spleen, thymus, thyroid, liver, salivary glands, and urine.
Both are present in large amount, in the urine, in acute atrophy
of the liver. Test for leucin: Evaporate carefully to dryness.
with nitric acid : the residue, if leucin, will be almost transparent
and turn yellow or brown on the addition of caustic soda. If now
heated with the soda it forms an oily drop. Test for tyrosin:
treated with strong sulphuric acid, gently warmed and chloride
of iron added, it gives a violet color.

Albumen is an important morbid constituent of urine, which
appears in a great variety of diseases (nephritis, pneumonia,
epilepsy, anzemia, leuceemia, diabetes, hematuria, heemoglobi-

nuria, hydreemia, infectious lung diseases, cardiac obstruction,
' yenous stasis in the kidney, dermatitis, burns, lesions of the
crura cerebri, floor of the fourth ventricle, spinal cord, or renal
vaso motor nerves). It also occurs after violent exertion, in
poisoning by strong acid, phosphorus, arsenic, lead, mercury,
opium or alcohol, and when an excess of albumen is injected into
the blood. All forms of albumen may enter the urine, but the
most common are serum albumen, globulin of serum, propeptone
and peptone. A simple test is to acidulate the urine with acetic
acid and boil : if the precipitate does not dissolve on addition of
nitric acid, itisalbumen. Sulphosalicylic acid added to the urine
will cause a precipitate in urine containing only s4yy of albumen.

202 Veterinary Medicine,

Glucose (C,H,,0,) is often normally present for a short
period in small amount after a full meal of farinaceous material.
It is permanently present in excess in glycosuria, which may re-
sult, among other conditions, from diseased liver, punctured
medulla, suppression of milk secretion on weaning the calf, oil
of turpentine, nitrobenzole, nitrotoluol or amyle nitrite. Test:
Add yeast to the urine and keep at 15° to 20° C. when if glucose
is present, it becomes cloudy and gives off carbon dioxide, or add
a little caustic potash solution, and a few drops of cupric sulphate
solution until it is blue: then heat and a red precipitate of cupre-
ous oxide is thrown down. ‘The amount gives the ratio of glu-
cose. Uric acid, hypoxanthin or mucus causes brown precipitate
in the absence of glucose: peptone, creatin, creatinine, pepsin
and urinary pigment prevent its formation though glucose be
present.

Bile Salts and Pigments are present in excess in cases of
icterus, where these characters may be studied. See Icterus.

Blood and Hemoglobin in Urine. Ina variety of diseases
(anthrax, hematuria, nephritis, Texas fever, hemoglobinuria,
etc.) blood or blood coloring matter escapes in the urine. When
blood escapes one finds the reddish color, and under the micros-
cope red globules, normal or crenated (especially in alkaline
urine), free, aggregated in masses, in small clots, or embedded in
casts of the uriniferous tubes. Under the spectroscope the spec-
trum shows two dark absorption bands, one in the yellow and one
in the green. When the color is due to hemoglobin the urine
shows under the microscope numerous masses of amorphous
brown pigment, and the spectrum shows one dark line in the yel-
low, and three others less deep, (but one of them very broad) on
the limit of the green and blue. Urine which contains the ele-
ments of blood is usually turbid and thick or glairy, by reason of
the presence of salts, albumen and fibrine. There may also be
crystals of urinary salts (calculi), fragments of broken down
tissue (tumors) or the ova of worms.

Epithelium in Urine. The slight cloud, seen in healthy
urine contains epithelial cells. The source of these may be often
determined under the microscope. The dladder epithelium are
the most numerous, the largest, and are squamous. ‘Those from
the ureters and renal pelvis are also squamous, but neither so
‘large nor so numerous. The epithelium from the urintferous

Physical Properties of the Urine. 203

tubules are polyhedral with large nucleus, or columnar. The cells
from the male urethra are also largely columnar. In cases, how-
ever, in which these cells are passed in large amount because of
catarrh of the mucosa all alike tend to assume the globular form.
with large nucleus so that their true source cannot be certainly
stated. It is only from such cells as have become detached with-
out change of form that the seat of desquamation can be deter-
mined. If an excess of cells approximating to the kidney type ,
are associated with albuminuria and cylindroid casts they become
diagnostically significant. Polygonal cells darkly granular with
large oval nucleus and nucleolus suggest kidney inflammation.
If the granules are freely soluble in ether there is probably fatty
degeneration. If hard, tough and glossy they suggest (but
don’t prove) amyloid degeneration.

Pus Cells in Urine. | Pus cells, with multiple nuclei revealed
by adding dilute acetic acid, may be found in small numbers in
apparently healthy urine. When present in large numbers, they
usually indicate a catarrhal affection of the mucosa, and especially
pyelitis, cystitis, or urethritis. ‘There is always cloudiness, excess
of mucin, and in the alkaline herbivorous urine, the liquid may
be glairy or stringy.

Casts of the Uriniferous Tubes. ‘These usually indicate
the existence of nephritis, yet they may be present in small num-
bers in the urine of healthy individuals under a slight toxic
action such as alcohol.

Unorganized casts of urinary salts or Wemateldia found in
sucklings appear to have no pathological significance. Organized
casts, on the other hand, usually imply renal troubles, and
especially inflammation. As these will be fully described under
Bright’s disease, it need only be noted here that they may be
composed in great part of ved globules, leucocytes, epithelium, bac-
teria, granules, a homogeneous wax-like matter, fat globules, hya-
line matter, or urinary salts. ’The predominance of one or other
of these determines the nature of the cast.

The observations of Mayer, Knoll, Bovida, Von Jaksch and
others seem to show that the basis substance of urinary casts
differs from all our familiar proteids and must be considered as a
distinct nitrogenous compound, a derivative of one of the com-

mon proteids.

GENERAL SYMPTOMS OF URINARY DISEASE.

External symptoms, arched back, stiff gait, straining, tender loins, back-
ing, turning, dropping under weight, urine checked, dribbled ; in dogs and
cats, palpation of kidney ; bladder, urethra, pains in different animals. In-
ternal symptoms, rectal exploration, vaginal, urethral, straining, ureters,
bladder, calculi, neoplasms, prostate, urethritis.

External Symptoms. With inflammatory or painful affec-
‘tions of the urinary organs the ariimal tends to roach the back
or loins, tuck up the abdomen, move the hind limbs stiffly and
with a straddling gait, protract and withdraw the spenis which
may be semi-erect, retract and drop the testicles alternately,
and stretch himself and strain to pass urine without success.
Lying down and fising may be accomplished with marked
effort and groaning. The loins along the spines or beneath the
outer ends of the transverse processes may prove tender to tapping
or pinching, the animal drooping to excess. Backing or turning
in a narrow circle.may be aecomplished awkwardly and stiffly
though usually more easily than with lumbar sprain. The >
animal drops when mounted but less than with . sprained back.
Urine may be passed in excess or in: diminished: ‘amount, or it may.
be entirely suppressed. It may be abruptly interrupted when in
full stream, suggesting calculus or polypus, or it may be passed
often in mere driblets, or finally it may ooze away constantly
partly lodging in the sheath and partly trickling down the thighs.
In dogs or cats with flaccid walls of the abdomen external -
manipulation may detect i in the kidneys, differencés im’size, posi-
tion, and tenderness as well as the presence of tumors. The dis-
tended bladder also may be distinctly felt, and the pyriform area of
flatness on percussion will serve to map out its size and outline.
In the horse the urethra is superficial and easily traced over
the ischiatic arch and for some distance downward, when it’ be-
comes deeper and is less easily felt. .In the bull the urethra is
deep over the ischiatic arch but becomes more superficial lower
down and can be easily felt at the sigmoid flexure and below. In
sheep and dog it is easily followed from the ischium to the end of
the penis.
Asa rule the penis is easily drawn ftom its sheath in the horse
204

ee

General Symptoms of Urinary. Disease.. 205

and dog ; this is more difficult in the sheep and goat and still
more so in the bull and boar. In the small animal protrusion is
favored. by setting him on his rump, with his back between the
operator’s legs, and pelvis doubled forward toward the
sternum. ‘The penis of the bull may be extended in presence of
a cow in/heat, and promptly seized, or it may be seized through
the sheath back of its first bulging part and skillfully worked out.
In the ruminant, calculi may be felt at the sigmoid curve, and in
the ram, in the vermiform appendix at the free end of the penis.

Internal Exploration. This is accomplished in the larger
animals with the oiled hand in the rectum, the nails having been
pared short and even to avoid injury to the mucosa: In ponies
and yearlings the kidney may be felt, and this may be true also
of mature animals of larger species in cases of hypertrophy or
floating kidney. The ureters, bladder:and intrapelvic urethra
are easily felt in the male. The empty bladder lies on the an-
terior border of the pelvis ; when full, it profects forward into the
abdomen but retains its pyriform or, in the very young animal,
its fusiform shape. In the female the sensation is somewhat
modified by the presence on its upper surface of the uterus divid-
ing into its two horns anteriorly. The single enlarged horn of
pregnancy is especially misleading.

The female urethra, cervix and bladder may be explored
through the vagina. ‘To explore the cervix vesicee and urethra
the fingers are slowly drawn back from the bladder along the.
median line of the floor of the vagina. Inthe. mare the cervix
and adjacent portion of the bladder can be further explored with
the index finger introduced through the opening of the urethra
in the floor of the pelvis and at the junction of the vagina and
vulva. Inthe cow the urethra is too small to be readily explored
from within, and the orifice is still further guarded by the two
lateral blind canals of Geertner, into which the unskilled fingers
more readily pass. Success only attends the careful search for
the small central lower orifice. In the smaller animals the finger
only can be introduced into vagina or rectum and the urethra,
cervix and bladder only can be felt. Zhe result of such explora-

_fion is straining even in healthy conditions but which becomes
excessive in nephritis, pyelitis, renal, uretral, vesical or urethral
calculus; cystitis, rectitis or enteritis.

206 Veterinary Medicine.

The ureters are tender when inflamed, and they are swollen in
calculous obstruction with an elastic feeling in front of the stone.

The bladder is very sensitive when overdistended, inflamed or
pendent on the abdominal floor, or when the seat of calculus.
In the absence of any liquid contents a calculus is felt as a hard
solid mass firmly clasped by the contracted vesical walls. If
liquid is present the solid hard calculus is felt movable in the
fluid. An empty contracted bladder is firm and pyriform.
An empty flaccid bladder, resulting from rupture or exhaustion,
is flabby, with indefinite form and, if the seat of a lesion, tender.
It varies in consistency with neoplasms (papilloma, sarcoma, car-
cinoma, or-epithelioma). These have not the free mobility of
the calculus floating in urine, and their point of connection with
the wall may often be made out. When a solid body is felt, or
suspected to be in the contracted bladder, an injection of sterilized
water will usually facilitate diagnosis, and a differentiation of
calculus and neoplasm.

Hypertrophy of the prostate is felt as a swelling of uneven
outline over the cervix vesicz. It is to be looked for especially
in old dogs.

Urethritis is indicated by swelling and tenderness along the

median line of the pelvic floor, back of the cervix. With a cal-
culus in the urethra the swelling is more strictly localized and the

canal in front of it may be full and elastic.

HAMATURIA.

Symptoms of different lesions of kidneys and constitutional states, of
poisoning by irritant plants, common on moors and in woods. In puerperal
cow fed on turnips raised on mucky, unreclaimed, sour lands. Bacteria.
Toxins. Anzemia. Poor wintering. Limed new soils. Symptoms : in plethoric,
congested mucosa, vascular tension, hurried breathing, colics, straining,
red urine ; in vegetable irritants, depression, weakness, coldness, trembling,
stiffness behind,scanty red or black urine, diarrhoea, constipation; in anzemia,
poverty, debility, red urine, pink tinge in milk, emaciation, hide-bound,
anorexia, colics. Chronicorintermittent. Lesions : in plethoric, congested
enlarged kidney, without softening ; in irritant poisons, congestion also of
throat, stomachs, intestines, liver with haemorrhagic extravasations; in
aneeniia, kidneys pale, flaccid, hydrozmia, liver enlarged, softened, reddish

Hematuria. 207

liquids in serous cavities. Treatment : avoid the injurious soils, drain, cul-
tivate, feed products of such soils with other food, oleaginous or saline laxa-
tives, antiferments, tonics, astringents, flax seed, farinas.

The passage of blood or blood elements in the urine.

Causes. A symptom of a variety of diseases, producing lesions
of the secreting structures of the kidneys; acute congestion,
tumors, calculi, parasitism. Also as a manifestation of diseases
of distant organs—hzemoglobinuria, southern cattle fever, an-
thrax, poisoning by irritant diuretics, wounds of the bladder,
pelvic fracture with injury to bladder or urethra, cystitis with
varicose cystic veins, etc.

Among the irritant plants charged with producing the affection
are the young shoots of oak, ash, privet, hornbean, alder, hazel,
dogberry, pine, fir, and coniferze, generally. Also ranunculus,
hellebore, colchicum, mercuriales annua, asclepias vincetoxi-
cum, broom, etc. The disease is common in spring in cattle
tnrned out too early to get good pasturage and which, it is
alleged, take to eating the swelling buds and young shoots of
irritant plants.

The disease has occurred mostly in woods and wild lands and
has accordingly been vulgarly named the wood evil, (maladie de
bois, holzkrankheit), and moor ill.

In England, as occurring in the puerperal cow, Cuming, of
Ellon, attributes it to a too exclusive diet of turnips. His analy-
sis showed that turnips contained 10% sugar and 1 to 14%
vegetable albumen. The sugar is held to stimulate unduly the
milk secretion, but fails to supply the nitrogenous materials need-
ful to form it and the cow is speedily rendered anzemic, with
solution of the blood globules or of the hematin and its excre-
tion by the urine. No attempt was made to produce hematuria
by an exclusive or excessive diet of sugar, and cows fed on
turnips grown on well drained lands never suffered from the
disease.

Williams says that urine in such cases had a strong odor of
rottenturnips. ‘This argues not an anzemia determined by sugar,
but rather an intestinal fermentation, perhaps superinduced by
ferments introduced along with the turnips. Add to this the
notorious fact that the offending turnips are usually such as are
grown on wild, damp, undrained, swampy, or mucky lands, and

208 Veterinary Medicine.

we have the suggestion of a bacteridian poison, or a toxic product
of bacteria. Williams and Reynal practically agree on the point
that the common hematuria is the result of anemia. It has long
been noticed that the herds which suffer from the affection are
those which have come out of the winter in low condition, the
victim is the poor man’s cow, and the symptoms are most likely
to appear when turned into the fieldsin spring before the pastures
have come up. The anzemic condition of the carcasses is quoted
in support of this view, but perhaps’ without making sufficient
account of the extraordinary destruction of blood globules during
the progress of the malady.

Pichon and Sinoir see in the liming of soils and the production
of larger crops, a cause of anzemia in the rank and aqueous
growth of the meadows, and their overstocking in order to eat
them down, or to consume their products. They found that an
abundant artificial feeding was the most efficacious mode of
treatment.

Reynal, who endorses this-view, tells us that in the anzemic
and liquid blood the globules become smaller and can pass more
readily through the walls of the vessels. But this is exactly the
opposite effect from what we see when the blood is diluted with
water. The globules in such a case are distended and enlarged,
and may finally have their protoplasm and hzematin dissolved
and diffused through the liquid. If the blood globules are
shrunken, then we must look for a cause very different from
anzemia.

Reynal further assures us that inion is a common cause of
heematuria in cattle. ‘‘ Under the prolonged influence of a very
assimilable diet, the blood becomes more plastic, circulates with
difficulty in the capillaries, and may even rupture them, with a
resulting capillary renal hemorrhage, and bloody urine.’’ He
further intimates that this occurs especially in spring after the
animals have been turned out on very rich pastures, and that in
Normandy certain pastures of unusual richness are notorious for
producing hzematuria.

Apart from the fact that the rich grasses of spring produce at
first intestinal congestion, and diarrhcea, with consequent disorder
of the liver and kidneys, this spring affection on particular pas-
tures suggests some special poison in the pasture as the unknown
cause of the disease. .

Hematuria. 209

In all forms alike of this affection the nature of the soil ap-
pears to have a preponderating influence. It is the disease of
the woods, and waste lands, of damp and undrained lands, of
dense clays, of lands underlaid by clay or hard pan, of lands rich
in vegetable humus, or vegetable moulds the decomposition of
* which has been hastened by the application of quicklime.

Pottier, Salomé, Wiener and Reynal especially testify to the
prevalence of hematuria on soils that are either dense and im-
permeable, or that have a subsoil of clay or hardpan.

The disease has not been traced to any definite microbe nor
toxin, but there is much to suggest the necessity for inquiry in
that line. The special susceptibility of animals that may be
plethoric on the one hand, or in low condition on the other, would
be entirely in keeping with such a view, as the debility or de-
rangement of health would lay the system open to attack.

Symptoms. In the plethoric animal there are congested mu-
cose, full, strong pulse, forcible heartbeats, full veins, accelerated
breathing, colicy pains, dullness, straining frequently and the dis-
charge of thick, red or bloody urine.

If from irritant buds and shoots, or plants, there is more de-
pression, weakness, fever, dry skin, staring coat, coldness of the
surface, tremblings, stiffness or weakness of the hind limbs,
diarrhoea, followed by constipation, frequent straining and the
passage of colored urine with pain. In violent cases the expul-
sion of bloody urine may be excessive, and the cow may die in 24
hours. From irritant plants however the quantity of urine is
liable to be small, but frequently passed. -

As occurring irrespective of plethora or irritants there may be
at first only poor condition and debility with the passage of blood.
A pink tinge may show on the froth in the milk pail, and a red
precipitate on its bottom. If not anzemic at the outset they soon
become so, and the pulse which was at first bounding becomes
small and weak, the heart palpitates, the red mucosz become
pale. The subjects become tucked up, emaciated, weak, rough
coated, the skin adherent to the bones, and the appetite and
rumination impaired or lost. Sometimes colics are present.

In the milder anzemic forms it may continue for months before
it causes death. In such cases it may prove intermittent.

Morbid Anatomy. In the hematuria of plethora the kidneys

4

210 Veterinary Medicine.

are large, congested and of a dark red, but preserve their normal
consistency and texture.

In the form associated with ingestion of irritant plants, there is
congestion of the pharynx, stomachs, and intestines with
. hemorrhagic spots, congestion of the liver, violent congestion of
the kidneys which are of a blackish red color, and enlarged to ~
perhaps twice the normal size, with haemorrhagic exudations, the
convoluted tubes filled with fibrinous exudate and blood globules,
the pelvis red and like the bladder containing some reddish urine.
The vesical mucosa may be black.

In anzemic cases the kidneys are pale, flaccid and colorless, with
a reddish liquid in the pelvis and bladder. ‘The vascular system
is comparatively empty, and the blood, thin and watery, and often
coagulates loosely or not at all. As noted by Herland globules
are greatly reduced in numbers and size, and often crenated or
partially broken down. Slight serous effusions in the serous ;
membranes arecommon. The liver is softened and enlarged, the
lacteals have reddish contents, and the ingesta are dark colored.

Treatment, Preventive. Avoid hematuria pastures and the
fodder grown on‘such lands. Drain and cultivate such soils.
When animals must feed on the products of such soils supplement
the food by grain, oil cake, cotton seed meal, etc. Avoid stag-
nant waters draining from such soils.

Therapeutic Treatment. Give oleaginous or saline laxative to
clear out poisons and ferments from the bowels and add if
necessary an antiferment (salol, salicylic acid, carbolic acid, tur-
pentine oil, chlorate of potash, sulphites or hyposulphites), even
if diarrhoea is present. Follow with tonics (copperas, chloride
of iron) and stimulant antiseptics (ol. terebinth, potas. chlorate)
and sound food. Flax seed, linseed meal, farinas. Bitters may be
added (gentian, quinine, quassia). Asa calmative, camphor (2
to 4 drs.) 2 or 3 times a day has proved useful.

In case of nephritis treat as for that affection.

Weiner lauds empyreumatic oil and oil of turpentine with cam-
phor.

In chronic cases, nourishing food with change of locality and
water are very important.

A course of iron tonics should wind up the treatment.

ACUTE CONGESTION OF THE KIDNEYS IN SOLIPEDS.

Definition. Causes: bacteria, toxins, irritant diuretics, musty oats or
fodder, foul water, cantharides, turpentine, aqueous grasses, onions, moult-
ing, cold, chills, injuries to loins, over driving. Lesions : kidney enlarged,
red, black, softened, capsule loose, cut surface drops blood, brown, softened
necrosed areas, gorged capillaries of glomeruli and convoluted tubes,
granular or fatty changes in epithelium, may be ruptures. Symptoms:
sudden ; weak tender loins, slow dragging straddling gait, accelerated pulse
and breathing, anxious countenance, colics, sweating, urine from limpid to
black, with red globules, and casts. Prompt recovery or nephritis. Diag-
nosis : from nephritis, hemoglobinuria, laminitis, indigestion. Prevention :
Treatment: bleeding, laxatives, diffusible stimulant diuretics, bromides,
diluents, mucilaginous agents, fomentations, sinapisms, rectal injections,
clothing, friction to the skin, restricted laxative diet.

Definition. Active congestion of the renal capillaries, especially
of those of the glomeruli and convoluted tubes, with colicy pains,
and free discharge of urine, in some cases bloodstained.

Causes. It may be determined by local irritation caused by the
passage of the bacteria and toxins of infectious diseases such as
influenza or contagious pneumonia. In the same way irritant
diuretics, medicinal, alimentary and toxic, operate. Diuretic
balls and condition powders given recklessly by stablemen and
grooms, saltpeter, resin, oleo resins, turpentine, rue, savin, col-
chicum, squill, anemone nemorosa, adonis, cynanchum vincetox-
icum and other species of ascelepias, hellebore, mercurialis annua
and bryony are examples. The young shoots of the coniferous
plants, fir, balsam fir, pine, white and yellow, and hemlock,
are at times injurious.

In the same way, damp moldy oats or fodder produce renal
congestion and excessive polyuria, also corrupt, stagnant water
and that of marshes which often contains complex toxic products
of fermentation. Water of ponds in which cantharides or potato
beetles have been drowned, is dangerous. ‘The cantharides, eu-
phorbium, or oil of turpentine applied too extensively to the skin
as a counterirritant, is another factor.

Even the rich aqueous grasses of spring succeeding to the dry
winter diet, stimulate the kidneys, determining an active conges-
tion with polyuria and in bad cases heematuria. In many such

211

212 Veterinary Medicine.

cases there are superadded the acrid diuretic plants already re-
ferredto. In Denmark where onions are grown on a large scale,
the tops fed to animals have produced renal congestion.

There appears to be an extra susceptibility in spring when the
winter coat is being shed, and at this time especially, but also in-
dependently of this and at otherseasons, exposure to cold and the
occurrence of chills tend to induce an attack. Exposure to cold
storms of rain or sleet when perspiring or fatigued, standing tied
out of doors in zero weather without a blanket, wading or swim-
ming deep rivers in cold weather and while fatigued, standing
wet and unblanketed in a cold stable when returned from work,
exposure to draughts between open windows or doors, the con-
tinuous falling of cold rain from a leaking roof on the loins, the
cold of a damp stable newly finished in brick or stone, the cold
and damp of an undrained floor in a wet retentive soil, all have
a tendency to drive the blood from the surface, to increase the
tension of the blood in the heart and internal organs, to stimulate
the kidneys to extraordinary secretory activity, and at the same
time to temporarily debilitate the whole system and lessen the
power of resistance and recuperation. The factor is especially
potent when it involves the nervous interdependent sympathy
between the chilled loins or abdomen and the kidneys. Sprains and
other injuries of the loins have long been charged with producing
renal congestion and inflammation, and even Trasbot, who doubts
the reality of this, acknowledges that the already diseased kidneys
are seriously injured in this way. Cadeac and Schmid record
cases of actual rupture of the horses’ kidney-from violent move-
ment, and other cases of congestion and bloody urine have been
traced to kicks on the loins, falls, sprains and the carrying of un-
duly heavy loads. The overexertion which produces albumin-
uria, casts and sanguineous transfusion in athletes has a similar
effect on the overdriven race horse, trotter or draught horse.

Lesions. The congested kidney is enlarged, sometimes to two
or three times its natural size, softened, and red, especially in
the cortical portion which may be so dark as to appear cyanotic.
The capsule is also the seat of ramified redness, and is very
loosely adherent to the cortex. Beneath it may be considerable
yellowish exudate especially abundant in the vicinity of the
hilus. On section the cut surface is very bloody, the cortex

Acute Congestion of the Kidneys in Solipeds. 213

literally dropping blood, though brownish spots may appear at
intervals representing areas of necrosis, which under pressure
break down into a pulpy débris. Microscopically the glomeruli
appear hzemorrhagic, the capillary vessels being gorged to ex-
cess, while blood globules and even minute blood clots are found
in the intervascular spaces. The epithelium covering the glom-
eruli and lining the convoluted tubes show granular or fatty
changes, and granular matter is found outside the vessels.

The congestion is less in the medullary portion and even in
the convoluted tubes and the tubes of Henle, though these may
be the seat both of hyperzemia and exudation.

In case of very violent congestion, extensive sanguineous ex-
travasation may occur, leading even to rupture of the capsule
and the escape of blood into the perirenal adipose tissue or into
the abominal cavity. Cases of this kind in the soliped are re-
corded by Caroni, Cadeac, Moussu, Kitt, Zundel, Mollereau and
Porcher. Averons describes in the Revue Veterinatre (1897) a
case in which both kidneys were surrounded by an immense
black clot, and weighed no less than 36 lbs. Leblanc records a
similar case affecting the one kidney. ‘The mass measured about
10 inches by 8.

Symptoms. ‘These are liable to appear suddenly, often while
the patient is at work, and are manifested by weakness in the
loins, slow gait or sudden stopping, the hind limbs are held in
abduction, and advanced with apparent stiffness and pain. There
is much excitement and anxiety, the face is pinched and strained,
the respiration accelerated, the pulse hard, tense and rapid, and
the eyes or nose may be turned toward the flank or loins. ‘There
may be colicy pains, with uneasy movements of the tail and hind
limbs, pawing, and even lying down and rolling. The visible
mucose are strongly injected and in bad cases the skin may be
drenched withsweat. ‘There is at first little or no hyperthermia.

At first there may be no micturition but in an hour or more,
urine may be discharged in excess, sometimes as much as 25 quarts,
and of a low specific gravity (1001 to 1005). If there has been
no blood extravasation it is usually clear and limpid but with ex-
travasation it may be of all shades of pink or red to black. In
the latter case the suffering is liable to be acute (Cadeac), and
contrary to the condition in hemoglobinuria, the urine contains

214 Veterinary Medicine.

blood globules and even tubular coagula representing the
uriniferous tubes and entangling the blood cells. This is com-
plicated by albnminuria.

Course. Duration. The congestion is short lived. It speedily
undergoes resolution with the passage of normal, clear urine, and
the recovery of appetite and spirit, or it becames rapidly aggra-
vated, with continuous suffering and colic, complete loss of appe-
tite, dullness, constant decttbitus, weakness, debility, small or
imperceptible pulse, palpitations, darker color and perhaps com-
plete suppression of urine, and stupor or other nervous disorder.
Death may occur on the fourth to the sixth day. It may be
delayed by a partial recovery followed by a relapse.

Diagnosis, Acute renal congestion is distinguished from
nephritis by the suddenness of the onset, the absence of fever.
and the comparative absence of tenderness of the loins, and of
tubular casts.

From hemoglobinemia it is distinguished by the absence of the
conditions under which that affection appears:—the previous
heavy work and full rich feeding, the day or more of complete
rest on full ration, and the suddenexercise following. ‘The hind
parts in hemoglobinzemia are benumbed, paretic, or paralytic
and not unfrequently rigid and swollen, and the brownish or
reddish urine contains hemoglobin in amorphous particles, and
not red blood globules and sanguineous tubular casts as in renal
congestion.

From laminiztis it is distinguished by the absence of high fever,
by the absence of the advance of the fore feet resting on the
heels, of the heat and tenderness of the feet, by the ability to
bear the lifting of one fore foot, or the tap of a hammer on the
toe, by the lack of improvement after the first few steps as is
seen in laminitis, and by the absence of the strong pulsations
in the digital arteries.

From zzdigestion it is distinguished by the absence of the his-
tory which leads up to that condition, of abdominal tympany, of
rumbling, of impaction and of frequent attempts to defecate, and
by the presence of the stiffness, straddling, and the blood globules
and albumen in the urine of low density.

Prevention. This must be sought by the avoidance of all the
factors of causation :—autointoxication in contagious diseases,

Acute Congestion of the Kidneys in Solipeds. 215

excessive renal irritation from the injudicious use of diuretics, or
the accidental ingestion of irritant or acrid diuretic plants or
waters, or musty fodders, or the sudden change to the succulent,
watery, first vegetation of spring, or of exposure to cold, wet, or
damp, in all their forms, or of direct injury to the back or loins
by blows, shocks, or violent exertions.

Treatment. 'Trasbot and Cadeac strongly recommend vene-
section, and at the very outset in specially acute cases the sud-
den lessening of the arterial and capillary tension, by this potent
means, may furnish the opportunity for the capillaries of the
glomeruli and tubes to regain their normal tone, and thus contri-
bute to a speedy abortion of the affection. If resorted to at all it
should be made in a full stream from the jugular, so as to secure

_ the fullest and most prompt result with the least possible effusion
of blood.

Much, however, must depend on the attendant conditions. In
toxin poisoning following on an infectious fever, the already
existing debility will sufficiently forbid a resort to the lancet, and
we must seek elimination by the bowels, the skin or even the kid-
neys. Antiseptics, too, are in order if there appears any ground
for suspicion of the action of infecting agents. Some cases will
recover promptly under diffusible, stimulant diuretics such as
spirits of nitrous ether, which by stimulating the circulation in
other organs and especially the skin, appears to relieve the kidney
and solicit normal secretion. But most veterinarians dread the
stimulus and irritation and prefer small doses of refrigerant diure-
tics: bicarbonate of soda 4 drs., saltpeter 2 drs. or the tartrates,
citrates or acetates of the alkaline bases. In case of irritation by
acrid diuretics, but especially by cantharides, camphor 2 drs., has
been found to be particularly soothing, and next to this, bromide
of camphor or bromide of potassium 1 to 2 drs. may be resorted
to. Zundel prescribes acidulated camphorated drinks. The free
use of mucilaginous drinks, such as boiled flax seed; and the
persistent application of fomentations or wet compresses to the
loins are of equal value in soothing irritation. Sinapisms may
advantageously follow the local emollients.

Laxatives act with less promptitude than diuretics, but on the
whole constitute a safer treatment ; since they secure elimination
and derivation without risk of irritation to the kidneys. The

216 Veterinary Medicine.

oils: castor 1 to 2 pints, linseed 2 pints, or olive 2 pints, are
especially to be recommended in this respect, but 1’ Homme advises
manna, and calomel may also be used as a substitute. Injections
of warm water are valuable in unloading the rectum and colon,
soothing the kidneys and soliciting peristalsis.

A restricted amylaceous diet is essential, and a warm stall or
abundant clothing. Grooming or active rubbing of the skin
tends to active derivation and often materially relieves. The case
should not be abandoned until a day or two after the urine has re-
turned to the normal, and for some time special care shonld be
taken of the diet, stabling and work. ?

©

ACUTE CONGESTION OF THE KIDNEYS IN CATTLE. .

‘Causes : infection, toxins, etc., irritant diuretics, chills, moulting, swill.
Lesions : cortical kidney congestion, red to black, softening, friability ;
urine limpid to red, with blood globules, albumen, and crystals. Symptoms :
chill, tender loins, colic, straining, recovery in fourdays. Diagnosis : from
hemoglobinuria, cystitis, calculus. Prevention: diet, etc. Treatment:
laxatives, flax seed, wet compresses, bromides, camphor, disinfectants,
bitters.

Causes. In cattle this malady is largely traceable to the same
causes as in the horse, and is very often but a complication of
some other affection. The renal congestion of infectious diseases
is seen in the advanced stages of lung plague, in anthrax, in
malignant catarrh, in heemoglobinemia, and implies an ac:
cumulation of irritant toxins in the system. The abuse of
diuretics, the ingestion of acrid diuretic plants, including
the early shoots of the coniferee, the introduction through
any channel of cantharides or potato beetles; the drinking of
stagnant water charged with deleterious fermentation pro-
ducts, the consumption of musty or spoiled fodder, and the sud-
den change to the succulent grasses of spring, operate as in the
horse. So it is with cutaneous chills, cold stone floors, cold wet
storms, draughts and dropping from a leaky roof. The shed-
ding of the coat in spring is an undoubted predisposing cause.

Cattle in the swill stables of breweries and distilleries are the
subjects of a constant renal congestion and polyuria, which,
however, does not prevent rapid fattening. ‘This diet, how-

Acute Congestion of the Kidneys in Cattle. 217

ever, unfits the animal for a future vigorous life, and any
concurrent injurious influence may easily bring on active kid-
ney disease.

Lesions. ‘There is redness and swelling of the kidney, it may
be to two or three times its normal size, the enlargment being
especially referable to the cortical portion, which may be mottled
in different shades of red up to black extravasations. The lack
of firmness in its connection with its sheath, and the softening
and friability of the parenchyma resemble the same conditions in
the horse. The urine may be clear or more or less tinged with
blood, and contains blood globules, albumen, and crystals of car-
bonate of lime and urate of ammonia, which seem to indicate the
presence of a bacterial ferment.

Symptoms. The patient usually shows some indication of chill,
with staring coat and arched back, which is very sensitive to
pinching. There is impairment of rumination and appetite, de-
crease of milk in dairy cows, uneasy movements of the hind
limbs and tail, frequent straining to urinate, and the passage
of urine often in small amount and sometimes of a pink or
reddish tinge. In bad cases this may become deep red, or
black, and the pulse becomes weak, with palpitations, marked
muscular weakness and a tendency to lie down most of the
time. :

With early improvement recovery may be complete in from
four to six days. In the more severe and fatal cases death
may occur as early as the sixth day. Unless under the in-
fluence of violent irritants or a persistence of the original poison
the prognosis is favorable.

Diagnosis. It is especially important to distinguish this from
hemoglobinemia, which shows an uniform red or brown
‘discoloration of the urine and an entire absence of blood
globules as such. In congestion the reddish material tends to
precipitate and is found to consist largely of blood globules. It
is further associated with albuminuria.

Hemorrhagic cystitis and cystic calculi are both chronic
affections, and identified on rectal exploration by the tenderness
of the bladder and the presence of the stone.

Prevention consists in the avoidance of the various causative
factors, and especially those that find access among alimentary

218 Veterinary Medicine.

matters. Cattle turned out in early spring should be fed
before going and should be returned from the pasture in an
hour or two. This repeated day by day, allows the digestive
and urinary organs to accommodate themselves to the fresh
spring grass and to any vegetation to which the animals have
not been accustomed. Chill, draughts, injuries and other dis-
turbing conditions must be guarded against.

Treatment. Bleeding is strongly recommended by Cruzel and
Cadeac. In Germany, England and America derivation toward
the digestive organs is more generally relied on. Laxatives
should be, as in the horse, oleaginous (castor, olive, linseed) or
manna, rather than agents that may perchance act on the kid-
neys. Free purgation should be secured. Flaxseed tea, and
wet compresses over the loins are valuable adjuncts, and anodyne
agents like camphor, bromide of camphor, or other bromides
may be added, and when there is any suspicion of infection, salicy-
lates, or iodide of potassium may be employed. Finally a
course of bitters (salicin, quinine, nux,) may be employed to re-
store tone and iron carbonate with sodium carbonate as a recon-
structive tonic. The diet must be changed to wholesome food,
but not too stimulating, and the animal kept quiet.

ACUTE CONGESTION OF THE KIDNEYS IN SHEEP
AND GOAT.

Causes: irritant food. Lesions: Symptoms: separates from its fellows,
arched back, stiff straddling gait,straining, muscular weakness, recumbency,
urine red, with blood globules and albumen. Prevention : care in feeding
and watering, change of pasture and treatment as in the ox.

Causes. Asin cattle, the smaller ruminants appear to suffer
especially from an alimentary renal congestion, showing itself
mainly in animals that are unaccustomed to the particular
toxic aliment. Thus, Cornevin finds that the Pyrennean sheep
thrives on the leaves of the Quercus tosa, while Southdown sheep
taking them in any considerable quantity perish of renal congestion
or nephritis. Similarly Weith fed four sheep on cynauchum
vincetoxicum and developed renal congestion in the course of

Acute Congestion of the Kidneys in Swine. 219

three days. Other causes doubtless contribute in individual
cases but have not been specially traced to their effects.

Lesions are in the main the same.as in cattle, the kidneys
being bluish red, soft, flaccid and friable.

Symptoms. ‘The sheep lags behind the flock, frequently lies
down and rises, strains to urinate, and passes often considerable
quantities. The back is arched, the loins tender, the walk stiff
and straddling, the pulse small and weak. If the disease ad-
vances, there come on extreme muscular weakness, a disposition
to lie, an uncertain, gait, with frequent stumbling, dullness,
stupor, and it may be coma. The urine is usually tinged with
blood or of a deep red or black, and contains well-formed blood
globules and more or less albumen.

Prevention and treatment should proceed on the same lines as
in the ox, but in dealing with a large herd it becomes diffcult to
treat each separate case with special care. The avoidance of
sudden change of food as in turning out in spring, the feeding of
grain before turning out, the return to the fold after a short
freedom, and the gradual transition to the new food are im-
portant. When the disease has developed, an entire change of
pasture or food, the use of roots, ensilage, or grain, or of freshly
cut meadow grass, and an oleaginous laxative (castor oil 2 to 3
ozs.) are indicated. Oilcake or flaxseed meal will often prove
a most valuable article. Beyond this the same agents would be
indicated as for the ox.

ACUTE CONGESTION OF THE KIDNEYS IN SWINE.

Causes: infection, toxins, fermented food, traumas, crowding, cold.
Symptoms : stiff loins and quarters, frequent micturition, urine limpid or
red. Treatment.

Renal congestion in pigs has been seen mainly as the result of
toxin poisoning in swine erysipelas, hog cholera or caseous pneu-
monia. It is also liable to occur from putrid or overfermented
food, and in fat, heavy animals from injuries sustained in ship-
ping by rail by trampling on or squeezing each other. Kicks
and other injuries may at times contribute to its occurrence.

220 Veterinary Medicine.

Exposure to cold storms, to which swine are especially sensitive,
a wet, cold bed, or a leaky roof, are additional causes.

The Symptoms are more or less stiffness of the loins and hind
parts, frequent urination, the secretion being often passed in ex-
cess, and though at times clear yet at others pink and bloody and
precipitating blood clots or at least containing blood globules.

Treatment is mainly prophylatic. If therapeutic measures are
desirable for valuable animals, they should follow the same lines
as for sheep: rest, fomentation, aqueous food, anodynes, weak
alkaline diuretics, laxatives, and balsams.

CONGESTION OF THE KIDNEYS IN CARNIVORA.

Causes : acrid diuretics, loss of kidney, catheterization, dermatitis, burns,
traumas, overexertion. Lesions : enlarged, blood-gorged kidney, ted or
black, petechiated. Symptoms: stiff, arched, tender loins, tardy, dragging
of hind limbs, urine passed often, clear to bloody, albuminous, anorexia,
nausea, vomiting, diarrhoea, dullness, stupor. Treatment : stop cause, give
emetic, laxative, in surgical cases antiseptic, for cantharides, camphor,
bromides, vegetable food. Warm clothing or building.

Causes. ‘This comes most commonly from the ingestion of acrid
or diuretic agents, saltpeter, turpentine oil, cantharides and,
according to Cadeac, various essential oils including oil of mus-
tard. It takes place in the remaining kidney after the one has
been extirpated, or had its functions abolished by disease or
uretral obstruction. Again, surgical operations on the urinary
organs, even the simple passing. of a catheter, will cause sym-
pathetic renal congestion. Extensive acute dermatitis, and burns
of the skin may have a similar sequence.

Falls, kicks, blows, or crushing beneath a wheel or otherwise
are additional causes.

Finally violent overexertion as in coursing, causes congestion
with albuminuria, and blood globules and even. casts in the urine.
This is common to the human athlete (who undergoes a violent
and continued over exertion), also in race and draught horses, and
dogs.

Lesions. When congestion is produced experimentally by can-
tharides the kidneys are found to be enlarged and the cortex
gorged with blood so that it has a deep red or blackish port wine

Nephritis. 221

hue, with here and there spots of ecclymosis. ‘The veins capil-
laries and glomeruli are especially congested, and the epithelial
cells of the convoluted tubes have become laterally distended, so
that they approximate to a globular form. A loose coagulum
containing blood globules may be found in the capsule of the
glomerulus and in the convoluted tubes.

Symptoms. ‘These are arching and stiffness of the loins, a
tardy, dragging movement of the hind limbs and tenderness of
the loins. The urine may be scanty or in excess, and tends to

‘be passed frequently, in small quantities and with evidence of
pain. It may be clear, pinkish or bloody, and shows albumen
and frequently casts, and blood globules or small clots. There
is some impairment of appetite, and, in severe cases, nausea and
vomiting, with, it may be, diarrhoea, nervous depression, dull-
ness and stupor. When due to poison or other transient cause
the symptoms improve when this factor has been stopped.

Treatment. When due to poison taken by the stomach this
must be stopped, and the stomach and bowels evacuated by
an emetic (ipecacuan) and laxative (sodium sulphate). Appro-
priate treatment must be made in case of burns or skin eruptions.
When surgical cases are due to infection rather than simple
shock or sympathetic irritation, antiseptic injections of the
bladder are indicated. In all cases alike a warm bath is an im-
portant adjunct. When irritation is due to cantharides, it may
be calmed by camphor, 2 grains every three or four hours.
Other anodynes may be given as required. Rest isessential and,
as appetite is recovered, a moderate amount of amylaceous pud-
dings. A warm building or comfortable clothing is desirable.

NEPHRITIS. :

The renal iuflammations have not been fully investigated in the
domestic animals, and even in man, the pathology of several of
the forms is still enveloped in some measure of doubt. Jn man
the following conditions have been noted :

1st. Acute parenchymatous nephritis with enlarged kidney and
degenerated tubules.

222 Veterinary Medicine.

2d. Chronic parenchymatous nephritis with enlarged kidney and
degenerated tubules.

3d. Acute diffuse (desquamative, interstitial) nephritis with en-
larged kidney and glomeruli, tubules and connective tissue degen-
erated.

4th. Chronic diffuse (desquamative, interstitial) nephritis.

Sth. Suppurative nephritis and pyelo-nephritis, infection may
be from injury.

6th. Peri-nephritis - infection of connective tissue with adjacent
disease.

In domestic animals the following distinctions have been made :

ist. Acute nephritis.

2d. Chronic nephritis.

3d. Purulent nephritis and pyelo-nephritis.

4th. Peri-nephritis.

ACUTE NEPHRITIS. ACUTE BRIGHT’S DISEASE.

Animals affected. Causes : hyperaemia, traumas, cold, chill, fever, bic-
teria, toxins, overfeeding, nitrogenous food, raw potatoes, xanthin products,
acrid diuretics, diuretic insects, suppression of micturition, skin lesions,
burns, embolism, calculus. Symptoms: colic, trembling, rigor, arched,
stiff, tender loins, stiffness in quarters, drags hind legs, urination frequent,
movements of penis and testicle, costiveness, grinding teeth, anorexia,
vomiting (in dogs, cats and pigs), fever, dropsies, uremic convulsions,
urine scanty, high colored, red or bloody, thin, cloudy or turbid, albnmi-
nous, purulent, oxalates, urates, hippurates, hzematoidin, epithelium,
mucus, casts. Prognosis: resolution in three days, or urzemia, suppuration,
degenerations. Lesions: kidney enlarged, softened, friable, red, yellow,
black, purulent, glomerulitis, tubular hephritis, interstitial nephritis. Treat-
ment: rest, warm building, warm clothing, green or sloppy, amylaceous
food, bleeding, cupping, skin friction, fomentdtions, warm bath, hot air
bath, sinapisms, anodynes, laxatives, diaphoretics, heart tonics, alkaline
diuretics, paracentesis, bitters, iron, phosphates, hydrogen peroxide, cubebs,
etc.

Genera affected. ‘This has been seen in horse, ox, dog, sheep
and pig.

Causes. It is ascribed to the most varied causes, such as:
hyperzemia, blows and injuries on the back and loins, sprains of

Acute Nephritis. Acute Bright's Disease. 223

the loins, abrupt wheeling when in galop, exposure to cold winds,
and storms, especially when perspiring and fatigued, sudden sup-
pression of perspiration, extreme terror, bacterial infection and
infection by toxins (in septiczemia, pyzemia, influenza, contagious
pneumonia, uterine sepsis, omphalitis, infectious angina (Fried-
berger), bronchitis (Siedamgrotzky), glanders; tuberculosis.
Among dietary causes are named: a rich nitrogenous food
(grains, beans, peas, vetches, cotton seed, clover), raw potatoes
in excess, cotton seed meal, agents that increase the nitrogenous
and xanthin bodies in the urine.

Dr. Alfred C. Croftan, in his experiments with xanthin
bodies on rabbits, found that xanthin and hypoxanthin pro-
duced great increase of arterial pressure, atheromatous changes
in the vessel walls consisting in thickening of the intima, with
small celled infiltration and necrotic changes in different areas of
the vessel walls. ‘This in the kidney produces the primary inter-
Stitial form of nephritis known as gouty kidney and associated
with retention of uric acid and other xanthin bodies. The
accompanying cardiac hypertrophy, so common with such kid-
neys, he attributes to the increased intravascular pressure.

Irritant vegetables that are resinous or diuretic, and irritant
diuretic insects are incriminated (cantharides, caterpillars in
grass, or on plants, etc., lice on cabbages particularly,—Cruzel,
Neubert). Irritant drugs that are eliminated by the kidneys
have been equally charged (tar, carbolic acid, iodoform, chlorate
of potash, nitrate of potash, phosphorus, arsenic, lead, mercury).
Compulsory suppression of micturition is undoubtedly injurious
in house dogs shut up, mares kept long in harness, or horse on
railway car, above all if this follows a diuretic or drinking
abundantly. In such cases it is altogether probable that bacteria
already exist in the blood or kidneys and take occasion to attack
the tissues weakened by the overdistension or other inimical
cause. ‘This is all the more probable seeing that the kidneys are
a favorite channel for the elimination of bacteria present in the
system, It should be noted that nephritis is liable to supervene
on extensive skin burns, chronic dermatitis and other skin
diseases. Some cases are traceable to embolism, the clots coming
from the lungs, heart or arteries, in others the irritation is due to
calculi in the renal pelvis or tubules, and their attendant bacteria.

224 Veterinary Medicine.

f
These are especially common in cattle that are winter fed on dry
food. Again, the infection may have travelled forward through
the ureters from a pre-existing infective cystitis.

Symptoms. ‘There may be obscure or intense colic ; trembling
or rigor may occur, yet is often omitted or unobserved ; the loins
are arched ; the hind feet are advanced under the belly, or there
is frequent shifting of the weight from one foot to the other; the
walk shows stiffness of the back and hind limbs which appear to
straddle or drag behind ; urination is frequent in small amount,
or there are frequent inffectual attempts to urinate; the patient
is indisposed to lie down, and if he does so it is carefully, with
difficulty and groaning ; the testicles are drawn up and dropped
alternately, the penis is often protruded from and retracted
within its sheath, the loins are sensitive ‘to pinching, percussion,
or electric current ; when mounted the animal drops under the
weight ; he carries the head low and refuses to go fast. In bad
cases there is constipation, grinding of teeth, anorexia, and in
dogs, vomiting. Temperature may be normal or there may be
considerable fever. Dogs may lie curled up, with occasional
tremors. Dropsical effusions are frequent in the form of anasarca
under the chest or abdomen, or beneath the lower jaw, or as
stocking of the limbs, or the effusion may occur into an internal
serous cavity. Convulsions may occur from brain poisoning by
urea or other retained urinary product.

In the slighter forms the severe symptoms may be absent, and
the condition of the urine must be investigated as affording the
most constant and characteristic phenomena.

The urine is usually scanty, high colored, of a high specific
gravity and is passed often with pain and groaning. At the out-
set of an acute attack it may be bloody; later it may be only
cloudy or turbid from the excess of epithelial and pus cells,
leucocytes, salts and albumen. Early in the disease the casts
may contain red blood cells, and renal epithelium, later leucocytes,
nuclei, granules, pus cells, crystals and other matters. Albumen ~
is usually abundant as demonstrated by boiling and nitric acid.

Soda carbonate crystals, rhomboid, rosette-shaped or spherical
and effervescing with acetic acid, abundant in normal herbivorous
urine, may be greatly reduced or absent in nephritis.

Soda oxalate crystals, tetrahedral and insoluble in acetic

Acute Nephritis. Acute Bright's Disease. 225

acid, and normal in herbivora and carnivora, are increased if the
urine is acid as in severe nephritis, but also in rheumatism, te-
tanus, septiceemia, angina, heaves, and other affections with de-
fective eration of the blood.

Ammonio-magnesian phosphate crystals, rhomboid but
insoluble in acetic acid, are found in alkaline (ammoniacal) or neu-
tral urine, and appear to be often due to intestinal fermentations.

Cystine crystals, flat hexagonal plates, precipitated in healthy
urine, but dissolved by ammonia are absent in retained and fer-
mented specimens.

Uric acid crystals, rhomboids and plaques, brick red, and
normal in the urine of carnivora and flesh-fed omnivora, may be
present in herbivora not only in acute nephritis, but in other ex-
tensive inflammations attended with anorexia and the consump-
tion of the animal tissues.

Hippuric acid crystals, right rhombic prisms and their de-
rivatives, and insoluble in hydrochloric acid or ether, are greatly
increased in all febrile diseases in herbivora, nephritis included.

Hezmatoidin crystals, fine needles or bundles of the same,
yellowish red, are found in nephritis, heematuria, heaves, etc.

Epithelium, if columnar, points to disease of the kidney
tubes, though very similar cells are derived from the urethra in
both male and female. Squamous epithelium points to the cystic
mucosa and is not increased in nephritis.

Mucus in cylindroid form may point to nephritic congestion or
inflammation, but this may be present in health, and may show
in irregular masses derived from the renal pelvis or the bladder.
Mucous casts are always extremely elastic and mobile, and lack
the even clear cut margins of the casts of nephritis. They are
much more common in horse’s urine than in that of other animals.

Tube casts are especially indicative of nephritis and exuda-
tion into the uriniferous tubes. They are much firmer than the
mucous cylinders and have smoother and more even margins.
If relatively thick and straight they probably-come from the
straight tubes ; if sinuous or twisted, from the convoluted tubes.
With. a similar basis substance they often enclose different solid
bodies and have been named accordingly :—epithelial casts
when containing cylindroid, or polyhedral cells may be unhesi-
tatingly referred to the uriniferous tubules :—granular casts in

15 ‘

226 Veterinary Medicine.

which the homogeneous cast is impregnated with granular cells
and free grariules of proteid, fatty, or mineral matter, point
directly to inflammation affecting the uriniferous tubules and
their epithelial lining :—blood casts enclosing red blood globules
imply hemorrhage, or congestion or inflammation of the tubules,
. with blood extravasation or diapedesis:—casts containing
leucocytes and pus cells bespeak suppurative inflammation of
the tubules :—calcareous casts entangle numerous crystals and
granules, mainly of lime carbonate, and effervesce with acetic
acid :—hyaline casts are homogeneous, clear, so transparent
that it is sometimes necessary to stain them with iodine or ani-
line to make them distinct; they are found in nephritis and
especially in the chronic forms :—colloid casts or waxy casts,
or amyloid casts may designate a class of firmer cylinders,
clear, homogeneous and refractive, and often bearing fatty or
blood globules, crystals or fungi. They may have a yellow.
color, or they may give the amyloid mahogany reaction with the
iodo-potassic iodide solution (even in the absence of amyloid de-
generation of the kidney ; Jaksch).

Progress. Acute nephritis may advance for three days or more
and then terminate in resolution, or go on to complete anuria
with coma, to suppuration, gangrene or chronic nephritis.

Resolution is marked by general improvement of pulse,
breathing and expression, clearing of the urine, and return of
appetite. The urine may remain albuminous for eight days
longer.

Complete suppression of urine has persisted five days in
cattle (Funk), and seven days in horses (Friedberger), accom-
panied by intense fever, dullness, stupor and coma ending in
death from uremia.

Purulent urine is white, milky, albuminous, granular, with
epithelial cells and casts and pus cells, showing their double nuclei
with acetic acid. There are usually rigor, hyperthermia (106°
F.), thirst, intermittent colics, diarrhoea, perspiration, uncertain
walk, and stocked legs. Convulsions have been noticed in the
horse (Didie), cow (Pflug) and bitch (Trasbot). The horse may
turn in a circle (Friedberger) or have amaurosis (Didie). Death
usually occurs in two weeks,

Gangrene is likely to prove fatal. Berger has seen death oc-

Acute Nephritis. Acute Bright’s Disease. 227

cur in three days in the horse, and Trasbot in four days in a cow,
after a large cantharides blister.

Pathological Anatomy. 'The kidney is enlarged, soft, friable,
dark red, yellow with red spots, or having areas of hemorrhage.
When fatty it is marbled, pale yellow or white and red. The cap-
sule is easily detached. On section it is bloody, oozing or even
dropping blood, or a pale creamy fluid. The pelvis contains
urine, thick, gelatinoid, bloody or purulent. The latter condi-
tion must not be confounded with the thick pus-like mucus which
normally occupies the renal pelvis in the horse.

The lesions of the secreting portions of the kidney will vary
with the concentration of the inflammation in one or other of
the separate tissues.

In glomerulitis from toxic irritants, the capsules enclose an
albuminous liquid exudate, the capillaries are overdistended,
their walls thickened and cloudy, and thrombi with an excess of
red globules and leucocytes block them at intervals. This capil-
lary obstruction extends to the plexus surrounding the convoluted
tubules.

In tubular nephritis there is congestion of the plexus cover-
ing the convoluted tubes, and the epithelium shows cloudy swell-
ing, with fatty granules and hyalin droplets in the desquamating
cells.

With interstitial nephritis there is an exudate into the in-
terstitial connective tissue between the tubules, and into the
tubules forming hyaline casts. The epithelium of the tubules are
swollen, granular, opaque and desquamating.

In suppurative nephritis may be found all stages of ab-
cedation from minute points, gray or yellow, and only just visible
to the naked eye, in the midst of the deep red congested tissues,
through the larger white suppurative areas, to the extensive
abscess formed by a coalescence of the many, the intervening
tissue having broken down by a necrotic disintegration. In the
earlier stages the pus infiltrates the parenchyma so that it may be
comparable to a sponge filled with this liquid,

Treatment. ‘The first consideration is rest, with a warm build-
ing or clothing to solicit the action of the skin and lessen the
work of the kidneys. Warm summer weather is favorable, or
we should secure a sunny, comfortable, loose box, or a building

228 Veterinary Medicine.

heated by a stove. In default of this, warm woolen blankets,
hood and leg bandages should be secured, If the case is mild
enough to allow of appetite, the food for herbivora may be green
food in summer and carrots, beet, turnip, potato or ensilage in
winter. ‘The dog may have buttermilk or sweet milk or mush
and milk. Meat is objectionable because of the amount of urea
and other urinary products which it produces.

Trasbot strongly recommends general bleeding in strong,
vigorous horses and cattle, attacked by the disease in an acute
form, but deprecates it in the lymphatic, fat, or debilitated.

Omitting the general bleeding, one can always find a good and
safe alternative in bleeding the animal into his own tissues.
Shaving the loins and cupping las often an excellent effect. An
approach to this may be had by vigorous rubbing by several mcn
at once, of the limbs and the whole surface of the body, by warm
fomentations over the loins by means of spongio-piline or sur-
geon’s cotton covered with dry blankets, or by winding a hose
round the body through which warm water is forced, or finally
by a bath of steam or hot air, or insmall animals of warm water.
The dog may be placed in a bath of 80° or 90°. F., which is al-
lowed to gradually cool to 65” or 70°. In all these cases the
greatest care must be taken to avoid chill when the animal is
taken out. He should be quickly rubbed dry in a warm room
and blanketed.

Counter-irritants act in the same way, and mustard, or hot
water hotter than the hands can bear may be applied. Turpen-
tine, cantharides and other diuretic counter-irritants must be
carefully avoided. An old practice of laying a freshly removed
sheep skin over the loins, with the flesh side inward, often causes
a distinct exudation, thickening of the skin and derivation.

A damp cloth, laid across the loins and thoroughly covered
with dry to prevent any evaporation and chill, will usually give
great relief and may be kept on for days.

Internal medication must at first be mainly anodyne, laxative
and diaphoretic. The two latter classes are at once derivative
and eliminating, carrying out through other channels, waste
products that would otherwise have taxed the kidneys.

Among anodynes, the bromide of camphor (horse, 1-2 drs.,
dog, 2 to 5 grs.), bromide of potassium (horse, 1 dr., dog, 1 to3
grs.) or hyoscyamus may be used, and repeated twice daily.

Acute Nephritis, Acute Bright's Disease. 229

Purgatives must be restricted to such as have no tendency to
act on or irritate the kidneys. Castor oil, or sweet oil for the
larger animals, or for the dog senna or jalap, may be given every
morning to secure free movement.

As diaphoretics, ipecacuan, Dover’s powder, tartar emetic and
even pilocarpin may be used. ‘The last named agent is especially
useful when dropsy sets in, or ureemic stupor or coma threatens
(horse 3 grs., ox 7 grs., dog 4 to 4 gr. according to size). If
the heart shows weakness it must be sustained by digitalis,
strophanthus, caffein or nitroglycerine, and the pilocarpin with-
held.

In a sufficiently strong subject the stupor or coma may be met
by the abstraction of blood, which benefits by the dilution of that
which is left. .

Eclampsia may be further met by the inhalation of ether or
chloroform, or the rectal injection of chloral or bromide solution.

As the inflammation abates, if the action of the kidney is still
insufficient in spite of the free drinking of pure water, alkaline
diuretics may be given in small doses (tartrate, acetate or citrate
of potash, bicarbonate of soda, saltpeter).

In excessive dropsy avoid sloughing by lancing the most tensely
swollen parts to allow drainage, and keep the parts disinfected
with carbolic or other antiseptic lotion. For ascites or hydro-
thorax, aspirate, and apply a compressory bandage.

During convalescence a course of bitters (cinchona, salicin,
gentian, nux vomica) and iron (phospho-tartar, iodide or phos-
phate) will often be called for. Anzemia may be met by doses of
peroxide of hydrogen or the inhalation of oxygen.

In the advanced stages benefit may accrue from the use of
small doses of cubebs, copiaba, oil of turpentine or buchu, which
have a tonic action on the renal mucosa.

PURULENT NEPHRITIS.

Causes : general, traumatic, metastatic, infective, wounds, shocks, strains,
blows, falls, crowding, heavy loads, calculi, infective embolism. Lesions:
miliary or large abscesses, diffuse suppuration, softening, disintegration,
fistula. Symptoms: obscure, nephritic symptoms following distant abscess,
chill, hyperthermia, general symptoms of nephritis, pus in urine, anzemia,
emaciation. Treatment : to external wound, antiseptics, evacuate abscess;
extirpate kidney with pyonephrosis, in dog or pig, calcium sulphide, sul-
phites, copiaba.

Causes. Aside from the main causes of nephritis, the sup-
purative form may be determined by traumatic or metastatic
infective conditions. Under traumatic factors may be named
punctured or gunshot wotinds, shocks and strains connected
with falls, blows, crowding, compression, too heavy weights on
the back (pack, rider, two wheeled cart loaded too heavily
forward and going down hill), and finally calculi in the urini-
ferous tubules. Under metastatic factors come all infections,
pyemia, omphalitis, any suppurative affection of the lungs,
(abscess, pneumonia, broncho-pneumonia), pharangitis, etc.
Embolic renal abscess may start from endocarditis, arteritis, or
pulmonary phlebitis.

Lesions. ‘There may be a circumscribed renal abscess like a
good large orange, or many small gray spots like millet seeds,
peas or hazel nuts, having purulent centres and containing pus
cocci or bacilli. In other cases a diffuse inflammation suppur-
ates throughout till the whole gland becomes a pulpy mass of
pus, blood and broken down kidney tissue (pyonephrosis).
In traumatic cases the pus centres around the wound or injury,
perhaps invading adjacent parts, and even communicating
through the skin externally along the line of the original wound.
The pus may burrow in different directions in the cortex or
under the capsule with abscess at intervals (perinephritis), or
along the vessels to the medullary structure.

Symptoms, These are often obscure. The sudden appearance
of kidney disease in the course of a suppurative affection else-
where, the extension being ushered in by a chill or rigor or
attended by a succession of these, and the course marked by

230

Purulent Nephritis. 231

a variable hyperthermia is very suggestive. Stiffness and weak-
ness of the hind parts and tenderness of the loins are sigifi-
cant; also, in carnivora and omnivora, nausea and vomiting.
When the kidney can be felt by the hand in the rectum or in
the small animals, through the flaccid abdominal walls, the
manifest enlargement, the tenderness, and in some cases even
fluctuation will assist in diagnosis. In such cases, puncture. by
a large hypodermic needle, or a small trochar may betray the
presence of pus and complete the diagnosis. If the pus escapes
into the pelvis of the kidney it may be recognized in the urine.
The case is very liable to become chronic, and is then marked
by anzemia and emaciation.

Treatment. When an external wound exists it must be treated,
antiseptically, with boric acid, potassium permanganate, or other
antiseptic lotion. Ifa single large abscess exists, puncture evac-
uation through needle or trochar, and washing out with an anti-
septic solution is the obvious resort. Any foreign body must of
course be removed. If the suppuration is diffused through the
whole mass of softened kidney, the resort of extirpation may be
considered. ‘This is always dangerous as provocative of infec-
tious peritonitis, but it is less so in dogs and swine than in other
animals owing to their natural antagonism to pusmicrobes. The
operation should be attempted extraperitoneally, the incision be-
ing made beneath the anterior lumbar transverse processes and
carried inward through the sublumbar connective tissue. The
renal artery will require ligature with antiseptic catgut and all
manipulations should be aseptic or antiseptic. Evenif successful,
this operation leaves the subject in a dangerous state, as in case
of kidney disease at any future time, there is no second kidney
to compensate for the temporary loss of function and urzemic
poisoning is to be dreaded.

Apart from surgical measures the general treatment would be
largely the same as for acute infectious nephritis. As antiseptics
calcium sulphide, the different sulphites, copiaba, etc., will be
indicated.

PERI-NEPHRITIS.

Definition. In cattle on low damp lands, acrid plants, sprain, blow, cal-
culus, from purulent nephritis, in anzemia. Symptoms: of nephritis, soil-
ing of tail or prepuce, albumen, pus or blood in urine, lameness, unilateral
or bilateral, lumbar swelling, in smallanimals fluctuation, history. Lesions :
abscesses around kidney, under capsule, intercommunicating. Treatment:
as in purulent nephritis.

Suppuration in the connective tissue between the kidney and
its capsule is seen in cattle in low condition, on damp, un-
improved soils like undrained river bottoms and _ estuaries,
abounding in acrid and diuretic plants. Even among such ani-
mals it is rare and has probably a directly exciting cause in a
sprain or blow on the loins, or the presence and movement of a
renal calculus. It may extend from suppurations in the sub-
stance of the kidney and to:such extension the weak or anzemic
condition materially contributes. In man, in which such condi-
tions have been more frequently observed, a weak or cachetic
condition is considered as an essential accessory factor along with
the traumatic lesion (R. Harrison). Similar conditions may be
expected to bring about peri-nephritis in any one of our domestic
animals. ‘The author has observed it especially on the low lands
on the banks of the Ouse in Yorkshire, England.

Symptoms. ‘These are mainly those of nephritis in general,
shivering, stiff movement in the hind limbs, straddling, frequent
passage of urine, straining, difficulty in lving down and rising,
tenderness of the loins, dropping when mounted, groaning when
turned in a short circle. If the suppuration communicates with
the pelvis of the kidney there may be, in females, soiling of the
tail, and in males of the prepuce. Blood may be passed with the
urine, and pus cells and albumen are found when it is examined.
If one kidney only is affected, there is lameness in the corre-
sponding hind limb, the special feature being inability to extend
it backward. A swelling on the one side of the loins, and be-
neath the lumbar transverse processes just’ posterior to the last
rib, is likely to be a marked symptom, and if this persists and is
especially prominent at one point, an exploratory incision or

232

Pyelitis. Pyelo-nephritis. Inflammation of the Renal Pelvis. 233

puncture will detect the presence of the pus. Fluctuation can
rarely be detected, yet in small animals with very flaccid ab-
domen, the swollen, tender kidney and even fluctuation should
be detected at times. The history of the case, the low, damp
pasturage, the access to acrid plants, the alimentation with hay
or grain covered with cryptogams, the fact of an injury and the
low, weak, anzemic condition of the animal should contribute to
a satisfactory diagnosis.

Lesions. In bovine kidneys affected in this way we have found
general inflammation and exudation around the entire kidney and
inside the capsule, with numerous small abscesses, in many
instances communicating with each other. They may extend
through the capsule and invade surrounding organs.

Treatment. In the treatment of cases of this kind the general
principles of therapeutics for nephritis are about all that can be
attempted in the lower animals. Fomentations over the loins are
especially desirable as a means of relieving the suffering, and
moderating inflammatory action. To the same end is the allow-
ance of plenty of pure water as a diluent. Then the various
agents that antagonize suppuration may be thought of, and some

‘one selected for use. Beside the antisuppurants already men-
tioned one may use copiaba, cubebs, or turpentine in small doses,
salicylates, or the sulphide or sulphite of calcium. Surgical inter-
ference by puncture or incision and antiseptic irrigation can only
be thought of when the abscess is single and circumscribed ; never
when the whole periphery of the organ isinvolved. In the latter
case the only rational surgery would be the desperate resort of the
removal of the entire kidney.

PYELITIS. PYELO-NEPHRITIS. INFLAMMATION OF
THE RENAL PELVIS.

Definition. Causes: primary from vegetable irritants in food, toxins,
cryptogams, pelvic calculus, strongylus gigas; secondary from renal calcu-
lus, parasite, tubular uretral or vesical infection, infecting deposits, metasta-
sis. Symptoms: asin nephritis, pus, blood, or albumen in urine, tender,
arched loins, purulent polyuria, with spheroidal epithelium. Diagnosis.
Lesions: inflammation, calculus, etc., in pelvis. Treatment: pure water,
sodium bicarbonate, antiseptics, balsams, fomentations, piperazin, extraction
of calculus.

234 Veterinary Medicine.

Suppurative inflammation of the mucosa lining the renal pelvis:
may occur in the acute or chronic form.

Causes. It may be either primary or secondary. Asaprimary
disease it may be the result of poisoning by irritant diuretics such
as cantharides, turpentine, colchicum or balsams, or shoots of the
coniferze, it may be due to the passage of the irritant products of
cryptogams found in musty fodder, or grain, or it may come from.
the irritation caused by the toxins of bacteria developed in the
system orinfoodordrink. Cases that develop from the irritation
of a pelvic calculus or precipitate, and from the presence of the
strongylus gigas (in dogs) may also be placed in this class.

As secondary causes are those in which the inflammation start-.
ing in the uriniferous tubes extends down to and implicates the
pelvis, and the still more frequent instances of extension of puru-
lent infection upward from the ureter, bladder or prostate, so as to:
involve the pelvis. So in blocking of the urethra by strongylus,
stricture, clot or calculus, and in spasm of the sphincter vesice,
the delayed urine is liable to undergo fermentation with evolution
of ammonia, and not only the bladder but the ureter and renal
pelvis may suffer. Again, the occurrence in the kidney of the
hyperplasia of cancer, glanders (horse) and tuberculosis (cow)
may be the direct cause of pyelitis. Similarly foci of infection in
the kidney may be found in distemper in the dog, and in the con-
tagious pneumonia and influenza of the horse. In man infection
from the bowel through the migration of the bacillus coli com-
munis to the devitalized kidney and contents in hydronephrosis,
has been traced, and the liability to this must be still greater after
the surgical insertion of the ureters in the rectum as a substitute
for the obliterated bladder and urethra. Again, in the intra-ar-
terial migrations of the strongylus (sclerostoma) armatus pus
microbes may be carried to the kidney and reach the pelvis.

Symptoms. ‘These are in the main those of nephritis with
marked rigors. The presence of pus cells and albumen in the
urine may come from suppuration in the substance of the kidney
itself, or sub-capsular abscess opening into the pelvis, or it may
come from cystitis, prostatitis or urethritis. The special stiffness
and tenderness of the loins, polyuria in which the liquid is puru-
lent, but free from uriniferous casts, and in which it is charged
with the spheroidal epithelium of the pelvis (not the columnar of

Pyelitis. Pyelo-nephritis. Inflammation of the Renal Pelvis. 235

the tubules), may afford presumptive evidence of pyelitis. But
pyelitis is usually combined with nephritis or cystitis and the com-
plications prevent diagnosis. In some cases the urine is scanty
and strongly albuminous, and in others a round calculus will
block, at intervals, the opening of the ureter giving rise to
obstruction of the flow from that kidney and the occurrence of
violent renal colic lasting until the stone is again dislodged back-
ward.

Diagnosis cannot often be certain. Purulent urine, with a
considerable number of the spheroidal cells of the pelvis, and the
general signs of nephritis may be taken as diagnostic. A great
excess of such epithelial cells would on the contrary point to
cystitis.

Lestons. In the early stages the mucosa of the pelvis is con-
gested, red, aud sometimes, with calculus, hemorrhagic. Later
it becomes thickened by exudate, which fills also the submucous
tissue. Insome instances the pelvis is distended by an impacted
calculus, in others the obstruction of the ureter by an impacted
calculus or a swelling has led to overdistension of the pelvis, and
ammoniacal fermentation of its contents. Coincident inflamma-
tory lesions of the kidneys, ureter, or bladder are common.

Prognosis is not hopeful. Where it has resulted as a descend-
ing infection from the kidneys, the severity of the primary lesion
renders the case a grave one, while if it has been an ascending in-
flammation from the bladder it is no less so.

Treatment. Diluent (watery) diuretics are especially indicated.
Pure water may be given ad libitum. 'To this may be added if
necessary moderate doses of bicarbonate of soda or potash with
such non-irritating antiseptics as salicylic acid, salicylate of soda,
sulphite of soda, sulphide of calcium, quiniaorchamomile. Tras-
bot even recommends small doses of vegetable astringents, balsam
of Tolu, or Peru or of Copiaba, or oil of turpentine or tar water.
Apart from simple water, the diuretic agents may be used with
greater freedom if the solid parts of the kidney are little or not at
all involved and if the urine contains no casts of the uriniferous
tubes.

Benefit may also be obtained from fomentations, or cupping of
the loins, and even from the application of mustard and counter-
irritants.

236 Veterinary Medicine.

If the active symptoms subside the continued use of tonics
would be indicated, especially quinia, and also of the balsams with
the view at once of antisepsis and toning up of the mucous mem-

brane.
In case of calculus of the pelvis surgical extraction is virtually-

the only resort, though a very desperate one. Its increase may
be retarded or prevented by antisepsis, a liberal use of water, and
the exhibition of piperazin or some of the essential oils.

CHRONIC NEPHRITIS.

Cases destroyed as eating their heads off. Causes : sequel of acute nephri-
tis, swill, lead, experimentally, microbian invasions, toxins, metastatic em-
bolism, extension from aortic disease, sclerostoma, nitrogenous overfeeding,
toxins of putrid food, or cryptogams, valvular disease of the right heart,
rheumatism, heaves, calculus, starvation, debility, retention of urine.
Symptoms: emaciation, flabby muscles, lack of vigor, stiff loins and
quarters, short step, straddling, fatigue under slight exertion, groaning in
trot, or in turning, droops when mounted, slow to rise on hind limbs, poor
capricious appetite, anaemia, stocked legs, dropsies, urine of lower density,
albuminous, with granular epithelium and casts, abundant in early stages,
scanty with weakened heart and degenerated kidneys. Secondary palpita-
tions, bronchial catarrh, pneumonia, hemorrhage, stupor, lethargy, vertigo,
etc. Lesions: recent cases, kidney large, cortex firm, capsule adherent,
with granular fatty debris, and tubular casts ; old cases, kidney contracted,
fibroid, glomeruli and tubules atrophied. Bronchitis, pneumonia, hepatic
cirrhosis, heart enlarged, fatty, dilated, insufficient valves. Prognosis un-
favorable. Treatment : gentle exercise, warmth, succulent food, amylacegus,
tonics, iron, bitters, mineral acids, heart tonics, for polyuria bromides or
iodides, balsams, pilocarpin, fomentations or sinapisms to loins.

Chronic nephritis has reeeived little attention in the lower ani-
mals for various reasons. ‘The lower animals largely escape the
causative factors of alcholism and chronic lead and copper pois-
oning, and when suffering from any chronic affection that dis-
qualifies the animal for use and renders it anzemic and emaciated
it is naturally sacrificed to save the cost-of maintenance. In spite
of this a considerable number of cases have been recorded in
horses, and cattle and especially in dogs and cats.

Causes. Cases of acute nephritis sometimes improve and give
promise of recovery without completing the work of convalescence.

Chronic Nephritis. 237

Trasbot notes such cases in the dog, and Dickinson in the ox.
Alcoholic nephritis and degenerations are to be sought for espe-
cially in cattle kept on distillery and brewery dregs. Lead taken‘
in small quantities in soft water that has run through lead pipes
or stood in leaden cisterns produces in cows and other animals
chronic affections of the kidney. Ellenberger and Hoffmeister
have produced the disease experimentally with lead and copper
respectively.

Microbian invasions of the kidney that advance slowly like
glanders and tubercle are further causes of chronic nephritis.
Other secondary microbian infections of the kidney are complica-
tions of infectious diseases in other parts, including abscess,
pyzmia, septicaemia, ulcerative endocarditis of the left heart,
bronchitis, pneumonia, (Frdéhner), and of others less directly in
the line of the circulation, as omphalitis, uterine phlebitis (Lustig),
abscess of the nasal sinuses, bones, and fistula (Trasbot).

In other cases the nephritis is evidently a result of the irritation
caused by toxins in process of elimination by the kidneys, as
there is no evidence of a nephritic infection.

In some instances minute emboli originating in the lungs or
heart, become the starting point of the nephritis, which slowly
extends by reason of infection or low condition and special sus-
eeptibility. Disease of the aorta or renal artery may lead to this
condition as noticed by Cadeac and Lustig. Cadeac has also
noticed its association with aneurism of the mesenteric arteries so
that the strongylus (sclerostoma) armatus may be considered as a
factor. Again in old horses and dogs it has been associated with
atheroma of the aorta and renal vessels (Trasbot).

Overfeeding is not without its influence, especially when on ani-
mal food, which charges the kidneys with excreting an excess of
the irritating urea and uric acid, and this is one reason why it is
far more frequent in house dogs than in other domestic animals.
When the meat is already decomposing and putrid there is the
added evil of a quantity of toxins and even of microbes to be elimin-
ated from the system by the much abused kidneys. Add to these
that the dog’s urine is even in the normal condition more dense
and contains more irritating ingredients than that of herbivora,
and that owing to the slight activity of his perspiratory apparatus
he can obtain less relief from the skin, and we find a substantial
ground for the prevalence of chronic nephritis in this animal.

238 Veterinary Medicine.

Disease of the valves of the right heart or dilatation with in-
sufficiency of the auriculo-ventricular valves is a potent cause of
‘nephritis, the reflux of blood into the veins and the increased
vendus tension, speedily producing passive congestion and a slow
type of inflammation in the kidney. ‘This factor is especially
liable to operate in dogs, which are particularly obnoxious to
rheumatism and valvular ulceration, and are very subject to
nervous cardiac disorders ; in horsés that have contracted heaves ;
and in beef breeds of cattle which suffer from fatty degeneration
of the heart with dilatation.

The influence of calculi must not be seeioad. whether they
are lodged in the pelvis, the chalices, or the uriniferous tubules.
Their tendency is to induce local irritation and exudation, with
fibroid degeneration and thickening of the walls of the tubules or
pelvis and of the adjacent tissue.

When to one or more of the above conditions there are added
overfeeding or what is worse a low condition from starvation or
unwholesome food (permeated by bacteria or cyptogams or con-
taining vegetable acids), and when to crown all there are fre-
quent exposures to cold or wet, we have a vicious combination
especially conducive to kidney trouble.

Habitual retention of urine in mares in harness, in house dogs,
or in horses in railway cars, and violent exertion, or sprains of the
back are among the remaining accessory causes.

Symptoms. ‘These are often slight or obscure, so that not only
owners and attendants but even veterinarians are liable to over-
look them. Loss of flesh, flabbiness of the muscles aud a lack of
spirit and energy are among the first symptoms. The horse ap-
pears stiff, especially in his loins and hind limbs, and fails to ad-
vance the hind feet as far under the belly as formerly, and
straddles more. When put to work he is early fatigued and ap-
pears unfit for sustained exertion. His movements are slow and
if urged toa trot he may even groan with every step and quickly
settles back to his sluggish pace. If turned sharply round on
himself he does so with difficulty and often groans. When he is
mounted or when the loins are pinched he may droop to excess.
If you come on him lying down, and urge him to rise he may
rise on his fore limbs and sit on his haunches until urged before
he makes any attempt to raise himself on his hind. The dog may

Chronic Nephritis. 239

spend most of his time in the kennel, and show little disposition
‘to run, play or hunt. On the contrary the owner may have to
‘call him several times before he will come out and then he moves
‘listlessly, wearily and even weakly.

In all animals the appetite is poor or capricious, and the
‘patient gradually loses condition, at first slowly and later, after a
few weeks or months, more rapidly. The advance of anzemia is
also steadily progressive.

Dropsical effusion is not uncommon. It is often prominent in
‘the horse as stocked limbs, but may be absent for a length of
time. In other animals it is more likely to appear later in the
‘disease and under the chest or abdomen or in one of the internal
serous cavities. Trasbot has found it absent for months in the
nephritic dog.

The.exploration of the kidney through the flaccid abdominal
walls in small animals, and through the rectum in small horses
and cattle, may reveal renal tenderness and even swelling. If
there is a tendency to frequent passage of urine in small quanti-
ties, or to straining without micturition, the indication is of
value.

There may be little or no fever, and, when left at rest, little
evidence of discomfort.

Any indication of urinary trouble, and especially with dropsy,
‘weakness, flabbiness and anaemia and a subnormal temperature,
sshould lead to examination of the urine, as a crucial test. A
high density is good ground for suspicion. But this is not con-
stant. In advanced cases (chronic interstitial nephritis, small
white kidney, atrophic nephritis) it may be 1015 to 1025, in ex-
ceptional advanced cases with polyuria, it may be 1010, 1005, or
even 1001. With such a condition, however, there is great
anemia, pallor of the muscoz, and prostration. Tested with
nitric acid and heat, the urine throws down an abundant precipi-
‘tate of albumen. Under the microscope it shows a profusion of
-granular, degenerating epithelial cells, and casts of the urinifer-
-ous tubes.

Progress. The course of the disease is usually slow, extending
over several months, but with a tendency to constant advance.
The thirst increases and the urine increases in amount, clearness
and levity. There may supervene extreme sluggishness, drop-

240 Veterinary Medicine.

sies, anzemia, and weakness, irritability of the heart, and pal-
pitations on slight exertion. So long as the heart’s action is
strong, elimination may be maintained and life prolonged for
months (in cow, Dickinson), or years (Friedberger and Frohner)..
When the heart’s action becomes weak, elimination is rendered
imperfect and the animal shows catarrh of the lungs or bowels
(common in dogs), local inflammation of the lungs, pleura or
pericardium, or cedemas, or hemorrhages. The toxic effect on
the nerve centres is shown by stupor or lethargy, or vertigo.
When an abscess forms it is associated with a temporary rise of
temperature (Trasbot). The patient may die in convulsions, ina
state of coma, or by gradually advancing debility and failure of
the heart.

Lesions. In cases of comparatively short standing the kidney
is usually of full size, or somewhat enlarged, with firmly ad-
herent capsule and rough or even nodular surface. The surface
of the cortex may be red or grayish or parti-colored, pink and
gray. The cortical portion is firm and it may even be attenuated
somewhat, while the medullary portion, naturally lighter, has .
often grayish streaks converging toward the hilus. When the
gray streaks are scraped with the knife a serous fluid, mixed with
fatty granules or- globules, is obtained. The giomeruli may be
still about the normal size with some increase of the epithelial
tuft cells. The tubules contain casts (colloid, hyaline, granular),
and their epithelium normally columnar, are flattened down to
cubes and are swollen, granular or fatty.

In cases of older standing the connective tissue has usually
undergone a marked increase. The capsule is thick, dense and
adherent. ‘The cortical substance is shrunken with a great in-
crease of the fibrous elements, and the same holds true of the
medullary portion. In consequence of this, even in the cortical
substance the white or gray color predominates. The parenchy-
matous tissue (glomeruli, tubules) have greatly shrunken. In
connection with the contraction of the forming fibrous hyper-
plasia, there is a general shrinkage of the kidney in size, it may
be to one-half its original volume. ‘Trasbot reports a case of
nephritis, of 8 months standing, in the dog, with a kidney half the
normal size. In the end the parenchyma may have practically
disappeared, and the kidney may have shrunken to a small, firm,

Chronic Nephritis. 241

white, fibrous mass. Abscess of the kidney is exceptionally met
with (Laurent, Lafosse).

Lesions of distant organs are not uncommon. Bronchitis,
pneumonia, pleurisy, insufficiency of the tricuspid or mitral
valves, dilated heart, hypertrophied or fatty heart, congested or
fibroid liver, arteritis, and dropsies are among such morbid -con-
ditions.

Prognosts. ‘This is almost always unfavorable. Death may be
delayed for months or years, and partial transient recoveries may
take place but a restoration to normal structure and function’ is
not to be looked for.

Treatment. ‘This cannot be expected to be much more than
palliative. The avoidance of overwork, and of the exposure to
cold and wet, and the securing of a free action of the skin by
warm buildings and clothing, are essential. The diet should be
easily digested and non-stimulating, for hevdivora green food, car-
rots, roots, apples, silage, with a moderate allowance of oats to
counteract weakness and anemia ; and for carnivora, milk, butter-
milk, mush made of oat, wheat or barley meal, with, if necessary,
a slight allowance of tender raw meat. ‘Tonics fill a similar need.
Iron and bitters may be combined., Or hydrochloric acid or nitro-
muriatic acid with bitters (nux, calumba, salicin, quassia) may
be tried. These acids are especially valuable when the case has
originated in or is maintained by calculi, indigestion or hepatic
disorder. When the heart is defective in tone, it may be stimu-
lated by small doses of digitalis, strophanthus, spartein, caffein,
or nitro-glycerine, or to a certain extent by strychnia or nux.
These, however, must be used with judgment, if it is found that
they aggravate the case by increasing the arterial tension. In
those cases in which there is an excessive secretion of watery
urine, the possible source of this in musty aliment should be
avoided, and the flow checked by nux vomica, in moderate doses,
and bromide or iodide of potassium in full doses. When, on the
other band, the-urine becomes scanty and dense, the great danger
of a toxic action must be met by agents that favor excretion.
Pure water at will is perhaps the least objectionable of such
agents, but potassium or sodium acetate or citrate, or even sodium
chloride, in weak solution, may be given. In some cases benefit

will come from a moderate use of the balsam of copiaba, or the
16 '

242 Veterinary Medicine.

leaves of buchu, or piperazine, which may improve the tone of the
secretoryelements. The most promptly effective of these agents is
pilocarpin (Friedberger and Frohner), but it has the serious draw-
back of inducing profuse and dangerous depletion and debility.
Yet in careful hands, and with good cardiac tone, it may often be
used to advantage.

Fomentations over the loins, warm baths and mustard embro-
cations, may at times be beneficial. Attempts have been made to
check the hyperplasia by the use of arsenic, mercury or the com-
potinds of iodine, but their use in such cases is based on theory
rather than accomplished results.

HYPERTROPHY OF THE KIDNEY.

Hypertrophy of both kidneys has not been recorded in do-
mestic animals. On the other hand the extraordinary develop-.
ment of one in compensation for the loss or atrophy of the other
is not uncommon. In this the organ follows the general law of
adaptation, seen in the double-symetrical organs (testicle, etc. )
and the more so that its functional activity is indispensable to life.
Among causes are: blocking of an ureter by calculus, worms,
neoplasm, nephritic abscess, gangrene, etc. The enlargement
of the remaining kidney is a vicarious act and essentially a
physiological one.

If compensation is perfect, it may be impossible to detect symp-
toms apart from those of the primary disease.

Prognosis. J,ife is endangered in case of any subsequent kid-.
ney disease.

ATROPHY OF THE KIDNEY.

Result of hyperplasia of connective tissues and compression and absorp-
tion of parenchyma. Unilateral or partial. Causes : chronic productive in-
flammation, calculus in tubes, ureter, or pelvis, tumor, retention cyst, em-
bolism. Lesions: sclerosis of kidney, firmness, pallor, anzemia, lack of
glomeruli and tubules, cysts, congenital, urinous retention, colloid. Symp-
toms: reduced secretion, palpation of kidney. ‘Treatment: Prevention :
arrest conditions, abundance of water, succulent food, parasiticides, opera-
tion on cysts, counteract nephritis.

Unlike hypertrophy, this is constantly the result of a patho- -
logical process. So long asa normal functional activity of the
secreting elements is carried on, such parts must maintain their
size and healthy characters. But with the compression of such
secreting elements (glomeruli and convoluted tubes) by a hyper-
plasia of connective tissue, by pressure from without or from the
damming back of the urine in the pelvis and tubes, the secretory
elements are absorbed and removed, and the final result is a
general atrophy. If such atrophy appears in both kidneys at
once it can only be very partial in extent, as extreme atrophy of
both, with loss of their secretory function, would entail poisoning
and death from the retained urinary products. The comparative
frequency of the disease may be inferred from the reports of the
numbers of specimens found by Barrier and Moussu in old horses
in the dissecting rooms. ‘The latter observed a dozen cases in a
single winter, other examples are recorded by Cadeac (horse),
Soula (swine) and Trasbot (in various animals). .

Causes. ‘The most common source of the condition is the
occurrence of chronic productive inflammation. The new
product in such cases, if not pus, or a growth that rapidly passes
into fatty or granular degeneration, or into gangrene, tends to
form tissue of alow organization, especially fibrous. The re-
sulting increase of the fibrous trabeculz, in undergoing subse-
quent contraction necessarilygcompresses the secretory tissue and
the final result is a visible and, it may be, extreme wasting.
Hence any slowly advancing productive inflammation is liable
to result in absorption and removal of the kidney parenchyma,
and distinct atrophy of the gland.

243

244 Veterinary Medicine.

Again the obstruction of the ureter by a calculus in the
pelvis which falls into the infundibuliform entrance, or a stone
arrested at any part of the duct (or even of the urethra) or by
worms, hydatids, cysts or tumors, throws back on the kidney
the secreted urine, which distending the pelvis and urinifer-
ous tubes leads to direct compression and absorption of the
secretory parenchyma. Direct compression of the kidney by
an adjacent tumor will act in a similar manner. Retention cysts
by their gradual increase and augmenting pressure cause ab-
sorption of the gland tissue.

The blocking of individual uriniferous tubules by minute
calculi, which is so often seen in cattle, kept on dry feeding
in winter, is a cause of partial nephritis, and absorption, as
noted by Roll.

A somewhat rare cause of atrophy is the diminution of the
blood supply by arteritis and embolism of the renal artery, or
by pressure of tumors on that vessel. Arteritis and blocking
suggests at once the possible agency of the strongylus (sclero-
stoma) armatusin the horse. Trasbot records a striking instance
of compression of the renal artery and kidney by an enormous
sublumbar melanoma. This occurred in an aged horse and
led to atrophy.

Lesions. Incases due to productive inflammation with sclerosis
of the kidney, the firmness, pallor and bloodlessness of the
organ is a marked feature. When incised it is found to be
composed mainly of fibrous tissue, while the glomeruli and
tubuli have to a large extent disappeared.

If there has been simple lack of circulation the kidney becomes
flaccid, pale and small in size. The secretory elements (glomer-
uli and uriniferous tubes) are first absorbed, leaving the fibrous
network, which tends to shrink and form a hard resistant mass.
In extreme cases there may be absolutely no glandular tissue left,
and the dense shrunken mass represents only the hyperplasia of
the original fibrous network. In the different successive stages
of this process the glomeruli and tubules become flattened, the
epithelial cells become granular, or contain colloid casts and re-
frangent elements like oil globules and finally ey are repre-
sented by a small mass of fibrous material.

Of all the atrophies caused by the pressure of tumors perhaps

Atrophy of the Kidney. 245

that caused by cysts is the most characteristic. ‘There may be a
single cyst or they may be multiple ; they may range in size from
a pea to the size of the two fists the total size exceeding that of
the normal kidney. In all such cases the cysts project visibly
from.the surface of the organ. They vary according to their
origin and nature. Congenital cysts are said to have resulted
from distention by retained urine of the capsule of the glomerulus.
The arterial tuft is atrophied and flattened against the wall.
Serous cysts with clear contents are found in the old. Urinous
cysts again form by distension of the tubules that are obstructed
by cysts or minute calculi. Colloid cysts are found in certain
forms of nephritis formed by the dilatation of the capsule of the
glomerulus or of the uriniferous tubules. The liquid often con-
tains leucin, tyrosin and cholesterine. In all such cases the walls
of the cyst become thick, and the glandular parenchyma is com-
pressed leading to progressive degeneration and atrophy.

Symptoms of atrophy of the kidney are necessarily those of
suppression of urine, with, in certain cases, the passage of casts of
the uriniferous tubes and of crystals of salts. There are, how-
ever, no absolutely pathognomonic symptoms. When the kidney
can be reached through the flaccid walls of a comparatively empty
abdomen, or through the rectum, its hard, shrunken condition
may assist in diagnosis.

Treatment is not successful in advanced cases. Prevention is
to be sought by obviating or treating the conditions on which the
atrophy depends. Nephritis must be treated on general principles.
Calculi must be avoided by a liberal supply of water, by soiling,
or by pasturage. Strongylus parasitism should be dealt with by
destroying the parent worms in the bowels, and by securing pure
drinking water free from their eggs and embryos. Cysts, and .
tumors are only amenable to surgical measures and not often
open even to these.

FATTY DEGENERATION OF THE KIDNEY : STEATO-
SIS OF THE KIDNEY.

Causes : age, overfeeding, idleness, atony, retention of urine. Lesions:
kidney enlarged, pale yellow, capsule loose, cut surface glistening unctuous,
oil globules in scrapings, granules soluble in ether. Symptoms: in idle,
overfed, obese, improved meat producing breeds, closely confined, starchy
or saccharine food, fatty granules in urine, finally, dropsies,anzemia, debility,
sluggishness. Prognosis unfavorable in advanced stages. Treatment :
butcher, restricted regimen, open air exercise, nitrogenous diet, crossing,
diuretic food or drugs, oil of turpentine, balsam copiaba. Palliation only.

Fatty degeneration of the kidneys is by no means unknown in
the domestic animals. It has been observed in dogs and cats
(Rogers, Goubaux, Vulpain, Trasbot). In dogs it has been
erroneously set down as a characteristic lesion of rabies. Like-
fatty degeneration of other organs, it is also met with in old
and over-fed individuals of meat producing breeds of animals, in
which the tendency to early maturity and rapid and excessive
fattening has been fostered from generation to generation. In
man small, granular, fatty kidney is a common result of chronic
parenchymatous nephritis, and often coincides with fatty liver.
Chronic poisoning by arsenic or phosphorus is another cause, as
it is of fatty degeneration in other organs.

Vulpain has attributed it to a lack of active exertion and of
general tone, associated with excessive amylaceous feeding,
sluggish, shallow breathing and tardy elimination. Goubaux
and Trashot attach great importance to the compulsory retention
of urine in house dogs, cats and horses. The damming back
of the urine in the convoluted tubes and glomeruli, temporarily
arrests secretion, and the inactive and compressed cells tend
at once to granular and fatty degeneration.

Lesions. ‘The gland is sensibly increased in size, and pale
yellowish or straw yellow. ‘The capsule is easily detached from
the cortical substance, contrary to what is the case in chronic pro-
ductive inflammation. The cortical substance is increased in
thickness, and pale, the pallor being largely in ratio with the du-
ration or extent of the fatty degeneration. The cut surface may
be glistening and unctuous to the touch. It is softer than usual,

246

Fatty Degeneration of the Kidney. 247

rather friable, and if scraped, furnishes a serous or grayish pulp
in which oil globules are prominent features, together with gran-
ular epithelium and free granules that dissolve readily in ether.
Tubules are varicose and unequal at different parts. The medul-
lary portion has undergone little change. It may be paler at cer-
tain points, with some shrinking of its substance and increase of
firmness. °

Symptoms. Asa rule the disease occurs in pampered, overfed
and obese animals, and in those of the improved breeds which
have great power of digestion, assimilation and fattening. It is
especially to be looked for after close confinement on full, stimu-

‘lating, amylaceous diet. Symptoms are not usually recognized
during life. There is, however, a lessening of the urinary secre-
tion, and, as the disease advances, albuminuria. When ex-
amined microscopically this is found to contain characteristic ele-
ments, such as granular epithelial cells, the granules soluble in
ether, oil globules, and at times crystals of cholesterine (Beale).
A diagnosis based on the mere presence of oil globules may, how-
ever, be fallacious, as these may be present in animals that have
just been heavily fed on oleaginous food, and again the oil used
to smear the catheter may float in the urine and prove misleading.
Under such circumstances vaseline or glycerine may be substi-
tuted on the catheter. Scriba induced fatty urine by injecting
fat or oil emulsion into the blood, and Chabrie by ligating the
large intestine. Trasbot says- that cylindroid casts may be
present. As in other grave kidney affections, dropsies supervene
as the disease advances. ‘These may show in the limbs, in the
abdomen, or in other serous cavities. A steadily advancing
anzemia with pallor of the mucosze, listlessness, weakness, debility
and sluggishness are to be noted.

Prognosis. Since the disease is rarely diagnosed until it has
reached an advanced stage, it usually progresses steadily to a fatal
issue. If, however, it can be detected at an earlier stage, it may
be palliated, or held in abeyance, for a length of time varying
with the extent of the lesions. As it is very largely a disease of
meat producing animals and as the subject is at first in a condition
of marked obesity, it can usually be turned over to the butcher

without material loss.
Treatment. If the disease has resulted from the inbred pro-

248 Veterinary Medicine.

pensity to fattening, the family that shows the disposition must
be subjected to a somewhat different regimen, open air exercise
must take the place of confinement in warm stables, a rather bare
pasturage is valuable for herbivora, and restricted diet in which
the oleaginous, saccharine, and amylaceous constituents do not
predominate, is strongly indicated. Crossing with a strange male
having many of the desirable qualities of the herd, but which is
more vigorous may be resorted to. When the secretion of urine
becomes scanty an abundance of pure water, or a diet of succu-
lent grass or roots or ensilage or even small doses of alkaline
diuretics may be resorted to. Any source of arsenic or phosphorus
poisoning should be cut off, and as an antidote to phosphorus,
oil of turpentine may be given in small doses. This agent may,
indeed, replace the alkalies as a diuretic, bringing in an element
of tone for the mucosa which is not to be despised. Or balsam of
copiaba or buchu leaves may be substituted.

When the small white kidney (granular, fatty) results from
chronic nephritis, the prevention and treatment would be as for
that disease. Little hope is to be entertained of entire restoration
to health.

AMYLOID KIDNEY. LARDACEOUS OR WAXY KIDNEY.

This condition of the kidney has been found in the ox (Ger-
lach) and dog (Rabe, etc. ). There are commonly similar degenera-
tive lesions in the liver, pancreas, intestines and other organs. It is
usually a concomitant of some chronic wasting disease (chronic
nephritis, tuberculosis, etc.).

Morbid Anatomy. The kidney is usually enlarged, pale and on
section waxy or glistening. Soaked in dilute compound tincture
of iodine it shows spots of a walnut or mahogany brown color.
The glomeruli are well marked and show the earlier changes,
later the tubes do so excepting the epithelium. The latter is
swollen, granular, fatty.

Symptoms. ‘There may have been those of chronic nephritis.
Rabe has noticed in dogs dropsy of the limbs, ascites, emaciation,
anorexia, followed by urzemia, coma, weakness, vomiting, and if
the kidney alone was affected great lowering of temperature

Renal Calculus. 249

(35-9° C). With hepatic complication there was greater weak-
ness, giddiness, and higher temperature (39.6°C). Urine is com-
monly increased (in man albuminous) and the casts have shown
the amyloid reaction. They tend to be fatty or finely granular.
Casts may, however, show amyloid reaction when the kidney,
post-mortem, does not (Jaksch’.

Diagnosis from Bright’s disease is often impossible.

Treatment is essentially the same as in chronic nephritis, and is
not hopeful.

Trasbot recommends KI 3 to 7 grs., or tinct of iodine 3 drops
for shepherd dog. Ol. terebinth and alkaline diuretics are also
commended.

RENAL CALCULUS.

This is much more common than is supposed. Small calculi
formed in the tubuli uriniferi of cattle on dry winter feeding often
pass without recognition, and habitually disappear on rich spring
and summer grass.

If retained in the pelvis until increasing size forbids their pas-
sage through the ureter they form pelvic calculi.

If retained in the bladder so that they cannot enter the urethra
they form cystic calculi.

Pelvic calculi or concretions are often (in cattle and swine) mere
scales lying in chalices. They may fill the whole pelvis and send
branching processes into chalices.

Causes. ‘They are attributed to phosphaturia, lithzemia or uric
acid diathesis, oxaluria, etc. In cattle they are associated with dry
feeding and are common on all magnesian limestone soils. ‘There
are usually catarrh of the kidney and the presence of bacterial fer-
ments and colloids (pus, albumen, etc.). (Sharing and Ord.)
Calculi or gravel is preceded by renal catarrh, but this is aggra-
vated by the crystalline deposit. Bacteria act also in producing
NH,O, which instantly precipitates ammonio-magnesian phos-
phate. Retention of urine greatly favors the precipitation.

Symptoms. A white or brownish yellow deposit in the last urine
discharged collects on the floor. Cloudy urine. Passage of crys-
tals—round—or angular. Colic. Lameness in one or both hind

250 Veterinary Medicine.

limbs. Arched back. Sensitive loins. Pain paroxysmal. Attempts
to urinate. Little passed but often with drops of blood. Sudden
relief when the calculus enters the bladder.

Retained in the kidney it may cause no suffering in meat pro-
ducing animals, but in horses it usually causes stiffness or lame-
ness especially under violent effort. Also hematuria ; blood glob-
ules are found in the deposit when placed under the microscope.
There may be sepsis and specially cloudy offensive urine.

Diagnosis ; May be confounded with renal tuberculosis, or sar-
coma or oxaluria. Examine for bacillus, small cells, or oxalate of
lime or oxalic acid.

Prophylaxis. In the early stages give succulent, watery food,
ensilage, roots, potatoes, spring grass, and water ad libitum.

Treatment. Salt may tempt the patient todrink. Nitro-muri-
atic acid is a solvent and antiseptic. Or alkalies with salicylate
of soda. Alsotonics. Quiet pain by morphia and other anodynes.
Use piperazine.

These failing, an operation on the kidney may be considered.

HYDRO-NEPHROSIS.

A common result of calculus or other obstruction, causing in-
creasing pressure of urine in the pelvis and absorption of the
parenchyma, and finally leaving a mere urinous sac.

RENAL TUMORS.

1. Non-malignant: Fibroma.
Lipoma.
Angioma.
Adenoma,
; Papilloma.
2. Malignant: Sarcoma.
Carcinoma.

RENAL PARASITES.

Echinococcus: Herbivora, Omnivora.
Bilharzia Crassa: Egyptian cattle.
Strongylus Gigas: Horse, ox, dog, man.
(Cysticercus Tenuicollis: Ruminants: Pig).
Tenia serrata :'Dog. Pelvis.

Injuries of the Ureters. 251

Sclerostoma equinum : (renal arteries, kidney pelvis), soliped.
Stephanurus dentatus : Pig, (pus cavities).

Trichosoma plicata: (Urinary bladder), dog.

T. felis : (Cat), bladder.

Indetermined embryos: Kidney, dog; small tumors.
Cytodites nudus: Kidneys ; hens.

Céstrus, (Gast. Hemorrhoidalis) : Bladder walls ; horse.
Mucorimyces : Kidneys ; dog.

Coccidia : Kidney, Horse, dog, goose.

INJURIES OF THE URETERS.

Lesions by bullets, arrows, stabs, bruises and lacerations in parturition,
treads, wheels, tumors, ulcers, calculi, tubercles, parasites. Course.
Pathology : transverse division may cause hydronephrosis, or septic peri-
tonitis. Symptoms: uncertain, traumatism, bloody urine, arched, stiff,
tender loins, straining, recumbency, groaning in turning or rising, rectal
palpation of distended ureter, of ascitic fluid, pitting on pressure of loin,
flank or groin, liquid drawn through a cannula is urinous, urine still dis-
charged by normal channel. Crystals in urine, worm ova, Treatment:
compresses, fomentations, sinapisms, anodynes, balsams, antispasmodics,
extraction of calculus, lateral implantation of urethra.

From their deep and protected position it might be plausibly
concluded that the ureters were secure against every kind of
traumatism. ‘This however, is not the case, since in both man
and animals they have been known to have been injured by
bullet wounds, arrow wounds, and stab wounds of various kinds.
In distokia with laceration of the womb, vagina or bladder the
ureter is liable to be injured. By blows and kicks it may even
be ruptured or torn across, and also by sudden and severe me-
chanical compression of the abdomen as when run over by a
wagon or trodden on by a horse, ox, or other large animal. Tu-
mors of various kinds may grow in, or press upon the ureter,
ulcers with thick indurated margins or base may obstruct the
passage, or calculi, or worms may block and give rise to over-
distension and even rupture. Kopp describes obstruction by
multiple calculi with saccular dilation in front, close to the kidney
in a cow. Cadiot records cases of thickening of the mucosa by

252 Veterinary Medicine.

numerous cysts assmallashempseed. Intra-abdominal tumors of
the spermatic cord have been known to block the passage. Again
tubercles have formed on the urethra, and polypi on the trig-
onum vesice have blocked the ureter and produced all the evil
consequences of calculus, parasites, etc.

Course.. The progress of the disease will vary greatly according
to the nature of the lesion. With complete rupture of the ureter
the urine as a rule escapes into the peritoneal cavity. If the
urine is aseptic this may not lead to serious results and the edges
of the wound cicatrizing, the urine is imprisoned in the ureter
and pelvis of the kidney, and leads to final.atrophy of the kidney
and hydro-nephrosis. When on the other hand infecting matter
escapes with the urine, as in perforating ulcer, tubercle, glanders,
cancer, infective catarrh of the kidneys or ureter, such infection
is brought in contact with the whole peritoneal surface, where
secondary infections follow. In cases associated with penetrating
wounds, wounds resulting from dystokia, calculous or parasitic
obstruction, similar infection is to be dreaded.

The symptoms are by no means clear, unless the injury result
from external traumatism, or when it can be detected by rectal
exploration. ‘There may be blood staining of the urine, stiffness
of the loins, lameness in one hind limb, tenderness of the lumbar
vertebree and of their tranverse processes on pinching, frequent
straining to pass urine, a disposition to remain recumbent, pain
and groaning when rising, or when turned in a narrow circle.
Under rectal examination the blocked ureter may sometimes be
recognized, its cystic end shrunken and empty, up to the seat of
obstruction, and its renal end, from the hypersensitive seat of ob-
struction forward, full, rounded, elasticandfirm. Ifthe ureter has
been ruptured, it may be impossible to distinguish it, but the
presence of urine free in the peritoneum may be detected through
the rectum as it may often be through the abdominal walls.
Sometimes the urine infiltrates the subperitoneal connective tissue,
and forms a pasty swelling on the loin or flank. Ineither casea
hollow needle inserted will draw off a liquid having an urinous
odor. That this urine has escaped in front of the bladder may be
safely inferred from the continued discharge of urine by the
urethra and by the absence of cystic swelling, heat and tender-
ness. If the kidney can be reached by rectal exploration it is

Injuries of the Ureters. 253

felt to be firm and resistant up to the period of rupture of the
ureter.

In case of obstruction by calculus, crystals and even small cal-
culi may be passed in the urine, there is usually a history of
previous attacks of renal colic, and the suffering is manifestly ex-
treme. In case of worms (strongylus gigas) the use of the cen-
trifuge on the urine, may possibly secure in the sediment speci-
mens of itsova. The existence of tumors or tubercles can usually
be clearly made out.

Treatment will be as varied as the lesion. Simple ureteritis
may be met by wet compresses, sinapisms, and internally by bal-
sams and anodynes. Calculi and parasites may be passed with
some aid perhaps from fomentations, antispasmodics, and diluents.
Obstinate cases can only be successfully met by surgical interfer-
ence. The resulting wounds in the ureter, like ruptures, perfor-
ating ulcers and strictures may be met by Van Hook’s ‘‘ lateral
implantation’’ ; the divided cystic end of the ureter is ligatured
and on the cystic side of the ligature a longitudinal incision is
made, large enough to admit the divided extremity of the renal
portion, and through each of the two sides of this last a fine liga-
ture is passed ; these ligatures are then passed into the lumen of
the cystic portion of the ureter through its longitudinal incision
_ and brought outward through its walls ; next the renal end is in-
serted into the incision in the cystic end and the two are firmly
sewed together by the two ligatures. When a small portion of an
ureter must be excised it may sometimes be possible to save a val-
uable animal by such an expedient.

In some cases of rupture into the vagina or uterus an available
fistula may sometimes be established into one of these.

URETERITIS.

From wounds, calculus, parasites, infection, injuries in parturition.
Symptoms: in wounds of ureter. Course: danger of infection of kidney or
bladder. Treatment : for calculus, antispasmodics, anodynes, fomentations ;
for parasites, arsenious acid; for catarrhal conditions, balsams, buchu,
salicylates, etc. Operation. Uretero-vaginal fistula.

This may arise from the passage of a rough calculus, from
wounds of the ureter sustained in kicks and blows or by being run
over by wheels (dogs, cats), it may be due to the blocking of the
tube by a parasite such as strongylus gigas, ecchinococcus, etc., or
it may be the result of extension of an infectious inflammation
backward from the kidney or forward from the bladder. Again
it may be the result of a lesion of the ureter in cases of dystokia.

The symptoms are obscure but there is likely to be frequent
straining and passage of urine, tenderness of the loins, all the.
more significant if confined to one side, lameness or halting on
the corresponding hind limb, and on examination through the
rectum the swollen and tender cord representing the ureter may
be recognizable. In case of calculus or other obstruction the
ureter may be felt to be swollen, elastic and tender back toa
slight nodular, painful, firm swelling at the seat of obstruction.

Course. In all such cases there is always danger of inflamma-
tion (infectious or otherwise) of the kidney with degeneration
and loss of structure and function, the organ being reduced to a
simple urinous cyst (hydronephrosis). In some cases, however,
the obstruction (calculus, parasite) may escape into the bladder
and a recovery follow. Slight infections, too, may improve and
advance to complete convalescence.

Treatment will depend much on the causative factor: Calculus
must be treated by anodyne anti-spasmodics, and fomentations,
and in case of relief by measures calculated to’ prevent its forma-
tion anew : parasites may be treated by arsenious acid, oil of turpen-
tine, and other parasiticides which are secreted by the kidneys:
catarrhal and infected conditions may be met by balsams, buchu,
salicylic acid, piperazine, and even peppers. In case of calculus
which does not give promise of passing, even a surgical opera-
tion may be thought of, especially in the smaller house animals.

254

Acute Catarrhal Cystitis. 255

In rupture of the ureter in dystokia the walls of the womb or
vagina have usually suffered, and a recovery with a uretero-
uterine or uretero-vaginal fistula is not unknown.

ACUTE CATARRHAL CYSTITIS.

Acrid diuretics, by mouth or skin, microbian infection, retention of urine,
urethral calculus, parasites, spasm, enforced suspension of micturition, un-
clean catheter, adjacent infection, chill. Lesions: hyperzemia of mucosa,
thickening, vascular distention, clouding of epithelium, muco-purulent se-
cretion, alkaline fermentation, ammonia liquefaction of cells, erosion.
Symptoms: Slight fever, stiff, straddling gait, urine scanty, cloudy, alka-
line, penis or clitoris semi-erect, smearing of tail or prepuce. Crystals of
triple phosphate. Treatment: Antiseptics, boric or salicylic acid, gum
arabic, astringent, antiseptics, laxatives, flax seed, slippery elm, anodynes,
diluents, piperazine, drainage rest, restricted laxative diet, warmth, avoid
stimulants.

Causes. Cystitis is caused in all animals by irritant diuretics
like cantharides, copaiba, or oil of turpentine given by the mouth
or applied to an extensive cutaneous surface. It is an error, how-
ever, to conclude with Williams that this is the sole cause. The
very existence of calculi virtually implies bacterial infection, and
fermentation. The presence of free ammonia in the urine usually
implies fermentation, and fermentation must be looked upon as
practically synonymous with microbian invasion. ‘That bacteria
may be present without serious injury is undoubted. The pro-
tective power of the healthy mucosa is very great. But whén the
mucosa is weakened, microbes that would otherwise be harmless,
find a ready infection-atrium, and triumph over the weakened
tissues. Hence retention of urine and overdistension of the blad-
der as in urethral calculus, blocking of the urethra by a parasite,
spasm of the sphincter vesicze, compulsory retention as in the
mare in harness, the dog kept indoors, or in railway car on a
long journey, or in mares so travelling, may become the occasion
of cystitis. Even in cases in which no microbe is present at first,
this reaches the bladder by the introduction of an unclean cathe-
ter, or by extension from an uretheritis, vaginitis or metritis, or
even from a peritonitis, or infected urachus. Or the infection

256 ; Veterinary Medicine.

may descend from a suppurating kidney. Another occasion of
microbian invasion is the congestion which attends on exposure
to cold.

Lesions. Wypereemia of the cystic mucosa, with dilation and
tortuous deviations of the larger vessels, thickening of the mem-
brane, and distension and clouding of the epithelial cells, with a
thick covering of tenacious mucus containing epithelial, pus, or
white blood cells. As the disease advances epithelium is desqua-
mated abundantly, and degenerates with production of free nuclei
and pus. Along with these are microbes, usually the bacillus coli
communis, and various cocci. In the fully established disease
there is liable to be alkaline fermentation, and the liberated am-
monia dissolves the epithelial cells, leading to extensive desqua-
mation and raw granulating surfaces, so that the malady tends to
run in a vitiating circle, the alkali dissolving the epithelium and
increasing the microbian development and fermentation, which in
its turn prodnces an increasing quantity of ammonia.

Symptoms. ‘There is slight hyperthermia or none, stiff or strad-
dling gait, frequent passage of urine in small quantities and
cloudy, or straining without passage, the penis or clitoris is semi-
erect, eversion of the lips of the vulva is frequent, and the blad-
der is tender (through prepubian wall, vagina or rectum). Ifa
finger is inserted into the bladder in the mare the thickening of
the walls can often be recognized. The urine often contains pre-
cipitated crystals of ammonio-magnesian phosphate, and even
clots of blood. It has an alkaline reaction even in herbivora.

Treatment. The danger centres around the bacteridian fermen-
tations, and a main object must be to disinfect the bladder. This
will be all the more effectual if the lotions used are of an acid re-
action. Thus boric acid or salicylic acid in 3 per cent. solution,
injected after evacuation of the bladder and repeated a number of
times a day may soon establish a healthy action. If the bladder
is especially irritable a boiled weak solution of gum arabic will
form a suitable medium. Other antiseptics are often used as
creosote (0.5 : 100), carbolic acid (3: 100), chloride of zinc
(3: 100), chlorate of potash (3 : 100), mercuric chloride (1: 5000),
silver nitrate (0.5 : 100), or astringents are often better: PbA,
Zu $ O, tannic acid, ferri chloridi in dilute solution so as not to
cause pain.

Acute Croupous Cystitis. 257

The bowels should be kept open by an occasional saline laxa-
tive, pain moderated by codeine, and abundance of pure water
and a laxative diet enjoined. Linseed tea, and infusions of slip-
pery elm or marsh mallow have long been employed, and by
soothing and relaxing the bowels they act favorably on the
urinary mucosa. Stimulants of the urinary track like buchu,
uva ursi or copaiba in small doses, or antiseptics like creosote,
boric acid, salicylic acid, peperazine, are available in slight cases or
when the acute symptoms have subsided somewhat. With prior
infection of the kidneys, the latter maybe used. Constant drain-
age may be necessary to avoid distension.

Perfect rest is absolutely essential, a restricted laxative diet,
and a careful avoidance of cold, and stimulants.

When urine is retained it should be removed with a thoroughly
asceptic catheter.

In case of blood clots in the bladder, wash out with a boiled
normal salt solution.

ACUTE CROUPOUS CYSTITIS.

This has been found to follow the use of cantharides and other
irritant diuretics, and to follow on certain specific diseases. Its
nature is that of catarrhal inflammation, but with a fibrinous
product or false membrane formed more or less extensively on the
inflamed mucosa.

Symptoms are essentially those of catarrhal cystitis from which
it is distinguished by the presence in the urine of flakes of the
fibrinous membrane.

Treatment is essentially the same as in the catarrhal form, to
which may be added the injection of a solution of 4 grains scale
pepsin to the ounce of sterilized water. The boric acid solution
may be of the strength of 20 per cent. Irrigate two or three
times a day.

17

CHRONIC CATARRHAL CYSTITIS.

This may begin as a mild attack or it may continue after an
acute one. It has been noticed in horse, ox, and dog.

It may be associated with calculi, gravel, papilloma, and bac-
terial invasion especially by the colon bacillus.

Lesions. Mucosa and muscular coat are thickened, corru-
gated, puckered and contracted so that the bladder will not con-
tain more than,a few ouncesofurine. The surface of the mucosa
is discolored, mottled and variegated, slaty blue, brown, red,
purple, or even black, with ulcers, encrustations of triple phos-
phate, and fungoid elevations. In dogs especially, the prostate
is often enlarged.

Symptoms. Frequent urination accomplished with pain, groan-
ing, or whining and it may be with sudden arrest. There may
be incontinence, the urine dribbling almost continuously from
the penis or vulva and in the latter case trickling down the thighs.
The presence of pus and mucus tends to mat the hairs, and a
strong urinous and ammoniacal odor is emitted.

Palpation of the prepubian region often, and of the vagina or
rectum always causes pain and wincing. Temperature is normal.

Urine is albuminous in ratio to the amount of pus, or above
that, and is then suggestive of kidney disease and likely to be
complicated by casts.

Complicating lesions of the womb, vagina, prostate, and kid-
ney are to be carefully looked for, also cystic papilloma.

Prognosis. Recovery though not uncommon is too often but
partial and it is usually desirable to fatten the animal.

Treatment. Rest, moderate laxative diet, pure drinking water
ad libitum, warmth, antiseptic irrigation.

258

CYSTITIS IN THE OX.

Special Symptoms. Beside general disorder there is a dis-
position to decubitus, but with frequent rising to urinate though
the bladder is not filled to repletion. Then the urine is passed
in a slow stream by abdominal contraction, and without pulsating
contractions of the urethra at the ischium which are so marked
in calculus. Cystitis is greatly aggravated by overdistension,
and if the bladder is paralyzed is very liable to go on to rupture.

Galtier considers enzootic heematuria as essentially a heemor-
rhagic cystitis, due to marshy soils, disordered liver, often dis-
tomatosis, and irritation of the urinary organs by the poisons
which the liver was helpless to destroy or eliminate.

The treatment of cystitis in cattle does not differ materially
from that of the horse.

The hemorrhagic form demands prevention by drainage, cul-
tivation and the use of phosphates to the soil.

CYSTITIS IN DOGS.

The special symptoms in dogs are uneasiness and frequent
changes of place. The patient passes urine often in small quan-
tity, and with whines or cries. He walks slowly and stiffly with
the back arched, and compression of the abdomen and especially
of the prepubian region is painful toa marked degree. The tense
elastic bladder may often be distinctly felt through the abdominal
walls. The inflamed bladder is liable to paresis and paralysis
with great overdistension, and aggravation of the general symp-
toms, the eyes sunken, and dullness, stupor and coma betraying
urzemic ‘poisoning. Some claim rupture of the bladder as is so
common in the ox.

In the main, freatment is as for the horse. Rest, warm bath,
or fomentations, catheterism with aseptic catheter, draw urine
through hypodermic nozzle in prepubian region. Antiseptics :
boric or salicylic acid by the mouth andbladder. Laxatives, and

259

260 Veterinary Medicine.

plenty of water are important. Free access to open air where
the animal can urinate, is very essential. In chronic cases,
buchu, copaiba, balsams, or piperazine may be employed. Mus-
tard blister. Electricity. Small doses of belladonna to give tone
to the bladder.

ATONY AND PARALYSIS OF THE BLADDER.

Causes. ‘This comes usually from troubles of innervation.
Paraplegia, dorsal and lumbar fractures with injury to the spinal
cord, brain lesions, hemoglobinuria with effusion pressing on
the cystic plexus, overdistension of the viscus, from cervical
spasm, urethral stricture or calculus or parasite (strongylus gigas),
acute or chronic cystitis. In dogs it may come from obstruction
by enlarged prostate. Polypus blocking the cervix and chronic
disease of the walls of the organ are additional causes.

Symptoms. More or less complete retention of the urine.
The bladder cannot be completely emptied except by powerful
contractions of the abdominal muscles. Habitually it may es-
cape in drops, or in jets at intervals during exercise. Palpation
will show overdistended bladder as a tense, elastic mass. But as
overdistension may occur without paralysis, no case can be cer-
tainly diagnosed without catheterization to show that the urethra
is free.

When the paralysis affects the cervix, the urine escapes con-
tinually and trickles down the insides of the hips in mares, or
from the sheath in males.

Diagnosis demands catheterism and rectal examination.

Complication. Cystitis by retention. Infection by catheter.

Treatment. Corresponds to causes. These corrected, use
aseptic catheter often. After extreme distension empty partially,
or inject a few ounces of borax or boric acid solution. ‘Thus
avoid collapse and inflammation, and secure antisepsis. Give
tone by a course of strychnia, (ergot, belladonna), mustard
blister ; turpentine in small doses. Better electricity, 1 pole in
bladder, 1 on public symphysis. Apply for 5 minutes.

TUMORS OF THE BLADDER.

Recorded cases of sarcoma (Mauri), carcinoma (Cadeac,
Hink, Friedberger), and tuberculosis can be adduced. Papilloma
is perhaps as frequent as any of the above. ‘The author has
treated two cases of papilloma in mares complicated with multiple
small calculi and gravel. Zvreatment is exclusively surgical and
in the mare with the widely dilatable urethra this is sometimes
possible through that channel. In the same animals diagnosis
may be accomplished by introducing the finger into the urethra
and bladder. In other females and males, vaginal or rectal pal-
pation must be resorted to.

VESICAL PARASITES.

Eustrongylus gigas. Dog, horse, man.
Trichosoma plicata. Dog.
G&strus Hemorrhoidalis. Mare.

SPASM OF NECK OF BLADDER.

Spasm of the cervix vesicee has been doubted, save as the re-
sult of local inflammation, yet it not uncommonly takes place in
horses and other animals in connection with irritation attendant
on the retention of urine during work, or in dogs during a period
passed indoors. ‘Trouble and suffering continues, with ineffectual
efforts to micturate, but practically complete relief is secured by
catheterization or by a spontaneous abundant discharge. The
neurosis which leads to it is produced or aggravated at times by
enlarged prostate, or lesions in the urethra. Intense fear may
cause it.

Treatment. Remove cause. Give antispasmodics, valerian,
musk, bromides, chloral hydrate, opium, stramonium, hyoscya-
mus, codeine, etc.; may be given as injections or suppositories.
For the horse spread the litter and soothe by whistle or song. Or
use the catheter and correct any local irritation.

261

RUPTURE AND LACERATION OF THE BLADDER.

This occurs most commonly in oxen from obstruction of the
urethra by a calculus. Similar obstruction in the horse causes
most acute symptoms, calling for immediate relief, and ruptureisa
comparatively rare occurrence. Peuch mentions a case resulting
from a fall during an attack of colic, and with a full bladder. It
has happened during lithotrity, or lithotomy, and even during
parturition. Perforation by parasites has been noted and in one
case by an osseous tumor of the pubic symphysis. In horses a
fatal result is prompt, in cattle from 6 to 48 days.

Treatment surgical.

EVERSION OF THE BLADDER.

This is really invagination into the female urethra and vagina.
It has only been seen in mares, and then by reason of the ex-
treme dilatability of the urethra. A pyriform, red, perhaps ru-
gose tumor shows between the lips of the vulva, during strain-
ing. It is covered by mucosa, and on its upper surface near to
its neck are two small orifices from which urine oozes or comes
in jets during active expulsive efforts. It soon becomes muco-
purulent on the surface, and even excoriated. Urine escaping
continuously trickles down the thighs with much feetor. It
occurs especially during violent expulsive efforts as in parturition
or constipation.

Treatment essentially surgical consists in uniform compression
to expel blood and exudate followed by the pushing of the
fundus through the bladder and urethra. ‘The more recent the
case, the easier is the process. Pressecq claims to have cured an
obstinately recurring case, by cauterizing the urethra up to the
cervix vesicee with a round iron rod an inch in diameter. The
resulting loss of substance, with the neoplasia and constriction
effectually prevented renewed eversion even during parturition.
Other veterinarians have successfully excised the bladder, but
this entailed incontinence and constant offensive soaking of the
thighs with urine.

262

HERNIA OF THE BLADDER.

This is commonly seen in the mammalian female in connection
with rupture of the floor of the vagina during dystokia. It has
also been observed without such lesion in both male and female
dogs and horses, the bladder forming a cystocele of the vagina,
or bulging between the anus and the ischium.

Diagnosis is confirmed by careful palpation through the
rectum. ‘The folding of the bladder backward obstructs the exit
of urine.

Treatment, essentially surgical, might include replacing of the
organ and suturing of the wound, or, in the absence of a wound,
evacuation of the bladder by a hypodermic needle, and replacing
by palpation through the vagina or rectum. Sometimes suture
of the vulva is desirable.

ANOMALIES OF THE BLADDER.

Persistent urachus. Seen in the new-born and mainly in
males. Antiseptic closure is essential after having ascertained
that the urethra is pervious.

Imperforate cervix vesicz. A case reported by Lapotre, in
a calf, had no cervical orifice, and the ureters were blocked
by pea-shaped nodules. .

Recto-vesical fistula. In a calf 13 days old the rectum
opened into the bladder and the feces and urine escaped by a
pervious urachus. (Kaufmann and Blanc).

URETHRAL ANOMALIES.

Imperforations. Inthe new born male, foal, lamb, etc. Usually
at the outer end, and it may be for some distance back. In one
case the sheath was firmly adherent on the wall of the abdomen,
thus shutting off all exit of urine. If the canal is absent only at

263 ‘

264 Veterinary Medicine.

the orifice or for a short distance, the urethra beyond this can be
felt full of liquid and fluctuating. The patient being properly
fixed a fine trochar is pushed from the end of the penis into the
blind end of the urethra, which will be ascertained by the over-
coming of resistance. The trochar is now withdrawn aud the
urine flows through the cannula. A catheter or sound is now tied
in the passage to maintain it pervious until cicatrization shall
have taken place.

fTypospadias. Short urethra opening backward on the lower
surface of the penis. Considered irremediable.

Epispadias. Urethra opening on the upper surface of the penis.
Much more rare.

ACUTE URETHRITIS. CATARRH OF THE URETHRA.

This occurs in all genera of domestic animals, and may be
either acute or chronic. It is most common in the entire males,
not only because of infections sustained in copulation, but be-
cause frequent erection exposes the opening of the urethra to in-
jury and inflammation, and to the entrance of pathogenic germs.

Symptoms. Pruritus of the penis, and difficulty and pain in
urination and straining are frequent, but a single small jet may be
all that is passed at a time. The. papilla on the end of the
penis is red and angry and somewhat swollen. Later a few
drops of muco-purulent fluid may be pressed from’ the orifice.
In the bull, dog and boar this oozes from the retracted penis into
the sheath, so that a collection is found in that canal, and the
mucosa becomes infected causing a balanitis.

The infection may be conveyed from male to female and vice
versa. Dr. Horand of Lyons even found that the muco-purulent
discharge of gonorrhoea in man caused an urethral catarrh in the
dog, which however did not persist for any great length of time.

Diagnosis is based on frequent and painful urination in jets,
tenderness of the urethra under palpation or catheterization, red-
ness and swelling round the urethral orifice, and the oozing of
pus. Inthe absence of any external injury one should always
ascertain if cystitis is present.

Prognosis is favorable under appropriate treatment. Spon-
taneous recovery will usually occur early.

‘

Wounds of the Urethra. 265

Treatment. Dilute the urine. Give pure water to drink at
will, or flaxseed gruel, or gum or barley water. Alkaline car-
bonates. In the early stage foment and use injection of potassium
permanganate (2 grs. to 1 oz.). Later may be used more
astringent agents (boric acid 1 : 100, zinc sulphate 1 : 100, lead
acetate I : 100, potass chlorate 3: 100. In the presence of great
pain cocaine muriate 2: 100). There is danger of stricture from
the stronger astringents or caustics in the early stages before sup-
puration. To complete the cure give copiaba, buchu, resin, or
essence of turpentine.

WOUNDS OF THE URETHRA.

Acual wounds occur in surgical operations, or accidentally as
by shafts, poles, forks, hooks, bites, etc., or from calculus or a
catheter forced into a false route. An arrested or slowly moving
calculus has been known to induce several perforating ulcers
causing infiltration of urine and infecting germs into the connec-
tive tissue. This determines rapidly increasing cedematous fluctu-
ating tumors. Gangrene and septic intoxication are common re-
sults, especially in cattle.

Longitudinal wounds keep more open and heal more readily
than transverse wounds, probably because the circular muscular
fibres in contracting, pull the edges apart and counteract stricture,
the breach being filled up by granulations. The perineal wound
in lithotomy will heal thus in 20 days, while that made in ampu-
tation of the penis is exceedingly liable to circular contraction
and stricture or occlusion.

Contusions of the perineum, may cause lacerations of the urethra
and heemorrhages, with bloody discharge or sanguineous swelling.

Treatment, Willvary. Calculi must be diagnosed and removed.
Breach of the walls of the urethra may necessitate frequent
catheterization or, better, the wearing of a catheter. Escape of
urine into the connective tissue should be met by a counter open-
ing in the skin to drain the part and allow free antisepsis. Simi-
lar resorts are required for urinary infiltration, accompanied by
antiseptic injection subcutem. Abscesses must be located, punc-
tured with trochar and cannula, evacuated and injected anti-

septically.

FOREIGN BODIES IN THE URETHRA.

Apart from calculi, may be found straws, glumes, chaff and
catheters and even stones and small bodies which must have been
introduced deliberately. An irritation corresponding to the offend-
ing mass and its seat, ensues, and must be treated by soothing
and anti-phlogistic measures while the offending body must be
found and completely extracted.

STRICTURE OF THE URETHRA.

This may be suspected when in spite of much straining the
urine is habitually passed in a very fine ‘stream, which has be-
come finer and finer for a length of time, without complete arrest
asin calculus. The introduction of a catheter will confirm the
diagnosis and show the exact seat of the stricture.

It is determined by irritation caused by calculus, urethritis,
ulcer, wounds, etc., which tend to the formation of a cicatrix en-
circling and narrowing the canal. One efficient cause is the in-
jection of strong astringent or slight caustic solutions in the early
stages of urethritis.

Treatment is by dilation, by bougies pointed and gradually
thickening, or simply by an elastic staff which at first passes with
some force and is replaced by a larger one as the urethra stretches
under daily use.

Catheterization. In connection with diseases of the bladder
and urethra the passing of the catheter is a most important opera-
tion which requires considerable skill on the part of the operator.
A short statement of the method to be adopted for each of the
domestic animals will therefore be in place.

Catheterization in the male Soliped..The catheter, a hollow,
gum elastic tube, must be proportioned to the size of the animal,
but for the average adult horse about 3% feet in length and %
inch in thickness. To give it the requisite solidity and resist-
ance it is usually furnished with a stilet of whalebone or cane.

The operation is performed with the animal standing, in quiet.

266

Stricture of the Urethra. 267

animals without any restraint, but in the more sensitive or
restive, with one fore foot held up; or with both hind feet in
hobbles furnished with ropes passing between the fore limbs and
tied over the neck in front of the withers; or finally with a
twitch on the nose.

The rectum is emptied, and with the oiled or soapy hand the
penis is found and slowly withdrawn from the sheath by steady
traction. This is usually easy, though in certain cases, with a
short penis and specially strong retractors, it will seriously tax
the operator’s skill and address. In a specially obstinate case a
hypodermic injection of morphine may be resorted to.

If the horse is down, as in paraplegia or heemoglobinzemia, he
may lie on his right side while the operator stoops over him from
the loins ; or his feet may be drawn together by hobbles, and the
subject turned on his back, the operator placing himself as before
on the left side.

The catheter must have been previously cleansed and disin-
fected outside and in. A mercuric chloride solution 1:2000, or
boric acid 1:50 or permanganate of potash 1:50 may be em-
ployed. Then it must be smeared, preferably with vaseline
but, in case of necessity, with sweet oil, glycerine, borated lard,
or even castile soap.

The penis being withdrawn from the sheath, the catheter con-
taining its stilet is introduced into the urethra and pushed on
slowly and carefully until its point can be felt over the ischiatic
arch. The stilet is now drawn out a few inches and the point of
the catheter is bent forward over theischium by the finger. The.
stilet is further drawn out and the catheter can easily be
pressed on into the bladder. If any difficulty is experienced it
may be guided by the hand introduced into the rectum.

In a number of cases, I found that the catheter entered a
dilated seminal vesicle and failed to evacuate the bladder. This
untoward occurrence must be rectified by the aid of*the hand in
the rectum. Usually the penetration of the bladder is signalized
by the overcoming of resistance, and when the stilet is withdrawn
the urine flows in a steady stream. If it fails to flow, a slight
compression of the fundus of the bladder by the hand engaged in
the rectum will start the stream.

‘She catheter should be withdrawn slowly and carefully.

268 Veterinary Medicine.

Catheterization in the Bovine Male. Most veterinarians
suppose that this is impossible, owing to the narrowness of the
sheath interfering with the extraction of the penis, and the S
shaped curve in the penis preventing the introduction of the
catheter. Both obstacles can, however, be overcome in many
cases. The bull may be tempted to protrude the penis by the
presentation of a cow in heat, or in bull or ox the bulging
anterior part of the organ may be protruded by careful manipula-
tion through the sheath. Then the free extension of the penis ,
can be made to efface the S shaped curve. The catheter must be
small, not much over a line in caliber, and a metal stilet is em-
ployed. ‘The animal may have to be placed under restraint, and
the same antiseptic precautions are demanded as in the horse.

Catheterization in the Ram and Wether. ‘These must be
dealt with like the bull, the only additional difficulty being in the
vermiform appendix. This issmalland sinuous but the longitudi-
nal opening on its lower surface is favorable to the introduction
of the catheter.

Catheterization in the Dog. ‘The fact that the urethra
traverses the groove on the lower aspect of the bone of the penis,
is held to prove an obstacle to the catheter, yet the introduction
of the later is in no sense difficult. Small or moderately sized
dogs, may be held upright, the body resting on the rump and the
pelvis inclined forward, which will favor the spontaneous pro-
trusion of the penis. Or it may be pressed out by manipulation
through the sheath. The catheter 2% ds. to 1 line in diameter
may be 1% to 2 feet in length according to the size of theanimal.
It should be used aseptic.

Catheterization of the Mare. Nothing can be easier than
this operation in the mare. The shortness and dilatability of the
urethra, and the accessibility of its external orifice in the center
of the floor of the vulva, 4 or 5 inches in front of the lower commis-
sure, favors the introduction of the catheter. The latter may bea
footinlength, perfectly straight and it may be constructed of silver
or some other metal, which may be readily boiled and rendered
aseptic. Inthe absence of a catheter the germ free nozzle of a rectal
syringe may be used, or two fingers may be passed through the
urethra and parted from each other so as to allow the exit of the
urine.

Acute Prostatitis and Hyperemia of the Prostate. 269

Catheterization of the Cow and Heifer. The operation is
often very difficult in the cow, by reason of the small size and un-
dilatability of the urethra, and by the presence of two blind ducts
(canals of Goértner) above and to the two sides of the urethral
opening. The thin rigid upper margin of the orifice projects
down over it in a valvular manner so that the catheter will almost
always find its way into one of the blind sacs. By introducing
the tip of the index finger beneath the valvular fold and into the
opening of the canal, the catheter may be directed beneath it and
into the bladder. An apparatus consisting of a series of ribs of
spring wire arranged in the form of a funnel and converging at

, one end to a point has been devised to insert into the urethral
orifice, and guide the catheter which is passed through it. A
metallic catheter cut off obliquely at its point will enter easily.

Catheterization of the Bitch. The operation is rendered
difficult by the narrowness of the passage, and the puckers and
folds of the vaginal mucosa which serve to hide the urethral ori-
fice. A small catheter like that used on the male is used or a
short metallic catheter may be substituted. By directing this
forward exactly in the median line of the floor of the vulva,
with gentle pressure downward it may be made to enter the
urethra. In case'of special difficulty a bivalve speculum may be
resorted to, to efface the mucous folds and reveal the orifice.

ACUTE PROSTATITIS AND HYPERAMIA OF THE
PROSTATE.

Causes : In dogs, house life, overfeeding, compulsory retention of urine,
and feeces, constipation, proctitis (rectitis), piles, calculi, strangury, uric
acid, urethral ulceration or stricture, rude catheterization, chill, generative
excitement to excess, secondary abscess orinfection. Forms. Lesions: fol-
licular, interstitial, circumscribed and diffuse suppuration. Symptoms:
frequent straining urination, rectal palpation, incontinence of urine, cos-
tiveness, tender perineum, dullness, recumbency, fever, pus in urine, col-
lapse of swelling, fistula. Diagnosis. Prognosis: grave. Tyeatment : lax-
atives, mercurials, salines, leeches, acid laxative, non-stimulating, camphor,
bromides, ergot, witch hazel, opium, belladonna, enemata of cold water, or
ice suppository, catheterization, perineal incision, anti-septics.

Causes. This is most commonly seen in dogs, in which it may

270 Veterinary Medicine.

depend on house life with overfeeding on stimulating, spiced,
albuminous food, compulsory restraint of urination and defeca-
tion in obedience to the demands of cleanliness, distended bladder,
and rectum, constipation, proctitis, piles, and other sources of
local irritation. In all animals its origin is favored by the forma-
tion or arrest of calculi in the prostate, the pelvic urethra or
even the bladder ; by drug strangury from cantharides or other
irritant diuretic ; by excess of urea, uric acid or other irritant in
the urine; by infection extending from the urethra or bladder ;
by ulceration or stricture of the urethra ; by rude or incautious
catheterization, or injection ; by exposure to cold ; and by local
infection in pyeemia and other general zymotic disorders. Most
of these conditions conduce to local excitement and hyperzemia,
which from adjacent organs, are sympathetically transferred to
the prostate. The same is true of frequent, and intense genera-
tive excitement which according to Lafosse and Cadiot is a com-
mon cause of prostatitis in stud horses. Again the abscess of
strangles may become localized in the prostate, or the nodule of
glanders, or tlie tubercle of tuberculosis (cattle, pigs, dogs).
Cadiot suggests that in animals, divested of the tail, external
injuries to the perineum may extend by continuity to the prostate,
as happens to man from horseback or bicycle riding. He adduces
no cases however. The habit of masturbation acquired by cer-
tain males may also be adduced theoretically as both cause and
consequence of prostatitis but future observation must show how
frequently this really operates.

Forms. Lesions. According to the nature of the lesions the
affection has been divided into different forms: 1st, Follicular or
Parenchymatous ; 2d, Diffuse or Interstitial ; 3d, Circum-
scribed Prostatic Abscess ; 4th, Multiple Miliary Abscesses.

Follicular Prostatitis implicates primarily the follicles and
gland ducts and finally the entire gland tissue. It is usually
associated with and doubtless often proves an extension from an
adjacent infective urethritis, and tends, in persistent cases, to go
on to interstitial inflammation and abscess, or hypertrophy. This
is characterized by more or less swelling of the prostate, with
increased vascularity of its mucosa and the oozing from its open-
ings and gland ducts under pressure, of a thick, yellow, gelatinoid
fluid containing pus and granular epithelial cells and sometimes
strize of blood.

Acute Prostatitis and Hyperemia of the Prostate. 271

Diffuse (Interstitial) Prostatitis shows, in addition to the
general swelling and muco-purulent discharge, a considerable
exudate into the interstitial tissue, with increaged tension and
resistance of its substance. It is associated during life with more
fever and constitutional disturbance than the simple catarrhal or
follicular form.

In Circumscribed Prostatic Abscess we find, in addition to
the general hypereemia and swelling, a much more prominent
local swelling, the seat of intense inflammation, at first firm and
resistant and later softer and fluctuating in the center, which is
filled with pus. This may have its origin in the follicular form,
the pus becoming shut up ina follicle and gradually increasing
until it bursts into the urethra, the bladder, the rectum, the peri-
toneum, or pelvic fascia and perineum. In other cases it becomes
complicated by pyzemia and secondary abscesses.

Miliary Abscesses may be comparatively few in number or
generally diffused through the prostate, and are often the result
of a pre-existing general infection.

Symptoms. As the disease usually begins as a local infection
the first symptoms are, as a rule, unattended by fever, which,
however, appears in two or three days as the local lesions in-
crease. The urine may be passed frequently in small amounts,
or there may be frequent straining without passage of urine, the
pressure of the swollen prostate, with or without spasms of the
sphincter vescicze, causing retention. It is no uncommon thing
to find the last urine passed of a milky or glairy character and,
coagula moulded in the prostatic canals may at times be found.
The presence of spermatic crystals, fusiform, with very pointed
extremities, and precipitated on the addition of ammonium phos-
phate, is characteristic of prostatic fluid. (Furbringer). In
other cases there is incontinence, the urine dribbling away. in-
voluntarily as the animal walks, and especially if anything occurs
to excite him. Micturition may be painless or attended by acute
suffering, which causes a sudden arrest of the flow. Defecation
is attended with difficulty and more or less pain, and obstinate
constipation is likely to set in. The animal is dull, spiritless and
seeks to lie undisturbed. Pressure on the perineum is painful
and exercise aggravates the symptoms. Rectal examination by
the hand or finger according to the size of the animal, reveals

272 Veterinary Medicine.

the enlarged, tender prostate lying on the cervix vesice. ‘This
swelling may be unilateral but most commonly it is bilateral or
general. Wheh fever sets in with a temperature of 102°-104°,
thirst, anorexia and weakness or stiffness in the hind parts may
be noticed. In case of abscess, the urine may be perfectly clear
until it bursts into the urethra or bladder when there is an
abundant flow of pus,:and rectal examination shows that the
swelling and tension have notably diminished. Should it burst
into the rectum, the pus shows in the feeces. Reinemann records
a case in a bull with dysuria, cedema of the sheath and a swel-
ling like the fist in the perineum, containing pus, and which
communicated with the prostate and urethra. With the rupture
of the abscess there is a marked amelioration of the symptoms.

Not infrequently the affection subsides into the chronic form
and the abscess, having a restricted channel for evacuation, re-
mains as a suppurating cavity.

Diagnosis. The enlargement and tenderness of the prostate
as felt on rectal examination is pathognomonic. If the body of
the urine is clear there is further corroboration, as in cystitis it
is more or less turbid and flocculent or even bloodstained. Mic-
turition is likely to be much more frequent in cystitis than in
prostatitis. Catheterization is much more painful when the
catheter passes the prostate in prostatitis than in cystitis.

Prognosis is always grave. Some cases recover completely,
while others run on to a fatal termination, and still others merge
into the chronic form. Cases that are complicated by abscess are
always to be dreaded, as chronic suppuration, or pelvic or perito-
neal infection, or pyzemia, or septic poisoning is liable to super-
vene. As the disease is more common in the old so it is liable to
prove more severe and redoubtable.

Treatment, In acute cases active derivation toward the bowels.
is desirable. A mercurial purge (calomel—horse or bull 1 to 2 drs;
dog, 2 to 5 grs.) may be followed a few hours later by salines
(sodium sulphate—horse or bull 1 lb. ; dog 1 oz.). Sodium sul-
phate or magnesium sulphate may also be given with glycerine as
anenema. Great benefit may often be obtained from the applica-
tion of leeches on the perineum or around the anus. ‘The diet
must be restricted and non-stimulating, mainly of amylaceous
materials, and with the water, flaxseed tea may be liberally

Chronic Prostatitis. 273

mixed. When the suffering is severe it may be met by camphor,
camphor bromide, ergot, hamamelis, gelsemium or potassium
bromide, given by the mouthorrectum. With violent strangury,
opium, belladonna or hyoscyamus may be used. Some cases may
be relieved by the use of enemata of cold water, or pieces of ice
in the rectum. In retention of urine, careful catheterization is
imperative, the hand or finger in the rectum being employed to
guide the point of the catheter under the prostate.

In case of abscess an opening by the side of the anus is prefer-
able to one by the urinary passages or rectum, and will obviate the
danger of rupture into the peritoneum. A pasty or fluctuating
swelling inthe perineum should be incised until the pus flows.
A tense elastic fluctuating prostate may be transfixed by a can-
nula and trochar from the side of the anus, guided by the hand
or finger in the rectum. When the pus has been evacuated
a drainage tube may be inserted through the cannula and
left in place when the latter is removed so as to allow
free drainage at all times and frequent antiseptic injections.
Punctures and even incisions have been made from the rectum,
but they make badly infected wounds, and a rupture into the
urethra, determines infection on that side, without any possibility
of any effective antiseptic injection or perfect drainage. As in-
jections may be used permanganate of potash 1 : 10000, or boric
acid, a saturated solution. Poisonous agents must be eschewed
or used with the greatest circumspection.

CHRONIC PROSTATITIS.

Causes. Follows acute. Same causes less potent. Lesions: as in acute,
or sclerosis, and abscess. Symptoms: delayed urination, last glairy or
purulent, constipation, defecation followed by urethral discharge, little
genital ardor, rectal palpation, tenderness of prostate to hand or catheter,
atony of hind limbs. Treatment: open air life, idle, milk or succulent diet,
saline laxatives or enemata, avoid generative excitement, castrate, check
masturbation, iodine, camphor, antiseptic irrigations,

Causes. ‘The acute disease often subsides leaving an indolent
chronic inflammation of the organ. Apart from this, the causes
18

274 Veterinary Medicine.

are essentially those of the acute, but acting with lessened force
or ona less susceptible system. Thus indoor life and overfeeding,
with constipation and urine of a high density, calculus, irritant
diuretics, the frequent incautious use of the catheter, infection
from the catheter or otherwise, intense and frequent generative
excitement, and exposure to cold are all occasional factors. Old
age jis a common concurrent cause.

Lesions. As inthe acute form these indicate three successive,
independent or concurrent forms, follicular, interstitial and sup-
purative.

With the distinctly follicular form the gland is usually en-
larged and of a deep red color, but soft and friable, and when
compressed exudes from its follicles and gland ducts a whitish
muco-purulent glairy liquid. With the interstitial changes,
which are often an advance on the follicular, the organ may be
enlarged or shrunken, but the connective tissue has undergone a
thickening and sclerosis which renders the mass firm and re-
sistant, and which may have extended to the tissues in the im-
mediate vicinity. In the suppurative form or stage, foci of
suppuration are found throughout the gland substance, bulging
out on its surface and even encroaching on surrounding tissues.

Symptoms. ‘These are by no means obtrusive. There may be
some delay in the discharge when the animal attempts to urinate,
and the last drops of the urine, white and purulent or glairy, may
be passed with evident pain. There is a tendency to constipa-
tion with painful straining to defecate. Compression of the
prostate during defecation presses out its muco-purulent contents
so that there is a greater urethral discharge following this act
than at other times. This is also more abundant from the com-
pression of the abdomen when the animal is lying down. ‘This
discharge is easily distinguished from semen by the absence or
almost complete absence of spermatozoa and the abundance of
spermatic crystals, precipitated by ammonia phosphate. In the
earlier stages there may be undue generative excitement, erec-
tions, and even seminal discharge, with or without the move-
ments of masturbation but in advanced cases genital ardor is
usually defective or there may be practical impotence. Con-
clusive evidence is obtained by rectal exploration, when the en-
larged, or irregularly shaped and tender prostate can be easily

Chronic Prostatitis. 275

recognized. If a sterile catheter is passed, the pain caused as
it touches the prostate is significant.

In the dog the affection may last for years, and tends to
advancing atony of the hind limbs. A temporary arrest of the
affection is often misleading, though the urine may be clear and
normally discharged, yet manipulation may show a gradually
advancing abscess, and when this bursts, usually into the urethra,
all the symptoms become aggravated and cystitis, urethritis
and general infection are to be dreaded.

Treatment. 'This is far from satisfactory yet in certain purely
follicular or catarrhal cases-it may prove successful. An open
air life, without exertion, and a milk and farina diet are de-
sirable, yet any tendency to costiveness must be obviated by
saline laxatives and enemata. ‘The avoidance of generative ex-
citement must be secured, not only by restraining stud animals
from service, but by keeping them well apart from all females
of the same species. Even castration may be sometimes re-
sorted to with advantage. Stallions given to masturbation must
be restrained by net or otherwise. Any disease of the rectum,
anus, urethra or bladder should be corrected, and undue ex-
posure to cold prevented. Lafosse advises to slaughter butcher
animals for food. Hertwig recommends iodine ointment on the
anus and perineum of affected dogs. It must be borne in mind
that the affection is maintained by infective microbes yet it is
difficult to reach and deal with these thoroughly and effectively.

As an anaphrodisiac may be given camphor, or camphor bro-
mide, ergot or potassium bromide, along with the mild stimulating
antiseptic eucalyptol, piperazine or copaiba. But the irrigation of
the urethra, bladder and as far as possible the prostate with such
antiseptic solutions as potassium permanganate (1 : 10000) or
silver nitrate (0.5 to 1 : 100) or zinc chloride (1 : 100) is desir-
able. ‘These should be injected into the urethra so as to reach the
bladder, the contents of which they will render antiseptic and thus
protect the organ against the transported microbes of the prostate.
In man iodoform, europhen, and ichthyol are made into a bougie
with gum, palm butter or other soluble liquefiable agent and in-
serted in the urethra as far as the prostatic part. Similar agents
are used as suppositories or enemata. Hertwig’s iodine ointment
on the perineum may be advantageously replaced by sinapisms.

HYPERTROPHY OF THE PROSTATE.

In old dogs. Causes: age, overfeeding on albuminoids, rectal impaction.
or irritation, calculus, cystitis, urethritis, productive inflammation, trophic
derangement when function declines. Lesions: hypertrophy general or
partial, hard or soft, condensed or with sacs of pus, red or pale _Infective
cystitis. Calculi. Symptoms: straining before urine comes, small or weak
stream, sudden check, last part purulent or mucous, incontinence, triple
phosphate, ammoniacal odor, crystals and dark color imply calculus. Diag-
nosis: by rectal exploration, and catheterization. Treatment ; palliative,
moderate, farinaceous, laxative diet, warmth, correct contiguous troubles
iodine, castration, extirpation of prostate.

This has been seen almost exclusively in old dogs, among the
domestic animals.

Causes. Age and good living, more particularly on highly
albuminous food, may be adduced as the most prominent. Per-
haps even more important are continued irritation in adjacent
organs such as the rectum, bladder and urethra. It is the old,
pampered dog that above all suffers from atonic, overloaded

rectum, proctitis, piles, calculus, cystitis, and stricture, and the
constant local pelvic congestion caused by one or other of these
tends to a hyperplasia of the prostate. Again atheroma which is
especially a disease of the aged is regarded as a cause of both
cystitis and prostatic hypertrophy. Chronic inflammation in the
prostate has been claimed as a factor, but contested on the ground
that inflammation never increases normal growth though it may
cause degeneration. The exudate of inflammation, tends, how-
ever, on its temporary arrest, to undergo organization, and such
organization inclines to assume the structure which is normally
built up by the adjacent trophic cells. The products of inflam-
mation may, therefore, well contribute to hypertrophy, and above
all to the increase of the simpler tissue represented by the fibrous
framework of the gland. The congestion attendant on excessive
venery has also been incriminated, and this too has been denied
on the ground that the hypertrophy is not found in the young
animals and men in which the generative ardor is greatest and
most frequently aroused and gratified. ‘Thompson’s idea is that
the prostate, like the ovaries and womb, is especially prone to
276

Llypertrophy of the Prostate. 277

morbid growths and developments at the time when in advancing
age, the normal generative functions are undergoing a rapid
decline. The two conditions may well be recognized without con-
sidering them as mutually excluding each other as causative
factors.

Lesions. The enlargement is usually, general, but it may pre-
dominate in the right, left or median lobe, the latter as a rule
exercising greater compression of the urethra so that this is often
marked in the worst cases. The hyperplasia may feel firm and
resistant or it may be more or less soft from sacs of muco-puru-
lent fluid imprisoned by the obstruction of the outlet canals.
On the surface and on section the general appearance of the
gland is pale, bloodless and uniformly solid. This comes from
the great hypertrophy of the fibro-muscular stroma which has in
many cases compressed the parenchymatous or secreting struc-
ture so as to cause its atrophy. The presence of calculi (mainly
phosphatic) in the follicles is not uncommon.

The complication of infective cystitis is frequent, the congestion,
redness, ecchymosis, maculation, puckering and thickening of
the mucosa, the granular degeneration and desquamation of the
epithelium, the exposure of a raw vascular surface, the dis-
coloration of the urine by mucus, pus and blood, and the forma-
tion of ammonia and other products of decomposition, becoming
marked phenomena. Vesical calculus is not uncommon, the
slowness of the exit current of the urine retarded by the en-
larged prostate, tending to prevent its impaction in the orifice
and thus minimizing one of the most prominent symptoms.

Symptoms. Among the earliest symptoms, is some modifica-
tion in the act of micturition. Straining a few seconds before
urine comes, retention, incontinence and dribbling, discharge in
a small or weak stream, and sudden arrest of the flow and the
last few drops may contain muco-pus showing abundance of sper-
matic crystals, on the addition of ammonia phosphate. Impac-
tion of the rectum tends to occur sooner or latter, the animal
making little effort to unload the viscus, and the overdistended
organ becoming more and more atonic, congested and catarrhal
and reacting injuriously on the urinary organs. Incontinence
may be especially marked during sleep, the sphincter being suf-
ficiently controlled by volition during waking hours. Retention

‘

278 Veterinary Medicine.

may be at first temporary from excitement and later more con-
tinuous by reason of the greater compression of the neck by the:
enlarged and indurated prostate. With the advance of the dis-
ease the urine shows abundance of triple phosphates, and be-
comes ammoniacal and feetid. A dark or bloody color of the dis-
charge and the presence.of crystals suggest calculus.

An accurate diagnosis can only be had by rectal examination.
The great enlargement of the prostate, in the absence of heat
and tenderness is characteristic. Enlargement is usually uni-
form, though it may be concentrated on the right, left or central
lobe. The passage of the catheter may be obstructed, but is- not
specially painful at the prostatic region as in prostatitis. From
vesical calculus it is distinguished by the fixity of the swelling
on the neck of the bladder as contrasted with the mobility of the
stone inside that half-filled organ. From stricture it is differen-
tiated by the fact that the obstruction offered to the catheter and
the swelling of the prostate exactly correspond in position, that
the stream is lessened in force rather than simply reduced in size,
and that the history of the case shows no antecedent cause for
stricture.

Treatment. This has been considered as mainly palliative.
Special care of the general health and above all of the diet which
should be moderate, farinaceous and laxative, protection against
cold and wet, the correcting of any coexisting trouble of the
urinary or generative organs, and the removal from all sources of
generative excitement are important elements. Occasional small
doses of Epsom or Glauber salts in draught or enema obviate
rectal hyperemia. Ergot, potassium iodide internally, and iodine
or mercurial ointment to the perineum have had little good effect.
Moller claims to have secured improvement from the injection
into the prostate at intervals of fourteen days, of a solution of two
parts each of tincture of iodine and iodide of potassium, and sixty
parts of distilled water. A small hypodermic syringe is used and
the injection is made through the rectum directly into the sub-
stance of the prostate. Glass has adopted the recent surgical
alternative of castration, with the result of marked relief from the
active symptoms in a number of cases, but with a more rapid
advance through emaciation and marasmus to death in three or
four weeks in others. We would suggest a careful antiseptic

Tuberculosis of the Prostate. 279

castration in such cases, to obviate any added trouble from ab-
sorbed toxins or sepsis.

For the human subject, Lydston strongly advocates removal of
the enlarged prostate by surgical means in strong, vigorous sub-
jects, with healthy bladder and kidneys. The difficulty of such
an operation in the dog is greatly enhanced by the relatively
greater length of the pubio-ischiatic symphysis, and the lessened
diameter of the pelvic cavity. Yet with the comparative
immunity of .the dog from suppuration, and the hopelessness of
the case without such radical measure, and with the rigid applica-
tion of an antiseptic technic, the operation would appear to be
fully justified. It would be contra-indicated in all advanced cases,
in which the prostate was the seat of active suppuration with dis-
charge into the urethra, in cases complicated by urethritis, cystitis
or nephritis, in cases in which there is marked prostration from
sepsis or absorbed toxins, and generally in old, worn out and
cachectic animals.

Short of this, in cases complicated by cystitis, antiseptics by
the stomach and as injections into the bladder are desirable.
Eucalyptol in doses of ten minims four times a day, or piper-
azin 15 grs., or beta naphthol, guaicol, or phenol have been
used in man. As injections mercuric chloride I : 20,000; boric
acid, saturated solution ; or carbolic acid .5 : 100 (Lydston) may
be used warm several times a day. -

TUBERCULOSIS OF THE PROSTATE.

This is‘a common seat of tubercle in generalized tuberculosis
in cattle, and may give rise to the same urinary troubles as
chronic prostatitis or hypertrophy of the organ. Ina remarkable
case recorded by Frauenholz the tuberculous prostate of an ox
weighed 10% Ibs. and had contracted adhesions to surrounding
pelvic organs. Section of the mass showed numerous centres of
extensive caseous degeneration. In such cases the generalized
tuberculosis is the important fact and the prostatic disease is only
an unusually intractable complication. If less generalized, the
implication of the testicle or epididymus is strongly suggestive,
and examination of the urine may detect the tubercle bacillus, or
the tuberculin test may develop the characteristic febrile reaction.

CANCER OF THE PROSTATE.

Lafosse records as colloid cancer a case of diseased prostate in
an ox, in which the mass approximated to the size of the human
head, and was made up of numerous cavities the largest not
over 11% inch in diameter, and all intercommunicating, and con-
taining a gluey, or gelatinoid liquid with numerous small round
cells and afew multinucleated giant cells. No evidence is given
of the implication of even the adjoining lymph glands, so that
the case was probably only an enlarged cystic prostate.

Fournier records a case in a three year old horse, which on
necropsy showed a ruptured bladder, general peritonitis, and an
enlarged prostate, involving Cowper’s glands. Nocard identified
its cancerous nature by microscopic examination. Yet there is
not a word of the implication of adjacent lymph glands.

Goubaux says prostatic cancer is common in dogs.

PROSTATIC CYSTS.

These are not at all uncommon as a complication of hyper-
trophy of the prostate, fhe ducts having become obstructed and
the follicles indefinitely distended. The case described by

_ Lafosse as cancer of the prostate of a bull is strongly suggestive
of such retention cysts.

CALCULUS OF THE PROSTATE.

Two forms of calculi have been found in the prostate in do-
mestic animals: 1st, small, round, angular or branched bodies
made up in concentric layers and formed of organic nitrogenous
bodies: and 2nd, genuine calculi of calcium phosphate or am-
monia magnesian phosphate. These may cause pressure on the
parenchymatous tissue and atrophy, but in the lower animals
they are seldom the direct cause of prominent morbid symptoms.

280

Diseases of the Female Generative Organs. 281

They must, however, be recognized as one of the causes of

chronic irritation that contribute to prostatic inflammation and
hypertrophy.

DISEASES OF THE FEMALE GENERATIVE ORGANS.
MALPOSITION OF OVARY AND WOMB. HERNIA OF THE OVARIES.

Inguinal or crural hernia of ovary or womb. Bitch. Long uterine borns,
loose broad ligaments ; Sow ; Ewe ; Cow. Other openings. Symptoms : not
marked : strangulation: inflammation : abscess. Gravid hernial uterus.
Treatment : reduction : surgical means: Czesarian section.

The most common displacement of the ovary in the lower ani-
mals is through the inguinal or crural arch. It is most frequent
in the bitch doubtless for the reason that the horns of the womb
are long, and widely separated from each other, and in any case
‘of inguinal or crural hernia, ‘or of undue dilatation of the openings
they are liable to pass through. A relaxation of the broad lig-
aments is another condition of such displacement. ‘The laxity of
these ligaments in the normal condition in the sow favors ovarian
hernia, and Dupont found the ovaries in the perineal region in
five sows examined. Laux found the condition in ewes, and
Miiller in cows, one ovary lying on each side of the mamme.
With relaxation of the uterine ligaments the hernia might occur
in any female mammal, and not only through the orifices named,
but through any normal or adventitious opening in the abdominal
walls.

Symptoms. In the bitch the hernia is often overlooked although
an examination of the inguinal region will reveal the presence of a
small nodule and vermiform body which may usually be returned
into the abdominal cavity. In some cases it becomes strangulated
by the gradual contraction of the neck of the hernial sac, followed
by swelling, heat and tenderness of the hernial mass, which may
go on to abscess formation. In exceptional cases impregnation
occurs with the womb in this position and the steady nodular in-
crease of the mass, and finally the automatic movements of the
contained foetuses become very characteristic.

Treatment consists in passing the womb and ovary back into
the abdomen, and if adherent or incarcerated, in exposing and

282 Veterinary Medicine.

releasing, and if necessary extirpating them. In case of advanccd
pregnancy with the gravid womb on the inner side of the thigh,
a modified Czesarian operation is required without the attendant
danger of laying the peritoneal cavity directly open. Inflamma-
tion and abscess must be treated on general principles.

UNDEVELOPED OVARIES. ABSENCE OF OVARIES.

The absence of ovaries has been often noticed in twin heifers,
and most commonly associated with deficiency or absence of the
womb, and even at the anterior part of the vagina. The condi-
tion is especially common, though not constant as some have
supposed, when the other twin is a male. Such females are
known as free martins and fail to breed. Even when the ovaries
are present in such twins they remain undeveloped, and are no
larger than a bean or hazel nut. “These usually have a firm,
fibrous structure, and though there may be interspaces filled with
a transparent fluid, no true Graafian follicles are formed. In
birds, the left ovary only is developed and physiologically active.
The absence of ovary has been noted also in the ewe, and less
frequently in the mare and other species, and appears to be more
common in twins than in single pregnancy. In cattle only has
the influence of the male on the female twin of the same preg-
nancy been specially noted.

It has been noted that females with ovaries undeveloped, tend
to show many male characters, in head, horns, and neck in cattle,
in plumage in birds, and in voice in both.

ATROPHY OF OVARIES.

This is observed as a physiological result of having passed the
breeding age, and may also take place from disease and degene-
ration of the organ. The fibrous stroma is usually increased and
the cell elements reduced, yet in some cases, a cystic develop-
ment occurs, giving the appearance of hypertrophy, while the
ovarian parenchyma has actually been diminished.

SUPERNUMERARY OVARIES.

Extra ovaries have been found in different cases in the human
female, the additional organ being furnished with a fallopian
tube, and in some instances an extra uterine horn. No facts are
at hand concerning the lower animals, but the occurrence of ges-
tation and the birth of a single puppy a year after careful castra-
tion, would seem to suggest that the condition occurs in the bitch.
There is no embryological reason why the lower animals should
not at times show this deviation from the normal.

IRRITABLE OVARY. NEURALGIA OF THE OVARY.

This has been noticed most commonly in the mare, which
from a quiet, docile animal, has become very ticklish, especially
in the region of the flank, kicking on the slightest touch, or
even when approached and showing an amount of nervous ap-
prehension, that may render her useless, for work. ‘The ovaries
are usually found to be enlarged, diseased and very sensitive.
CEstrum may be in some cases constant and excessive and in
others entirely suspended. Such cases are difficult or dangerous
to shoe. In one case recorded by Thierry, handling of the flank
promptly induced an epileptic attack. Cows with nympho-mania
(bullers) are often victims of this condition. The only remedy
is castration, which is best performed by the vagina. ‘The shorter
the period of the irritability the more perfect is the cure. In
some old standing cases the vicious habit may have become so
fixed, that it is continued in spite of the operation.

283

HAMORRHAGE ON THE OVARY.

Mare and Cow: genital excitement, mechanical injury, diseased ovary in
unimpregnated, ovulation with bleeding, falls, slings. Lesions: old de-
generations, productive inflammation, varicosities, aneurisms, torpid vessels,
blood staining, clots, follicular or not, ruptures into peritoneum, amount,
microbes usually absent. Symptoms : obscure, arched, stiff loins, colics,
recumbency, large tender ovary. Shivering, fever, anorexia, anzemia, sur-
face coldness, unsteadiness, blood from vulva, liquid in abdomen fluctuates,
Treatment : cold, ice, snow, on loins, cold acid drinks, tannin, iron chloride,
matico, gelatine subcutem, atropin, ergotin, viburnum, derivatives, castra-
tion.

This has been seen in the mare and cow especially in connec-
tion with genetic excitement and mechanical injuries, and more
especially pre-existing disease of the ovary. Trasbot notes that
it has always been inthe absence of pregnancy, a fact which we
can easily explain on the ground that most active diseases of the
ovary render the animal barren. Gestation like castration, calms
the genetic instincts, and prevents the recurrence of cestrum with
its vascular excitement, general and ovarian, which characterizes
the unimpregnated condition. The normal rupture of the
Graafian follicle and escape of the ovum is attended by some
effusion of blood which passes through a series of changes pre-
paratory to absorption. A more extensive bleeding, at the time
of cestrum or otherwise, into a follicle or intrafollicular, and with
or without rupture of the albugenic tunic constitutes the morbid
hemorrhage. Among mechanical causes may be named violent
exertion, falls, and suspension‘in slings.

Lesions. Some cases in mares and cows show old standing
lesions, to which the extravasation is secondary: a productive
inflammation of the ovarian stroma; varicosity of the ovarian
veins ; aneurism of the utero-ovarian artery; the presence of
emboli or thrombi. In the area of the effusion there is a general
turgescence of the vessels, and blood staining of the stroma. Or
there are distinct blood clots in the follicles or between them, a
few lines or an inch in diameter, buried in the depth of the
organ, or standing out in rounded swellings on its surface, and
sometimes with a rupture two or three inches in length, and the

284

Hemorrhage on the Ovary. 285

escape of blood into the peritoneal cavity. This may be sufficient
merely to stain the peritoneal fluid, or it may amount to one or
two bucketfuls as in cases recorded by Barrow and Palat. In
the absence of rupture the effused blood may completely surround
the ovary, or may accumulate in one or several of its distended
follicles. The effused blood is rarely septic, being usually free
from microbes, and it may remain fluid in the peritoneum, or
coagulate in the ovary. The enlarged follicle may contain a
dark red fluid, in which floats a solid clot, varying in color from
dark red to light yellow, according to age.

Symptoms. ‘These vary greatly with the extent of the lesion,
and are always somewhat obscure. With slight interstitial or
intra-follicular effusion, there may be only some general disorder,
with, it may be, arching and stiffness of the loins, colicy pains,
a desire for recumbency, and enlargement and tenderness of the
ovary on rectal examination. In more severe cases as noticed
by Cordonnier, Saucour and Palat in mares, by Laponsée in the
ass, and Renault in the cow, there were shivering, hyperthermia,
respiratory and cardiac acceleration, congested mucosz, dull
colicy pains, and anorexia, followed by indications of anzemia,
small, weak, rapid pulse, pale mucosze, coldness of ears and legs
(in cows, of muzzle and horns), violent heart action, indisposition
or inability to rise, unsteadiness on the limbs when up, and in
some cases the escape of blood from the vulva. By rectal ex-
amination the enlarged, tender, doughy ovary may be character-
istic and the fluctuation of liquid in the peritoneal cavity, which
may also be recognized by manipulation of the flank.

Treatment, 'This should be directed toward checking the hem-
orrhage : Cold water or ice, on loins or flank : injections of cold
water : cold water or acids or astringents by the mouth : tannic
acid : iron chloride : matico: gelatine : atropine, ergotin. By way
of quieting ovarian excitement, viburnum prunifolium or opium
may be tried. Sterilized solutions of gelatine may be given sub-
cutem. Mustard or ammonia may be applied to limbs or flank.
In case of survival, castration will be indicated.

INFLAMMATION OF THE OVARIES. OOPHORITIS.
PERIOOPHORITIS.

Mares, cows, sows, etc. Causes: traumas, cestrum, parturition, leucor-
rhoea, pus infection, strangles. dourine, glanders, abortion, tuberculosis,
chill, poisons. Lesions: Ovary enlarged unequally, red, congested, exu-
date, extravasations, fibroid, caseated, purulent, abscess single or multiple,
indurations, cretefactions, cysts, blocking of Fallopian tube, adhesions.
Symptoms: mare: genital erethism, soiling of vulva and tail, colics, tender
loins and mammez: fever, dullness, emaciation, decubitus, paraplegia,
swollen tender ovary: cow bellows, paws. Sterility, anzemia, pyzemia.
Treatment : Cold to croup, mustard, anodynes to vagina, calmatives anti-
septics. Castration. :

This has been frequently seen in mares, cows and sows, but it
may occur in any of the female mammals or even in birds.

Causes. The condition has been ascribed to blows on the flanks,
pressure on the abdomen and the congestion of the ovary which
attends on frequent cestrum in the absence of the physiological
quiet which comes from conception. Ina large proportion of the
cases, however, the attack has followed on parturition, abortion,
a preéxisting leucorrhcea or metritis, or a suppurating process
in some other part of the body. ‘These cases therefore, must be
looked upon as secondary and infective, the microbes having been
transferred from the womb, along the Fallopian tubes, or through
lymph vessels, or peritoneal cavity, or finally through the circu-
lating blood. In mares strangles, abortion, leucorrhoea, dourine
and glanders, and in cows and sows abortion, metritis, leucor-
rheea, and tuberculosis, may prove the starting point of the in-
fection.

Sudden chills when heated, perspiring or exhausted and es-
pecially exposure in inclement weather just before or after par-
turition, have been regarded as effective causes, and doubtless
these lower vitality and power of resistance, but back of these we
must look for infection coming from the parturient womb.

Bivort records an extensive epizootic of odphoritis in sows kept
on waste ground which had been used for herding swine years
before. He attributes the trouble to poisonous plants, without,

286 :

Inflammation of the Ovaries. Oophoritis. Periosphoritis. 287

however, attempting to identify them, and the probability is even
more strongly in favor of infection left over from the former
herds.

Lesions. ‘The inflamed ovary is swollen slightly, or to a great
size, in mare or cow like the fist or even an infants’ head. ‘The
swelling, however, is unequal throughout, and the surface may
bulge in rounded masses at different points. In the early stages
the organ is firm, elastic, red and on the cut surface bleeding,
with here and there a distended follicle with bloody or gelatinoid
liquid contents. The exudate into the fibrous stroma may be-
come coagulated, and later may be organized into fibrous sub-
stance giving a hard resistant sensation to the finger (sclerosis).
In some cases this may become partly cartilaginous. In other
cases the distended follicles may have their contents coagulated
and transformed into a caseous mass, while much of the stroma
has become liquefied and absorbed. When suppuration has set
in, the gland is softened at this point, the parenchyma giving
way before the pus. The pus may be in multiple sacs, as if
formed in the Graafian vesicles, or it may be in one undivided
abscess. In the ovary of a cow, Eléouet counted no less than
sixty-three separate abscesses. In cases complicated by ovarian
glanders, tuberculosis or actinomycosis, the gross, microscopic,
and mycotic characters of the lesions will afford the means of
diagnosis.

In chronic forms indurations, cretefactions, cystic degenera-
tions, caseations, and sclerosis may be met with.

Lesions in adjacent structures are common, such as thickening
and stenosis of the Fallopian tube; congestion, thickening and
puckering of the mucosa in the adjacent part of the womb ; peri-
tonitis ; adhesions of the ovary.to the abdominal walls or to an
adjacent organ.

Symptoms. Mare. In many cases the early phenomena are

_ those of excessive genital erethism : the animal is restless, fever-
ish, whinnies to attract other horses, snuffs the males on their
approach, contracts the vulvar muscles constantly, exposing the
congested mucosa and clitoris, and ejecting a glairy liquid which
soils the tail, hips, thighs and hocks. She strains frequently,
passing small jets of high colored turbid urine, and rubs the tail
and hips against available objects, twisting and breaking the hair

288 Veterinary Medicine.

and abrading and excoriating the surface. The croup may be
alternately drooped and raised and the tail switched. These phe-
nomena are not abated by copulation, nor by time, like ordinary
heats, but will last for one or more weeks when a new set of
symptoms set in. Meanwhile dull colicy pains cause restless
movements, arched back, frequent moving from place to place, |
crouching by partial bending of the limbs, twisting of the hind
parts from side to side. The loins are tender to pressure, and the
middle of the flank to pressure or percussion. The mammary
glands are usually hot, swollen and tender. The genital erethism
‘may last from four to seven days. ‘Then it subsides, with coinci-
dent improvement of the general symptoms and a recovery ensues.
Relapses are to be expected sooner or later.

In fatal cases the erethism subsides, but fever, dullness and
emaciation continue, the case becomes aggravated at intervals,
weakness and exhaustion increase, decubitus may become con-
stant or paralysis ensue. ‘The patient diesin marasmus in one to
three months.

In some the genital erethism is absent from the first. There is
dullness, prostration, anorexia, fever, ‘hurried breathing, small
rapid pulse, colicy pains, tender abdomen, difficult defecation,
coated dung, a glairy (perhaps reddish or fcetid) discharge from
the vulva, hot, tumid, tender mamme, arched and sensitive loins,
and stiffness of the hind limbs.

In all cases alike a rectal examination detects the ovary swollen
and exceedingly tender.

Cow. ‘The same general symptoms appear with characteristic
modifications. Restlessness, bellowing, pawing, inappetence,
arched, tender loins, swollen vulva with discharge, shiny and
perhaps foetid but without contractions, abdomen pendent and
flanks hollow and tender, udder turgid, hot and painful, move-
ments of the hind limbs stiff, halting, straddling. There is
greater tendency to salacious movements of the croup. The
diagnostic feature is palpation of the ovary through the rectum.

In chronic cases more or less of the above symptoms are shown
in a greatly mitigated form, but oftentimes there are long inter-
vals of apparent health. Palpation through the rectum is the
final test in this as in the more acute cases.

Ovarian Cysts. 289

Prognosis. ‘This is very uncertain. Unless complete recovery
takes place in a few weeks, the inevitable consequence is sterility,
or death from hemorrhage, peritonitis, pyeemia, marasmus.

Treatment. In acute cases Trasbot strongly urges bleeding in
the larger races and leeching of the flanks in the smaller. Mus-
tard plasters to the loins and abdomen, and cold or damp appli-
cations to the croup are in order. Vaginal and rectal injections
of mucilaginous liquids, containing anodynes and antiseptics are
indicated. Opium, belladonna, hyoscyamus, chloral, borax, ace-
tate of aluminium may serve as examples. If needful to quiet
the excitement, morphia, atropia or hyoscyamin may be given
subcutem. Or the anodynes may be administered by the mouth.
Asa last resort, and by far the most radical treatment, castration
may be performed. With small ovaries this is best done through
the vagina in the larger animals, while with large and adherent
ones the flank operation isimperative. If the peritoneum is in-
volved, careful antisepsis of the cavity is desirable. In case of
adhesions the operation may be risky, but if successful it will
obviate secondary infections and establish a permanent cure.
Complications must be treated according to their nature.

OVARIAN CYSTS.

Mare, cow, ewe, sow, bitch, hen. Forms Histogenesis. Dilated vesicles,
egg tubes, blood obstruction. Lesions: Ovary large, smooth, lobulated,
vascular, size, connective tissue, epithelium, liquid contents. Abscess.
Symptoms: impaired portal circulation, muco-enteritis, piles, intestinal
torpor, impaction, constriction, obstruction, congestions, inflammation.
Urinary disorder. Strangulation. Sterility. Abortion. Dystokia. Indigestion.
Anorexia. Colic. Genitalerethism. Straining. Altered Urine. Peritonitis.
Septic infection, Collapse. Rectal palpation, enlarged, sensitive ovary.
Treatment: Castration. Tapping cyst. Rupturing cyst by compression.

These have been met with in all races of domestic animals,
mare, cow, ewe, sow, bitch and hen. They vary greatly in
their characters, being unilocular, multilocular, rounded or
lobulated, serous, albuminous, colloid, or hzemorrhagic, strictly
ovarian or parovarian (in broad ligaments), in one ovary or in
both.

19

290 Veterinary Medicine.

Fiistogenesis. ‘The source of these cysts has been much debated.
Many have held with Spencer Wells that they have their origin
in dilated Graafian vesicles, and the discovery of an ovum in
the contents, by Rokitansky and Ritchie showed at least that
this follicle had formed part of the cyst. On the other hand
Foster, Rivolta, Klebs, Malassez and others, constantly failed
to find ova or other distinct elements of the Graafian follicles,
but did not find epithelial elements, and note that the cysts are at
an early stage connected with the surface of the ovary like the
egg tubes. These embryonic tubules of Pflueger are therefore
held to be the starting point for the cysts, which because of their
mixed epithelial as well as liquid contents, seem allied to adenoma.
From observations on the ovarian cysts of the lower animals
Galtier, attaches great importance to vascular obstructions. Ob-
struction by pressure or otherwise led to hzemorrhages and
transudation of blood, and the cavities formed in this way be-
came the seats of epithelial growth, and liquid effusion. The
blood remained for a time as distinct clots, and was later indi-
cated by the pigmentation of the walls of the cyst.

Lesions. ‘The enlarged ovary may be uniformly rounded and
smooth, or it may be marked by irregular bosses, giving it a
lobulated appearance. It is very vascular, and is often covered
by a thickening of peritoneum. When multiple they are usually
closely adherent and may even be included one within another.
The individual cysts may be of the most varied sizes. T’he cystic
ovary has at times reached enormous dimensions : in the mare 46
Ibs. (Bouley, Rivolta, Thiernesse) : in the cow 250 lbs. (Rey-
nolds, Meyer): in the ewe 7 lbs. (Willis): in the sow 7 lbs.
(Reyer): in the bitch 15 lbs. (Bovett). The walls of the cyst are
formed of connective tissue more or less perfectly organized, ar-
ranged it may be in several superposed layers (Galtier) and lined
or not by epithelial cells (cylindroid, nucleated, or of various
forms). ‘They may be reddened by hemorrhages or pigmented
from former blood extravasations. The liquid contents may be
clear and watery, white, straw yellow, or of a deeper yellow,
brown or red. Among other constituents there are alkaline
chlorides and sulphates, albumen in solution or flakes, mucin,
fibrine, fatty granulesand cholesterinecystals. Insome instances
they contain pus cells (chronic abscess).

Ovarian Cysts. 291

Symptoms. Small, tardily growing cysts may cause no ap-
preciable symptoms. The larger ones or those that increase
rapidly are liable to cause disorders of circulation, innervation
and digestion. ‘The mere pressure of a considerable cystic ovary
may interfere with portal circulation so as to entail muco-enteri-
tis, rectal congestion, piles, or intestinal torpor or impaction.
Adhesions of the diseased ovary to adjacent intestinal viscera,
tend to produce constrictions, obstructions and local congestions
or inflammation. In adhesions to the womb or bladder, ureter
or kidney, the symptoms will indicate disorder of these respective
parts. The weight of the enlarged ovary causing extension of
its ligamentous connections will allow of its winding around a
loop of intestine and producing strangulation. In those unusual
cases in which pregnancy occurs it may interfere with its com-
pletion, causing abortion or, failing in this, with parturition,
by becoming imbedded in the pelvis. In the line of innervation,
disorder is especially common in the digestive organs, anorexia,
nausea, impaired rumination, and colicy pains resulting. Again,
in many subjects the genesic instinct is stimulated, the patient is
more or less constantly in heat, cows become dudlers, and mares
switchers, they cannot be impregnated, and under the continuous
excitement undergo rapid emaciation. There is often urinary
disturbance, frequent straining with the passage of a small quan-
tity only of turbid or glairy liquid, colored, it may be, by blood,
or foetid. ‘The colics are liable to be dull and slight, the patient
moving uneasily, switching the tail, moving the weight from one
hind foot to the other, pawing, looking at the flank, but sel-
dom lying down or rolling. In other cases, with adhesions,
impactions, obstructions, and congestions, all the violent motions
of the most intense spasmodic colic may be shown. Where there
has been rupture of the obstructed bowel, these symptoms may
merge into those of peritonitis, septic infection, or collapse. When
with these symptoms of intestinal disorder, there are tender loins
and flank, abdominal plenitude and tension, genital excitement,
frequent straining to pass urine, the discharge of a glairy or foetid
liquid, and when all these symptoms have increased slowly for
weeks or months in a female, the ovaries may be suspected and a
rectal examination should be made. Usually the outline of the
womb can be made out with the enlarged and irregularly shaped

292 : Veterinary Medicine.

ovary anteriorly and adherent to it through one of the broad lig-
aments ; it may be sensitive to touch, tense, or even fluctuating.
Difficulty may be encountered when the enlarged ovary is so
great as to fill the whole region, or when adherent to or wound
round the rectum, thus hindering the advance of the hand or the
movement of the gut, or when it has become pediculated and dis-
placed to a distant part of the abdomen. Even the obstructed
and distended intestine, may prevent a satisfactory diagnosis.
Yet in the great majority of cases rectal examination gives con-
clusive results.

Treatment. Medicinal measures are useless: surgical alone
are of any avail. Castration is the natural resort, and in all re-
cent cases, uncomplicated by adhesions, is to be preferred. In
the large females it may often be performed through the vagina,
but if the ovary is very large the flank operation becomes imper-
ative. Sometimes the evacuation through a cannula of the con-
tents of one or more large cysts will so reduce the mass as to
allow of the safer vaginal operation.

A less radical measure is the evacuation of the cyst with can-
nula and trochar and the injection of tincture of iodine. With a
hand in the rectum the ovary may be held against the abdominal
wall to facilitate the operation. The results, however, are not
satisfactory, for, although re-accumulation of the liquid is delayed,
itis not entirely prevented. Moreover, when the cysts are multiple,
the punctures also must be numerous, or remain ineffective.
Nor is the operation unattended by danger as deaths often occur
from resulting inflammation, infection, or iodine poisoning.

Zannger, in 1860, introduced the method of rupturing the
cyst without incision, and met with considerable success. With
the hand in the rectum the cystic ovary is pressed against the
wall of the pelvis or abdomen, until the attenuated wall of the
cyst gives way, the fluid is left in the abdominal cavity, to be ab-
sorbed and many animals will afterward become pregnant. Ina
large proportion of cases in which the symptoms are marked,
the walls of the cyst are sufficiently attenuated to allow of rup-
ture by pressure, and, if the escaping contents are free from in-
fecting microbes, no immediate harm comes to the peritoneum.
It should be avoided in case of abscess, following perhaps on
a shivering fit and constitutional febrile reaction, and when there

Dermoid Cysts of the Ovary. Pilous Cysts. 293

is a foetid discharge from the vulva, suggesting microbian infec-
tion likely to dangerously infect the serosa. In appropriate
cases it is a resort of very great value, in restoring to use ani-
mals that are especially valuable for their progeny and which be-
come utterly useless when rendered barren. According to different
observers an average of 70 per cent. can be restored to usefulness
in this way. Friedberger and Fréhner claim 90 per cent. Some
febrile reaction may be noted for twenty-four hours demanding
rest, restricted, cooling, laxative food and sometimes laxatives
and anodynes.

DERMOID CYSTS OF THE OVARY. PILOUS CYSTS.

Closed cutaneous sacs, with hair and sebum. Causes: enclosure of der-
moid tissue in embryo: aborted ovum: virgin gestation. Symptoms.
Treatment : Castration.

These are much less common than are simple cysts. ‘They are
closed sacs, lined by. a tissue essentially representing skin, and
containing sebaceous matter and hairs, some growing from the
dermoid surface, and others detached and formed into a loose
mass.

Causes. ‘These cysts have been attributed to the enclosure, in
the forming embryo, of the formative elements of dermoid tissue,
which may or may not remain latent and inactive until maturity,
or until the ovary becomes physiologically active.

Another theory is that an impregnated ovum has remained im-
perfect, developing only the elements of the skin, instead of the
whole fcetal body. Many cases cannot by any possibility be in-
cluded under this head, seeing that the cyst is found at much too
early an age, and its bearer has never had sexual intercourse.

Another doctrine is that the dermoid cyst is derived from the nor-
mal plastic or formative powers of the ovary, and the product be-
comes stiggestive of parthenogenesis or virgin gestation. The fact
that these cysts are not confined to the production of skin and hair,
but at times form bone, teeth, nervous and other tissues as well,
corroborates this view. On the other hand we must bear in mind
that dermoid cysts are much more common in other tissues than

294 Veterinary Medicine.

they are in the ovaries. Thus they are common in the sub-
cutaneous connective tissue and between the muscles.

The symptoms do not differ essentially from those of simple
cysts and ¢veatment is mainly by castration. As the escape of the
contents into the peritoneal cavity is especially provocative of in-
fection, the greatest care must be taken to extract the mass whole,
or to use the most thorough antiseptic precautions.

SOLID OVARIAN TUMORS.

‘These are much more rare than cystic tumors. They seldom
maintain the character of perfect solidity, for whether fibrous,
sarcomatous, melanotic, cretaceous, myomatous, cancerous,
epithelial, tubercular, glanderous, or actinomycotic, they are’
usually associated with the cysts to a greater or less extent. Not
only are they liable to stimulate the formation of cysts, but the
special heteroplasia may become engrafted on the walls of pre-
existing cysts, as well as on normal tissues.

The symptoms of the solid tumors are in the main, those of the
cystic form, and ¢veatment resolves itself into extirpation by
castration. Its success will vary according to the nature of the
tumor, sarcoma, melanoma and carcinoma being especially liable
to recur in the same or in distant situations, and the same is
true of the colonizing with infectious germs (glanders, tuber-
culosis, actinomycosis) which are presumably already present
in other parts of the body. Castration has however, this
recommendation, it secures the removal of the entire diseased
organ, and if the morbid process or infection is confined to that
only, it holds out the best prospect of recovery.

INFLAMMATION OF THE FALLOPIAN TUBES.
SALPINGITIS.

This condition is met with in the female mammals of all
species and mainly as the result of an infection extending from
diseased womb or ovary. ° The results are degeneration of the

Diseases of the Oviduct in Birds. 295

epithelium, exudation into the mucosa with thickening, stenosis
of the tubes, the formation of cysts along the line of the
canal, with pink or straw colored contents, including fibrine,
leucocytes, epithelium and granular débris. As in odphoritis
there may be blood extravasations and clots and abscess. In
the cow they are at times calcified and create a suspicion of
tuberculosis.

The symptoms are essentially those of metritis or ovaritis,
and as these are usually more prominent the attendant sal-
Pingitis is generally overlooked during life. Careful rectal ex-
amination may detect the enlarged, tender or sacculated tubes.
Treatment may be laxative, diuretic, derivative, and antiseptic
toward the womb. Ablation of the ovaries, tubes and even the
womb is often required.

DISEASES OF THE OVIDUCT IN BIRDS.

Imperforate tube near cloaca. Polypus: snare and twist off. Egg im-
paction: from atony, inflammation, stricture, congenital smallness, ex-
haustion, large eggs, thick end first, broken egg. Symptoms: mopes
alone, feathers erect, wing and tail drooping, large, solid swelling around
anus and abdomen. Ruptureinto abdomen. Treatment: oil cloaca and
oviduct, manipulate, turn, break egg and scoop out, incise and extract,
antiseptic oils. Excision of ovary.

Imperforate oviduct usually occurs in the lower part of its
course, the tube being connected with the cloaca by a short,
fibrous cord. In the case of a very valuable bird it may be in-
-cised and the walls of the duct may be brought down and fixed
to those of the cloaca.

Polypi of the oviduct may seriously impede laying, and start ob-
struction and impaction. The seat of the tumor having been as-
certained, it may be seized and twisted off by a snare. An
elastic wire is passed through a small metallic tube so that a loop
protrudes large enough to pass over the polypus. When fixed
around the pedicle, it is tightened, and the tissues twisted through.

Egg Impaction in the Oviduct. From weakness or lack
of tone in the bird, by inflammation and loss of contractile power
in the oviduct, by stricture of the duct as a sequel of inflamma-

296 Veterinary Medicine.

tion or abrasion, by congenital narrowing, by weakening of the
oviduct through constant laying, by excessive size of the egg, by
double yolked eggs, by presentation of a large egg with its thick end
first, or by an egg with broken shell, the oviduct may be rendered
incapable of passing the egg on and out, and as others continue
to press down from above an excessive and dangerous impaction
ensues. ‘The bird refuses food, mopes around with ruffled feathers
and drooping head, wings and tail. The region of the anus and
in front of it hangs downward and feels firm and solid, and the
oiled finger introduced into the cloaca comes in contact with the
impacted mass. The bird strains violently but ineffectually and
rubs its anus on the ground. ‘The swelling goes on steadily and
rapidly increasing, and the bird becomes more prostrate and hope-
less. Sometimes the overdistended and congested oviduct gives
way and the eggs escape into the abdomen. Reul has counted as
many as 24 eggs that had thus escaped into the abdominal cavity.
Or without rupture of the oviduct, the soft eggs pack together
into a solid, dry, yolk-like mass, the watery parts having been
pressed out or absorbed. In bad cases this may weigh 1% lb. in
the hen (Weber). In the way of ¢veatment the cloaca and oviduct
should be thoroughly lubricated with a bland oil, which might be
injected with a syringe, so as to pass it, if possible, around the
impacted egg or mass. By careful manipulation the egg may now
be brought away. If the thick end is presented it is sometimes
possible to turn it so that the thin end will come first. Should
all fail the egg may be broken and its contents together with the
other impacted matter may be dislodged with a looped wire or
small spoon. The oviduct should be lubricated for some time
with a bland antiseptic oil (olive oil and boric or salicylic acid).
In obstinate cases the abdomen and oviduct may be laid open and
both evacuated of any egg matter that may be present. After
suitable antisepsis the wounds in the oviduct and abdominal walls
are to be sutured. If there appears to he danger of the further
early descent of eggs into the weakened oviduct the ovary may
be removed.

LEversion of the Oviduct. This appears at times as a result of
the intromission of the penis (ducks) being shown immediately
after copulation as a pink, lax membrane one or more inches long,
dragging from the anus. In other cases it appears to result from

Diseases of the Oviduct in Birds. 297

the paresis that occurs in old birds from prolonged laying, or
from inflammation and impactions. It may appear abruptly or
gradually, and after a few hours becomes the seat of exudation,
swelling and redness, forming a pyriform mass. In some cases
it is carried out around an egg which does not glide through its
canal and may be felt through its walls, and through its terminal
opeving. A partial eversion may take place as an invagination into
the cloaca, without showing externally. When an egg is im-
pacted, or when the protruded organ is inflamed and swollen,
violent straining continues, which tends to aggravate the con-
dition, and the bird gets rapidly exhausted, resting on its breast,
later upon its back, and dying in convulsions.

In slight cases following copulation, the vermicular movement
of the duct, of the cloaca and anus may serve to secure speedy
spontaneous reduction. In the partial cases, of eversion into the
cloaca, the free local use of oil, may secure the passage of the
presenting egg and the return of the oviduct. If necessary the
egg may be broken and its shell thoroughly extracted. This last
method is imperative when the egg enclosed in the oviduct has
already passed through the anus. The oviduct should then be
cleansed in tepid water, and laudanum, oiled and returned.

Inflammation of the oviduct is a common condition resulting
from debility, from impaction of an egg or of egg-material, from
scratching with the shell of a broken egg, and from microbian
invasion. ‘The frequent passage of large eggs is an accessory
cause, and the egg becomes an important factor in the mainte-
nance and aggravation of the inflammation. The mucosa be-
comes red, dry, infiltrated, thickened and friable, and the muscu-
lar coat increasingly paretic. The egg, becoming impacted, and
subjected to constant pressure in the vain efforts at expulsion,
hinders circulation and nutrition, and favors necrotic and ulcera-
tive processes, and too often the fragile membranous walls yield,
and the mass drops into the abdominal cavity. Short of this,
the exudate at a particular point, the main seat of inflammation,
contracting in undergoing organization, forms a distinct stricture,
which renders the further laying of fully formed eggs difficult or
impossible, and further impaction, inflammation and rupture may
follow. Sometimes the irritation causes undue peristalsis in the
anterior and less actively inflamed part of the tube, and the eggs

298 Veterinary Medicine.

are laid prematurely without albumen or without shell, yet with
much effort and suffering. Or the bowels become irritable and
a profuse diarrhoea sets in, hastening the exhaustion of the
patient.

Treatment should be applied early. A ‘cooling diet of vege-
tables or slops, the careful removal of all irritating contents
from the oviduct, and its frequent injection with bland oils medi-
cated with mild anti-septics (boric or salicylic acid, or potassium
permanganate) will usually serve a good purpose.

HYDROMETRA AND PYOMETRA.

Cause: chronic metritis, tumors, microbian infection. Symptoms: ill-
health, low condition, vulvar swelling or discharge, swelling and fluctuation
of womb. Rectal exploration. Treatment: evacuate liquid, disinfect
womb and passages, creolin, iodine.

As a rule these conditions belong to obstetrics and would not
come under the scope of this volume, but when in chronic cases,
with closure of the neck of the womb, the liquids accumulate and
distend the uterus, they may deserve mention in a medical
work.

The cause is usually a chronic metritis, originating it may be at
the time of a now distant parturition, or associated with tumors
or microbian invasions of the womb. In the deadly cases that
follow upon parturition and abortion streptococcus is usually
present, in the more chronic forms the staphylococcus or other
pus microbe.

The symptoms are those of general ill-health, low condition,
pallor of the visible mucosz, sometimes swelling of the vulva
with discharge, serous or purulent, lessened milk yield, enlarge-
ment of the abdomen with fluctuation felt in the right flank, or
still better with the hand inthe rectum. Rectal exploration will
further detect the distended uterus connected with the vagina
behind and dividing in front into two horns.

Treatment consists in the evacuation of the liquid through a
catheter or cannula introduced through the os, or through the
vaginal wall immediately above, followed by a systematic disin-

Uterine Tumors. 299

fection. By placing the patient upon her back, gravitation of the
liquid is more marked, but when this is not convenient it may be
done with the animal standing. ‘The flow may be favored by
raising the abdomen with a sheet held by two assistants. The
womb may be thoroughly cleansed by a normal salt solution
which has been boiled, and then daily injected with a creolin
solution (1:100). In hydrometra an iodine lotion may be used,
A course of tonics is often indicated.

UTERINE TUMORS.

‘These are somewhat rare in the domestic animals, yet they have
been met with in the form of cysts, fibroma, fibro-myoma, sar-
coma, aud carcinoma. Ina number of cases the nature of the
tumor has not been clearly made out. Mangot saw a mare with
two pediculated uterine tumors having an aggregate weight of
12 lbs. ‘These were expelled with much straining and suffering.
LaMaitre and Rodet record other cases. Stockfleth describes
multiple pediculated fibroid tumors in the womb of the cow.
Cysts have been especially seen in the cow and bitch, and car-
cinoma in the bitch.

Symptoms. These may for.a length of time be overlooked, though
breeding animals usually fail to conceive. Then a slimy, muco-
purulent, serous, bloody or foetid discharge may escape habitually
from the vulva, smearing the tail and hips and collecting on the
floor. If the os is sufficiently patent to admit the hand vaginal
and uterine exploration will detect the tumor. In other cases it
may be felt by rectal examination.

Treatment is essentially surgical and will consist in dilatation
of the os, and the removal of the tumor by twisting, ecraseur, or
curette, and with careful antiseptic precautions before and after.
In malignant tumors in the uterine walls it may be expedient to
remove the entire organ.

UTERINE TUBERCLE.

This has been seen especially in sterile cows, the subjects of
nymphomania, and it may be associated with a muco-purulent or
bloody discharge from the vulva, nodular swelling on the uterine
horns, perhaps also on the broad ligaments, one or both ovaries,
and the, mesentery, to be recognized by rectal examination. The
presence of tuberculosis in the lungs or throat, and the response
to the tuberculin test will confirm the diagnosis. Asa rule it is
not desirable to institute treatmeut.

IMPERFORATE HYMEN.

Cases of this kind have been described in mare and cow, pre-
venting copulation and conception, and leading to a distension of
the vagina, with a glairy fluid, which obstructed defecation,
irritated the bladder and caused violent but fruitless straining,
under which the mass would project from the vulva. The centre
of the swelling may be penetrated with a trochar or bistuory and
enlarged by incisions in several directions. Relief is prompt and
lasting.

VAGINITIS. LEUCORRHGA.

Inflammation of the vaginal mucosa is usually a concomitant
of metritis and like that follows parturition. It will however oc-
cur independently from direct injury or infection or from.the
presence of neoplasms. In dourine and horse-pox, vaginitis is a
common symptom ; to mare, cow and bitch infection is conveyed
by coition. Dieckerhoff quotes old chronic cases, also acute ones
which extended to the peritoneum and proved fatal in a few
days. The common symptom of muco-purulent discharge having
a heavy or feetid odor is together with the discharge from the
womb known by the common name of leucorrhcea.~ The frequent
irrigation of the whole passage with antiseptic solutions is usually
successful in putting a stop to the affection, unless in case of con-
stitutional infection, or the presence of some neoplasm.

300

TUMORS OF THE VAGINA.

The vagina is the seat of different forms of neoplasms in the
various domestic animals. Thus cystoma, lipoma, adenoma,
fibroma, fibro-myoma, sarcoma and epithelioma have been noted.
They are essentially surgical and to be dealt with as such. They
are mainly important in this connection as inducing a leucorrhea,
which in the absence of careful examination might be mistaken
for that of uterine or vaginal infective inflammation.

PARTURITION FEVER (COLLAPSE). MILK FEVER.
PARTURIENT APOPLEXY. CALVING FEVER.
PARTURITION PARKESIS.

Definition. Predisposing causes; genus, breed, great milking capacity,
heredity, mature age, vigor, high-feeding, powerful digestion and assimila-
tion, sudden plethora, drying up of milk, parturition, easy delivery, warm
season, chills, idiosyncrasy, cardiac hypertrophy, contraction of womb,
emotional excitement : Supposed causes: absorption of toxins from womb,
colostrum, Schmidt treatment its significance, microbian infection and in-
toxication, effect of changeof stable. Microbiology. Nature: Theories of
nervous explosion, vaso-motor cerebral anemia from exaggerated excita-
bility of the uterine nerves, or from dilatation of the portal system and
womb, metro peritonitis, cerebral anzemia from congestion of the rete
mirabile, etc., palsy of the ganglionic nerves, plethora, intra cranial arterial
tension, narcotic poisons from leucocytic or microbian source. Lesions:
variable, cerebral and spinal congestion, pulmonary congestion, collapse,
septic inhalation, bronchitis, dessication of ingesta in omasum and large
intestine, black thick blood, yellowish gelatinoid exudates in cranium and
spinal canal and under spine, glycosuria. Symptoms: time, post partur-
ient, plethoric subject, sudden onset, comatose and violent forms, discom-
fort, restless movements, inappetence, moaning, mental dullness, unsteady
walk, muscular weakness, compulsory recumbency, retained urine and
feeces, drowsiness, somnolence, unconsciousness, stertor, venous pulse,
tympany, sudden recovery, complete, with paralysis, fatal cases, violence,
tossing head, trembling, cramps, convulsions, temperature. Mortality.
Prevention : bleeding in plethoric, heavy milkers, purging, low diet, exer-
cise, comfort, milking, blisters, sucking by calf, disinfection, iodine solution

301

302 Veterinary Medicine.

in udder. Treatment: in early stages bleeding, purgatives, peristalsis
stimulants, antiseptics, injections, stimulants, rubefacients or cold sponging,
elevation of the head, udder massage, milking, iodine injection of the
mamme with iodine or creolin or salt solution, oxygen or sterile air.

Definition. A nervous disorder which develops suddenly in
plethoric cows, heavy milkers, after calving, and is characterized
by loss of sense, of consciousness and of muscular control, by
hypothermia or hyperthermia, convulsions, coma, and mellituria.

Causes. While one cannot speak positively as to the essential
cause of this disease, certain conditions are so constant and
prominent that they must be given a high value as pre-disposing
causes.

Genus and Breed. Milking Capacity. 'This is essentially a
disease of cows, probably largely because of all domestic animals,
cows only have been long and systematically bred to secure the
greatest power of digestion and assimilation and the highest yield
of milk. It is the disease not only of cows, but of milking
breeds, and preéminently of individuals that give the most abun-
dant dairy product. It is rare or unknown in scrub or common
herds, while common and fatal in the best milking breeds, in ad-
vancing ratio about as follows : short horn, red polled, Normand,
Swiss, Ayrshire, Flemish, Dutch, Alderney, Jersey, Guernsey,
and Holstein. Heredity may be claimed, as the special pre-dis-
posing qualities are hereditary.

Age has a marked influence, but this is subsidiary to the milk-
ing qualities. The disease rarely attacks a cow after the first or
second calving when the system is as yet immature, and the milk
yield has not reached its maximum: nor one that is past its
prime and already failing in vital energy and milking qualities.
The following table is from statistics complied from veterinary
records in Denmark and Bavaria :

Age, yrs—3 4 5 6 7 8 9 10 «Ir 12. 13andover.
Cases 8 21 65 160 I71 202 117 124 44 7o 78

It will be noted that it is in the period of the most vigorous,
mature life, from the 6th to the 1oth year inclusive that the great
majority suffer. In a judiciously managed dairy it is the best
cows that are carried at these ages, and although the very best
are kept on into old age they show a steadily decreasing number
of cases as they begin to fail. ‘The disease is all but unknown
in primipara.

Parturition Fever, Ete. 303

High Feeding. Weavy and rich feeding prior to calving and
immediately after, is a most prominent cause of the affection.
This is so well known to owners of milking breeds, that they
usually hold to the principle that the cow that is a heavy milker,
should be all but starved for a fortnight before calving and for a
week after. In herds where this rule is acted on the disease is
rare and may be altogether unknown, and when it is neglected the
malady is often very destructive.

Plethora. High Condition. Weavy feeding and high condi-
tion usually go together, and the majority of the victims are fat or
in good flesh, yet a certain number are actually thin. The
predisposing condition is plethora rather than fat or flesh, and
this may be present in the comparative absence of flesh. The
cow that is from a stock famed as heavy milkers, does not tend to
lay on flesh, but, on succulent diet especially, the greater part of
the nutritive matter assimilated goes to the production of milk,
and she remains thin in flesh no matter how heavily she may be
fed. Many such cows never go dry, but give a liberal yield of
milk up to the day of calving, and if measures are taken to dry
them up, it is done at the expense of a sudden plethora, as the
milk giving system does not at once accommodate itself to the
laying up of fat and flesh.

The drying up of the milk secretion sometime before calving in
a cow which is normally a heavy milker is therefore a potent factor.

Parturition is an almost indispensable factor as the disease oc-
curs one to seven days after that act, and only in rare and some-
what doubtful cases before it.

Easy Delivery with little nervous outlay or loss of blood, and
no exhaustion is a special feature. The attack almost never oc-
curs after a difficult parturition with considerable loss of blood
and much nervous exhaustion. This should to a large extent
exclude such alleged factors as shock or wearing out of nervous
energy. The nervous prostration which figures so prominently
in the disease, seems to be less the result of wear and tear, than
of the supply of an excess of blood, which is either over-
enriched, or charged with some injurious toxic matter. At the
same time there is a manifest susceptibility at the parturient
period which is not present at other times, and the plethora or
toxin takes occasion to operate when this predisposition renders

304 Veterinary Medicine.

such an attack possible. Zhe Warm Summer Season has been
claimed to induce a greater number of cases, and doubtless ex-
posure to continuous heat, tends to prostrate the nervous system
and predispose to congestion, this fails to take into account the
still more important element of the rich spring and early sum-
mer pastures, where the already plethoric animal is left to feed
without stint, or the tempting red clover, alfalfa and other fodder
crops, rich in albuminoids, which are fed liberally in a succulent
condition.

Chills in cold winter weather have been similarly invoked as
driving the blood from the surface to collect in internal organs,
including the brain. That chills do act in this way cannot be
denied, but there is no demonstration that any number of cases
have been materially affected by cold.

Idiosyncrasy. Constitutional Predisposition. ‘This must be al-
lowed, inasmuch as that it covers all those individual conditions,
functional and structural, which belong to the heavy milker, or
the animal with extraordinary powers of digestion and assimila-
tion. The same shows in the predisposition to a second attack
of an animal which has survived a first one. The structural
changes in the nerve centres, which occur in the primary attack,
leave traces, which render these parts more susceptible at the
next calving. In my own experience the violence of the disease
is liable to increase with successive attacks, so that a second or
third cannot be hoped to be as mild as was the former one.

Cardiac Hypertrophy. Cagny draws attention to the fact that
in man and beast alike the heart undergoes hypertrophy during
gestation and, above all, during the later stages. In improved
breeds of cattle, and especially in milking breeds, a great de-
velopment of the whole circulatory system is seen, and a large
heart is a constant feature of this. This implies an increased
force of cardiac systole, an increased blood tension in the arteries
and capillaries, a condition which tells with special force on the
soft tissues of the brain, as the violent abdominal compression in
the expulsive efforts of parturition, tends to drive the blood from
the great vascular viscera situated back of the diaphragm.

Parturition and the subsequent contraction of the womb and ex-
pulsion of the great mass of blood, must be accorded a prominent
place among causative factors. The disease is almost restricted

Parturition Fever, Ete. 305

to the first week after parturition, and its gravity is greater the
more nearly itis related to the parturient act. Cases occurring in
the first three days are usually fatal, The gravid uterus contains
a very large amount of circulating blood, and when the womb con-
tracts, the greater part of this is suddenly thrown upon the general
circulation, already plethoric to an undue extent. As yet the
mamimee are congested and there is no free depletion through
that channel, so that there isa marked temporary plethora and
vascular tension, before the system can establish free elimination
and, as it were, strike a healthy balance. In this period of tran-
sient plethora there lies a source of great danger to.the general
system and, more particularly, to the brain.

Emotional Excitement connected with the removal of the calf
is urged by Giinther, Jaumain, Félizet and others as a prominent
cause. ‘This, however, must be rare, at the most; the disease
does not attack the primipara that should be most susceptible to
this influence, but the mature animal, at her third calving or
later when she is already well accustomed to this treatment ; it
supervenes so quickly on parturition in many cases, that there
was no opportunity for such emotion ; it occurs also in cows, the
calves of which have remained with them or have received no at-
tention from them.

Absorption of Leucomaines from the Udder. At parturition the
trophic and secretory activity of the udder of the heavy milking,
plethoric cow is phenomenal, and with this extraordinary and
sudden rise in the circulation, and in cell growth and work there
is a corresponding increase in the leucomaines or toxic alkaloids
of the cells. If those alkaloids are promptly introduced in large
quantity into the general circulation, the highly susceptible
nerve centres at once succumb to the poison. This theory agrees
perfectly with the therapeutic developments of the last few years.
The Schmidt treatment, by injecting the teats with a quart of
water holding 100 to 200 grains of iodide of potassium in solution,

reduced the mortality from the disease from 70 per cent to 15 per

cent. Injections of other antiseptic solutions proved equally effec-

tive. So did a simple normal salt solution. Overfilling of the

udder with milk by putting off the first milking for, 24 hours

after calving virtually put a stop to cases of the disease. The

filling of each teat and quarter of the udder to repletion with
20

306 Veterinary Medicine.

oxygen in every case of milk fever, reduced the mortality to a
fraction of one per cent. Finally the injection with simple
sterilized air proved equally effective and deaths came to be con-
sidered as extremely improbable even in very bad cases. This
points unequivocally to the arrest of the formation of leucomaines
by the reduction of the circulation in the udder. The extreme
distension of the milk ducts and follicles by bland gas, or liquid,
compresses the vessels in their walls and reduces the flow of
blood. With this reduction of the circulation comes thearrest of
the formation of the toxic leucomaines and of their absorption.
When the poison no longer reaches the nerve centres in danger-
ous quantity the nervous disorder, and collapse are prevented or
corrected. This hypothesis explains every phenomenon and is
obviously the right one.

Microbian Infection or Intoxication. ‘This has been of late a..
favorite hypothesis, apparently sustained by the sudden and pro-
found prostration of the nerve centres, the notorious prevalence
of milk fever in given hamlets, and the occasional arrest of the
disease in a herd, by moving the parturient cows to a previously
unoccupied stable and holding them there until nine days after
calving. But on the other hand the disease occurs in the strong
plethoric cow, not in the impoverished one which should have
less vital resistance ; it follows the easy unassisted parturition in
which there has been no chance for the introduction of bacteria
by the womb nor any shock nor exhaustion to render the system
more susceptible, while it respects the cases of difficult parturition
with abundant introduction of microbes on hands and instru-
ments ; no inoculation from the womb upon another parturient
cow has produced the disease ; finally, if it were due to the ab-
sorption of microbes or their toxins from the milk in the udder
the bacteria should be increased in the abundant lacteal culture-
medium and the absorption of the toxins more active from the
tense and overfilled milk ducts into the relatively more flaccid
blood vessels, whereas the simple overdistension with milk is the
best prevention of the disease. ‘The mere presence of cocci or
bacilli, which are by no means constant, nor always of the
same species in cases where they do occur, can mean nothing as
causative factors in the face of the above facts. In short, bac-
teridian infection of womb or udder must be eliminated from the
list of essential causes.

Parturition Fever, Ete. 307

Nature of Milk Fever. As above intimated, everything points
to the excessive production of leucomaines in the udder which
has been called to undergo a sudden, phenomenal congestion and:
physiological activity. The other explanations, put forth at
different times, are one and all untenable. Contamine considers
the disease as the reaction of the surplus nerve force, which was °
not used up in the edsy parturition. The theory is fantastic as
accounting for the rapidly developing ssthenia and paralysis.
Billings thinks the cerebral anzemia is due to vaso-constriction
produced by the exaggerated excitability of the uterine nerves.
Yet the most marked features of these cases is the quiescence of
the womb. ‘Trasbot looks on the affection as a congestion of the
myelon apparently shutting his eyes to the far more prominent
encephalic symptoms. Haubner considers it as a cerebral anzemia
induced by the vaso-dilatation in the portal system and abdominal
viscera generally, the result in its turn of the vacuity of the
abdomen, from the expulsion of the foetus and its connections.
But the womb is often contracted and comparatively exsanguine,
the plethoric condition of the systemic vessels is suddenly in-
creased by the great mass of blood from the uterine vessels which
maintains a marked general blood tension, and finally, the closed
box of the cranium cannot have its blood drained from it without
some effusion to take its place. Stockfleth attributed the malady
to a metro-peritonitis, but there is rarely any indication of such a
condition. Frank claims a cerebral anzemia due to an over-dis-
tension of the vete mtrabile, but sheep and goats, with more
abundant vetia mirabilia, do not suffer. Palsy of the ganglionic
system with succeeding congestion of the myelon and encephalon
(Barlow, Kohne, Carsten Harms) fails to explain why the effects
are concentrated on the cephalic nerve centres. Glucosuria is
constant in the disease in ratio with its violence, but this contin-
ues for days after the cow has recovered and is to be looked on
as a result of disorder of the medulla and consequent derange-
ment of the liver and not as the cause.

Lesions. These are exceedingly variable in successive cases.
Congestion and effusion in the meninges, cerebral or spinal, in
the rete mirabile and choroid plexus have been often noticed, and
exceptionally clots of extravasated blood. In certain cases con-
gestion and pink discoloration of portions of the brain substance
(cerebral convolutions, bulb, ganglia) with marked puncta vas-

308 Veterinary Medicine.

culosa, are found, while in others the greater part or the whole
of the encephalon is anaemic. The puncta in such cases, large
and dark, on the surface of the section, promptly enlarge until
they may form distinct drops.

In the /ungs areas of collapse, and of dark red congestion- and
infiltration are common, mostly as the result of the entrance
of alimentary or medicinal matters into the bronchia owing to
palsy of the pharynx. Such materials can be found in the
bronchial tubes. ‘

The third stomach and the large intestine may be impacted,
the contents more or less baked and glossy on the surface, and
coincident congestions of the mucosa are not uncommon. In
some instances, however, the contents are soft and pultaceous
and the absence of mucous congestions is remarkable.

The womé rarely shows characters differing from the condition
which is normal to the first few days after parturition.

The dlackness and thickness of the blood has been noted by prac-
tically all observers. This is partly the result of its density, but
doubtless also of the undetermined toxins which are operative
in the disease.

Yellowish gelatinoid exudates have been found in the subdorsal
and sublumbar regions, as well as the cranium and spinal canal.

Glucose appears to be constantly present in the urine, and in
excess in the more violent and fatal cases: from 1.19 grm. per
litre in slight cases to 41.8 grms. in a fatal one (Nocard). Al-
bumen may be present, though probably only when local inflam-
mation has supervened.

Symptoms. ‘The conditions of the attack should be noted.
This is a disease of the first six days after parturition, rarely
seen in the second week, and never after the fourteenthday. Itis
very exceptional before parturition, yet Miiller quotes 47 cases in
1107 births. The breed, condition, milking qualities, plethora,
feeding, etc., of the patient are, as already noted important data
indiagnosis. Theonsetissudden without premonitory symptoms.

Two very distinct types are met with, the comatose and vio-
lent or spasmodic, which, however, merge into each other by
insensible gradations, and may follow each other.

From twelve to seventy hours after an easy parturition there
suddenly appear signs of discomfort. Feeding and rumination

Parturition Fever, Etc. 309

cease, the calf is neglected, there may be plaintive moaning, the
eyes seem dull and clouded, the eyelids drooped, the conjunctiva
red, the pulse normal for parturition, sometimes extra strong, the
breathing excited often with moans or grunts. The senses are
dulled, the walk is unsteady, the feet being abducted and planted °
like clumps, or the legs sway, perhaps cross each other, remain
semi-bent, and soon give way leaving the animal prostrate, rest-
ing on the sternum and abdomen, or later on the ribs, with head
extended. Attempts may still be made to rise, but this is rarely
accomplished unless when improvement sets in. This is the con-
dition in which the patient is usually found, being the first to
be noticed by the owner. ‘The bowels are torpid, the urine
retained in the bladder, and the animal may remain thus in a
drowsy condition, without changing from the sterno-ventral de-
cubitus, or dropping the head on the ground until improve-
ment sets in. The head rests on the shoulder or upper flank.
If held outward or forward the upper border of the neck has
an S shaped outline.

More commonly the somnolence increases, passing into a
complete torpor, insensibility, the eye may be touched
without causing winking, pricking or other injury causes no
further response, the patient turns upon its side, with its head
extended on the ground. She may lie in this condition with
no sign of vital activity save pulsation and breathing, and the
latter is liable to be slow and'stertorous by reason of the paraly-
sis of soft palate and larynx. The jugulars usually show a
venous pulse. Fermentations in the inactive paunch cause the
evolution of gas with tympany, which still further obstructs the
breathing, and reacts injuriously on the nerve centres. The
normal eructations from the rumen may continue, with liquids
and floating solids, and in the paralytic state of the throat these
too often pass in part into the bronchia, causing septic bronchitis
and pneumonia. The same is liable to follow the administration
of liquids, the irritant drugs passing into the larynx, trachea and
lungs. The pulse becomes soft, small and finally almost imper-
ceptible. It may be 50, 60 and upward.

In favorable cases, defecation may still occur, or the rectum
once emptied may fill again through the continuance of peri-
stalsis, the milk continues to be secreted, and in one to four days,

310 Veterinary Medicine.

spontaneous defecation and micturition may be resumed, and the
patient may get on its limbs and commence feeding. There is
usually at first a little weakness of the limbs, but this is transient
and health is restored in a very short time. The suddenness of
the improvement is often as marked as of the attack. The
patient is left prostrate and insensible, without giving any re-
sponse when the eyeball is touched and in two or three hours it
is found on its feet, eating, with eyes bright and clear.

Some patients, however, are restored to ordinary sensation, in-
telligence and appetite, while the hind limbs remain paralytic, or
paretic, and the station and gait both weak and uncertain for
days or even weeks. In such cases there have been presumably
structural changes in the nerve centres, which require time for
repair.

In fatal cases, death may occur quietly from apoplexy, cerebral
compression, or narcotism, or it may be preceded by a period of
marked excitement or disorderly muscular movements. Lifting
of the head, throwing it alternately on the shoulder and on the
ground, trembling of head, members and. body, cramps or jerk-
ing of the limbs or of other parts, drawing the hind limbs up
against the abdomen, and again extending them, rolling of the
eyes, loud, noisy, irregular, embarrassed breathing and a run-
ning down pulse are often marked features.

The temperature range is peculiar. At the start there may be
some hyperthermia 103° or 104° ; with the advance of the dis-
ease it tends to become lower, 98°, 96°, or 94°. When improve-
ment sets in, it rises again promptly to the normal.

Cadeac describes a special form which is ushered in by great
restlessness, bellowing, throwing the head to right and left,
grinding the teeth, sucking the tongue, salivation, licking of cer-
tain parts of the body, spasms in the neck, back or limbs, and
prompt recovery, or lapse into the comatose condition as above
described. It proved less fatal than the ordinary comatose type,
but seems to depend on similar conditions.

Prognosis. Mortality. The disease is very deadly, the mor-
tality in time past having reached 4o, 50 or even 60 per cent.,
the gravity increasing as the disease set in nearer to parturition.
Cases occurring on the first or second day were mostly fatal,
those’at the end of the first week were hopeful, and those occur-

Parturition Fever, etc. 311

ting during the second week were very hopeful. With the
Schmidt (iodine) treatment the mortality is claimed to be reduced
to 16 or 17 per cent., and with the air inflation treatment to .5 per
cent.

Prevention. Measures directed toward the lessening of
plethora tend to remove one of the most fruitful causes of the
disease and though not invariably successful, are yet of great
value. ‘The most direct is the abstraction of blood in the last fort-
night of pregnancy, to the extent of 6 or 8 quarts. This tends
to secure a lessening of the blood tension, and blood density, but
‘there is the drawback of a created tendency to a subsequent in-
crease in the blood formation to make up the loss. This measure
should be reserved for cows that are very plethoric, extra heavy
milkers and such as have already suffered from the disease.

Purgatives will measurably secure the same end without the
same degree of danger. One to two pounds of Epsom or Glauber
salts in the last week of gestation, or at latest when labor pains
set in, tend not only to remove solid or impacted masses from the
first and third stomachs, and inspissated contents from the large
intestines, but to secure a free depletion from the portal system.
If not before, this should always be given immediately after
parturition to cows in extra high condition, heavy milkers, and
that have had a short and easy delivery.

Restriction of food for a week before and as long after parturi-
tion is of equal importance. A very limited supply of aqueous,
easily digested, and laxative food (roots, sloppy bran mashes,
fresh grass, ensilage) will meet the demand.

Exercise in the open air is of great value in giving tone to the

“muscles, and especially the nervous system, and in stimulating
the enunctories and other functions.
' Inthe cold season protection against cold draughts and chills
must be seen to, and in the hot season the avoidance of an excess
of solar heat and above all of the confined impure air of the barns.

At midsummer and later, there is often great danger in the
rich clover and alfalfa pasture, or soiling crop, with which the cow
will dangerously load her stomach, and the only safe course is to
remove predisposed animals and shut them up ina bare yard or
box-stall. Under such simple precautions herds that had formerly
suffered severely, have had the disease virtually put a stop to.

312 Veterinary Medicine.

In individual cases other measures are indicated. When the
udder has reached an enormous size and development, and is
gorged with milk, days before parturition, it may be syste-
matically milked. The irritation in the gorged gland is quite as
likely to induce premature parturition, as in milking, and, at the
worst, the result is not so bad as an attack of parturition fever.

Basing his advice on the fact that parturition fever does not
follow a case of severe dystokia, Cagny applies sinapisms on the
loins, croup and thighs of a fleshy, plethoric, heavy milking,
parturient cow. Proof of their efficacy is not obtainable.

Felizet advises leaving the calf with its dam for one week.
Kohne doses the cow with nux vomica: Harms, with tartar
emetic.

In view of the probability of a bacterial infection the cow
should be taken to a clean, pure, well-aired stable a day or two
before calving, having been first cleansed from adherent filth,
and sponged all over with a 4 per cent. solution of carbolic acid.

To prevent diffusion of infection Bournay recommends anti-
septic injection of the womb immediately after calving. Bis-
sauge adds that the stable should be disinfected after every case
of parturition fever, the manure carefully removed and the
ground scraped and well watered with a disinfectant.

For fleshy, plethoric, predisposed cows, the distension with
air or gas of the udder should be applied immediately after calv-
ing. Or the udder should be left unmilked and gorged with its
own secretion for twenty-four hours after calving. ‘I‘hese meas-
ures are incomparably more effective than all others quoted
above.

Treatment. With the state of plethora and congestion about
the head in the early stages the question of bleeding at once arises.
If early enough while there is a full bounding pulse, and as
yet no sign of great loss of muscular control it is often very bene-
ficial, as much as 6 quarts or more being withdrawn. It is well
however to avoid cording the neck, which must increase thc vas-
cular tension in the brain, and to trust rather to digital com-
pression of the vein. The blood should be drawn from a large
opening in a full free stream, and may be stopped when the pulse
softens. Inthe more advanced condition, with paralysis and more
or less dulling of the senses, or coma, bleeding may be dangerous

Parturition Fever, ete. 313

rather than useful. There is then serious pressure on the brain,
with serous effusion, and perhaps blood extravasation, and in any
case anzemia, and this latter may be dangerously or even fatally
increased by the lessening of the blood pressure, without any
compensating advantagein the way of reabsorption of the effusion.
In such cases eliminating agents are a safer resort.

Purgatives commend themselves, but with the drawback of a
too tardy action. Now however with the peristaltic stimulants
given hypodermically this objection is largely obviated. Pilocar-
pin 1% gr., and eserine 3 grs. will often secure a noticeable
movement of the bowels in the course of fifteen minutes, imply-
ing a corresponding motion onward inthe bowels more anteriorly,
and even of the contents of the gastric cavities. If there is al-
ready palsy of the muscles of deglutition, this may be repeated

_several times at intervals of four or five hours. If however de-
glutition is still well performed a purgative of one or two pounds
.Epsom salts, with 10 drops croton oil, and 1 oz. oil of turpentine
may be given by the mouth. Should this operate, it will supple-
ment and carry on even more effectively the work of the hypo“
dermic agents, and even lessen the density, plasticity and ten-
sion of the blood and act as a potent derivative from the brain.

A compromise may be made by giving aloes 2 ozs., croton oil
20 drops in bolus; or 1 to 2 ozs. sulphate of soda in solution
may be injected subcutem.

In any case oil of turpentine or other antiseptic is of great
value in the stomach in preventing fermentation and tympany,
and thereby obviating a whole series of troubles such as : cerebral
disturbance by nervous shock and blood pressure ; impaired res-
piration and hzematosis by pressure on the diaphragm : and eruc-
tations of food to the pharynx and its inhalation or gravitation
into the lungs.

It is always well to clear out the rectum by injections, when if
there is any indication of pharyngeal paralysis most of the
remedies may be given by this channel.

Stimulants (ammonia carbonate, alcohol, anise, fennel, ether,
nux, etc.) have been largely employed by the mouth and may
be by the rectum. In the absence of spasms I have relied largely
on nux or strychnia.

When the skin chills, some have sought to heat it by enveloping

‘

314 Veterinary Medicine.

the prosterior half of the body in cotton or wool soaked in tur-
pentine, by applying sinapisms, or by moving over the surface a
warming-pan containing red hot charcoal.

More generally cold in the shape of cold water, ice or snow has
been applied 4o the cranium or Spine. Theoretically the anaemic
brain might be thought to forbid this, but clinically it often oper-
ates well, possibly by inducing a sympathetic contraction of the
vessels in and around the nerve centres aud thus indirectly favor-
ing the resumption of active circulation and the reabsorption of
effusions.

An elevated position of the head is no less important. "It favors
the-return of blood from the brain by gravitation, and in this way
improves the intracranial circulation, and the resumption of nor-
mal function. A halter, or a rope around the horns, may be tied
to a beam overhead, or the head may be laid on thick bundles of
straw which will keep it up to or above the level of the chest, and
in this way not only is gravitation ensured, but the brain is pro-
tected against the violent blows and concussions, which come
from dashing the head on the ground.

Modcrn Treatment of Milk Fever. 'The modern treatment was
inaugurated in 1897, when Schmidt, aiming at antisepsis, injected
into the four teatsa quart of previously boiled water holding 100
to 200 grains of potassium iodide in solution. The mortality
which had been as high as 70 per cent was at once reduced to 15
per cent. Others followed with solutions of other antiseptics
(creolin, cresol, lysol, chinosol, boric acid, phenol, and even com-
mon salt) and had a corresponding success. The Jersey Island
dairymen found that by leaving the udder unmilked for 24 hours
their predisposed cows were protected against attack. Next came
the full repletion of the udder with oxygen gas which excelled
all other methods, reducing the mortality to a fraction of 1 per
cent. The final step was inevitable and the pumping of the udder
full of sterilized air proved the simplest, most soothing and most
effective of all. My first case in 1903 had been eight hours under

‘the Schmidt treatment without relief from coma, but was on her
feet exercising all her functions healthily 2% hours after the
sterile air treatment had been applied. She lived to prove the
heaviest milker of that season in a large herd of extra-milking
Holsteins. In one remarkable case the fever, the second attack

Parturition Fever, ete. 315

in the same animal, came on a month before parturition, and a
prompt recovery followed the distension treatment. Parturition
was accomplished normally and safely more than a month later,
no nervous prostration appearing: In the past two years thou-
sands of cases have been treated by the distension method (with
oxygen or sterile air) with less than 1 per cent of losses. ;

Technique. ‘To prevent infection, the main danger, the most
careful antiseptic or aseptic precautions are demanded.

The injectors found on the market are generally clumsy and
unwieldy but operate well in careful hands. In the absence of
this an excellent substitute can be made from a common Davidson
syringe. Having secured the elastic ball and delivery tube
furnished with valves to direct the current of air, the delivery
tube is cut across and the two ends connected with a small glass
tube loosely filled with sterilized cotton. In the free end of the
rubber delivery tube fit a silver milking tube for insertion into
the teat. Sterilize the entire apparatus by heating in a water
bath for five minutes, and enclose it in a sterilized towel and tin
box until taken out for immediate use. The patient is to be pre-
pared by thorough washing of udder and teats with soapsuds,
rinsing off with clean boiled water at a moderate temperature,
and finally applying to the teats a 5 per cent solution of creolin
or lysol and supporting the gland on a sterilized towel until in-
jected. All being ready the middle of the teat is held between
the finger and thumb of the left and the teat-tube held by its
attached end in the right hand is inserted in the teat, the elastic
bulb being manipulated by an assistant until the quarter is in-
flated like a bladder. ‘The tube is now withdraw and the end of
the teat is tied with a broad tape to prevent the escape of the gas.
The tube is inserted in each of the teats in turn, with the same
precautions, and the other three quarters are blown up in the
same way. It isa good practice, in passing the tube from one
teat to another, to dip the tube in strong creoline, rinse it off in
boiled water and then it is in an aseptic condition. The cotton
used as a filter may have a small crystal of some volatile anti-
septic (salol, naphthol, thymol) inserted into it. This is not
strictly necessary, yet it is an excellent placebo and serves to en-
hance the impression of the importance of the other and more
indispensable antiseptic measures. The recumbent cow should

316 Veterinary Medicine.

be kept on her breast bone with the head elevated even if it
should be necessary to pack her around with straw bundles or to
suspend the head by a halter. Lying on her side is liable to
develop bloating, regurgitation'from the paunch, and inhalation
bronchitis, or pneumonia.

The almost invariable result of the treatment is that in two to
two and a half hours the cow gets on her feet, the bowels move
freely, urine is discharged copiously, and water and food are
taken, indicating a resumption of the normal nervous functions.
If in two hours the patient is not on her feet, nor looking brighter
and more intelligent, if she has passed no manure and urine, and
if the injected air has been absorbed, leaving the udder less tense,
the injection of the bag may be repeated under the same
scrupulous antiseptic precautions as at first. This may be re-
peated later if necessary. In all cases, but especially in severe
ones, it is well to keep close watch of the cow for twenty-four
hours, and if there is any indication of a relapse to repeat the
treatment by udder distension. ~

Complications must be met according to their nature. Bloat-
ing may require puncture of the rumen, evacuation of the gas
and the introduction of ammonia solution or other antiseptic.
Inhalation of food-materials may demand antiseptic inhalants, or
even solutions, but is very liable to prove fatal. Lesions of the
back or limbs may require appropriate treatment. Congestions
or infections of the udder may require active antiseptic injections
(2 per cent solution hydrogen peroxide, iodoform, creolin) in such
amount as will not diminish the mammary tension. Complications
affecting the womb, bowels, brain or other organ must be dealt
with according to indications.

The economic value of the new treatment is almost inestimable.
In the past milk fever has been the bane of the best dairy herds,
and of the best cows in such herds, of those which, if preserved,
would have brought offspring capable of increasing the general
yield by 50 or 100 percent. ‘Thus by this disease the maximum
value was continually being cut down, the survivors, the ances-
tors of future herds, being mainly the less valuable, the less pro-
ductive.and the less remunerative. When, however, we can
guarantee the recovery of even the most strongly predisposed cow
from milk fever, we preserve the phenomenal milker for a long

Parturition Fever, Etc. 317

lifetime of service, we secure from her a numerous progeny
which under judicious management would be even better than
herself, and we increase the yield and profit beyond the dreams
of the dairyman. Suppose our 17,000,000 of cows should have
their yield doubled, the resulting enhanced profit might at a very
moderate computation be set down at $30,000,000 to $40,000,000
per annum. ‘This assumes that this modern gift of veterinary
medicine should be generally availed of ; should it fail to be so, it
will be the fault of the stockowner in neglecting the boon which
the veterinary profession has generously placed in his hands.

DISEASES OF THE EYE.
DESIRABLE FEATURES IN THE EYE.

The eye in the physiognomy. Broad forehead. Full eyes. Both eyes
alike. Iris smooth, lustrous. Media translucent. Pupil sensitive to light.
Convexity median, uniform. Pupil black in ordinary light. Lids open and
mobile. Sclera light pink. Tears clear, limpid without overflow. Lids
thin, delicate, margins evenly curved. Whole eye responsive to moving
objects. Defects: small eye: semi-closed, thick, sluggish lids; convex
cornea: sunken eye : projecting eye: weeping eye: blear eye : watch eye:
irresponsive iris : dilated pupil : unequal eyes: flat cornea; ovoid cornea.

Much of the expression of the face depends upon the eyes, and
in animals as in man it is difficult to find compensations for a for-
bidding countenance. Perfect, sound, intelligent eyes are always
pleasing ; imperfect, defective, sunken or lifeless eyes mar the
whole expression. The following points may be specially noted :

1st. Ample breadth between the orbits. ‘This is of great
importance in the horse, in which we seek for intelligence,
courage and indomitableenergy. ‘This conformation does not in-
dicate the size of brain, as the cranium is situated higher up, but
by placing the eyes well outward, it indicates a wider range of
vision, and usually implies large, clear eyes, and since interde-
pendent parts tend to correspond in development and quality,
this commanding vision bespeaks a large, active brain, intelli-
gence, docility and activity.

2d. Full, prominent eyes. This may be excessive, either
through primary conformation or disease. Abnormal convexity
of the cornea implies myopia. But within normal limits the
prominent eye suggests good health, condition and vigor, with
ample cushions of fat under the bulb and a sound, well-developed
condition of the eyeball and its muscles.

3d. Both eyes equal in all respects. Any variation in

size, shape, color, fullness, clearness or in any other respect is at
318

Diseases of the Eye. 319

best unsightly, and implies not only defect but often disease as
well. |

4th. The iris Should be lustrous, uniform in color and
even in surface. Whether dark brown as in the horse, or yel-
low as in the dog, it should be brilliant. Any part that lacks
lustre, being lighter brown, or yellow and dull like a dead leaf,
usually indicates previous disease and a tendency to further
trouble. Albinos and those in which the pigment’ is congenitally
absent in patches must be considered as exceptions, yet, even in
them, the peculiarity cannot be held to add to the beauty.

5th. Allthe Media (Cornea, aqueous humor, lens and vit-
reous) must be perfectly clear andtranslucent. The slightest
cloudiness or opacity in any of these is a serious blemish and
usually indicates disease, past or present.

6th. The pupil should promptly and freely respond to
light and darkness by contraction and expansion. Absence or
tardiness of movement indicates impaired vision, from disease of
the eye, its nerves, or their nerve centres.

7th. Each cornea should have a median convexity, uni-
form in all directions implying the absence of myopia,
presbyopia and astgimatism. Any deviation from this will
interfere with the perfection of sight, and endanger shying and
other troubles.

8th. Under ordinary light the pupil should appear black
throughout. In the larger animals such dilation of the pupil as
to expose the tapetum lucidum under such circumstances implies
impaired vision (amblyopia, amaurosis), inflammation of the.
iris or undue intraocular pressure. A white color or spot shows
cataract.

gth. The lids must be open and mobile without excessive
dilation. Tardily moving or semi-closed lids, distorted by scar
or angle, everted or inverted, are unattractive and usually imply
disease in the eye, nerves or brain.

roth. The unpigmented portion of the sclera should be
light pink. The dark red of congestion and the pallor of anzemia
are equally objectionable.

trth. The tears must be clear, limpid and confined within
the lower lid. Any milkiness, flocculency or overflow is in-
dicative of disease.

320 Veterinary Medicine.

12th. The eyelids must be thin, delicate, evenly and
uniformly curved along the borders, and fringed by an
abundance of strong, prominent and well ‘directed lashes.
Puffiness or swelling betrays inflammation, dropsy, anzmia,
parasitism or other disorder, angularity of the upper lid an in-
ternal ophthalmia, and depilation or wrong direction of the lashes,
local disease.

13th. The eye should respond instantly, by movement, to
new objects and noises, without showing undue irritability
or restlessness. ‘The intelligent apprehension of the objects
will introduce an aspect of calmness and docility.

DEFECTS, BLEMISHES AND ABNORMALITIES OF THE
HORSE’S EYE.

Some of these may be present in the absence of actual disease, .
and yet prove so objectionable that they disqualify the animal for
any use, in which style or zsthetic appearance is demanded.
Among such sources of disqualification may be noted :

1st. The small eye. One or both eyes may appear small
because of internal pain and retraction within their sockets, or
from actual atrophy or contraction of the eyeball, the result of deep.
seated disease, or the organ may be congenitally small, and deep
seated in the orbit, and the thick, tardy eyelids may have a narrow
opening through which they can only be partially seen. ‘This
last condition usually implies a dull lymphatic constitution, low
breeding and a lack of intelligence, docility and vigor.

2d. The semi-closed eye with thick, coarse, sluggish lids.
In this case the bulb may not be unduly small, yet as it is not

. freely exposed it conveys the same general expression to the ob-
server. Like the small eye it indicates low breeding, lack of in-
telligence or docility and often stubbornness or even vice.

3d. The convex eye. In this the transparent cornea de-
scribes the arc of an unduly small circle, suggesting a conical form.
and projecting unduly beyond the margins of the lids. It implies
imperfect vision, myopia, and, it is alleged, low breeding and lack
of alertness. :

Defects, Blemishes and Abnormalities of the Horse's Eye. 321

4th. The sunken eye. This has been already referred to
under the small eye. The eyelids are usually flaccid, the upper
being drawn in by its levator so as to form an angle, and the
edges of the orbit are somewhat prominent. It is seen in old,
worn out animals, which have lost the pads of fat in the depth
of the orbit, and more commonly in animals that have suffered
several attacks of recurrent opthalmia. :

5th. The projecting eye. In this case the lids are unduly
contracted and the eye protrudes between them so as to show a
large amount of sclerotic around the transparent cornea. ‘This
may be due to nervous strain and suffering but, however pro-
duced it is decidedly unsightly and objectionable.

6th. The weeping eye. This is alwaysa condition of disease.
It may be due to irritant gases, or solid particles, to inturned
cilia, everted lids, conjunctivitis or a variety of other conditions.
A careful examination may show whether it is only a transient
and remediable fault of a good eye or a permanent and irremedi-
able defect.

yth. The blear eye. With swelling and scabbing of the edges
of the lids and Meibonian glands, and congestion of the adjacent
conjunctiva, there is usually some blurring of the surface of the
transparent cornea. The trouble is mostly chrohic and consti-
tutes a serious objection.

8th. The watch eye. In this, as in the albino, there is a
lack of pigment, so that the iris and sclerotic are white or bluish
white in part or in whole. Such an eye may be good and dura-
ble, but not beautiful nor attractive.

gth. Blindness of one or both eyes. In all such cases the
pupil remains fixed and immovable, showing no accommodation
to light and darkness, and there is a lack of prompt respon-
siveness on the part of the eye to sounds and objects. In amau-
rosis, glaucoma and cataract especially, the pupil remains widely
open, and alert movements of the ears are employed to make up
for the lack of sight. The condition often comes from internal
ophthalmia, such as the recurrent form, and is associated with
atrophy of the bulb.

roth. Eyes of unequal size. This usually implies serious
disease in one, not infrequently recurring ophthalmia.

21

322 Veterinary Medicine.

11th. Too flat corneal surface. In this case there is a mani-
fest lack of the normal projection, the anterior surface of the
cornea describing the arc of a larger circle, the visual rays coming
from a distance alone converge on the retina and presbyopia
occurs. In this as in myopia and other visual imperfections a
horse is liable to stumble and, if nervous, to shy.

12th. Ovoid cornea. In such’ cases the front of the trans-
parent cornea has an ovoid outline the arc formed by it in one
direction being that of a greater circle, than the arc which crosses
this at right angles. In consequence of this, the rays impinging
on the outer portions of these respective arcs do not converge to
the same point on the retina and a blurred and imperfect image
results. ‘This astigmatism causes the subject to stumble and, if
nervous, to shy.

SYSTEMATIC INSPECTION OF THE EYE.

System in Examination. Eyelids: cilia; lachrymal puncta: mucosa,
light pink, brick red, yellow, puffy, dropsical : Ciliary vessels deep, immov-
able ; nictitans ; transparent cornea equally smooth, glossy. with clear imaye
at all points : foreign body on cornea : corneal ulcer: opacities in aqueous
humor : iris and pupil : corpora nigra: changes in passing from darkness to
light : pupillary membrane : adhesions of iris: intraocular pressure: con-
tracted pupil: hole in iris. Oblique focal illumination of cornea, aqueous
humor, iris, lens, Purkinje-Sanson images.

In examining animals for soundness and especially the horse or
dog, the condition of the eye must be made one of the most im-
portant subjects of inquiry, as a disease or defect may render the
animal altogether unsuited to the object to which it is destined.
As in every other field of diagnosis thoroughness is largely de-
pendent on the adoption of a system which will stand in the way
of any flaw being too hastily overlooked. Many of the points to
be noted will be decided at a glance, yet this does not obviate the
necessity of turning over in the mind, in succession, the different
points of inquiry, and directing the necessary attention, however
hastily, to each in turn. The following points should be observed :

ist. Are the eyelids swollen, hypertrophied or faulty in
form, position or movements. Faults as thus indicated may

Systematic Inspection of the Eye. 323

imply any one of a great variety of disorders which should be
followed out to their accurate diagnosis. It may be bruises,
lacerations, punctures, parasites, conjunctivitis, keratitis, dropsy,
anemia, hepatic or intestinal parasitism, nephritis, paresis,
entropion, ectropion, etc.

2d. Inspect the cilia as regards form, size and direction.
Absence or wrong direction may imply disease of the Meibonian
glands, infective inflammation, demodex or other acarian infest-
ing, or turning in or out in inflammatory conditions.

3d. See that the lachrymal puncta are open and that
there is no overdistension of the sac. ‘The overflow of tears
and the swelling of the caruncle and of the area beneath it will
often indicate such trouble. In its turn it may imply inflamma-
tion of the duct, and obstruction by the tenacious mucopurulent
product, or it may imply merely obstruction of its lower end by a
dried scab. This last may be seen in the horse, on the floor of the
false nostril at the line of junction of the skin and mucosa, and in
the ass, higher up on the inner side of the ala nasi. In excep-
tional cases it may be desirable to pass a stilet through the canal
from the puncta downward or from below upward to determine
whether it is pervious.

4th. Determine the vascularity ofthe conjunctiva. When
free from pigment as it habitually is in pigs and birds this is
easily done, while in animals like the horse, in which the bulbar
portion, which covers the sclerotic, is largely pigmented, we can
scrutinize only the pigment-free parts. In health there should
be only a few, fine, pink vessels which move with the mucosa
when pressed aside on the bulb. In congestion the surface may
appear brick red, and the vessels are irregular, large, tortuous and
are seen to anastomose at frequent intervals. These move on the
bulb when pressed. The congestion is usually deepest on the
palpebral mucosa and in the cw/ de sac, and may be whitened for
an instant by pressure through the eyelid. To expose the con-
junctiva the right fore finger and thumb may be pressed on the
upper and lower lids respectively of the left eye, and the left
finger and thumb for the right, allowing them to slide backward
above and below the eyeball. Another method is to seize the
cilia and edge of the upper eyelid between the finger and thumb,

324 Veterinary Medicine.

and draw it downward and outward from the bulb, and then deftly
invert it over the tip of the finger. In the old the unpigmented
conjunctiva may appear yellow from the presence of subcon-
junctival fat, or this may appear at any age from hepatic disease
(distomatosis) or icterus. It is swollen, or dropsical in anzemia,
distomatosis, etc. ;

5th. Examine the ciliary vessels whether they are con-
gested or not. These are distinguished from the conjunctival
vessels in that they radiate in straight lines outward from the
margin of the transparent cornea and do not move on the sclerotic
under pressure. They are enlarged and very red in congestion
of the ciliary circle and in iritis. In eyes devoid of pigment over
the sclerotic, there is usually a circular, narrow, white zone be-
tween the congested area and the margin of the transparent cornea. |

6th. Examine the Membrana Nictitans. See that its free
margin is uniformly smooth, even, and thin and that there is no
swelling, congestion nor morbid growth on any part of the
structure. ,

7th. See if the transparent cornea is perfectly and uni-
formly smooth, transparent and glistening and if it reflects
clear, erect images of all objects in front of it. The image
of a round object which shows any irregularity in the curvature
of its margin implies a deviation from an uniform curvature of
the cornea: the image narrows in the direction of the smaller arc
and broadens in the direction of the larger one (see keratoscopy,
and corneal astigmatism).

8th. A foreign body on or in the cornea may be recognized
in a good light, but better and more certainly under focal oblique
illumination (see this heading).

goth. A corneal ulcer may be similarly recognized, It is
made more strikingly manifest by instilling into the lower cud de
sac a drop of a solution of fluorescin and rubbing it over the eye
by moving the eyelids with the finger. This will stain the whole
cornea. If now the excess of stain is washed away bya few
drops of boric acid, the healthy part of the cornea is cleared up
and the ulcer retains a bright yellowish green tint.

1oth. Opacity or Floating objects in the aqueous humor
(flocculi of lymph, pus, pigment, blood, worms) are always to be
looked for. They may be detected by placing the eye in a favor-

Systematic Inspection of the Eye. 325

able light. They may be still more clearly shown under focal
tllumination (see below). ‘

t1th. Changes in the iris and pupil may also be noticed in
a good light. The surface should be dark in the horse, and of
the various lighter shades in the smaller animals, but in all alike
clear, smooth and polished, without variation of shade in spots or
patches and without bulging or irregularity atintervals. Apart
from the congenital absence of pigment in whole or in part,
which may be found in certain sound eyes, a total or partial
change of the dark iris of the horse to a lighter red, brown or
yellow shade implies congestion, inflammation, or exudation.
‘The corpora nigra in the larger quadrupeds should be unbroken,
smooth, rounded, projecting masses outside the free border of the
upper portion of the iris. They should show a clear, polished sur-
face like the rest of the iris. The pupil should be evenly oval with
its long diameter transversely (horse, ruminant), circular (pig,
dog, bird), or round with an elliptical outline on contracting and
the long diameter vertical (cat). It should contract promptly in
light and dilate as quickly in darkness. Place the patient before
a window, cover one eye so as to exclude light, then cover the
other eye with the hand and quickly withdraw: The pupil
should be widely dilated when the hand is withdrawn and should
promptly contract, and it should actively widen and narrow al-
ternately until the proper accommodation has been secured.
Any failure to show these movements implies a lesion in the
brain, optic nerve, or eye which impairs or paralyzes vision,
interferes with accommodation or imprisons the iris. In loco-
motor ataxia the pupil contracts in accommodation to distance, but
not in response to light.

12th. Other causes of pupillary immobility include: (a)
Permanence of a pupillary membrane, which has remained from
the foetal condition and may be recognized by oblique focal illu-
tination and invariability of the pupil: (b) Adhesion of the iris
to the capsule of the lens—complete or partial—in the latter
case the adherent portion only remains fixed, while the remainder
expands and contracts, giving rise to distortions and variations
from the smoothly curved outline: (c) Adhesion of the iris to.
the back of the cornea—complete or partial—and leading to
similar distortions: (d) Glaucoma in which intraocular pressure

326 Veterinary Medicine.

determines a permanent dilatation of the pupil and depression of
the optic disc: (e) The pupil is narrowed in iritis, and is less
responsive to atropia or other mydriatic: (f) Lesions of the oculo-
motor nerve may paralyze the iris and fix the pupil. ‘The first
three and the fifth of these conditions may be recognized by the
naked eye, alone, or with the aid of focal illumination, the fourth
may require the aid of the ophthalmoscope and the sixth which
cannot be reached by such methods, might in exceptional cases
be betrayed by other disorders of the oculo-motor nerve (dropping
of the upper eyelid, protrusion of the eyeball, squinting outward).

13th. Coloboma (fenestrated iris), and lacerated iris are
recognizable by the naked eye in a good light, or by the aid of
focal illumination.

14th. Tension of the eyeball ( Zonometry). Elaborate in-
struments constructed for ascertaining ocular tension are of very
little use in the lower animals. The simplest and most practicable
method is with the two index fingers placed on the upper lid to
press the eyeball downward upon the wall of the orbit using the
one finger alternately with the other as if in search of fluctuation.
The other fingers rest on the margin of the orbit. All normal
eyes have about the same measure of tension and one can use his
own eye as a means of comparison. The educated touch is
essential. In increased tension, the sense of hardness and resist-
ance, and the indisposition to become indented on pressure is
present in the early stages of internal ophthalmias (iritis,
choroiditis, retinitis), phlegmon of the eyeball, glaucoma,
hydrophthalmos, and tumors of the bulb.

Oblique Focal Illumination.

This is so essential to clear and definite conclusions and is so
easily practiced on the domestic animals that every veterinarian
should make himself familiar with the method. The method is
based on the fact that when two perfectly transparent media
touch each other a reflection of luminous rays takes place only
at the surface. But in case any opacity exists in any part of the
thickness of one of these media, it reflects the rays from its surface
no matter what may be its position in the medium. ‘Thus corneal
opacities appear as gray blotches and under careful focal illumi-

Systematic Inspection of the Eye. 327

nation it may be determined whether these are on the conjunctival
surface, in the superficial or deeper layers of the cornea or in the
the membrane of Descemet. Similarly cloudiness or floating ob-
jects in the aqueous, reflect the luminous rays, and so with opaci-
ities in the lens or its capsule, or in the vitreous. In the same way
the surface of the iris and corpora nigra may be carefully scrutin-
ized. For satisfactory examination of the media, back of the iris,
the pupil should be first dilated, by instillation under the lid of a
drop or two of a 3 per cent. solution of atropia, and the ex-
amination proceeded with twenty minutes later. Homatropin is
preferable to atropin as being less persistent in its action, and less
liable to produce conjunctivitis. If it fails to produce the requi-
site dilatation, it may be followed by a drop of a 4 per cent.
solution of hydrochloride of cocaine, which will secure a free
dilatation, lasting only for one day in place of seven days as with
atropin. The cocaine further removes pain and favors the full
eversion of the eyelids.

The instruments required for focal illumination are a biconvex
lens of 15 to 20 diopters, and a good oil lamp or movable gas jet,
The light of the sun is not satisfactory. The examination ought
to be conducted in: a dark room, or less satisfactorily in semi-
darkness. The lamp is held by an assistant at the level of the
eye to be examined, either in front or behind, or first one and
then the other, so that the rays of light may fall upon the eye
obliquely. If the lids are kept closed it may be necessary to ex-
pose the cornea by pressing on the lids with the finger and thumb.
The light is held 8 or 10 inches from the eye and the lens is in-
terposed between it and the eye and moved nearer and more dis-
tant until the clearest illumination has been obtained of the point
to be examined. In this way every accessible part of the eye
may be examined in turn. The examiner may make his results
more satisfactory by observing the illuminated surface through
a lens magnifying three or four diameters. It is important to
observe that the eye of the operator must be in the direct line of
reflection of the pencil of light. :

Cornea. By focusing the light in succession over the different
parts of the surface of the cornea, all inflammations, vascularities,
opacities, ulcers, and cicatrices will be shown and their outlines
clearly defined. By illuminating the deeper layers of the cornea

328 Veterinary Medicine.

proper, the lesions of keratitis, opacities, ulcers and cicatrices will
be shown. ‘To complete the examination of the cornea the light
should be focused upon the iris so that it may be reflected back
through the cornea. This will reveal the most minute blood-
vessels, any cell concretions on Descemet’s membrane, or any
foreign body in the cornea which may have been overlooked.

Aqueous Humor. Unless the cornea is densely opaque, the
anterior chamber can be satisfactorily explored by the oblique
focal illumination. The cloudiness or milkiness of iritis or
choroiditis furnishes a strong reflection from its free particles of
floating matter, its blood and pus globules, and its flocculi of
fibrine. ‘The latter have usually a whitish reflection, the blood
elements a red (hypohzema), and the pus a yellow (hypopyon).
The writhing movements of a filaria scarcely need this mode of
diagnosis. Sometimes, and especially in the horse, detached
flocculi of black pigment are found floating free in the aqueous
and are highly characteristic.

By this illumination one can easily determine the distance of
the cornea from the iris and lens (depth of anterior chamber)
which is lessened by the forward displacement of iris and lens in
undue tension in the vitreous (glaucoma, retinitis, tumors,
bladderworms),or of the iris alone, in irido-choroiditis with accum-
ulation of exudate in the posterior chamber of the aqueous. The
depth of the anterior chamber may increase in cases of luxation
or absence of the lens or softening and atrophy of the vitreous.

The adhesion of the iris to the back of the cornea may be satis-
factorily demonstrated by focal illumination.

Iris. The lesions of the iris are exceedingly common in con-
nection with recurring ophthalmia in the horse, and examina-
tions in the intervals between attacks are of the greatest import-
ance. The eye should be examined as already stated, at a window
or door, and if available by the aid of a mirror. Any changes in
form or color, or luster should be carefully noted, any tension of
the eyeball, or angularity of the upper lid, and any slight blue
opacity round the margin of the cornea. Then the prompt or
tardy response of iris and pupil to light and darkness must be
made out. To complete the test the eye should be treated with
homatropin for three-quarters of an hour and with cocaine for ten
or fifteen minutes,and then subjected to oblique focal illumination.

Systematic Inspection of the Eye. 329

With partial posterior synechia the rest of the pupil is found
dilated while the attached portion extends inward remaining fixed
to the capsule of the lens. If the synechia is complete no dilata-
tion whatever has occurred. The edges of the adherent iris
extend inward as adherent projections, and any exposed portion
of the lens is likely to show black points, the seat of previous
adhesions that have been broken up. In such cases the periphery
of the iris bulges forward from the accumulation behind it of
aqueous humor or inflammatory exudate which cannot escape.
The discoloration of the iris as the result of inflammation, stands
out more definitely under the fuller illumination.

Crystalline lens. In exploring the crystalline lens or its cap-
sule for opacities (cataracts) oblique focal illumination can be em-
ployed to the very best advantage, if the pupil has first been
widely dilated by homatropine and cocaine. The light is con-
centrated on all parts of the anterior capsule in turn, then in suc-
cession on the different layers of the lens at all points and finally
on the posterior capsule. The striking reflection from any
points of opacity whether pigmentary, gray or pearly white is
diagnostic, not only of cataract, but of its exact position—an-
terior or posterior, capsular or lenticular.

Purkinje-Sanson images. If the flame of a candle is passed
in front of the eye, at a suitable distance, in a darkened room,
and the observer looks into the eye obliquely from the opposite
side, he observes three images of the flame, reflected respectively
from the front of the cornea, from the anterior surface of the
lens and from the back of the lens. ‘The image from the cornea
is erect, bright and clearly defined: that from the front of the
lens is still erect, but larger and dimmer, because the difference
between the index of refraction of the aqueous and lens is
very slight :' the third image, which is smaller and clearer than
the last, is inverted, because the surface of reflection on the back
of the lens acts as a concave mirror. The beginner may at first
find it difficult to make out the image from the front of the lens
but with a little care he can do so, and then by moving the light
he should cause each image-to pass over all parts of the reflecting
surface in turn. Any unevenness or opacity at any point of the
reflecting surface, will cause the image reflected from it to be-
come blurred or diffused as it passes over it and thus, not the

330 Veterinary Medicine.

existence only, but the exact seat of such opacity is easily demon-
strated. Opacities on the cornea cause blurring of the bright,
erect image of the flame as it passes over that part : opacities on
the anterior capsule of the lens blur the dim, erect image when
passed over them: finally, opacities in the body of the lens or
on its posterior capsule, blur the small inverted image as it passes
over them.

Add to this method the oblique focal illumination and the
images of the flame reflected from the three mirror surfaces
(cornea, anterior and posterior lens surfaces) are made much
clearer and more distinct than in any other way. ‘To do this
effectively the convex lens should be held so as to focus the flame
in the air nearly in front of the cornea. The Purkinje-Sanson
images are made very definite and clear. If the lens is ap-
proached nearer to the eye so as to throw the image of the flame
within or behind the lens, a gray phosphorescent streak of light
is seen in the depth of the pupil. This is due to the laminated
structure of the lens as well as to the fact that the lens itself is
not perfectly transparent even in its normal condition. The ab-
sence of the lens or its dislocation and displacement downward,
below the line of vision may be inferred from the absence of this
gray luminous reflection under this test.

OPHTHALMOSCOPE.

Principle of ophthalmoscope: Angle of incident and angle of reflection
in same line, light close to one side of the eye, reflected into it by a mirror,
having a hole in the centre for eye of observer. Opacities show a dense
white in transparent media: ifin front of lens move with rolling of eye: if
behind in opposite direction. To see fundus must use biconvex lens,
Emmetropic eye: myopic.: hypermetropic. Static refraction. Mydriatics :
Atropine, homatropine, daturine, duboisine, hyoscyamine.

In the healthy eye, the pupil and iris, and in cataract, even the
opaque anterior capsule of the lens, can be clearly seen. The re-
flection of the pupil, however, is dark and no object back of the
iris can be observed. ‘The reason of the difference is that the
rays of light, entering through the whole cornea, are reflected at
the same angle at which they strike the surface of the iris. The

Ophthalmoscope. 331

angle of incidence is the same as the angle of reflection. In the
hollow fundus of the eye, however, the light entering through
the narrow pupil, strikes the fundus at a point which is hidden
from the observer, behind the iris; and being reflected by the
concave fundus, in exactly the same line along which it entered,
it remains invisible. ‘To illuminate the fundus of the eye, for
the observer, his line of vision must be made exactly the same as
that in which the pencil of light enters the fundus. This is best
effected by reflecting the light into the eye by the aid of a small
plane or concave mirror having a hole in the center through
which the observer looks into the pupil. The concave mirror
gives the stronger illumination, but the plane article is more
easily manipulated and tends to cause less active contractions of
the pupil. This is the simplest form of ophthalmoscope. For
careful examination of the fundus of the eye, it is best to have
the subject in a dark chamber, with a single large flame of an oil
lamp or gas (electric light with an obscure globe may answer).
The light is held behind and on the same side as the eye to be
examined; at the level of the eye and the perforated mirror and
the eye of the observer are kept from 10 to 20 inches in front of
the eye and also at the same level. For the horse or ox under
favorable conditions in a stall, the light of day coming from a fan-
sash over the door may serve the purpose. Nicholas assures us
that it may be accomplished even under the shadow of a shed ora
tree. In such a case it is better not to have too much glare of
light as the reflection from cornea and lens may prevent accurate
observation. A somewhat cloudy day may therefore prove ad-
vantageous.

In focusing the reflected light on the cornea, and then on the
pupil and lens, any opacities in these will be shown as a grayish
nebular reflection or a denser white according to their degree of
opacity. The opacities in the cornea or aqueous, in front
of the axis of vision in the lens, move in the same direction and
to the same degree as the eye rolls, while opacities on the pos-
terior capsule or in the vitreous, move in a direction opposite to
the motions of the eye, and toa degree corresponding to their
distance back of the lens. ‘Thus if the eye looks downward such
opacities move upward ; if it looks upward they move downward ;
" if it looks inward they move outward ; and if it looks outward
they move inward.

332 Veterinary Medicine.

To secure an image of the fundus of the eye, including the
entrance of the optic nerve (optic papilla), the tapetum, the
pigmentary surface and retina and vessels, accommodation must
be made for the normal refraction of the eye of the patient, and
even for that of the observer.

In the emmetropic (normal) eye, the rays leave the surface
of the cornea parallel to each other and it may be possible for the
observer to secure a good image on his retina, without the aid of
lenses. In the myopic (short sighted) eye they assume a con-
vergent course on leaving the cornea, and to secure a satisfactory
image a biconcave or plano-concave lense must be interposed be-
tween the cornea of the patient and the eye of the observer.

In the hypermetropic (long sighted) eye, the rays diverge in
leaving the cornea of the patient, and a convex lens must be
interposed between this and the eye of the observer, in order that
the rays may be focused on the eye of the observer.

To adapt the vision to the different eyes the modern ophthalmo-
scope is furnished with a series of lenses concave and convex, any
one of which can be moved behind the hole in the mirror to suit
the demaids of the particular case.

To make a satisfactory examination the pupil should be dilated
as for oblique focal illumination. A 1 : 200 solution of apomor-
phia may be instilled into the eye (a drop or two) and in 20 to 25
minutes a satisfactory dilatation will have been secured. ‘The
effect of the homatropin will usually have disappeared in ‘twenty:
four hours.

Determination of Static Refraction.

This can best be done in the lower animals by determining the
strength of the lens required to render clear the image of its
fundus. By knowing the refracting power of the lens, we may
ascertain what deviation from the normal refraction there is in
the eye under observation.

In making this test the mirror of the ophthalmoscope must be
brought closely to the eye of the patient—1 to 2 inches.

If in such a case and without the use of any lens a distinct
image of the fundus is obtained, and if this is rendered less dis-
tinct by interposing the lowest convex lens in front of the eye of
the observer, the eye is emmetropic. |

Ophthalmoscope. 333

If the ophthalmoscopic mirror without a lens gives an indis-
tinct vision of the fundus, and if the image is rendered clear by
interposing one of-the convex lenses, the eye is hypermetropic.
The strength of the convex lens, + 1, + 2 or + 3, dioptrics will
give the measure of the higperinietrepia:

If, on the contrary, the ophthalmoscopic mirror gives an indis-
tinct image of the fundus, which is rendered even more indis-
tinct by the interposition of a convex lens, but is cleared up and
rendered definite by a concave lens, the patient is myopic. The
strength of the concave lens used will give the degree of myopia,
— 1 dioptric, — 2 dioptrics, etc.

The tendency in the horse is constantly to slight long-sighted-
ness, but the deviation is rarely found to be serious either in this
direction or in that of astigmatism.

Mydriatics,

Dilation of the pupil by mydriatics (mydriasis, dilation of the
pupil) isa most important means of diagnosis, and therefore a
knowledge of the action of the different mydriatics is essential.
The mydriatics in common use not only dilate the pupil, but also
paralyze the ciliary body and the power of accommodation in
ratio with the strength of the solution employed. This determines
an adaptation of the eye to the farthest point of vision and holds
it there until the action of the mydriatic passes off and normal
power of accommodation is restored. In short it renders the sub-
ject long sighted, during its action. 5

Atropine the alkaloid of atropa belladonna is the most gener-
ally available and persistent of the mydriatics, and is in most com-
mon use. It is usually employed as sulphate of atropine, though
some prefer the nitrate, the salicylate or the borate to obviate the
danger of atropinism. This form of poisoning may show in the
occurrence of conjunctivitis and in case of one attack the suscepti-
bility to atropine is greatly to be dreaded, so that it should never
again be used on the same subject, The real cause of atropinism
is uncertain, it has been variously ascribed to too great acidity or
alkalinity or to micro-organisms growing in the solution. Hence
the importance of using the antiseptic salts of atropine, and of
testing the solution to see that it is exactly neutral before it is

applied.

334 Veterinary Medicine.

The strength of the solution of atropine is an important con-
sideration. Donders found that 1 : 120 of water produced a full
effect, while Jaarsma obtained the full effect in one hour from a
drop of a solution of one to twelve hundred of water. The action
on carnivora (dogs and cats) is equivalent to that on man, while
on the herbivora (rabbit, horse, ox, sheep) it is somewhat less,
and on birds very slight indeed. On diseased eyes a large amount
may be required, and with senechia (adhesion of the iris to the
capsule of the lens) dilatation may be impossible. The full
effect may last 24 hours, and accommodation may remain very
imperfect for 11 days.

The direct action of atropine on the eye is shown in dilatation
of the pupil of the frog after the eye has been detached from all
connection with heart or brain, by excision. It acts also in the
normal system through reflex nervous action, since, after division
of the sympathetic trunk going to the eye, that eye does not di-
late so much under atropia as the opposite eye.

Atropine is usually employed by lodging a drop in the pouch
of the conjunctiva (inside the lower lid), and from this it makes
its way into the aqueous humor, for if that liquid is transferred to
the conjunctiva of another animal it causes dilatation. Puncture of
the cornea with evacuation of the aqueous humor lessens the action
of the atropine. Atropine dilatation is increased by following it
with cocaine which causes contraction of the iridian vessels, the
antithesis of the dilatation of the vessels which occurs when the
cornea is perforated and the pressure of the aqueous humor is re-
moved.

Atropine is one of the most potent poisons and must be used
with caution especially in the carnivora and omnivora. The
danger lies not alone in the absorption from the conjunctiva, but
also from the escape of the liquid through the lachrymo-nasal
duct, to the nose and later to the actively absorbing mucosz of
the lungs and stomach. :

The symptoms of general poisoning are : rapid pulse, vertigo,
weakness of posterior limbs, general prostration and thirst or
dryness of the throat.

Homatropine is an oily liquid produced by the action of
muriatic acid on the cyanate of atropine. With hydrobromic
acid it forms a readily crystallizable salt, the solution of which

Wounds of the Eyelids. 335

acts on the eye like atropine, but more promptly and transiently.
One drop of a solution of one to one hundred and twenty, usually
gives in twenty minutes, full pupillary dilation and complete
paralysis of accommodation which lasts only for twenty-four
hours. Add to this that there is little danger of constitutional
disturbance and poisoning, and homatropine must be accepted as a
more desirable agent than atropine. It is especially to be preferred
in cases of senility with shallow anterior chambers, and in glau-
coma, in which atropine tends to aggravate the lesion.

Daturine, the alkaloid of datura stramonium is a potent my-
driatic, causing pupillary dilatation in a solution of one to one
hundred and sixty thousand of water. It appears to be identical
with atropine.

Duboisine, the alkaloid of duboisia myoporoides is also a
potent mydriatic. Jaarsma found that a solution of the sulphate,
of one to three thousand, paralyzed accommodation for twenty-
four hours. It acts more promptly than atropine but is more
poisonous.

Hyoscyamine, the alkaloid of hyoscyamus niger, is also
strongly mydriatic. One drop of an one to three hundred solu-
tion of the sulphate paralyzed accommodation for from seventy-
five to one hundred hours. Risley found it to act more promptly
than atropine, and to be less dangerous than duboisine.

WOUNDS OF THE EYELIDS.

Traumas : bites, lacerations, blows, penetrating wounds, gunshot, scratches,
kicks. Upper lid or commissure. Reparatory power of eyelid. Danger of
distortion. Treatment: sutures, plaster, shellac, collodion, gelatine, Frick’s
gelatine, birdlime, sterilisation : Quilled and twisted suture. Position in
stall. Metallic guard for eye.

Causes. ‘Traumatic injuries of the eyelids are especially com-
non in the horse mainly because of his exposure in connection
with the services required of him. Ina team he is liable to be
bitten by one of his fellows, or the lid may be caught on nails,
in turning, or on hooks upon harness, chains or wagons. It
is sometimes injured by a blow from a club or whiplash, or

336 Veterinary Medicine.

by knocking the head against solid objects that he failed to
see on account of the blinds. Again the injury will come from
running against prongs of bushes or trees, or of stump fences.
Occasionally a blow with the horn of an ox or cow is the cause,
but this is much more frequent with the bovine races. Then
again gunshot wounds are found in all animals. In sheep the
eyelids sometimes suffer from bites of dogs, while in dogs and
cats, the teeth and claws are the main causes of injury. ‘These
smaller animals also suffer from brutal blows and kicks.

Nature. Wounds of the eyelids almost invariably affect the
upper lid, because of its extra size and prominence. Sometimes
one commissure or the lower lid is the injured part.

Clean incised wounds are rare, while lacerations, with or with-
out contusions are the common experience. ‘The laceration often
extends through the free margin of the lid, and then to one
side, mostly the outer, in a direction more or less parallel to the
tarsus. The result is that the detached flap drops downward
exposing a greater or less portion of the bulb covered with blood.
The conjunctiva, the cornea, the sclerotic or iris may be impli-
cated in the lesion in different cases, so that such wounds are of
the most varied degree of gravity. If, however, the lesion is
confined to the lid, and in the absence of absolute detachment of
the flap, or severe contusion, a good repair may be confidently
hoped for. The vascularity and reparatory powers of the eyelid
are unusually great, and the looseness of the skin, connective tis-
sue, mucosa, and even the muscles is such that they do not draw
injuriously upon the edges of the wound to disturb the process
of cicatrisation. If the two opposing ends of the divided tarsal
cartilage are kept in accurate apposition, the elasticity of this
structure serves to preserve the even contour of the palpebral
margin, and the adhesion or granulation process between the edges
of the wound, soon becomes firm enough to prevent further dis-
placement. Even when one-half of the eyelid is torn loose, remain-
ing attached only by a narrow portion, reunion without any un-
sightly distortion is not to be despaired of. In case of a mere vertical
laceration on the other hand, the case is very simple and hopeful.
Even when a portion of a lid has been completely torn off and
lost, the loose textures of the remaining part, often appear to
stretch in the process of healing so that a fairly serviceable,

~

Wounds of the Eyelids. 337

though by no means an esthetic covering for the eye may remain.
This may serve for a common work horse, but the unsightli-
ness would necessarily debar him from use in a carriage or as a
saddle horse. ‘The imperfect protection too, exposes the eye
to rainstorms, hail and snow, as well as to dust, and greatly
predisposes to conjunctivitis. i

Treatment. One can trust implicitly to the extraordinary re-
paratory power of the eyelids, yet so unsightly is any distortion
of these parts, that the greatest pains must be taken to obviate
loss of substance, or unevenness or puckering in healing. The
points to be mainly sought for are the perfect coaptation of the
divided edges, and the restraining of the patient from interrupting
the healing process and breaking loose the forming adhesions, by
rubbing the eye.

Inconsiderable wounds of the skin may be simply stitched
together with sterilized.catgut. Then the intervals between the
stitches may be approximated, dried, and covered with strips of
sticking plaster, or with shellac, collodion or gelatine. Frick’s
gelatine is made by dissolving fine gelatine in a 1 per cent. solu-
tion of corrosive sublimate and adding about ro per cent. of glycer-
ine, perfecting the admixture by the aid of heat. When wanted
for use it may be melted by heat and applied on the skin with a
camel’s hair brush. Bird lime may be used as a substitute.
Sterilization must be sought by the use of sublimate lotion 1 : 2000,
or boric acid 2: 100. Formerly the edges were kept in close
opposition by the use of quilled sutures, the stitches passed around
the quills being inserted at the usual distances while the quills,
applied against the edges of the wound kept them smooth and
even and obviated puckering. Or, perhaps better, the twisted
suture may be employed, the edges being brought together by
pins placed close together and a silk thread carried around each
in figure of 8, and spirally from pin to pin along the entire length.
If one pin comes out it ought to be promptly replaced and the
whole left in place until a firm adhesion is established. The
points of the pins are cut off short so that there may be no risk of
their pricking.

With any method the horse or ox may be turned in his stall so
that his tail may be toward the manger and his face outward, and
he may be tied by two halters to the two posts, right and left. His

22

338 Veterinary Medicine.

food may be furnished in a sack hung from the ceiling and cut
down one side. In this way the animal may be absolutely pre-
vented from rubbing the itching sore against any solid body, and
thereby interrupting the healing process. Another method.is to
apply a hood of stiff material with a metallic guard for the face,
having bars extending from above downward and arched outward
so that they shall effectually protect the eye in any attempt at
rubbing.

DEFICIENCY OF THE EYELIDS. COLOBOMA PALPE-
BRARUM.

The term coloboma representing merely a hiatus or deficiency
is applied to different parts of the eye according as there may be
a lack of substance of the part in question :— Coloboma palpe-
brarum (deficiency of the palpebre or lids), C. iridis (perfora-
tion of the iris), and C. choroidez (partial absence of the
choroid).

Coloboma palpebrarum is usually congenital and takes the
form of a vertical notch on the upper lid, separating its two
lateral parts into independent flaps. According to the breadth
and depth of the notch are the extent of the exposure of the
bulbar conjunctiva and the liability to irritation and infection by
foreign bodies. ‘The same condition of things will occur trau-
matically and require identical measures of repair. "These con-
sist in paring the edges of the notch and bringing them accu-
rately together with cat gut, silk or quilled suture, the approxi-
mation being rendered more perfect by the application of col-
lodion, shellac or gelatine mixture (see wounds of eyelids). The
vascularity and extensibility of the tissues of the lids greatly
favor a kindly healing. Rubbing of the eye must be guarded —
against as advised under wounds of the eyelids.

ORGANIC UNION OF THE EYELIDS. ANKYLOBLE-

PHARON. NARROWED FISSURE BETWEEN THE
LIDS. BLEPHAROPHYMOSIS.

Complete closure of the palpebral fissure has been seen as a
congenital infirmity in sheep, dogs and cats, while the partial
closure has been found in all classes of animals as the result of
chronic conjunctivitis and contraction of the exudation in under-
going organization. Narrowing of the fissure gives the appear-
ance of a small eye, so that a progressive diminution is usually
supposed to come from a reduction in size of the bulb, though no
‘actual atrophy of that organ has taken place. In drooping of
the upper lid (ptosis) too, the fissure is reduced and the illusion
of an atrophy of the eyeball is induced. The closure of the
fissure may come from blepharospasm, as the result of irritants
in the eye, or even of nervous disorder.

Treatment. In case of complete closure of the palpebra:
fissure, the skin is picked up with forceps and an incision is made
between the two tarsi into the conjunctival sac. Then with
probe pointed scissors, or a grooved director and bistuory the in-
cision is carried between the tarsi to the proper position for the
internal and external canthi. During healing the lids should be
frequently bathed with a boric acid solution, and an ointment of
the same with vaseline should be applied to prevent adhesion.

When the trouble consists in a drawing together of the skin at
the outer canthus, the result of inflammation, the adhesions are
separated by a horizontal incision leading outward from the line
of the angle. ‘The edges of the conjunctiva and skin are then
sutured together, so as to prevent further adhesion and the part
treated as an ordinary wound. This is known as canthoplasty.

Ptosis coming from tumors on the lid, or excess of fat in its
substance, or from oculo-motor disease must be treated according
to indications. The same remark applies to spasm of the orbicu-
lar muscle (blepharospasm), whether clonic or tonic. In domestic
animals the removal of the cause (foreign body, eyelash), will
usually succeed.

339

WIDENED PALPEBRAL FISSURE.

After wounds of the outer canthus the union of the edges may
remain imperfect so that the fissure is enlarged and the eye un-
duly exposed. The case is still worse if the wound has deviated
from the horizontal and has involved the orbicular muscle, the
divided ends of which continue to draw the edges apart, and
cause a constant overflow of tears (epiphora). Enlargement of
the bulb or its protrusion by reason of a swelling beneath it may
give rise to the same appearance (exophthalmos).

Treatment. Pare the edges of the upper and lower lids at the
outer canthus and bring them together by sutures.

LAGOPHTHALMUS. INABILITY TO CLOSE EYELIDS.

This is called have-eye (lagos, hare) from the fact that the
hare habitually keeps the eyelids open. It is mostly due to
spasm of the levatores palpebre, or to undue size of the orbicular
opening. It may, however, accompany ectropion, exophthalmos,
and enlargement or swelling of the eyeball from any cause.
Bayer has seen cases in diseases of the trifacial nerve, in neo-
plasms in the orbit and in buphthalmus.

Cases of the kind are especially liable to irritation, inflamma-
tion and ulceration due to foreign bodies falling on the exposed
bulb.

The ¢veatment is largely that of the attendant condition ectro-
pion, tumor, etc., which may be consulted.

340

ADHESION OF THE EYELID TO THE BULB. SYM-
BLEPHARON.

Causes : Conjunctivitis, burns, operation and other wounds. In front of
or behind the reflection of the mucosa from eye to lid. Prevention. Treat-
ment : section of adhesion, and vaseline, etc. Two edges of healthy mu-
cosa sutured together over the sore. When fornix is implicated mucosa is
transplanted.

This is liable to occur to a greater or less extent, in all animals,
in connection with violent conjunctivitis, burns and operation
and other wounds. It has been divided into anterior and pos-
terior symblepharon, the former being an union in front of the
normal reflection of the conjunctiva from the lid upon the bulb
(fornix), and the latter involving the fornix in the substance of
the adhesion. ‘The azterior form by anchoring the lid to the
eyeball is much more likely to induce blindness, but it has the
compensation that the union may be broken up and the parts
healed without subsequent reunion. In the posterior form the
eye can be better exposed and vision retained, its repair is much
more difficult demanding transplantation of skin or mucous mem-
brane on to the sore, and even then the granulation tissue being
continuous from bulb to eyelid may so contract in healing as to
leave matters no better than before.

These adhesions not only restrict the movements of the lids,
preventing their opening and the exposure of the bulb, but they
also anchor the bulb itself, and hamper its movements, neces-
sitated for vision. In all cases therefore of wounds, burns, abra-
sions and ulcers, of the palpebral and bulbar mucosz it is highly
important to take precautions against the formation of such con-
nections. Any forming adhesions must be broken up day by day
and the surfaces must be kept apart in the intervals by borated
or iodoformed vaseline.

In a small anterior symblepharon the connections may be cut
through and subsequent adhesion prevented by the frequent in-
troduction of iodoformed vaseline, and if need be, by the daily
separation of the surfaces by a probe. When this fails a plastic
operation may be resorted to, the mucosa on the inner side of the

341

342 Veterinary Medicine.

lid being incised in a vertical direction a short distance on each
side of the sore and the inner edges accurately stitched together.
‘The raw surface left on the bulb thus comes in contact only with
the healthy mucous strips on the eyelid, which have been drawn
together over the seat of the former sore, and the two new raw
surfaces formed on the lid are well to each side of the sore on
the bulb, and are in contact with its healthy mucosa only. Thus
no two raw surfaces can come in contact, and adhesion is obviated.

When the fornix is implicated mucous membrane from the
mouth, vulva, the bronchia of the rabbit, or the skin of the frog
must be transplanted after the requisite incision of the cicatrix
has been made.

INFLAMMATION OF THE EYELIDS. BLEPHARITIS.

Phlegmon. Causes : traumas, skin disease. Symptoms: swelling, red-
ness, distortion, infiltra ion, semi-closed lids, scabs, sloughs, ‘abscess.
Tenderness. Itching. In eczema papules, vesicles, weeping eye. Treat-
ment: antiseptic astringent lotions, almond oi], vaseline, zinc oxide,
salicylic acid, boric acid, starch, xeroform, pyoktannin ; for eczema, mer-
cury oxides, silver nitrate, collargol.

Conjunctivitis will be treated’ later, and under the present head
there will be considered only the phlegmon of the outer structures.

Causes. "This lesion may come from two distinct causes, traum-
atism and skin disease. The traumatisms in /orses and cattle are
bruises sustained in rolling, especially during colics, in striking
the head against posts, poles, shafts and other solid bodies, in
enduring blows with ‘horns or clubs, or frictions by the halter or in
putting onacollar. Dogs suffer especially from blows with clubs
and kicks from men or animals. Ad/ may suffer from wounds of the
lids, and from extensions of eczema, acariasis and other skin dis-
eases.

The symptoms consist in swelling, redness, distortion, and often
extensive infiltration of the lid, some times eversion with exposure
of the reddened conjunctiva, ustally abrasion, contusion, puncture
or laceration, semi-closed eye, the upper eyelid being compara-
tively immovable (ptosis), and the formation of scabs, sloughs,
or abscess. There may be extreme tenderness, or, more com-

Inflammation of the Eyelids. Blepharitis. 343

monly, intense itching. Where eczema exists there may be
found minute shot-like papules at times surmounted by small
vesicles and the skin disease is continuous backward upon the
face. When abscess forms, the rounded swelling and manifest
fluctuation will betray its presence. Usually the eye waters and
the side of the cheek is wet and the hairs matted by a whitish
coagulated lymph and mucus.

Treatment. ‘In the early stages without scabs, sloughs, or ab-
scess, antiseptic astringent lotions are in place. Weak solutions
of zinc sulphate, boric acid and morphine may be kept applied
on alight bandage. Or silver nitrate 1 gram to I oz. water may
be applied daily with a fine brush.

When scabs and crusts have formed they may be softened by
the application of almond oil, and then removed. ‘The surface
may then be dusted with a bland antiseptic powder such as:
zinc oxide Io parts, salicylic acid 1 part ; or boric acid and starch
equal parts; or iodoform; or xeroform. Or unctuous applica-
tions may be used : zinc oxide Io, salicylic acid 1, vaseline 10;
or iodoform 1, vaseline 5. Ora watery application may be used,
such as the silver lotion or that of pyoktannin 1 : 1000.

For eczema yellow oxide of mercury 1, to vaseline 10, has an
excellent reputation. It may be alternated with pyoktannin.

When abscess has formed it should be incised in a line parallel.
to the free border and the resulting cavity injected with the silver
or the pyoktanin solution.

In all cases the patient must be fastened as for wounds of the
lids so that he cannot rub the eye.

For eczema, acariasis and other skin diseases the special treat-
ment appropriate to the disease should not be omitted.

(EDEMA OF EYELIDS.

In anthrax, malignant cedema, disease of heart, kidney or liver, distoma-
tosis, trichiniasis, wasp stings, urticaria, petechial fever. Treatment: cor-
rect general disorder, remove local irritant, antiseptic astringents.

An cedematous condition of the eyelids with or without in-
flammatory conditions may be due to local disease or it may be
the result of more general disorder. In anthrax districts any of

344 Veterinary Medicine.

the herbivora, but especially cattle and sheep, are liable to a dif-
fuse anthrax of the eyelid with a special petechial or brownish
condition of the palpebral conjunctiva. Malignant cedema and
other local bacteridian affections affect the loose textures of the
eyelid in a similar manner, but with extrication of gas and crack-
ling under pressure. Such cases are complicated by local in-
flammation. When in the absence of inflammation the lids pit
on pressure, one should seek for some disease of the heart, kid-
ney or liver, also for indications of similar dropsical effusions in
other parts of the body. Distomatosis and to a less extent, pul-
monary and duodenal strongylosis are especially common factors
in sheep. In distomatosis (liver rot) a simultaneous dropsy is
often present in the intermaxillary space, the chest or the ab-
domen. ‘The puffiness of the eye is especially marked in the pal-
pebral conjunctiva, and is exposed by everting the eyelid over
the tip of the finger. In trichinosis in man and less frequently
in swine, dropsy of the eyelid is often present at the end of
the first week. Other swellings of the lids partaking more of the
nature’of inflammation, result from the stings of wasps, hornets
and other insects, from urticaria (in horses especially) and from
petechial fever in solipeds.

In ¢reating such cases the general disorder, if present, must be
first attended to, then the removal of any local irritant, and finally
the antagonizing of any local inflammation or infection. Astrin-
gent and antiseptic lotions are especially called for.

EMPHYSEMA OF THE EYELIDS.

This has been already referred to as occurring in malignant
cedema, black quarter and other gas producing infections. It
may also come from lacerations made in puncturing the lachrymal
sac, and from fracture of the margin of the orbit—the air enter-
ing the connective tissue in this case from the cavities of the
nasal sinuses. The lid feels puffy and crackles when pressed and

apart from a general infection it requires only soothing and anti-
septic dressings.

DISEASE OF THE MEIBOMIAN GLANDS. BLEPHAR-
ADENITIS. SEBORRHGA.

This is a blepharitis of the edges of the lids which are swollen,
red, and incrusted along their margins with scabs and sebaceous
concretions. When this scurf is removed the skin is found to be
red, tender and glistening. ‘The glands are the seat of conges-
tion, and produce a modified secretion in excess, which dries into
crusts instead of preserving its normal oleaginous consistency.
As these glands open into the follicles of the eyelashes, their
walls are implicated and shedding of the lashes is a common re-
sult. It may be assumed that this affection is often associated
with the proliferation of microbes in the glands and gland ducts,
while in other forms the presence of acari is the controlling fac-
tor. Wilson found the demodex folliculorum in the Meibomian
glands of the horse, Oschatz in those of the sheep, and others in
those of the dog.

Treatment. Smear the margins of the lids with vaseline and
when the crusts have been thoroughly softened wash them off
with Castile soap and warm water. Then dress the margin with
the ointment of the yellow oxide of mercury 1, in vaseline Io.
If demodex is suspected they may be squeezed out and the lids
washed frequently with spirits of wine as a solvent.

HORDEOLUM. STYE. ACNE.

- Like acne of the skin in general, this consists in inflammation
and suppuration of a hair follicle and sebaceous gland. The
whole lid or a large part of it may be swollen, but by stroking it
with the finger, a hard, rounded, very tender spot will be de-
tected, and as the disease advances this develops a minute collec-
tion of pus. A specially wide orifice favors the entrance of the
pus microbes, and the onset of the disease. It has been noted in
dogs (Frohner).

For abortive ¢veatment Fick recommends dry heat from a pocket
handkerchief or a heated teaspoon. If pus is present it must be
evacuated, and recurrence guarded against by cleanliness and

345

346 Veterinary Medicine.

antiseptics. " Use pyoktannin solution (1 : 1000), or mecuric
chloride (1 : 5000) or yellow oxide of mercury ointment.

CHALAZION.

This is a pea-like tumor growing from the tarsal cartilage, its
flattened side toward the mucosa, which is red and angry, and
its round surface toward the skin. When manipulated between
the fingers it moves with the tarsus. It is usually of slow growth
and may continue for years apparently unchanged. Some have
thought it tuberculous, but its true nature is uncertain. Warner
records the disease in the horse.

Treatment consists in incision and removal of the tumor, cur-
retting of the cavity, and after antiseptic douching, suturing the
lips.

TUBERCULOSIS OF THE EYELID.

Described by Jewsejenke in the lower lid of birds, this is mani-
fested by small, hard round knots, covered by bluish red, or yel-
lowish red skin, and when incised showing a characteristic miliary
tubercle, with bacilli and sometimes a caseated centre. It is
treated by incision, curretting and caustics.

TURNED-IN EYELASH. TRICHIASIS.

Sometimes an eyelash grows inward so as to impinge upon the.
front of the eyeball, or even to extend between this and the eye-
lid. The condition exists in extropion but trichiasis is rather the
deviation of one or two cilia by reason of their false direction, in-
dividually. It may occur as the result of a pre-existing inflam-
mation affecting the edge of the lid and the follicle, and the
offending hair is not only badly directed but small and shrunken
as well. On this account it is not always easy to recognize it,
and accordingly in cases of conjunctivitis without apparent cause

Exntropion. Turning in of the Eyelid. 347

it is well to examine carefully with the aid of oblique focal
illumination.

Treatment consists in pulling out the offending hair with ciliary
forceps, avoiding bending it lest it break off short and become at
once more irritating and more difficult of extraction. In case
the hair grows anew in the same direction extract it anew and
destroy its root with the electric cautery. Or the cilia being
drawn out with a smooth ring or spatula, an incision is made on
the inner side of this, between the tarsal cartilage and the orbic-
ular muscle. The skin is drawn out by plaster, or stitch, or
plastic operation, and the wound allowed to heal by granulation.

ENTROPION. TURNING IN OF THE EYELID.

In foals, puppies, hounds, with narrow fissure, and conjunctivitis, or
tarsitis. Permanent bandaging, orbicularis spasm. Symptoms: disappear-
ance of tarsus and lashes by involution. Treatment: in spasm fix by plas-
ter; suture skin: excise elliptical section of skin and suture edges together.
Release cicatrices.

Inversion of the eyelid or a portion of it, with consequent
trichiasis, conjunctivitis and lachrymation has been met with con-
genitally in foals (Aubry, Bourdeau, Hamon) and puppies
(Cadiot, Almy). Hounds have especially suffered. In the older
animals it is largely determined by abnormally narrow fissure,
and by old standing disease of the conjunctiva or tarsus, with
cicatricial contraction or adhesion. Persistent bandaging turns
in the cilia and contributes to entropion. Finally a persistent
spasm of the orbicularis muscle may bring it about.

Symptoms. ‘Trichiasis is usually, though not always, present.

In any case the tarsus is turned. inward so as to press upon the
front of the bulb, or even to disappear completely. Thickening
and distortion of the lid is a not infrequent condition.

Treatment. In case of simple spasm clip or shave the hairs
from the lid corresponding to the lesion, and close to the tarsus
attach a strip of plaster. When firmly adherent draw it suffi-
ciently to efface the entropion and attach it to the skin of the
face.

348 Veterinary Medicine.

This failing, Gaillard’s sutures may succeed. With a pair of
forceps with looped, transversely elongated blades, pinch up skin
and muscle sufficient to correct the entropion, and passing a
needle twice through this fold with an interval of 3 mm., tie
the suture over a small roll of cotton. ‘The stitches may be re-
moved in two days and the cicatrices may permanently obviate
the deformity.

The older plastic operation is more trustworthy: ‘The skin of
the affected lid is pinched up to such an extent in length and
breadth, as to correct the entropion and is then excised with
sharp scissors or bistuory so as to leave a long elliptical sore.
The edges of this are then carefully sutured together and the re-
sulting union corrects deformity. Frohner excises a circular
piece of skin and allows it to contract and heal by granulation.
In case the entropion is caused by an old standing cicatrix, it may
be necessary, first, to make a careful incision along the edge of
the lid so as to separate the tarsus and conjunctiva from the cilia.
and Meibomian ducts, and then to proceed with the plastic oper-
ation on the skin.

TURNING OUT OF THE EVELID. ECTROPION.

In large dogs, in old age, debility, conjunctival swelling, cicatrized skin
of lids, distortions of lids. Symptoms: exposure of pelpebral mucosa,
weeping eyes, conjunctival hypertrophy (chemosis). Treatment : :carify
or excise a fold of mucosa, astringent antiseptics, Snellen’s suture, Diefen-
bach’s operation, Wharton Jones operation.

This is much more common than entropion, but much less in-
jurious as the tarsi and lashes do not irritate the conjunctiva. It.
is especially common in large dogs (hounds, mastiff) and usually
affects the inner part of the lower lid. Old age and debility con-
tribute materially to the condition, the lack of tone or paresis
being an important factor. It may, however, occur in any ani-
mal, from conjunctivitis and swelling of the mucosa, from cica-.
trices or old standing disease of the skin of the eyelids, or from
imperfectly healed wounds leaving distortions of the lower lid.
It is most frequent in the lower lid, and the slightest pendulous.
condition, which detaches the tarsus from the bulb, and exposes.
a narrow zone of the conjunctiva is considered to be an ectropion.

Turning Out of the Eyelid. Ectropion. 349

Symptoms. Beside the exposure of the zone of mucosa, there
‘is the overflow of tears, and in old standing and bad cases a
hypertrophy of the exposed conjunctiva, which projects as a
‘fleshy-looking mass, and weighs down the lid, with a continual
tendency to aggravation.

Treatment. Where the main factor seems to be the infiltration
of the mucosa this may be reduced by scarification, or by the
complete excision of a fold of the membrane. Use an antiseptic
wash (boric acid) and the retraction of healing tends to brace up
the lid against the bulb.

Snellen’s suture is sometimes employed successfully. A silk
thread is armed at each end with a needle, and the needles are

- passed into the conjunctiva just inside the tarsus and brought
out through the skin near the margin of the orbit, where they
are tied round a sniall roll of cotton. Several of these may be
inserted side by side so as to extend the whole length of the
ectropion and they should be drawn tight enough to correct the
deformity. If left some days they will usually determine cica-
trices which will overcome the deformity.

The most common operation (Dieffenbach’s) is the excision of
a triangular portion of skin from just outside the lower lid and
having its base or upper side running horizontally outward from
the outer canthus. Then pare the margin of the lower lid for a
distance equal to the base of the triangle. Then bring together
and suture the skin forming the right and left sides of the tri-
angle, and the raw edge of the lid to the skin that formed the
base of the triangle. In this way the triangular sore formed by
the operation is completely covered and the margin of the lower
lid is shortened so as to brace it up against the bulb.

In case of cicatricial ectropion the Wharton-Jones operation is
to be adopted. A V-shaped incision is made in the skin of the
lower lid commencing just beneath the tarsus and carried down
so that the two lines of incision meet well down beneath the cica-
trix. ‘The triangular flap of skin thus made, is detached by a
bistuory from the cicatricial tissue beneath, and allowed to shrink
upward toward the tarsus. Finally the two edges are sewed to-
gether from the angle upward, as far as may be necessary to allow
the proper application of the tarsus against the bulb, and the re-
mainder of these edges are sutured to those of the triangular flap.

TUMORS OF THE EYELIDS.

Warts. ‘The most common tumors of the eyelids in horses,
cattle, and dogs are warts, These are most simply disposed of
by seizing them with rat-tooth forceps and clipping them off with
sharp scissors curved on the flat. Any bleeding may be checked
by a pencil of silver nitrate.

Sarcoma, melanoma, and epithelioma are common in soli-
peds, especially in the gray and white. They usually form a
cauliflower-like mass red and angry and bleed easily. They
may occupy any part of the lid, the skin, the dark tarsal margin,
the connective tissue or the mucosa, and not unfrequently they
involve the eyeball, and the surrounding tissues, even the bones
of the orbit.

Treatment. 'These may be excised like warts taking care to
remove every vestige of disease. In these cases I have usually
found it necessary to remove the entire bulb. Popow cured a
polypus (probably actinomycosis) by applying tincture of iodine
daily for four weeks.

FRACTURE OF THE ORBIT.

Nature and Causes. ‘The usual seat of fracture is the orbital
process of the frontal bone, yet any portion of the orbital mar-
gin may suffer, and even the inner wall or floor of the orbit
may be broken by a penetrating instrument. Horses and polled
cattle and sheep are especially exposed to the injury, while in
horned stock the region is in a measure protected. Carnivora,
which have no bony orbital process, are less liable but may
still sustain fractures of the remaining parts. Horses and polled
ruminants suffer mainly from beating the. head on the ground
or other solid body in the paroxysms of colic and enteritis, or
in nervous affections ; horned stock suffer from concussions in
fighting and direct blows by the horns. All animals suffer from
blows with clubs, kicks and other mechanical injuries.

Symptoms.: With (and less frequently without) a skin wound,
there may be indication of depression, or mobility of the de-

350

Bruises and Wounds of the Orbit. 351

tached segment, or its sharp edge may be felt, through the skin,
or by the sterilized finger introduced into the orbit. In case of
a penetrating or stab wound, which cannot be followed by the
finger, it may be followed by an aseptic probe and any fracture
recognized. The conjunctival sac must be first thoroughly
‘ washed out with an antiseptic lotion, as the introduction of any
septic germs into the osseous wound is likely to cause a danger-
ous infection or abscess.

Treatment. Simple, slight fractures with blunt instruments
are treated by rest and cooling, disinfectant lotions. If foreign
bodies or detached particles of bone are found in the wound they
should be extracted. Shot that are difficult to find, may be left,
as they are often aseptic and tend to become encapsuled. Should
they cause abscess they will usually be found in the pus sac and
may then be removed. Displaced bones may often be replaced
by the finger in the orbit. Sometimes they can be best reached
by trephining the frontal or maxillary sinus and introducing a
lever through the cavity (Hendrickx). If the sinus has been
involved it must be opened in any case. Cadiot advises bandages
impregnated with black pitch to fix the bones in certain cases.
Antiseptic washes (sublimate 1: 5000) and antiseptic cotton
packing are demanded for all wounds.

BRUISES AND WOUNDS OF THE ORBIT.

These may come from the same causes as fractures and though
less violent may occasion inflammation which involves the eye
or even the brain with fatal results. Thus in horses it has
been a cause of infective inflammation, with a fatal extension
(Robellet) ; in cattle a similar inflammation has extended to the
cerebral meninges and caused death (Leblanc), and in dogs an
advance to the eyeball threatens its destruction (Moller). Short
of this necrosis is not uncommon (Rey).

Treatment. ‘This does not differ materially from that de-
manded by penetrating wounds with fracture. A perfect cleans-
ing and antisepsis of the wound is the first demand. A solution
of boric acid (4 per cent.) or of mercuric chloride (1 : 5000)

352 Veterinary Medicine.

liberally applied, and maintained thereafter on soft pledgets of
surgical cotton, will often have the best results. All foreign
bodies must be carefully removed, lacerated flaps and shreds may
require suturing, dead portions excision, and finally abscesses or
excessive exudate may require the lance, but cooling, antiseptic
lotions and an elevated position of the head are among the most
prominent resorts.

RETRO-BULBAR ABSCESS.

Schindelka has observed this in the horse, in connection with
petechial fever. If connected with meningeal abscess it will be
necessarily fatal. In favorable cases evacuate the pus as soon as
detected and dress with pledgets of cotton saturated with a mer-
curic chloride solution (1 : 2000) or-other antiseptic.

PERIOSTITIS OF THE ORBIT.

This may be shown by the firm swelling of the bone and, in
case a wound has been formed, by the contact of the probe with
the denuded, hard, rough bone. When thus exposed or necrosed
on the surface, or when an exostosis has formed, the bone may
be laid open and scraped down to the healthy tissue, and then
dressed with antiseptic pledgets.

TUMORS OF THE ORBIT.

These may be of different kinds, as sarcoma, encephaloid,
osteoma and actinomycosis. ‘They demand thorough surgical
treatment, except perhaps in the case of the latter, which may re-
cover under iodide of potassium. Emmerich records an extensive
sarcoma of the orbit in a cow, weighing six pounds and extend-
ing into the nasal sinuses and chambers, and implicating the
cerebral meninges. Moller records cases of sarcoma and car-

Disease of the Lachrymal Gland and Ducts. 353

cinoma of the orbit in horses and dogs, and Leblanc in cattle.
Melano-sarcoma is not uncommon in the orbits of gray horses
which are changing to white.

Exostoses are common around the orbits of cattle.

If such growths do not show on the surface they cause a more
or less unsightly protrusion of the eyeball, owing to the presence
of the neoplasm in the depth of the orbit, and the removal of
the bulb becomes a necessity.

DISEASE OF THE LACHRYMAL GLAND AND DUCTS.
DACRYO-ADENITIS.

Even in man these parts are remarkably free from disease,
while in the lower animals, we have literally no record of such
conditions. Inflammation of the gland (dacryo-adenitis) would
be manifested by a sensitive swelling under the outer part of
the orbital process, and upper eyelid and by lachrymation, and
obstruction of the gland duct and by a tense transparent rounded
swelling inside the lid. A fistula is possible from a penetrating
wound of the lid in the same situation. In both of the latter
conditions an opening made through the palpebral conjunctiva
will allow the discharge of the tears in the proper place, and
healing of any external wound may be hastened by suture or
plaster.

OBSTRUCTION OF THE LACHRYMAL PUNCTA.
ATRESIA. INFLAMMATION.

Congenital atresia of these puncta has been recorded in foals, by
Hollmann, and obstruction as the result of inflammation, by La-
fosse, Verjaus and Tyvaert, and of the entrance of the seeds of
bromius by Stockfleth.

Apart from congenital atresia and impaction of foreign bodies
the symptoms are those of conjuctivitis, with escape of tears
over the face (epiphora). Injection of aseptic water into the

23

354 Veterinary Medicine.

lower puncta and its escape by the upper, and by the nasal ori-
fice, will determine the patency or otherwise of the various
channels.

Treatment consists in astringent collyria to check the inflam-
mation, in the removal of any foreign body, in the dilation or
slitting of the lachrymal canaliculi, and in case of complete
atresia, in incising the lachrymal sac. Slitting of the canaliculi is
accomplished by a small probe-pointed bistuory (canaliculus
knife). The lid is drawn away from the carnucle, and the probe
point inserted at first downward, then inward and backward, and
when it is well inside the sac the handle is brought to the vertical
and the walls of the duct slit open.

In case of atresia Leblanc recommends to seize the inner can-
thus with rat tooth forceps so as to include the structures about
the sac and to plunge the bistuory directly into the sac. Then
by the aid of a whalebone staff he passes three silk threads
through the duct and fixes them in place by attaching them to a
copper ring at each end. This is retained in place and moved
daily until the passage has been definitely healed and its per-
manency assured.

WOUND AND FISTULA OF THE LACHRYMAL, SAC.

The lachrymal sac, which receives the tears from the canali-
culi, is situated in the infundibulum at the upper end of the
lachrymal canal and is in great measure protected against exter-
nal injuries by the prominent orbital edge of the lachrymal bone.
Yet violent blows with, or without fracture, sometimes lead to
rupture of the mucous walls and the formation of a fistula.
Wounds made with penetrating bodies, more or less pointed are
also liable toinvolvethesac. The fistulousorifice may be through
the skin at the inner canthus or through the mucosa by the side
of the caruncle. The cutaneous opening may bea minute orifice
from which tears and muco-purulent matter escapes, to mat to-
gether the hairs on the side of the face. Sometimes there is a
reddish elevation, the size of a pin head, and in fistula through
the mucosa this is the rule, and the orifice is elevated so that the

Catarrh of the Lachrymal Sac. Dacryo-Cystitis. 355

tears flow out over the face. For the symptoms of the attendant
catarrh of the sac see below. In infected cases with obstruction
of the lachrymo-nasal duct, it has been known to extend to the
bone and even to open into the sinuses, or tooth follicles. (Gerard,
Leblanc).

The condition is found in horses, cattle and dogs.

Treatment. In fistula resulting from simple traumatism, noth-
ing more may be requisite than rest and soothing astringent ap-
plications. Sutures are sometimes resorted to but are liable to
cause itching and do more harm than good. It is above all im-
portant to keep the lachrymo-nasal duct patent, and for this
purpose a lead or silver stilet, or a thick cat gut suture may be
worn in the canal until healing has ensued.

CATARRH OF THE LACHRYMAL SAC. DACRYO-
CYSTITIS.

Connected above through the canaliculi with the conjunctiva,
and below through the lachrymal duct with the nasal chamber
this cavity is liable to be more or less implicated in all cases of
nasal catarrh and conjunctivitis, (strangles, canine distemper,
influenza). If the lachrymal duct is obstructed so that the tears
accumulate in the sac, the tendency to catarrh is further en-
hanced by the distension and weakening of its walls, and by the
propagation of bacteria which have entered with the tears, and
find in them a favorable and abundant culture medium ; the di-
ameter of the sack in the horse being about 7rds. of an inch.
The presence of foreign bodies is another cause.

Lesions. Symptoms. Swelling at the inner canthus, which
raises the caruncle above the normal level, and the escape of tears
over the lower lid are the most prominent symptoms. If the
swelling is pressed it subsides, the contents, clear or purulent, es-
caping through the lachrymal duct, to the nose, or through the
puncta and accumulating in the inner canthus or flowing over
the check. ‘The hair beneath the inner canthus is matted to-
gether, or drops off leaving bare patches. Wolff found in one

356 Veterinary Medicine.

case, a distension of the sac to over two inches in breadth, and
1% inches long. To the swelling there is soon added conjunctival
inflammation, closure of the puncta by swelling and the escape of
all tears over the face. Suppuration supervenes in the sac, and in
the larger animals the pent up pus often makes its way outward,
causing destructive ulceration of the walls of the canaliculi and
puncta, or of the walls of the sac, the skin, or even the subjacent
bone. In this way fistula results. Caries of the bone and pene-
tration of the molar alveoli may ensue. (Girard, Leblanc).

Treatmént, ‘The first object must be to secure a free drainage
into the nose. ‘The evacuation of the sac by compression having
been accomplished, an astringent solution may be injected through
the nasal opening of the lachrymal duct. If the canal is per-
vious the sac will be re-filled and will swell out as before. The
injection may be 0.5 per cent. sulphate of zinc, 1 per cent. ace-
tate of lead, 0.3 per cent. nitrate of silver, 1 per cent. tannic
acid, 2 per cent, boric acid, or 0.02 per cent. corrosive sublimate.
Cocaine may be added in the proportion of 5 per cent. The in-
jection may be repeated thrice a day at first, then twice, and
finally once as the catarrh subsides. Lubke uses aluminate of
copper.

If the injection fails to reach the sac, thoroughly sterilized,
flexible probes may be used daily, increasing the size as they can
be passed without too great pressure.

Or the puncta and canaliculi may be injected as in the human
subject, the conjunctiva having been first anzesthetized by co-
caine, or general ether or chloroform anzesthesia having been in-
duced. The slitting of the puncta and canaliculi may be re-
sorted to, as spoken of under atresia.

The frequent passage of a sound is usually resorted to, and a
stilet may even be worn, but there is always danger of resulting
thickening and narrowing of the duct, and, if healing can be se-
cured without this measure, it is to-be preferred.

STENOSIS OF THE LACHRYMO-NASAL, DUCT.

Obliteration of the lachrymal duct may occur from stricture of
the canal, the result of wounds or other irritants: from pres-
sure by the inflamed mucosa in nasal catarrh, or strangles: from
polypus or osseous tumor in the nose: from actinomycosis or
other disease of the Bones.

The one manifest symptom is the escape of the tears on to
the face. To complete the diagnosis, injection of one punctum
will cause distension of the lachrymal sac.

Treatment. 'This may be attempted by bougies. In the horse
a small sound, metallic or whalebone bougie, thoroughly sterilized
and smeared with aseptic vaseline, or oil, is inserted from the
nasal opening and carefully passed on into the sac. In the dog
the nasal opening cannot be reached and the bougie must be
passed by the punctaand lachrymal sac. Tosecure the requisite
dilation, it is usually necessary to probe the passage daily, using
a larger probe when the first passes easily, until the canal has
been sufficiently dilated.

A second resort is to distend the canal by a liquid injection
thrown into the nasal opening. This will succeed when the ob-
struction is only caused by concretions in the canal.

A somewhat similar resort is the insufflation of the duct by
means of a finely pointed tube inserted from below into the nasal
orifice of the duct.

Still another method is to make a new opening for the escape
of the tears into the nose. When the stenosis is at or near the
nasal opening of the duct, an artificial opening is easily made and
usually satisfactory. Under anesthesia, a sterilized silver
probe is passed through the upper punctum, the sac and
canal. When it meets definite obstruction its position is ascer-
tained inside the nose, and an incision is made so as to allow its
escape. The constant escape of tears tends to prevent it from
closing up again, but it is well to examine into this until it
has thoroughly healed. A silk thread worn in the duct and
held in place by a copper or aluminum ring on each end may be
resorted to.

357

358 Veterinary Medicine.

Attempts have been made to establish a new outlet by boring
through the lachrymal bone into the nose, but without a perma-
nent success. It has also been advised to obliterate the lachrymal
ducts and sac, on the one hand and to excise the lachyrmal
gland on the other, but the proposed cure is worse than the
disease. ,

DISEASE OF THE LACHRYMAL CARUNCLE.

The caruncle is inflamed in conjunctivitis. When this inflam-
mation leads to hypertrophy it is known as encanthis. ‘This is a
common condition in dogs and the caruncle may increase to the
size of a pea or acorn, and by compressing the canaliculi it leads
to a profuse overflow of tears on the cheek. At first there is
the acute congestion of conjunctivitis, but later there may be in-
duration and pallor.

The treatment of this condition consistsin astringent and seda-
tive collyria in the early inflammatory stages, and later in the
ablation of the hypertrophied mass. The caruncle is seized with
a pair of rat-tooth forceps and snipped off with curved scissors,
the free bleeding being afterward checked by cold water.

In cases that seem, by reason of excessive vascularity ill
adapted to this method, the hypertrophied mass may be tied at
its base with a stout silk thread so as to cut off the supply of
blood, and cause it to slough off. A collyria of boric acid (4 per
cent.) or mercuric chloride (0.02 per cent.) may be used to
prevent infection.

Tumors of the Caruncle are met with, such as fibroma
(Worz), Sarcoma and Melanosarcoma. For all alike the com-
plete extirpation of the neoplasm is demanded.

‘

WOUNDS AND INFLAMMATION OF THE MEMBRANA
NICTITANS.

Like other parts of the ocular apparatus, the third eyelid and
gland of Harder are subject to accidental injuries of various kinds.
What is worse, ignorant persons seeing the castilage and mem-
brane projected over the eye in ophthalmias and tetanus, have
mistaken it for a morbid product and deliberately cut it off in
part. The condition of the organ may be ascertained by parting
the lids with the fingers and pressing gently on the front of the
eyeball, when the nictitating mentbrane will be fully exposed.

If detached portions cannot be restored, but threaten to slough,
or cause distortions or unsightly and irritating neoplasms they
should be seized with forceps and snipped off with scissors.
Otherwise the treatment consists in soothing astringent and
anodyne Collyria as in conjunctivitis.

TUMORS AND HYPERTROPHY OF THE MEMBRANA
NICTITANS.

Papilloma is seen in the dog (Hobday), epithelioma and lipoma
in the horse (Fréhner, Williams), also dermoid (Schimmel).

Neoplasms of this organ may occur in any quadruped or bird
and may be recognized by the swelling of more or less of its sub-
stance, by the unevenness of its free margin, or by distinct out-
growth from its surface. ‘They are especially common in dogs
and pigs and may be fibrous, epithelial or otherwise. The treat-
ment is purely surgical and in case of a malignant neoplasm
should demand the removal of the entire organ.

ADENOMA OF THE GLAND OF HARDER.

Cases in dogs have been recorded by Frohner and Schimmel,
and it might be expected in other carnivora, ruminants, pigs,
rabbits and birds. ‘The treatment is by excision with forceps
and scissors, and subsequent treatment with an antiseptic zinc
lotion.

359

360 Veterinary Medicine.
FOREIGN BODIES IN THE CONJUNCTIVAL SAC.

Frequency ; seeds, glumes, awns, dust, sand, wood, metal ; exudate; in
conjunctival pouch, under nictitans in puncta. Filaria lachrymalis.
Symptoms: closure of lids, epiphora, congestion, inflammation, infection.
Treatment : local anzesthesia, forceps, lead pencil, pin’s head, collyria.

So common are foreign bodies in the conjunctival sac of the
domestic herbivora, that in any case of epiphora, hyperzemia or
inflammation of the mucosa, the first care should be given to see
that the condition is not-caused by the presence of such an irri-
tant. In animals fed from high racks, seeds and glumes of the
graminez, awns of barley, and dust of various kinds often get
into the eye and stick fast. Under other conditions, insects,
particles of sand, dust, wood, metal, etc., prove equally injurious
by their presence. Awns and chaff are particularly liable to ad-
here to the mucosa and even to become covered by an exudate,
which renders them more firmly adherent. Other objects lodge
under the eyelids, or membrana nictitans, or in folds of the mu-
cosa. Their entrance into the lachrymal puncta has already been
referred to. ‘The larger and more rounded bodies are likely to
be washed off by the excessive flow of tears, assisted by the move-
ments of the nictitating cartilage, but flat glumes, or awns stick
too closely to the surface, while the smaller objects become en-
tangled beneath the lids, or hair, or in the folds of the mucous
membrane. ‘The filaria lachrymalis may be the cause of trouble.

Symptoms. 'There is closure or semi-closure of the lids, the
escape of a profusion of tears over the cheek, and active con-
gestion or hyperemia. A careful examination with everted lids,
or even with raised nictitans will usually reveal the foreign body.
If overlooked or neglected the hyperzemia rapidly advances to
active inflammation, with or without an infective complication.
Foreign bodies blown into the eye, as a rule carry with them
more or less bacteria, and, if these have any tendency to patho-
genesis, the itritation of the mucosa easily paves the way for
their colonization. Thus, any grade or form of conjunctivitis
may supervene upon the introduction of a foreign irritant.

Treatment. Nearly all such bodies are most easily and cer-
tainly removed by a pair of fine forceps. It may be necessary to
first aneesthetize the eye with a 5 per cent. solution of cocaine.

Wounds of the Conjunctiva. 361

The clean tip of the finger passed under the lid and nictitating
membrane is a safe and effective method. Less effective methods
are to pick up the offénding body on the point of a lead pencil, or
a small, blunt metallic spud, or with a pin’s head covered with a
clean pocket handkerchief. This may be followed by an anti-
septic (boric acid) collyria, with or without cocaine or morphia.

WOUNDS OF THE CONJUNCTIVA.

These occur in all domestic animals, but are especially fre-
quent in dogs and cats from scratching with the claws. In
clumsy handling of the eyelids, the mucosa is wounded by ragged
and uneven nails. Injuries and stings by insects which are at-
tracted by the reflection from the eye constitute a specially grave
lesion, often proportionate to the nature of the poison instilled.

Symptoms. ‘There are usually closure of the eyelids, with
exudation and thickening of the conjunctiva especially in the
vicinity of the wound, a free flow of tears, mingled it may be
with blood, and the visible evidence of the lesion on the exposure
of the injured part. If the cornea is implicated, even the pupil
is contracted, showing photophobia.

Treatment. Slight noninfected wounds will heal readily under
simple astringent collyria, following upon the removal of any
cause of mechanical irritation. A solution of corrosive sublimate,
1 : 5000, or of boric acid, 4 per cent. may be used. If photopho-
bia exists 1% per cent. of atropia sulphate or 1 per cent. of cocaine
hydrochlorate will usually give relief. Extensive wounds may
require sutures, and sloughing tissue may be excised with fine
curved scissors. Excessive granulations may be removed in the
same way. For stings use a potassium permanganate solution:
(2 grs. to1 oz). Violent inflammation may be met by a laxative
and by leeching the periorbital region.

BURNS OF THE CONJUNCTIVA.

Burns and cauterizations may occur in all domestic animals
from acids, alkalies, quicklime, carbolic acid, boiling liquids, etc.
The cornea usually suffers, being the part most exposed. The
caustics cause swelling, blanching and finally exfoliation of the
epithelium, or even of the superficial layers of the cornea. In
burns by hot liquids vesication may be present. If the destruc-
tion extends deeply into the cornea there may be escape of the
aqueous humor and destruction of vision. If less penetrating,
there may still develop vascularity, and permanent opacity by
reason of the formation of a cicatrix or a change of structure in
the layers of the cornea, or, in dogs especially, adhesion of the
cornea to the eyelids (symblepharon). In the early stages there
is closure of the eyelids, with swelling, profuse lachrymation,
and photophobia.

Treatment. 'The first object is to remove or neutralize the
offending body. Thus sulphuric or other mineral acid would
demand a free irrigation with a 1 percent. solution of carbonate
of soda or potash. For alkalies, carbonated water, or a 4 per
cent. solution of boric acid may be employed. For lime, Gosselin
recommends free irrigation with saccharated water. ‘The first
step, however, should be to wipe out the particles of lime with
a soft rag soaked in oil.

The pain may be met by a solution of cocaine (1 per cent.),
or atropia % percent. In addition, we may irrigate with cold
water or apply weak antiseptic collyria, and employ derivation
by the bowels or the skin.

SIMPLE ACUTE CATARRHAL CONJUNCTIVITIS.

Causes : irritant gases, smoke, dry air, dust, pollen, microbes, insects,
seeds, chaff, awns, sand, dust, quicklime, coal dust, hairs, whips, canes,
branches, stubble, fences, nails, claws, teeth, iodine, chlorine, bromine,
formalin, turpentine, rain, hail, sleet, glare of sun, ice, snow, white sand or
clay, filaria, acari, infectious diseases. Symptoms : closed, lids, epiphora,
redness diffuse on lids, ramified on sclera, projected nictitans, milky floc-
culent discharge, later purulent, matted lashes or tarsi. No photophobia.

362

Acute Catarrhal Conjunctivitis. 363

Fever variable. Lesions: exudate: cell proliferation : papilla enlarged :
desquamation : swollen lymphoid bodies: hyperplasia : abscess : ulcer.
Treatment : remove cause, sterilized syringing, antiseptic and astringent
collyria, sublimate, zinc sulphate, lead acetate, pyoktanin, silver nitrate,
morphia, atropia, cocaine, vaseline, cupping, leeching.

Under this head may be noted the simple forms of conjuncti-
val inflammation, which result from direct injuries, irritant
gases from manure, smoke, very dry air, dust, pollen, and
in which no specific nor contagious element is a prominent
feature. Strictly speaking, all purulent conjunctivitis are prob-
ably infecting, as all may be held to be associated with the
presence of pus microbes. As early as 1864, de Graefe
said every inflammation of the conjunctiva which “secretes,
is inoculable and therefore transmissible,’’ and Warlomont con-
curs, saying that ‘‘ conjunctival ophthalmias have one character in
common : all can produce a secretory product which, when brought
in contact with a sound conjunctiva, is capable of provoking
the different affections of this mucosa.’’ The exposure of the
conjunctiva of man and beast alike, to the germs borne on the dust
or carried in liquids or on solids; renders this structure preémi-
nently susceptibile to infection, while the lachrymal and mucous
secretions furnish a favorable culture medium. Fortunately in
the lower animal the danger of infection is greatly reduced, since
there are comparatively few opportunities for the transference of
the germ through water, soap, sponge or towel, to which man is
“exposed, not only in public lavatories but even in private families.
Thus in the animal the single case remains isolated and in a
sense sporadic, only because there have not been the means of
transferring and inoculating the morbid product.

Causes. ‘The contact of mechanical and chemical irritants of
all kinds, insects, seeds of gramineze, chaff, particles of fodders,
barley and other awns and spikes, grains of sand, dust, quick-
lime, coal dust, smoke, hairs, blows with whips, canes, branches,
stubble, fences, etc. Also erosions caused by nails, claws, teeth,
and by falls must be considered.

Irritant gases and vapors whether from accumulation of
manure in the stables, or from chemical products of fires and
factories are direct causes. The mere exposure for sometime
to the warm, dry air from a furnace is injurious to the mucosa,

364 Veterinary Medicine.

and the emanations from certain medicines, iodine, chlorine,
bromine, formaline, turpentine are strongly irritant.

Exposure in a cold draught, or in a blast of cold rain or hail,
or even to a cold dry wind, in the case of hunting dogs working
much in water, are potent factors.

The glare of the sun through a window at the front of a
stall, or from a white surface of snow, ice or water or even from
white sand, lime or clay isan active cause. The overdraw check
exposing the eyes directly to the sun is often injurious. We
must include the irritations caused by the filaria lachrymalis and
by various lesions already described—trichiasis, entropion, ectro-
pion, stenosis of the lachrymal duct, etc.

In certain animals a distinct predisposition exists, often as the
result of a previous attack, and such are readily attacked under
slight disturbing causes.

It should not be forgotten that hyperaimia and even inflam-
mation of the conjunctiva, often accompanies different infective
diseases—strangles, influenza, contagious pneumonia, rinderpest,
canine distemper, etc.

Symptoms. 'The discharge of tears and the closure more or
less complete of the eyelids are among the earliest and most
marked symptoms. ‘The general conjunctiva is congested and
that on the inner side of the lids especially, so as often to
hide the individual vessels, while on the sclerotic portion they
usually remain distinct, tortuous and freely movable with the
mucosa upon the sclera beneath. The membrane is more or less
infiltrated, swollen and opaque. In two or three days this has
increased so that the lids are visibly swollen, and completely
closed, or the paw is projected over the cornea. The discharge
has become milky or flocculent, and mats the cilia together, or
holds the eyelids closed. Unless the cornea has been directly
injured it usually remains clear, and there is no photophobia
nor contraction of the pupil. The lids, however, are tender and
nervous animals show active resistance to any attempt to ex-
amine the eye. In aggravated cases a free muco- -purulent dis-
charge takes place, and the red, swollen mucosa projects
between the eye and the tarsus, constituting chemosds. In such
circumstances the inflammation may extend to the cornea causing
opacity and photophobia or to the iris and choroid or other
deep-seated parts.

Acute Catarrhal Conjunctivitis. 365

In the milder forms of the affection there may be little or no
hyperthermia, while in severe attacks the febrile reaction may be
considerable. |

Lesions. ‘The non-traumatic cases which are not complicated
by varied wounds and injuries, show exudation and cell prolifer-
ation in the palpebral conjunctiva and to a less extent in the bul-
bar. The conjunctival papille are swollen and become visible to
the naked eye and in aggravated cases stand out like fungous
masses. The superficial layer of cylindroid epithelium is found
swollen, opaque and sometimes desquamating. The lymphoid
bodies which are most abundant in the depth of the conjunctival
sac, are infiltrated, swollen, and bulging in reddened masses.

Other lesions in the nature of granular or follicular hyper-
plasia, abscess and corneal new growth and ulcers may follow,
but will be better considered under separate headings.

The tendency of simple uncomplicated conjunctivitis is to re-
covery which may be completed in a week or ten days. In case
of contused wounds, abscess, ulcer, special infection in a lym-
phatic subject like the ox, the affection is more likely to be
prolonged or followed by grave lesions.

Treatment. ‘The first object must be to remove the cause,
hence foreign bodies, displaced lids or cilia, irritant gases, excess
of light, cold draughts or exposure, etc., must be sought and
corrected. For the removal of the foreign bodies, fine forceps or
various common articles (hair pin, lead pencil, a pin head, a
folded clean handkerchief, or even the clean finger) may be used.
In case of wounds especially, they» should be first sterilized.
Boiled water which has been cooled to luke warm may be used
from a sterilized syringe.

Locally antiseptic and astringent collyria (sublimate solution—
I : 5000, zinc sulphate—1 : 1000), lead acetate, alum, tannin,
creolin, boric acid, tannoform, formalin, itrol, colargolum, silver
nitrate, etc., are valuable and may even be thrown under the
eyelids from a syringe with a finely rounded nozzle and many
orifices. Even a 2 per cent. solution of silver nitrate may be ap-
plied in the conjunctival sac twice daily, or as being less irritating,
a solution of pyoktanin (1: 1000). If the irritation is great a
soft rag wet with the solution may be attached to the headstall
of the bridle and hung loosely over the eye, care being taken to

366 Veterinary Medicine.

prevent drying. A few grains of morphia added to the collyria
will be specially soothing. Irrigation of the eyelids or bathing
for ten or fifteen minutes at a time with luke warm water, will
often greatly relieve. When the eyelids become agglutinated
during sleep or prolonged closure, as in the small animals, cleanse
with a tepid sublimate solution, and smear with vaseline. In
severe cases local depletion may be resorted to. The hair may
be shaved off from an area of 2 inches below the orbit, and a cup
applied for ten minutes. Scarification may or may not be re-
sorted to. Ora leech may be applied to the same part.

A laxative often proves an excellent derivative especially use-
ful in costive conditions.

CHRONIC CONJUNCTIVITIS.

Sequel of acute. Same causes. Old horses, young foals, damp lands, |
night dews, frosts, eczema, fo)licular scabies. Lesions: swelling of lymph
bodies in conjunctival pouch, general congestion, chemosis, hypertrophied
papille, clouded cornea; Symptoms: as in acute form but less intense,
Treatment: Remove cause, irritants, damp soils, stables, etc., glare of
light, heat, etc., astringent antiseptic lotions, atropia, mercury oxide, coun-
ter-irritation, setoning, cupping, leeching.

This is generally recognized by veterinary writers as a sequel
of the acute form, though it may begin de zovo, from slight per-
sistent causes of irritation. Habitual exposure to fierce light, dusty
roads, ammoniacal and other gaseous emanations, and at other
times to the dust from musty fodders in a high rack, trichiasis, .
entropion, ectropion, and indeed any continued irritation may
start the disease or keep it up. Leblanc says it is especially
common in old horses and young foals pastured on low damp
grounds, bottom lands and lake shores, and in worn out work
oxen which have been exposed to cold night dews, or frosts. In
this respect it resembles the recurring ophthalmia of the horse
which prevails especially in lymphatic subjects. In dogs, Leclainche
has observed it associated with eczema or follicular scabies of
the lids.

Lesions. Besides the general congestion of the mucosa, there
are liable to be special lesions in the depth of the conjunctival sac
at the point where the mucosa passes from the eyelid to the scler-

Chronic Conjunctivitis. 367

otic, causing uneven swellings from infiltration in this region.
The lymph bodies or follicles in this part are swollen and project
as small red or grayish nodules visible when the eyelid is everted,
and at other times the whole infiltrated conjunctiva projects be-
tween the lids constituting the condition known as chemosis.
The papillae conjunctivee are also hypertrophied, so as to become
visible to the naked eye, and ulcers may be present on the mu-
cosa. ‘The cornea is often clouded blue or milky, or it may have
become in part vascular and reddish, or even ulcerated. A more
or less abundant muco-purulent discharge is always present.

Symptoms. ‘The inflammation is usually moderate in degree,
the eyes water without being habitually closed, the hairs are lost
from the cheek, which is habitually wet, the lids are swollen, and
like the cilia tend to stick together after sleep, and the whole
mucosa is visibly infiltrated and congested, but usually especially
at given points, as in the cul de sac, on the lids or membrana
nictitans. Unless the animal has been treated with irritant
dressings, there is much less pain on manipulation than in acute
conjunctivitis. On everting the lids the folliculitis in the cul de
sac and the circumscribed swellings become apparent. The
membrana nictitans is partly projected over the cornea, and the
eyeball usually appears smaller by reason of its retraction within
the orbit.

In cases of eczema, or demodectic mange, the lesions of the
skin of the eyelids will furnish the key to the trouble.

Treatment. 'The first object must be to remove the cause
which tends to keep up the malady. Foreign bodies, musty hay
fed from high racks, dusty roads, excess of light, windows in
unsuitable places, damp stalls or pastures, and local parasitism
must be corrected. In case of persistent chemosis keeping up
the inflammation, and which will not subside under the usual
astringent lotions, the hernial mucosa may be excised. (See
-chemosis. )

The usual astringent lotions may be employed, sulphate of zinc
(2:100), sulphate of copper (1:200), alum (5:100), tannin
(10: 100) to which may be added sulphate of atropia. In place
of being simply applied to the surface of the lids, or the cornea,
it is usually desirable to inject it into all parts of the cul de sac
beneath the upper and lower lids and beneath the nictitating

368 Veterinary Medicine.

membrane. Alum 4 grs. and boric acid 3 grains, in water 1 oz.
make a good combination. As the mucosa becomes accustonied
to one agent, we may change for another. Thus in addition to
the above, silver nitrate (2:100), and lead acetate (2: 100) are
often useful as alternates. In obstinate cases ted or yellow
oxide of mercury in vaselin (5: 100) may be applied inside the
lids and on their margins.

Counter-irritation is often desirable, in the horse a blister of
cantharides or mercury biniodide to cover a spot as large as a
silver dollar above the anterior end of the maxillary spine
(zygomatic), or a stout silk thread as a seton inserted in the same
place. In the dog the blister may be applied on the temporal
region.

Cupping or leeching beneath the eye, or phlebotomy from the
angular vein of the eye may prove useful. Great care should be
taken to prevent further injury by rubbing.

PURULENT CONJUNCTIVITIS. BLENNORRHGA.

More purulent and more infective through dust, tongues, rubbing posts,
kennels, swill; a class due to different microbes. Prevalence in dogs,
swine, horses, sheep, goats, cats. Symptoms: acute conjunctivitis with
excess of pus, follicular swelling and enlarged lymph bodies in cul de sac.
Diagnosis. Treatment: Astringent and antiseptic lotions, injected often :
silver nitrate : pyoktanin. :

The forms of conjunctivitis in which there is an abundant pro-
duction of pus are usually relatively more inoculable and there-
fore more liable to pass from animal to animal in a casual manner.
Infection takes place through the dried up discharges floating as
dust, but more directly by means of the tongue when the animals
lick each ‘other, and through posts against which they rub the
head. Animals smelling or licking the infected genital organs
and then the eyes of their fellows may convey it readily. Dogs
occupying the same kennel successively, contract the disease
(Guilmot). Swine feeding from the same trough and plunging
the face into swill up to the eyes are especially subject to infec-
tion. In speaking of such infections one must be understood to
refer to a group and not toa specific disease, as that will vary

Purulent Conjunctivitis. Blennorrhea. 369

with the particular pus microbe present, and with the virulency
of such microbe in the particular case. In keeping with the
greater fertility of microbes in the warm season, these affections
have been more commonly met with in summer than in winter,
and where the animals are kept in filthy surroundings rather than
otherwise. This is above all true of swine. Moller records a
wide spread epizootic of gonorrhceal ophthalmia in dogs in Berlin
and environs in 1883. In different cases, however, he failed to
induce disease in the eyes by direct inoculation with the preputial
secretion. Heinman equally failed with the gonococcus of man
in inoculations on the eyes of rabbits, and dogs. Frohner, how-
ever, succeeded in infecting the eye of the dog by applying the
gonorrhceal discharge of man.

‘Infecting inoculable, purulent ophthalmia has been reported
in the horse (Vermast, Sobornow, Blazekowic, Menard, Moller,
Leclainche), in sheep (Repiquet), and in goats (Mathieu).
Again Blazekowic found in an infectious ophthalmia of horses,
‘dogs and cats a microbe which was like that of malignant oedema.

The symptoms are those of conjunctivitis with especially free
production of pus, and a tendency to chemosis or to follicular in-
flammation in the depth of the conjunctival sac, with irregular
swellings of the lymph bodies. The pus accummulates in the
inner canthus, inside the lids and along their margins, and tends
to mat them together. The diagnosis depends on the rapidity
and severity of the course of the malady, on the depth of the con-
gestion and on the profuse suppuration.

Treatment.. Astringent and antiseptic lotions are especially
indicated. Mercuric chloride (1 : 5000), boric acid (2 : 100),
creolin (1 : 100), salicylic acid (1 : 1000), silver nitrate (1 : 200),
It isnot, however, enough that these should be applied externally ;
they should be freely injected under the lids at all points so as to
act on the deepest portions of the conjunctiva, and this should be
repeated once or twice daily. Or they may be applied with a soft
brush. Ina specially virulent outbreak silver nitrate (2 : 100)
or pyoktannin (1 :; 1000) solution may be used. Setons and
blisters, laxatives and cooling diuretics may be employed as in
the severe types of simple conjunctivitis.

24

370 Veterinary Medicine.

INFECTIOUS CONJUNCTIVITIS IN HERBIVORA.
ENZOOTIC OPHTHALMIA.

Causes: infection, pollen, soil emanation, winter or summer ; cases of
extension by infection. Cattle, sheep, goats, ponies. Accessory irritants.
Symptoms : severe purulent conjunctivitis. Papillary and follicular hyper-
trophy, uniform redness, protruding head, opacities, erosions, ulcers, pho-
tophobia, staphyloma. Treatment: rest, darkness, coolness, elevated head,
purgative, diuretics, sedatives ; locally solution of pyoktanin, sublimate,
silver nitrate, boric or salicylic acid, atropia, puncture.

Causes. 'This affection which attacks at once or in rapid suc-
cession a large portion or the whole of a herd or flock, is by many
held to be infectious while others attribute it to irritant pollen
or soil emanation. Its origin from vegetation in flower is held
to be supported by its greater frequency in summer than in
winter, and the few outbreaks seen in winter are attributed to
pollen preserved in the hay. But other things being equal,
organized germs are preserved, multiplied and diffused to a
greater extent in the hot season so that the origin of the dis-
ease from a purely microbian source is at least equally plausible.
Certain outbreaks indeed show the transmission of the infection
in a most unequivocal manner. A cow suffering from the
affection was brought into a stable occupied by a herd previously
sound, and in a few days the cow standing next her was attacked,
and thereafter a number of others in rapid succession. A small
number of cattle from the Buffalo Stock Yards, but which had
sore eyes on their arrival in Tompkins Co., N. Y., were placed in
a sound herd and the disease spread rapidly to the other members
of the herd. Similarly in both sheep and cattle the writer has seen
.the disease prevail in one herd or flock, while the adjacent herd
or flock, separated only by a good stone wall and subject to ex-
actly the same condition of soil, water, exposure, vegetation and
pollen has entirely escaped. Kayser has seen it introduced into
a herd by a bull; Fiinfsttick saw a herd of 300 head attacked in
a few days, and Klink 20 out of a herd of 4o head in 14
days. ‘Trumbower has never seen an animal. suffer a second
time. This is the common experience and would suggest an
acquired immunity, yet the comparative rarity of the disease for-
bids a positive conclusion, without further experience. Menard
saw an outbreak among the ponies in the Jardin d’ Acclimatation,

Infectious Conjunctivitis in Herbivora. 371

and as many as fourteen weeks later in the same gardens it at-
tacked the bovine animals.

In sustaining the doctrine of infection, however, we must not
altogether ignore accessory causes. Like other affections of the
eye, this has seemed to appear especially in low, damp lands,
bottom lands, deltas, marshy borders of lakes and level prairies,
so that a general lack of tone or alymphatic constitution may be
held.to predispose. Nor is it necessary to ignore the influence
of pollen, dust and other irritants, which though they may not
cause the specific disease, yet prepare the way for its attack by
reducing the resisting power of the tissues.

Symptoms. ‘These are the phenomena of severe purulent con-
junctivitis. Closed eyes; profuse secretion of tears, sometimes
mixed with blood, changing in a few days toa thick, purulent,
white or yellow secretion, which collects in masses inside the lids,
along their margins, in the inner canthus and on the cheeks,
gluing together the cilia, lids and hairs. When separated the
lids show a mucosa of an uniform deep red, covered with pus,
and irregularly swollen according to the amount of infiltration.
Papillary and follicular hypertrophy are marked features, and
the nictitans projects excessively over the eyeball. In many
cases the cornea becomes opaque and in some instances erosions
occur which may cause perforation or loss of the eye. In other
instances the ulcers heal with the formation of cicatrices, or the
weakened portion of the membrane yields under the internal
tension and staphyloma supervenes. In such cases the pupils
are contracted.

The disease is usually attended by marked hyperthermia, the
secretions, including the lacteal, are materially decreased, appe-
tite and rumination are impaired and the animal leaves the flock
or herd. ‘The disease affects cattle and sheep, and Menard, Ma-
‘thieu and Hoffmann add horses and goats.

Treatment, This must be primarily antiseptic, but without
neglecting constitutional disorder. Rest in a dark, cool stall,
with the head elevated by tying to a high point. Give at once
an active purgative 14%4lb. Glauber saltsin 4 quarts warm water,
and follow up with cooling diuretics and sedatives (saltpeter 1%
oz. and tincture of aconite 20 drops, thrice a day). If the tem-
perature runs very high a few doses of acetanilid or phenacetin
may be given. Locally use silver or other antiseptic collyrium

372 Veterinary Medicine.

Locally use pyoktannin solution (1 : 1000) or mercuric chloride
(1 : 5000) injecting under the lids so as to bring it in contact
with the whole diseased surface. A cloth wet with the same solu-
tion may be hung over the eye. Boric acid (1 : 100), salicylic
acid (1: 1000), or silver nitrate (1 : 100) may be substituted for
the above when they seem to be losing their efficacy.

Ulcers are treated by pyoktannin or silver nitrate solution ap-
plied daily with a soft brush. Keratitis will demand atropia.
Abnormal tension or staphyloma will demand puncture of the
cornea. Improvement may be expected in a few days and re-
covery in a week or ten days.

VARIOLOUS CONJUNCTIVITIS.

In cow pox, horse pox, and above all sheep pox, the infec-
tion sometimes falls on the conjunctiva, giving rise to the for-
mation of the specific eruption on that membrane. The co-
existent eruption on other parts of the body (udder, heels,
hairy portions of skin) of the specific variolous eruption, fur-
nishes the means of a satisfactory diagnosis. ‘he lesions in
the eye develop rapidly to an extreme severity. The lids are
swollen and closed, lachrymation abundant, and early mixed
with pus, and when exposed the conjunctiva is strongly con-
gested with circumscribed areas of elevation. In cow pox these
are circular in form, raised above the surrounding mucosa,
having a deep red areola and a paler, flattened center. In sheep
pox the elevations have the same general character, but are liable
to be more numerous and confluent, and tend to permanent
opacities, cicatrices, and perforations of the cornea with loss of
the eye. Short of perforation, internal inflammations are not un-
common.

Treatment. At the outset this form may be aborted by the
application of silver nitrate solution (2 : 100) or sodium hyposul-
phite (1% : 100). Otherwise the local treatment is like that for
simple conjunctivitis, cooling astringent and sedative lotions, and
if need be, derivatives and eliminants.

APHTHOUS CONJUNCTIVITIS. PHLYCTENULAR
CONJUNCTIVITIS.

Closely allied to the last, are those cases in which vesicles ap-
pear on the conjunctiva. In exceptional cases these are seen
during an epizootic of foot and mouth disease, while in other
instances they are associated with eczematous eruptions on other
parts of the body, particularly in dogs. Inthe human subject
conjunctival vesicles are often associated with tuberculosis, but
this has not been recorded of animals so far. The disease
usually makes a rapid eruption,, with symptoms of extreme in-
flammation, and its duration is largely determined by the general
disease.

Beside the local ¢veatment by astringent or antiseptic and sedative
collyria it may be desirable to correct the hepatic, digestive or
other disorder on which the eczema depends, or to improve the
general health by a course of bitters or even of cod-liver oil.

DIPHTHERITIC CONJUNCTIVITIS IN BIRDS.

Hens, ducks, pigeons. Local inflammation, fibrinous exudate, concreting
or becoming cheesy, necrotic, sloughy. Beneath the mucosa red, raw;
without epithelium, but excess of lymphoid cells, some only muco-purulent,
gravity varies. Grave cases inoculable on birds, mice, rats and rabbits.
Bacillus diphtherize avium, morphology and biology. Pathogenesis. Pre-
vention: exclude germ; cleanliness; pure air; pure food; pure water.
Quarantine strange fowls, keep flocks apart, seclude manure, segregate
sick, disinfect. Treatment: Antiseptics ; boric acid ; sublimate ; ichthyol ;
silver nitrate. Infection to man.

A disease of the mouth, fauces, nose and eyes, associated with
the formation of false membranes, has been long recognized in
birds (hens, ducks, pigeons, etc.), and is known to bird-fanciers
by the names of roup, and diphtheria. The disease is character-
ized by the presence of a local inflammation in patches, associated
in the early stages, with a free serous discharge, but, later, with
the formation of white, or grayish, fibrinous exudate, which may
be at first firm and smooth, later soft and cheese like, and still

373

374 Veterinary Medicine.

later in many cases more or less necrotic and sloughing. In Dr.
Moore’s experience this is more common on the conjunctiva
than on the nares or fauces. The interior of the eye was not in-
volved in the inflammation. Beneath the false membrane the
mucosa was devoid of epithelium and the underlying tissue was
red, raw and angry, bleeding readily when handled, and infiltrated
with an excess of lymphoid cells.

The lesions, however, were by no means constant. In some
even of the fatal cases, the exudate was merely muco-purulent,
while in others the false membrane was quite abundant.

The gravity of the affection also varies in different outbreaks
or in the same outbreak at different times. Sometimes it runs a
very rapid and fatal course, while at others it becomes chronic
and comparatively dormant and the great majority recover.

In its more viruJent form it is readily inoculable on birds, mice,
rats, and rabbits, while the milder cases are not easily propagated
in this way.

The false membrane contains a variety of saprophytes, and
among them the pathogenic bacillus, which may be obtained in
pure culture by inoculating it on a rabbit or mouse. Emmerich
believed this bacillus to be identical with the Klebs-L6ffler bacillus
of diphtheria in man, but Loffler recognizes it as essentially
distinct.

The bacillus diphtherie avium is 0.8 to 1.5 long, by 0.8 to
1.24 broad. ‘The ends are oval so that short specimens seem
round. In bouillon culturés they form chains or clumps. ‘They
stain in aniline dyes, most deeply at the poles. Are not stained
by Gram’s method. They are non-motile, zrobic, grow in agar,
and alkaline bouillon, but render the latter acid in one or two
days. Do not grow on peptone gelatine, nor produce gas with
sugars. Are killed in 5 minutes at 58° C. (137° F.). Are killed
by dryness in 24 hours, by sulphuric acid (0.25:100) in 10
minutes, by lime water in 1 minute, and by sulphur fumes.

Pathogenesis. Hight rabbits inoculated subcutaneously with
o.1 cc. of the bouillon culture died in 18 to 36 hours. Of several
white and gray mice inoculated only one died. Inoculations of
mature hens subcutem and on the nose had no effect. Inocula-
tion of a six weeks old chicken caused death in 4 days with ba-
cilli in the liver and blood (Moore). Inoculation of pigeons pro-

Diphtheritic Conjunctivitis in Birds. 375

duced the disease (Léffler). It seems doubtful whether the
milder forms part with their virulence to birds, when cultivated
artificially, or whether a special susceptibility is required in order
to render the inoculation effective.

Prevention. Besides the general conditions of good hygiene,
cleanliness, pure air, and pure water, the strict exclusion of the
germ is the great desideratum. New fowls should not be taken
into a flock, when they show any indication of disease in the
mouth, throat, nose or eyes, nor when they come from a flock in
which such signs of disease can be found. When examination
of the flock, from which they are sold, cannot be made, the new
fowls should be placed by themselves in quarantine until proved
sound. Sound flocks should not be allowed to wander at large
and mingle with the birds that are unsound, or open to sus-
picion. Neither should they be allowed to come in contact with
manure from suspected poultry yards. If disease of air passages,
mouth or eyes appears, separate at once the diseased fowl, and
sprinkle roost, house and yard with dilute sulphuric acid, quick-
lime, or other disinfectant.

Treatment. Beside separation and disinfection the local use
of antiseptics to the surface divested of the false membrane gives
the best promise. Boric acid solution (4: 100) or sublimate
solution (1 : 5000) may be applied to the eye. For the nose and
mouth somewhat stronger applications may be made.

Prevention of infection to man. ‘The essential difference of the
Klebs-Loffler bacillus of diphtheria in, man, and the microbe of
this affection in fowls does not exclude the necessity of avoiding
contagion from birds to man. Among reported cases of such in-
fection are: (1) That at Wesselhausen, where 4 attendants on
the fowls contracted the disease from the sick fowls at a time
when no other cases existed in the human population: (2) That
of Sebdon where 6 persons suffered and 10 fowls fed by a hospital
attendant also suffered : (3) That of Tunnis in which diphtheria
prevailed in fowls, and soon also in those who fed them pro-
ducing an extended epidemic: (4) That of Jacksonville, Ill.,
where a diphtheritic chicken, conveyed the disease, with fatal
effect, to a child which fondled it (Moore).

These and other similar instances seem to show that the disease
of the bird may become so virulent as to be communicated to

376 . Veterinary Medicine.

man, and the disease of man so potent as to be transmissible to
the bird. Every precaution therefore should be taken to prevent
infection passing from one to the other.

FOLLICULAR CONJUNCTIVITIS.

Common in dogs. Violent congestion with enlargement of lymph fol-
licles, or beneath the nictitans, dark red, likeymillet seed, also over sclera
and lids. Enlarged lymph follicles with excess of lymphoid cells. Often
chronic. Entropion. Infection. Treatment: astringent and antiseptic
lotions : lunar caustic: cocaine and crushing of follicles: pure air: excision
of nictitans.

Frohner has drawn attention to the frequency of this affection
in the dog, which according to him attacks 4o per cent. of the
race. It is especially liable to begin on the inner surface of the
membrana nictitans, and though it may be at first somewhat
hidden by the severe congestion, yet when that subsides in part,
the swollen follicles can be seen as dark red elevations, the
size of a millet seed, when the nictitans has been everted. It
may extend over the sclerotic and palpebrze. Microscopically
these swellings are found to be enlarged lymph follicles, with
an excess of lymphoid cells.

The disease tends to assume a chronic course and may cause
entropion and other troublesome lesions. The diagnosis depends
on the recognition of the swollen follicles, and especially in the
depth of the conjunctival sac.

It is presumably infective yet all Frohner’s inoculation gave
negative results.

Treatment. Intheearlier stages the commonastringent and anti-
septic lotions may be used. Sublimate, or boric acid lotions are
especially valuable for their antiseptic properties. Should these
fail, the eyelid and nictitans may be inverted and the individual
follicles touched with a fine pencil of lunar caustic, the resulting
smarting being lessened by application of cold water. In case
they should still prove obstinate, the conjunctiva may be co-
cainized and the follicles individually crushed with ciliary forceps.
Pure out door air is a prime essential in the treatment.

In extreme cases Frohner counsels the excision of the mem-
brana nictitans. ,

NEOPLASMS OF THE CONJUNCTIVA.

Pinquecula: fatty growth: Lipoma: Melanoma: Dermoid tumor in
young dogs, calves, sheep. Cocainize the part and excise. Cold water:
silver nitrate. Polypus. Pterygium.

A pale fatty looking elevation on the sclerotic at the inner side
of the cornea is not unknown in the dog, resembling pinquecula
of man. It has not been seen to prove harmful and may be
safely ignored.

Lipoma has also been observed (Miiller) and when trouble-
some may be removed by excision with scissors.

Melanosis is met with in gray horses in connection with the
same disease of the skin of the lids, and usually with generalized
pigment tumors. In the latter case surgical interference is use-
less unless it is to secure a very temporary relief.

Dermoid Tumor of the Conjunctiva. This consists in a
cutaneous product, consisting externally of a mass of epidermic
cells, beneath which are connective tissue, fat cells, and muscular
fibres, glands and growing hairs. It usually extendsinward from
the outer portion of the sclerotic conjunctiva and may encroach
on that of the cornea. It is firmly adherent to the sclera, and
sometimes to the cornea by its base and deeper aspect, but the
apex is free and more or less projecting. The color is yellow, or
more or less blackened by pigment or even reddened by blood.

It has been observed, above all, indogs, Prince reports a case in
a calf and Zundel in a sheep. The Cornell Veterinary College
clinic has furnished cases in ox and dog. ‘They have, however,
nearly always been seen in young animals and are probably
congenital.

These are easily removed from the eye anzesthetized by a 4 per
cent. solution of chloride of cocaine. The inner projecting end
of the tumor is seized by rat-tooth forceps, and carefully snipped
off with sharp scissors curved on the flat. Where adherent to
the cornea it must be carefully handled, but where attached to
the thicker and more resistant sclerotic it can be dealt with more
freely. A pencil of silver nitrate may be used to check the
bleeding, or that may be effected by cold water freely applied.

Polypus, a small, pale, pediculated tumor of the conjunctiva
is described by Lafosse and should be removed by scissors, and
bleeding checked by cold, wet applications.

377

PTERYGIUM.

This name is employed to designate a triangular conjunctival
fold broader at its sclerotic end and gradually narrowing to its
corneal extremity, with loose, slightly overlapping borders, and
firmly fixed to the structures beneath. It is more vascular than
the surrounding conjunctiva, and its comparatively large blood-
vessels have suggested the veins of an insect’s wing—hence its
name. The growth may extend from either canthus toward or
partly over, the cornea.

Méller and Leclainche claim its existence in dogs, thougti
rarely to such an extent as to demand surgical interference.
Dunewald operated on a case in the cow.

Unless growing, it need not be interfered with. It may be dis-
sected up with scissors, the narrow end being dragged on by for-
ceps. Another method is to cauterize the narrow end with the elec-
tric cautery which leads to material contraction of the entire mass.

XEROSIS CORNE# (EPITHELIALIS). DRY KERATITIS.

This is described by Mayer as following distemperin dogs. It
seems to begin in the epithelial layer of the conjunctiva, which
becomes dry, lustreless, spotted, opaque and fatty so that water
runs over it without wetting it. It may extend deeply into the
substance of the cornea and lead to the development of a scar.
When scraped and examined under the microscope the scrapings
are found to consist of epithelium undergoing fatty degeneration
and myriads of xerosis bacilli. As the disease takes occasion to
attack by reason of the debility of the system, the ¢veatment is
mainly corroborative and tonic, including the arrest of the affec-
tion on which the weakness depends. The early application of
antiseptics is desirable (iodoform 1, vaseline 10; mercuric
chloride 1, vaseline 3000). Warm compresses and a bandage
may be tried.

378

WOUNDS OF THE CORNEA.

Causes : harness, whip, nail, hay, straw, stubble, thistles, spikes, twigs,
pine needles, cones, burdocks, stones, gravel, glass, splinters of wood or
metal, scratches, stings. Symptoms: closed lids, epiphora, sight of lesion,
soon cloudy swelling, opacity. Treatment : antiseptic bandage and lotion,
boric acid, sublimate, potassium permanganate, avoid lead or zinc ; atropia,
cocaine, with perforation, bandage, eserine, excision. For foreign body,
antiseptic cotton, spud or curette.

Causes. Corneal wounds are common in working animals by
reason of contact with harness, canes, whips, etc., and in the
stable from contact with nails or with the hard ends of hay or
straw. At pasture the cornea is injured by the ends of long
stubble, the sharp points of thistles, the spikes of various thorny
plants, and twigs of bushes and trees. The last named factors
are especially operative in hunters and horses worked in forests.
Punctures with pine needles and cones, and with burdocks, are
other common causes. Stones, gravel, pieces of glass, and
splinters of wood or metal, produce traumas of the cornea, and,
in cats and dogs, scratches and even perforations with the claws
are common. In this connection the stings of insects are not to
be forgotten.

Symptoms. There is always a prompt and complete closure of
the eyelids and a profuse secretion of tears. Then on parting
the eyelids with finger and thumb, the lesion of the cornea, its
nature and extent should be recognizable. In case of a small,
punctured wound, however, as with a smooth thorn or other
conical body, the normal elasticity of the corneal tissue may lead
to such a perfect coaptation of the divided edges that the lesion
may escape even a close scrutiny. If the case is seen early, be-
fore time has been allowed for cloudy swelling and opacity the
wound is all the more likely to escape observation. In incised,
scratched and torn wounds, on the other hand, the seat and nature
of the lesion are made out with the greatest ease.

Treatment of a slight wound which is at once recent and free
from infection, is by a simple antiseptic bandage and lotion.
Boric acid (1 : 100), sublimate solution (1 : 5000) or potassium
permanganate solution (1: 100) may be used. Lead and even

379

380 Veterinary Medicine.

zinc salts, are liable to precipitate in the abraded tissue and cause
a lasting opacity. If the pain is severe it may be moderated by
the addition of atropia sulphate, or a solution of 1 to 100 water
may be instilled into the eye several times daily. Cocaine makes
an excellent substitute. In deeper wounds, perforating the cor-
nea and allowing the escape of aqueous humor, there may be
prolapse of the iris through the wound. It may be pressed back
with a flat sterilized spatula, and retained by bandage and a course
of eserine. Should it still escape, it must be seized with forceps,
drawn out and snipped off with a sharp pair of sterilized scissors.
The greatest care must be taken to avoid infection which may
cause panophthalmitis and destruction of the entire eyeball.

FOREIGN BODIES IN. THE CORNEA.

In case of penetration of the cornea by thorns, thistles, glass,
metal, etc., there usually follows inflammation with a red area
around the offending object. If the foreign body is a piece of
iron there is a brownish area caused by iron oxide. Focal or
transillumination will usually reveal the object. Should both
fail, a solution of fluorescin when applied will develop a greenish
area around it.

Treatment may be made as advised by Gould by pressing a
little antiseptic cotton to the front of the eye, so as to entangle
and withdraw the foreign body when the eyeballis rolled. Fail-
ing in this we may cocainize the eye and remove the offending
object with a small curette orspud. A careful focal illumination
of the eye will enable the operator to see and remove the smallest
particles without injury. Subsequent treatment is that of wounds.

ACUTE KERATITIS. INFLAMMATION OF THE
CORNEA.

Extension from conjunctivitis, wounds, foreign bodies, bites, stings,
blows, infections, filaria. Symptoms: eye tender, closed, epiphora, red,
pannus, photophobia, congested sclera, opaque or ramified red cornea, or
diffuse red, exudation, suppuration, corneal abscess, ulcer, perforation, pro-
lapsus iris, panophthalmia. Focal illumination. Recovery. Permanent

Acute Keratitis. Inflammation of the Cornea. 381

cicatrix or opacity. Lesions: exudates of lymph and leucocytes into cor-
neal layers: embryonic tissue vascularization: abscess: ulcer: cicatrix:
opacity : staphyloma : hypopion : prolapsus iridis: panophthalmia. ‘Treat-
ment : antiseptic astringents, atropine, leeching, derivatives, blister, seton,
opacities; in severe cases antiseptic puncture, sublimate lotion, silver
nitrate, potassium permanganate, boric acid, pyoktanin : in perforations
antiseptic bandage and eserine, iridectomy : in chronic cases mercury oxide.

Keratitis occurs in all domestic animals asa primary disease, or
as an extension from conjunctivitis.

Causes. Extension from acute, enzootic. infections conjuncti-
vitis in sheep and cattle has been noticed by a great number of
observers. Bayer and Lohoff have studied maculated keratitis of
the superficial layers in horses. Again it has followed wounds by
foreign bodies, spikes of vegetables, particles of iron and glass,
blows of whips, or insects, stings, etc. It also occurs in con-
nection with the local action of particular poisons, such as variola
(foot and mouth disease), canine distemper, etc., and from the
local irritations caused by trichiasis or entropion or by the filarize
lachrymalis (ox) and palpebralis (horse).

Symptoms. ‘The eye is extremely sensitive, and habitually
closed, with a profuse flow of tears, and a disposition to resist
opening of the lids. When exposed the cornea is seen to be
more or less clouded and perhaps reddened by the formation
of vessels proceeding from its sclerotic margin. This is known
as pannus. If the anterior chamber is still visible the pupil is
found to be contracted showing photophobia. The congestion
is first visible in the sclerotic and in the absence of pigment
is most intense near the margin of the cornea. Upon the cor-
nea itself it is preceded by a deep white opacity, into which
the vascularity gradually extends. Téhe whole cornea may finally
become of a bright pink hue.

The congestion of the cornea may advance to fibrinous exuda-
tion, or the formation of pus between its layers, to molecular
degeneration and the formation of ulcer, or even to perforation
and escape of the aqueous humor. In this case prolapsus iris,
panophthalmia and destruction of the eye are likely to ensue.

Ulcer if not readily seen with unaided vision can be easily
recognized by the aid of focal illumination, and abscess can be
detected by the presence of a sharply circumscribed centre of in-

382 Veterinary Medicine.

tense opacity, white or yellow, and some bulging of the mem-
brane. ;

The pus may be absorbed, or it may escape by rupture and
discharge externally, or into the anterior chamber when the re-
sistance is least in that direction, and when this takes place, a
dangerous internal infective inflammation is the result.

In the slighter forms of keratitis the inflammation may come
early to a standstill, and recede, tenderness and photophobia pass
off, the eyelids may be opened, and the corneal opacities gradually
disappear. If any portion of the cornea has become vascular, that
portion is liable to remain opaque or even pink.

Lesions. Under the influence of an irritant on the cornea, the
vessels in the margin of the sclerotic become actively congested
and pour out lymph freely, leucocytes also escape and with the
lymph pass through the lymph channels into the substance of the
corneal tissue. .Here they undergo active fission and increase,
and the normal cells of the corneal tissue multiply in like manner,
so that in a short time there is an extraordinary production of
embryonic cells. Into the embryonic tissue so formed, blood
escapes from forming loops of new vessels, and tliis goes on ex-
tending until the whole cornea may have become vascular.
Degenerations in the newly formed structure may result in sup-
puration, (hypopyonkeratitis) or molecular decay and ulceration,
(ulcus corne@) or organization may take place into the fibrous
tissue with contraction and permanent opacity, (macula) or a
hyperplasia may form in the shape of a staphyloma.

Among the other complications may be named pus in the
anterior chamber (hypopion), prolapsus of the iris, iritis and
panophthalmia.

Treatment. In the milder form of keratitis, antiseptic astrin-
gents with atropia sulphate are often effectual: zinc sulphate,
boric acid or alum (1: 100). Any direct mechanical cause of
the irritation must be removed, and the eye rendered as far as
possible antiseptic or aseptic. Derivatives also may be of'ser-
vice, and Trasbot especially advises bleeding ‘from the angular
vein of the eye but only in the very earliest stages. Cupping,
leeching or setons may be employed. Excessive tension may
_ be relieved by puncture of the cornea near its margin. The
remaining opacity after the inflammation has subsided may

Poisoning with Cotton Seed or Cotton Seed Meal. 383

usually be removed by touching it daily with a camel’s hair
brush dipped in a solution of silver nitrate (1 : 200).

In the more severe cases antiseptic lotions are even more es-
sential, mercuric chloride (1: 5000), potassium permanganate
(1:100), boric acid (1:100), silver nitrate (1:200). Careful
massage is of value.

Ulcers may be touched daily with a solution of silver nitrate
(1 : 400), or of pyoktannin (1: 100).

Perforations must be treated by antiseptic bandage, eserin,
and in case of necessity, iridectomy as advised under perforating
wounds.

Abscesses of the cornea should be opened with a flamed needle
and treated with antiseptic lotions.

Obstinate cases are often benefitted by ointment of yellow oxide
of mercury 1, vaseline 10, or by the red oxide of mercury or
calomel.

POISONING WITH COTTON SEED OR COTTON SEED
MEAL.

Poisons in cotton plant: on man, pig, cow, stock cattle. Symptoms in
latter: Nervousness, debility, exhaustion, in-codrdination, paresis, dysp-
noea, dullness, anorexia, drooping head, trembling, lachrymation, corneal
ulcer, opacity, vesiculation ; unilateral or bilateral ; with rest and change
of food recover in five days except eye lesions. Treatment; suspend cot-
ton seed, purge, and treat eye lesions.

The cotton plant develops poisons for various genera of ani-
mals. ‘The bark of the root isa favorite abortifacient for woman
and may be used for the same purpose in the domestic animals.
The seed when fed continuously to swine will destroy life with
symptoms of scorbutus, and grave constitutional disorders. Cot-
ton seed meal fed in excess to dairy cows has a bad reputation
for inducing garget and mammitis. In stock cattle it has the
reputation of producing diarrhcea, running from the eyes, ab-
scess and ulceration of the cornea, staphyloma, hyperthermia
(103° to 109° F.), swelled legs, congestion of the liver and
spleen, and high colored urine. As described by Dr. F. C.
McCurdy, of Kansas City, the southern cattle arrive in poor con-
dition, seem nervous, weak and exhausted, move with an uncer-

384 Veterinary Medicine.

tain, staggering gait, and may fall and make convulsive but in-
effectual efforts to rise. Dyspnoea, blue mucosz, and protruded
tongue are noticeable in such cases. In the slighter cases, dull-
ness, inappetence, suspended rumination, drooping head, and
trembling limbs are characteristic features, and profuse lachry-
mation is constant, In some eyes there is a small opaque spot
around a minute ulcer containing small granules like dust or
sand, and situated in the centre of the cornea on the line of ap-
proximation of the two eyelids. Larger opaque areas when
present were generally confined to the corneal surface, without
any areola of distended vessels, and without a vascular zone at
the junction of cornea and sclera. In certain cases the whole
‘transparent cornea stood out in the form of a vesicle, so promi-
nently as to interfere with closure of the eyelids. ‘The affection
might attack both eyes or only one.

An important feature is that cattle coming from-the cars in
this condition and left at rest for five days on hay without cotton
seed recovered rumination and appetite, and the weakness and
nervous excitement or depression disappeared. There remained
only the lesions of the eye which progress tardily according to
their extent or severity.

The southern origin of the cattle, together with the congested
liver and spleen and the high colored urine would have suggested
the southern cattle fever, but from the promptitude of the re-
‘covery under a change of regimen and the prominence of the
lesions of the eye.

The important point in connection with this subject is the
prophylaxis by avoidance of the too liberal diet of cotton seed.
When the disease has actually set in, the true course is to suspend
this aliment, clear the bowels of any that may remain therein,
and treat the lesions of the eyes according to their respective con-
ditions.

CHRONIC KERATITIS.

Sequel of trichiasis, entropion, eczema, etc Age. Symptoms: moder-
ate, lids partly closed, cilia matted together, crusted, cornea clouded, dull,
with ramifying vessels. Resolution. Fibroid degeneration, permanent.
opacity. Treatment: tonicregimen, out-door exercise, iron, bitters, calcium
sulphide, astringent antiseptic collyria, atropia, mercury oxide.

Chronic Keratitis. 385

This is especially common in dogs in warm latitudes. Trichiasis
and entropion are perhaps the most common of the direct causes.
Eczema and other skin eruptions affecting the lids are additional
causes, while old and debilitated dogs are especially subject to the
affection. It is less frequent in horses.

The symptoms are much less severe than in the acute form.
The lids are usually partially but rarely completely closed,
lachrymation may be absent and is never excessive, the secre-
tion usually sticks together the cilia and lids, and always forms
crusts on them, the palpebre are less sensitive than in acute
keratitis, the cornea is habitually clouded of a bluish-white color,
yet in the main partially transparent and without the disc
opacities of the acute type of disease, and the pupil, which is
usually visible in a good light or under oblique illumination, may
be slightly but is not excessively contracted. The surface of the
cornea seems to have lost some of its polish, and in its sub-
stance blood vessels can usually be made out.

Under favorable conditions these cases may end in resolution
and especially under a change of food and environment. In
less fortunate cases they result in a fibroid degeneration of the
cornea and deep permanent opacity.

Treatment. It is usually desirable to change the regimen so
as to improve the general health, and to allow a fair amount
of out-door exercise. Inthe very old and debilitated the ' case
is rather hopeless. A course of iron or bitters will sometimes
have a good effect. In other cases sulphide of calcium jy grain
thrice a day will prove useful. Eczema must be treated se-
cundum artem.

Locally astringent and antiseptic collyria may be used as in
the acute form. Atropia, 5 grs. to the oz., is a valuable ad-
juvant, to be instilled in drops. Ointment of yellow oxide of
mercury, a piece like a pin head rubbed inside the lids once
or twice a day often acts well. Finally Trasbot strongly com-
mends liquor of Van Swieten. .

25

OPACITY OF THE CORNEA. NEBULA. MACULA.
LEUCOMA.

Nebula, macula, leucoma, pigment spots, infiltration, cicatrix, vascular
or not, result of lead, silver or cocaine. Treatment: silver nitrate solution
in young and vigorous ; calomel : iodoform : avoid mercury and iodine at
the sametime. Tatooing.

As a sequel of inflammation of the cornea, persistent opacities
are very common occurrences. ‘These may last only a short time
after the subsidence of the inflammation, or they may be per-
sistent and chronic. ‘hey are of all degrees of severity from a
mere bluish haze to a dense white cloud, or a dark pigment spot.

The term nebula is given to the slightest form which appears
as a grayish blue but still transparent blue and may be so slight
as to pass without recognition except under focal or oblique il-
lumination. It shades off gradually into the adjacent healthy
cornea, and is often seen as a marginal zone when the centre of
the cornea is clear. F

Macula is more marked, requiring no special illumination to
detect it, especially when the dark pupil forms a background for
the affected area. It is not, however, of a clear white, but of a
grayish blue tint.

Leucoma is a dense white spot or patch which reflects all the
light falling upon it, and has usually a sharply circumscribed
margin.

Pigment spots are usually on the membrane of Descemet and
are the result of a previous adhesion of the iris and detachment
of a portion of its pigment.

The white opacity may be merely a remnant of inflammatory
infiltration or it may be a fibrous cicatrix with or without a re-
maining minute ulcer. It may be the result of an insoluble de-
posit of lead or silver in the tissues. Sometimes it will form as
the result of the application of cocaine.

Treatment. A case of slight inflammatory infiltration can
usually -be cleared up by touching it daily with a solution of 2
grs. silver nitrate in an ounce of distilled water. This is es-
pecially satisfactory in the young and healthy, in which the

386

Ulcer of the Cornea. 387

power of repair is greatest. Finely powdered calomel or iodo-
form applied to the cornea will often prove effective. In case

_ potassium iodide has been given by the mouth, calomel or corro-
sive sublimate is liable to form mercurous or mercuric iodide
and cause ophthalmia. ‘The same is true of iodoform if mercury
has been given internally. As a last resort tatooing the spot has
been resorted to, to hide the opacity.

ULCER OF THE CORNEA.

Infection of abrasions may cause ulcer. Age. House dogs. Puppies on
- vegetable food. Exhaustion. Starvation. Improper, insufficient diet.
Specific microbes and toxins. Symptoms: Ulcer with peripheral zone of
opacity. Photophobia. In marasmus little other local trouble. Diagnosis:
by oblique focal illumination or fluorescin. Granulation of Descemet’s
membrane. Escape ofaqueous. Keratitis. Panophthalmia. Staphyloma
Prognosis in debilitated, vigorous. Treatment: tonics, fresh air, good
food, sunshine, exercise, silver nitrate, mercuric chloride, iodoform, alcohol,
chlorine water, boric acid, cocaine, eserine, atropine, warm antiseptic com-
press, juice of fresh cassava.

Causes. Wounds of the cornea, making an infection entrance
for pus microbes, are liable to lead to ulceration, and a corres-
ponding destruction of the epithelium and superficial layers by
inflammation, may start a similar ulcerative process. Apart from
these conditions, ulceration is especially liable to occur in very
old dogs, in closely confined house dogs, in puppies raised on an
exclusive diet of vegetable food, and in animals worn out by
disease, exhaustion, starvation, or improper and insufficient diet.
Majendie’s dogs fed on sugar, starch and other imperfect diet,
suffered in this way. Finally, the local action of certain specific
disease poisons, enzootic purulent ophthalmia, canine distemper,
dogpox (Trasbot), equine influenza (Schindelka), sheep-pox,
and blennorrhcea (Moller), leads to ulceration.

Symptoms. In keratitis there is usually a marked local opacity
in the centre of which the breach of the surface may be found.
The attendant photophobia with closure of the lids and pupil is
strongly suggestive of ulcer. In the specific diseases, the local
inflammation, the rapid progress of the lesion and the coexist-

388 Veterinary Medicine.

ence of the particular infective disease are characteristic. In
cases due to debility and marasmus the disease may appear with
little indication of attendant irritation, lachrymation, tenderness,
photophobia, or even opacity. At one circumscribed point only
is there a grayish cloud, perhaps no more than a thirtieth of an
inch in diameter, and slightly projecting. This becomes soft,
and gelatinous and finally drops off, leaving a shallow excavation
or abrasion, surrounded by a narrow grayish zone. ‘This ne-
crobiosis may extend inward and even penetrate the membrane,
before the lesion has enlarged to more than a hemp seed in diam-
eter. In other cases lateral extension occurs.

It is always important to recognize the ulcer at an early stage,
and this may be done by oblique focal illumination and the use
of a magnifying lens. In case of doubt a drop of solution of
fluorescin placed on the cornea and at once washed out, will
promptly reveal the lesion by the high color given to the tissues
which have been denuded.

When perforation has'taken place the membrane of Descemet
may bulge out of the orifice and undergo granulation, or it may
open and allow the escape of the aqueous humor. Active kera-
titis and even panophthalmia are liable to follow perforation.
Again, the escape of aqueous humor tends to the approximation
or contact of the iris or lens, with the cornea, where it may be-
come adherent and staphyloma may ensue, or a central cataract
forms.

Prognosis is unfavorable in debilitated subjects, and when the
lesion is extensive and in the line of vision. In slight recent
cases in good constitutions it is favorable.

Treatment. Debility must be met by tonics and rich diet,
fresh air, sunshine and exercise. Specific diseases must be met
according to their nature.

Locally the daily application of silver nitrate lotion (1 : 200) is
often very effective, proving an excellent antiseptic, checking the
microbian proliferation, and coagulating the albumen in the
wound so as to form an antiseptic barrier to further invasion. A
mercuric chloride solution (1 : 5000) is an excellent substitute.
Iodoform powder though less antiseptic, is especially valuable in
favoring the healing process. It is dusted over the cornea, and
the upper lid immediately drawn down and held over the cornea
for several minutes. If this is neglected the dry powder is re-

Corneal Staphyloma. 389

moved by the flow of tears, and the movement of the lids and
membrana nictitans. Trasbot recommends dilute alcohol (5 : 100).
Moller advises chlorine water reduced to one-third the standard
strength, or boric acid solution (2:100). Bouley found good
results from a cocaine solution. Cadiot and Almy get the best
results from creolin (.5 to 1:1000) 5 or 6 times a day, with
eserine.

In all cases great relief can be obtained from a strong atropia
lotion (1: 100), in contracting the capillaries and dilating the
pupil. Indolent cases may often be helped by warm antiseptic
compresses, which seem to stimulate the circulation and nutri-
tion of the part. The juice exuding from the scraped fresh cas-
sava and concentrated to a syrupy consistency, is strongly antisep-
tic, and used with atropia or pilocarpin is the best agent known
for senile ulcer (Risley).

In perforation employ rest, eserine, and antiseptic compression
bandages and in case of prolapsus iris, excise as already advised.
This contracts the pupil, increases tension and favors exit of the
aqueous humor and the approximation of the edges of the open-
ing. serine has been used for central ulcers; atropine for
peripheral.

CORNEAL STAPHYLOMA.

Bulging corneal scar with adherent iris: from perforation, escape of
aqueous, intraocular pressure, vascularization of cornea. Diagnosis by cen-
tral cicatrix, vascularization, pigmentation. Oblique illumination. Treat-
ment : iridectomy, eserine. Suture. Enucleation.

This is a bulging forward of a corneal scar with the iris ad-
herent to its internal surface. It may originate in perforation of
the cornea and escape of the aqueous humor, or in intraocular
pressure that advances the iris until it comes in contact with
the cornea, which becoming adherent and receiving an abnormally
large supply of blood or plasma, softens and bulges outward. It
may grow out to a great length in some cases, Eck has seen it
two inches in the horse, and somewhat smaller in an ox. May
records a case affecting both eyes in the dog.

Diagnosis is not usually difficult. The scar in the midst of a
granulating projection of the cornea is nearly conclusive, but the

390 Veterinary Medicine.

recognition of pigmentation of the growth and the adherent iris
often revealed by oblique illumination will nearly always show
the true nature of the case.

Treatment is by iridectomy and eserine if the disease can be
recognized in its earliest stages, but it is rarely satisfactory.
Later the choice may be between excision of the staphyloma and
coaptation of the edges of the wound by suture, and the enuclea-
tion and removal of the eyeball. The last resort is preferable to
the continued irritation of the staphyloma by the lids and cilia
under the ocular movements.

ECTASIA CORNEA. KERATOCONUS. CONICAL
CORNEA.

This consists in a thinning and protrusion of the cornea in the
form of a blunt cone, without loss of transparency. It has ac-
cordingly been called staphyloma pellucida. ‘There isa gradual
attenuation and distension of the corneal tissue from some un-
known cause. It has been seen mainly in the young and is
manifestly due to a trophic defect. Stockfleth records a case in
a foal and Bayer inacow. No satisfactory treatment has been
proposed, but as the trouble usually comes to a standstill without
perforation, it can be left to take its course. With rapid in-
crease and manifest tension antiseptic puncture of the cornea or
even iridectomy might be tried.

KERATOGLOBUS.

This is a variety of ectasca in which the clear, pellucid, pro-
truding cornea is more globular and less conical in outline. It
is seen especially with enlargement of the entire eyeball (duph-
thalmus). ;

TUMORS OF THE CORNEA.

Various tumors may grow from the cornea. Dermoid cysts
may implicate the cornea and demand excision. Malignant
growths demand extirpation of the eyeball.

WOUNDS OF THE SCLERA.

Covered as it is by the bones of the orbit, and by the palpebrz
the sclera is little liable to traumatic lesions. Wounds with
swords, needles, nails, splinters of wood, and other sharp pointed
bodies are not unknown, however, and penetration by shot is es-
pecially common in setters. Rupture from blows of clubs, beams,
poles, stumps, etc., are also met with.

The symptoms are great fear and apprehension if the head is
touched, profuse lachrymation with more or less of blood, and
when the eyelids are separated the wound may be discovered
and its gravity estimated by protrusion of the vitreous. Slight
injuries which are not infected heal readily under the treat-
ment recommended for keratitis. Infecting and penetrating
wounds are liable to cause panophthalmitis and destruction of
the eye. Foreign bodies, if present, should be removed when
possible. Pyoktanin is especially recommended by Stilling.

EPISCLERITIS. INFLAMMATION OF THE SCLERA.

Scleritis in man is described as a manifestation of rheumatism,
gout, or tuberculosis. It occurs in animals in connection with
traumatic lesions, with iritis, cyclitis and choroiditis and is mani-
fested by more or less congestion, swelling and tenderness of the
sclerotic, but is always subordinate in importance and the /veat-
ment demanded is for the more serious disease.

ECTASIA (BULGING) OF THE SCLERA.

Cases of this kind are adduced by Scleich and Mayer, in dogs,
in which there was a corresponding bulging or even an absence
(coloboma) of the choroid and retina. With a large protrusion of
the sclera behind, there was a shrinkage of the front of the globe
(microphthalmus), so that an atrophy might be suspected. The
condition is irremediable.

391

PROLAPSE OF THE IRIS.

This has been already referred to as a complication of perfor-
ating ulcer or wound of the cornea. If it cannot be returned and
maintained by a compression bandage and eserine, the only. resort
is to draw out the prolapsing portion and cut it off with scissors,
the eye and instruments having been rendered thoroughly aseptic.

INTERNAL OPHTHALMIA.

Diagnosis of internal ophthalmias difficult. Causes: as in conjunctivitis,
extension of conjunctivitis or keratitis to iris, choroid, ciliary circle, retina ;
Lymphatic constitution, damp soil, air and stable, pit life, dentition, grain
feeding, training. Symptoms: ophthalmic symptoms generally, enlarged
ciliary vessels in sclera not movable; white zone around corneal margin ;
iris dull, brownish, sluggish; intraocular tension increased : flocculi in
aqueous humor: photophobia: oblique focal illumination ; sudden change
from darkness to light : synechia: ophthalmoscope. Cyclitis. Diagnosis:
from keratitis, recurrent ophthalmia. Lesions: according to chief seat of
the disease: inflammation of Descemet’s membrane, iris, choroid, ciliary
circle, lens, vitreous and retina in variable degree. Opacity of aqueous;
lens, capsules, or vitreous. Prognosis : always grave, often vision impaired
or lost. Treatment: rest, pure air apart from strong sunshine, removal of
causes, local bleeding or cupping, derivation, purgative, cooling diuretics:
locally astringent antiseptic lotions, cocaine, homatropine, blister, undue
tension antiseptic puncture, mercury oxide ointment ; in rheumatic cases
salicin or sodium salicylate.

In the domestic animals it is not always possible to distinguish
between inflammations affecting different portions of the inner
and middle coats of the eye (iritis, cyclitis, choroiditis, retinitis),
so that it is. convenient to give in general terms the phenomena
and treatment of the class known as ophthalmia internus. ‘This
is all the more appropriate that inflammation of one of these
divisions so frequently extends to the others producing panoph-
thalmitis, that the disease in one usually implies an early impli-
cation of all.

392

Internal Ophthalmia. 393

Causes. Many of the causes of conjunctivitis, when acting
with special intensity, or for too long a time, may cause internal
ophthalmia. Severe blows, bruises, punctures, lacerations, sand,
cinders, dust, lime, foreign bodies inducing traumas, sudden
transitions from darkness to bright sunshine, habitual exposure
to sunshine or to the reflection from snow, ice or water, through
a window in front of the stall, the abuse of the overdraw check
rein, the glare of electric light or of lightning flashes, draughts
of cold damp air between windows or doors, the beating of cold
storms on the eyes and skin, a sudden chill from plunging in
water or standing in a cold draught when perspiring, blows with
branches, pine cones or needles in the eye, the constant irritation
from entropion, trichiasis, burdocks or thistles in the forelock,
irritant gases, etc., are among the factors which codperate in
setting up the disease. Again diseases of the digestive organs,
rheumatism, influenza, canine distemper, brustseuche, petechial
fever, variola, eczema, and aphthous fever may be direct causes.
Conjunctivitis and keratitis are liable to merge into irido-choroidi-
tis by extension, and above all when owing to perforation
of the cornea a direct channel is opened for the easy entrance of
infective, pathogenic microbes. A lymphatic constitution, con-
nected with low breeding, or living in a low, damp, cloudy region,
or in dark, damp, impure stables, has a strongly predisposing in-
fluence. The period of dentition, connected as it usually is with
domestication, stabling, grain feeding, and training is often a
potent accessory cause.

Symptoms. With the general phenomena of superficial or ex-
ternal ophthalmia there are some indications which may be called
pathognomonic. ‘These may be summarized as follows : in eyes
devoid of pigment the exlarged ciliary vessels run deeply and are
not tortuous, nor mobile when rubbed , the scleral redness increases
toward the margin of the cornea, but leaves a white zone in front
of the penetration of the ciliary vessels ; the tris has lost its clear re-

flection, appearing dull or brownish ; the pupil ts contracted and
sluggish in response to light and darkness, it may be fixed or may
-show marked unevenness in its margin - the tension of the eye ball
zs often increased, flocculi of lymph may be seen in the aqueous humor
settling into the lower part of the anterior chamber. This deposit
may be white or yellowish or it may.even be reddened by ex-

394 Veterinary Medicine.

travasated blood especially in traumaticinjuries. In traumas, too,
the cornea and even the aqueous or vitreous humor may be
opaque. In cases resulting from exposure to cold or from inter-
nal causes, the media of the eye are at first clear and transparent.
The condition of the interior of the eye is usually to be learned.
by examining the patient as he stands facing the light from a
dark back ground. A stable door or window will afford the re-
quisite amount of rays falling from above and from each side
upon the interior of the eye. The observer looks indirectly or
obliquely and under favorable conditions can see the iris and
through the pupil., If the pupil is unduly closed it may often be
dilated by instilling a few drops of a 5 per cent. solution of
atropia and waiting for fifteen or twenty minutes.

The examination is made more satisfactorily with a candle or
other single source of light in a dark chamber. If this light is
surrounded by a chimney opaque except at one side which is
directed toward the eye, the results are much more satisfactory.
Focal illumination with a biconvex lens, or oblique illumination
will show a swollen condition of the iris with uneven bulging
swellings at different points, and generally a lack of the clear
dark surface which marks the healthy iris. It may be yellowish
or brownish, rather than dark, or blue, or yellow, but is always
duller than normal. The pupil may be contracted or dilated, but
is always uneven at the margin according to the degree of con-
gestion of the different portions. It may be quite immovable
under the stimulus of light and darkness, and is always sluggish
as compared with the healthy condition. To test this reflex
action, the one eye may be bandaged, and the other eye covered
with the palm of the hand for one or two minutes. When ex-
posed the pupil will be found to be widely dilated, and in the
healthy eye it will rapidly contract and dilate alternately until it
has reached a condition of adaptation to the intensity of the light
when it will remain immovable. With the inflamed iris these
contractions and dilatations will be lacking altogether, or they
will be sluggish and imperfect in various degrees according to
the intensity of the inflammation, the degree of congestion or
the tension of the liquid media of the eye. Restricted move-
ment may also be due to adhesion to the cornea, (synechia an-
terior) or to the capsule of the lens (synechia posterior).

Internal Ophthalmia. : 395

When viewed with the ophthalmoscope properly focused the
choroid may show a lack of its normal lustre and an uneven-
ness due to the formation of small rounded elevations in con-
nection with congestion, or exudation, and patches of yellowish
red or whitish discoloration together with lines of the same color
following the course of the blood-vessels. It may also reveal
dark spots of opacity in the lens (cafaract) or clouds in the an-
terior region of the vitreous, the result of exudations. The
blood-vessels may appear enlarged and tortuous.

In some cases the exudate may form a false membrane which
completely closes the pupil.

A special tenderness around the margin of the cornea is sug-
gestive of cyclitis. Internal ophthalmia is usually accompanied
by a variable amount of fever.

Diagnosis. From simple keratitis, it is distinguished by the
thickening, discoloration and sluggishness of the iris, by the ab-
sence, in many cases, of corneal opacity, and of free lachryma-
tion, and in some instances by increased tension of the eyeball.

Recurring ophthalmia, which is usually also an internal in-
flammation, appears more abruptly and often at first with greater
severity, and accompanied by more hyperthermia. There is
almost always a bluish white opacity around the margin of the
cornea, the eye is retracted in its sheath so as to appear smaller
and the upper lid usually shows a marked angle between its inner

and middle thirds in place of the evenly curved arch of the

healthy palpebra. It usually appears for the first time in the
young and in those that have inherited the susceptibility and
have been kept on damp soils, in cloudy districts, or dark
buildings.

Lesions, ‘These are necessarily varied according as the inflam-

mation is concentrated on particular parts of the interior of the .

eye. ‘The secreting membrane ofthe aqueous humor is nearly
always inflamed giving rise to an exudate and a milky opacity
of the aqueous humor. ‘The iris is the seat of congestion exuda-
tion, thickening, cell proliferation and investment by false mem-
branes. ‘The capsule of the lens isearly clouded, may be covered
by exudate and is rendered vascular insome cases. The choroid
is also the seat of congestion, exudation and discoloration with
the covering up at points of its pigmentary layer. The vitreous

396 . = Veterinary Medicine.
and lens finally become the seat of exudation and opacity which
is liable to prove permanent

Prognosis. ‘The internal ophthalmias are always to be dreaded.
In other organs exudates may take place and become organized
as permanent structures without abolishing the function or ren-
dering the organ physiologically useless, but in the delicate and
transparent tissues of the eye, any such permanent product almost

. infallibly causes opacity and loss, or serious impairment of vision.
In the retina the displacement, derangement, or covering up of

. the cones and rods necessarily interferes with or abolishes sight,
the opacity of the cornea, lens, capsule, or vitreous interrupts
the rays of light, and the destruction, or coating over of the pig-
tment of the choroid leads to undue reflection and destroys vision.
Besides this the destruction or impairment of one part of the eye,
changes the refraction and blurs the vision, or interferes with
accommodation and destroys the utility of the organ. Unless
therefore the disease can be cut short in its early stages and a
complete resolution effected it is likely to leave the patient very
much deteriorated in value. Fortunately it is only in the most
violent cases or in very susceptible animals that the disease in the
one eye is transmitted to the other by sympathy and leads to des-
truction of that eye as well.

In the ¢veatment of internal ophthalmia, rest in pure air and
moderate warmth, away from a fierce glare of light is impera-
tive. The causes should as far as possible be removed. Next, it
is desirable to establish derivation. Leblanc and Trasbot attach
great importance to phlebotomy from the jugular on the same
side. A more direct local action with less loss of blood may be
obtained from opening the angular vein of the eye or applying a
leech beneath the lower lid. In most cases a sufficient derivative
action can be secured by an active purgative which may be fol-
lowed by daily doses of cooling diuretics. Locally astringent
lotions (lead acetate or zinc sulphate 1 dr. to 1 qt. water; mer-
curic chloride, 1 : 5000 ; boric acid, 2 : 100; pyoktannin, 1 :1000)
in combination with cocaine hydrochlorate, homatropin, atropia
sulphate, duboisia or hyoscyamin (1 : 1000) would be appropriate.
These may be applied over the eye on a soft cloth, and in cases
of infective inflammation the more antiseptic agents may be in-
jected under the lids. When the inflammation is very severe the

Simple Iritis. 397

atropia or other sedative agent may be made of the strength of
I : 100 and a drop or two placed inside the lids with a dropper
every two or three hours.

A blister of biniodide of mercury may be applied to a space
the size of a dollar above the anterior end of the zygomatic ridge, .
or in dogs back of the ear on the side of ‘the neck: or a seton
may be passed through the skin in the same situation.

When the eyeball is unduly tense, puncture throtigh the mar-
gin of the cornea with a fine aseptic lancet will relieve the tension
and in some cases induce a more healthy action. Assiduous anti-
Sepsis is needful until the wound has healed. -

In other cases benefit can be obtained from the use of an oint-
ment of yellow oxide of mercury 1 part, in vaseline 10 parts, or
of iodoform of the same strength. A small portion the size of a
grain of wheat is put under the lid, and the latter manipulated
with the finger to bring it in contact with all parts of the surface.
In case of a rheumatic origin, salicin and salicylate of soda are
demanded.

SIMPLE IRITIS.

Causes. Symptoms: redness of sclera, in dogs, cats, birds, pigs, with a
narrow zone of white next the cornea, red scleral vessels immovable, iris
dull gray or brown, uneven, sluggish in response to light, synechia anterior
or posterior, lens and capsule clouded or clear, pupillary margin uneven,
myosis or midriasis, black cataract. Treatment: rest, dark stall or covering,
head elevated, midriatics, cocaine, antiseptic puncture, purgation. leeches,
seton, cooling astringent lotions, diuretics, for tension in convalescence
iridectomy. In traumatic cases careful antisepsis.

This may come from any one or more of the causes of internal
ophthalmia above named. ‘The inflammation, however, concen-
trates itself on the iris so as to overshadow the disease in the ad-
jacent organs.

The more distinctive symptoms are the redness of the sclerotic
in unpigmented organs (swine, birds, dogs, cats), the redness in-
creasing as it approaches the margin of the cornea but leaving a
narrow white zone surrounding the edge. The red vessels on
the sclerotic are not moved with the conjunctiva when the lid is
moved over the front of the eye. The front of the iris is dull,

398 Veterinary Medicine.

grayish or brownish, it is thickened unevenly and very sluggish
in response to light and darkness. Not infrequently it is ad-
herent to the back of the cornea (synechia anterior) or to the
front of the lenticular capsule (synechia posterior). The lens
and its capsule may or may not be clouded, but if the interior of
the vitreous can be seen it is found to be clear. The pupil is
more or less uneven in outline and sometimes it is torn at its
inner edge so as to form shreds and projecting tongues. Myosis
(contraction of the pupil) or midriasis (dilatation) may be
present. If the latter has been preceded by adhesion, a portion
of the uvea may remain attached to the lenticular capsule consti-
tuting black cataract. The lens or its capsule may become
opaque, and a fibrinous membrane may form over the pupil.

Treatment. Rest for body and eye are essential. A dark stall,
or a thick covering for the eye is desirable. The head should be
kept moderately elevated to facilitate the return of blood. ‘The
pupil should be kept widely dilated to prevent adhesions to the
lens. Sulphate of atropia 5 grs. to the oz. of water should be
applied a few drops at a time, thrice a day, or as often as may be
necessary to secure dilatation. In case the atropia fails to secure
dilatation a 5 per cent. solution of cocaine should be dropped into
the eye every three or four minutes for four or five times and
then another application of atropia may be tried warm. Should
it still fail and should there be indications of extra congestion
and swelling of the iris or of excessive tension of the eyeball, relief
may be obtained by puncturing the cornea. With the reduction
of the tension the iris will often respond to the midriatic. Bene-
fit may also be obtained from an active purgative, or the applica-
tion of leeches in the vicinity of the eye.

Cooling astringent applications may be kept up over the eye,
or warm antiseptic applications will often give great relief.

In obstinate cases the yellow oxide of mercury ointment may
be applied as advised for zuternal ophthalmia.

Cooling diuretics may also be of essential advantage.

If, after a fair recovery the bulb remains unduly tense, iridec-
tomy may be resorted to asa prophylactic measure for the.future.
An incision is made with a lancet close in front of the margin of
the cornea, and the iris seized and withdrawn with a pair of fine
forceps, and a portion snipped off with fine scissors. The eye

Symptomatic or. Metastatic Lritis. *\°)

and instruments must be rendered absolutely aseptic by carbolic
acid and boiling water, and the antisepsis of the eye must be
carefully maintained until the wound is healed. ‘This tends to
relieve congestion in the iris and to moderate the secretion in the
anterior chamber, so that the former extreme tension does not
recur. In making choice of the seat of the iridectomy a selec-
tion may be made which will do away with adhesions, or one
that will expose a portion of the lens which is still transparent,
and which may restore vision when obscured by a cataract.

In traumatic cases there should be extra care in maintaining a
thorough antisepsis of the eye as the great danger is that of in-
fective panophthalmitis. The injection of antiseptic liquids
under the eyelids, and the covering of the eye with antiseptic
cotton wool or with a soft rag wet with an antiseptic lotion are
important factors in treatment.

SYMPTOMATIC OR METASTATIC IRITIS.

Complications of infectious diseases, influenza, contagious pneumonia,
strangles, tuberculosis, omphalitis. Symptoms: exudation of fibrine and
blood, with those of simple iritis. Treatment: as in iritis, plus measures
for the specific primary disease. When second eye is threatened enuclea-
tion.

Under this head Moller describes those forms of iritis which
occur as complications of various infectious diseases. It has
long been observed that iritis and other ophthalmias, occurred as
complications of the acute infectious diseases of the respiratory
organs of the.horse formerly known under the general name of
‘‘influenza.’’ More recently many veterinarians and others have
classed these influenza irites separately under the name of ‘‘ pink-
eye,’ The same can be said of ‘‘contagious pneumonia’’
(brustseuche) of horses which is distinctly caused by the dzplococ-
cus (streptococcus) pneumonia equina. Attention was called to
the iritic complication of this disease in 1881 by Siedamgrotzky
and it has been often noticed since. Conjunctivitis is however a
more frequent complication of this disease than iritis. In both
influenza and contagious pneumonia the iritis often supervenes

400 Veterinary. Medicine.

when convalescence has apparently set in. Strangles is another
affection in which the iris occasionally suffers. Mathieu has
described tuberculosis of the iris in cattle, and Méller mentions
with some hesitancy cases of iritis which complicated the infection
of the navel in new-born animals. ,

The symptoms of symptomatic iritis vary according to the par-
ticular infection. In addition to the fibrinous exudate the in-
fections of the respiratory organs are liable to be complicated by
blood extravasations. Ininfluenza this may show as deep blotches
on the bulbar conjunctiva and in chemosis. In contagious
pneumonia Shutz met with iritis of a distinctly hemorrhagic
character.

In Mathieu’s cases of tubercle of the iris there was first a
slight lachrymation, and soon the irisassumed a grayish tint, and
became uneven and unduly approximated to the cornea though it
failed to become adherent to it. The swellings of the iris in-
creased and became of a grayish yellow color, and the pupil was
usually contracted and varied little in size. Post mortem ex-
amination showed the presence of tubercles. The same con-
dition has become familiar in connection with experimental inocu-
lation in the eye. Asin ordinary iritis, adhesion to the capsule
of the lens and cataract are common results.

Apart from the ¢veatment of the specific primary disease this
type of iritis demands the same treatment asotherforms. Strong
atropia lotions to prevent or break up adhesions and antiseptic
astringents are especially indicated. When implication’ of the
second eye is threatened it may be desirable to remove the first
by enucleation. (See Panophthalmitis. )

FOREIGN BODIES IN THE IRIS.

These are sometimes fine shot particularly in dogs, and splinters
of iron and steel in otheranimals. Their presence can sometimes.
be made out by careful focal illumination. If septic they cause
violent iritis and panophthalmia. If aseptic they may sometimes.
cause little trouble. If they can be exactly located, they should
be removed at once before the aqueous humor and cornea become

Coloboma Ividis. Congenital Aperture in Iris. 401

clouded. If the offending body is a piece of iron or steel and
can be reached by a magnet introduced through the original
wound or through one made with a lancet in the edge of the
cornea it may be extracted by this means. If it is shot or other
body that-is not attracted by a magnet the portion of the iris in
which it is entangled may be drawn out with forceps and snipped
off with fine scissors. Due antiseptic precaution must be exer-
cised.

COLOBOMA IRIDIS. CONGENITAL APERTURE IN IRIS.

This is a congenital defect in which there is an aperture in the
iris. Hering figures the two eyes of a horse in which these ap-
peared in the direction of the outer canthus. Renner records a
case in-a foal in connection with intra-bulbar enchondroma.
Dochtermann and Berlin record that among 64 pigs the result of
breeding a boar on his daughters and grand-daughters no less
than 36 showed coloboma. Moller figures a dog with the same
affection.

The condition is not known to prove hurtful to the affected
animal so that it may be wisely let alone.

DOUBLE PUPIL.

Mayer notes a case of congenital double pupil in the horse, a
bridge extending across the space from the upper to the lower
border and cutting off the outer third of the opening. The
present writer has seen a similar condition as the result of union
of the corpus nigrum in severe iritis. Section of the bridge is
possible, though rarely desirable, seeing that it opens a door to
possible infection.

ALBINISM. WATCH-EYE.

The albino is an animal in which there is a complete absence
of pigment in the eye. It is usually seen in white races of rats,
26 “

402 Veterinary Medicine.

rabbits and dogs, and both the iris and choroid reflect a pink
tint. It may cause photophobia and some weakness of vision
but, in the main, it seems to be harmless to the lower animals.
In horses it is occasionally seen as a partial defect, a portion only
of the iris and adjacent sclerotic appearing of a brilliant white
color. It does not usually seem to impair the visioh, so that at
the worst, it is only looked on as a blemish. It is needless to at-
tempt a remedy.

PERSISTENT PUPILLARY MEMBRANE.

The persistence of this embryonic membrane has been noticed
in the horse (Schindelka), ox (Meyer), rabbit (Mayerhausen),
and dog (Moller). It tends to disappear with the growth of the
animal and rarely does any perceptible harm.

OCCLUDED PUPIL.

This has been frequently found in horses as a sequel of iritis,
and permanent adhesion of the contracted iris to the front of the
lens capsule. It is in short, a posterior synechia with closure of
the pupil. The lens and its capsule are usually opaque so that
there would be no gain in detachment of the iris. If, however,
there is reason to conclude that any part of the lens is still trans-
parent, the performance of iridectomy over this portion, would
produce a new aperture for the entrance of light.

CYCLITIS.

This is described by MOller as occurring in the domestic ani-
mals, but he fails to furnish instances of its diagnosis during
life, and it is not likely to be often recognized in the living ani-
mal. Beside the usual signs of iritis, there is extreme tender-
ness to pressure around the anterior border of the sclera, increase

Cysts and Tuberculosis of the Iris. 403

of intra-ocular pressure, followed later by its diminution, and a
cloudiness of the anterior portion of the vitreous humor. ‘This
last condition can only be detected by a full illumination of the
vitreous, and its examination with the ophthalmoscope. It is
quite liable to be complicated by suppuration and to go on to
panophthalmitis.

The ¢veatment does not materially differ from that of iritis, yet:
atropia must be used with caution as it is liable to increase the
suffering. The preparations of mercury have been especially
recommended.

CYSTS OF THE IRIS AND CORPORA NIGRA.

Mayer speaks of these lesions in horses, but it is very difficult
to diagnose them correctly, even with the aid of the ophthalmo-
scope. ‘The very manifest bulging at the part may be due to ex-
cess of pigment, especially in the corpora nigra, and an explora-
tory puncture would only be warranted when the protrusion be-
came excessive and injurious. One such puncture by Eversbusch
led to infection and loss of the eye.

TUBERCULOSIS OF THE IRIS.

This has occurred as the result of inoculation of the aqueous
humor in the smaller animals, and as a spontaneous localization
of the disease in cattle (Hess, R6der, Fischdder, etc.). In Hess’s
case, the left eye was shrunken to half the size of the sound right
eye, and small caseated tubercles were present in both iris and
choroid. ‘There are usually coincident tubercles in other organs,
and these with the nodular appearance of the iris swellings, if
visible in life, may assist in diagnosis. (See Symptomatic [ritis
and Zuberculosis.)

CHOROIDITIS.

Causes : as in iritis: traumatic and infective. Exudative. Suppurative.
Symptoms: as in iritis : less change in iris and of flocculi in the aqueous
humor ; opacity of lens and vitreous. Lack lustre choroid under ophthal-
moscope, uneven, detached. Suppurative form: early profuse weeping,
bleeding, later suppuration, pus oozing from orifice; panophthalmitis.
Treatment: as in iritis; atropia; cocaine; astringents; purgatives;
diuretics.

Causes. 'These are largely the same as those of iritis and cy-
clitis. Blows, traumas, foreign bodies, sand, cinders, dust, lime,
fierce light, reflection from snow, water, ‘etc., chills, draughts,
storms, irritant gases, and a number of specific diseases like in-
fluenza, contagious pneumonia, canine distemper, rheumatism,
omphalitis, pyzemia, etc., may be named. It is a common lesion
of recurrent ophthalmia in horses, and is not unknown in tuber-
culous cattle. It is usually more or less involved in iritis, as
the iris is in choroiditis. The name given to the disease which
involves both, will depend mainly on whether the inflammation
predominates in the iris or choroid. Mayer divides it into exu-
dative and suppurative, the latter being the common result of
trauma, and likely to issue in panophthalmitis.

Symptoms. ‘These are largely those of iritis. The/congestion
and redness of the sclerotic around the margin of the cornea, the
fact that the enlarged vessels are firm in the sclera and not easily
moved as in conjunctival congestion, and a certain partial blind-
ness, without much change in the brilliancy of the iris, or opacity ,
or flocculi of the aqueous humor, would suggest choroiditis.
Later some opacity of the lens, or its capsule or of the vitreous
humor would be equally significant.

The only certain manifestations would be such as are found on
ophthalmoscopic examination. Swelling and unevenness of the
inner surface of the choroid, and a loss of luster, a change of its
dark surface to light colored spots and patches, (dull-red, yellow-
ish red, grayish green) and of the tapetum lucidum to a dirty
grayish green in solipeds. Areas of minute blood clot may also
be seen. But these are rarely recognized or indeed skillfully
sought during life, and it is mainly to necropsies that we owe most
of our diagnosis of choroiditis in the lower animals.

404

Detachment of the Choroid. 405

In the suppurative form there is early profuse lachrymation
more or less tinged with blood, and later oozing of pus from be-
tween the lids. The redness and swelling of the conjunctiva
and lids are very prominent features, and if the lids can be sepa-
rated the corneal or scleral orfice may be seen oozing pus. If
visible at all, the anterior chamber shows yellowish opaque con-
tents, and the symptoms of panophthalmitis supervene.

Treatment of the exudative form is essentially the same as
for iritis. Atropia lotions with or without cocaine, also astrin-
gents, which may be used warm, and generally purgatives,
diuretics, local bleeding, cupping, and counter-irritants are in
order. In obstinate cases ointment of the yellow iodide of mer-
cury, and in cases of extra tension puncture of the cornea may
be the means of relief. Colargol or pyoktanin is a safe anti-
septic. Iridectomy may be advantageous under careful anti-
septic precautions. In case of extensive or general suppuration
(panophthalmitis) enucleation of the eye may be the only resort,
and may contribute to save the other eyeball. (See Panophthal-
mitis. )

DETACHMENT OF THE CHOROID.

The choroid is detached from the sclera by exudates, blood
effusions, or blows with blunt articles. The lesion is especially
common in recurrent ophthalmia, choroiditis, and cyclitis. The
ophthalmoscope will show the detached portion as a rounded
elevation on the otherwise smooth concave surface, with normal
or diminished intraocular tension. A ‘mor of the choroid is
usually associated with increase of tension. After inflammation
has been subdued these cases may be left to rest and time, and
will often recover through absorption of the exudate. Rupture
of the choroid from violence is to be similarly dealt with.

RECURRENT OPHTHALMIA OF SOLIPEDS. PERIODIC
OPHTHALMIA. MOONBLINDNESS.

Definition. Causes: wet impermeable soil, clay, river bottoms, deep
valleys, inundations, enclosing forests, damp air, lack of sunshine, rank
fodders, wet seasons, damp, cold, basement stables, heating constipating
fodder (corn, buckwheat, wheat), dentition. training, age of domestication,
sale, etc., spring, shedding coat, heredity, debility, ill health, worms, de-
bilitating infections diseases, over work, insufficient, indigestible food,
local irritants. Microbes. Rheumatism. Parasitism. Symptoms : fever
variable, lack .of vigor, sudden attack, irritation, photophobia, lachryma-
tion, closed lids, contracted pupils, retracted eye, redness, swelling of lids,
conjunctiva, haw, sclera, slight corneal opacity, with vascularity, aqueous
turbid, flocculent, iris of dull color, sluggish, pupil contracted, hypopion,
posterior chamber yellowish green, intraocular tension, crisis seventh to
tenth day, convalescence fifteenth day. Recurrence. Obscurity of vision.
Eye between attack : blue zone around cornea, eye seems smaller, retracted,
prominent haw, angle in upper lid, dull iris, tint lighter, contracted pupil,
cataract, alert ears. Lesions : exudates back of cornea, narrowed anterior
chamber, sizy aqueous, thickened iris, adhesions of lens capsule, or iris,
torn iris, lens opaque, fibroid, calcareous, atrophied, black cataract, vit-
reous opaque, yellow, black, shrunken, choroid uneven, discolored, de-
tached, retina with exudate, detacted, posterior chamber contracted.
Prevention : drainage, mature horses for damp lands, liming soil, get fod-
der from dry locality, don’t breed in cloudy regions, good diet and regimen,
avoid corn, wheat and buckwheat, Glauber salts, pure dry stable, exclude
debilitating diseases and parasites, keep in hard muscular condition, change
to dry locality, don’t breed from blind stock, legislation. Treatment: re-
move causes, cure rheumatism or other morbid factor, darkness, antiphlo-
gistics, laxative, diuretic, antimicrobian-potassium iodide, local bleeding,
cupping, blister, seton, locally atropine, cocaine, pyoktanin, potassium
iodide, sublimate, lead, puncture, tonics, treat corneal opacities... Jurispru-
dence: return a newly bought horse in 30 days, (France) or more: extend
the time if suspected. ;

Definition. 'This is an inflammatory affection of the interior of
the eye, intimately related to certain constitutions, soils, climates,
and systems of managenient, showing a strong tendency to recur
again and again, and usually ending in blindness from cataract
or other destructive lesion.

Causes. A wet, impermeable, swampy or undrained soil
is a potent cause of thisdisease. Heavy clays, which absorb and
retain moisture, river bottoms and deltas which are frequently

406

Recurrent Ophthalmia in Solipeds. Moonblindness. 407

overflowed and constantly wet, hollow basins where no effective
drainage has been secured, and the coasts of seas and lakes which
scarcely rise above the level of the water and are submerged at
intervals, are the especial homes of the affection. In time past the
disease was very prevalent in the low districts of France (Reynal),
Belgium, Alsace-Loraine (Zundel, Miltenberger, ) Germany, Hol-
land (Moller), the English fen country and, above all, the damp
lands of Ireland. lLafosse mentions a whole family of horses in
South Western France which were characterized by blindness.
Reynal records the terrible devastation which it caused in former
times in the government studs at Limousin and Pompadour. It
also prevails on the low banks of the Guadalquivir near Seville
(Hurtrel d’ Arboval), around Ostend, Cassel and Frankfort (Hof-
geismar). At Saarburg in 406 horses on the drier limestone, 5
per cent. were blind, while in 226 on the wet clay, 40 per cent.
were blind (Schwartznecker). In Schlettstadt before drainage
there were 75 per cent. blind : after drainage, 4 per cent. (Ztindel).
Wet soils surrounded by forests or hills, which hinder free circu-
lation of air, are especially injurious (Reynal). At Schlestadt,
Alsace, at the beginning of this century, Miltenberger found 75
per cent. of the horses of the environs affected, whereas after
great drainage works and the removal of all stagnant water
Zindel found in 1870 not more than 2 percent. In many locali-
ties in England, Ireland, France, Belgium and Germany the dis-
ease has greatly diminished in connection with land drainage and
improved methods of culture. Harmon tells how in different
parts of Brittany, drainage supplemented by the free use of marl
and lime on the soil has caused a striking decrease in the prev-
alence of the malady. Inthe department of Ain a ratio of 333
per 1000 was thus reduced to 100 per 1000 (Reynal.) On the
contrary, in the absence of such drying of the soil the previous
high ratio of attacks was maintained. This has been notorious
in the damp lands of Northern France and Belgium (Picardy,
Artois, Flanders, where it often reaches 40 to 70 per cent. Reynal) :
Alsace-Loraine, Holland, Hanover, Mecklenberg, North and
East Prussia, Lithuania, the low parts of Austria and Hungary
and the Danubian Principalities—Moldavia and Walachia.
Reynal further shows that dealers are in the habit, of taking
young horses, which have so far escaped, or which have suffered .
but one moderate attack, away from the low damp soils of the low

408 Veterinary Medicine.

Pyrenees or of the Jura Valley in France to the dry elevated lands
of Dauphiny, Provence and Lanquedoc in France, or to the
mountainous regions of Catalonia in Spain in the well justified
confidence that few of them will suffer a second attack.

It is rare in native horses in Denmark (Bang), Norway and
Sweden (Malm), but less so in imported German horses.

As a direct test the French Government sent ten yearling foals
from the affected depot at Limousin to the healthy depot at
Tarbes, retaining an equal number at home as test animals; it
also sent ten yearlings from Tarbes to Limousin, retaining an
equal number at Tarbes as test cases. Then the twenty yearlings
at Limousin were divided, five of the home bred and five drawn
from Tarbes having been sent into a very low wet country at
Lariviere, and the rest were sent to a high dry location at Mara-
val. The result was that but one of the ten yearlings sent from
Limousin to Tarbes contracted the disease, while on the damp
land at Lariviere one Limousin-bred and four T'arbes-bred colts
suffered ; and finally, on the dry soil at Maraval not a single colt,
from either Limousin or Tarbes was attacked.

The other conditions that usually attach to a low, damp soil
are important factors. Damp air and a cloudy, rainy climate
are potent accessory causes. Hence the great prevalence of the
disease formerly in Ireland, on the west coast and in the fen
country in England, in Belgium, in the Low Pyrenees, in the
valleys of the Loire, Jura, Meuse, Moselle, the Guadalquivir,
etc., (Reynal). Such. an atmosphere relaxes the system, in-
duces a heavy lymphatic temperament, with coarse bones and
muscles, an excess of connective tissue, thick hide and hair, and
thick, shaggy and often gummy legs. All this implies a low
tone of health which will less effectually withstand inimical
influences.

The rank, aqueous fodders grown on such damp localities
have a similar effect. These are more bulky and less nutritive
and fail to maintain the highest tone and vigor. The animals
must overload the stomach and intestines in order to obtain the
requisite amount of nutriment, so that with a large, pendent
belly they are still in poor condition. ‘The case is even aggra-
vated when they go on the succulent grasses of early spring, as
they continue to gorge and may even make fat, but they lack in
muscle and tone and in this condition even the rapid formation

Recurrent Ophthalmia in Solipeds. Moonblindness. 409

of blood seems to favor the attack. Mller records the great
prevalence of the disease in Central Germany in 1884, in connec-
tion with excessive rainfall, inundations, and spoiled fodder.
Leblanc, Foggia and Hugues give further instances. Hugues
attributes the disease to a cryptogam growing on the fodder.

Dard records that a low, overflowed meadow in the Soane bot-
tom near Chalons, caused blindness in nearly all horses put upon it.
Bouin quotes a case of a sewage irrigated meadow in Vendée
which almost infallibly produced recurrent ophthalmia in the
herses fed on its products. On the other hand, oats and hay
from a dry, rich soil and well harvested, are the most trustworthy
food when the disease is to be dreaded.

Damp night air on wet, impermeable soils is to be es-
pecially feared as not only relaxing the system and lowering its
power of resistance, but also producing a chill and thereby in-
creasing the susceptibility.

Damp, cold basement stables are concurrent causes acting
like the wet soils, the damp air, and the attendant relaxing con-
dition. Thierry long ago noticed that improved stable hygiene
around Strassburg led to a notable decrease of recurrent ophthal-
mia. In 1807 horses were blind to the extent of 16.5 per cent.,
in 1821 to 8.5 per cent., and in 1870 Zundel found but 1.79 per
cent., and few of the latter from recurrent ophthalmia.

Again the ventilation, lighting and drying of close, low, dark
damp stables where the disease had previously prevailed has often
practically banished the affection. Hofgeismar states that during
the prevalence of the disease in a detachment of the German
army in Alsace, out of 84 attacks in 700 horses 52 appeared in
February and March, the period of severe weather and close
stabling. ‘

Fodders of a heating, or starchy nature, like Indian corn,
buckwheat, or wheat strongly predispose to the disease,
probably by inducing .costiveness, slight impactions and indi-
gestions, and in bad, frequently recurring cases the writer rarely
fails to find that the animal is being fed on corn. Beans, peas,
vetches and other leguminous fodders are less injurious and when
grown on high, dry soils and fed judiciously they are as a
rule harmless. When grown rank, badly harvested, and used to
excess they become distinctly hurtful. Any fodder which has
been allowed to become musty is to be avoided, since any con-

410 Veterinary Medicine.

dition which lowers the general tone of health strongly predis-—
poses to an attack. ‘The same remark applies to irregularities.
and faults in feeding. The best food and the most abundant
supply will fail under such circumstances to maintain the con-
dition, and the horse that is losing condition is becoming increas-.
ingly susceptible to this malady.

The period of dentition and training is the most common
occasion for the attack, partly because this is the time when the
colt is taken from the pure air and exercise of the field, into the:
hot, close, impure atmosphere of the stable, partly because he
is made to exchange the cooling succulent grass for the stimula-
ting ration of hay and grain, partly because he is subjected to-
severe constraint and much excitement in the hands of the trainer,
and partly because of the irritation of the gums, the jaws and
the whole head in connection with the shedding and eruption of
the teeth. When injudicious bitting is resorted to, to give a
special curve to the neck, the consequent obstruction of the
jugulars and capillary congestion in the head is another potent.
cause. Heavy draught and overdriving have a similar effect.
In 53 cases Schmidt found that 3 occurred under one year old,
5 in the 2d year, 10 in the 3d year, 16 in the 4th, 15 in the 5th,
and 4 from the 5th to the 9th years.

Influence of Season. Mayer gives a statement of the per-.
centages seen in the various months of the year as follows:
January 4.9%, February 4.7%, March 10.1%, April 15.1%,
May 13.4%, June 9.9%, July 11.9%, August 6.4%, September
4.9%, October 6.2%, November 6.7%, December 5.2%. ‘The
high rate in March, April and May may have a significance in con-
nection with the debility connected with shedding the coat, and
the resumption of more active work, when somewhat out of con-
dition, it must also be noted that this is in Germany the season
of the most active trade in horses and consequent change of
ownership, stabling, feeding, work and management.

Heredity must be accepted as one of the most potent accessory’
causes. ‘The lymphatic constitution is of course transmitted and
with it the special susceptibility. This is notorious in the case-
of both parents, and is of course more potent if both sire and
dam were predisposed, and have themselves suffered. In the-
latter case the heredity of the lymphatic temperament, and of the.
impaired organ of vision combine to render transmission more

Recurrent Ophthalmia in Solipeds. Moonblindness. 411

certain. A mare may have born a number of sound foals before
suffering from the malady and then have offspring that do contract
the disease. So with the stallion. Moller quotes the case of
the eastern horse Turk-Mayn-Atty which served for a length of
time in Prussian Studs and left a great stock of blind progeny.
Lafosse records the existence of a family of horses in Southern
France all of which went blind. ‘The same cause has greatly ex-
tended the disease among fast American horses in which the great
strain of the track served to intensify the tendency. The
writer has seen a colt which was born blind, by a blind dam and
got by a sire with diseased eyes, but still held at $300 for service.
Mangin, Marimpocy and Hamon record congenital cases from
parents with affected eyes.

This hereditary susceptibility is so strong and pernicious that in-
telligent horsemen everywhere refuse to breed from either horse
or mare that has once suffered from recurrent ophthalmia, and at
the Government studs in Francée not only is every unsound stal-
lion rejected but the service of the healthy stallion is refused to
any mare which has suffered from disease of the eye. A con-
sideration for the future of our horses would demand that no
stallion shall stand for the public service of mares unless he has
been examined and licensed as a sound animal.

Yet, as already stated, heredity is not the one controlling
factor, since the offspring of the victims of this disease will often
escape when brought up in a high, dry locality.

Reynal records the appearance of the disease in alternate gen-
erations, the stallion offspring of blind parents remaining sound
himself but producing foals which became victims of the disease
in large numbers. A partial explanation may be found in the
better conditions under which the stud horse was kept, while
under less favorable surroundings his offspring developed the
disease.

It must be added that every condition which induces debility
or ill health‘is favorable to the development of themalady. The
presence of worms in the bowels is a familiar example. Any
debilitating disease like strangles, influenza, contagious pneu-
monia, indigestion, etc., and overwork or insufficient or in-
digestible food act in the same manner.

Again, localirritants may rouse the latent tendency. Street
or stable dust, sand, hay seeds, chaff, blows on the eye with

412 Veterinary Medicine.

whip or other object, wounds, irritant gases, smoke, flerce light,
cold draughts, storms, and whatever determines inflammation of
the eye may be the occasion of an outbreak of .recurrent oph-
thalmia.

Micro-biology. It will be recognized that none of these
causes fully account for the specific and recurrent nature of
this affection, and it is felt that something more is wanted to fur-
nish a full and satisfactory explanation of the malady. ‘This
explanation is sought in a direct zzfection, but in spite of ex-
. tended investigations by many observers no specific microbe has
been demonstrated as uniformly present in all cases.

Potapenke found in the blood of the affected horses a plasmo-
dium like that of ague. This agrees with the damp regions in
which the malady prevails and no less with its intermittent or
periodic character.

Vigezzi found in the aqueous and tissues a micrococcus (oph-
thalmo-coccus) which, cultivated’on gelatin agar and inoculated
in the interior chamber or under the conjunctiva, produced an
affection which he recognized as recurrent ophthalmia.

Trinchera found in the aqueous of the affected animals a ba-
cillus and cocci. Drawing this aqueous into a sterilized syringe
and injecting it into the interior chamber of sound horses pro-
duced in 12 to 48 hourscharacteristic periodic ophthalmia. This
was repeated by Schtitz and Schwartznecker.

Robert Koch found in the affected aqueous, cocci, singly or in
chains and bacilli with rounded ends. Injection of the latter into
a sound horse’s eye led to characteristic inflammation and loss of
vision. In the cornea of the rabbit it had no effect.

Richter found in the eyes of a foal born with recurrent oph-
thalmia, of sound parents, diplococci and triplococci.

These observations do not demonstrate the constant presence
of one definite microbe, nor that the disease is invariably due to
any one particular organism, yet they may be held as strongly
suggestive that any one of a variety of microorganisms may
prove an exciting etiological factor in a susceptible system, or
that, along with the organisms heretofore demonstrated, there
exists an essential microbian cause which has up to the present
eluded detection.

Other points which give circumstantial support to the microbian
theory may be shortly stated :

Recurrent Ophthalmia in Solipeds. Moonblindness. 413

1. The recrudescence of the disease after its various intermis-
sions, and its preference for low, damp, cloudy localities seem to
ally it to the malarial diseases of man.

2. Its appearance in certain predisposed systems, whenever an
injury or debility of the eye seems to open the way for the ad-
mission of the hypothetical microbe.

3. The increased susceptibility of the malady when the system
has been debilitated by disease, overwork, heating food, bad hy-
giene, or parasitisms, which have undermined the native power
of resistance.

4. The prevalence of the affection in given localities has been
supposed to imply the preservation and perhaps the multiplica-
tion of the germ in such places.

5. The increasing number of victims, year by year, when the
same regiment or stud has been kept for a number of years in the
same place. The theory is that with the presence of infected
horses the hypothetical microbes become increasingly prevalent
in the locality and above all, in the stables, until even the more
resistant subjects tend to succumb under the repeated infections.
Thus Zindel says that in 1878, 700 army horses were stationed in
Saarsburg, in 1879, 6 were attacked with recurrent ophthalmia,
and in 1880, 84; Hofgeismar mentions that a dragoon regiment in
Frankfort had 5 horses attacked in 1876, 12 in 1877, 11 in 1878,
14 in 1879, and 42 in 1880. We have, however, no assurance
‘that the excessive rainfall, spoiled food or other unhygienic condi-
tion, may not have been a potent factor in the increase.

6. The obvious connection of certain cases of recurrent oph-
thalmia with a rheumatic condition suggests the probable opera-
tion of the same microbian cause.

7. The success of the treatment with potassium iodide in cer-
tain cases.

Up to the present‘the microbian causation of this malady cannot
be taken as proved, yet as a hypothesis it explains satisfactorily
many of the observed morbid phenomena. That there is no such
rapidly spreading infection, as would warrant us in listing this
with animal plagues, is conceded, and that constitutional condi-
tions have a potent influence is allowed, but that, in addition to
these, microbian invasion is often a means of precipitating the
malady is altogether probable. It may not be necessary that the
microbe should in every case be of the same kind, yet the addi-

414 Veterinary Medicine.

tion of a germ as the last item in the chain of causes is presump-
tively true.

Parasitism. Willach claims that many cases are directly due
to parasites in the eye. In 19 affected eyes he found one young
filaria, a number of rhabditis (?), 1 cysticercus, and a number of
distomata. Leider also found round wormsinsucheyes. Mayer
and Dexler examined a number of cases, using the centrifuge on
the liquids of the eye, without in any case finding such parasites.
It may be assumed that the presence of embryo worms may rouse
a latent predisposition into activity, but they cannot be adduced
as active causes in the vast majority of cases.

Symptoms. ‘These vary with the severity of the attack. In
some cases there is high fever while in others this may be absent,
yet a lack of vigor and energy bespeaks a general constitutional
disturbance. ‘The attack is sudden with marked local irritation,
photophobia and lachrymation. The eyelids are closed some
times so firmly as to suggest blepharospasm, and if opened the
pupil is seen ta be contracted. The affected eye is retracted and
appears smaller, the conjunctiva is the seat of diffuse redness and
swelling, and there isa bright red peri-corneal injection, occupy-
ing the anterior portion of the sclera. The outer zone of the
cornea is already the seat of a bluish white opacity, the surface
appearing dull and as it were smeared with oil. The centre of
the cornea may be opalescent but not so obscure as to prevent
examination of the interior of the eye. In a few days the outer
margin of the cornea may show vascularity, and the aqueous
humor a certain degree of turbidity. The iris if still visible is
seen to be swollen and rigid, and to have parted with some of its
lustre, assuming a grayish or lighter color owing to congestion
and exudation. The pupilis usually contracted and dilates only
sluggishly and imperfectly in darkness or under the action of
atropia. The iris arches forward more than is normal and may
even approximate and adhere to the back of the cornea. Bayer
noticed that in a partial albino (watch eye) the iris becomes sul-
phur yellow. The anterior chamber of the aqueous humor usually
shows a grayish yellow sediment which in severe cases may fill
one-third or even one-half of its depth. This may be grayish
white flocculi of lymph only, or it may be colored with blood
or in suppurative cases by pus. In the first day of its appear-
ance this may be diffused through the humor, but from the fifth

Recurrent Ophthalmia in Solipeds. Moonblindness. 415

to the seventh day it precipitates and leaves the iris and pupil
open to inspection. The pupil if not already open, may be par-
tially dilated with atropia and then discloses the interior of the
eye of a dark green, or sometimes with much exudate on the
choroid, of a more yellowish green. ‘This greenish discoloration
appears to depend on opacity of the vitreous, on an exudate
between the choroid and retina or on some opacity of the cornea
and aqueous. At the same time under a good light some opacity
of the lens or its capsule may be detected, or, with direct illum-
ination, of the vitreous as well.

The tension and hardness of the bulb is materially increased in
some cases but not at all perceptibly in others.

From the seventh to the tenth day the acute inflammation sub-
sides, the lids and pupils dilate, and the deposit in the anterior
chamber is rapidly reabsorbed. It may first assume a dull
brownish green or brownish tint. Meanwhile the opacity of the
cornea commences to clear up, and any redness or congestion of
its margin to diminish or disappear.

With this disappearance of opacities in the cornea, lens and
humors, all the symptoms of congestion subside and by the tenth
or fifteenth day from the commencement of the attack the eye
may have become approximated to its normal condition.

The characteristic of the disease, however, is its tendency to
return again and again until the eye is destroyed. From five to
seven attacks usually result in blindness, and then the second eye
is likely to have a similar experience until both are useless. In
some instances the eye which is first attacked may recover and
remain well, while the second to suffer is rapidly ruined by a suc-
cession of severe attacks. The intervals between the attacks may
be thirty, forty or sixty days and upward according to the state
of the health, the condition, the food, the regimen, the exposure,
and perhaps of other accessory causes.

Reynal claims that some eyes which have retained their normal
function after one of two attacks will gradually lose the power
of vision without any new appearance of inflammation. In other
cases an eye which has been clear and transparent becomes sud-
denly filled up with an inflammatory exudation in the anterior
chamber which obscures the iris and lens and in a few days
vision is permanently lost, yet without conjunctivitis or apparent
suffering.

416 Veterinary Medicine.

Condition of the eye between attacks. After one, two or
_more attacks the eye is not restored to its former condition in the
intervals, but continues to exhibit morbid phenomena which be-
tray the previous existence of the disease. ‘The recognition of
such persisting lesions is all the more easy that one eye only is
usually attacked at first and a comparison between this and the
sound eye renders the modifications all the more patent. Even
after a first attack there is usually a hazy bluish white zone
round the outer margin of the cornea and this becomes more dis-
tinct after each successive attack: ‘The faulty eye is distinctly
smaller in appearance, at first because it is retracted in its sheath
and later in certain cases because of actual atrophy. In propor-
tion to the retraction of the bulb, is the protrusion of the mem-
brana nictitans which covers a greater part of that eye than of its
fellow. The upper eyelid in place of forming a continuous and
regular arch shows a distinct abrupt bend between its inner and
middle thirds caused by the contraction of the levator muscle.
The front of the iris has lost something of its normal lustre, and
the posterior chamber is liable to show an abnormally light re-
flection, greenish yellow or yellowish blue. Under direct il-
lumination, lines of opacity may be detected in the aqueous
humor, or in the lens, or dark filaments in the vitreous. After
several attacks the lens is very distinctly obscure and this in-
creases with each relapse to a white or yellowish white complete
opacity. After the first or second attack the pupil may be dis-
tinctly contracted, while later in the disease, with advanced cata-
ract it is usually widely dilated. Another feature is the erect,
attentive carriage of the ear, to compensate for the waning vision.
Lesions. ‘These are not often seen, as animals do not often die
of this disease. Beside the superficial lesions of the conjunctiva
and cornea which may be seen during life, exudates have been
found on the posterior surface of the cornea, in some cases binding
that totheiris. Inadvanced cases the greatly contracted anterior
chamber may contain a little mucilaginous liquid strongly pig-
mented with debris from the iris, the whole mixed with shreds of
exudation. ‘The iris is thickened by congestion and by exuda-
tion on its surface and in its substance, and is displaced forward
so as to diminish the size of the anterior chamber, and it may
have contracted adhesions with the cornea (anterior synechia) or
with the lens (posterior synechia). This leads to unevenness in

Reccurrent Ophthalmia in Solipeds. Moonblindness. 417

the pupillary margin, where the iris is often torn into shreds.
The crystalline lens is usually opaque, and may have undergone
various changes, fibrous, calcareous, or atrophic. The anterior
surface of its capsule has often adherent masses of black pigment
derived from the uvea in previous adhesions.

The vitreous humor and hyaloid membrane are sometimes clear,
but usually yellowish or blackish and reduced to one-half their
normal bulk by accumulations under the retina. A dense exu-
date often exists on the lamina cribrosa. The choroid is very
uneven showing irregular rounded elevations, and like the iris is
the seat of active congestion, exudation and thickening. The
exudate on its surface raises and detaches the retina and, as shown
by Eversbusch, this may increase so that the retina from the two
sides may come together in the centre of the eye, the vitreous
having been absorbed and removed. Reynal records instances in
which the exudate had become cretified, or as he claimed trans-
formed into true bony tissue. Finally the optic nerve is atro-
phied, often in advanced cases to half its natural thickness.

Prevention. As treatment is somewhat unsatisfactory there is
the greater reason to give attention to measures of prevention.

In view of the great evil of low, damp, overflowed lands, it is
important to drain and improve such lands whenever possible,
and when this cannot be done, to abandon the breeding of horses
upon them, and to buy the, animals necessary for agricultural
purposes from high, dry, healthy localities and introduce them
only after they have passed the age of five years at least.

The improvement of wet lands by liming, so as to lessen the
amount of decomposing organic matter, and improve the charac-
ter of the vegetation has proved very beneficial in different parts
of England. The substitution for the products of marshy
meadows and wet lands, of those of dry cultivated meadows and
lands is important.

Misty cloudy regions in the vicinity of sheets of water, or cold
mountain ranges cannot be made wholesome, but they can be
abandoned for horse breeding, and devoted to more remunerative
uses. Something may also be done by stabling the working horses
at night.

’ Aninsufficient or debilitating diet, for example, in winter,
should be carefully avoided, the more so if it is to be followed by
a sudden access to rich grass in the spring.

27

418 Veterinary Medicine.

All forms of spoiled food, damp, musty, or fermented fodders
should be withheld, especially in the case of young and growing
horses.

Indian corn, wheat and buckwheat should be carefully excluded
from the grain ration or if used should be combined with 1 oz.
sulphate of soda for each animal daily.

Damp, close, filthy and underground (basement) stables should
be avoided, the building on the other hand should be placed on
high, porous and well drained ground, and should be clean,
moderately well lighted and well ventilated but without draughts.
While such special stable hygiene is demanded for all, it is doubly
demanded for young horses under six years of age.

As every debilitating condition renders the already predisposed
animal more open to attack, all causes of ill health should be
guarded against, and especially for the young, and in the case of
such as are inevitable, every effort should be made to curtail and
lessen the evil influence. Food or water which contains the eggs
and embryos of intestinal worms, must be avoided and parasites
which have already invaded the system must be got rid of as far
as possible. Care must be taken to exclude the various infec-
tious diseases, and in case of their introduction, to adopt every
measure to mitigate their violence and to prevent debility and
weakness. Overwork and irregular feeding and watering must
be guarded against.

At the same time moderate work or exercise daily which will
develop the highest tone of the muscles, nervous system, diges-
tion, assimilation and other functions is a measure that can
never be neglected. Idleness with resulting fatness, softness and
weakness of muscle, and lowering of the power of endurance
is always an invitation to renewed attacks. Regular invigor-
ating work is essential ; exhausting work is injurious.

Change of locality to a drier soil, clearer, drier atmosphere,
and more abundant sunshine, when it can be availed of, is a most
important preventive measure. Reynal who made an extended
official inquiry into this matter found conclusive evidence of its
truth. Young horses removed from the low affected regions of
Cantal, Poitou, Brittany and Anjou rarely suffered another at-
tack when taken to the highland of Catalonia, and those moved
from the damp lands ‘of Franche Compté, Bresse, Dauphiny,
Provence, Languedoc, Bassigny and Belgium to the dry, cal-

Recurrent Ophthalmia in Solipeds. Moonblindness. 419

careous portions of Champaigne also escaped further trouble. In
many such cases the eyes already slightly affected would mate-
rially and permanently improve.

Finally the influence of heredity is never to be overlooked.
The ideal system would be to have all stallions professionally ex-
amined, and licenses granted to such only as are free from this
affection, and to place the owners of such horses under obliga-
tion to serve only mares the eyes of which are sound. ‘This
might be enforced as a state or county ordinance. Serious diffi-
culties, it is true, stand in the way of such a measure. ‘The
horse, which has an extraordinary record on the track, and to
the development of the ophthalmia of which, overwork has
doubtless contributed, will be run after by breeders who seek
speed at any cost, and it may be questioned whether the State
has any right to interfere with the prospective profit which may be
expected from the reproduction of the strain of blood. But aside
from such fancy productsas racers and trotters, this objection has
much less force. For carriage, riding and road horses and for
the draught and agricultural animal the advantage of sound eyes
so greatly over balances all consideration of special values with
imperfect eyes, that a statute which will prevent the propagation
of such unsoundnegs is more than justified in every case. The
importance of this will be admitted when it is considered that in
the great majority of cases, the young animal is attacked after it
leaves the hands of the breeder, and therefore a high price is se-
cured for a subject which is almost certainly doomed to become
blind in given surroundings. Such a law would work well in
every locality. In the low, damp region where the disease pre-
vails habitually, the unprofitable breeding would practically
cease, unless a race could be secured which was proof against the
infection. The value of such a race could hardly be over-esti-
mated. On the high, dry lands, on the other hand, the natural
tendency to immunity would be still further enhanced, as the
most susceptible animals which contracted the disease, in even
such a healthful district, could bein no sense fit for reproduction,
and should therefore be doubly condemned.

In the case of the mare the proprietor is under strong tempta-
tion to ignore the sanitary measure under consideration. When
her eyes fail, her value in the public market is greatly depreciated,
yet she can yearly produce a foal, which is finely developed and

420 Veterinary Medicine.

will bring a high price if sold young, before it has been attacked
by the disease. Hence the great importance, at least in the case
of all horses which are not intended for exclusive use on the race
course, that a law shall be strictly enforced which will put an ab-
solute limit to the breeding from horses that have been affected
with recurrent ophthalmia.

Blows, dust, sand, smoke, irritant gases, fierce light, and all
sources of irritation must be avoided as in other eye diseases.

Treatment. Radical treatment for the disease is far from gen-
erally satisfactory. Too often the affected animal is still in the
environment which has tended strongly to its development, and
it is impossible to secure a satisfactory change. As far as possi-
ble, however, every available sanitary measure mentioned under
the head of prevention should be enjoined, and largely in propor-
tion to the thoroughness of such measures, and the slightness
and recentness of the attack will be the hope of a successful treat-
ment.

In some instances in which there appears to be rheumatic
complication, the employment of anti-rheumatic agents have
proved of essential value. Powdered colchicum corms may be
given twice a day in doses of 1 scruple, combined with salicylate
of soda, salicylic acid, or salicin in 2 drachm doses. ‘To these
may be added bicarbonate of soda or of potash in drachm doses.

In cases attended with marked fever, hyperthermia and anor-
exia, antiphlogistic treatment may be desirable, but with the
primary consideration that it must not be materially depleting,
nor calculated to induce debility or atony. A laxative dose of
aloes will sometimes benefit, but should be avoided in the absence
of manifest fever. Two or three ounces of Glauber salts, twice
a day, will effect the same purpose with less danger. Or salt-
peter or other cooling diuretic may be givendaily. In most cases
bitters may be added with advantage.

Iodide of potassium in doses of 2 drs. and, in larger animals or
more violent attacks, as much as 7% drs., singly or repeated on
two successive days, and supplemented by cold compresses over
the eye for several days of the same agent in a solution of three
per cent, has produced marvelous results in young horses suffer-
ing from a first attack. ‘The inflammation subsided, the aqueous
and cornea cleared up and there was no recurrence of the disease.
(Kroening, Gavrilescu, etc).

Recurrent Ophthalmia in Solipeds. Moonblindness. 421

This speaks strongly for a microbian origin either as the
essential cause, or as an accessory factor hardly less essential.

In severe cases, restis imperative until the violence of the in-
flammation shall have abated, and a dark stall or a cloth to ob-
scure the light is equally important.

Trasbot advises bleeding from the jugular, but such a deplet-
ing measure finds little support in England or America. Local
bleeding from the angular vein of the eye or by leeching or
cupping is not open to the same objection.

Counter-irritants are, however, more suitable. A stout silk
thread may be inserted above the lower end of the zygomatic
ridge and bathed and removed daily to prevent the lodgment of
pus. Or a blister of cantharides or biniodide of mercury may be
rubbed in on an area as large as a silver dollar in the same sit-
uation.

In all cases a strong solution of atropia sulphate (2 per cent).
may be instilled into the eye once or twice daily. Ora mixture
of atropia and cocaine (1 per cent. of each) will give even greater
relief. If to these is added 1 per cent. of pyoktanin we get a
collyrium which is at once anesthetic, midriatic and antiseptic.
This is often of material value. Pyoktanin solution (1 : 1000)
and potassium iodide (2 : 100) act well. Vigezzi advises a
mercuric chloride lotion (1 : 1000) as a collyrium, and for injec-
tion in the submucosa.

If the local inflammation runs high an astringent lotion may
be applied externally on a soft rag hung over the eye and kept
constantly wet. Sugar of lead or acetate of zinc may form the
basis of such lotion with a little atropia or morphia added.

Puncture of the cornea and iridectomy have been strongly
advocated on the ground that the disease is identical with glau-
coma, but the burden of evidence is decidedly against their use
as a regular method of treatment. In case of increased intraocu-
Jar tension, however, the puncture of the cornea can be very
profitably employed, but it should be reserved for such special
cases. ‘Theoretically, iridectomy should be advantageous in pre-
venting a relapse, but experience has not fully sustained this.
When employed, the most careful disinfection should be secured.
Under rational treatment the attack subsides in ten days and the
eye may appear to be restored to the normal condition in two
weeks. This natural tendency to a temporary recovery has

422 Veterinary Medicine.

served to give a wide acceptance to the most irrational methods
of treatment, which have not in any sense hastened the recovery.

As soon as active inflammation and hyperthermia subside,
every attention should be given to prevent a relapse, and to this
end all the measures mentioned under prevention and which can
be applied to the individual case should be adopted. Among
these, moderate exercise or regular work must never be omitted.

A course of tonics embracing preparations of iron and bitters,
is equally essential, and may be begun as soon as fever and
active inflammation subside.

Special lesions, like corneal opacities and ulcers, must be
treated as in other affections. ,

Jurisprudence. The question of the right to return upon
the seller a horse attacked with recurrent ophthalmia has been
beset with difficulty, mainly because of the intermissions during
which, to the ordinary observer, the eyes may appear sound.
In France a period of thirty days is allowed in which to return
such a horse after purchase. ‘This is, however, too narrow a
margin as the second attack may not appear until after two, four
or six months. It does, however, provide for the return of the
worst cases in which the recurrence is likely to take place at an
early date. Another provision is that a suspected horse may be
put in pound under veterinary observation for thirty days, in
anticipation of a second attack, and if such fails to appear the
purchaser is debarred from returning him.

In many cases the symptoms during an attack and between at-
tacks are such as to identify the recurrent inflammation, and the
expert can pronounce positively as to the nature of the malady.
In other cases there is a degree of uncertainty, and the animal
must either be returned on the general plea of diseased eyes, if
they can be shown to have been faulty at the time of sale, or
otherwise the horse must be put in the hands of a veterinarian
and the seller notified of the action, until it can be shown whether
it is the recurrent disease or not. If it can be shown that the
disease is the recurrent affection the seller is responsible at com-
mon law for selling a diseased animal for a sound one. If on
the other hand, it is a non-specific ophthalmia, it must be shown
that it existed prior to sale, and that a warranty of soundness
was given, in order to hold the seller responsible.

PANOPHTHALMITIS.

General suppurative inflammation of eye. Experimental cases. From
traumas. Diagnosis; foul wound, violent eye inflammation, yellow puru-
lent appearance, high fever, involves second eye. Treatment: antiseptic,
enucleation. ,

This term has been applied to a general purulent inflammation
of the eye resulting from infection with pus germs entering from
without through traumatic injuries, or by reason of inflamed tis-
sues, or on the other hand, reaching the eye as a general infec-
tion through the blood. It may begin therefore, as conjuncti-
vitis, scleritis, or keratitis, and gradually extend to active infec-
tion of the iris, choroid, and ciliary body.

Moller produced an experimental case in a foal by the injec-
tion of the staphylo-coccus pyogenes aureus into the anterior
chamber. In 24 hours there was violent inflammation : the eye-
lids were closed, the conjunctiva dark red, and a mass of glairy
pus under the eyelid. The cornea was cloudy throughout,
though still dimly transparent so that the accumulating pus in
the anterior chamber could be seen. The iris was strongly di-
lated and the eyeball abnormally tense. The second day the
bulb was visibly enlarged, the eyelids greatly swollen, the con-
junctiva infiltrated so as to cause chemosis, and the cornea com-
pletely opaque. The infiltration of the orbit caused the eyeball
to protrude from its sheath. A high fever set in and on the fifth
day the foal died.

Cases in the lower animals are usually the result of direct in-
fection through some traumatic lesion of the eye.

The special feature of the disease is the rapid and abundant
production in all parts of the eye of pus cells until the whole or-
gan has become a bag of pus.

The chief diagnostic symptoms are the presence of a foul
wound, the rapid advance of the phlegmonous inflammation of
the conjunctiva and lids, the yellowish opacity of the cornea, and,
if visible, of the aqueous humor, the prominence of the entire
eyeball, the high attendant fever and the early destruction of the

423

424 Veterinary Medicine.

eye. Inthe domestic animals the sympathetic irritation of the
second eye has not been observed so commonly as in man. If
the patient survives, the pus makes its way slowly to the surface,
and escapes, and the cavity granulates and heals with contrac-
tion of the eye into a small nodular mass.

The treatment of the condition is essentially antiseptic and
should be made preventive if possible, as there is little hope of
saving the eye if the suppurative inflammation has been already
established. The wound should be treated at the earliest moment
with antiseptic lotions, sublimate solution (1 : 5000) or potassium
permanganate solution (1: 100) or pyoktanin (1: 1000), or cre-
olin (1: 100), or colargolum. When inflammation has actually
set in, these should be used still more assiduously by frequent
injection under the lids, or by inserting antiseptic cotton between
these and the bulb.

Enucleation. When the eye has become a virtual abscess
the quickest and most perfect relief is secured by the complete
extirpation of the eyeball. The patient is narcotized by ether or
chloroform, and a thread or hook being passed through the
cornea, the globe is quickly dissected out by curved scissors.
Bleeding may be checked by pressure with cotton wool steeped
in tincture of the muriate of iron, and later the wound may be
dressed with stupes wet with a mixture in equal parts of standard
solution of sulphurous acid, glycerine and water.

GLAUCOMA.

Sea green. pupil. Causes: intraocular pressure from serous choroiditis,
deranged fifth nerve, increased blood pressure, inflammatory obstruction of
sclero-corneal canal, irritation of the ciliary ganglion. Symptoms: exces-
sive tension and firmness of the globe, anterior chamber shallow, iris con-
tracted, sluggish, pupil grayish or yellowish green, cupping of optic disc,
pulsations of retinal arteries. Acute, inflammatory form, simple form,
secondary form. Cunvexity of pupil with synechia. Traumas. Luxations.
Atheromas Lesions: inflammation of the iris, choroid, ciliary body or
cornea, round cell infiltration, cupped optic disc, atrophy of optic nerve,

hydrophthalmos. Treatment: massage, puncture of aqueous, iridectomy,
eserine, cocaine, antiseptic bandage.

This has been so named from the sea green color of the pupil.
The nature of the disease has been much debated and up to the

Glaucoma 425

present time ophthalmologists are far from being agreed as to its
true pathology. All are agreed as to the essential feature of the
malady, namely, increased tension of the eye ball, but every case
of increased tension of the bulb is not recognized as glaucoma,
and the true cause of the persistent and progressive increase of
pressure in cases recognized as glaucoma is not absolutely settled.

Causes. ‘The immediate cause of the condition is the increased
intraocular pressure, on this all are agreed, but as to the cause
of this pressure there is difference of opinion. Grafe attributed
it toa serous choroiditis: Donders to deranged innervation of
the 5th cranial nerve which controls secretion ; others to increased
blood pressure ; others to inflammatory contraction at the sclero-
corneal border where the principal drainage canal of the aqueous
humor lies. The increased blood pressure theory appears to be
contradicted by the fact that exalted blood pressure, as in fever,
does not tend toglaucoma. The arrest-of-drainage-of-the-aqueous
theory seems to be contradicted by the reduction of the anterior
chamber while the theory would demand its increase. Priestly-
Smith injected the sheep’s eye with a pressure of water of 30
centimetres high, but while he caused an increased outflow he
failed to induce distinct glaucoma. Moller tied the ophthalmic
vein of the horse, but he also failed to produce glaucoma. ‘By
artificial stimulation of the ciliary ganglion in dogs, the internal
tension of the eye can be noticeably and permanently increased,
and we may therefore assume that when this ganglion is stimulated,
the secretion of fluid is increased, and that glaucoma depends upon
an analogous process’ (Fick). It would seem that necessity de-
mands at the same time an obstruction of the normal drainage
through nervous influence or otherwise. Schcen ascribes glaucoma
to overexercise of the accommodation, a cause which would hardly
be expected to operate in dogs. As bearing on the nervous cau-
sation Fick mentions that in man glaucoma is often preceded
and accompanied by trigeminal neuralgia. Again the symp-
toms of glaucoma often appear in the course of recurrent
ophthalmia in the horse.

While it seems impossible to ascribe the disease to any single
definite cause there appears to be good reason to accept as
factors in different cases, a derangement of trigeminal innerva-
tion, an irritation of the ciliary ganglion, and an inflammation

426 Veterinary Medicine.

affecting the region of the ciliary circle and the sclero-corneal
line.

Symptoms, ‘The tension of the eyeball is excessive as ascer-
tained by pressure of the finger, or by the spring tonometer.
If the increase of tension has come on suddenly, the cornea is
somewhat cloudy, and less sensitive to the touch. If one eye
only is attacked the contrast between the two is very marked
and diagnostic. The anterior chamber is diminished in size by
the projection forward of the iris and lens. ‘The iris is usually
contracted so as to show a dilated pupil reflecting a smoky,
grayish green or yellowish green hue. The iris is either irre-
sponsive to light or responds very slowly and imperfectly.
With the ophthalmoscope the most marked features are the
“‘cupping’’ or depression of the optic disc by pressure, and the
pulsations in the retinal arteries. These pulsations are especially
easily seen at the margin of the depression which represents
the seat of the lamina cribrosa and the point of entrance of the
optic nerve. They are rendered even more manifest by pres-
sure on the eye. They are due to the prompt emptying of the
blood vessels by the intraocular pressure, so that these are only
momentarily filled at each cardiac systole. :

Ophthalmologists recognize three varieties of glaucoma: acute
inflammatory glaucoma, simple glaucoma without apparent
inflammation, and secondary glaucoma, the result of another
disease.

Acute inflammatory glaucoma is the one condition in
which, in the absence of a midriatic, inflammation is associated
with dilated pupil. It is liable to occur in a series of attacks,
which increase in severity, hence its supposed identity with re-
current ophthalmia in the horse. The entire group of symptoms
have, however, been rarely or never seen in the horse. They
are distinctly more common in dogs.

Simple glaucoma comes on more slowly, becomes chronic
and is to be recognized by the physical symptoms in the absence
of inflammation, notably by tension of the bulb, diniinution of
the anterior chamber and cupping of the optic disc.

Secondary glaucoma is the direct result of some other disease
of the eye:

; Glaucoma. j 427

Complete posterior synechia acts by confining the liquid which
is secreted, to the posterior chamber whence it finds no ready out-
let through the pupil, and causes a marked bulging forward of
the iris and tension of the eyeball.

Slighter anterior synechia in the form of cicatricial adhesions
between iris and cornea in the sclero-corneal margin, acts by
blocking the principal drainage canal of the aqueous humor,
which lies in this angle. _

Traumatic injuries implicating the capsule of the lens and ad-
mitting the aqueous humor freely to the lens substance deter-
mines softening, swelling and so much irritation as to increase
the secretion largely and determine intra-ocular tension.

The same may result from luxation of the lens and irritation
of the ciliary circle by dragging.

Other causes are disease (atheroma) of the retinal vessels and
the growth of tumors in the interior of the eye.

Lesions. ‘These are very varied. Inflammation of the iris,
ciliary body and choroid and even of the cornea is not uncom-
mon. ‘The iris and ciliary body show round cell infiltration, as
may also the choroid. In the ciliary body this is likely to be es-
pecially abundant along the drainage canal (canal of Schlemm)
thereby reducing its calibre. Leber and Fuchs found drops of
liquid in the epithelium and cornea. One of the most significant
lesions in man is the cupping or depression of the lamina cribrosa
of a depth in ratio with the force of the intraocular pressure,
and inflammation or atrophy of the optic nerve, back of the eye.
Moller, however, has never been able to find actual cupping of
the optic papilla in animals, but instedd thereof a general disten-
sion of the outer coats of the eye, a hydrophthalmos. In view
of the fact that these coats have the same structure and nearly
the same relative thickness as in man, this throws considerable
doubt on the supposed identity of glaucoma in man and cases
which have been considered such in the lower animals. The
comparative absence of pulsations in the retinal arteries in ani-
mals adds to the uncertainty.

Treatment. Although such cases lack some of the diagnostic
symptoms of glaucoma in ‘man, yet they agree with that in the
increase of the intraocular pressure, and demand similar meas-
ures for relief. Some reduction of the tension can be secured by

428 Veterinary Medicine.

careful massage over the eyeball so as to favor the progress of
the lymph out of the bulb. A prompt but rather transient relief
can be obtained from evacuation of the aqueous humor by punc-
ture with a lancet close to and parallel with the margin of the
cornea. ‘The most effective treatment is, however, by iridectomy.
On account of the great power of the muscles in the lower ani-
mals it is usually desirable to anzesthetize the patient and then
fixing the eyeball with a pair of rat-tooth forceps, an incision is
made close in front of the upper border of the cornea, and the
lancet slowly withdrawn. A pair of iridectomy forceps are then
introduced and the iris seized and drawn out through the wound,
and a portion snipped off with a pair of fine scissors. The iris is
then pushed back into the anterior chamber, and a drop of eserin
solution placed in the eye. The parts and instruments must be
rendered thoroughly aseptic before the operation, and the eye
cocainized both before and after. The eye should be kept covered
for some time with a cloth wet with a solution of mercuric
chloride (1 : 5000) or other antiseptic.

Appropriate treatment may be employed in case of co-existent
inflammation, or to improve the general health.

EXOPHTHALMOS.

This consists in an increase of the media of the eye so as to
cause an excessive increase in size, and an unsightly bulging
outward from the orbit and between the lids. It may be said -to
be a more exaggerated enlargement of the eyeball, than has been
already noticed under glaucoma. :

It has been seen in nearly all classes of domestic™animals.
Everhardt and Moller reports it in horses, Hausmann, Pradal,
etc., in cattle, LaNotte, in lambs, Coster, Trasbot, etc., in dogs,
and Trasbot, in birds (chickens and parrots). It has been found
congenitally in lambs and at a few days old in foals, especially
when weak and puny; in older animals it appears to be most
frequent in the anzemic or starved animal, in the lymphatic, or,
as in man, in the goitrous.

fTydrophthalmos or Buphthalmos Congenitus. 429

The manifest projection outward of the eye may occur asa
nervous phenomenon, without intraocular pressure, and without
abscess, neoplasm, or inflammation in the depth of the orbit. In
a case of tuberculosis in a three year old cow, I have found this
condition, with normal tension of the eyeball, but with acute

tubercular meningitis of the pia, surrounding the pons and crura
‘cerebri, a grayish exudate with lighter miliary centres, and a
considerable clot of extravasated blood.

Symptoms. Mostly without any febrile reaction, there ds a
manifest enlargement and bulging of the globe of the eye, so
that it stands out between the lids which can no longer cover it.
The cornea, aqueous, lens, and vitreous are not usually opaque,
but show only a pale, blue, opalescent tint. The pupil is often
widely dilated so as to show clearly the interior of the eye. Ver-
tiginous symptoms have been observed in the cow (Pradal), the
supposed result of intraocular pressure.

Treatment has had little effect when it stops short of puncture
of the cornea or iridectomy.

HYDROPTHALMOS OR BUPHTHALMOS
CONGENITUS.

This has been applied to a congenital enlargement of the eyes
from internal distension in children. The cases in lambs and
foals quoted in the last article were evidently of this nature.
They are charged on intraocular pressure acting on the delicate
tissues of the embryo or unborn animal. There is not necessarily
cupping of the optic disc so that persistent tension after birth
cannot be insisted on.

Cases occurring in older animals, may be forms of secondary
glaucoma though classed under hydrophthalmos by Mayer and

others.
Treatment when demanded is along the same lines as in glaucoma:

CATARACT. OPACITY OF THE LENS OR ITS
CAPSULE.

Definition. Forms: lenticular, capsular, cortical, nuclear, polar, black,
diabetic, traumatic, immature, mature, senile. Causes : impaired nutrition |
of lens, inflammation of iris, choroid, ciliary body, retina; recurrent oph-
thalmia. Proliferation of cells. Increased density, chemical changes, de-
generations. Sugar, sodium chloride, naphthalin. Rachitis. Senile.
Blodd pigment. Symptoms: shrunken bulb, opalescent zone around
cornea, angle on upper lid, shying, extra ear activity, high stepping, better
sight in twilight, homatropia, examination facing the light, Purkinje’s
images, ophthalmoscopic examination. Prognosis hopeless. Treatment :
phosphureted oil, massage, operation in horses, discission, under antiseptic
precautions, extraction under careful antisepsis, suction.

Definition. Any pathological change in the lens or its capsule
diminishing its transparency.

Varieties. 'The opacity may be. situated either in the lens
(lenticular) or in its capsule (capsular). Again, it may be in
the outer part (cortical) or in the central part (nuclear) of the
lens. If the opacity is on the capsule in front of the lens it is
anterior capsular; if on the portion behind the lens it is pos-
terior capsular. If the opacity is caused by black iris pigment
adherent to the capsule it ‘has been called black cataract. If
the lenticular cataract is small and round, it is polar, and it may
be anterior or posterior polar according as it is situated near
the front or back of the lens. Diabetic cataract is one associ-
ated with mellituria. A traumatic cataract is one resulting
from a wound of the lens which admits the aqueous humor and
causes softening, swelling and finally, solution of the substance of
the lens. The immature or unripe cataract is one in which
the lens is not yet wholly involved and indurated ; the mature
or ripe, when such consolidation has extended throughout.
Senile cataract is seen in old horses, dogs, cats, birds and very
exceptionally in cows. This usually attacks both eyes at once.
A degeneration takes place in the fibres of the lens, which are
invaded by sclerosis beginning at the centre of the organ.

Causes. In domestic animals cataracts are commonly the re-
sult of impairment of the nutrition of the lens in connection with

430

Cataract. Opacity of the Lens or its Capsule. 431

inflammation of the iris, choroid, ciliary body, retina, or hyaloid
membrane, and above all, in solipeds, in recurrent ophthalmia.
It may be assumed that a transparent tissue composed of cells
can only maintain its translucency so long as the most perfect
equilibrium is maintained as regards the mutual relation of the
cells, the pressure of its interstitial plasma, and the chemical
composition of both plasma and cell structures. The slightest
deviation in any direction will impair or abolish the transparency
of the tissue. In inflammation this occurs in various ways,
through the increased cell multiplication and the change in the
nature of the cells, through the increased exudation and the alter-
ation of the solid parts as regards compression and relative posi-
tion, and through chemical changes in the exudate which contains
more salts, fibrinogenous material, etc., than the normal plasma.
The same is true of all the post inflammatory degenerative pro-
cesses that take place in the lens.

The formation of cataract from chemical alteration in the
fluids is familiar in diabetic subjects,—man or beast (Altenhof).
It can be produced experimentally in frogs by injecting sugar,
common salt or any other readily diffusible saline solution under
the skin (Kunde). Rabbits that are fed naphthalin develop
cataract which radiates in lines and streaks from the pole towards
the periphery and in the cortical portion of the lens. Perhaps
the lamellar cataract of rachitic patients is also to be attributed
to the lack of earthy salts in the plasma of the lens.

Senile cataract may be hypothetically attributed to impaired
nutrition, degeneration in the lens or its capsule, or less common-
ly to disease of the blood vessels of the eye, or gradual changes
in the plasma. It occurs in horse, ox or dog at ten years old and
upward.

Anterior Capsular Cataract sometimes results from the
deposition of blood pigment on the capsule in cases of extra-
vasation into the anterior chamber. ‘This is closely allied to the
black or spurious cataract which consists in the adhesion of the
uveal pigment to the capsule, and its detachment from the iris.

Kunde who caused cataract in frogs by injection, subcutem or
ingestion of concentrated solutions of sugar or salt, attributes the
result to the sudden abstraction of water from the crystalline
Jens. Even the cell multiplication in inflammatory cases, he

432 Veterinary Medicine.

holds to favor this, since the new cells having little vitality are
especially subject to granular and other deposits and degenera-
tions, with loss of water or of transparency.

Symptoms and diagnosis, The examiner :should look for
cataract after internal ophthalmia. Much more so, if there is
apparent diminution of the bulb, an opalescent zone around the
outer border of the cornea, or a marked angle in the curvature of
the upper eyelid, as usually occurs in recurrent ophthalmia.
When a horse suddenly acquires a habit of shying, of starting
back or to one side when approached, when confronted with
strange or unexpected objects, or with deep shadows like those
from electric lights, he is to be suspected. When he carries his
ears in an unusually alert manner, turning one forward and the
other back, when he steps higher than before to avoid unseen
objects, suspicion should attach to him. If he sees better in
twilight than in the full sunlight, central cataract may,be feared,
while the periphery which is exposed by the dilatation of the
pupil in semi-darkness is still. clear. -In all examinations for
soundness, the greatest care should be taken to exclude the pos-
sibility of overlooking an existing cataract.

In the very early stages, while internal inflammation and pho-
tophobia are still present, the pupil may be contracted so that
lesion can easily escape notice. Any contraction. of the pupil
therefore disproportionately to the light, should demand a care-
ful examination with the pupil dilated in darkness or by the
action of atropia or homatropin. In the more advanced cases
with no persistent inflammation and an advanced opacity of the
lens, sensitiveness to light is greatly lessened, the pupil is dilated
and the cataract is easily detected.

In cases approximating to the condition last named it is
usually only necessary to place the animal in a sombre or dark
building, with his head facing the light at an open door, or
window and best with full sunlight. Let this fall full upon
the eye, and let the observer view the pupil diagonally from
each side when any opacity may be detected.

When the pupil is too narrow, several drops of a one per cent.
solution of atropia sulphate may be dropped within the lower
lid and left for ten minutes until the pupil is widely dilated.
Then the examination may be made as above, or still better

Cataract. Opacity of the Lens or Its Capsule. 433

the animal may be taken into a dark chamber and examined
by one of the following methods:

A light, preferably a candle, is placed in front of the eye and
moved from side to side, upward and downward, so as to bring
its images over all parts of the cornea and lens. In the normal
eye there are reflected three images of the light, one large, clear,
and upright from the anterior surface of the cornea, one, much
smaller but still upright, from the anterior capsule of the lens,
and one, small and inverted, from the posterior surface of the

‘lens and capsule. Any opacity in the lens or on its posterior
capsule, will cause the posterior (inverted) image to become in-
distinct, and as it were a diffuse white blur, as it passes over that
spot. The other small (erect) image may be even clearer than
normal in passing over the opaque area because of the mirror-like
reflecting action of the white cloud behindit. The movement of
the light so as to pass its,image over all parts of its surface in
succession will certainly reveal the existence and seat of the cata-
ract, by the blurring of the inverted image of the flame.

Another method is by oblique illumination, the patient’s head
being turned away from the light and the interior of the eye
being lighted up by reflection from a mirror. If the pupil has
been sufficiently dilated all parts of the lens can be scrutinized
in this way and the slightest opacity detected by the grayish or
whitish haze.

If there is still doubt as to the nature of such appearances, it
may be set at rest by illuminating the depth of the eye with the
ophthalmoscope when the opacities will appear as dark areas in
the general red ground. See Systematic Examination of the
Eye. ) \

The prognosis of cataract is almost invariably hopeless. I
have seen newly formed opacities of the capsule clear up in aday
or two, and such recovery in very slight traumatic injury and
superficial exudation is recognized as possible, but a slowly form-
ing cataract is usually there to stay. Those that clear are pre-
sumably only exudates on the capsule and not true cataracts.

Treatment. While exudates on the capsule may disappear
under a course of purgatives and diuretics, practically nothing is
to be expected from medical treatment in true cataract. The in-
stillation of phosphorated oil (1 — 2 percent.) daily into the con-

28

434 Veterinary Medicine.

junctival sac as formerly recommended, may be helpful in some
of the superficially opaque membranes, but for formed cataract it’
has proved useless. Massage with, or without ointments can
temporarily lessen ocular tension and reduce the liquids in the
zonula of Zinn, and canal of Schlemm, but it is only in very ex-
ceptional recent cases, in which it has given permanent benefit,
and even these were probably spurious cataracts.

The question then is essentially whether we should operate or
not. In the horse the objections to operation are almost conclu-
sive in all cases. The eye in which the lens has been depressed
or extracted can never see objects clearly without the aid of bi-
convex glasses, and it is impossible to fit these to the animal.

The horse that is blind can go to pasture or be driven in harness
with safety, but the one that sees all objects distorted or blurred
is liable to become a shyer endangering the life of his rider or
driver. The greater number of cataracts in horses come from
recurrent ophthalmia and are associated with opacity of the
vitreous, detachment of the retina, exudates in the choroid, de-
generation of the optic nerve, or other lesion which of itself
would destroy vision. Almost the only object of removal of the
lens in such cases would be to make an unsound horse pass for a
sound one. Even this is usually unattainable because the thick-
ened capsule remains as a dense white cloud or the opacity of the
vitreous shines through the pupil. In dogs the cataract is
usually associated with fewer complications, and the resulting
imperfect vision is not a source of danger to man. Extraction
of the opaque lens may in this case appeal so strongly to: the
sense of comfort of the owner that the operation may become
permissible or desirable. ,

In man the operation may have to be delayed for a consid-
erable time because of the unripeness of the cataract. ‘The
center of the lens may be firm and opaque while the outer layers
are so soft that they would be likely to be retained in the
capsule and would not only produce persistent opacity, but
would be a continual threat of destruction of the eye by active
inflammation. The ripeness is ascertained by careful scrutiny
of the shadow of the iris during illumination of the interior of
the eye. If ripe, the dark shadow of the iris approximates
closely to the margin of the iris itself, whereas if the outer

Cataract. Opacity of the Lens or Its Capsule. 435

portion is unripe there is a clear zone of greater or less depth
between the margin of the iris and the shadow reflected by the
opaque portion of the lens.

In the lower animals the question is less important as we
do not aim at securing perfect vision, and the danger of in-
flammation is therefore the main consideration. Escaping this,
the aqueous humor may be expected to dissolve and remove
the greater part of the still adherent lens substance, and the
unsightliness of the dense white cataract is largely done away
with. -

Discission, Tearing of the capsule so as to admit the aqueous
humor to the lens may be admissible in the young with soft cat-
aract. The liquid causes gradual swelling up, solution and
absorption of the lens so that in the course of a week or two the
whole may be removed. It is not, however, unattended by
danger, as the rapid swelling of the lens will sometimes determine
_ an inflammation which will lead to complete destruction of the
eye. The eye is first thoroughly washed with aseptic cotton and
a sublimate solution (1: 1000), or colargolum, and is then ren-
dered anzesthetic by cocaine (5 to 10 per cent. solution) or in the
large animals general anzesthesia is produced by ether or chloro-
form. ‘The eyelids are held apart by the lid speculum, the nic-
titans held if necessary by forceps, and the bulb steadied by seiz-
ing it with hooked forceps. A cataract needle is passed through
the cornea close to its border, and carried through the pupil,
previously dilated with atropia, so as to tear an opening in the
anterior capsule about two-thirds the diameter of the lens. If
the toughness of the capsule threatens to endanger the ciliary
body by dragging upon it, two needles or fine hooks may be in-
troduced through opposite borders of the cornea (inner and outer)
and the capsule may be torn without throwing any strain on sur-
rounding parts. The pupil must thereafter be kept dilated by
atropia to obviate adhesion of the iris to the wound and the eye
must be kept in comparative darkness and aseptic. If active
inflammation sets in, cold, astringent or iced dressings may be
called for, while if the swelling of the lens is threatening it
should be at once extracted. If the eye becomes unduly tense,
puncture of the cornea is indicated, and the relief of tension will
sometimes start a tardy solution into renewed activity.

436 Veterinary Medicine.

Linear extraction of the lens. The animal and the eye having
been prepared anesthetically, antiseptically, and midriatically as
for discission, the lids are fixed with a speculum, the nictitans and
the bulb with forceps, a Grafe cataract knife is introduced
through the inner side of the cornea, close to its margin and
with its point parallel to the front of the iris. The handle is
then raised. and the cornea detached from the sclera by a series
of gentle sawing motions until it has reached a point parallel to
the outer margin of the cornea. If the pupil is insufficiently di-
lated, the iris should now be seized by forceps drawn out through
the corneal wound and snipped off by scissors curved on the flat.

Then the cystotome (hooked knife) is introduced with its back
turned downward and carried to the further side of the capsule
and close to the iris, its cutting point is turned backward and in-
serted in the capsule, and drawn across from side to side to make
an orifice large enough for the escape of the lens. It is then
given a quarter revolution so as to turn the point of the knife
downward and is withdrawn from the wound back first. The
lower part of the sclera and cornea is now gently pressed with a
lens spoon so as to dislodge the lens from the capsule and deliver
it through the corneal wound. Counter pressure may be made
on the sclera at the upper part of the eye ball. The cornea is
now gently stroked with cotton dipped in sublimate solution to
pass all blood from the anterior chamber, and render the parts
antiseptic. The iris is carefully replaced inside the cornea and
any obstinately protruding parts must be excised. The eye is
now covered with cotton steeped in a sublimate solution (1 : 1000)
and bandaged without undue pressure, and the animal tied to
two sides of the stall so that it is impossible to rub the eye.

It is well to dress the eye on the second day, and if adhesion of
the wound is complete it may be left without bandage at the end
of a week or a fortnight.

Success depends mainly on the avoidance of infection. There-
fore every indication of local or general infection should forbid
the operation. Any existing infectious disease or any local
eczema, conjunctivitis or disease of the lachrymal apparatus
should be cured and the region thoroughly disinfected before
proceeding. ‘The head should have a good soapy wash, followed
by a sponging with sublimate solution (1 : 1000), the conjunctiva

Cataract. Opacity of the Lens or Its Capsule. 437

carefully washed out with the same and a bandage damp with it
applied over the eye. This bandage is only removed on the
operating table. Cloths dampened with the solution are laid on
the face around the eye, the eye is cocainized with a 5 per cent.
solution applied at intervals of one minute and when quite insen-
sible the operation is commenced. ‘The greatest care must be
taken to render the hands of operator and assistants and all in-
struments thoroughly aseptic. The instruments are taken from
a 4 per cent. solution of carbolic acid and placed in water (which
has just been boiled) until needed, and to wipe the eye or make
any application, sterilized cotton only is used and never touched
to the eye more than once. A sublimate bandage is placed over
the eye and worn for ten days or a fortnight or colargolum or
artol applied. Then if the corneal incision is healed and pale it
may be left off. The pupil should be kept dilated by a few drops
of atropia daily for this length of time.

Any occurrence of iritis or choroiditis usually indicates infec-
tion and must be treated on general principles, but with especial
reference to disinfection, and if this cannot be secured the eye
will be almost inevitably lost.

In case of renewed opacity through thickening of the capsule
an aperture must be torn in that membrane by the same method
asin discission. ‘This is commonly knownas needling. It must
be conducted under the same antiseptic precautions as in ex-
traction.

Suction. ‘This is only applicable to a lens which has become
fluid as well as opaque. It consists in withdrawing the liquid

lens through a hollow needle.

DISLOCATION OF THE LENS.

Congenital; acquired; traumatic, softening of suspensory ligament:
hinge motion, lens drops behind iris, protrudes through pupil, cataract.
Apparent increased depth of anterior chamber, tremulous iris, projecting

edge of lens like black ring. Treatment: extraction.

Dislocation of the lens may be congenital, or acquired, In the
latter case it is explained by a traumatism ora liquefaction of the

438 Veterinary Medicine.

vitreous and coincident softening of the suspensory ligament.
In either case, if the ligament is torn through in more than one-
half its circumference, the lens will hang by the remainder and
move on it as on a hinge so as to change its location in the dif-
ferent positions of the head. This is especially so where the
vitreous has become abnormally fluid as there is then no resist-
ance to the free backward movement of the lens. The writer
has seen the eye of a cow affected in this way, so that the cata-
ractous lens advances to the pupil and recedes from it as the eye
is moved. In other cases the dislocated lens, being attached
below only, drops down and virtually disappears behind the lower
part of the iris. In still other cases it becomes wedged into the
pupil, or protrudes into the anterior chamber and lies in front of
the pupil and iris. The semi-detached lens sooner or later be-
comes opaque. A cataract with contraction of the newly formed
tissue on the capsule and undue tension on the suspensory liga-
ment may, however, precede the dislocation which is then pre-
cipitated by some shock, asa blow, fall, sneeze, cough or emesis.

The condition leads to an apparent increase in the depth of the
anterior chamber, and tremulous movement of the iris, and if il-
luminated the impacted condition of the lens or its changes of
position can be detected. If its edge is exposed it appears as a
black ring.

Treatment is useless, unless it be extraction of the lens, or
iridectomy in suitable cases.

PERSISTENT ARTERIA HYALOIDEA.

In the embryo this artery occupies the central canal of the
vitreous and extends from the optic papilla to the posterior pole
of the lens. At times it persists after birth and even to mature
life and is then ‘detected as a gray or dark thread on ophthal-
moscopic examination. Berlin records a casein an old horse and
others in young cats, and Moller other cases in dogs. Treatment
is manifestly hopeless.

Ox

OPACITY OF THE VITREOUS.

From inflammation of the ciliary body, choroid or retina. Pupil copperas
green with white points, lines or patches, move in opposite direction from
the eye, liquefied vitreous, crystals of cholesterine, scintillance, opacity.
Treatment.

Opacities visible with the ophthalmoscope usually come from
effusion of blood into the vitreous, or inflammation of the retina,
choroid, or ciliary body. Blood thrown into the vitreous will
usually leave some permanent turbidity. In choroiditis or re-
tinitis the ophthalmoscope may reveal the changes in these
structures. A turbidity appearing in the anterior portion of the
vitreous, without any apparent cause, is probably due to cyclitis
which cannot be seen with the ophthalmoscope, but may cause
special tenderness around the sclero-corneal zone. It is common
in recurrent ophthalmia of the horse and in irido-choroiditis in
animals generally, and may be a distinct feature of glaucoma.
The general reflection of the pupil is copperas green, but gray
or white points, lines, bars or patches may often be recognized.
These being back of the lens and axis of the eye, move in the
opposite direction from the line of vision, thus if the eye looks
upward they descend, if it looks downward they ascend, if it
turns to the right, they turn to the left and vice versa. Tested
by a burning candle the three reflections remain clear and
distinct unless lens or cornea are affected.

Not infrequently the vitreous is found abnormally fluid, and
among its solid particles in affected horses have been found crys-
tals of cholesterin (Jacobi) and tyrosin (Moller). In the illumi-
nated vitreous such crystals may be seen to reflect the light like a
shower of sparks (synchysis scintillans). Opacity of the vitre-
ous has been seen in cases of amaurosis in horses (Hertwig) and
glaucoma in lambs (Prinz).

” Tyeatment is rarely satisfactory, though in some recent cases,
and in the absence of any other irremovable lesion, reabsorption
of a slight exudate may take place, in connection with the use of

mild saline laxatives and diuretics.
439

RETINITIS.

With choroiditis and cyclitis, albuminuria, nephritis, mellituria, leuka-
mia, petechial fever, contagious pneumonia. Photophobia, contracted
pupil, redness around optic disc, enlarged retinal vessels, white and gray
spots and radiating lines, exudates, clots, fatty degeneration. Treatment:
correct primary disease.

Retinitis is usually an accompaniment of choroiditis and cyclitis,
but it also occurs as a complication in a number of constitutional
maladies, such as albuminuria, nephritis, mellituria, leukeemia,
petechial fever, contagious pneumonia, etc. Frohner records a
case in a leukzemic horse, Peters in one suffering from petechial
fever, Schindelka in cases of contagious pneumonia in the horse,
and Eversbusch in recurrent ophthalmia of the horse, and under
other conditions in dogs.

The attack is accompanied at the outset with much photo-
phobia and contraction of the pupil. When this is dilated and
the fundus of the eye examined with the ophthalmoscope, the
retina is seen to be reddened for some distance around the optic
disc and the blood-vessels are materially enlarged. Later, white
or gray spots and lines are seen in and around the disc, tending
to assume a radiating direction, and the retina at large, on care-
ful examination may have a distinctly striped appearance.
Brownish, reddish or light colored exudates and haemorrhages
may be made out in certain cases between retina and hyaloid,
or between the retina and choroid. Fatty degeneration of the
fibrous tissue is common.

Treatment must be first that for the primary disease of which
the retinitis is a complication, and the result will depend on how
amenable that affection is to therapeutic measures. In advanced
albuminuria or mellituria, the retinitis, which is usually double,
is hopeless, while in contagious pneumonia, petechial fever, leu-
keemia and other less fatal affections, retinitis in its initial stages
may recover. In cases of advanced disease with serious struc-
tural changes in the retina, recovery cannot be looked for.

440

DETACHMENT OF THE RETINA.

This may occur in any case of retinitis or choroiditis. It is
especially common in recurrent ophthalmia in horses. It may
also occur through the dragging by contracting inflammatory pro-
ducts in organization. Spontaneous recoveries have taken place
through re-absorption, and attempts have been made by the in-
jection of iodide lotion to hasten this, or more safely by rest and
diaphoresis. Puncture and aspiration have also been tried with
most varied results. As arule in the lower animals the treatment
of the inflammation, with rest, a pressure bandage, and pilo-
carpin will be indicated..

RETINAL HEMORRHAGE.

This occurs in inflammations of the retina or choroid, also in
degenerations of the vascular walls and as a result of traumas, or
poisons. Schindelka quotes a case in a dog from ptomaines,
Eversbusch, one from scurvy in the dog, Appenroth, one ina
calf from a blow with a cow’s horn, and others in cats and horses
from traumas. It is present to a slight extent in all inflamma-
tions of the retina. With the ophthalmoscope the recent lesion
appears as a bluish red blotch on a bright red ground, and the
older lesion of a brownish red. Rest and a pressure bandage may
be employed after subsidence of the inflammation.

TUMORS OF THE RETINA.

Eversbusch found subretinal cysts in a 24 year old horse, Mer-
kel and others have found similar bodies in old dogs and cattle.
Sarcomata and melanosarcoma are found on the surface of the
choroid in gray horses, implicating the retina. The only remedy
is enucleation of the bulb.

441

INFLAMMATION OF THE OPTIC NERVE. PAPILLITIS.

Choked disc. Neuro retinitis. Papillo-retinitis. Nerve swelling blocks
veins. Causes : lead, tumors in brain bilateral, in orbit unilateral, influenza,
petechial fever. Symptoms: redness of optic disc, retinal arteries con-
traced, veins gorged, papilla swollen (woolly), vitreous opacity. Treatment.

This is also known as choked dise from the obstruction of the °
return of blood by the veins of the retina which pass out at the
cribriform lamina. The swelling of the nerve ending and papilla
compress the veins, causing stagnation and venous congestion in
the retina. When the retina is thus involved the term neuro-
retinitis or papillo-retinitis is often applied.

Causes. ‘The condition has been traced to lead poisoning,
brain or orbital tumors, and various infectious diseases. Except
in orbital tumor the disease is usually bilateral. In horses
Schindelka has seen the condition in influenza and Peters in pe-
techial fever, heart failure and dyspnoea. In a necropsy on a
horse the writer found complete cataract, atrophy of the bulb to
less than two-thirds the size of its fellow, thickening and furrow-
ing of the sclera, the presence of an extensive old blood clot in
the seat of the vitreous, cupping of the disc, retro-ocular neuritis
with exudate inside the sheath, and a considerable reddish brown
tumor of the choroid plexus on the same side. The trouble was
attributed to the blow of a rope on the eye a considerable time
before. The blood in the vitreous retained its dark hue and
showed no evidence of microbian invasion.

Symptoms. 'To the phenomena of retinitis there is added vio-
lent injection of the capillary plexus ofthe papilla. The arteries
of the retina are contracted while the veins are dilated and
tortuous. The papilla is swollen and is said to havea woolly ap-
pearance. The vitreous may be opaque by reason of exudation
or blood extravasation into its substance. Retro-ocular neuritis
is usually present, and brain tumor incertaincases. Moller calls
attention to the fact that with atrophy of the bulb the elliptical
outline of the papilla gradually lessens and it becomes more
nearly round. In dogs, too, the form of the papilla is also changed
and the same author has found it distinctly triangular. The
pupil may be at first strongly contracted and later freely dilated.

442

Retro-Bulbar Optic Neurités. 443

Treatment is usually of little avail and does not differ mater-
ially from that adopted in retinitis. In tumor of the orbit press-
ing on the optic nerve it may sometimes be reached through the
temporal fossa, but usually in all such cases enucleation of the
eyeball is demanded.

RETRO-BULBAR OPTIC NEURITIS.

Definition. Neurites descendens and ascendens, Extension to bulb,
other eye, or brain. Causes: traumas, meningitis, infectious diseases,
toxins, lead, tobacco, etc. Symptoms: partial blindness: congestion of
papilla. exudates in adjacent retina. Treatment : eliminate poisons, lead,
toxins, correct precedent disease, saline laxatives, diuretics, potassium
iodide, cupping, local bleeding, counter-irritants. Hygiene.

This is inflammation of the optic nerve commencing behind the
eyeball and only involving the papilla secondarily. Extension to
the papilla has been called neurites descendens in contra-distinction
to neuritis ascendens in which the inflammation extends along the
nerve toward the brain. There is always a tendency to exten-
sion, it may be to the papilla and retina, it may be to the chiasma
and opposite eye, and it may be inward toward the ganglia and
choroid plexus. ;

Causes. Apart from traumatic causes, retro-bulbar neuritis in
the domestic animals has been mainly, seen in connection with
constitutional or infectious diseases ; in the horse with petechial
fever (Peters), contagious pneumonia (Schindelka), meningitis
(Peters, Straub) and parotitis (Moller). It has also followed
meningitis in cattle (Nebelen). In man it has been traced to
lead, tobacco, alcohol and other poisons.

Symptoms. At first the patient may seem partially blind with-
out apparent cause. Later ophthalmoscopic examination reveals
congestion and swelling of the papilla, and congestion (especially
venous and capillary) of the retinal vessels. The discolorations
in streaks and spots, from exudates and degenerations follow as
noticed under papillitis. It is difficult to distinguish between this
and papillitis during life.

444 Veterinary Medicine.

Treatment should be first directed toward the elimination of
any poisons, such as lead or tobacco, which may act as a causa-
tive factor. Saline laxatives and in chronic cases potassium
iodide would be indicated. Every attention should be given to
the maintenance "of good general health, and in acute attacks,
local bleeding and counter-irritation: may be resorted to.

ATROPHY. PARALYSIS OF THE OPTIC NERVE. AM-
BLYOPIA. AMAUROSIS.

Definition. Horses, dogs, cattle, sheep. Amblyopia, Amaurosis. Causes:
retinal paresis from brilliant light, of cerebral ganglia, snow blindness,
poisons, lead, opium, atropine, lolium, tobacco, carbon bisulphide, crypto-
gams, mushrooms, ‘‘loco”’ plants, carbon monoxide, illuminating gas, qui-
nine, heat apoplexy, cerebral concussion, brain parasites, exudates, pres-
sure, degeneration, gastric or intestinal disorder, hemorrhage, anemia,
diarrhoea, diuresis, excessive milk secretion, gestation, embolism. Symp-
toms: constant excessive dilatation of pupil, no response to light, brilliant
reflection from retina and choroid, blue or yellow, (glass eyes) ; bilateral,
cerebral, tract or chiasma ; unilateral, bulbar or nervous; face without
expression, ears alert, head to one side, nose elevated, nostrils dilated, ox
and dog smell ground, slow pace, high stepping, does not dodge a feint to
strike. Lesions: inflammatory exudate and retinal atrophy, congested,
‘woolly’? papilla, retro-bulbar congestion or atrophy of nerve, thickening
of neurilemma, tumors of orbit or foramen optica, ccenurus, cysts, ab-
scesses, cholesteatomata, psammomata, hydrocephalus, meningitis, pineal
hypertrophy, cranial fractures or tumors, embolisms or aneurisms, hyper-
trophy of dura, apoplexy. Treatment : remove causes, laxatives, diuretics,
for lead, sulphuric acid and potassium iodide, darkness, extract ccenurus,
elevate depressed fractures, ice, cold water, snow, to head, blisters, setons,
electricity, strychnia, remove tumors.

Blindness without adequate, corresponding, visible changes in
the structure of the eye, has long been recognized in the lower
animals, having been observed in horses, dogs, cattle and sheep.
When partial it is known as amblyopia, and when complete as
amaurosis or blindness. The term amaurosis is, however, being
gradually eliminated from ophthalmological nomenclature in
favor of that of atrophy.

Causes. ‘These may be factors which act directly on the
retina, as the intense light of the sun, of an electric, lime or

Atrophy. Paralysis of the Optic Nerve. 445

magnesium light, of the reflection from snow, ice, water. sand,
or white dust. These exhaust the power of vision by over-stimu-
lating it, but whether the blindness is due to fatigue of the retina
or of the cerebral ganglia which preside over sight, it is difficult
to decide. This form is much more likely to occur in horses
which spend most of their time in darkness, as in unlighted
stables or mines, when they are suddenly brought into the sun-
light. Snow blindness, however, from prolonged exposure, is
common in animals asin man, and the case of the staghound
reported by Johan, is by no means an isolated one.

Much more common are factors which act primarily on the
nerve centres. Poisoning with lead, poppy, belladonna (sheep
and goats, Gerlach) lolium temulentum (Kltiver), tobacco, car-
bon bisulphide, cryptogams (musty fodder), mushrooms, as-
tragalus mollissimus, etc., abolishes vision more or less perfectly.
Common illuminating gas and carbon monoxide have shown this
effect on dogs and chickens. Quinia subcutem has induced the
condition in dogs (Becker and Eversbusch). More or less com-
plete amaurosis is noticed in connection with heat apoplexy in
horses and fat cattle.

Cerebral concussion from blows on the head, knocking the
head against a post or wall, or from violent falls induce blind-
ness which is to be attributed rather to lesion of the brain. ‘The
same remark applies to cases that appear during the progress of
brain disease, parasitic or otherwise, to those that occur in con-
nection with overloading of the stomach or intestines, and from
gestation (Riss).

In cases appearing after severe depletion, like profuse hamor-
rhage, diarrhoea, or diuresis, or excessive secretion of milk
(bitch) the anzemia of both eye and brain may be taken into
account.

When amaurosis develops during some inflammatory or in-
fectious disease, as in parturition fever in cows, the immediate
cause may sometimes be found in embolism of the retinal, or
cerebral arteries.

Symptoms. The most striking feature of amaurosis is the con-
stant excessive dilatation of the pupil. This is the same in light
and darkness, and in fully developed cases the animal may be
taken from perfect darkness to the full glare of sunlight or

446 Veterinary Medicine.

electric light without the slightest contraction of the pupil. The
pupillary reflex to light is entirely lost. In the slighter cases
(amblyopia) there remains some slight response of the iris to
light but always far short of the normal. The widely dilated
pupil admits a flood of light, and in the absence of cataract, lights
up the chamber of the vitreous to an unusual degree. The blue
or yellowish reflection of the tapetum is very striking, and led to
the obsolete names of gutta serena and glass eyes. Sometimes
the disease is unilateral and at others bilateral. In case it is
unilateral there is a strong presumption that the causative lesion
is in the affected eye or in the optic nerve in front of the chiasma.
In the bilateral cases it is more likely to depend on disease of the
brain or some more distant organ.

Certain important indications are to be drawn from the expres-
sion of the face, the position of the head and ears and the mode
of locomotion. In all blind animals the face is without expres-
sion. The dilated pupils give no suggestion of mind looking
through them, they have on the contrary an uniform stony stare.

There is no sense of fire or life, but the face is like a dull sculp-
tured mass. The immobile face finds a sharp contrast in the
alertness of the ears, which may be carried one forward. and
another back, but fixed and yet ready to turn to catch every
sound. In the horse the head is usually carried a little to one
side for the same reason, and with the nose elevated (star-gazer)
and nostrils dilated. The ox inclines to carry the head low,
while the dog keeps his nose near the ground to guide himself
by the sense of smell. All blind animals are disposed to move
slowly and carefully, and the horse acquires a habit of high
stepping to avoid stumbling.

A common and important test where both eyes are equally
affected and cannot be contrasted with each other, is to strike the
lower part of the face with the hand and immediately threaten to
repeat the blow. If the animal can see, it will seek to jerk the
head out of the way as soon as the hand is raised for the second
blow, while if blind there will be no such movement provided
the motion of the hand has not been such as to induce a current _
of air on the face.

Lesions. Blindness, or the general symptoms of amblyopia or
amaurosis, may attend on theatrophy of the retinal fibres in con-

Atrophy. Paralysis of the Optic Nerve. 447

nection with inflammatory exudation or blood extravasation on,
in, or beneath the retina. In other cases the lesion is in the
papilla which is inflamed and swollen with the woolly aspect
characteristic of choked disc. In others there is congestion of
the optic nerve behind the bulb, with exudation into its substance
or beneath its sheath, or the nerve has already undergone exten-
sive atrophy with thickening of its neurilemma. In other cases
there.is atrophy of the arteria centralis retinze, or tumors of the
orbit or optic foramen pressing upon the nerve. Cases of this
kind are reported in the larger animals by Leblanc and Tscheulin,
and in dogs and ducks by Hilbert. ,

Much more frequently the determining lesions are situated in
the brain or its meninges. In sheep it is very common from the
development of ccenurus cerebralis over the optic lobes. Kiihnert
found a cyst with delicate walls in the brain of a horse affected
in this way. Amaurosis is occasionally seen in connection with
the cerebral abscesses which form in complicated cases of strangles
or in pyzemia, also in cases of cholesteatoma of the choroid
plexus. Other conditions of its occurence are hydrocephalus,
meningitis, hypertrophy of the pineal gland, fracture of the
cranium, tumors of the cranium or dura mater, embolism or
aneurism of the cerebral arteries, hypertrophy and induration of
the dura mater (ox, Leblanc), or sanguineous apoplexy. Ina
certain number of cases there may be no lesion of brain or eye,
or only a congestion of the former in connection with lead
poisoning, rye grass poisoning or other gastric disorder, or of
gestation. ;

Treatment. Success will depend on the sympathetic nature of
the condition or on the transient and removable character of its
causative factor. When the condition is but a symptom of over-
loaded stomach or a transient poisoning by vegetable or mineral
agents a direct recovery may be expected to follow their disuse
and elimination from the system. ‘This may be hastened by the
exhibition of laxatives and diuretics, and in the case of lead by
sulphuric acid followed by iodide of potassium. In cases of snow
blindness it is only necessary as a rule to place the animal in the
shade until the over-stimulation shall have subsided. In all
these cases the attack has come on abruptly and without any
local symptom of ocular hyperzemia and this with the preserva-

448 Veterinary Medicine.

tion of the general senses can always be looked on as a favorable
indication.

In cases that come on slowly and which are accompanied by
symptoms of vascular disturbance or structural changes in the
eye, or brain, treatment is likely to be less successful. Never-
theless coenurus may be removed by surgical means, depressed
fractures may be elevated, and acute cerebral and meningeal
congestions may be met by appropriate measures. If the ,cere-
bral congestion is acute, free bleeding from the jugular witha
strong purgative and the application of ice or cold water to
the head may prove useful. Apparent benefit has also followed
the use of blisters on the face or back of the ear, of setons,
and later of a weak electric current and strychnia. Tumors also
may be advantageously removed.

But in cases marked by destruction of the retina or papilla,
by congestion or atrophy of the optic nerve, by destructive
disease of the optic foramen, or of the brain or its meninges,
treatment is futile. ,

ANOPHTHALMOS. ATROPHY OF THE EYEBALL.
PHTHISIS BULBI. MICROPHTHALMOS..

In some cases the eye is congenitally absent (Anophthalmos).
In others it is abnormally small. One such case came under
the notice of the author in which the eyeball was represented
by a small black sphere about half an inch in diameter moved
by the ocular muscles. ‘The dam of the filly, born with this
defect, had, during the pregnancy, a burdock entangled in the
forelock and causing a violent ophthalmia which was supposed
to have lasted for months. In other cases there is a fistula
opening from the vitreous behind.

Cases of wasting and atrophy of the eye follow on exudates
into the vitreous and their subsequent contraction, or on sup-
puration and granulation as noted under internal ophthalmia,
recurrent ophthalmia, and panophthalmia. ‘The condition may
also result from atrophy or degeneration of the optic nerve or
of its cerebral ganglia (thalamus, corpora quadrigemini, genicu-
lata, etc.). These conditions are irremediable.

LUXATIO BULBI. DISLOCATION OF THF GLOBE OF
THE EYE.

Definition. Dog, anatomical factors, Symptoms: protrusion of bulb
through palpebral orifice, orbicular spasm, vessel, muscle, nerve stretching
or tearing. Sphacelus. Panophthalmia. Fracture of orbit. Treatment :
early reduction, antisepsis, astringents, scarify sclera, cold, puncture
aqueous with hypodermic needle, enlarge palpebral opening, suture
and compress, remove foreign bodies and injurious fragments of tissues,
enucleation.

Definition. Displacement of the globe of the eye out of the
orbit and through the eyelids.

Causes. Among domestic animals the condition is most fre-
quently seen in the dog, which is predisposed by reason of the
normal prominence of its eye, the width of the aperture between
the lids and the absence of the orbital process of the frontal bone.
Blows upon the region and the insertion of pointed bodies, (teeth,
horns, etc.), which can act as levers using the margin of the
orbit as a fulcrum are especially liable to cause the lesion. Dog
fights are the most common occasions. Other animals may also
suffer but not at all frequently.

_ Symptoms and lesions. In the simplest form the bulb is dis-
placed forward out of the orbit and through the palpebrze which
latter contract spasmodically behind it and effectually prevent a
spontaneous reduction. The optic nerve, muscles, and vessels
are unduly stretched and the circulation in the bulb is seriously
impaired, so that even in the least complicated cases any undue
delay in reducing the dislocation will lead to serious and destruc-
tive changes in the eye. Sphacelus of the globe is not uncom-
mon under such conditions.

‘In the more complicated cases, the conjunctiva, palpebre,
nictitans, muscles, nerves, etc., may be more or less lacerated and
the globe itself may be seriously damaged either by internal
lesion or by an external trauma. In all these cases there is most
imminent danger of general infective inflammation of the eye, of

. panophthalmia, and even of secondary general infection of the

system. Fracture of the bones of the orbit may also be looked for.

29 449

450 Veterinary Medicine.

Treatment. ‘When dislocation is uncomplicated and recent,
say of a few hours standing only, it may be reduced and a favor-
able issue secured. The bulb should be first washed with water
which has been sterilized by boiling or rendered antiseptic with
sublimate (1 : 5000), and can usually be pressed back by -steady
uniform pressure. ‘The insertion under one lid of a small spatula
bent at the end or the one limb of a lid speculum may assist in
difficult cases. When replaced the parts may be again washed
with antiseptic solution and covered by a bandage wet with an
astringent collyrium.

When the condition has been neglected for a day or more the
bulb is congested and swollen so that its return is rendered much
more difficult, ‘and its subsequent retention may require much
care and ingenuity, ‘The reduction of the turgid globe may be
assisted by opening the veins and arteries on the sclera, by
astringent applications, by massage, and in obstinate cases by
evacuation of a portion of the aqueous humor, by the aid of a
fine aseptic hypodermic needle. Finally the palpébral opening
may be enlarged by incising the outer canthus with a probe pointed
bistuory. When the eye has been replaced in its socket this must be
closed by suture. For the retention of the eye in such cases a band-
age may suffice, or this failing, the lids may be held together by
strips of adhesive plaster, or by collodion. In very difficult
cases Lafosse and Trasbot recommend sutures through the skin
1% to 2 inches from the palpebral borders and the whole covered
with a bandage impregnated with an antiseptic and astringent
collyrium.

It is not requisite to keep the bandage in position for over four
or five days as the swelling of the eyelids and other adjacent
structures effectually prevents any tendency to repetition of the
luxation, and the eye may be treated like an ordinary traumatic
lesion.

At the outset, and later if need be, any foreign body in the
orbit should be removed and any detached pieces of bone which
cannot be retained firmly in position, and which are liable to
prevent healing or to determine infection of the wound.

In the worst cases and in those that have been neglected until °

gangrene or panophthalmitis threatens, the removal of the eye-
ball may be the only resort. The animal may be anzesthetized

Artificial Eye. 451

by chloroform or ether, or locally by cocaine. The conjunctiva
covering the sclera is then pinched up with forceps and cut
through with scissors, this is continued all around the globe.
Then the recti muscles, the superior and inferior oblique muscles,
‘the retractor and finally the optic nerve are cut through with a
pair of scissors curved on the flat. The divided ends of the mus-
cles are now sutured together around the nerve which has been
cut shorter, and the cavity irrigated by a cold antiseptic solu-
tion. Bleeding vessels may be twisted through with forceps if
the flow is not readily checked by cold irrigation. Ora pledget
of cotton dipped in tincture of muriate of iron may be loosely in-
serted (firm pressure would be unnecesssarily painful). As a
subsequent dressing, standard sulphurous acid solution, glycerine
and water in equal proportions, or other antiseptic dressings may
be applied.

ARTIFICIAL EYE.

‘These are largely in use in the human being, and have been
employed in the lower animals in different cases, especially in
the horse, with excellent effect. The advantages may be summed
up in this, that they do away with the unsightly appearance of
an empty orbit with the edges of the lids turned into the dark
aperture, enhance the value by restoring the face to nearly the
natural appearance, and prevent the lodgment of dust and insects
in the cavity.

The artificial eye may be made to appear more natural if made
of glass, yet when made of horn or still better of hard rubber,
colored like the normal iris and pupil, it has the advantage. of
greater lightness. It must be perfectly smooth so as to cause no
discomfort, and should never be introduced so long as there is
any irritation in the stump or conjunctiva. It may be slipped in
like a button, first beneath the deeper upper lid, and then be-
neath the lower, and should be worn only while at work and so
long as it causes no irritation nor purulent discharge. On the
return of the animal to the stable, the artificial eye is taken out,
washed and placed in clean pure water. The orbit should be
sponged out with a weak collyrium (boric acid 1 : 100).

- 452 Veterinary Medicine.

In man, excentration is sometimes substituted for enucleation,
the cornea is removed together with the lens, vitreous, choroid
and retina, leaving only the sclera which contracts into a dense
scar tissue with the muscles attached. Or an artificial vitreous
of glass or unoxidizable metal is introduced around which the
sclera is allowed to heal. This introduces an additional element
of danger over the formation of a simple sclerotic stump, but,
when successful, it affords a better support to the artificial eye,
turning it freely in harmony with its fellow and giving it a more
natural aspect.

STRABISMUS. SQUINTING. LACK OF MUSCULAR
BALANCE.

Causes : paralysis of eye muscles, bulb rolls from affected muscle, spasm
of eye muscles, bulb rolls toward affected muscle, convergent squint most
common. Hold head still and move object in front of eyes, imperfect
movement toward paretic muscle or away from the spastic one. ‘Ptosis.
Overfatigue. Debility. Nerve or brain lesion. Dislocation of bulb.
Treatment : treat any transient etiological factor, cerebral congestion, par-
asitisms, debility, anzemia. Tenotomy of rectus : advance of paretic rectus.

Strabismus may be due to a variety of causes, among others to
the following :

Paralysis of one of the ocular muscles. When the eyes are
turned in the direction away from the affected muscle the muscle
is deficient in power. It may be the exterfial rectus (abducent
nerve) producing convergent squint. It may be of the superior
oblique muscle (4th or pathetic nerve) causing a faulty move-
ment of the eye downward and inward or a slightly convergent
squint. Divergent squint commonly indicates paralysis of up-
per, lower and inner recti, and the inferior oblique (3d or
oculo motor nerve): this is usually associated with ptosis or
drooping of the upper lid, the levator of which is supplied by the
same nerve. ‘The existence of squint is usually so marked that
no special method of examination is required. If otherwise, how-
ever, the animal’s head may be held still and some object which
will attract his attention is moved before the eyes, outward and
inward, when the affected eye moving in the direction of the

Strabismus. Sgquinting. Lack of Muscular Balance. 453

paralytic muscle will lag visibly behind its fellow. These con-
ditions are usually due to lesions in the respective nerves or their
cerebral ganglia.

Spasmodic or Spastic Squint is the exact antithesis of the
above, the eye turning toward the muscle which is the seat of
spasm. It may be seen in certain cases of rabies and is always
due to disorder of the central nervous ganglia. :

In some cases squinting is associated with over fatigue, or de-
bility, and then usually partakes of the paralytic character.

In the lower animals convergent strabismus has been most fre-
quently observed. Brouwer records a case in the horse and
Koch a congenital one in the cow. Zschokke reports a case in
the cow connected with an angioma at the base of the brain.
Other forms are noted by Peters, Barrier, Bayer and others.
Stockfleth quotes a case in the dog following prolapsus bulbi and
doubtless connected with injury to ocular muscles or nerves,
sustained in the accident.

Treatment will vary with the ascertained cause. As a rule
cases that depend on structural changes in the brain are hopeless.
‘Those that depend on temporary congestion or other transient
disorder of that organ may recover when that has been overcome.
In cases in which debility is a prominent feature, tonics, moder-
ate exercise in the open air and general hygienic care‘are de-
manded. ‘The final resort in bad cases is tenotomy of the rectus
on the side toward which the eye turns. In man when this is
found to be insufficient the opposing weak or paretic muscle is
also advanced. ‘The tendon close to its sclerotic attachment is
laid bare by incision, and a silk or catgut thread is passed through
each border, upper and lower. The tendon is now cut through
with scissors on the corneal side of the sutures and, by means of
their needles, the latter are passed through the conjunctiva and
capsule of Tenon, from within outward and close to the margin
of the cornea. ‘The sutures are now tied somewhat tighter than
is absolutely necessary to properly balance the eye so as to allow
some room for relaxation in healing. We are not aware that
this measure of advancement has been employed in the domestic
animals.

NYSTAGMUS. OSCILLATORY MOVEMENT OF
THE EVE.

This consists in spasmodic involuntary oscillation of the eye-
ball in a horizontal, lateral, oblique or rotary direction. In
animals it-has been seen in connection with poisoning and brain
diseases. Johne has observed it in horses in cerebro-spinal
meningitis, Wenderhold in epilepsy, and Moller in chloroform
anesthesia. Moller has further seen it in puppies with con-
genital microphthalmos, and Siedamgrotzky in swine which had
been poisoned by herring brine.

Slight cases of functional disturbance may improve under good
hygiene, open air life and tonics, cases due to poisons may re-
cover spontaneously when such poisons have been eliminated,
but those which depend on structural disorder of the brain are
beyond remedy.

454

DISEASES OF THE SKIN.

‘Ultimate skin lesions in man and animals similar. Masked by thick
cuticle, pigment, hair, fur, feathers. White, hairless skin. Lesions and
deranged functions : Macule, erythema, papules, nodules, blisters, blebs,
pustules, boils, carbuncles, scales, crusts, sitfasts, horny growths, erosions,
abrasions, chaps, fissures, ulcers, excrescences, cicatrices, neuroses, morbid
secretions, changes in glands, hairs, in derma. Scleroderma. Elephanti-
asis. Vegetable and animal parasites.

In cutaneous diseases in man and animals the actual lesions
are largely of the same nature, yet in the animal covered with
hair, fur or feathers, and with the cuticle deeply pigmented, the.
diagnosis of the different affections becomes much more difficult.
On white-skinned animals and on parts with little or no hair, the
identification of the different forms is usually possible. ‘The fol-
lowing list may serve to indicate the nature of the different lesions,
but these must not be accepted as indicating distinct diseases, as
two or more of these forms often co-exist or succeed each other
in the same affection :—

Ist. Maculz: Spots: Discolorations. Examples: Black,
melanotic spots in skins of white horses : white spots in dourine,
after pustules, etc., : ecchymosis after contusions, stings, insect
bites, etc. : petechial spots in anthrax, rouget, hog cholera,
rinderpest, canine distemper, swine plague, scurvy, etc.

2d. Erythema: Rash: Flush. Congestive redness usually
disappearing under pressure. Physiologicalin blush or glow of
exercise, Dathological from insolation, friction, deranged innerva-
tion, etc..

3d. Papule: Papules: Pimples. Small, red, hard, coni-
cal elevations, not forming blister nor pustule. Due to exuda-
tion and the accumulation of leucocytes at given points, having a
local or general cause, (psoriasis, intertrigo, etc. ).

ath. Tubercule: Nodules. Larger but still circumscribed

455

456 Veterinary Medicine. ,

thickening of the entire skin from exudation and cell .growth,
from ¥% inch to 2 or more inches in diameter and sometimes be-
coming confluent. Examples: Urticaria (surfeit) in solipeds,
and cattle ; petechial fever, farcy, etc. Sometimes chronic.

5th. Vesiculz: Blisters. Rounded or conical elevations
the size of a millet seed to a pea, and having a small liquid exu-
dation under the cuticle in the centre. In inflammations of the
papillary layer, of a sufficiently acute type the tendency is to the
formation of vesicles. ‘These lesions are, therefore, often present
in very different forms of skin disease from those due to simple
thermic irritation, in constitutional diseases like eczema, or con-
tagious ones like sheep-pox. May merge into pustules or other
advanced lesions.

6th. Phlyctene: Bullz: Blebs. In these the individual
lesion is larger than in vesicles. They are of any size from a pea
upward. The most striking example is in cantharides, blisters,
scalds and burns, but in other cases it depends on a consti-
tutional condition or a specially exudative dermatitis.

7th. Pustulz: Pustules. ‘These differ from vesicles in that
the central exudate becomes the seat of suppuration and a
limited collection of pus, at first central, though later involving,
it may be the whole area of the exudate. It is often merely
an advanced stage of the papule or vesicle. We find examples
in the different forms of variola, in lesions caused by tartar
emetic or croton oil, and in several forms of dermatitis. It is es-
sentially microbian.

8th. Furunculus: Furuncle: Boil. Inflammatory nodosity
of the derma, resulting in a necrotic central core and suppuration.
Is bacteridian and common on the coronet and lower parts of
the limbs in solipeds. r

gth. Carbunculus: Carbuncle. An inflammatory nodosity
or cluster of nodes of much greater extent, tending to necrotic
change and sloughing over a much more extending area.
Microbian.

roth. Squama: Scales: Dandruff. Exudation products and
cells desiccate and exfoliate as bran-like scales or thicker co-
herent lamine. Examples are found in psoriasis, pityriasis,
eczema, variola, rinderpest, etc.

11th. Cruste; Crusts: Scabs. Hard, solidified masses of
epidermis, blood, pus and serous exudate.

Diseases of the Skin. 457

12th. Callositas: Callosity. Abnormal ,thickening of the
epidermis, as a physiological protective cell growth. Examples:
pads on the knees of camels, cows and even horses from kneel-
ing on a hard, uneven surface.
13th. Sitfasts: Necrotic Callosities. Combination of dried
up exudate of horny consistency, and a thickened, fibroid and
partially necrotic portion of the subjacent derma with little or
no disposition to spontaneous detachment.
14th. Cornu Cutaneum: Keracele : Horny Growth. Ab-
normal horny growth from keratogenous tissue, or from the
derma in its vicinity or at some other point of the skin. b
15th. Erosions: Abrasions. Lesions of the cuticle expos-
ing the true skin, and the result of itching, scratching, friction,
biting or other mechanical or thermic injury.
. 16th. Rime: Cracks: Chaps. These are linear breaches
often confined to the epidermis in the bends of joints, under
congestion and suppression of sebaceous secretion, in elephanti-
asis, dropsy, petechial fever, etc. Unless they have ulcerated
they may heal without cicatrix.
17th. Crevasses: Fissures. These are chaps, which ex-
tend into the derma, giving rise to destruction of tissue and leav-
ing a cicatrix on healing. Examples are found in the hollow of
the pastern, behind the knee (Mallenders), in front of the hock
(Sallanders), in the swellings of petechial fever, malignant
catarrh, stocked legs, grease, etc.
18th. Ulcus: Ulcer. A sore that extends by the continual
molecular breaking down of the forming granulations and of the
adjacent and subjacent diseased tissue.
19th. Excrescences: Hyperplasie: Phymata: Derma-
tomata. ‘These may include over luxuriant granulations which
rise above the level of the skin and become organized into pro-
- jecting fibro-cellular, raw or scabby masses : tumors of all kinds
—warty, papillomatous, horny, epidermic, cancerous, sarcoma-
tous, pigmentary, angeiomatous, tuberculosis, etc.
' goth. Cicatrices: Scars. These are puckered, raised or
sometimes depressed, lines or areas of condensed connective tis-
sue with a covering of epidermis, taking the place of the normal
dermis and epidermis and their appendages, which have been
destroyed. They result from traumatic, ulcerous, or atrophic
destruction of the skin.

458 Veterinary Medicine.

21st. Neurosis. These may be exemplified by the intense
itching of the skin without appreciable structural change. So in
cutaneous anesthesia and hypereethesia.

22d. Modified Secretions. These include absence of per-
spiration—anidrosis, excessive perspiration—hyperidrosis, sup-
pressed sebaceous secretion—asteatosis, excessive sebaceous secre-
tion—steatorrhea or seborrhea, foetid sweat—bromidrosis, colored
sweat—chromidrosis, uvinous sweat—uridrosis.

23d. Structural alterations in glands and ducts. Cystic
ducts—hydrocystoma, blocked ducts—acne, inflamed glands—
hidrosadenitis.

24th. Abnormal conditions of the hair. This embraces
baldness, hypotrichosis, alopecia, excessive growth of hair,
hypertrichosis, white patches, canities, nodular hairs, piedra,
brittle hair, fragilitas crinium, felted hair, plica, trichoma.

25th. Scleroderma. Hard, leathery, thickened skin. Exam-
ples in old boars on shoulders, and in other animals.

26th. Elephantiasis Pachydermia. Enormous hypertrophy
of the skin, with usually distention of the lymph plexuses and
vessels (lymphangiectasis : see Vol. I).

27th. Vegetable parasites. Trichophyton, achorion, mi-
crosporon, actinomyces, etc. (See parasites).

28th. Animal parasites. Lice, fleas, diptera, trombidium,
Acari, ixodes, cimex, filaria, coccidia, etc. (See parasites).

GENERAL CAUSES OF SKIN DISEASES.

External Internal. Traumas, abrasions, excoriations, lacerations, con-
tusions, compression, radiating heat, scalding, incandescent objects, solar
heat, chemical caustics, cold, freezing, kicks, bites, tusk, horn or claw
wounds, stings, venoms, envenomed bites, road dust, sweat, excretions,
sebum, mineral and vegetable poisons, essential oils, fungi. Hyperzemia,
exudation, depilation, sudation, moulting, climatic changes, unwholesome
or irritating foods, ptomaines, alimentary fermentations, hepatic, renal or
blood disorders, altered innervation, youth, age, temperament, heredity.
Experimental nervous cases.

‘These may be external or internal or both.
External Causes. Some affections of the skin are due to

General Causes of Skin Diseases. 459

external causes exclusively, while in others the local cause of
irritation is accessory but no less important in maintaining the
trouble. Among the more prominent external factors may be
named: traumatisms, abrasions, excoriations, lacerations, con-
tusions, compression, radiating heat, boiling water, hot or in-
candescent solids or liquids, solar heat, chemical caustics and
irritants, cold, freezing, injuries by harness, kicks, lacerations
with teeth, tusks, horns or claws, stings, bites, (leeches, snakes,
etc.), venoms, (snake, toad, etc.), road dust and sweat, liquid
feeces or urine, excess of sebum in sheath or vulva, mineral
poisons (mercurial, iodides, bromides, arseniates, caustic alkalies,
caustic salts, etc.), vegetable poisons (croton, bryonia alba and
dioica, heracleum or cow parsnip, polygala or milk wort, cycla-
men or sow bread, polygonum hydropiper, mustard, cenanthe,
cicuta, hypericum perforatum and androsaemum, rhus toxi-
codendron, radicans and venenata, capsicum, pepper, radish,
Indian syringa, anemone nemorosa and patens, ranunculus acris
scelerata, flammula, mericatus and bulbosus, cytisus, euphor-
bium and the essential oils of turpentine, origanum, lavender,
etc.), fungi of musty food, ergot, etc.

Internal Causes. Among these are all conditions that induce
stasis in the capillaries or lymph vessels, active hyperzemia, exu-
dation, depilation, profuse perspiration, shedding the coat, ex-
posure to cold, chill, etc., sudden access of warm weather, poor
and insufficient or rich, stimulating food, cotton seed meal, In-
dian corn, buckwheat, purple clover, animal food (in dogs),
‘spiced food, food spoilt by wet and cryptogams, indigestions,
gastric and intestinal fermentations, hepatic disorders, renal dis-
orders with imperfect elimination, blood disorders, and nervous
disorders which entail vaso-motor changes. Early age predis- .
poses to some affections (variola, warts); old age to others
(eczema). A nervous temperament in horses favors the drier
eruptions (pityriasis), a lymphatic temperament the exudative
(grease, canker, moist eczema). A hot, moist season favors
most skin affections (eczema, acariasis, etc.), dry insolation
others (erythema)'and cold still others (chillblaines, frost bite,
chaps, etc.). Some eruptions are at first summer troubles, dis-
appearing on the advent of cold weather, yet in time the predis-
position increases, or the inflamed skin becomes less resistant

460 Veterinary Medicine.

and the disease becomes permanent. A marked predisposition
in certain animals, appears to inhere in the constitution and
proves hereditary in the family (Blain, Lafosse, Cadeac). Ner-
vous causes have not been satisfactorily traced in the lower ani-
mals, yet the dermatitis of the face and neck caused by the ex-
perimental lesion of the cervical sympathetic or its connecting
ganglia shows clearly enough how any portion must be affected
by disorder of its trophic or vaso-motor nerves. Charcot found
that experimental lesions causing inflammation of the spinal
cord, led to trophic changes and finally gangrene of a corre-
sponding part of the skin. Babesiu and Israi injected oil of
mustard in one side of the cord, in three dogs, and found in
several days a vesicular eruption and atrophy of the skin on the
same side, a result they supposed of the myelitis.

DIAGNOSIS OF SKIN DISEASES.

Diagnosis. Clip or shaveskin. Examine in warmth ; skin and mucosa,
where uninjured by rubbing, moisture, dryness, color, odor, discharge.
Soapy. wash. Exudation into skin: pliancy: rigidity : eruption: tender-
ness, itching, history. association, feeding, watering, exposure, housing.
harnessing, driving. Coincident disease. Prognosis. Microbian derma-
tosis, parasitic dermatosis, external irritants, ingested irritants, toxic sys-
temic products, constitution, renal disease, movement of joints, harness,

The thick hairy covering of animals, and the vicious energy
with which they often rub, scratch and bite themselves, thus
turning simple into extensive and severe lesions interfere serious-
ly with a satisfactory diagnosis. The following precautions are
usually demanded :

ist. Clip the animal close to the skin to allow of careful exam-
ination. In some affections, this may be dispensed with, but as
a rule it should be followed. What appears to bea circumscribed
eruption may be shown to be general, or at least extensively
diffused over different regions. Or what was shown only by
scurf or scab may be seen in its earlier and more characteristic
stage as erythema, papule or vesicle. It may even be desirable
to shave the affected part, care being taken, not to slice off the
characteristic papules, etc.

Diagnosis of Skin Diseases. 461

2d. Make the examination in a clear day in full. sunshine if
possible. In dark, cloudy weather, and in dimly lighted stables
it is impossible to identify the different lesions. Artificial light
is very unsatisfactory. Warmth, as in sunshine, or in a warm
day or room, increases any itching and the cutaneous circulation
and congestion, and renders more: lively and active the animal
parasites that may be present. ‘These may be found in the
surface scrapings taken in warmth, and not at all if taken in
cold. A hand lens will assist in the discovery of the larger
parasites, while for the smaller ones the microscope must be
employed.

3d. Examine carefully all parts of the skin and even the
visible mucose, estimating whether any lesions of the latter in-
dicate extension from the skin, by proximity, or a general
constitutional affection. Scrutinize particularly such parts as
have not been abraded by mechanical injury—those which show
the primary character of the lesion. Is the affected portion of
the skin dry or moist? Some eruptions like impetigo or grease
are always moist, others like pityriasis or dry eczema are habit-
ually dry apart from mechanical injuries. Ascertain the color,
odor and consistency of any discharge. It may be a limpid or
reddish serum in grease, honey-like in impetigo, oily in farcy,
greasy in swine-plague. The odor is fcetid in grease, canker
and thrush of the frog, cheesy in variola, and mousy in favus.

4th. To learn the true nature of the eruption a warm, soapy
wash may be essential to remove scurf, scab, and other encrusta-
tions.

5th.. Note the depth and extent of the skin lesions, the thick-
ening of the skin, its pliancy or rigidity, its adhesions to subja-
cent parts or free movement upon them, whether it is contracted
into folds or ridges, the degree of congestion, the nature of the
eruption, uniform congestive redness, papule, vesicle, pustule,
squama, sore, ulcer, nodule, slough, etc. Are the individual
lesions isolated or confluent?

6th. The presence of itching and its degree are important data.
Pruritus is always excessive in ordinary acariasis, marked in
eczema, phthiriasis, and some neuroses, and very slight in a
number of skin affections (pityriasis, ringworm, grease, thrush,
contagious acne). ‘The abrasions and sores caused by rubbing,

462 Veterinary Medicine.

scratching, etc., will usually give a key to the degree of pruritus,
and handling the part will render the condition evident.

7th. The history of the case is always important. Is it chronic
or acute? Continuous or intermittent? Associated with any
special conditions of proximity to other diseased animals, to
special feeding, watering, exposure, housing, harnessing, driving,
which might account for it? Did there coincide with its erup-
tion any indigestion, gastric or intestinal, or any hepatic, urinary
or nervous disorder on which it might be dependent?

Prognosis. This is subordinate to the nature, causes, course,
duration and complications of the disease.

Microbian dermatosis (variola, aphthous fever, rouget)
usually follows a rapid course and recovery is perfect with some
measure of immunity.

Parasitic dermatosis (acariasis, phthiriasis), is liable to
have serious secondary results (infection to man or animals, loss
of wool, tender skin), and to run a chronic course.

Maladies from external irritants (chafing, caustics, traumas,
vegetable, or animal irritants), do not tend to chronicity and are
often promptly curable.

Maladies due to ingested irritants (urticaria, distillery
waste eruptions), also tend to recovery when the source of irrita-
tion is cut off.

Maladies due to toxic products of the system will be ob-
stinate or incurable, in ratio with the incurability of the causa-
tive factor. ‘Those due to the absorbed products of a simple in-
digestion, will tend to terminate with the removal of the cause,
while those dependent on chronic and perhaps irremediable dis-
ease of the digestive organs, liver, or kidneys will be correspond-
ingly inveterate or incurable.

Maladies due to a constitutional vice, in sanguification,
nutrition, innervation, etc., are likely to be Eaeneoa ae or only
temporarily curable.

Burns and some other skin diseases are table to become
complicated by renal embolisms, albuminuria, indigestions, etc.,
which may render the skin affection inveterate or incurable.

Dermatitis on the folds of articulations or.on the seats of har-
ness, are sustained by the local irritation, and may necessitate
long rest, or abstention from work requiring the use of such
harness.

General Principles of Treatment of Skin Diseases. 463

All dermatites are liable to show special features of inveteracy,
or amenability to treatment according to surrounding condi- ‘
tions—hygienic or otherwise.

GENERAL PRINCIPLES OF TREATMENT OF SKIN
DISEASES.

General and local. Diet: wholesome diet following a laxative : restricted,
generous, vegetable. Rest, avoiding congestion, perspiration, friction,
stretching, pressure. Cleanliness. Diuretics. Purgatives. Tonics. Al-
teratives. Sulphur. Antimony. Phosphorus. Calcium sulphide. Pilo-
carpin. Baths, tepid, warm, soapy, alterative. Emollients, simple, medi-
cated. Drying powders. Protective films. Stimulating and antiseptic
applications. Parasiticides. Caustics. Counter-irritants. Bandages.

' These must be general and local, and the first hygienic, dietetic
and medicinal.

The diet is especially important in eruptions due to poisons
such as green food, distillery refuse, silage, roots, ergoted or
smutty food, musty fodder, irritant plants in hay or grain
feed, buckwheat, etc. In many cases a change to sound fodder
and a laxative to clear the alimentary canal of the irritant, may
be all that is required. In cases where the feeding has been
parsimonious, a judiciously gradual change to a generous diet
may be required. Again when the feed has been unduly rich,
or spiced as in the patent food for stock or the table leavings
for dogs, a plainer, simpler and less exciting diet will be
called for. Indigestions, urinary and hepatic disorders due to
diet may be often corrected by a more judicious ration.

Rest is a most important element in horses and hunting
dogs. When pressure of the harness keeps up the irritation,
or when active movement reopens cracks in the tense rigid
congested skin of the heel, carpus or tarsus of the horse, the
parts must be kept quiescent. When on the other hand chaps
and fissures are caused and maintained by stocking, the patient
may do much better with exercise. In skin congestions which
are aggravated by work and increased cutaneous circulation,
rest is imperative.

Cleanliness is no less imperative. Many cases are started

464 Veterinary Medicine.

and maintained by filth on the skin and in the air of the stable
and hence sponging, currying, brushing, rubbing, are directly
therapeutic. Yet care must be taken to avoid irritation where
the skin istender. In the sensitive heels of the horse congestion,
chaps, and stocking are often determined by washing in ice cold
water and leaving to dry uncovered, in a draught of air, or by
washing with common laundry soap having alkali in excess.
Even tar soap will sometimes keep up the trouble in a specially
sensitive skin. Apart from such exceptional conditions, thorough
grooming is commendable, not only in cleaning the skin, but in
improving its circulation and nutrition.

Diuretics are often beneficial in eliminating from the system
the irritant products generated from ‘disorders in sanguification,
digestion, urinary secretion and hepatic function, as well as those
that are derived from the cutaneous disorder. They tend further
to reduce any existing fever, and to cool and relieve the burning
integument. The alkaline diuretics are often very useful.

Purgatives act in a similar way and are especially indicated
in cases due to ingested irritants, and in such as depend on
morbid products of gastro-intestinal or hepatic disorder. In
many acute attacks these may be said to be almost specific in
their action as in urticaria, and in the eruptions due to distillery
products or green food.

Tonics are often called for to correct dyspepsias, to improve
the general health and vigor, the sanguification and nutrition in
weak and debilitated conditions. Iron, cod liver oil, bitters,
quinia, quassia, calumba, gentian, nux, are often of value in
such cases. ;

Alteratives. Arsenic may be said to act as a tonic with a
special tendency toward the skin where it affects the epidermis
and epidermic products and is applicable to many subacute and
chronic disorders, as psoriasis, acne, dry eczema, and pemphigus.
It has been further supposed to be most useful in superficial
lesions, and in those due to a neurotic origin, from the known
operation of arsenic on the nerves. It is little suited to acute
skin diseases, and though often valuable is not to be trusted as
universally applicable.

Sulphur is often useful as a laxative, but also as a stimulant
to the cutaneous secretions when these are impaired.

General Principles of Treatment of Skin Diseases. 465

‘Antimony is similarly a cutaneous stimulant and is sometimes
useful in chronic inactive conditions.

Phosphorus has been found useful in obstinate cases and
probably acts on the nerve centres in improving nutrition of the
integument.

Calcium sulphide is sometimes useful with free secretion
from the diseased surface, but its action is somewhat uncertain.

Pilocarpin operates by securing free secretion from the skin
as well as from the various mucosz, and seems to benefit by
elmination, as well as by modifying the cutaneous functions and
nutrition.

Local Applications. Baths may be placed foremost among
these. Cleanliness is a prime necessity in treating skin disease.
Tepid or warm water is especially required in acute disease in
sensitive skins. In chronic cases with accumulation of scabs a
soap wash following a 24 hours inunction with oil or lard may
be demanded, but as a rule castile or other ncn-caustic soap
should be used. In certain cases the baths may be advantage-
ously medicated, as with calcium sulphide, potassium sulphide,
salt, alum, tannic acid, tar, creolin, lysol, cresol, chloro-naph-
tholeum, arsenic, mercury, etc. The water alone, is, however,
of great value in soothing and moderating inflammation, soften-
ing and dissolving scabs and epidermis, and relieving the dry-
ness and rigidity.

Emollients are used for the same end as calmatives, and re-
laxing and protective agents. Fatty bodies occupy a front rank,
the bland vegetable and animal oils being not only soothing but
nutritive (cod, lard, olive, cotton, almond, linseed, rape, pea nut,
lanolin, neats foot and goose oil.) Care should be taken that
these are pure and in no sense rancid. Vaseline or petrolatum
are free from the risk of rancidity, yet it should be free from
contamination unless a stimulating action is wanted. Glycerine,
often used as an emoilient,has thedisadvantage of drawing water
from the surface and of actually irritating some sensitive skins.
Glycerol made with glycerine and starchis more soothing. Glyco-
gelatine made with glycerine 5, gelatin 3, and water 9, is very
emollient and protective. This can be made the basis of astringent
sedative and antiseptic preparations by adding zinc oxide, lead
acetate, chrysarobin, salicyclic acid, tannin, sulphur, oil of birch

30

466 Veterinary Medicine.

or of tar, etc. An excellent emollient paste is compounded of zinc
oxide and vaseline one-half ounce of each, salicylic acid, ten
grains. Oleate of lead isan excellent sedative application in irrita-
tion or pruritus.

Drying powders are found in starch, talc, magnesia, zinc
oxide, lycopodium, bismuth oxide, boric acid, iodoform, aristol,
salicylic acid, tannin, and, above all, magnesia carbonate. A
slight addition of morphia sulphate will render them analgesic.
Tar in zinc oxide or bismuth will secure antiseptic and stimu-
lating qualities.

Protective films for irritable surfaces may be had from col-
lodion, or from a solution of gutta percha in chloroform 1:10
(traumaticin).

Stimulating and antiseptic applications are found in tar or
oil of tar in suitable excipient and of a strength suited to the
case, oil of white birch, oil of lavander, oil of cade, oil of cashew
nut, oil of juniper, oil of hemlock, Canada balsam, balsam of
Tolu or Peru, creolin, lysol, cresyl, creosote, carbolic acid,
chloro-naphtholeum, etc. Ichthyol, of great valuein chronic af-
fections, may be used in oil or vaseline (5 : 100), or in the form
of Nuna’s varnish : Ichthyol 40, starch 40, concentrated albumen
solution 1 to 14%, and water 20. Add the water to the starch,
then rub in the ichthyol and finally the albumen. Resorcin isa
useful stimulant, alterative, and antipruritic (1:30 alcohol and

oil).
- As Antiseptics and parasiticides, in addition to the above,
are alpha and beta-naphthol, iodized phenol, chloral camphor
(rub together till they form a clear fluid), phenol camphor (add
camphor gradually to the melted phenol crystals), mercuric
chloride, cupric sulphate and silver nitrate. Potash (green)
soap, medicated or not with tar or other agent, is of great use in
many chronic affections. ‘The phenol combinations are all more
or less anesthetic, and therefore sedative and antipruritic.
Quassia, Stavesacre, tobacco, etc., are-of great usein parasitisms
though not antiseptic. Sulphur fills both indications, and isa
bland, generally applicable agent.

Caustics (silver nitrate, antimony chloride, electric or thermo-
cautery) are useful in luxuriant granulations, hyperplasias, and
often in excessive secretion, or on infected surfaces.

Erythema. LErythematous Dermatitis. - 467

Counter-irritation over the vaso-motor centres, is often of
value, when the distribution of the eruption coincides with that
of particular nerves, and indicates a nervous element in the
causation.

Bandages of various kinds may be demanded to afford sup-
port in threatened dropsical effusion or excessive granulation or
hyperplasia, to protect the surface against outside infection, to
confine volatile applications to the affected part, and to prevent
injury from biting, licking, scratching, or rubbing.

For the same reason it may be desirable to employ a muzzle,
beads on the neck, tying to two opposite rings by short halters,
hobbles, or other means of restraint.

ERYTHEMA. ERYTHEMATOUS DERMATITIS.

Definition, congestion, heat, redness, tenderness without eruption. Sheep :
swine : dogs: white horses and cattle. Causes: slight irritants. Symp-
toms : congestion momentarily effaced by pressure, may go on to a distinct
eruption.

Definition. Congestion of the papillary and adjacent layers of
the skin with heat, redness, and tenderness, or a diffuse super-
ficial inflammation with some superadded swelling.

Genera susceptible. The affection is seen in sheep, swine,
dogs, and in white horses and cattle or on white parts of the
skin. It is not readily recognized on pigmented parts.

Causes. ‘The action of any slight irritant : pressure, friction,
brushing, currying, blows, vesicants, rubefacients, stings, para-
sitism, radiant heat, intense sunshine, cold (reaction), storm,
plunging in cold streams when heated, feeding on stimulating
agents, notably buckwheat. ;

Symptoms. On white skins there is a uniformly diffused red-
ness, without papule or other eruption, and the color may be
momentarily effaced leaving a perfectly white spot, made by the
pressure of the finger. The affected part is warm, tender, and
it may be, itchy. It may be but the first step of a distinct erup-
tion of another kind, such as variola, vesicles, papules, pustules,
but then the affection takes a different name. It has been
named according to its seat, cause and nature as follows :

INTERTRIGO. INTERTRIGO OF CHAFING.

Causes : friction,, inside thighs, side of scrotum or mammue, inner side of
elbow, between digits, on clipped heels, under harness. Dried sebum,
sweat, dust, clay. Pricks with stubble. Symptoms: lameness on starting,
abduction, straddling, knuckling, steps on toe. Treatment: abate cause,
cleanse, rest, dusting powders, zinc, lycopodium, magnesia, starch, bismuth,
alum, lead, morphia, surgeon’s cotton. Carron oil, vaseline, antiseptics.

This occurs where the folds of skin come in contact and rub
on each other as between the thighs or beside the scrotum,
sheath or mammee in fat horses and other animals, on inner side
of the elbow, between the digits in ruminants, on clipped heels
in horses, and under harness. Irritant perspiration and seba-
ceous matter dried on, and mixed with more or less gritty or
septic road dust contribute to it. Drying of clay and mud in
the cleft of the frog, or in the interdigital space of ruminants is a
common cause, also pricking with stubble.

Symptoms. ‘These are most marked when the animal has been
standing with the raw surfaces partially dried and adherent.
After moving for some time, and when the surface has been
moistened by the exudate there may be little lameness. Until
then he moves hesitatingly and stiffly, with the legs abducted or
in case of the hind ones straddling. With intertrigo of the
pastern or frog, the horse stands on the toe or with the fetlock
knuckled forward, and avoids as far as possible a full extension.
The same is true of cattle with interdigital intertrigo.

The affected part is hot, perhaps swollen, red, damp and ex-
ceedingly tender. Under renewed work, lameness disappears,
but becomes worse on standing, and an extensive exudation may
occur subcutaneously. If this becomes infected it may result in
severe and even destructive lesions, but it usually remains simple
and proves readily responsive to soothing and protective treat-
ment. It is most amenable to treatment in dogs and meat pro-
ducing animals of which no work is required. On the contrary
the latter when travelled long distances on foot may suffer
severely.

Treatment, First abate the cause. With castile soap wash

468

Intertrigo. Intertrigo of Chajfing.. 469

from the affected part the dried accumulations of sweat, sebum,

dust and other matters, remove clay from frog, interdigital space

or heels. Rest until the congestion and tenderness subside.

Drying applications in the form of dusting powders are usually
best : zinc oxide, lycopodium, magnesia oxide, may be dusted in

freely after the affected part has been thoroughly exposed and

dried. ‘In the absence of these use gloss starch, corn starch,

farina or white bismuth. To one or other of these may be added

a little alum, lead acetate or morphia. The addition of a layer
of surgeons’ cotton is useful, if in a place where it will be re-

tained. Of liquid applications the veterinarians white lotion (zinc
sulphate and lead acetate, of each 1 oz., water 1 qt.) is one of the

best, being at once sedative and astringent. In may be applied

on cotton. Astringent preparations with glycerine are useful:
but glycerine has the serious drawback of attracting moisture and
increasing the secretion when drying is desirable. Carron oil
(equal parts of lime water and linseed oil) is most effective and
free from this objection. Vaseline alone or medicated with zinc
oxide, lead acetate, alum or tannic acid may.be resorted to when
dusting powders fail. Morphia and camphor have been added

when itching is violent.

In intertrigo of the frog or interdigital space the danger of
infection from the floor or road is so great that the demand for.
antisepsis must overcome other considerations. Calomel freely
applied to the surface, previously cleansed and dried, is most suc-
cessful. It may be bound in place by a pledget of cotton and
bandage. In other cases alum 5 parts, copper sulphate 1 part, or
carbolic acid and tar may be bound to the part.

ERYTHEMA CALORICUM: SOLAR ERYTHEMA.

WHITE FACE AND FOOT DISEASE: IN HORSES.

England to Africa, on white skins, especially of face. Symptoms: local
congestion, swelling, itching, desquamation, during extreme heat : in worst
cases fever, dullness, inappetance, costiveness, diarrhcea, head constantly
moving, rubbing, vesicles, pustules, excoriations, cracks, fissures, septic
ulcers in nose and mouth, submaxillary and pharyngeal swellings, recovery
with dermal thickening and tenderness. Diagnosed from petechial fever
by the itching, and the absence of petechiz. Prevention: breed solid dark
colors, avoid white skinned in hot climates or work in shade, away from
hot winds ; sunshade ; avoid friction and wettingin sunshine. Treatment :
shade, astringents, cool irrigation, vaseline, zinc ointment, lamp black, an-
tiseptics. Tie so as to prevent rubbing.

This has been observed in different latitudes from the cool
climate of Great Britain, tothe burning suns of Africa, though
it reaches its highest intensity in the hotter regions. ‘The parts
to suffer are those that are devoid of pigment, as the white star,
snip or blaze on the face, the white feet or legs, the white areas
in the piebald, and the whole surface in the albino. The white
face, however, suffers more than the white legs, apparently be-
.cause of its more constant exposure, the absence of shadow from
the trunk, and the delicacy of the skin and fineness and thinness
of the hair.

Symptoms. In slight cases there may be no constitutional
disorder, only redness, itching, swelling and subsequent des-
quamation of epidermis on the white portion of the skin, which
may prove persistent so long as hot weather-lasts and recover on
the advent of cold.

The more violent cases seen in warmer climes, may be heralded
by febrile reaction, dullness, prostration, inappetance, constipa-
tion and sometimes diarrhcea. The head may be kept in con-
stant movement, the itchy white parts being rubbed on any
object within reach, and the limbs are stretched, the front ones
forward and the hind backward,. with a tendancy to rub them
with the nose or foot. The skin at first red, becomes later
swollen, covered with vesicles which pass into pustules, burst”

470

Lrythema Caloricum: Solar Erythema. 471

and discharge. Meanwhile the subcutaneous connective tissue
is infiltrated and gravitates toward the lowest parts, causing ex-
tensive submaxillary swellings and stocking of the limbs. In its
worst forms it may go on to necrosis and sloughing, but more
commonly the affected part becomes raw, excoriated, cracked
and fissured. Sometimes the pituita or even the buccal mem-
brane becomes involved, with muco-purulent discharge. In other
cases the absorption of septic products causes inflammation and
swelling of the submaxillary or pharyngeal lymph glands. Un-
-der favorable conditions,the secretions dry, the sores heal and the
exudate is in great part absorbed, but there usually remains some
thickening of the affected parts and a diminished vitality of the
skin, which renders it morbidly sensitive to sources of irritation.

Severe cases might be mistaken for petechial fever, but there
is much more pruritus, and there is an absence of the petechiz, on
the mucosz, and of a tendency to the extension of the disease
far beyond the patches of white.

Treatment. Prevention. ‘This malady should be warded off
by breeding or selecting for warm, sunny climes, animals of a
solid color, and discarding all with white patches. Animals
bred in a cooler climate should not be suddenly transferred to
a hot one. When the animal with white face or feet is found
in the hot sunny climate, it should be devoted as far as pos-
sible to work in the shade (indoors or in mines), or its white
patches should be protected against the full unmitigated rays
of the sun, and the hot winds. Sun shades are useful or in
their absence leafy branches fastened to the bridle so as to
protect the face. It is further important to avoid the friction
of harness on the susceptible parts, or wetting of them when in
the full glare of sunshine. Another obvious precaution is to
keep the white patches well covered with lamp black.

When attacked the animal must be placed under cover and
the eruption treated with cooling astringents, constant irrigation
with cool water, or lotions with acetate of lead, tannic acid,
alum or sulphate of zinc. When the skin is dry and rigid it
may be treated with vaseline, alone or with zinc oxide, lamp
black or any one of the astringents above named. Open sores
may be. treated like ordinary wounds, tense engorgements may

472 Veterinary Medicine.

be drained by punctures followed by antiseptic dressings, and
abscesses may be opened and evacuated.

During the treatment the patient should be tied short to two
sides of the stall, and other measures taken to prevent him
from rubbing or otherwise injuring the affected parts.

BUCKWHEAT ERYTHEMA : FAGOPYRISM. WHITE
SKIN DISEASE.

Form of white face disease, with irritating ingesta, buckwheat, etc.,
occurs from dried products, no insects; growing potatoes ; sunshine ; idi-
osyncrasy. Symptoms: as in white face disease: in winter itching and
rubbing : in summer may go on to nervous symptoms. Treatment: stop
feeding buckwheat. Give laxative and diuretics. Local treatment as in
white face disease.

This may be held to be but a form of the last named affection,
in which, however, certain irritating ingesta (buckwheat, maize,
wheat), are essential factors in addition to the white skin and
strong sunshine. It is seen only on white skins or the white
portions of parti-colored skins, while the blacks, browns and
other colors usually escape. Black breeds of hogs (Essex) escape
under the same feeding and exposure, as do solid colored horses
of the darker shades. Of the different food factors, buckwheat
(Polygonum fagopyrum, persicare, etc.), is the most to be
feared, and the poison seems to be inherent in all the products
(green vegetable, dry seeds, bran and straw) and is not destroyed
by cooking. Buckwheat cakes sometimes produce erythema in
man. This excludes the idea of the transfer of a living crypto-
gam to the skin, though not the theory of pathogenic products of
the fungi. The invoking of bee stings and the bites of insects,
which are strongly attracted to the buckwheat, is untenable
because the affection occurs from the dried seeds, bran and straw,
and has been known to break out weeks after the buckwheat was
withdraw from the ration. ,

In addition to buckwheat, maize and even wheat when liberally
fed have been known to cause erythema. Hemminger records a
similar outbreak in horses working among growing potatoes.

Erythema from Trritants. 473

In addition to the food, clear sunshine is essential and an
individual idiosyncrasy. All animals, though equally exposed
are not equally attacked.

Smptoms. 'These’do not differ materially from those of the
white face and foot disease already described. ‘There are in-
tense redness and tumefaction of the white skin or the white
portions, showing prominently in the delicate parts (ears, eye-
lids, lips), with violent itching, rubbing and sometimes vesicles
with yellowish contents, followed by sores and scabs. In the
winter season there may be itching and rubbing only. In
summer it may become erysipelatoid and extend to the mucosz,
of the respiratory and digestive organs, with hyperthermia, ner-
vous excitement,-vertigo, turning in a circle and even spasms
and convulsions.

Treatment. ‘This is essentially the same as for the white face
and foot disease with this additional that the buckwheat or other
offensive ingredient must be withdrawn from the ration, and
what remains in the bowels must be expelled by saline or other
laxative. Cooling diuretics must follow to eliminate irritant
matters that may have been absorbed.

ERYTHEMA FROM IRRITANTS.

Irritant agents of all kinds, even if caustic or pustulant in con-
centrated forms, may be so diluted as to cause simple erythema.
Among chemical agents we have ammonia, lye, caustic acids and
salts, iodine, carbolic acid, and various tar products, kerosene,
aniline, chloroform, ether, formaline, etc. Of thermic irritants
may be named solar heat, fire heat, steam, hot water, hot air,
and congealation (chillblains, freezing) the latter being especially
common in the digital region when salt has been applied to snow
orice. Vegetable irritants include mustard, capsicum, moulds,
euphorbium, rhus, milkwort, the volatile oils, etc. Among ani-
mal irritants must be named cantharides, mylabris, potato beetle,
insect stings, venom of the irritated toad, liquid discharges from
the kidneys or bowels, and discharges from open sores. Even
the escape of tears upon the face will cause erythema.

474 Veterinary Medicine.

The symptoms in all such cases will vary with the potency of
the factor and the susceptibility of the skin. Besidesthe common .
symptoms the color and odor of the skin will often yield valu-
able diagnostic indications. ‘There is the white of muriatic acid,
carbolic acid or zinc chloride, the black of silver salts or sulphuric
acid, the yellow of iodine, chromium compounds and nitric acid,
the well known odors of ammonia, iodine, chlorine, carbolic acid,
tar, essential oils, chloroform, ether, formaline, kerosene, mus-
tard, etc.

Treatment is that of simple erythema after one has applied the
appropriate antidote to the particular irritant. For the alkalies
and carbolic acid use vinegar, for the acids oxide or carbonate of
magnesia, chalk or lime water, for iodine and chlorine weak al-
kaline solutions, for rhus, ammonia or other alkali, or potassium
permanganate, and for insect stings and animal venoms, alkalies
or permanganates. The caustic salts may demand milk, white
of egg, or some other albuminous solution. When no chemical
antidote is available, the first step is to wash off the offending
agent, and then treat the erythema.

URTICARIA : NETTLERASH : DERMATONEUROSES

Definition. A mild congestion, and exudation into the skin in
the form of circumscribed rounded elevations, it may be sym-
metrical, often becoming confluent, resembling that caused by
stinging with nettles, appearing and disappearing very suddenly
excited by local irritation or auto-poisoning, acting on a specially
susceptible nervous system and skin.

Animals susceptible. Urticaria is comparatively common in
horses and dogs and somewhat less so in cattle and swine.

Causes. ‘The fundamental predisposing cause appears to be
the individual xervous and cutaneo-vascular susceptibility which
resents in this way any irritation to which the skin may be sub-
jected. Thus under the same causative factors some animals are
severely affected, while others are undisturbed. Like nervous-
ness this appears to be at times hereditary, in others it is an
individual idiosyncrasy, while in still others it is roused by some
weakness or morbid condition of the system, as after some
specially debilitating disease, or some abnormal fermentation
process in the system.

On the white and delicate human skin this may be especially
marked, the line drawn by the nail or a blunt lead pencil becom-
ing the centre of a promptly evolving, spreading eruption, last-
ing for a variable time and even appearing again and again. In
some animals, and especially in horses, a similar susceptibility is
shown, so that the stripe of the whip or friction of the harness
produces such irritation that it is impossible to keep the subject
at work.

It has been especially noted in army horses in low condition,
shedding the coat tardily, with coat harsh. and dry, skin hide-
bound, and in such as become rapidly plethoric on grain feeding or
rich spring grass. Again a rainy or stormy season, electric ten-
sion, hot moist summers, pregnancy, and lactation seem etiological
factors.

The exciting cause of the affection may be the stings of nettles
on the most delicate portions of the skin. In the same connec-
tion may be named pozson ivy (rhus toxicodendron), poztson
sumach (rhus venenata), the Thus diversiloba of Pacific Coast,

475

476 Veterinary Medicine.

and the rhus pumila of West North Carolina. Any one of these,
like o7/ of turpentine (Friedberger—Frohner) will rouse the special
susceptibility of the morbid skin and system.

The same may be said of the bites or stings of insects, especially
such as instil an irritant venom—the harvest mite (trombidium
holosericeum and Americana, Schindelka), chigoe, wood ticks,
hairy caterpillars, (bombyx pityocampa, Pourquieur), acanthia,
(bed bug), flea (pulex), biting fives, bees, hornets, etc.

The most common exciting cause of urticaria is, however, from
within, and especially from the circulation in the blood of pozsons
generated in the alimentary canal from particular disturbing
kinds of food. These operating on the susceptible skin and
nervous system determine the nettle rash as promptly and
severely as will the local irritant or the instilled venom. Among
such unwholesome or exciting foods may be named buckwheat,
Indian corn, green potatoes, partially ripened oats or other grain,
and leguminous seeds, especially if only partially matured.
Some animals have a special susceptibility to given articles of
food which are in no sense injurious to their fellows but which
promptly develop in them a marked urticaria. In other cases
an overfeed or an ordinary feed given when the animal is heated
and exhausted, failing to meet with prompt antisepsis and diges-
tion, passes into fermentation and determines a local irritation
and general poisoning which issuesin urticaria. A sudden ex-
treme change of feed will at times operate in the same way. A
sudden change from dry to green food has been particularly in-
criminated.

Other poisons produced in certain morbid processes have a
similar result. ‘Thus it has been observed to supervene on invet-
erate skin disease in the dog; on strangles in the horse ; on
erysipelas (rothlauf) in swine. It has appeared in the horse
during pustulous dermatitis, acne, and chronic eczema. Finally
it may be seen as a complication of renal disorder, or hamoglo-
binuria and even as the result of a sudden chill from plunging
in cold water, or standing in a cold rainstorm or draught, after
profuse perspiration. These all bespeak the presence of poisons
in the system, and suggest that still other conditions and their
resultant poisons may cause the same eruption. Lunwitz has
seen cases in pigs following exposure to the burning rays of the
sun.

Urticaria: Nettlerash : Dermatoneuroses. 477

Symptoms. Horse. A marked feature of the disease is its
sudden eruption. In two or three hours, a healthy skin, may
become covered with a nearly uniform eruption of projecting
nodules, varying from the size of a pea (Friedberger—Froéhner),
to one or two inches in diameter. ‘The nodules may stand out
¥% to 3% inch, and, when they become confluent, they form
extended patches of even greater thickness causing the unsightly
enlargement of the lips, nostrils, chin, cheeks, the whole lower
part of the head, the head asa whole, the sides of the neck, shoul-
ders, breast, dorso-lumbar region, abdomen, or even excep-
tionally of the legs. The engorged lips and eyelids become use-
less and the legs stiff and stocky. The hair covering the nodules
is dry and rigid, standing erect, and materially encreasing the
distortion. ‘The surface of the nodules, on a bare and hairless
part, is pink, or on pigmented parts purple or violet. Itching
may be present but is not usually a prominent feature. In the
milder cases the nodules may be few and isolated from each other
(discrete), in the more violent they become confluent, covering
an immense area or almost the entire skin. The individual
nodules often subside and disappear as rapidly as they came, but
as one crop is liable to be followed by another the condition may
be kept up for a considerable time. Schleg and Schindelka note
invasions of the mucose of the nose and vulva. |

Symptoms. Cattle. ‘These resemble in the main those seen in
the horse. ‘There is the sudden eruption, the large nodules vary-
ing from a walnut to the fist, the erect hair sometimes drawn
together into a pencil, and it may be matted with a dried exu-
date, the red surface of the affected white portions of skin, the
comparative absence of pruritus, the transient character of the
lesion, and the eruption of one crop after another. The nodules
are more likely than in the horse to develop small vesicles and to
exude a liquid which mats the hairs, and when dry and encrusted
this tends to lift the hair from the follicles, leaving bare spots of
a circular outline. The nodules formed near the natural open-
ings may extend on the mucose of the eyes, rectum, vulva
(Lipperlein) or even the nose. In the latter situation they inter-
fere seriously with breathing through the narrow nasal cham-
bers.

Symptoms. Dog. These follow the same course, the disease mak-

478 Veterinary Medicine.

ing a sudden eruption after spiced food, meat diet, putrid meat, or
anentire changeof aliment. The occasion may have been violent
exertion, thé irritation of vermin on the skin, or the presence of
the deleterious products of other diseases. Schindelka quotes a
general urticaria in connection with oldstanding mange; and a
second which invaded the ears uniformly, and more sparingly
the head and neck in connection with a condyloma and catarrh
of the vagina. The sudden eruption, the great thickening of
the skin without vesication, the speedy subsidence and the reap-
pearance in many cases, further ally it directly with urticaria in
the horse. The dog shows considerable pruritus and by licking
and scratching, the scurf skin is often removed leaving red bare
patches.

Symptoms. Swine. In connection with a sudden change of
diet, or with offensive fermented food, with inappetence,
diarrhcea or constipation and sometimes vomiting and slight
hyperthermia, the eruption takes place in a few hours. It
shows on the back, sides, and lower surface of the body, on the
shoulders, arms or thighs. The individual nodules may be one-
third to an inch in diameter, or by confluence they form exten-
sive patches or bosses, having it may be a white centre with a
pink or violet periphery, or black hzemorrhagic spots. ‘They
may disappear suddenly or they may transude serum and form
scabs, which falling leave a deep red surface.

General and Intestinal Symptoms. In the different genera
hyperthermia keeps pace with the extent of the eruption. In mild
cases it is usually absent, while in severe, general urticaria the
temperature may rise 1° or 2” or more. ‘Derangements of the
digestive organs are common as may be inferred from the frequent
presence of unwholesome or indigestible food as an etiological
factor. In the horse, ox, or dog there may be impaired appetite,
abdominal distension or rumbling, slight icterus, intestinal
catarrh, diarrhoea or costiveness. The nodules all end by an abrupt
margin, without gradual shading into the healthy skin as in
other inflammations.

Diagnosis, From farcy this is to be distinguished by the
suddenness of the eruption, by its tendency to bilateral symmetry,
by the absence of any disposition to follow the lines of the lym-
phatics, or to soften, producing abscesses or ichorous sores, and
finally by its disposition to an early and complete recovery.

Urticaria : Nettlerash ; Dermatoneuroses. 479

From cutaneous stvangles it is again distinguished by the
rapidity of its appearance, progress and subsidence, by the com-
parative absence of fever, of nasal discharge, and of submaxillary
swelling, and by its indisposition to form purulent centres. Nor
is it confined to solipeds that are young and still susceptible to
strangles.

From. petechial fever it differs in the absence (usually) of the
predisponent disease (strangles, influenza, etc.), of the marked
toxeemic prostration which accompanies the latter; of the pre-
sence of the early petechize, punctuate or in patches, on the
pituita, and other visible mucosze and on the skin as a precursor
or coincident of the nodules; of the early and free serous or
bloody oozing from the nodules; of their marked disposition to
persist ; of their predilection for the limbs and dependent parts
of the trunk ; and of their tendency to form extended clishions
and sloughs. .

From the eruption caused by green alfalfa and other legumes it
it is distinguished by its very rapid evolution and equally speedy
disappearance, by the much larger size and flattened surface of
the individual nodules, by the absence of the focus of suppura-
tion and of the resulting open sores.

From swine erysipelas (rouget) the distinction is clear in the
absence of the characteristic fever and prostration, in the presence
of a common, usually alimentary cause, and in the absence of all
indication of infection. ‘The malady lasts from forty-eight hours
to five or six days and usually ends in recovery.

Treatment. As the fundamental cause of the disease, the in-
dividual or racial susceptibility, is a constitutional condition,
usually beyond the reach of medicine, attention must be given
to the immediate or exciting causes of the malady. The vege-
table local irritants and animal venoms must be guarded against
or treated, by soothing measures or antidotes. Special care
should be exercised at the period of moulting, in spring, and
during the heats of summer. Careful grooming, and a moderate,
laxative, non-stimulating diet will be of value. But above all
attention must be given to the elimination of the irritant pro-
ducts of intestinal fermentation. In the pig or dog this may be
largely accomplished by emetics, such as a teaspoonful of ipe-
cacuan wine. In all animals aperients may be given and asa rule

480 Veterinary Medicine.

a saline (Glauber salts, Epsom salts, or for dogs, calomel). In
the horse aloes acts well, the eruption often disappearing as soon
as encreased secretion and peristalsis sets in, and long before
purgation is shown. A general, unsightly, eruption will dis-
appear in a night so that in the morning the animal seems in
perfect health. In other cases several days elapse before the
urticaria entirely disappears. In such cases alkaline diuretics
may be given (bicarbonate of soda, acetate of potash, borax,
cream of tartar). Bitters (nux vomica) will prove of value in
restoring the deranged tone of the stomach. Antiferments like
naphthaline, thymol, or calcium sulphide may be resorted to.
In obstinate cases arsenic with excess of bicarbonate of soda or
potash will sometimes prove of value.

Locally the irritation may be reduced or annulled by applica-
tions of cold water, by salt water, by weak solution of potassium
or sodium carbonate, by permanganate of potash, or by carbolic,
menthol, or chloral lotion. Carbolic acid 2 drs., alcohol 2 ozs.,
and glycerine 2 drs., in a pint of water, has been specially rec-
commended.

After recovery a moderate, slightly laxative and easily digesti-
ble diet should be given. Indeed in mild cases the simple regula-
tion of the diet will be effective, without internal or local medica-

tion.

PRURITUS. ITCHING. HAUTJUCKEN.

Definition. A functional nervous disorder, characterized by
intense itching and disposition to rub and scratch, without any
appreciable structural change in the skin of the part.

Causes. ‘Though itching is shown in nearly all skin diseases
at some part of their course, yet that is sufficiently accounted
for, by the local lesions, congestion, papules, scurf, vesicles,
pustules, rigidity, etc., and above all by the presence on the
integument of vegetable or animal parasites which create an active
irritation. But such pruritus is essentially symptomatic of the
visible local cause and is to be classed under ‘the head of the
particular disease, eruptive or parasitic, of which it is so promi-
nent a feature. In pruritus on the other hand the itching is the

,

Pruritus. Itching. Hautjucken. 481

only obvious symptom, and if local structural lesions appear, it is
purely the tesult of scratching, rubbing or tearing.

The pruritus of the skin may, however, be a symptomatic
manifestation of some deeper source of irritation, as in the case
of the inveterate rubbing of the tail in horses suffering from
sclerostomata or oxyuris, or even cestrus larve in the rectum,
the rubbing of the nose in dogs suffering from pentastoma, and
in sheep harboring cestrus larve in the head; the licking and
dragging of the anus in dogs suffering from whip-worm, uncinaria,
ascaris, or teemia : or an itching of the nose in different animals
in connection with gastric or intestinal worms.

Some of the conditions that give rise to urticaria may appar-
ently lead to the simple inveterate itching. Thus various gastro-
intestinal irritations create a neurosis of the skin, which is con-
tinuous with the intestinal mucosa and in the most intimate
nervous sympathy withit. The mad-itch of the western states
has been traced to impaction of the omasum and irritation of the
other stomachs. Yet the pruritus is so intense that even the
large ruminant rubs, scratches, and lacerates with its teeth the
affected parts of the skin. In dysentery cattle sometimes rub
the root of the tail and buttocks until the soft tissues are worn
to the bone (Trumbower). In both horses and cattle a chronic
indigestion is at times associated with universal pruritus (Haub-
ner). In victims of rabies, in which lesions of the throat and
stomach are often pronounced, itching may be so inveterate that
the victim tears his body and limbs with his teeth. Disorders of the
liver, which inevitably entail intestinal troubles are at timesa cause
of cutaneous pruritus. Again affections of the kidneys, with im-
perfect elimination of irritant waste products become an active
cause of itching without visible structural change. Other cases
might be attributed to nervous derangements as in rabies, and
even to disorders of sanguification. The chill in passing from a
hot building to cold wintry air may arouse it. The more cer-
tainly the affection is the result of a nervous reflex, the greater
its title to be considered pruritis.

Treatment, The most important thing is to discover and re-
move the cause. If intestinal parasites vermicides may prove
successful. If impacted and congested omasum in cattle 1 Ib.

31

482 Veterinary Medicine.

each of Epsom and common salt in 4 to 6 quarts warm water,
followed by free access to pure drinking water may suffice. If
needful a continuance of the same in smaller doses may be re-
quired. In indigestions saline, or in the horse aloetic, or in the
dog oleaginous laxatives with nux vomica or other bitters may be
used. Other tonics, like iron, arsenic, or echinacea may follow.
Where there is persistent intestinal fermentation, antiseptices may
be valuable: hyposulphite of soda, calcium sulphide, naphthol,
creolin, or sodium salicylate. In hepatic disorder calomel may
prove useful. Where no definite internal disorder can be made
out, the nervous irritability may be counteracted by a course of
bromides.

Local remedies are chiefly in the line of quieting nervous ex-
citement. Lotions of carbolic acid (1 : 100), thymol (1 : 100),
salicylic acid (1 : 100), naphthol, camphor, or creolin may serve
as examples. When a mucosa is implicated a cocaine (6 : 100),
or morphine solution may be tried, and balsam of peru, borax,
boric acid and chloral, have their advocates.

DERMATITIS.

Under this head may be included a class of inflammations of the
skin, due mainly or entirely to external causes, not essentially
parasitic, and attended by distinct eruptions (papular, vesicular,
pustular, etc. Many of these are but an advance beyond the simple
erythematous inflammation,and coincide with it, the one condition
being present at one part of the diseased area, and the more ad-
vanced and severe lesions at another part. Bearing in mind the
frequency of this connection, it will be unnecessary to dwell at
length on this class of affections.

Dermatitis Traumatica. Dermatitis from Mechanical
Injury. Besides the irritant factors already named as causing
traumatic erythema, we must here recognize contusions, over-
reaching, treads, interfering, bruising and chafing by harness,
girths, circingles, hobbles, ropes, traces, twists, and blows with
whip, club, chain or rope. Here the source of injury must be re-

Dermatitis. ' 483

moved, by attention to shoeing, harness, etc., and the lesions treat-
ed according to their gravity as simple wounds.

Dermatitis Venenata: Dermatitis Calorica. These, like
the corresponding erythema, come from contact with irritant
plants or animals or their products, from excessive heat or cold,
and may show any grade of eruption or even gangrene and slough-
ing. Apart from the washing off of the irritant or venomous
matter and the application of alkalies or permanganates in the case
of the latter, these must be treated like ordinary sores. In burns,
especial value attaches to solutions of sodium bicarbonate, and
preparations that will exclude the air. Vesicles may be emptied
by puncture and the part covered with cotton soaked in carbolated
sweet oil and lime water, or carron oil (linseed oil and lime
water) may be freely applied, or a resorcin solution (2 : 100 water),
or a thick varnish of linseed oil and litharge, equal parts, with
5 per cent. of salicylic acid, melted and painted over the surface.
A layer of surgeon’s cotton covered by a rubber bandage where
admissible, will complete the dressing. In the process of healing,
skin grafting may be required. Thin slices of cuticle are placed
in the center of the granulating surface, or at intervals and care-
fully bound in place. —

When a part has been frozen the usual method is to recover
circulation slowly by rubbing with cold water or snow. The
parts are then treated by astringent and antiseptic dressings. If
the skin sloughs use antiseptics until it separates, and then treat
like an ordinary sore.

Chillblains may be treated with a mixture of sweet oil, 5 ozs.,
oil of turpentine % oz., Aqua Ammonia ¥% oz., oil of peppermint
1 dr., or powdered camphor Io grs., Peru balsam 20 drops, lin-
seed oil 2 ozs. Nourishing food and a course of iron should be
given.

Dermatitis Medicamentosa. Medicines given by the mouth
sometimes cause inveterate skin eruptions. Among these are ar-
senic, belladonna, bromides, iodides, mercurials, salicylates, tan-
sy, turpentine, tar, and the carminative seeds and oils. The
latter are chargeable with many eruptions in live stock fed on
patent foods. In cattle treated with iodides for actinomycosis,
an universal eruption and desquamation is a common condition. -

484 Veterinary Medicine.

In all such cases the drug must be withheld, the bowels cleared
out by a purgative and the elimination of any remaining irritant
products favored by gentle diuretics.

ECZEMA. A BOILING OUT. A PUSTULE.

General method of eruption. Successive advancing lesions. Definition.
Causes : usual factors and special susceptibility.

This term, standing for what boils out, has long been applied
to vesicular eruptions on the skin, but inasmuch as the inflamma-
tion rarely stops short with vesiculation, but usually in part at
least goes on to more advanced lesions, it must be held to in-
clude in many cases erythema, papules, vesicles, pustules, crusts,
desquamations and erosions. All of these may co-exist or suc-
ceed each other in the same subject, so that considerable latitude
must be allowed to the name to cover all parts and stages of the
same attack. Dermatologists have defined eczema as a non-in-
fectious inflammation of the skin with multiform manifestations,
but recent observations would indicate that it may at times, at
least, be contagious, and micro-cocci have been found in the
serum of the vesicles, while the very occurrence of pus must vir-
tually imply the existence of a bacterial infection. Doubtless
different diseases pass under this name in the different genera
and species, and even in the same variety of animals, yet until
we learn to discriminate sharply the one from the other, it is
convenient to consider the whole as a kindred clinical group, if
not a pathological entity.

Definition. An acute or more frequently, a chronic inflamma-
tion of the skin and sometimes of the mucosz, characterized by
itching, erythema, papules, vesicles, serous or sero-purulent
exudation with squama or crusts and loss of hair, and usually
largely due to an internal cause. The exudative condition has
suggested a catarrh of the skin.

Causes. ‘These are the usual causes of skin disease, local and
general, together with a special susceptibility, under which, what
are ordinary irritants produce this characteristic disease. Many
local irritants can produce eczema, but again it is often the case

Acute Eczema in Solipeds. Dorsal Aspect. 485

that these factors will operate on a given susceptible subject
while on another they are without much effect. This suscepti-
bility is called a ‘‘dartrous diathesis’’ by the French writers,
while most English and American writers are willing rather to
find the hidden cause or causes in the disorder of internal organs
(digestive, hepatic, urinary, generative, hzematic, trophic, infec-
tive, plethoric, atonic).

ACUTE ECZEMA IN SOLIPEDS. DORSAL ASPECT.

Head, neck, shoulder, back, under girths, breeching, crupper. Summer.
Moulting, Heavy coat. Thinskin. Youth. Symptoms: erect hair, pa-
pular groups, hot, thick rigid skin, itching, abrasion, ulceration, encrusting,
pustules, white spot and hair. Treatment: laxative, cooling diet, cleanli-
ness, pure air, shade, rest, alkalies, locally vaseline, astringents dusting
powder, anodynes, tar water, creolin, etc.

This shows itself especially on the head, the sides of the neck,
under the collar, or saddle, the circingle or crupper, the breech-
ing or general surface. In these cases the profuse secretion
of sweat, and the friction of the harness is a marked local factor
in its production. It often shows a preference for the summer
season, the period of shedding the coat, the heavy coated ani-
mal, the animal with white, thin or delicate skin. Youth also
predisposes.

Symptoms. There is usually erection or roughness of the
hair, and the formation at such points of minute’ papules like
small peas collected in groups. The skin may feel hot, thick-
ened, lacking in pliancy, not to be pinched up in folds, the
panniculus is contracted, and manipulation shows tenderness.
Soon the papules flatten and desiccate and more or less violent
itching sets in. The patient rubs or scratches himself, causing
deep red congestion of the surface or even abrasion, or ulcer-
ation. Apart from abrasion the skin becomes covered with
crusts or even scales which agglutinate tufts of hairs and dry
up and desquamate.

In -other cases the eruption advances from the condition of
papules to that of vesicles and even of pustules, though finally
drying up with the same pruritus as in the papular form,

486 Veterinary Medicine.

In either case the affected parts are more or less depilated, red
if on unpigmented skin, grayish and scabby or scurfy if on the
darker. At times, after recovery, the patch remains devoid of
pigment and hairs growing from it are white.

Treatment. It is usually desirable to clear out the prima viz
by aloes or Glauber salts, to resort to a carefully regulated, non-
heating diet, to clean the skin of all concretions from sweat or
otherwise, to give pure air and shade and to protect the animal
from active exertion, profuse sweating and friction by har-
ness or otherwise. In the early stages benefit will often come
from the use of alkalies, especially sodium bicarbonate. Locally
an inunction with vaseline to soften crusts, and the subsequent
removal of these with tepid water, may be followed by some sooth-
ing or astringent application, always bearing in mind that what is
soothing to one skin may be irritant to another. Dusting powders
(starch, lycopodion, magnesium carbonate, oxide of zinc, calamine,
bismuth) will often do good; or soothing lotions or liniments (lead
acetate with laudanum, lime water and olive oil ; sodium bicarbon-
ate in well boiled gruel of oatmeal or marsh mallow ; zinc oxide or
sulphate in water or glycerine or as ointment in vaseline, etc.,
etc). .Inchronic stages with much squama and pruritus tar water
or ointment; a lotion of tar and alcohol; creolin lotion; chloral
lotion ; or other stimulant application may be used.

CHRONIC ECZEMA OF THE HEAD IN SOLIPEDS.*

Affects face, eyelids, cheeks. Symptoms: papules, vesicles, dry, rigid
skin, scurf, glistening, shedding hairs, Treatment: as in eczema; anti-
septics.

The chéeks and forehead are the most liable to sufferin this af-
fection, yet the eyelids and the parts below the inner canthus
may participate in connection with the escape of tears and the
disease of the lachrymal sac or ducts. It has been seen in the
young when strangles had merged into skin eruption, but also in
the aged and independently of that affection.

*Acute eczema of the heels, See chapped heels and grease,

Chronic Motst Eczema at the Mane and Tail. 487

Symptoms. Following strangles the papules or vesicular eruption.
may have passed leaving the skin thick, rigid, dry and scurfy.
The pigment may be increased and the hairs are usually shed in
connection with atrophy of their follicles and rubbing of the
itching surface, so that the cuticle is smooth, glabrous and even
glistening. In implication of the lachrymal apparatus, there is
shedding of hairs beneath the eye or the wet matted condition of
those that remain. ;

Treatment. In strangles use a lotion of silver nitrate or sodium
hyposulphite to destroy the local infection. In other cases treat
as for ordinary eczema.

.

CHRONIC MOIST ECZEMA (IMPETIGO) AT THE MANE
AND TAIL,

Fleshy neck, thick mane and tail, lymphatic constitution, profuse per-
spiration, lack of cleanliness, alkaline soaps, plethora, foul stable, pus mi-
crobes. Symptoms: itching or tenderness, shedding hair, thinning of
mane and tail, skin thickened, ridges and folds, tenderness, moisture,
crusts raise hairs from follicles, foetor, sores and ulcers, matted hairs.
Treatment : remove general and local causes, cleanse, cool, pure stable,
clip, reduce grain ; cooling, laxative food, soothing or stimulating applica-
tions, zinc oxide, talc, olive oil and diachylon plaster, iodoform, silver ni-
trate, oil of cade, or of white birch, sulphur iodide, Canada balsam and sul-
phur, green soap, dusting powders, ointments.

This condition is especially common in horses with a profusion
of long hairs in the main and tail, and in the heavy draught ani-
mal with a thick, fleshy neck. Insuch the skin is very sensitive
and when profuse perspiration soaks the skin, or concretes and
decomposes about the roots of the hairs, the local irritation
necessary to the production of the eruption is present. A lack
of careful grooming is therefore a common cause, yet soap left.
in washing the mane or tail may be no less injurious. Plethora
has its influence in many cases, and the ammoniacal fumes from
a wooden stable saturated-with excretions are not to be ignored.
Finally in cases accompanied by pustular eruption, the pus.
microbes must be recognized as factors.

Symptoms. ‘There may be marked itching or extreme tender-.
ness of the the part affected or in the absence of both there may

488 Veterinary Medicine.

occur a gradual shedding of the long hairs, so that an increasing
thinness of the mane and tail (rat tail) becomesapparent. The
skin covering the affected parts is thickened, inflamed and thrown
into ridges and folds, one rubbing against another. The surface
feels moist or is covered by crusts formed by the condensation of
the moist exudate, and embracing the hairs and drawing them
out of their follicles. Beneath the concretions the skin is soaked
in the tenacious feetid liquid discharge. The hair follicles become
atrophied in connection with the evulsion of the hairs, or under
congestion the hairs stand rigidly erect, and bristly or curly. As
the freer secretion abates, the exudate become more purely
scaly or encrusted, but the skin remains thickened and thrown
into folds. Under the inveterate rubbing or gnawing the skin is
often extensively abraded and large open sores are formed which
are indolent and slow to heal. That matting together of the hairs
which has been known as plica Polonica is often the result of the
disease of the hair follicles and the accumulation of scabs which
takes place in this disease, rather than to a special infection like
gregarina (coccidiosis).

Treatment. ‘The first consideration must be to remove all
general and local causes of eczema, insure perfect cleanliness and
good grooming in any case in which these may be lacking,
purify the air of the stable if that has been foul, procure a cool
environment when that has been too hot, clip the patient if habit-
ually soaked with perspiration by reason of a heavy coat, suspend
or moderate the work if that has been too exacting, withhold a
heating grain ration (corn, buckwheat, barley, wheat, peas,
beans), and furnish cooling, laxative, easily digested food. In
the cases before us the acute, irritable stage has usually passed,
so that the more stimulating applications may be safely used,
yet in many old standing cases a fresh eruption may have taken
place, which would demand for a time the most soothing applica-
tions only. Apart from such cases the more stimulating dress-
ings are applied at once.

The affected surface is exposed by clipping or shaving off the
long hairs, thus at once removing a source of heat and irritation
and allowing of the direct and thorough application of the dress-
ing. Among the astringent and stimulant applications oxide of
zinc ointment and benzoated oxide of zinc are among the sim-

Chronic Moist Eczema at the Mane and Tail. 489

plest and least likely to irritate, but the stronger applications can
usually be borne. ‘The Lassar paste consists of two parts each of
finely powdered talc and zinc oxide, four parts of vaseline and
three per cent. of salicylic acid. Oxide of bismuth may substi-
tute the zinc oxide. Three parts of olive oil and four of diachy-
lon plaster melted together and stirred until cool, makes another
mildly astringent and sedative application. Jodoform 1 dr. toan
ounce of vaseline is an excellent agent. A mixture of iodoform and
tannin is used as a dusting powder by Friedberger and Frohner:
or silver nitrate solution (6 : 100) may be used. T'ar ointment (1:8)
with a little subcarbonate of potassium added makes an excellent
application. Oil of cade and oil of white birch may be used in the
same way, the latter being the most desirable asa rule. Ammonia
chloride of mercury as an ointment (1:10), often acts well and
the black wash, formed by the decomposition of calomel with
potash is frequently serviceable. Iodide of sulphur and vaseline
(1:10) is also an excellent resort: An ointment of equal parts of
Canada balsam and sulphur or iodide of sulphur in four parts of
vaseline is often affective. Other valuable preparations are
ointments (10% ) of ichthyol, naphthol, chrysarobin or pyrogallol.
Hebra’s d/ast resort of green soap is never to be forgotten, the
affected skin being thickly smeared with the soap which is left
to dry on, and is repeated and rubbed in, for several days in suc-
cession. It may seem at first to aggravate the disease by reason
of the solution and removal of the covering of the vesicles or
pustules and the exposure of a pink sensitive surface, but day by
day this improves and the skin becomes smooth and more nat-
ural. After a few days of this treatment, it may, if necessary, be
followed by astringent or stimulant dressings, or the varied
medicaments may be incorporated with the soap so as to form
one dressing to be applied from the first. When a healthy action
has been once established, all that is required further may be
cleanliness, with the use of bland dusting powders or ointments
to establish the cure.

CHRONIC ECZEMA OF THE CARPUS AND TARSUS ;
MALANDERS : SALLENDERS.

Eruption in bends of carpus and tarsus and downward: Causes: lym-
phatic temperament, constitutional predisposition, deranged internal
organs, excessive secretions, modified, congested skin, friction between
dermal folds. Symptoms: stiffness, heat, thickening and redness, vesicles
or oozing, crusts, erect hairs, shedding’ hair, squamz, cracks, abrasions,
fissures, subcutaneous engorgement, lymphangiectasis. Treatment : Cleanse,
get pure air, regular exercise, non-stimulating food, avoid cold water, mud,
slush, caustic soap, lime, sharp sand, foul organic matter. Massage. Light
bandages. Bland ointments Dusting powders. Rest. Iodoform. Starch.
Zine oxide. Boric acid. Magnesia. Bismuth. Lycopodion. Lead.
Tannin. Pyoktannin. Stimulating ointments. Green soap. Arsenic.

The bends of the carpus and tarsus in heavy, lymphatic, coarse
skinned horses are especially subject to eczema followed by a
dense scabby eruption, which in the old farrier’s nomenclature
was known as malanders in the fore limb and sallenders in the
hind. It is not always confined to the joints but may extend
down the limb, especially on the back, where the hair is coarser
and the skin thicker, as far as the fetlock or even to the hoof.

In the matter of causation much depends on the general con-
stitutional state which tends to eczema, and on the torpor or
derangement of some of the internal organs the functions of which
are interdependent with those of the skin. Something too must
be attributed to the freer secretions of these parts in coarse bred
horses, to the accumulation of such secretions and of extraneous
irritants under the long hair, to the sluggishness of the circula-
tion in the limbs which has to overcome the force of gravitation,
and to friction between the thick folds of skin in flexion, and
stretching in extension. Swelling of the lower limbs is at once a
cause and an effect of the disease.

Symptoms. At the outset the animal may be seen to move
rather stiffly, and the skin is found to be hot, thickened and if
white reddened. Soon a close observation may detect the
eruption of vesicles, or simply an oozing of a yellowish or bloody
serum which concretes around the hairs forming an encrusted cov-

490

Chronic Eczema of the Carpus and Tarsus. 491

ering for the part, holding the hairs erect and bristly, and even
lifting them out of their follicles. Cracks also appear in the
depth of the fold, leading to a more abundant exudate, and the
disease-may extend around the whole surface of the limb.

In the more acute cases this may be followed by more or less
depilation, desiccation and recovery, but too often the condition
becomes chronic, the thickened, encrusted or squamous skin
continues to exude, crack and cover itself with crusts, under
which the decomposing liquids macerate and irritate the ex-
posed cuticle, and engorgement of the whole limb with hyper-
plasia of the connective tissue and lmyphatic plexus and vessels
is the result. This hyperplasia of the skin and connective
tissue (elephantiasis) is also a common result of lymphangitis.

Treatment. As in other skin affections attention must first
be given to removal of the causes. Ensure cleanliness, pure
air, regular exercise, non-stimulating food, the avoidance of cold
water, melting snow, soapy washes and all other sources of ir-
ritation. Deep mud, especially if charged with lime, sharp sand,
decomposing organic matter or other irritant, is particularly
offensive.

Hand rubbing (massage) of the limbs and evenly applied light
bandages are often of. the greatest value in dispersing or obviating
swelling.

The slighter attacks may be met at the outset by bland oint-
ments or dusting powders and rest from all but necessary exer-
cise. Dressing with iodoform may bring about a recovery ina
few days. Starch and oxide of zinc, boric acid, magnesia car-
bonate, bismuth or lycopodion may give good service. Lotions
of lead acetate, tannin, iron sulphate, alum, potassium perman-
ganate or pyoktannin may be used as in other forms of eczema.
In obstinate cases green soap followed by stimulating ointments
or liniments, tar, oil of white birch, Canada balsam, turpentine
and glycerine, oil of cade, etc., will often serve an excellent
purpose. In these advanced cases an alterative such as arsenic

may be employed.

ECZEMA OF ALIMENTARY ORIGIN IN CATTLE.

STARVATION MANGE. STALK'DISEASE. MALT ECZEMA.
POTATO ECZEMA.

In low condition : erythema, hemorrhagic extravasations, or vesicles on
tail, lips, fore legs, udder. Trombidium holosericeum. Malt or potato
eczema : marc eczema on legs and body. Causes: feeding on marc only,
skins, green potatoes, fermenting. Attack in ratio with marceaten. ‘Worst
on new stock, and feeding cattle. Calves have diarrhoea, children eruption.
Bean trefoil and milk sickness act similarly. Solanin. Unaffected by boil-
ing. Season. Field. Chlorophyl. Narcosis absent. Is brain ada:table?
Other ingredients inoperative. Eczema ceases with change of food: is not
inoculable. Symptoms: fever, costiveness, inappetence, red mucosz, weep-
ing, stringy salivation, debility, emaciation, black diarrhcea. May lie with
extended head, grinding teeth, tympany, lethargy, coma. Pig and dog
vomit. Abortion. Redness, swelling, stiffness in pasterns: may extend to
whole body : exudations: thick crusts: erect or shed hairs: rigid thick-
ened, folded, cracked skin, buccal mucosa may suffer: abscess, sloughs.
Mortality slight and up to 20 per cent. Lesions: congestions of small in-
testine, brain and muscle. Treatment: stop or lessen the mare adding
grain: turn to pasture: locally bathe, cold or tepid : lead lotions: dusting
powders: tannin: blue stone: creolin: creosol : tar or birch oil: carbolic
acid.

The skin of cattle seems to suffer more than that of other ani-
mals in connection with the ingestion of poisons. In starved or
very low conditioned animals, eruptions are met with which may
be in the form of a simple erythema, a heemorrhagic extravasa-
tion in spots, or an eruption on the end of the tailin the form of
epidermic concretions or pustules (impetigo). Among the vine-
yards it is common to find an eruption with papules and vesicles
on the lips, fore legs and udder of cows which were fed on the
succulent young shoots and leaves of the grape vine. In cases
of this disease, Railliet and Moreau have found a great number
of the silky trombidium larve (harvest bug), and accordingly
attribute the affection exclusively to their attacks. The growth
of the vine on the warmest and sunniest exposures, the most
favorable to the propagation of this acarus, gives much support to
this conclusion.

Malt or Potato Eczema. On thecontinent of Europe where

492

Eczema of Alimentary Origin in Cattle. 493

potatoes are largely used. for distillation and the production of
starch, herds of cattle are fed often almost exclusively on the re-
fuse or marc, and in such herds an eczematous eruption of the
legs and exceptionally .of the body is a familiar occurrence.

Causes. ‘The disease has been definitely traced to an exclusive
dietary on potato marc, and still more so to the skins, to tubers
rendered green by exposure to the sun, and to the distillery
potato refuse which has undergone fermentation. Thus 80 litres
of the pulp daily without dry food will determine a violent attack
in the animal consuming it, while the animal consuming 40 litres
has it much milder (Friedberger and Frohner). It attacks ani-
mals living in the best conditions of cleanliness and pure air,
and the essentially toxic quality of the cause may be deduced
from the fact that newly bought animals, which are not yet habit-
uated to it suffer the most, that fattening cattle are the common
victims, while work oxen which perspire more freely and milch
cows escape, yet calves fed upon their milk may suffer from diar-
rhoea and infants from a cutaneous eruption (Johne). The poison
it is to be inferred is eliminated in the milk. Similar examples
of the protecting of the milch animal by elimination of the poison
through the milk are found in bean trefoil (cytisus) which
poisons the milk while proving harmless to the goat which yields
it, and the poison of milk sickness which is deadly to cattle which
are not giving milk, and harmless to the milch cow, yet deadly to
those that consume her milk.

The exact nature of the poison is as yet uncertain, and as
solanin is the only toxic principle so far discovered in potato,
this has been held tentatively to be the essential cause. The
amount of solanin in-young and germinated potatoes has been
given by Cornevin as follows :

‘Germinated tubers Young tubers.
The entire tuber contains 0.21 0.16
The central fleshy part 0.16 0.12
The parings and pickings O 24 0.18

The toxic strength of the marc is not impaired by boiling,
cooking or other culinary treatment, and the same is true of
solanin. ‘The toxicity is greatest after the potato has been sub-
jected to germination, or when it has become green by exposure
to the sun, and in these conditions the solanin is increased. ‘The

494 Veterinary Medicine.

toxicity of the marc is higher in certain years, and in the product
of certain fields, than in others, and this is in keeping with the
effect of environment in modifying the products of a plant. The
increased production of chlorophyl under the action of sunlight is
associated with a material increase of the amount of solanin.
Until therefore another toxic product can be shown to be the es-
sential cause of this affection the solanin must be charged with
this result. This conclusion would be more inviolable if the
animals attacked showed other symptoms of solanin poisoning
such as narcotism, vertigo, stupor and paralysis, and the absence
of these may perhaps be due to the gradual advance of the toxic
action, and the progressive immunizing of the animal system.
The brain may be able to accommodate itself more readily than
the skin.

The other constituents of the potato or of the marc fail to pro-
duce the eruption under other conditions : the alcohol in brewers
and distiller’s grains, the acetic, lactic and butyric acids in the
refuse of starch, beet sugar and canning factories, the potash in
turnips and other roots, the yeast ferment in brewers’ grains.
The acarus of foot mange (symbiotis bovis) is rarely present in
the affected animal though the eruption in the same situation’
would strongly suggest its presence and lead to a search for it.
Moreover the eczema appears at once in a large number of ani-
mals, affecting a large area without evidence of slow and steady
progression and disappears with equal rapidity in many cases
when the diet is changed. Finally the eczema has not been suc-
cessfully propagated by inoculation which conveys mange in-
fallibly from animal to animal.

Symptoms. The disease is associated with slight fever, cos-
tiveness, impaired appetite, hypereemia of the mucosz, epiphora,
viscous salivation, muscular weakness, and finally emaciation
and black diarrhcea. The gravity of these symptoms varies,
being greater when the animals have eaten the leaves and stems,
the raw potatoes in their skins, the young shoots and parings, or
green potatoes which have been sunned. The animals may lie
most of their time stretching themselves out with head extended
on the ground, they may grind the teeth, may have pulse small
and rapid, tympany, lethargy, coma and even paraplegia but
these severe symptoms are exceptional and almost altogether

Liczema of Alimentary Origin in Cattle. 495

confined to the cattle of distilleries which receive an exclusive
diet of potato marc. In the pig and dog vomiting has been
noticed. (Cornevin). Pregnant animals may abort.

The local symptoms begin with redness and swelling of the
skin around the pasterns, especially of the hind limbs, stiffness
and a disposition to lie most of the time; then small flattened
vesicles appear, isolated or confluent, which bursting, form ex-
tended, raw patches the abundant exudations of which concrete
into thick crusts. ‘The hairs stand erect and are abnormally
thick at their roots. The eruption may extend to the whole
‘limb, the scrotum, mamma, tail and body at large, so that in
severe cases it is practically universal. ‘The skin becomes thick,
rigid, hide bound, wrinkled and folded with intervening cracks.
As a rule, however, the eruption is confined to the limbs,
scrotum, mammeand tail. In some extensive and persistent cases
the buccal mucosa suffers, particularly on the pad on the upper
jaw, which shows extensive and irregular ulcers with purulent
centre and swollen, congested margin. Abscesses may develop
in the skin and subcutem and sloughing of the integument is
not unknown.

Mortality is slight as a change of food is usually made and
a recovery ensuesin a few weeks. Yet Baranski noted 20 per
cent. of deaths in Galicia, mostly in old, worn out animals
which had been stabled for a length of time.

Lesions. On examination, post mortem, there are found hy-
perzemia and inflammation of the small intestine, some conges-
tion of the cerebral meninges, and a red, bloody condition of the
muscular system.

Treatment. ‘The toxic provender must be stopped, or reduced
to 20 or 30 litres of pulp daily, supplemented by sound whole-
some dry fodder. Marker claims that 70 quarts daily of the
potato marc may be given if combined with a fair ration of
Indian corn. Turning out doors to pastures usually effects a
speedy cure.

Local treatment is rarely demanded but when the irritation
is great it may be soothed by bathing with cold or tepid water,
lead lotion, glycerine and lead lotion, or by the application of
ointments of lead, tar, oil of cade or birch, or carbolic acid.
Dusting powders of zinc oxide, starch, lycopodium, ‘boric and

496 Veterinary Medicine.

tannic acids may also be employed. Decoction of oak bark or
solution of blue stone is often used, also creolin or cresol one
part, to alcohol five parts.

It is rarely necessary to use other than the cooling and as-
tringent lotions, yet the persistence of irritable sores, ulcers and
crusts must be treated as in other chronic skin affections.

MOIST ECZEMA OF THE PASTERNS IN THE OX.

Causes : hot season, foul stables, streptococcus. Symptoms: sudden at-
tack, red, swollen, warm, tender pastern, vesicles, crust, scabs, lameness,
foot rested on toe, cracks, fissures, interdigital foot rot, shedding hoof,
scaly chronic form, Treatment: clean stables and yards, cleanse feet, lead
lotion or zinc, phenol, iron or copper. Tar water, tar, creolin, creosote,
iodo}.

This affection is comparable to the simpler forms of grease or
digital eczema in horses.

Causes. It occurs especially in the hot mid-summer season in
cattle kept in filthy stables, where the feet and pasterns are kept
filthy and the air charged with irritant ammoniacal fumes. A
streptococcus is usually met with and may be found in pure cul-
tures in resulting abscesses.

Symptoms. ‘The attack is sudden, the skin around the pas-
tern becoming red, warm, swollen and tender, with the for-
mation of vesicles, isolated or confluent, which rupture and
discharge a serous exudate that dries up into crusts and scabs.
Lameness is a marked symptom and in bad cases the swelling
and pain are such that the foot may be habitually raised from
the ground and rested only on the toe. The swollen skin is
thrown into folds which rub on each other, and breaks open into
cracks from which exudes a serous fluid that macerates and ir-
ritates the skin, the heel pad and the interdigital space, so as to
determine interdigital foot rot. This may lead to inflammation
inside the hoof with shedding of the horny mass, or it may sub-
side into a chronic form with an abundant squamous product.

Treatment should be mainly prophylactic in the direction of
cleanliness and abundant litter in the stables, and the avoidance

Moist Eczema of Cattle. 497

of pools of liquid manure and of septic mud puddles in the yards
and roads. .

In the early stages of the affection the pasterns and interdigital
spaces should be thoroughly cleansed and covered with a band-
age with a weak solution of acetate of lead, or of sulphate of zinc,
or carbolic acid, or sulphate of iron or copper. In the more ad-
vanced stages tar water or crude tar will serve a good purpose,
or watery or alcoholic solutions of creolin, creosote, oil of tar,
carbolic acid or iodol. When the horn has been separated from
the quick, it is usually best to pare away all such, to bevel the
edges so as to make them less rigid and more pliant and to dress
with tar water and later to cover with undiluted tar and bandage.

MOIST ECZEMA OF THE TAIL, NECK, CHINE AND
DEWLAP OF CATTLE.

Definition. Causes: in work oxen, winter, foul stables ; dairy cows on
spoiled fodder or maize, wheat, buckwheat, cotton seed, etc. Contagion.
Symptonis : skin hot, thick, tender, exuding, matted hair, vesicles, itching,
excoriation, ulceration, bleeding, sloughing. Treatment : Soothing.
Cleanliness. Pure air. Tepid sponging. Dusting powder. Clip or shave.
Calomel with care. Phenol. Creolin. Silver or copper salts. Tannic or
boric acid.

This is an acute eczematous eruption of cattle beginning as a
congestion and swelling of the skin and advancing to an exuda-
tion or secretion which bedews the surface with a sticky discharge,
and concretes into scabs and crusts.

Causes. ‘The disease has been mainly seen in work oxen during
winter, when kept in close, foul stables and not properly groomed.
It is also seen in dairy cows and may be attributed to the indiges-
tion and gastric disorders which come from the ingestion of spoiled
fodders, or from a too stimulating diet, such as Indian corn,
wheat, buckwheat, barley, cotton seed, and the seeds of the
leguminosz. Lafosse looked upon it as contagious, but Cadeac
denies both this and its alimentary origin.

Symptoms. ‘The attack is severe, the skin becoming swollen,
hot and tender, especially at the base of the tail, on the neck,
chine and forehead. Soon the turgid, congested skin exudes a

32

498 Veterinary Medicine.

somewhat glutinous serous product, which mats the hairs into
tufts and exposes the intervening red, excoriated skin, with here
and there vesicles singly or in groups. Itching is usually in-
tense and the animal licks, rubs ‘and scratches the affected sur-
face unmercifully. The resulting excoriations and sores add
greatly to the severity of the troubles, including ulceration, bleed-
ing and even sloughing.

Treatment. Prophylaxis should be the first consideration, and
in the acute stages of the disease, its arrest by soothing applica-
tions. Cleanliness, pure air, and tepid sponging, to be followed
by a dusting powder of boric or salicylic acid, or a lotion of ace-
tate of lead or sulphate of zinc may serve a good purpose. Ifthe
case proves obstinate, the hair may be clipped or shaved to allow
of the more direct and thorough application of the dressings.
Cadeac especially recommends an ointment of calomel (1 : 10)
but this must not be applied over an extended surface, nor must
it be recklessly repeated owing to the dangerous susceptibility of
the bovine race to mercurialism.

Lotions and ointments of carbolic acid are of great value in
moderating the intense pruritus, and a combination of this with
lead acetate will often prove quite effective. Lotions, liniments
or ointments of tar, oil of cade, creosote, or creolin. When ul-
cers are present they may be treated by solutions of silver nitrate
(2: 100) or cupric sulphate (2: 100) or powdered iodoform.
When the exudate is excessive, astringent dusting powders often
serve a good purpose ; tannic acid and boric acid, with starch or
lycopodion.

CHRONIC ECZEMA IN CATTLE.

Summer disease. Depilation. Scaly. Itchy at first. Lesions of bones,
red zones representing successive attacks. Alterative tonics indicated.

Megnin records the case of an ox which on three successive
springs had a miliary vesicular eruption on the loins and upper
walls of the abdomen, which persisted until the advent of cold
weather in the fall. The vesicles were followed by an exudate
which concreted in solid crusts, enveloping the roots of the hairs
* which were lifted from the follicles and failed to be renewed, so

Eczema in Sheep. 499

that the animal entered on the winter with an appearance of alo-
pecia. The denuded surface was red, shining and covered witha
dense covering of lamelliform epidermic scales. In the early
stage of the eruption there was moderate pruritus, but when the
scaly stage was reached it was neither tender nor itchy to any
marked degree. Tar ointments had no effect in stimulating the
‘growth of the hair, and the skin remained bald until the next at-
tack. The second and third years the eruption extended farther,
invading not only the trunk, but the legs, and passing through
the same successive stages.

The animal was butchered and the shafts of the bones were
found to be abnormally red, and showed three concentric rings of
deeper brown, manifestly representing the three acute attacks and
resembling the concentric rings formed in growing bones when
the young animals are fed on madder.

The manifest disorder of nutrition in this chronicskin disease,
is an argument for the ¢veatment by alterative tonics, such as ar-
senic, as well as for the employment of tonics and corroborants in
general. In such cases the presumption is that local treatment
would be useless or nearly so until the general disorder could be
repaired.

ECZEMA IN SHEEP.

In anzemias squamous eruptions. In cold rainy weather moist eczema.
Salving. Thin wooled. Congestion, swelling, papules, vesicles, scabs,
depilation. Recovery with dry weather. Prevention : fold in rainy weather,
covers. Pruriginous eczema. Fagopyrism.

The skin of the sheep is so densely covered by wool and so
lubricated with its own secretion, that it is little liable to non-
parasitic dermatitis, or such as exist are to a large extent over-
looked. Ininternal parasitisms (distomatosis, strongyliasis, etc. ),
the wool becomes flattened (‘‘clapped’’) and the skin the seat
of a dry (squamous) eczema with scaly accumulations around
the roots of the wool.

Moist Eczema, the ‘‘vazz rot’” of the Germans is seen in
low conditioned sheep which have been left out in the heavy
cold rains, and is attributed to the direct entrance of the rain by

500 Veterinary Medicine.

the dorsal shed of the wool. In salving sheep it is a great point
with the shepherds to avoid opening the way for such entrance,
by shedding only at a short distance on each side of the spine, and
never directly in the center. Thin wooled sheep are also specially
liable to the disease. When the rain enters so as to soak the
skin and deeper layers of the wool, it softens and macerates the
skin, introduces microbes and favors decomposition and in var-
ious ways incites to dermatitis. The skin becomes red and swollen
with an eruption of papules and vesicles, and anexudation which
concretes in scabs around the wool, which under the constant,
accretions from below lifts the wool from its follicles, leaving
bare scurfy, or vesicular patches. ‘Thisappears in different parts
of the body beginning in the region of the vertebrz (back, loins,
croup), and extending on the shoulders, neck, sides of the
chest and abdomen. ‘The disease is rarely inveterate and gener-
ally subsides spontaneously on the return of the dry weather.
Still it may cause considerable loss of wool and hence it may
be desirable to fold the flocks during cold rainy seasons, or, if
they must be run at pasture, to cover the back of each witha
piece of sacking.

OTHER CUTANEOUS ERUPTIONS IN SHEEP.

A dry and a moist eczema have been noticed in the sheep,
(pruriginous eczema. tmpetiginous eczema) and a moist eczema
of the pastern comparable to grease in the horse. Fagopyrism
also occurs.

ECZEMA IN SWINE.

Secondary skin lesions, maculz, vesicles, seborrhoea, crusts. Impetigo
of young : cold weather : exposure : filth : spoiled or improper food. Symp-
toms: eyelids, etc., show itchy, red, swelling, pustules, scabs, erosions,
may affect nose or mouth. Duration 20 days. Hot weather aggravates,
Treatment: cleanse: soapy washes : emollient ointments, astringent lotions,
saline laxative, diuretics.

Disease of the skin is by no means uncommon in swine, but
it occurs mostly as a manifestation of an acute general malady.
Thus in the different specific diseases, caused by microbes,

Vesicular Irruption in Pig's. 501

maculee in the form of blood extravasations, punctiform or in
extended patches are constant phenomena. In some cases this
is complicated by a vesicular eruption, or by a seborrhcea and
by a dense accumulation of black crust on the surface.

Impetigo of Pigs. Benion and Cadeac describe this as a
sporadic affection of young pigs especially, which has been at-
tributed to cold stormy weather, lack of shelter, filthy pens,
spoiled food and insufficient nourishment.

Symptoms. The skin of the eyelids and other parts of the
body presents itchy, red, hot and swollen patches, which grad-
ually pass into a pustular eruption. The pustules no larger
than a millet seed, burst in forty-eight hours, and discharge a
yellowish or purulent liquid which concretes around the eye-
lashes or bristles, and glue the eyelids together. The crusts
may increase so as to cover the affected part of the skin by a
dense scabby covering which is firmly adherent and when de-
tached leaves 4 bleeding surface. It may extend to the differ-
ent mucosz of the eye, nose or mouth. ‘The disease runs a
course of twenty. days or less being retarded by the extremes
of temperature. During the heats of summer the attendant
pruritus is very great and annoying. During convalescence the
scabs and crusts gradually detach themselves and drop off leav-
ing the healthy skin covered at first by a somewhat delicate
epidermis.

Treatment is confined to cleanliness, soapy washes, emollient
ointments and astringent lotions (lead acetate, sulphuric or hydro-
chloric acid) but no premature detachment of scabs is per-
tmissible. Saline laxatives and diuretics are often called for.

VESICULAR IRRUPTION IN PIGS. PITCHY AFFEC-
TION. SEBORRHGA.

This also affects the young and is characterized by the succes-
sive appearance of vesicles, pustules and scabs or crusts, Fried-
berger and Frohner associate it with debility from youth, disease
or neglect, from articular rheumatism, rachitism, hog cholera,
etc., but also as a result of lying on manure, and the accumula-
tion of sebaceous matter and filth of all kinds on the skin.

502 Veterinary Medicine.

Symptoms. Among the symptoms of general disorder are
dullness, inappetence, prostration and slight fever. There is red
eruption with vesicles and even pustules on the early rupture of
which the discharge concretes into a black pitchy layer. It may
be at first most marked on the ventral aspect of the body, but
usually extends to the whole integument.

Treatment. Where it is not dependent on some grave internal
disorder, this commonly. yields to soapy washes, generous food
and a clean pen.

GRANULAR ERUPTION IN SWINE.

Zschokke describes a disease of this kind affecting the ears,
“back and croup, and caused by a micrococcus in the epidermis.
and papillary layer of the derma. It appears in the form of
patches, often of the size of the palm, showing bluish gray
papules which dry up without forming pustules. It runs a
chronic course and produces little or no itching.

Treatment would consist in absolute cleanliness, soapy or
alkaline washes, and the free use of solutions of the hyposul-
phites, sulphites, or other antiseptics which are neither irritant
nor poisonous.

URTICARIA is met with in swine as already noticed.

SCLERODERMA occurs in boars especially in the region of the
shoulders and back.

ACUTE ECZEMA OF THE DOG.

Prevalence and forms. Red Mange. Causes: constitutional, hereditary
races most susceptible, short-haired, delicate skins, 1st and 2d years, flesh
fed, overfed, spiced food, secondary to internal disorders, heat, cold, dust,
irritants. Symptoms: blush inside elbow, thigh, belly, heat, tenderness,
itchiness, scratching, vesicles, abrasions, sores, skin thickens, wrinkles,
moistens. Diagnosis: from demodex, distemper, mange. Treatment ;
change diet, restrict in quantity, from flesh, or stimulating food, one meal
daily, laxative, bitters; locally, cleanse skin, antipruritic non-poisonous
dusting powders or lotions, starch, magnesia, bismuth ; with muzzle, phenol,
lead, thymol, thiol, later creolin, oil of cade, lysol, etc. Acute general ec-
zema, Causes asin red mange. Symptoms: Common on head, ears, back,
rump, eyelids, lips, scrotum, arms, digits, crusts and depilation, large vesi-
cles, bleeding digits. Treatment.

Acute Eczema of the Dog. 503

In none of our domestic animals is this condition so common as
in the dog, and of all canine skin affections this is the most
frequent. As in other animals it may show itself in all forms or
grades from simple erythema, through the papular, vesicular,
pustular and scurfy or scabby, and often all of them may be seen
at the same time in one animal. Vet special names have been
given to different forms and localizations and it seems convenient
to retain some of these for every day use.

Eczema Rubrum. Red Mange. ‘This form is familiar to
dog fanciers as one of the acute types of this disease.

Causes. Among these are recognized a constitutional predispo-
sition, so that the disease appears in successive generations in the
same family, without apparent reason for charging the trouble on
any particular feeding or management. While not confined to
any race or group of races it has been noticed especially in grey-
hounds, setters, pointers, fox hounds, harriers, bulldogs, St. Ger-
mains and braque hounds. It is especially common in dogs in
their first and second years, and those that are nervous and lively,
with a delicate and naturally dryskin. Again, the dog fed large-
ly on fiesh, and above all the house dog fed thrice a day or oftener
on highly spiced animal food from the table, or on cakes, rich in
fat, isa frequent victim. There is besides that tendency to irri-
tation of the skin which comes from hereditary peculiarities and
idiosyncrasy, from diseases of the stomach, intestines, liver or
kidneys, from faults in sanguification, nutrition and secretion,
agencies that disturb the circulation in the skin, like excessive
heat or cold, irritant dust, desiccated perspiration or sebum, over-
heating and subsequent plunging in cold water. These acting
locally may serve to precipitate that which was otherwise imi-
nent from a generally acting cause.

Symptoms. There is first erythema, usually on the inner side
of the elbow, or thigh, with redness, heat and tenderness, which
soon extend to the belly, breast and inter-maxillary region, but
it confines itself as a rule to the ventral aspect of the body where
the hair is sparse and delicate, and the skin thin and sensitive.
The symptoms are more marked in white haired dogs. The ten-
der skin is more or less: (usually intensely) itchy, causing violent
scratching with the development of minute vesicles and even open
sores. The skin may become moist, thickened and wrinkled.

504, Veterinary Medicine.

but is rarely encrusted toany degree. Spontaneous recovery may
take place under a change of diet (restricted or vegetable), or an
outdoor life in summer with liberal exercise, or the disease may
last indefinitely so long as the etiological conditions are un-
changed. :

Diagnosis. The affection is easily distinguished from demo-
dectic acariasis which attacks a different part of the body, namely,
the head, the eyelids, the feet, and the back, whereas, this form,
of eczema confines itself to the ventral aspect of the trunk. From
the eruption of distemper it is diagnosed by the absence of the
hyperthermia and catarrhal symptoms of that disease, and by the
very small size of the vesicles ; those of distemper are broad, flat-
tened and often have dark colored contents. From acariasis itis
differentiated by its confinement to the ventral aspect, in place of
attacking the head, ears, neck and back, by the less severe and
incessant itching, and above all by the absence of the acarus, and
the element of contagion.

Treatment. A change of diet is a prime consideration. It may
be in the direction of simple restriction, but usually also in the
avoidance of meats that are highly peppered or spiced. A change
to vegetable food,—biscuit or mush and milk, is of great import-
ance, but in some animals a little fresh plainly cooked steak or
raw lean meat may be essential. In other cases a little beef
juice or gravy well skimmed of fat may tempt the patient to eat
mush. In the same way it may be necessary to temporize in the
matter of meals. Some dogs can.be safely put on one meala day,
while for others accustomed to frequent feeding it may be needful
to give two and restrict the amount. For the overfed or dyspeptic
animal a laxative, at the outset, serves to remove irritating and
fermenting ingesta, and to place the stomach and liver, and in-
directly, the skin in a better condition for recovery. Any per-
sistent indigestion should be treated in the ordinary way.

Locally it may be requisite to first clean the surface by spong-
ing with tepid water, to be followed by soothing and antipruritic
agents, due care being taken to avoid such as when licked will
poison the patient. Starch powder, magnesium carbonate, and
bismuth oxide may be used without apprehension. ‘The same is
true of limewater and to some extent of zinc oxide. When we
advance to others we must take the precaution to use a close wire

Other Acute Eczemas in Dogs. 505

muzzle, to prevent the ingestion of the agent. Carbolic acid
lotion (1-2 : 100) acts as a local anesthetic, and often materially
lessens both licking and scratching. Lead acetate or thymol
or both (1 : 100) have a similar action. Thiol 20, glycerine 50,
water 50, often acts as well. When the acute symptoms have
subsided the more stimulating agents may be employed : Creoline
(2 : 100) ; oil of cade 1, vaseline 5 : Canada balsam 1, vaseline 5;
zinc ointment, or lead acetate ointment. ;

OTHER ACUTE ECZEMAS IN DOGS.

Apart from eczema rubrum, the acute forms have been desig-
nated according to their seat and the nature of the attendant erup-
tion.

Acute General Eczema. ‘This may be often traced to various
causes of irritation local or general : overfeeding, over-stimulating
or spiced food, digestive, hepatic, or urinary disorders, irritant
dust or inspissated secretions on the skin, hot season, over exer-
tion, cold baths when heated, skin parasites and scratching.

Symptoms. 'The whole skin, or a portion thereof is the seat of
pruritus, causing active scratching and on separating the hairs on
the affected parts there is found redness, congestion, and swelling
with the formation of papules or vesicles, abraded, or moist
surfaces, and scales or crusts. These patches are common on the
back, the head, ears, rump, (Caudal eczema), the palpebre, the
lips (eczema labialis), the tnterdigital space (interdigital ec-
zema) the scrotum, or the anus.

Sometimes the formation of crusts and the loss of hairs is to be
noted, sometimes the eruption of large vesicles which burst and
discharge a honey like fluid (impetiginous eczema), sometimes
blood escapes from the irritated surface and concretes in dark
crusts. ‘The vesication and moist exudation is especially common
about the head, ears, eyelids, and rump, while bleeding is
especially seen around the claws and in the interdigital spaces in
connection with running on rough ground, snow or stubble. The
impetiginous form often bears a strong resemblance to vesicles
caused by a burn with hot water. The treatment of these differ-

506 Veterinary Medicine.

ent forms does not differ materially from that of eczema rubrum,
being first dietetic and hygienic, then soothing, and finally stimu-
lating.

CHRONIC ECZEMA IN THE DOG.

Follows acute. Same general causes. Symptoms: skin thickens with
papules, vesicles or pustules, scurf, crusts, depilation, surface glossy,
abraded, scratched, raw, rough, fcetid, itching, emaciation, exhaustion.
Chronic eczema of the back. Fat, old, gluttons. Symptoms: circum-
scribed patches on back, loins, quarters, tail, intense itching, skin thick-
ened, cracked, raw, encrusted, black, folded, rigid, fcetid, hair broken,
erect, shedding. Very inveterate. Chronic eczema of elbow and hock.
Causes : friction on summits of prominent bones, filth, infection, predis-
position. Symptoms: red, thickened, bare, indurated, calloused skin,
cracks, sores, discharge. Inveterate. Chronic dry eczema of head, ears,
neck and limbs. Circumscribed area, slow progress, thick, rigid, folded
skin, hairless, dry, scaly, moderate itching. Treatment: Fresh eruption
like acute form. For old chronic form, stimulating astringents, silver,
mercury, copper, boric acid, tannic acid, iodoform : for dry and scaly, oint-
ments of oil of cade, tar, green soap, zinc, cresol, lysol, chloronaphtho-
leum, sulphur, sulphur iodide, ichthyol, salicylic acid, chrysarobin, naph-
thalin, naphthol, resorcin.

While acute eczema may recover permanently under hygienic
measures alone, yet any case is subject to relapse and the new
eruptions may succeed each other so persistently that the affec-
tion becomes essentially chronic. Like the acute, chronic eczema
may be general or local and be named accordingly.

The same general causes as produce acute eczema are oper-
ative in maintaining the disease indefinitely. Faults in diet,
overfeeding, unhealthy kennels, foul ‘air and surroundings,
hot weather, licking and scratching are among the common
causes.

Symptoms. Under the continued inflammation the skin be-
comes thick (on the back it may be double or treble its nor-
mal thickness), it has a general angry congested appearance,
papules, vesicles and pustules coexist or succeed each other and
as these dry up; scales and crusts accumulate. The hair drops
off over extensive patches, leaving a somewhat shining skin.
What hair remains is largely twisted or broken by rubbing and

Chronic Eczema in the Dog. 507

scratching. Hypertrophy of the papillary layer is not uncom-
mon giving a rough uneven aspect and feeling to the skin. A
common feature is an offensive odor from the affected skin, and
which may betray the persistence of the disease when it has been
supposed that all eruption has been overcome. While not pre-
pared to follow Cadeac in making this a diagnostic symptom
from other skin diseases, yet as an evidence that an eczema is
not yet entirely healed it serves a very useful purpose. In old-
standing cases the continued irritation, the unintermitting itching,
the absorption or circulation of morbid products, and the con-
stant nervous excitement may lead to emaciation, exhaustion and
death.

Chronic Eczema of the Back in Dogs. Rodent Eczema
is a disease of fat, old, voracious dogs. It appears in circum-
scribed spots and patches on the back, loins, croup or tail and is
marked by inveterate itching, congestion and thickening of the
skin, cracking of its surface, bristling, breaking and shedding of
the hair, exudation from the surface and its desiccation in the
form of crusts. ‘These crusts may be black from contamination
with dust or blood, and the affected surface is more or less fcetid.
The skin may be puckered into irregular folds, thick and inelastic.
Not infrequently the malady may remain dormant for some time,
only to break out again and again with renewed energy. It is
very obstinate and intractable. ,

Chronic Eczema of the Elbow and Hock in Dogs. ‘This
attacks the summit of the olecranon or calcis and is manifestly
connected with compression and friction on these parts when
lying down, and perhaps with foul and irritating matters on the
ground. ‘This need not be looked on as the sole cause but only
as the occasion for the localization of a predisposition which was
already present in the general system. The skin becomes red,
thickened and indurated, the epidermis undergoing hypertrophy
to form a callus, in which a few cracks and sores may form,
giving rise to a discharge which encrusts the surface and adds to
the thickness and induration. The affection is very inveterate.

Chronic Dry Eczema of Head, Ears, Neck and Limbs
in Dogs. ‘The dry eczema of the head, neck and limbs is
characterized by its slow progress and its restriction in the
majority of cases to one or more of these parts. The small

508 Veterinary Medicine.

affected patches, have some thickening and folding of the skin,
which is usually dry, scaly and largely divested of hair. Itch-
ing is moderate only, and the hairs are shed less rapidly than in
the encrusted forms.

Treatment. When there has been a fresh irruption it may be
requisite to.treat chronic eczema, for a time, after the manner
of the acute, so as to avoid any tendency to aggravation of the al-
ready existing irritation. A careful regulation of the diet is as
essential in the chronic forms as in the acute and in the inveterate
types, especially those of a squamous character, alteratives like ar-
senic are often of value. In theacute stage or during a recrudes-
cence the mild dusting powders (starch, zinc oxide, lycopodium,
magnesia bicarbonate, bismuth oxide, thiol) may be applied, or
bland unguents (zinc, benzoated zinc, lead, vaseline, glycerine,
spermaceti and almond oil, paraffin, wax), or sedative lotions
(lead, opiate, thymol, thiol, carbolic acid).

In the more advanced and moist forms astringents and stimu-
lants may be adopted : silver nitrate (2: 100), applied with soft
cotton, mercuric chloride (1 : 1000), or black wash (calomel 1:
lime water 60) care being taken to use a close wire muzzle to pre-
vent licking. Copper sulphate (1: 100) is at times useful, and
boric acid, and tannin may be tried. Iodoform 1 part and tannic.
acid 5 has a good effect in many cases.

For the dry and scaly forms, and indeed for many of the
others, as well, the more stimulating ointments and liniments
are called for. Cadeac recommends oil of cade, tinctures of can-
tharides, or a tar liniment made with alcohol, as a supersedent to
produce an active inflammation and displace the unhealthy ecze-
matous one. The agent is rubbed upon the skin and the resulting
scabs are left for a week when it is washed off with tepid water
and the skin is found healthy or greatly improved. Asa rule a
second dressing of the taristhen applied. Muillerstrongly recom-
mends Hebra’s treatment with green soap and alcohol (2:1) to
be rubbed on the affected surface and washed off the following
day when all scales and crusts will come off with little trouble.
He follows with zinc oxide or lotions of mercuric chloride or sil-
ver nitrate. Friedberger and Frohner use cresol 2 parts, green
soap 2 parts, alcohol 1 part ; also creosote in alcohol (1 : 10) or in
paraffin (1:10). Zuill looks upon sulphur iodide as virtually

Lichen. Heat Papules. Prickly Heat. 509

a specific: sulphur iodide 1 part, sublimed sulphur 7 parts, cod
liver oil 7 parts. This is applied once and repeated at the end of
ten days, if necessary. Application is made to the whole skin
healthy and diseased alike, and rarely requires to be repeated.

Ichthyol is commended by Miiller in cases which show great
cutaneous thickening with cracks and fissures. It may be made
with water (1:5) or in glycerine or lanolin of the same strength.
Miiller combines it with lime water and olive oil and applies it
daily.

Other agents in use are salicylic acid in olive oil (1:3) : chry-
sarobin in paraffin ointment (1:4): naphthalin or naphthol
(1:10): resorcin in water (2: 100).

LICHEN. HEAT PAPULES. PRICKLY HEAT.

Horses, cattle, sheep and dogs suffer in hot season or hot stables. Ner-
vous temperament. Delicateskin. Over-driving. Heating foods. Cold
water when heated. Unwholesome food. Indigestion. Chronic affections
of stomach, liver, kidneys, etc. Symptoms: Clusters of small papules on
neck, back, croup, or thighs, crest, tail, exudate concretes, lifts hairs from
follicles, depilation in round spots, or patches, abrasions, ulceration, corru-
gated skin. Diagnosis: sudden eruption, its isolation, subsidence on the
coming of cold weather, and reappearance with the hot, intense itching.
Treatment: Asin eczema. Protect against friction, give shade, and spray
with cold water.

Under this name has been described a papular erruption occur-
ing in horses, cattle, sheep and dogs in the hot season, but also
occasionally, in winter, in hot, confined stables.

It is seen especially on the neck, back, croup and thighs, is
common in fine bred horses with delicate skins, and nervous tem-
perament, and is pre-eminently a disease of hot weather. Over-
driving, heating food, a drink of cold water when heated or indi-
gestion connected with unsuitable food may be the occasion of its
irruption or tend to perpetuate it. In the same way different
chronic affections of the stomach, liver, kidneys or other organs
may be causative factors.

Symptoms. The affection usually begins with a few minute
papules, isolated or in clusters, which dry up into scales or crusts.

510 Veterinary Medicine.

These are mostly situated at the roots of the mane or tail or on
the sides of the neck, withers or trunk, and as a rule produce a
pruritus, resembling that of scabies in its intensity. When the
exudate agglutinates a tuft of hair, enclosing it in a dense
crust, the hairs may be lifted from their follicles and thus small,
round spots of depilation appear. Ifrecovery ensues and new hair
starts, it differs in color from the old and gives a dappled appear-
ance tothe skin. In many cases, however, the points of erup-
tion and encrustation become confluent and an extensive area of
bareness, with more or less abrasion, and even ulceration may be
formed.

Megnin mentions two cases and the author can adduce an-
other in which the eruption appeared in vertical lines, so that the
skin of the trunk was raised in a series of elevated lines or ridges,
running transversely to the body, like the stripes of a zebra. In
the author’s case the skin seemed to be thrown into a series
of foldsin the production of which the cutaneous muscle evident-
ly took part. The itching was doubtless the immediate cause.

Diagnosis is based largely on the suddenness of the eruption ;
on its limitation to a given area instead of spreading from the
primary seat of invasion as in acariasis ; on the fact thatit is usu-
ally confined to a single animal and has not spread with the use
of the same brush, comb and rubber ; and on the absence of acari
and vegetable parasites from the affected parts. The absence of
chicken roosts or manure is another valuable indication.

Prognosis. Appearing in spring or early summer, the disease
is liable to persist until the advent of cold weather in fall, and
even after a winter’s intermission there is a strong tendency to its
re-appearance on the following spring or summer. ‘The intoler-
able itching interferes seriously with docility and steadiness in
harness, and the loss of hair renders the subject very unsightly,
and as a family or driving horse practically useless.

Treatment. As in cases of eczema the general and special
causes should be corrected by hygienic and general medicinal
measures, laxatives, diuretics, antacids, tonics, and in the ad-
vanced stages, alteratives coming in as important factors. (See
under acute eczema). Great care should be taken to prevent ir-
ritation by pressure of the harness, and shade and daily cold
spraying may be availed of.

PITYRIASIS : SQUAMOUS SKIN DISEASE : HORSE.

Dry, scaly, or powdery affection. Causes: Fine, thin, dry skin with
little ‘hair, race, Arab, Barb, racer, trotter, nervous temperament, age, dry
summer heat, dry winter cold, foul skin, caustic soaps, ingestion of salt,
iodides, bromides, etc., derangement of internal organs bacteria or
cryptogams. Symptoms: scurfy patches, general or circumscribed, where
little hair is, where harness rubs, depilation of ears, crest, tail, shoulder,
back. Diagnosis, from eczema by lack of pruritus, of rapid extension, of
thickening of the skin, from acariasis by absence of acarus. Treatment :
correct disorder of stomach, liver, or kidneys : green, succulent or nutritive
food ; alkalies ; arsenic ; tonics ; locally potash soaps, ointments of tar.
birch oi], creolin, creosote, naphthalin, lysol, mercury, iodine, salicylic acid,
zinc oxide.

This is a skin disease characterized by excessive production of
epidermic scales, and depilation without any attendant elevation
of the skin. The desquamation may be of fine scales like wheat
bran, or of a fine dust like flour.

Causes. 'The disease is especiallv characteristic of animals in
which the skin is naturally fine, thin and dry and covered sparsely
with hair. It is therefore more common in the Arabian, Barb,
English racer, American trotter and other breeds of a nervous
organization than in the heavier draught breeds. Old horses in
which the skin is drier and the hair thinner are more subject to it
than the young. Again it has been especially noticed in the
heats of summer with thin coat and a withering action of radiant
heat on the skin, and less frequently in winter when the blood is
driven from the surface by cold. Much also depends at times on
the lack of grooming, on the accumulation of dust and dried up
secretions about the roots of the hair, and on washing with
caustic irritant soaps especially in long-haired regions. It has
even been claimed that the ingestion of salt, potassium iodide, or
bromide, etc., contributes to the affection. There is undoubtedly
a certain individual predisposition to the disease, shown as already
stated in certain breeds, but also inherent in particular families
and even animals, and associated not only with the character
of the skin, but also probably with variations in the activities and
products of various internal organs. In man pityriasis versicolor

511

512 Veterinary Medicine.

‘is associated with a specific fungus, and in the horse Megnin has
described cases in which the surface of the skin and especially
the hair follicles show a mass of epidermic cells mingled with
mycelium and an abundance of spores. :

Symptoms. ‘The scurfy product and depilation may be found
in patches scattered indiscriminately over the body (generalized ),.
or confined to particular regions (circumscribed) as to the head,
ear, crest, tail, or the parts that receive the friction of the harness.
It may commence as a dry, rigid, state of the skin under the
headstall with loss of hair and the excess of dandruff. From
this or from another point the extension takes place slowly and
with comparatively little irritation or itching. ‘The hair is pulled
out with great ease, and from its spontaneous evulsion, more or
less baldness appears progressing slowly from the original centres
of the disease. It may leave. the whole crest divested of the
mane, or the tail of its hairs (rat tail), or the ears may become
bare and scurfy. Again the parts subject to friction like the
back of the ears, the crest, in front of the shoulder, or the seat
of the saddle may be the main seats of depilation and baldness.

It is to be distinguished from dry eczema mainly by its
tendency to spread over a larger area in place of confining itself
to circumscribed patches, and more particularly by the absence
of the marked thickness and rigidity of the skin which charac-
terize eczema. From acariasis it is distinguished by the lack of
the intense itching, of the tendency to more or less moist exuda-
tion and above all by the absence of the acari.

Treatment, It is well to correct any disorder of any of the
internal organs, notably of the stomach, liver or kidneys, and to.
encourage a free circulation in and secretion from the skin. To
fill the latter indication green food, ensilage, roots, sloppy mashes.
of bran, oilcake and the like may be given. Also bicarbonates.
of soda or potash or other alkaline diuretics, and in certain ob-
stinate cases a course of arsenic. ‘The alkalies tend to eliminate
offensive and irritant matters and to lessen the irritation in the
skin. A course of tonics is often valuable.

‘Locally Cadeac recommends potash soaps rubbed well into the
affected parts. If this should fail some of the stimulant oint-
ments as of tar, oil of tar, oil of white birch, oil of cade, creo-
line, creosote, lysol, naphthalin, may be tried. Megnin strongly

Pityriasis in the Dog and Cat. 513

recommends a combination of ointment of biniodide of mercury;
I part, to mercurial ointment 3 parts. Others advocate salicylic
acid (10 to 20 %) mixed with Lassar paste which is compounded
of 1 part each of zinc oxide and starch in 4 parts vaseline.

PITYRIASIS IN CATTLE.

On neck and dewlap ; Causes : anzemia, debility, spoiled food, starvation,
constitutional predisposition. Symptoms: shedding hair and scales without
skin thickening, or itching. Treatment; green soap, tar, creolin, lysol,
naphthalin, etc. Alkaline lotions: generally nutritive, succulent food, bit-
ters, iron, arsenic. etc.

This is noticed especially on the neck and dewlap in connection
with anzemia, low condition, unsuitable, innutritious and spoiled
fodder and a constitutional predisposition. It has the same gen-
eral characters as in the horse, an excessive production of dand-
ruff or dry scales without any marked change in the thickness of
the skin or inits circulation. Treatment consists in the application
of green soap, pure or medicated, with tar, creolin, lysol, or other
empyreumatic product. Lotions of carbonate or bicarbonate of
potash are often effective. Any disorder of digestion, or of the
urinary or hepatic functions, or of general nutrition should be cor-
rected, and in most cases, a course of bitters, with iron and
arsenic is desirable. A good, in-door hygiene or a run on suc-
culent grass in the open air may be resorted to with benefit.

PITYRIASIS IN THE DOG AND CAT.

Head, neck and back of overfed, old house dogs. Symptoms: floury
dandruff, with little itching or redness, on limited areas; in cats over the
whole back, where stroking causes electric development, the collecting of the
hair in tufts, and insufferable irritation. Hair constantly shedding without
necessarily bare patches, Treatment: simpler, restricted diet, correct in-
ternal disorders, laxatives, arsenic, locally solutions of alkalies, borax,
potassium sulphide, sulphur iodide. baths.

In dogs this affection attacks especially the head, neck and back
of pet and house dogs gorged with dainties, and particularly in

33

514 Veterinary Medicine.

those that are already becoming aged. ‘The affected parts are
covered with a floury or branlike product lying upon a dry surface
usually devoid of irritation or congestion, though it may
be distinctly congested and reddened, and éven the seat of pru-
ritus. ‘The affection is usually confined to limited areas, more or
less destitute of hair, and without showing a disposition to active
extension. Inthe cat, however, it.may affect the whole dorsal as-
pect of the body, being associated with extreme electrical suscepti-
bility, so that on being stroked the hair at once collects in tufts,
crackles, and in the darkness sparkles, and the animal at first fawn-
ing on the hand, will fly at and scratch it after a few strokes.
The scaly product is excessive and drops off abundantly when
handled, without, however, leaving thin or bare patches.

Treatment is mainly in the line of a simpler and more natural
diet, the avoidance of sugar and cake, the correction of disorders of
the digestion, or the hepatic or urinary functions, the exhibition
of an occasional laxative, and of alteratives, especially Fowler’s
solution.

Locally, alkaline lotions, carbonate or bicarbonate of soda or
potash, borax, sulphide of potassium and iodide of sulphur are
often useful. A moderately strong solution of common salt with
glycerine in water is an useful alternate, and a warm saline
or bran bath may soften the skin and modify its nutrition.

CONTAGIOUS PUSTULAR DERMATITIS IN THE
HORSE. ACNE.

History. Cause: bacillus. Symptoms; incubation 6 to 15 days, skin
tenderness, heat, swelling like peas, hazel nuts, vesicles, pustules, exuda-
tion, concretions among hairs, depilation, healing in 15days. Leaves white
spots with lighter hair. Extension by grooming: general eruption : sub-
cutaneous swelling, sloughs, delayed healing. Lymphangitis. Diagnosis:
from chaps and bruises, from horse pox, from impetiginous eczema, from
urticaria, from farcy. ‘Prevention, quarantine new horses, separate dis-
eased, disinfect skins of the unaffected, disinfect stables and harness.
Treatment: soapy wash: germicide lotions.

This has been largely described as an imported disease thus on
the European continent it is the English variola, and in England

‘Contagious Pustular Dermatitis in the Horse. Acne. 515

the Canadian contagious pustular affection. Vet the first authen-
tic account dates back to 1841-2 when Goux found it attacking
an entire squadron of the French army ina fortnight. Axe de-
scribed it in England in imported Canadian horses in 1877, and
Weber observed it in the same year on the continent, where it
was attributed to imported English horses. In 1883 it was noted
by Schindelka, in 1884, Siedamgrotzky inoculated it from the
horse on two rabbits and two Guinea pigs, and to horse and goat.
The rodents developed a ‘‘ malignant cedema’’ at the point of
inoculation and died in six days. Grawitz and Dieckerhoff cul-
tivated the bacillus on ox or horse serum and found it 2m in
length, dividing by segmentation into round or ovoid refractive
spores, which may remain connected as diplococci or short chains
and which color deeply in fuchsin. It grows most rapidly at a
temperature of 37° C., growth ceases at 17° C., and it is destroyed
in half an hour at 80° to 90° C. Preserved, dry, it remained
virulent for four weeks and produced the characteristic eruption
‘when rubbed on the skin of the horse, ox, dog, sheep or rabbit.
It proved fatal to all rodents, including white mice. The microbe
is found abundantly in the pus and crusts and is easily shown
when these are treated with potash. It produces no putrid
fermentation.

Symptoms. When inoculated it has an incubation of six to
fifteen days followed in mild cases by swelling heat and tender-
ness of the skin with collection of the hair in erect tufts. Next
day there are rounded elevations like peas or hazel nuts, discrete
or confluent on the swollen patches. These nodules, at first firm
and resistant soon become soft in the center, forming vesicles
and finally pustules, which burst in five or six hours and exude
an abundant liquid which concretes in a thick amber colored
mass. ‘The hairs in the center of the resulting raw surface are
easily detached leaving bare spots the size of a dime, with often
times a slough attached in the center. When this is finally
eliminated the surface gradually cicatrices and recovery may be
complete in fifteen days. The skin remains long dappled from
the partial discoloration of the epidermis in the seat of the pus-
tules. ‘he malady is local and hyperthermia is rarely seen.
The submaxillary and pharyngeal lymph glands are usually
swollen and indurated, but this disappears speedily after the sub-
sidence of the eruption.

516 Veterinary Medicine.

In certain cases the extent of the primary eruption is greater
from the first, or it extends through reinfection by combs, brushes
and rubbers used in grooming or by friction by the harness, the
affected skin is hot, painful, congested and thickened throughout
its entire substance, the pustules are much more numerous, often
confluent, and may even implicate the subcutaneous connective
tissue. The crusts formed on the sores may acquire a breadth of
1 inch to 1% inch. Considerable abscesses may be formed and
the lymph glands communicating with the affected part are hot
and swollen. Even after the opening and discharge of the ab-
‘scess, the base of the sore remains indurated and indolent, and
centres of softening and caseation may appear so that healing is
delayed for one or two months or more. In such cases extensive
cicatrices remain after recovery. Lymphangitis is a common
accompaniment with even abscess of the lymphatic glands.

Diagnosis. From chafing and bruising by the harness, this is
easily recognized by its appearing also on other parts than those
covered by the harness, by the development of the characteristic
pustules, by its following a regular cycle of eruption and sub-
sidence covering a definite period of usually 15 days, and by the
indisposition to maintain itself indefinitely under the friction of
the harness.

From horse pox it is distinguished by the habitual avoidance of
the common seats of election of that disease (heels, lips, nostrils,
buccal and nasal mucosz, lips of the vulva), by the absence of
hyperthermia, and by the comparative absence of the remarkable
amber-like concretions which characterize horse-pox in the lower
limb.

From impetiginous eczema it is diagnosed by its contagious and
inoculable properties, by the absence of the early falling of the
hair from the circumscribed rounded nodules, and by the ab-
sence or moderate character of the pruritus which is usually in-
tense in the eczema.

The eruption of urticaria appears much more suddenly, shows
no tendency to form vesicles nor pustules, is not inoculable, and
subsides often as suddenly as it appeared when the irritant food
materials have been expelled from the alimentary canal.

From acute farcy it is distinguished by the moderate degree of
the implication of the lymph vessels and glands, by the white

Pemphigus in Horse, Ox, Pig, and Dog. 517

creamy nature of the contents of the pustules, as compared with
the glairy, oily nature of the farcy discharge, by the absence of
coincident nasal ulcers, submaxillary nodular swellings or other
lesions of glanders, by its short course and tendency to spon-
taneous early recovery, and by the absence of reaction under
the mallein test.

In all cases the known prevalence of the contagious pustular
dermatitis in the locality, or the introduction of strange horses
which exhibit sequele of the lesions will assist greatly in the di-
agnosis.

Prevention. Tf animals are introduced from an infected or un-
known locality they should be kept apart from others for two
weeks. Ina stable where it has already appeared the diseased
and healthy should be carefully separated and the skins of those
as yet unaffected may be washed with a solution of mercuric
chloride (1 : 1000) or creolin (1: 100). ‘The walls of the stable
should be whitewashed, and all stable utensils disinfected in boil-
ing water or one of the above named antiseptics. The harness
demands particular attention.

Treatment. ‘This is essentially germicide. After a soapy wash,
any one of the usual disinfectants may be used : aluminum acetate,
(1:15), mercuric chloride (1 ; 1000), carbolic acid (1 : 50), creo-
lin (1:50), copper sulphate (1:50), etc. Lead acetate 2 parts,
alum 1 part and water 50 parts, has been found to be effective.

PEMPHIGUS IN HORSE, OX, PIG, AND DOG.

On rare occasions the horse or ox is attacked with a skin erup-
tion, attended with the formation of bullze or blisters, from the
size of a hazelnut to a hen’s egg, or larger. It is sometimes
shown sporadically and at others appears at once in a large num-
ber of animals in the same herd. The causes are obscure, yet the
enzootic appearance of the affection is suggestive of a common
factor entering probably by the food. Loiset and Seaman have
recorded enzootic outbreaks in cattle and Dieckerhoff in the horse.

Symptoms are cutaneous congestion with the formation of
swellings like a walnut, but exceptionally as large as the fist, on

518 Veterinary Medicine.

the head, neck and thorax, which in 2 to 4 days form a large
central vesicle, with yellowish serous contents. Cases in the ox
(Loiset, Seaman) had a similar eruption on the loins, quarters
and hind limbs, some of the swellings attaining the size of a hen’s
egg, and with similar contents. Later these ruptured, crusted
over and healed, with, for a time, a smooth glistening surface.
Winkler records cases in swine and Schneidemiihl in dogs, but
the condition is rare in both animals.

Treatment. To a nutritious, non stimulating and easily digest-
ible diet, may be added a course of arsenic and, in low condition,
of bitters. Locally dusting powders of zinc oxide, boric acid,
starch and lysol. Should the exudate form these into hard cakes,
they may be replaced by carbolized: oil or, better, a 5 per cent.
mixture of ichthyol in vaseline.

CRACKED HEELS IN HORSES. SCRATCHES.

Special susceptibility and exposure of posterior pastern region. Di-
visions. Causes: local irritants, decomposing manure, chill water, slush,
mud, pools of liquid manure, septic irritation, stones, sand, lime in mud,
salted snow or ice, washing heels, caustic soaps, stubble, clipped or singed
hair, stocking of limbs, lymphangitis, sprains, arthritis, anzemia, cardiac,
urinary or hepatic disease, parasites, heavy bedding, constitutional predis-
position. Symptoms: redness, heat, tenderness, swollen, erect hairs, lame-
ness, knuckling, or exudate, crusts, scabs, abrasions, chaps, fissures, ulcers,
loss of pliancy, engorgment of limbs, foetid secretion. Prognosis accord-
ing to cause. Treatment: remove causes, give rest, cleanse limb and
stable, astringent antiseptic lotions, sulphurous acid, carbolic acid, cre-
olin, lysol, pyoktanin, chrysophanic acid, moderate laxative food, diuretics,
arsenic, bandaging, hand rubbing, exercise.

The affections of the heel or posterior part of the pastern in
horses are largely modified by the anatomical character of the
skin in this region, and the special exposure to inimical agents,
so that it is convenient to consider them under special headings,
even though the eruption may be of the same kind with that seen
in other parts. The dermatites of this region, which ate not
primarily contagious may be conveniently divided into rst, such
as are unattended with free secretion, and 2d, those that implicate
the sebaceous glands and are marked by an offensive discharge.
Cracked heels belong to the former category.

Cracked Heels in Horses. 519

The causes are extremely varied, consisting in the application
of irritants of many kinds, to the susceptible skin in a system
too often already predisposed to skin disease.

Standing on reeking dungheaps, or on heating manure in
filthy stalls subjects the heels, and especially the hind ones, to
ammonia and other irritating fumes, and when taken out to the
cold air, chill water and mud, the sensitive parts suffer. Again
in the farm yard and even in neglected stalls the hind feet are
immersed in pools of liquid manure, the ferments and toxic mat-
ters of which dry on the skin, attack the surface and determine
septic congestions and inflammations. On country roads where
there is no pretense of pavements, or macadam, the mud in spring °
and fallis a source of great irritation on certain soils which con-
tain small flat stones, pebbles or sand, or in which lime or de-
composing manure is a prominent feature. Standing in snow or
slush, especially if chilled by salting, produces partial or com-
plete congelation with the result of chillblains or even more
active and destructive inflammation or sloughing. The habit of
washing the heels and allowing them to dry spontaneously in the
stall is only less injurious by the chill induced. ‘This is still
further aggravated by the use of caustic soaps on the already
tender skin. ‘The lighter breeds of horses, devoid of long hair
on the pasterns, though less subject to the greasy secretion, are
even more exposed to chills and direct injuries, and suffer readily
and often persistently from erythema and cracks. In many cases
trouble comes from the ends of stubble and other vegetables
acting on the skin. A common fault is the close clipping and
even singeing of the hair in the hollow of the heel. The stiff,
bristly ends of the hairs on one fold of the pastern continually
prick the skin of the adjacent fold when the animal is in motion
and not only is this irritating to the healthy skin, but it becomes
incomparably more so when that is congested and tender.
Even in summer the deep dust on unpaved roads, mixing
with the normal secretions of the heel, rolls into semi-solid masses
between the folds and proves the more irritating, the greater the
admixture of sand or solid bodies. A common cause is the stock-
ing of the limbs, with the attendant congestion, distension and
debility of the skin. This may be due in its turn to a great
variety of proximate or remote causes, lymphangitis, sprains,

520 Veterinary Medicine.

arthritis, osteitis, anzemia, cardiac, urinary or hepatic disorder,
parasitisms, etc.,so that accessory causes must often be widely
sought. Even an excess of straw around the hind limbs will
cause stocking in some animals which escape on bare pavement.
Finally we must take into account that constitutional predisposi-
tion in some animals that makes them liable to inveterate skin’
disease under the slightest causes.

Symptoms. In the milder forms there may appear a redness,
with heat, tenderness and swelling in the hollow of the pastern,
the hairs stand stiffly erect, and the surface may be perfectly
dry. The affected limb has the pastern more upright than the
‘others and the fetlock starts slightly forward. In anervous, sen-
sitive horse the skin is so tender and rigid, that the animal can
hardly be persuaded to use the limb, and goes dead lame for
a considerable distance until it has become more pliant.

With some aggravation of the condition the skin is felt to be
somewhat rough and uneven by reason of the encrustations of
epidermis, dried secretions and dust over its surface, which may
convey to the finger a slightly oily sensation. In many cases
these epidermic and exudation products form scabby elevations,
and a chronic condition of this kind may persist indefinitely, con-
stituting what is known in America as scratches. ‘This will vary
by reason of the detachment of these concretions with the forma-
tion of abrasions and sores of various sizes, which may heal, or
extend by coalescence, chapping, or ulceration.

In other cases, even at an early stage, the formation of chaps
or cracks is a marked feature. At times this may seem to be the
result of over distension in the inflamed superficial layers of the
skin which have lost their natural pliancy and cohesion. They
will, sometimes, form under slight exercise, but not when at rest.
-They may simply extend through the epidermis, exposing the
papillary layer, or in bad cases one or more fissures may extend
through the integument and expose the tendons beneath. ‘They
may extend forward on the sides of the pastern or upward over
the back of the fetlock and metatarsus.

In all cases, when the local inflammation is acute, some swelling
of the limbs appears, and this keeps pace with the character and
extent of the trouble. With extensive chaps or fissures it becomes
extreme, extending up toward the hocks and attended by great

Cracked Heels in Horses. 521

‘pain and stiffness. The sores become the seat of active suppura-
tion, with it may be considerable destruction of tissue. Even in
the milder forms there may often be seen a foetid muco-purulent
‘secretion in the depth of the folds of the pastern, and in the worst
‘cases this extends to the whole surface after the manner of grease.

Prognosis. The milder uncomplicated cases recover readily
and perfectly under rest and judicious treatment ; the more ad-
vanced cases are liable to leave swelled legs with susceptibility to
a relapse, and in cases associated with a constitutional diathesis or

chronic internal disease, recovery may become problematical and
uncertain.

Treatment. In all cases the cause must be done away with,
whether filthy stalls, reeking dunghills, septic pools, work in ir-
ritating road-mud, or melting snow, washing the heels with caustic
soaps, drying them in cold draughts, pricking with stubble or
clipped hairs, and all the causes of stocking of the limbs. If
heels are washed, use pure tepid water, and, if necessary, the
best Castile soap, and rub them dry at once. If this cannot be
done bandage them rather than leave them in a cold draught.

Give rest in a clean stall and thoroughly clean the affected heel,
then wrap in a bandage wet with an acetate of lead or sulphate of
zinc lotion (1:50), or apply Boao ee oxide of zinc, or cream of
‘glycerine and salicylic acid.

When chaps have formed they will often promptly heal under
standard solution of sulphurous acid 1, glycerine 1, and water 1.
This is applied on soft cotton and covered by a rubber bandage to
confine the acid. The sulphurous acid solution should be recently
prepared, since it will prove injurious if it has oxidized into sul-
phuric acid. To one or other of these preparations the addi-
tion of a little carbolic acid, creolin, pyoktanin, or lysol will
often prove useful. When the cracks have healed, zinc ointment,
chrysarobin ointment, chrysophanic acid 1, vaseline 15, or other
soothing and antiseptic agent may be employed till all inflamma-
tion has subsided, and the animal must not be returned to work
until the skin has been restored to its former healthy and elastic
condition.

It may be desirable to greatly restrict the grain during treat-
ment and even to give cooling laxatives or diuretics. With a
constitutional diathesis arsenic or other alterative may be tried,

522 Veterinary Medicine.

and any internal disease must be attended to. For stocking, use
careful bandaging, hand-rubbing and exercise.

With the formation of the deeper fissures the same antiseptic
agents may be employed, or salol, iodoform, glutol, aristol, or
some tincture of iodine, or iodide of starch may be used. A weak
solution of copper sulphate has often an excellent effect. The
measures advised below for gvease will usually apply in this con-
dition.

SEBORRH@A OF THE DIGITAL REGION: DIGITAL
IMPETIGO, GREASE: STREPTOCOCCIC DERMA-
TITIS IN HORSES.

A sequel of erythema or cracked heels. Causes : constitutional predis-
position in lymphatic draught horses, rare in ass and mule, anatomical con-
‘ ditions, wet damp regions, digestive disorder, over-feeding and lack of
exercise, diseases of liver or kidney, change to stable life, cold water, slush,
mud, salted snow, steaming manure, urine in mares, infection, strepto-
coccus pyogenes. Symptoms: swelling, heat, and tenderness of pastern
hollow, itching, hairs erect, unctuous. exudate, vesicles, excoriations, dis-
charge opaque, grayish, sticky, foetid, chaps, knuckling, resting on toe,
kicking : in severe cases discharge purulent, more opaque, sloughs, exces-
sive granulations, ‘‘grapes,’? extensions forward, upward, downward,
canker, quittor, sand crack, etc. Lesions: first, congestion of derma, hair
follicles full, hairs loose, connective tissue infiltrated, or thickened, liga-
ments and bones involved, grapes in superposed clusters pediculated. Diag-
nosis: from horse-pox. Treatment: remove causes, secure cleanliness,
laxative, diuretics, moderate grain ration, or tonic regimen ; locally, sooth-
ing antiphlogistic, antiseptic treatment, lead, zinc, phenol, creolin, lysol,
when advanced, antiseptic dusting powders, calomel, salicylic acid, iodine;
zinc oxide, salol, or solutions, zinc chloride, tar. Value of changes. For
‘‘ grapes’? actual cautery, excision, ligature.

This may develop as an advanced condition of the erythema or
cracked heels already described. Vet it is so distinctive in its
habit of profuse secretion, the eruption of vesicles or pustules and
the abundant, foetid sebaceous discharge that it deserves a special
consideration.

Causes. Something depends on constitutional predisposition.
This is preéminently a disease of the heavy, lymphatic, draught

Grease. Seborrhaa of the Digital Region. 523

horse, being rare in racers and trotters, with fine sinewy limbs,
no long hair on the fetlock, delicate skins, and less -abundant
sebaceous glands. It is almost, though not quite, unknown in the
spare limbs of ass and mule, and though claimed by Reynal as
attacking cattle its occurrence is equally rare in them. Much of
this may be attributed to conformation. The limb of the draught
horse is so much thicker and coarser, with a great excess of con-
nective tissue and lymph plexus which become readily gorged in
idleness, inducing stocking, congestion and debility of the whole
limb. This same condition operates as a powerful predisposition to
lymphangitis. Again the great length and profusion of the long
hairs, entails the necessary compliment of an excessive development
of the sebaceous glands which become over-stimulated by conges-
tion, and afford a much more open and favorable infection atrium for
the pus microbes. These structural conditions are much more
marked in the draught horses of wet regions as in Ireland, the
western counties of Great Britian, Belgium, Holland, and the At-
lantic provinces of France, and in these the affection is remarkably
prevalent. In our Eastern States and on the Plains, where the
progeny of imported draught horses lose their digital hair, the
malady is comparatively rare. A similar immunity has long been
noticed in the horses of Spain and Africa. Disturbances of the
digestion in heavily fed horses, subjected to transient confinement
in the stall, and diseases of the liver and kidneys, must be recog-
nized as further predisposing causes. The age of five and six
when many horses change hands, and are subjected to extreme
changes of stabling, feed and work, has furnished the greatest
number of cases.

External causes we find in all those conditions already
enumerated which favor chapped heels. Wet, mud, gritty
masses, irritant fumes of manure, cold, heat, filth are potent
factors. In connection with these are the pus and septic microbes
that are always present in stables, farm yards, manure, street
dust, etc. No one of these can be adduced as the constant and
exclusive cause, and it is inevitable that a complex infection
should be present, yet the propagation and persistence of the
disease may often be connected with the streptococcus pyogenes.

As emphasizing the importance of such external irritants and
infections, it should be noted that the disease bears an appreciable

!

524 Veterinary Medicine.

relation to the filth and wet of the stable and farm yard, and to
the absence of cleanliness in dealing with the feet, and that the
extension of good pavement and protection from road mud have
invariably lessened its prevalence. The irritant action of the
urine renders mares more susceptible in the hind limbs than horses.

Symptoms. ‘The disease may appear as a swelling, heat and
tenderness of the hollow back of the pastern, involving the fet-
lock and lower part of the metatarsus or metacarpus, and this may
last for one or two weeks, the engorgement lessening or disappear-
ing during exercise and reappearing when at rest in the stall.
The local tenderness is great as manifested by the prompt and
excessive lifting of the leg when the heel is touched, as well as
by the lameness when first moved, which subsides with further
exercise.. Itching may be shown by kicking the floor, or by a
disposition to rub the pastern. The hairs of the affected part are
rigidly erect, and a slightly moist, soapy sensation is felt on the
skin. Close examination may detect the presence of small
vesicles with as yet limpid contents, but the greater part of the
liquid product is traceable to the openings of the hairs and gland
ducts. ‘This is followed by small excoriations taking the place
of the ruptured vesicles, and the discharge becomes more pro-
fuse, opaque, white or grayish white, sticky, and fcoetid. It
covers the entire affected surface, mats together the hair in tufts
and forms a thicker grayish border. The hairs are loosened in
their follicles and easily pulled out. The erosions become com-
plicated by chaps, and the swelling increases around the pastern
and above the fetlock. When at rest in the stall the foot miay be
rested on the toe only, or held suspended and occasionally kicked
backward as if to dislodge the cause of irritation, yet if moved
the patient may gradually get over the greater part of the lame-
ness, and the swelling partially subside.

In severe, protracted cases the discharge becomes essentially
purulent, but often with a darker, greenish, reddish or blackish
tinge, and portions of the skin may slough, leaving deep intract-
able sores. Still more commonly the raw surfaces become the
seat of hypertrophied granulations, which grow out to form raw,
red fungous like, pediculated neoplasms familiarly known as
grapes. Between these the spaces are filled with tufts of hairs and
the condensed discharges, in process of active septic change,

Grease. Seborrhea of the Digital Region. 525

and giving off a most repulsive odor. Like the preceding erup-
tion these gvapes may extend around the front and sides of the
pastern, and upward beyond the fetlock, but especially behind.

This advanced condition shows no tendency to spontaneous
recovery and the connective tissue and lymphatic plexus becoming
involved, the leg often swells to enormous dimensions, from six
to twelve inches in diameter at the fetlock. It may last indefi-
nitely until the patient is worn out, or it may extend to other
organs by contiguity or embolism. Canker of the frog and sole,
fistula (quittor), sand crack and seedy toe may be named as
complications, also septiceemia or pyeemia with abscesses in the
lungs, liver, brain or bowels.

Lesions. In the first stage there is mainly the congestion of
the skin extending into the large and numerous hair follicles of
the pastern. If pressed, a transparent serum bedews the surface,
and if sectioned the follicles around the hair bulb are seen to be
distended by a similar product. The hairs are easily pulled out.
The subcutaneous connective tissue is filled with a yellowish
serosity and at intervals may be seen a red point of vascular
stagnation or blocking. Later these products are more abun-
dant and those on the now swollen and excoriated surface are
distinctly foetid. The infiltrated lymph plexuses in the con-
nective tissue are more distended, their walls thickened and con-
solidated, and the rigid skin is thus firmly bound to the
structures beneath. A careful examination shows the presence
of subepidermic vesicles of various sizes. The congestion may
extend deep enough to involve the periosteum of the digital bones
and the ligaments of the joints. The gvapes are each attached
by a pedicle from which branch out cauliflower-like, fine pa-
pillary processes, that aggregate into a solid cluster. They
are very vascular and grow out cluster above cluster until they
reach large dimensions.

Diagnosis from Horse Pox. Since the days of Jenner the
claim has been constantly made that grease and horse pox were
one and the same. Horse pox is however to be distinguished
by its transient course, its inoculability, its incubation of three
‘ days, its abundant exudate concreting on the hairs of the pastern
as a yellow mass sugestive of crystalline structure, by the red pit
in the skin in which this mass is inbedded, by the spontaneous

526 Veterinary Medicine.

recovery in about 15 days, and by the immunity on a subsequent
inoculation. It is communicable to cattle and to man, producing
the characteristic large umbilicated vesicle and scab.

Treatment. ‘The first consideration is to remove the causes of
local irritation and infection, give a clean sweet stall, with dry
floor, and allow no contact with putrid liquids, mud, cold water,
melting snow or other irritant. If exercise is needful to obviate
stocking of the legs give it on dry clean ground.

If inflammation runs high with fever and costiveness a laxa-
tive will be valuable and it may be well to follow this in some
cases with cooling diuretics. When the animal has been on a
heavy grain ration this should be largely cut down in keeping
with enforced idleness, or restricted work. If, on the other hand,
condition is low, and the discharge profuse, a more generous ra-
tion may be desirable. ,

Local treatment is essentially soothing and antiphlogistic, and
in view of the infection should be antiseptic. White lotion
(acetate of lead and sulphate of zinc of each % oz., water
I quart) has been long used with fair success, for although lead
sulphate is thrown down, itis in part freed again through contact
with the exudate, It will be materially improved by the addition
of 1 dr. carbolic acid, creolin, lysol or chloronaphtholeum or by
‘some other antiseptic. Lead acetate alone with an antiseptic is
an excellent substitute. In mild cases the surface may be wet
with the lotion several times a day: while in severe ones the
lotion may be applied on a bandage kept constantly wet.
When secretion is well established it may be better to use dry appli-
cations, as calomel ; salicyclic acid 10 parts, with iodine Io parts ;
calomel and lamp black ; carbolated oxide of zinc or burned alum,
salol, etc. After washing and drying the skin, dust this freely
even into the deepest wrinkles and cover with cotton and bandage.
Dress twice daily. For very foetid cases, Robertson recommends
zinc chloride 1 oz. ini qt. water with the addition of glycerine
and phenol, and again a saturated solution of copper sulphate
with carbolized glycerine. For profuse secretion after the sub-
sidence of active inflammation Renal highly recommends wood tar
with 5 to 10 drops of sulphuric acid to the ounce. Under these

- circumstances a powder of gloss starch 5 ozs. with iodine % oz.
may be employed twice daily. Or again, 1 oz. each of carbolic

Grease. Seborrhea of the Digital Region. . 527

acid, tincture of iodine and glycerine may be employed. When
one agent seems to be losing effect, it is well to change for an-
other and never to neglect the regular dressing, until full recovery
has been secured.

In case of gvapes the actual cautery is the most efficient
measure. Heat a blacksmith’s fire shovel to a bright red and
use this to cut through the pedicles, a cool shovel being kept
constantly beneath it and in contact with the pedicles, so as to
protect the adjacent skin from injury by the radiated heat. The
lower shovel must be dipped in cold water at very frequent in-
tervals to cool it and prevent cauterization of the skin between the
pedicles. This not only removes the diseased and infected
masses, but leaves the stumps of the pedicles aseptic. Another
method is to cut off the ‘‘ grapes’’ and staunch the blood with
the acutal cautery at a dull red heat. Still another is to tie the
pedicle of each excrescence separately so as to cut off circulation
and secure sloughing. ‘This is, however, a long, tiresome pro-
cess, and entails prolonged contact with much infecting dead
tissue. After any method the parts must be dressed with an-
tiseptics, and dealt with generally like cases in which the ex-
crescences had not formed.

CUTANEOUS HEMORRHAGE: BLOODY SWEAT:
HAMATIDROSIS. HAMATOPEDESIS.

Forms of cutaneous hemorrhage ; in specific diseases ; in parasitism ; in
insect bites ; in congestions of sweat glands ; in deranged innervation ; in
hemophilia. Section ofsympathetic. Saltonsciatic. Hysteria. Sclerosis
ofcord. Inflammation. Symptoms: drops, crusts. Haemorrhagic nodules.
Treatment: styptics, cold, ice, snow, tannin, matico, iron chloride, alum,
gelatine, atropine, ergot, lead acetate, quinia. Gravitation.

The escape of the blood by the skin is seen in a variety of
morbid conditions, due it may be to profound changes in the
blood and capillary walls, as in petechialfever, anthrax, scorbutus,
septiczemia, swine erysipelas, etc., in which this is only a sub-
sidiary phenomenon of a general disorder :—to the presence of-
parasites (Filaria heemorrhagica, ) in the skin :—to insect bites :—
to violent congestions implicating the sweat glands (bloody
sweat):—or to deranged innervation of the part as in cases of
trauma of the sympathetic or sciatic nerve, or disease of the
nerve centres. It may further be a manifestation of heemophilia.
in which any slight lesion becomes the occasion of persistent
heemorrhage.

Cases that appear in the course of specific contagious diseases.
and those dependent on filaria will be considered under these
headings, and we may confine our attention here to the forms of
sweating and oozing of blood from independent causes. German.
writers draw attention to its frequency in eastern horses at-
tributing it to the great development of the vascular system.
especially of the skin, but its comparative infrequency in the
English racer and American trotter would throw doubt on this
doctrine. It may be questioned whether the frequency of the
disease in Oriental horses is not to be ascribed rather to filariasis.
This idea is not contradicted by the especial prevalence of the

528

Cutaneous Hemorrhage. Bloody Sweat. 529

bleeding in summer when the filaria is most active, but when also
the skin is the most vascular and its tissues most relaxed.

Of nervous hemorrhages we have the experimental examples
of Bouchard and Simon from section of the sympathetic nerve in
animals, also those of Glen and Mathiew from irritation of the
sciatic in dogs with common salt. In man the nervous causation
has been seen in hysteria, under profound nervous shock, in
sclerosis of the cord, and even as the result of auto-suggestion.
This influence is constantly operative in violent inflammations in
which diapedesis and minute hzmorrhages into the affected
tissues are marked phenomena, and under such a cause the gland
ducts especially are the seat of transudation. When the skin is
abraded, cracked, or blistered it occurs also on the surface of the
exposed derma.

Symptoms. With active local congestion or inflammation the
blood usually oozes in drops from the surface, and drying con-
cretes into dark red crusts. In other instances, however, it drops
from the surface, or even flows, producing anemia and even
death. Into such cases hemophilia presumably enters. Heemor-
rhagic swellings like wheat kernels or beans also form in the
skin.

Treatment. Apart from the contagious and parasitic diseases,
and scurvy, the general treatment will be styptic. Cold water,
ice, snow, a stream from a hose, solutions of tannin, matico, iron
chloride or sulphate, alum or gelatine may be employed. In-
ternally the iron salts, gelatine, atropine, ergot, lead acetate, or
quinia may be given. In hzemophilia the gelatine especially
should be tried both locally and generally. When it is possible,
as in the case of the head, gravitation should be availed of. Else-
where a compress bandage may be used.

34

ULCERATION. GANGRENE. RED-SORES.

Causes: inflammation, exudation, obstructed circulation, lesions in
trophic nerve centres, sclerosis, toxins, ergot, caustics, freezing, gangrene,
microbes, cryptogams, spoiled fodder, white skins, buckwheat, insolation.
Symptoms : inflammation, molecular disiutegration, dry sloughs. ‘Treat-
ment : camphorated spirit or vaseline, antiseptics, phenol, salicylic acid,
iodoform, iodine, creolin, lysol, tar, detach sloughs.

In all cases in which the skin is violently inflamed, and particu-
larly when the seat of an abundant exudation or infiltration which
blocks circulation and retards nutrition, the tissues are especially
liable to death, molecular or by sloughing, and formation of bed-
sores. Asa general cause lesions of the trophic centres in the
medulla and cord must be accepted as leading to imperfect
nutrition and lack of vitality. This is seen in sclerosis of the
cord, but may appear as the result of poisoning of the
myelon as well as the gangrenous tissues by absorbed toxins.
Again a common cause of circumscribed cutaneous gangrene is
the capillary contraction and obstruction of ergotism. ‘This
usually involves all the tissues, soft and hard, at the distal end of
a member or organ, causing the separation of all at one common
level, but in less severe forms the skin only sloughs, in the form
of round or irregular masses, usually around the coronet, and the
resulting sores heal up under an appropriate diet. Cauterization
and freezing may be a further occasion of gangrene. Finally, the
local operation of the microbes of gangrene, determines both
ulceration and sloughing. Cryptogams on spoiled fodders
(trefoil, lupins, vetches, rusty gramineze) are also charged with
developing gangrene.

White skins or white patches on the skin are especially liable
to suffer as in cases of fagopyrism and ‘‘grease’’. ‘The action of
the solar rays in summer must therefore be accepted as a con-
current cause.

Symptoms. ‘The first symptoms are usually those of cutaneous
congestion or inflammation. Redness, swelling, pitting on pres-
sure, or tension, are accompanied or followed by vesicles, chaps

539

Cutaneous Hypertrophy. LElephantiasis. Pachydermia. 531

or erosions. The margins of the sores become thick andirregular,
often undermined, and they gradually increase by breaking down
of tissue in their depth or on their margin. In other cases
patches of skin dry or wither up, either ina superficial layer or
throughout its entire thickness, and these dried extra vascular
sloughs are gradually detached by granulation beneath. ‘The
surrounding tumefaction is always extensive and the sores may
expose the deep seated structures—tendons, ligaments, fascia,
bones, joints—causing widespread destruction.

Treatment. If the disease is due to capillary occlusion of
nervous origin, compresses with camphorated spirit, followed by
camphorated vaseline may be of advantage. If otherwise, anti-
septics will be in order: carbolated vaseline, salicylic acid cream,
iodoformed vaseline, a weak iodine ointment, creolin, or lysol in
water, or tar water. When the dead tissues are partially separated
the detachment may be hastened with knife or scissors and the
sores treated like a septic sore.

CUTANEOUS HYPERTROPHY. ELEPHANTIASIS.
PACHYDERMIA.

Chronic thickening of skin and lymph plexuses, horse’s hind limb after
eczema, grease, glanders, ox neck and head, knees, shoulder. Calcification.
Treatment: laxatives, diuretics, exercise, elastic bandage, friction, astrin-
gents, iodine.

Chronic thickening of the skin is most commonly seen in
horses as a sequel of lymphangitis in the hind limb, the engorg-
ment of the lymph plexus and thickening of its walls being asso-
ciated with a general productive inflammation and thickening
of the derma until the fetlock may be thirty inches or more
in diameter. It may follow eczema, grease or chronic glanders.
In cattle a productive dermatitis in the region of the head and
neck, has led in the experience of the author to a similar-disten-
tion of the lymph vessels and morbid thickening of theskin. The
pads and calluses which form on the knees of the camel and on
other parts subject to friction, furnish examples of hypertrophy
of another kind. Again the thick dense cutaneous plates on the

532 Veterinary Medicine.

shoulders of the old boar may serve to illustrate a physiological
hypertrophy. The writer has seen thickening of the skin in the
seat of an incision made in spaying the pig and the deposition of
earthy salts so as to form a distinct calcification.

Treatment is very unsatisfactory, yet something may be done
by laxatives, diuretics, regular exercise, and evenly applied elastic
bandage when in the stable, massage and the use of astringent
and dilute iodine ointments. It is much more important to pre-
vent the lesion by cutting short the morbid condition on which it
depends. When developed, attention is usually given to prevent
its advancement and to utilize the animal at slow work.

ICHTHYOSIS. FISH-SKIN DISEASE.

This consists in a scaly formation of the epidermis which is
also formed in excess, and is supposed to be dependent on dis-
ordered trophic innervation. In new born calves suffering in
this way VanStettin found an excess of phosphate of lime in the
epidermis. The calves usually die in a few days.

FURUNCULUS. BOIL.

Definition, pustule with necrotic core. Digital region. Microbes. Symp-
toms: Prevention : antisepsis. Treatment : phenol, iodine, alcohol, boric
or salicylic acid, iron, bitters, calcium sulphide, sulphur, sodium sulphite.

A deep seated inflammation of the derma resulting in suppura-
tion with the formation of a central adherent necrotic slough or
core.

Boils are not uncommon on the digital region of horses in
winter ; or where the parts are exposed to street mud containing
an abundance of decomposing organic matter. They are unques-
tionably due to pyogenic microbes, and have been largely asso-
ciated with staphylococcus pyogetes aureus. As they often come
out in successive crops, it may be assumed that the second focus
is infected from the first, or that there is a special susceptibility

Flyperplasia of the Skin. 533

in the particular animal system, or that both these factors con-
tribute to the result. Debility and traumas contribute to bring
about the infection.

Symptoms. A nodular, hot, and very painful swelling, impli-
cating the substance of the true skin, and surtounded by a hot,
, swollen zone, progresses to suppuration in the center, yet when
it bursts, or is opened, a cove or small mass of necrotic, tough,
fibrcus tissue is found to be firmly adherent in the center of the
bottom of the sore.

Prevention. Must be sought in sustaining the general health
and in preserving the greatest cleanliness of stables and skin.
Washing with a weak antiseptic solution when returning from
muddy streets may be of use.

Treatment. When developing, the application of carbolic acid
in crystal or on the end of a glass rod may often relieve the pain
and destroy the microbes. Next day the part may be painted
with tincture of iodine. If already opened the phenol may still
be applied and followed after five minutes by alcohol to check
the caustic action. Or boric or salicylic acid may be applied.
To counteract the constitutional tendency, iron, bitters and other
tonics and antiseptics, calcium sulphide, sulphur and sodium
sulphite may be given.

HYPERPLASIA OF THE SKIN.

Productive inflammations and tumors of the skin are common
in domestic animals but as they are essentially surgical lesions,
they will be better considered under that head. We may name
papiloma, warts, fibroma, melanoma, epithelioma, sarcoma,
adenoma, carcinoma, dermoid cysts. Parasitic and microbian
diseases of the skin will be found under their respective headings.

ALOPECIA CONGENITA. CONGENITAL BALDNESS.

Cases of this kind have been met with in foals and calves,
which were born entirely bald or with only a few thin delicate
hairs scattered over the surface. In a calf observed by the
author, and which lived for several months, the body was almost
absolutely bald, and the mouth remained edentulous, a coinci-
dence which has been observed in other cases. ‘The teeth belong
to the same class of embryonic tissues as the epidermis, and a
failure in the development: of the one is likely to entail a cor-
responding failure of the other. Schneidemiihl observed. that
the few hairs present in such cases were especially delicate and
brittle.

ALOPECIA. POST PARTEM. ALOPECIA AREATA.

Normal shedding. Shedding out of time; laminitis, dropsy, exudative
dermatitis, acariasis, ringworm, traumas, folliculitis. Debility, excessive
lactation, starvation, petechial fever, spoiled fodder. Without apparent
cause, alopecia areata, neurosis, micrococci, disease of derma. Symptoms:
general disorder has general shedding. Local disorder extends from a
centre. In horse with increased pigmentation.. Treatment: correct general
causes, use hair stimulants, cantharides, kerosene, tar, pilocarpin, mercuric
chloride, cresol, iodine, balsam of Peru, silver nitrate. Arsenic.

Acquired baldness is recorded in horse, cattle, sheep and dog.

Causes. ‘The simple shedding of hair occurs physiologically
in animals with the change of season, and if anything interferes
with the growth of the new hair a transient baldness may ensue.
If such shedding occurs from any cause at the wrong season, be-
fore the new hair has started, the baldness may be accentuated.
Thus shedding may occur in some forms of indigestion, in
laminitis, in dropsical swelling of the limbs or ventral aspect of -
the body, in dermatitis with an exudation which concretes
around the hairs and raises them out of their follicles, in mange,
in demodectic acariasis, in circinate ringworm, in traumas as on

534

Alopecia, Post Partem. Alopecia Areata. 535

the elbows of dogs, etc., from lying on them, and in inflamma-
tion of the hair follicles from a variety of infections. It has
been charged to general debility in excessive lactation, in gesta-
tion, and in starvation, to poisons in the blood as in petechial
fever, and to musty or spoiled fodders in bad seasons, or from
low damp lands.

When in the absence of such appreciable causes it commences
at one or more points and gradually extends, and persists, it con-
stitutes alopecia areata. This has been attributed to a disorder
of the cutaneous nerves (tropho-neurosis), but the progressive
advance of the disease, without limitation to areas representing
the distribution of given cutaneous nerves, and the complete ab-
sence of other derangement of nerve function, throw doubt on
this conclusion. Another doctrine attributes it toa microbe, but
though micrococci and other organisms have been found, they
have not been proved to be constant nor to be absolutely causa-
tive of the disease. Still another theory holds that it is a disease
of the.derma and not of the hair at all, the evulsion of the hair
following the implication of the tissues around the follicles.

Symptoms. ‘The baldness dependent on a general disorder oc-
curs at once over an extended area. That of ringworm, acariasis,
and of the specific alopecia areata, advances gradually and often
slowly from a given point, until it may include a large area.
Roll has seen it extend from a few points to nearly the whole
body of the horse in a single year. In this, asin other cases in
horse and dog, the baldness was followed by a considerable in-
crease of the pigmentation of the skin.

Treatment. Jn cases that occur'as the result of other diseases,
the rational treatment is to deal with these diseases, and then to
stimulate the growth of hair by some one or other of the known
stimulants (dilute tincture of cantharides, kerosene, tar water,
solution of pilocarpin hydrochlorate). In the more specific
form, no treatment has been very successful, yet the best re-
sults on the whole appear to have come from local germicide ap-
plications. Mercuric chloride in alcohol and water (1 : 500);
cresol 1, alcohol 20 ; tincture of iodine reduced to half its strength
by addition of alcohol; balsam of Peru 1, alcohol 5 ; nitrate of
silver 1, alcohol 15, serve as examples.

As general treatment arsenic has been employed, but with no
very encouraging results.

TRICHORRHEXIS NODOSA. NODULAL SWELLING:
AND SPLITTING OF HAIR.

Debility, ringworm, nodular hair. Hair bursts with brush like end.
Cases in horse like singed hair. Causes : infection probable, disturbed in-
nervation, dry air, impaired nutrition. Treatment: shave, oil, vaseline,
petroleum, cantharides, sulphur, tar, favor shedding coat.

In a variety of conditions the hairs split up and break, leading
to bristling or baldness. In debilitated conditions, when the hair
is badly nourished, in ringworm when it is invaded by a crypto-
gam, and in the various nodular or ringed conditions of the hair
this brittleness and splitting appears. The term 77cchorrhexis
(rexis a bursting forth) has been applied to one of these affec-
tions, in which the hair swells and bursts into a number of fila-
ments giving it a broom-like termination. Trofimo describes this
as affecting two-thirds of the horses of an artillery brigade, and
showing upon the back, croup, mane and tail in isolated patches.
Megnin, Trasbot and Roy have observed similar cases. The
affected hair a short distance from the skin swells into a grayish
white nodule and breaks across, leaving a tuft of fine filaments.
The patches look to the naked eye as if singed, but when the hair
is magnified the difference is easily made out, as there may be

several nodular enlargements on the same hair, and the brush-
’ like spread of filaments at the broken end is entirely unlike
the solid node on the end of a singed hair.

The causes of the affection have not been demonstrated, though
indications point to an infection which gradually extends from
the first point of attack. This extension is not limited to
the area presided over by particular nerves, and there is no
other indication of disordered innervation. Trasbot has seen the:
disease transmitted from horse to horse by the use in common of
combs, brushes and rubbers, and in other cases experimentally
by rubbing the scurf from a diseased animal on the skin of a
healthy one. From observations on the human subject Mont-
gomery looks on it as a result of extreme dryness and brittleness
of the hair, and charges dry climates and seasons, and an abuse

536

Trichorrhexts Nodosa. 537

of soap in washing as conducive causes. Debility and impaired
nutrition of the hair may operate in the same way. No specific
microbe has been constantly found in these cases and until such
factor can be proved, it may be held that among the etiological
agents impaired nutrition and dry air are important.

In the way of treatment shaving of the affected parts and oily
or vaseline applications may be tried, together with. such slight
cutaneous stimulants as petroleum, weak tincture of cantharides,
sulphur, tar ointment, etc. Roy noticed that cases that had
lasted all winter recovered after shedding of the coat. It might
be assumed that the evulsion of theinfected hair, and the vascular
stimulus necessary to the new growth contributed to the result.

°

CONSTITUTIONAL DISEASES.
RHEUMATISM.

Definition. Past views. Causes: heredity, age, cold, damp, cold cli-
mates, seasons, exposure, buildings, cellars, night chills, weather vicissi-
tudes, valleys, wading, checked perspiration, lactic acid, metabolic products,
acid phosphate of soda, vegetable acids, neuropathic causation, infection,
microbes, injuries, over work. ‘ Lesions: in joints, synovia, serosa, articular
cartilage, fibro. cartilage, articular lamella, bone, eburnation, ligaments,
joints affected in horse and ox, blood: changes, albumen, fibrine, blood
globules, pericardium, endocarditis, valvular disease, myocarditis, embo-
lisms in lungs, pleura, nervous lesions, digestive system. ‘

Definition. A constitutional, inflammatory affection, probably
toxic, tending to localization in the joints, muscles, tendons,
fascia, skin, heart and serous membranes and with a marked
disposition to shift from place to place.

The word is derived from pevya flow, and was origin-
ally employed to indicate that an acrid humor, generated in the
brain or elsewhere escaped mainly by the nose and eyes as a
catarrh. ‘The idea naturally followed that the retention of this
humor caused inflammation in the joints, muscles, heart or else-
where. The connection of these various conditions with exposure
to cold, led to the association of the name with the various in-
ternal inflammations in which chilling appeared to have been a
factor, untilit was difficult to limit it by any definite line. Finally
infectious diseases implicating the joints or muscles (influenza,
contagious pneumonia, omphalitis, gonorrhceal rheumatism), and
diseases of metabolism (gout and possibly rheumatoid arthritis)
have added to the general confusion.

GENERAL Causes. Heredity, ‘This has been more definitely
traced in man than in the lower animals, the line of family
descent being more easily followed in man. Children of rheu-

538

Rheumatism. 539

matic parents are more obnoxious to the disease in the ratio of
5 tor. In the absence of data for animals, we may say that it
is probable that the influence of heredity will hold good for live
stock in this matter. Whether the disease results from faulty
metabolism or from microbian invasion or toxins, the hereditary
defensive powers of the animal cell are likely to be an important
factor.

Age. Genuine rheumatism is not common ata very early age,
but in animals as in man, attacks especially those in the prime of
life, accustomed to vigorous exercise, free perspiration and suc-
ceeding chills. There is as yet no direct evidence of an exhaus-
tion of the susceptibility of early maturity and of any consequent
immunity of the old.

Cold and damp. ‘The association of rheumatism with cold and
damp has always been so notorious that no argument is needed
to enforce the truth. It is pre-eminently the disease of cold.
climates and cold situations exposed to the north and east in
Europe, or to the north and west in North America on the At-
latic slope. It is very little prevalent in the tropics. Buildings
and yards that lack sunshine and exposed storm-swept hillsides
show cases most numerously. Dogs kept in cold, damp sunless ,
cellars often suffer. Cold, damp or frosty nights start or aggra-
vate cases in animals left out in the field, while warm sunshine
usually brings immediate improvement. A sudden change of
weather to cold and wet is the signal for aggravation of the exist-
ing disease, though this may have set in before the change of
weather has been fully developed. Late autumn and early spring
with their sudden changes, their sleet and rain are especially
hurtful and particularly to chronic cases. The cold, raw ocean
winds on the Pacific coast contrasting with the warm sunshine is
a marked contributing cause. The currents of cold air that draw
up through shaded valleys, gullies and ravines expose their
denizens to attacks. Rheumatism is more rare among well
housed and carefully treated family horses, and less so in draught,
dray and other hard working horses that are made to cross
streams and stand with feet and legs in cold water while the
body is drenched with perspiration. Dogs suffer in the same
way while hunting. Haycock attributes many attacks to wash-

540 Veterinary Medicine.

ing the legs with ice cold water when the animal has just re-
turned to the stable heated and perspiring. If then left undried
and unbandaged in a cold draught these conditions are still
farther aggravated. This was formerly attributed to the sup-
pression of perspiration, but it occurs in an animal which has
just perspired freely and is now in no special need of further
elimination through the skin. It appears to be due rather to
the action of the cold on the nerve endings, the susceptibility of
which has been enhanced by the free secretion and general relax-
ation. .

But potent as cold is in precipitating or aggravating an attack,
it cannot be looked on as the sole or essential cause of rheuma-
tism. The great majority exposed to the cold escape. The
animal which has stood in the stall, or shed, is less likely
to be attacked than the one at work in which the heat pro-
duction has been more active. Indeed an immunity has been
claimed for the Artic regions, provided the subject is not exerted
so as to cause perspiration. One might readily conclude that this
apparent immunity, depended on the’ absence of an essential
germ, as is also claimed for catarrhs, yet Nansen after his pro-
‘longed bath in the frigid waters seems to have had an attack of
rheumatism. Cold appears to be one of the most potent accessory
causes, but evidently not in itself the essential cause.

Cold undoubtedly affects profoundly the metabolism of the
body and especially when the vital powers have been reduced by
severe exertion, fatigue and perspiration. The same applies to
many other affections especially such as are associated with an
infecting element, which takes occasion of the debility caused by
the cold to establish itself in the tissues.

Lactic acid and other metabolic products. Prout long ago
claimed that rheumatism was caused by an excess of lactic acid
in the system, and this was supported by the fact that an exclu-
sive diet of buttermilk given in diabetes, is likely to produce
acute articularrheumatism. Again the production of rhachitis in
the young can be traced in certain cases to excess of this acid.
The strongly acid odor of the sweat in certain rheumatic attacks
is thought to support this theory. The excess of lactic acid is
variously explained by the overwork of the muscles of which it
is the normal product, and by the imperfect oxidation of the

Rheumatism. 541

muscular tissue and its product into lactic acid (C,H,O (OH), ),
instead of carbonic acid (CO(OH),). But in spite of the per-
fect theory, there is the fact that as a rule no special increase of
lactic acid can be found in blood or urine in acute rheumatism
and the improbability that an excess of this acid caused by sud-
den excessive muscular waste could be kept up during a long
attack of acute much less of chronic rheumatism. Again the
comparative immunity of sucklings in which there is the greatest
opportunity for the production of lactic acid, would imply that
that alone cannot be accepted, as the one essential cause of the
affection. That its excess in the system will aggravate rheuma-
tism, or even produce it under favorable circumstances must be
freely acknowledged ; also that acidity of the saliva is a marked
feature of rheumatism. ;

The acid phosphate of soda may be assigned a somewhat sim-
ilar réle. In strongly predisposed subjects the ingestion of citric
or other organic acid will sometimes precipitate rheumatic articu-
lar pains.

Still other products, the result of imperfect oxidation or meta-
bolism must be allowed a place as probable factors in rheumatism.
The occurrence of gout in connection with the excess of uric acid
in the system is strongly suggestive of this, and the frequency of
muscular rheumatism in pampered, overfed dogs with diseased
livers and abnormal hepatic products, seems to give further sup-
port. Even in man, the subject of acute rheumatism, often leads a
luxurious life and suffers from inactive or disordered liver, while
in man and animals alike, a low grade of health and imperfect
functional activity of important organs, are often precursors and
accompaniments of acute rheumatism.

Neuropathic theory. 'The doctrine of a neurotic cause originat-
ed by Dr. Mitchell, of Philadelphia, has considerable basis in
theory. The primary chill tends to nervous derangement,
which may readily affect the overworked or already diseased and
debilitated joints. Siniilar peripheric disturbance of nutrition oc-
curs in locomotor ataxia in which the central nervous lesion is
very evident. There is a strong disposition in rheumatism to
show a bilateral symmetry, which points directly to a central ner-
vous control. The frequent violence of the pain, disproportionate
to the moderate structural changes, points in the same direction,

542 Veterinary Medicine.

and the free perspiration present in some severe attacks, points
alike to its origin in cutaneous chill and to derangement of the
centres presiding over perspiration. It may be added that the de-
velopment of rheumatic symptoms in the advanced stages of in-
fectious diseases, when the toxins are accummulating in the sys-
tem, suggests that they are the direct result of a toxic action on
the nerve centres. In man the influence of severe nervous shock
in developing and maintaining rheumatism is recognized.

Theory of infection. 'This has been advocated by Cornil and
Babes and Friedberger and’Fréhner. The former quote the fre-
quent presence of microdrganisms and above all of micrococci in
the liquids of the affected joints, serosze and valvular exudates and
ulcers, and even in the blood, and the occurrence of rheumatism
in the course of various septic affections. The latter quote Auer and
others as to the frequent supervention of articular rheumatism
on the retention of the afterbirth inthe cow. The weak point in
these theories is the multiplicity and variety of the microbes found
in the exudates. Either we must accept the rheumatic lesions as
an occasional result of many microbes, which habitually act differ-
ently on the system, or we must look upon them as mere acces-
sory causes or accidental complications. It might even be, that
the invasion of these microbes is made possible by the inflamma-
tion and debility of the tissues, without being directly chargeable
with the rheumatic process. Even then there remains the possi-
bility that a specific microbe is present, which by reason of its in-
finitesimal size, or other physical property, has as yet escaped
recognition. If such specific microbe is present, it manifestly re-
quires a very special predisposition, since it is not seen to advance
from one individual to another unless such favoring conditions
are present. ‘The symptoms and lesions of rheumatism are not
incompatible with the idea of such an essential, specific germ, but
as yet no such germ has been satisfactorily demonstrated as pres-
ent in all cases.

Local injuries. Rheumatism seems to attack by preference parts
that have already been debilitated by disease, a disposition which
is also true of distinctly microbian infections. A’ pre-existing
sprain, blow, bruise or an inflammation arising from any other
cause seems to practically invite the localization of the morbid
process at that point, and thus what was at first a purely traumatic

Rheumatism. 543

lesion becomes the seat of active and perhaps permanent rheuma-
tism. Unusual overwork and fatigue of given joints and muscles
induce a similar pre-disposition, and habitual overexertion, sprain,
injury or inflammation affecting repeatedly the rheumatic organ
tends to fix the process in chronic form.

Articular lesions. ‘These tend to concentrate as a form of in-
flammation in the synovial membranes, but usually implicate
all the constituent structures of the joint, capsular and binding
ligaments, cartilage and fibro-cartilage, articular lamella and
osseous tissue. The synovial membrane may show only slight
hypereemia; or in severe cases it may be congested, red, thick-
ened or even extensively infiltrated with a serogelatinoid liquid.
These lesions are most marked around the line of attachment
on the articular surface and in the synovial fringes. The syno-
via is usually in excess, distending the capsule and is whitish,
opaque, flocculent or more or less deeply colored with red. It
contains flakes of fibrine, leucocytes, albumen and it may be red
blood globules. Pus célls are usually absent unless in distinctly
infective cases. Coagula and false membranes floating from or ad-
herent to the solid tissues, may be present in considerable amount
and if these become organized they tend to lay the foundation for
future stiffening and rigidity. In and beneath the serosa, cell
proliferation may go on actively, especially in the synovial fringes.
‘The synovia is usually neutral or slightly alkaline, though in rare
instances it has proved to be acid.

The inflammation of the synovial membrane of the joint often
extends to those of the adjacent tendons, implicating at the same
time the tendons and their fibrous sheaths. Softening and rup-
ture of the tendons have been noted by different observers (per-
forans, Oger ; gastrocnemii, Trasbot : suspensory ligament, Olli-
ver.

The articular cartilages and the fibro-cartilages may be the seat
of congestion, with ramified or uniform redness, and areas of
swelling, softening, absorption, erosion, and ulceration, the ulcers
varying in size from a millet seed upward. The nuclei increase
in size and the cartilage cells multiply. In chronic forms calci-
fication is not uncommon.

The articular lamella and subjacent bone may show inflamma-
tion with increased vascularity, softening and even ulceration.

544 Veterinary Medicine.

In the chronic forms on the parts denuded of cartilage, the surface
of the bone may show the clear, polished condition known as
eburnation.

The binding ligaments may show congestion, thickening, exu-
dation, softening, with increased rigidity, or in some cases relax-
ation. Calcification is not uncommon in chroniccases. The soft
parts around the joints are often extensively infiltrated and.
swollen. ‘

In horses these lesions are specially common in the fetlock,
but occur also in the knee, elbow, shoulder, hips, stifle and hock.
In cattle they tend to attack the same parts with a preference per-
haps for the hocks and fetlocks.

Changes in the blood. ‘The blood becomes profoundly altered,
the albumen reduced, the fibrinogenous elements increased (5 to:
Io parts per 1000 instead of three), the red blood globules disap-
pear (in man 2,850,000 per cubic millimeter instead of 4,500,000),
the hemoglobin and oxidizing power of the blood are reduced
by about 50 per cent., the leucocytes are relatively increased, and
coagulation takes place with unusual firmness, a cupped surface
and an excess of buffy coat. No excess of urea, uric acid, nor
lactic acid, has been found, nor has acidity been found save in.
very rare cases. In rare and severe cases petechiz have appeared.
on the skin and mucosa.

Lesions of the heart. ‘The implication of the fibrous structures.
of the pericardium and heart and especially of the valvular struc-:
tures is a common lesion, and to be dreaded more than all others.
In all animals this tendency to cardiac lesion is well marked, but
especially in solipeds in which the great demands made on the heart
during rapid paces, heavy draught, jumping, etc., severely strain
the cardiac mechanism. In dogs there are not only the violent ex-
ertion and high blood pressure, but also the great irritability of
the nervous mechanism presiding over the heart and the tendency
to irregularity and intermissions in the rhythm and palpitations.
even when the organ issound. ‘There is every reason to conclude:
with Trasbot, Magnin, Heu and Laurent that in many cases the
heart is primarily attacked, and that this heralds the articular
rheumatism. In other cases undoubtedly the cardiac affection is.
secondary, following the articular attack.

Rheumatism. 545

Endocarditis is the most frequent, being found ina large propor-
tion of fatal cases, and thickening of the valves, wart-like exudates
and coagula are especially common. The clots may fil) nearly
the entire ventricular cavity, or at times the auricular, and show a
preference for the left side, probably because of the more vigorous
systole and the higher blood tension. ‘The clots as a rule are
firmly adherent to the diseased valve. Ulceration of the valve is
rare in rheumatism. Other parts of the ventricular endocardium
may be involved, becoming red, congested, rough or thickened,
with adherent blood clots.

Pericarditis is less common though it may exist on either or
both the cardiac and visceral folds. It is shown by vasculariza-
tion, thickening, fibrinous exudate, and serous effusion. Hay-
cock found in a horse a quart of reddish serous exudate with
floating fibrous shreds and false membranes. Pus has been found
in exceptional cases manifestly indicating a complex infection.
Like endocarditis it may precede, follow, or coincide with an ar-
ticular attack (Leblanc, Cadeac).

Myocarditis is usually seen as a complication and extension of
rheumatic inflammation of the visceral pericardium, or of the
ventricular endocardium. ‘The muscular tissue may appear par-
boiled and friable, and shows granular or fatty degeneration.

Pulmonic and pleuritic lesions. Embolism of the lungs and pleura
may occur from the transference of clots from the right heart,
yet the sequence is much more commonly an articular rheumatism
following infective disease of the lungs. Cadeac suggests that
the impaired nutrition in pneumonic and pleuritic animals pre-

_disposes to the rheumatic arthritis, and again that the microbes

of the infectious chest affection, colonizing the joints and other
synovial sacs, determine the rheumatism. This last theory has
the weakness of identifying influenza and contagious pneumonia
with articular rheumatism, and is negatived by the experience
that these two pulmonary affections never develop de novo from
simple rheumatism. The rheumatism which follows influenza
and contagious pneumonia therefore must either be considered as
a pseudo-rheumatism, or a rheumatism occurring only concur-
rently and accidently with the pulmonary affection. Apart from
this, pleurisy or even pneumonia occurs as a simple extention
from a rheumatic pericarditis.

35

546 Veterinary Medicine.

The occurrence of the rheumatoid affection as a complication
of influenza and contagious pneumonia in the horse, usually ap-
pears not earlier than 15 days after the outset of the pulmonary
affection and may be delayed, according to Palat, for 102 days.
Palat who had excellent opportunities for observation in army
horses found that about one in ten was the ratio in which the
rheumatic affection followed these pulmonary diseases.

The pulmonary lesions in these affections are essentially those
of uncomplicated influenza, or contagious pneumonia.

Cerebro-Spinal Lesions. Nervous disorders are occasionally
seen in rheumatism in man (dullness, prostration, delirium, coma,
spasms) and traced in different cases to hyperthermia, congestion,
exudation, embolism and toxins. In a few cases in the horse,
cerebral complications have been observed. Oliver saw a horse
with lachrymation, closed eyelids and hot, tender forehead, which
showed at the necropsy articular inflammation, and sanguineous
effusion in the cranium, encephalon, frontal and maxillary
sinuses and ethmoid cells. Jacob records two cases (mare and
horse) in which rheumatism was complicated by meningo-en-
cephalic congestion but without necropsy as both recovered.

Digestive system. In man rheumatism has been exceptionally
preceded by pharyngitis, dysphagia, and diarrhcea. In the horse
Haycock has seen concurrent congestion of the pharyngeal mu-
cosa, Olivier congestion of the stomach and intestine, and Jacob
diarrhoea and abdominal pain, Leblanc and Palat record cases of
peritonitis accompanying articular rheumatism in the horse.

SYMPTOMS OF ACUTE ARTICULAR RHEUMATISM IN
THE HORSE.

Chill, hyperthermia, lameness in fetlock, hock, knee, shoulder, stifle, hip,
elbow, tendons, sheaths, bursze, bilateral, shifting, swelling, heat, tender-
ness, decuhitus, joint semiflexed, pain on extension or flexion, signs of
cardiac disease. Course: rapid to recovery, improvements and relapses,
metastasis, debility.

The attack is usually sudden and marked by a slight chill, shivering
or staring coat with hyperthermia and lameness. The temperature

Symptoms of Acute Articular Rheumatism in the Horse. 547

may vary from normal to 107° or 108° F. in severe attacks. In
many cases the fever and Jameness appear simultaneously, the
former being in ratio with the extent and severity of the latter,
but not infrequently the elevation of temperature precedes the
articular symptoms, and then it is to be considered as concurrent
with the internal lesions—cardiac, pericardial or otherwise. In
other cases the articular lesions and lameness precede by several
days thé appearance of the fever. So far as we know the fever
never antedates the occurrence of some local lesion, external or
internal. , .

The joints affected are very varied. ‘The fetlock is the most
frequently attacked, but some of the other larger joints, the hock,
knee, shoulder, stifle, hip and elbow are often involved or ex-
clusively affected. The adjacent tendons and their synovial
sheaths are very often implicated; the attack is very prone to
show a bilateral symmetry, the same joints (right and left) on the
corresponding fore or hind limbs, suffering at once, or, asin the

"case of the fetlocks, all four are simultaneously attacked. A
joint that is weak by reason of previous injury or disease is espe-
cially liable to suffer, and is then less likely than joints that had
been previously healthy to undergo speedy improvement. When
the symptoms wander from joint to joint or from joint to muscle,
or fascia or tendon, the disease in its earlier seat seeming to
undergo almost complete resolution, while it advances with great
intensity in the newly affected joint or part, the occurrence is
highly significant. These transitions often take place with great
rapidity. Thus the centre of suffering may shift from one joint
to another in an hour, (Magnin, Cadeac), or from a limb to the
loins in a quarter of an hour (Lewis). The fact that the inflam-
mation remains fixed in one or several joints, is not, however;
proof of the absence of rheumatism. A joint with a primary
weakness or injury may remain the seat of disease through even
a chronic rheumatism.

The affected joint is usually swollen, hot and tender the tender-
ness being as a rule greatest where the capsular ligament is
pressed upon. ‘These symptoms ate very evident in joints that
approach the surface, and obscure in such as are thickly covered
by muscle (shoulder, hip). The swelling is soft, or tense and
elastic (especially over the synovial membrane), or cedematous

548 Veterinary Medicine.

and pitting on pressure. On white skins sparsely covered by hair
there is marked redness and congestion, the veins standing out
prominently and the arteries above the joint pulsating strongly.
When the tendinous sheaths are involved, they stand out as
elastic lines following the course of the tendons, and with more
or less pasty swelling adjacent.

In some cases, however, the swelling may be entirely absent,
and the trouble is to be located only by the local tenderness and
pain during motion.

Small, hard, pea-like, subcutaneous nodosities were first
noticed by Floriep, in 1843, in rheumatism in man, and have been
met with in different cases in the horse. Rodet fils met with great
numbers of these nodules crepitating under pressure, in a horse
that had suffered for months from chronic rheumatism.

Acute pain on moving the affected joint or tendon is a most
characteristic symptom. The horse goes dead lame, walks on
three legs, or with great stiffness, and avoids as far as possible
all flexion of the joint. If left alone the animal stands stock still, °
never moving from the place, or in the worst cases lies down
and refuses to rise. If compelled to walk the suffering is shown
by hastened breathing, dilated nostrils, anxious, pinched
countenance and low plaintive neighing. ‘The affected joint is
held semiflexed, to relieve the tension, the pastern is habitually
more upright, and if the foot is lifted and the affected joint bent
or extended, the animal winces, or resists, and tries to draw away
the limb and groans. The movements of the affected joint. in
walking or under manipulation, are often attended by cracking
which may be both felt and heard. It has been variously attrib-
uted to lack of synovial lubrication (Cadeac), and ulceration of
the articular cartilage (Lafosse), yet it may occur from the con-
strained position assumed, as in the case of a man attempting to
walk noiselessly on tip toe, and in other cases from the extension
of false membranes, or of rigid or contracted binding ligaments.

Rheumatism of the fetlock and sesamoid pulley, as the most
common form in solipeds, demands a special notice. The swelling
of one fetlock, of the two fore, of the two hind or of all four at
once, extends beyond the limits of both joint and sesamoid pulley
and may form a general engorgement or stocking which serves to
hide the synovial distension. Pressure however shows that while

Symptoms of Acute Articular Rheumatism in the Horse. 549

all is tender, the extreme tenderness is referable to the joint, the
synovial sheath of the flexors, to the flexors or suspensory liga-
ments. As the general swelling subsides the rounded or ovoid
synovial distensions become more patent. The swelling and
tenderness may extend to the knee in which case the synovial
membrane of the carpal arch is especially distended and tender
from the carpus down, or in the hind limb the synovial membrane
of the tarsal arch is distended showing in this case on the inner
and outer sides in front of the calcis, and not infrequently im-
plicating the summit of that bone as a capped hock.

In rhenmatism of the shoulder the coraco-radial tendon and
pulley may be involved, causing a diffuse swelling on the point of
the shoulder. If the hip is the seat of disease the median gluteaj
may suffer, causing an indefinite swelling over the joint. If the
stifle is affected the patellar capsule suffers and not infrequently
the tendon and pulley of the flexor metatarsi are involved. _

The most important internal complications, pericarditis and
endocarditis, are manifested by their usual symptoms, sharp,
variable, irregular, unequal or intermittent pulse, blowing mur-
mur usually with the first heart-sound, oppressed breathing, and
it may be muffled heart sounds, or dropsies.

Course., ‘This is exceedingly uncertain. Some cases make a
rapid progress to complete convalescence ; others make partial
improvements interrupted by relapses ; others have the morbid
process subside in great measure in one joint or organ only to re-
appear in full force in another ; others leave complications on the
part of the heart especially and are rendered permanently useless.
Even should the heart escape, the health often suffers so much in
connection with the destruction of the red globules, the malnu-
trition, and the local disease, swellings and distortions of the
joints that a perfect recovery seems distant and problematical.

SYMPTOMS OF CHRONIC ARTICULAR RHEUMATISM
IN THE HORSE.

Larger joints, muscles, heart, false membranes, indurations, thickenings,
calcifications, remittent, weather changes, cold, damp beds, winds, open
windows or doors, draughts, cold sponging, clipping. Diagnosis: lameness
variable, shifting, electric and meteoric storms.

Chronic rheumatism may be a sequel of the acute, or it may oc-
cur from the same causes acting with lessened force, or on a less
susceptible animal. It tends to attack the larger joints especially,
though it may implicate the muscles as well. Coincident affection
of the heart, is less common than in the acute, and when it
does arise seems to advance slowly. It is liable to cause perman-
ent distensions of the affected joint capsules, as well as false mem-
branes, articular abrasions, degenerations and ulcerations and less
frequently bony enlargements and calcifications, the latter impli-
cating the soft tissues in the vicinity.

The attendant lameness is liable to be remittent or intermittent,
subsiding in warm buildings and during genial, clear sunny
weather, and relapsing in connection with cold, raw nights and
mornings, exposure in the dew or rain, and before and during
great changes of weather. Cold, damp beds, chilling draughts be-
tween open doors or windows, washing with iced water, sudden
intense cooling of the body after perspiration, clipping during
cold weather, any cause of sudden rigor, when followed by stiff-
ness, lameness and articular swelling, serves to identify the latter
as rheumatic. Even the warmth induced by judicious exercise,
may cause improvement, so that a horse, starting out stiff or
lame, may drive out of it after going a mile or two. The for-
mation of subcutaneous nodules, though rare, appears to be more
frequent than in acute rheumatism.

Diagnosis is to be based largely on the variability of. the lame-
ness at different times, its propensity to shift from place to
place, its manifest association with exposure to cold, and with
the immanence of electric storms or change in the barometric
pressure, and its improvement under genial weather, warmth and
comfort.

55°

SYMPTOMS OF MUSCULAR RHEUMATISM IN HORSES.

Under usual causes, muscles tender, stiffness, groaning, loins, quarter,
shoulder, neck, chest.

Developed under conditions similar to those causing rheumatism
of the joints, rheumatism of the muscles tends to attack those of
a particular region, and to continue in these throughout the
attack rather than change to others. ‘The affected muscles are
very tender to the touch, but usually show no swelling nor heat.
The muscles are relaxed and tend to atrophy, fever is little
marked, there is comparatively little tendency to the implication
of the heart, and the suffering and stiffness vary with the varia-
tion of the weather, or with electric or barometric changes.
When generalized, however, fever may superveue, and the joints
may be implicated (Thompson).

When the Joins are affected they become extremely tender to
the touch, and the horse shows great stiffness, and groans when
made to walk and above all when turned or backed. He does
not, however, show the unsteadiness in gait and tendency to
stagger that is shown in sprain of the loins, and there is no history
of a slip, fall or injury, but an unmistakable connection with
cold, exposure, change of weather, or overfeeding on grain.

When the ‘gluteal muscles are attacked there is intense lame-
ness, and dragging of the hind limb, with an acute sensitiveness
of the skin of the region, which characterizes neither disease of
the hip nor of the trochanterean bursa.

When the scapulo-humeral muscles are the seat of disease, there
isa marked stiffness, shortness of step, dtooping of the head,
and great tenderness of the skin and muscles to manipulation or
the use of the currycomb. Like the other cases named it occurs
suddenly, without evidence of accident, but bearing a relation to
cold or other change of the weather, and is better or worse as the
weather is more or less genial.

When the cervical muscles are affected (torticolis), the same
features are noted, the absence of traumatic cause, the presence
of a meteorological one, or at least of cold or wet, the respons-

55!

552 Veterinary Medicine.

iveness of the disease to the state of the weather, and to revul-
sive agents applied to the part. The neck may be held rigidly in
one position, to one side or elevated so that there is great difficulty
in getting the nose to the ground.

The costal muscles are less frequently attacked (pleurodynia),
but the same general principles guide in diagnosis.

Seidamgrotzky alleges the constant existence of acidity of the
urine in muscular rheumatism. ‘This may be attributed to the
active trophic changes going on in the muscles.

SYMPTOMS OF ACUTE ARTICULAR RHEUMATISM
IN CATTLE.

Sudden onset, hyperthermia, chill, fever, acid saliva, decubitus, does not
stretch on rising, lameness, joints involved, metastasis, variability, morning
and noon, suppuration, walking on toe, secondary articular rheumatism.
Course : muscular symptoms, cardiac, pleurilic, digestive. Chronic. Mus-
cular rheumatism: of back, loins, shoulder, quarter, neck. Changes in
blood and nutrition.

There is a sudden attack with constitutional disorder, chill,
staring coat, cold horns and ears, dry muzzle, impaired appetite
and rumination, acid saliva, constipation, thirst, hurried breath-
ing, hard accelerated pulse and more or less hyperthermia.
Then there may come reaction with surface heat and glow. The
patient inclines to lie and when raised fails to stretch the back or the
hind limbs, stands with arched back, and walks stiffly and with
more or less lameness. The joints attacked may be determined
by local strain, compréssion on concussion, hence the frequency
of lesions of the knees and fetlocks. Yet any of the great joints
of the limbs may suffer,—hip, stifle, hock, shoulder or elbow—or
several may be affected at once. The disease may extend from
one joint to another, may improve in one or more, only to suffer
a relapse, and may oscillate better and worse according to the
state of the weather or the exposure to warmth or cold. Often
almost helpless in the early morning, the patient improves greatly
in the heat of the sun.

The affected joint is swollen, distended with liquid, hot and ten-
der with considerable infiltration of the surrounding tissues, in-

Symptoms of Acute Articular Rheumatism in Cattle. 553

cluding the tendons and their synoveal sheaths. Suppuration is
much more common than in the same affection of the horse ap-

pearing to be due to a complex infection with pus microbes. In
walking in severe cases the foot of the affected limb is planted-
with great care and caution, mainly on the toe and there appears

to be exquisite suffering when weight is thrown on it, so that
the fetlock and knee may knuckle over and the patient comes to
the ground. Great infiltrations, fibroid, and other hyperplasias
and even calcifications are not uncommon.

Cadeac describes as secondary articular rheumatism, those in-
fective inflammations of the joints that follow on parturition,
abortion, omphalitis, enteritis, etc., but it is manifest that these
ate special disorders due to the presence of the microbes of
specific diseases or their toxins and should be described with
these rather than with rheumatism.

The course of acute rheumatism in the ox is very uncertain.
Mild cases may recover in a few days.- In others the lesions be-
come extensive, great hyperplasia and induration occur around
the joint and permanent stiffness and even anchylosis may super-
vene. ‘The occurrence of temporary improvements and relapses
isa common feature. The extension of the disease to other
joints, tendinous sheaths, muscles and even internal organs is to
be dreaded. Extreme tenderness of the back and loins when
handled or pinched, with groaning is a marked feature especially
in cold and damp times or in early morning. Cardiac complica-
tions show themselves by shortness of breath, palpitations, hard
intermittent, irregular or unequal pulse, blowing murmur with
the first heart sound, and other signs of circulatory trouble,
Pleuritic, pulmonic and abdominal complications are also to
be looked for. ‘The costiveness by which acute rheumatism is
ushered in, becomes complicated by congestion of stomach and
intestine, and impaction of the first and third stomachs, great
dullness, anorexia and even nervous disorder. Colic and even
diarrhoea are occasional consequences.

Many cases subside into a chronic Jorm which shows a variable
condition, better and worse, according to the condition of the
weather, the exposure to cold and damp, and even the changes
of diet. This may last throughout life.

SYMPTOMS OF MUSCULAR RHEUMATISM IN CATTLE.

This may set in with the same abruptness as articular rheu-
matism, the animal in the morning after a wet, dewy or frigid
night showing general stiffness and lameness with extreme sen-
sitiveness of the skin and muscles along the back and loins.
The animal moves slowly and stiffly, grunting perhaps at each
step and shows inappetence, fever, dry muzzle and costiveness,
This is essentially vachialgia or lumbago. Pandiculation on
rising is entirely omitted.

Not infrequently the muscles of the shoulder are mainly affected
and become exceedingly tender to manipulation. The patient
seeks to remain recumbent and when raised will get up on his
hind parts and remain thus for some time resting on the knees
before he can be made to get up in front.

When the muscles of the croup are attacked the mode of getting
up is reversed, the animal rising first on its fore feet and re-
maining for a time sitting-on its haunches or resting on the
hocks before it gets on the hind.

If the muscles of the neck are involved there is the same stiffness,
soreness, tenderness and twisting to one side or rigid elevation
of the neck as seen in the horse in similar circumstances.

In any case there is a tendency to extension or shifting from
one part to another, and notably to the implication of the tendons,
synovial sheaths and joints. This is especially the case in the
acute type, while chronic rheumatism may remain long confined
to the groups of muscles which are first attacked. In the acute
forms too there is the greatest liability to internal complications
not only cardiac, but according to Cruzel abdominal and thoracic
as well.

A fatal result is rare, but the impairment of appetite and di-
gestion, the constant and often severe suffering, the destruction
of the red globules, and the malnutrition, and increased and per-
verted metabolism as shown in the pallor of the visible mucous
membranes, the steady loss of condition and advancing emacia-
tion, the rigid, dry, scurfy, hidebound skin, tends to wear out
the subject or render it unprofitable. In the chronic form it
may last for months.

554

SYMPTOMS OF RHEUMATISM IN SHEEP.

Articular rheumatism seems to be very rare in mature sheep,
while it has been recorded in lambs. Muscular rheumatism on
the other hand has been seen in connection with untimely shear-
ing,exposure to cold storms and cold, damp folds. The back
and loins, are tender to the touch, or in other cases the neck or
hind quarter, the limbs are carried straight and rigid, the animal
moves slowly and stiffly, falls behind the flock, and is found alone,
unthrifty and emaciated. It usually terminates in recovery |
though it may cause chronic disease and distortion of the affected
joints or it may even prove fatal. The usual tendency of the
morbid process to shift from joint to joint or to muscles, is here
again characteristic.

SYMPTOMS OF.ARTICULAR RHEUMATISM IN SWINE.

Climatic influences. Rheumatoid. Joints attacked. Muscles. Decu-
bitus. Stiff, rigid, steps on toes, grunts, swelling, heat, tenderness, chaps,
cracks, suppurations, inappetence, emaciation, metastasis, cardiac disorder.
Duration ; course. Chronic form. Muscular form. Diagnosis from trichi-
nosis. Connection with arthritis. Metastasis. Remissions.

The pig. which shows an extreme sensitiveness to climatic
vicissitudes and cold winds, fleeing instantly to his lair on their
advent, is yet protected by his subcutaneous fat, so that he is not
a frequent victim of simple rheumatism. Leblanc attributes it to
unwholesome pens: Chaussade to too rapid fattening (overfeed-
ing). Rheumatoid attacks are very common at the onset of hog
cholera, swine plague and other infectious diseases, when they
are probably but local manifestations of the general infection.

The lesions are mainly concentrated in the stifle, hock, knee
and fetlock. In some cases the dorsal and lumbar muscles suffer
and there is arching of the back with great tenderness on manip-
ulation. In other cases the muscles of the quarter or shoulder
are involved as shown by their stiffness and extreme sensibility to
touch.

555

556 Veterinary Medicine.

The pig is found down, indisposed to rise, and when up, stands
drawn together with limbs rigid and feet resting on the toes.
He will often point one toe to the ground repeatedly, before rest-
ing on the foot, or shift the weight uneasily from foot to foot.
If moved he grunts plaintively and if handled squeals.

The affected joints may be surrounded by hot tender swell-
ings or they may be nearly normal in outline, but they are
always very sensitive to pressure and above all to flexion and
extension, and the skin is usually hyperemic and red. There
may be engorgments of the lymphatics on the inner side of the
. limbs, and chaps, and cracks in the flexures of the joints. Sup-
purations may follow (Graignard) suggesting a complex infec-
tion.

There is little appetite and though the disease becomes sub-
acute or chronic there is a steady loss of condition or at least
a failure to thrive.

Benion’s reference to a coincident or sequent inflammation of
the respiratory or digestive organs and Spinola’s similar refer-
ence to pleurisy are strongly suggestive of swine plague and hog
cholera. Any manifest disposition to shift from one part to
another and any concurrent disorder of the heart, other than
simple palpitation is strongly confirmatory of rheumatism.

The disease tends to recovery in from four to twenty days,
or to pass into the chronic form. In this state the symptoms
are materially mitigated. Fever is absent, but the appetite, di-
gestion and assimilation are poor, the animal remains stunted,
emaciated or unthrifty, there is a disposition to lie most of the
time under the litter, and when up it moves stiffly with short
steps, semi-flexed joints and upright digits. Sometimes the
joints are permanently swollen and rigid by reason of thickening
and shortening of the binding ligaments, by the organization of
false membranes or by anchylosis.

Muscular Rheumatism in Swine. ‘This appears to be
rarely seen as an independent disease, but appears at times to
coincide with the arthritic form. In such cases the back is
arched and very sore to the touch or to pressure. It must be dis-
tinguished from the muscular soreness of trichinosis which oc-
curs in infested localities, after trichinous food or water, is pre-
ceded by digestive disorder and diarrhcea, and by the passage of

Symptoms of Articular Rheumatism in Dogs. 557

the nearly microscopic worms in the stools, and is independent of
arthritis.

Muscular rheumatism leads to atrophy of the muscles, especially
those of the quarters, and this may resemble, somewhat, partial
paraplegia from disease of the spinal cord. Its connection with
arthritis, its tendency to shift from place to place, to undergo
ameliorations and relapses, and its exquisite tenderness, serve to
distinguish it from paralysis.

SYMPTOMS OF ARTICULAR RHEUMATISM IN
THE DOG.

Articular rheumatism rare. Femoro-tibial joints, bilateral, remissions
Exudation, swelling of joint ; muscular atrophy, weakness, swaying, stagger-
ing, falling, paresis. Chronic, muscular rheumatism common, back, loins,
neck, general, stiff, painful movement, decubitus, muscles tender, yelps,
stiff neck, wry-neck. Masseteric. Painful defecation and urination.
Metastasis. Cardiacsymptoms. Pleurodynia. Digestivetroubles. Emaci-
ation, weakness, atony, paraplegia. Diagnosis from strongylus, stephan-
urus, and cysticerus.

This affection seems to be rare in the dog. What is known as
rheumatism in this animal, consists in an inflammation with hy-
perplasia around the articular ends of the long bones, the new
material being partly fibrous and partly calcified. It shows a
special predilection for the femoro-tibial joint and confines itself
mainly to the inner side of the head of the tibia. Here the swell-
ing may reach the size of a walnut. The whole head of the
tibia and lower end of the femur are however often involved, en-
tailing a general enlargement of the joint. It follows the general
rule of rheumatism in usually attacking both stifle joints at once,
and also in alternate ameliorations and relapses. Less frequently
other joints are affected. In all such cases the joints become over-
distended and swollen, partly by synovia, and partly by surround-
ing exudate, the muscles of the quarter and thigh become atonic,
soft and flaccid, and are steadily atrophied. The dog shows a
lack of strength in the hind parts, swaying, staggering or even
falling, and advancing to amarked paresis. The malady follows
a chronic course, lasting for months, a‘year, or more.

‘SYMPTOMS OF MUSCULAR RHEUMATISM
IN THE DOG.

Muscular rheumatism is common in dogs. It is most common
and most marked in the back and loins, though the neck may
suffer, or the disease may be generalized. It is painful to move and
the subject seeks to be as much as possible undisturbed. He
walks stiffly and slowly, carrying the limbs with as little movement
of the joints as possible, and in bad cases yelps occasionally from
sudden pain. Hecan no longer be tempted to go up or down
stairs or to make any special effort. When touched on the back
or loins he will wince, cry out, or even snap at the offender. In
some cases the pain is so acute that even a feint to touch the back
will draw out a yelp. If the neck is affected it may be held so
stiffly that the dog can barely reach the ground to find his food, or
if unilateral the head is turned to one side. Even the muscles of
the jaws may be affected, causing prehension and mastication to
be difficult and imperfect. Defecation and urination are also in-
terfered with and the straining may draw forth plaintive cries.

The rapid shifting of the morbid process from one group of
muscles to another is often very striking, and if one pronounces
on the exact seat of the disease, it is liable to be speedily rendered
inexact by a sudden change of place. There is further a great
disposition to the implication of the heart and especially: the
valves. This is shown by irregularity and inequality of the pulse
by intermissions and palpitations, by a blowing murmur with the
first heart sound and by oppressed breathing.

Short, shallow breathing is also caused when the intercostal
muscles are attacked (pleurodynia). Various digestive troubles
are also common, to which the difficult defecation and impacted
rectum largely contribute. ;

Emaciation makes more or less progress, and the muscles of the
hind parts especially become weak and atonic until marked paresis
or actual paraplegia setsin, and the hind limbs are.extended back-
ward and dragged helplessly. In fat, sluggish, overfed and pam-
pered animals the lack of control of the hind limbs may come on
at an early stage. Stiffness due to strongylus gigas in the kidney
or stephanurus or cysticercus cellulosa in the lumbar muscles
must not be mistaken for rheumatism.

558

PREVENTION AND TREATMENT OF
RHEUMATISM.

Prevention. Avoid known causes, untimely clipping, exposed buildings,
over fatigue, chills, cold rains, dews and frosts, disorders of liver and bowels,
sweets, spiced food, over-feeding, constipation, torpid liver, injuries to joints
ortendons. Treatment: warm stall and clothing, laxative food in modera-
tion, purgatives, aloes, castor oil, jalap, saline enemas, colchicum, alkalies,
trimethylamine, acetate of ammonia, salicylic acid, salicylates, salicine, oil
of gaultheria, salicine for debilitated. Largedoses hourly or every two hours.
Less effective in chronic cases. Heart failure. Salol. Salophen. Pheno-
coll. Antipyrin. Acetanilid. Pilocarpin. Tartar emetic. Dover’s pow-
der. Ammonium acetate. Chamomile. Boneset. Hot baths and packs,
with cold on bead. Hand-rubbing. Hot drinks. Nauseants. Hot iron.
Anodyne. liniments. Rubefacients. Blisters. Salicylate of methyl and
other salicylates. ‘Quinine and potassium iodide. Tincture of muriate of
iron. In chronic cases, tonics, cod liver oil, arsenic, guaiacum, potassium
iodide. Essential oils. Electricity.

Prevention. ‘This consists in the avoidance of all known causes
of the disease and must vary to some extent for different genera
of animals. The avoidance of cold and exposure, of clipping at
unsuitable seasons, of exposed sites for buildings (north and
northwest exposures, narrow valleys and ravines), of over-fa-
tigue, of perspiration and subsequent chilling, of cold rains, dews
and frosts, of inactivity, or habitual overloading of the liver and
bowels, and of local injuries of joints or tendons. House dogs
especially should be protected from sweets, spiced food, frequent
feeding, constipation and torpid liver.

Treatment. One of the most important considerations is a
warm stall or building, or warm clothing including loose woolen
‘bandages on the legs, in the horse, Laxative food is called for.

In acute cases and especially in fat pampered dogs, and in all
cases associated with torpid or disordered liver, a preliminary
laxative will be of great service, and others should be given later
as demanded. ‘The horse may have aloes or salines, and saline
enemata may be given to all animals when called for throughout
the progress of the disease. Pigs may take 1 or 2 drops croton
oil, or like dogs they may be given castor oil or jalap. Torpid
liver and constipation must always be carefully guarded against.

559

560 Veterinary Medicine.

To cut short the attack much reliance was formerly placed on
colchicum which increases the elimination of solids in the urine,
and on alkalies, which beside the theoretic antagonism to
acidity are at once cholagogue and diuretic. The action was
somewhat slow but on the whole satisfactory, usually abating the
suffering very materially in the course of a few days. To the
horse or ox %4 dram doses of colchicum were given daily in com-
bination with 4 to 6drams of bicarbonate of soda ; pigs of 100 lbs.
may take 1 grain of the former to Io grains of the latter; a
shepherd’s dog may take half the amount just named. Trimethyla-
mine proved even more effective than colchicum, and acetate or
citrate of ammonia, soda, or potassium was often substituted
for the carbonate.

But. the modern treatment of rheumatism dates from 1876,
when the introduction of salicylic acid and later sodium salicylate,
salicine and ol. gaultheriz gave to such treatment an efficacy pre-
viously unknown. Salicylic acid acts very harshly on the gastric
mucosa, and with sensitive stomachs is advantageously replaced
by sodium salicylate, into which it is transformed in any case in
the blood. Salicine which is held to be transformed into salicylic
acid in the system, is specially recommended for its bitter and
tonic action exercised in the stomach and prior to such transfor-
mation. Indebilitated subjects, therefore, and in those that suffer
from the characteristic rheumatic reduction of the red blood
globules it would be somewhat preferable. As a prompt and.
effective anti-rheumatic agent however it appears to be somewhat.
less reliable than sodium salicylate or ammonium salicylate. Ol.
gaultherize may be better borne by the stomach of the dog and
pig than the salicylates, the dose being 10 to 15 drops thrice a day,.
The secret of success with all of these salicylate compounds,
lies in the speedy saturation of the system with the drug, rather
than in its moderate and continuous administration. ‘The horse
or ox may take ¥% oz. repeated every two hours for ten hours if
relief is not obtained earlier. The pig may take 20 grains, and.
the dog 5 to 10 grains at similar intervals. It is not desirable,
however, to continue this indefinitely, and therefore when im-
mediate relief has been secured it is well to give the agent but
twice or thrice a day, and resort in part to the alkaline treatment.
If the salicylates fail to relieve when pushed energetically for ten.

Prevention and Treatment of Rheumatism. 561

hours, there is reason to fear that the case is not one of genuine
rheumatism. ‘

The salicylates are less applicable to chronic cases and may be
even dangerous when the heart is affected, as they tend to render
the heart’s action slower and weaker, and thus add to the dangers
of Hhypo-hzemoglobin, and heart failure. A similar caution applies
to an excessive use of alkalies and especially of compounds of
potassium which depress the heart action.

As substitutes for the salicylates, salol, salophen, phenocoll,
antipyrine and acetanilid have been largely resorted to. ‘The first
is safe and trustworthy and does not irritate the stomach nor
interfere with digestion. It may be given to horse or ox ina
dose of 3 drams, thrice a day, to the pig in 10 grain, and to the
dog in 5 grain doses.

Hubner had good success with pilocarpine hydrochlorate hypo-
dermically (4 grains for a 7-months colt, ) but this was not equally
successful in the hands of Siedamgrotzky. Other sudorifics like
tartar emetic, Dover’s powder, ammonium acetate, hot or spiced
drinks (chamomile, boneset, ) hot baths, hot air baths, and wet
packs have been used successfully and may still be employed in
suitable cases. ‘The opium is often very helpful in relieving in-
tense suffering, and beside or in place of the Dover’s powder
internally, morphia may be injected subcutem over the affected
region. ‘The main objection to its use in its tendency to lock up
the liver and bowels. Liquor of the acetate of ammonia fills at
once the réle of a potent diaphoretic, an antacid, and an eliminant.

In the use of baths and packs it is well to consider the condition
of the patient. If the surface is cold with little reaction, and if
the attack has supervened on exposure, or chill, persistent hot
applications are indicated. Dogs and other small animals should
have full hot baths lasting for 15 or 20 minutes, and while in full
glow may be quickly sponged with cold water and rubbed dry in
blankets, great care being taken to avoid exposure or chill when
damp. Or for these and the larger animals as well, a hot air or
steam bath may be applied under similar precautions. A cold
wet wrapping on the cranium will tend to relieve cerebral conges-
tion during the administration of the hot bath. In horses and
cattle, surface heat and sudation may be secured by active rubbing
with wisps of straw, of both body and limbs, or by covering the

36

562 Veterinary Medicine.

neck and trunk with large bags containing a small amount of
chaff, sand or grain hot from an oven. Hot carminative or
alcoholic drinks are excellent adjuvants, and even sedatives or
nauseants (opium, veratrum, aconite, tobacco). Another resort
is to pass a hot smoothing iron an indefinite number of times over
the affected region. ‘The part may be finally wrapped in cotton.

In cases where the temperature runs high, on the other hand,
and when the surface glows, this dread of chill and reaction may
be dismissed. For the small animal a bath starting at 70” F. may
be gradually lowered to 60° or 50° F. Or a full pack may be
employed, a sheet wrung out of cold water being closely wrapped
around the body, and covered at all points with two or more dry
woolen blankets, care being taken to avoid the entrance of air and
the occurrence of evaporation from the inner, damplayer. This
cools the surface also the blood passing inwards, and in fifteen
or twenty minutes it should induce free perspiration. It may be
kept up twenty to thirty minutes and may be repeated as often as
there is a serious rise of temperature. A less energetic method
is the mere sponging of the surface with cold water. In all such
cases friction is a valuable accessory.

Anodynes and revulsives are often applied to the affected parts
with good results. In very acute cases (especially articular),
lotions and liniments of salicylic acid or salicylate of soda with
laudanum, aconite, or chloral hydrate may be used. In the less
violent cases camphorated spirit, soap liniment, or a combina-
tion of essential oils (gaultherium, turpentine, cajeput, origanum,
peppermint) with aqua ammonia and sweet oil may secure great
relief. Mustard or essential oil of mustard in vaseline is an ex-
cellentalternate. Finally active cantharidine blisters are usually
most effective. These are applied over the affected joints or
muscles and if the inflammation shifts to other parts it is fol-
lowed up until it finally disappears. A concurrent alkaline
treatment, and more important still, absolute rest, will serve to
protect the heart to some extent, against a metastasis from the
exterior. It has been supposed that the beneficial action of the
blister is in ratio with the amount of exudate, and hence
cantharides has been highly esteemed in this connection. Fried-
berger and Frohner have used tincture of iodine and biniodide
of mercury.

Prevention and Treatment of Rheumatism. 563

The local application of anti-rheumatic agents would embrace
all the salicylates, oil of wintergreen and guaiacol, the latter
mixed with an equal amount of glycerine. Methyl salicylate
has been strongly recommended for external use.

Stenel covers the surface with lint smeared with salicylate of
methyl ointment, and then applies a plaster bandage over all.
This removes muscular spasms, pain and swelling and is rarely re-
quired for longer than a few days.

In cases in which salicylates fail, other agents have been re-
sorted to in man and to a lesser extent in the lower animals.
Greenhow strongly advocates a combination of quinine and potas-
sium iodide internally, while Russell Reynolds has successfully
employed tincture of muriate of iron in large doses repeated every
three hours.

In chronic cases these would especially commend themselves as
calculated to repair the general health and overcome the loss of
hemoglobin. In chronic rheumatism a course of tonits is often
the best resort, and in dogs especially, cod liver oil has benefitted
when all else has failed. Arsenic too (3 to 8 drops Fowler’s
solution thrice daily) has been beneficial in both dogs and_pigs.
In other cases iodide of iron has been helpful. So also with
gum guaiacum given in combination with potassium iodide. In
such cases too, treatment by alkalies and salicylates may be called
for, and close attention should always be.given to secure a free
action of the liver, bowels and kidneys. The local treatment
recommended for acute rheumatism, (hot baths, frictions with
essential oils and above all blisters of mustard or cantharides) is
even more applicable to the chronic. A firm bandage over a
covering of cotton wool, and a systematic application of electricity
will often help.. Warmth, a run at grass in a sheltered sunny
paddock, moderate exercise and a nutritious and easily digestible
diet are important conditions.

GOUT. PODAGRA. ARTHRITIS URICA.

Definition. Affects birds, dogs, perhaps pigs. Causes: excess of nitro-
genous foud, imperfect oxidation, impaired metabolism and elimination.
Susceptibility of birds in confinement. Xanthin bases, Nuclein. Hepatic
torpor. Contracted kidney. Affects tissues of little vascularity. Lesions:
chalky deposits around joints, and in internal organs, Solubility of biurate
of soda in synovia, serum, etc. Symptoms: arthritis, joint tenderness,
resting on breast, hard or fluctuating swellings, desquamation, ulceration,
chalky urates Diagnosis: test for biurate. Treatment: less albuminoid
diet, eliminating salts, colchicum, piperazin, surgical and antiseptic dress-
ing.

Definition. An arthritis characterized by periodical exacerba-
tions, by the deposit of sodium biurate in and around the joints
and at times in other parts of the body, and by more or less con-
stitutional febrile disturbance during the paroxysms.

Animals susceptible. Among the lower animals the disease has
been noticed almost exclusively in birds, which even normally
excrete so much uric acid that the liquid may be semi-solid as
found in the cloaca or inthe droppings. While this is a consti-
tutional peculiarity in the bird yet it is enhanced in connection
with an abundant diet of rich nitrogenous materials, as in forced
feeding, and in old animals in which the eliminating action of
the kidneys is more or less impaired. Ebstein has shown that
gout can be produced in birds by tying the ureters. All domesti-
cated birds, chickens, turkeys, pigeons, ostriches, geese, ducks,
Guinea fowl, have been found to suffer. A case of gout has been
reported ina dog, and Pradal has described it as existing in
swine, but the symptoms given are more in accord with articular
rheumatism.

Causes. The causes of gout are overfeeding especially on
highly concentrated nitrogenous food, acid sweets, and in turn
sweet and acid alcoholic drinks, an excess of uric acid in the
blood and tissues, imperfect oxidation of albuminoids, impaired
metabolism, imperfect elimination of uric acid, and impaired in-
nervation. Probably no single morbid condition is in itself
sufficient to induce the disease but a combination of several, un-
questionably operate in many cases.

564

Gout. Podagra. . Arthritis Urica. 565

The uric acid theory is favored by the constant presence of
this acid in considerable amount in the blood of birds, and by
- Ebstein’s experiment in tying the ureters, but it has to face the
fact that young and active birds living in the open air, and hunt-
ing for their food do not suffer, that it is usually scanty in the
blood of man just before an attack, that Gilman Thompson failed
to produce any symptoms of gout by injecting into the blood of
animals more uric acid than the amount which they normally
excrete in twenty-four hours, that the familiar symptoms of
uric acid poisoning are not at all those of gout, and that the ex-
cess of uric acid in leuceemia, aneemia and pneumonia produces
no such symptoms. In addition to excess of uric acid some
other factor is required. /

Xanthin bases (Xanthin, hypoxanthin, etc.) found in the blood
by various observers, are derived from albuminoids, especially
nuclein and nuclein bases, including in man caffein and theine,
and being closely allied to uric acid are believed to have anearly
similar action.

‘Various forms of abnormal metabolism are invoked as the
cause of uric acid and gout, and Haig and Vaughan hazard
the theory that the breaking down of the nuclein is an important
factor. ‘This and other metabolisms are atrributed to the local
action of the uric acid and urates, and again to a fault in innerva-
tion. The imperfect action of the liver where the uric acid should
be largely resolved into the more soluble urea, and of the kid-
neys through which it should be promptly excreted must be at-
tributed to a nervoussource. Levison incriminates the granular,
contracted, inactive kidneys.

Ebstein attaches great importance to impaired nutrition in the
affected tissues which undergo necrotic changes that pave the
way for the deposition of urates in their substance. This is some-
what sustained by the occurence of the local deposits in tissues in
which circulation and nutritive changes are slow, and in older
animals in which not only are the osseous tissues more calcic and
Jess vascular, but the articular lamella has been formed by
cretefaction of the bone and cartilage. Haig suggests that in the
old, the joints are less vascular and less alkaline, and more sen-
sitive to cold. On the other hand those in the greatest vigor of
life are more ravenous, digest more actively and are in this sense

566 Veterinary Medicine.

more subject to injury from excess of uric acid and allied
products. Birds at this age, confined and in process of fattening
are thereby exposed. Overfed, obese, lazy, old house dogs are’
under similar causative conditions.

Lesions, ‘The most prominent lesions in birds are chalky con-
cretions of urates on the articular ends of the bones and in the
structures around the joints including even the tendons, with
more or less inflammatory exudate and even necrosis, invading
the bony tissue and articular cartilage. Abscesses may be present
usually outside the bursa. Birds suffer especially in the tarsal,
metatarsal and phlangeal joints, but often also in the correspond-
ing joints of the wing, and less frequently in the joints of the
trunk, and in the internal organs,—kidneys, liver, lungs, serosa—
andskin. In these last, miliary chalky concretions and encrusta-
tions are found. In Briickmiiller’s case in the dog the chalky
deposits of urates were found mainly onthe epiphyses of the ribs,
but also on the joints of the limbs. .

Uric acid is always abundant in the blood of birds, and Roberts
has shown that biurate of soda (the usual form of precipitate) is
insoluble in blood serum, synovia and other body-fluids when in
excess of I : 10,000.

Symptoms. In birds the febrile and constitutional symptoms
have not been carefully observed so that the objective symptoms
in the affected joints have been mainly relied on. There is
extreme tenderness marked by standing on one limb, or resting
on the breast, and hence moping apart from the flock. “When
made to rise, the affected limb may be used to steady the body, or
even to walk, with a limp, though in bad cases the sound limb
only may be used. The affected joints are swollen, soft, hot,
extremely tender, pitting on pressure, and later the seat of
nodular yellow masses, usually hard, but sometimes fluctuating
and in size from a pea to a hazel nut. The superimposed
epidermis is thick, dry and scaly, falling off in flakes. Ata more
advanced stage the concretions may burst through the skin, dis-
charging a buffy, granular, debris containing crystals of urates of
ammonium or calcium, or of uric acid. Later still are ulcerous
sores, involving the disintegrating urate nodules and the necrotic
bones and cartilages. The deposits deflect the bones from their
normal direction, causing not only nodular swellings on the toes

Scurvy Scorbutus. 567

but much crookedness and distortion. Asin man the disease is
essentially chronic and advances slowly, with anzemia, emaciation,
debility and at timea diarrhcea. ;

Diagnosis depends largely on the recognition of the excess of
urates in the deposits. These appear under the microscope as fine
acicular crystals, which in the harder portions have a concentric
arrangement. A portion of the concretion may be moistened with
a few drops of nitric acid and evaporated to dryness. To one
part of the residue is added, by means of a pipette, a drop of aqua
ammonia, and to another caustic soda. ‘The ammonia develops a
beautiful purple red color, and the soda a blue or purplish blue
ring (Murexide test). In tubercular joints, which are common
in birds, the caseated nodule is made up of cells and granular de-
bris, with tubercle bacilli, and though cretaceous particles may be
present they fail to give the microscopic and color appearances of
uric acid.

Treatment. 'This must be largely preventive. The rich al-
buminoid feeding and close confinment must be modified especi-
ally in the older birds, and eliminating agents must be given in
the drinking water. The Carlsbad combination (sodium sulphate
22; potassium sulphate 1 ; sodium chloride 9 ; sodium bicarbon-
ate 18) may be used. Powdered colchicum ¥% gr. once or twice
daily during an attack, or piperazin % gr.twiceaday. Locally,
abscesses should be opened, and like any sores or ulcers, treated
with antiseptics (Salicylate of sodium 75 grs., glycerine 2 ozs.;
or piperazin solution 2: 100).

SCURVY : SCORBUTUS.

Definition. Susceptible animals: pigs, dogs. Causes : unwholesome salt
meat, lack of fresh food, vegetables, potassium, bad environment, unvary-
ing diet, lack of free range, putrescent food, foul water, infection ; non-re-
currence. Lesions : blood black, diffluent, little rigor mortis, excess of so-
dium, petechice and extravasations, red marrow, softened, swollen, bleeding,
ulcerating gums. Symptoms: Anorexia, prostration, debility, tardy move-
ments, petechiz, loss of bristles, ulcers, gum lesions, joint swellings, blood
extravasations. Diarrhcea. Prognosis unfavorable. Treatment : correct un-
wholesome environment and food, wash, rich food partly green or animal,
iron, bitters, arsenic, mouth wash (potassium chlorate), for suckling milk.
Butcher.

568 Veterinary Medicine.

Definition. Scurvy is a subacute or chronic trophic disorder
characterized by debility, inanition, anzmia, swelling and
bleeding of the gums, gingival ulceration, dropping of the teeth,
and petechial or more extensive hemorrhages and exudations in
the skin, serosa, and solid tissues.

Animals susceptible. In past times man has suffered extensive-
ly in connection with unwholesome food and environment on
long sea voyages, on uninhabited islands, in military campaigns,
in besieged cities, in famines, when restricted to one article of
food, etc. Among the lower animals, pigs especially suffer,
when kept in close, foul quarters and fed a monotonous and in-
sufficient ration. Dogs suffer under similar conditions, and
probably other animals would if equally badly used.

Causes. Formerly it was attributed to an exclusive diet of salt,
meat and bread ; to excess of sodium, and deficiency of potassium
salts ; to the absence of fresh vegetables ; totainted food, ete. A
broader generalization shows the Eskimo living on a pure meat
diet, the Mongolian on rice alone, the Congoese on plantains, and
without scurvy. Yet it cannot be denied that these various con-
ditions undermine the general health, and prepare the system for
those faulty states of nutrition which areseenin scurvy. In pigs
the food and environment are usually chiefly at fault, the subjects
have been kept closely confined in foul buildings, in a hot, moist
atmosphere, and with an uniform diet of maize or other unvary-
ing and insufficient ration. It does not appear: when there is a
free access to a spacious yard or open field, and where the monoto-
nous diet can be varied by a variety of slugs and other inver-
tebrates. Roll attaches great importance to a putrid con-
dition of the aliments (putrescent swill). Benion has found it
mainly in obese swine, the forced feeding and intestinal fermenta-
tions manifestly operating as factors. Corrupt drinking water
has proved a manifest factor among men living in camps, and
pigs above all other animals are subjected to this cause: Benion
says it occurs in the advanced stages of measles (cysticercus
cellulosa).

It is evident that unwholesome conditions of life such as the
above, contribute strongly to the affection, yet probably no one of
these is by itself an effective factor. Its rapid extension among
men and animals, that are huddled together in close, filthy

Scurvy . Scorbutus. 569

quarters suggests an epizoOtic or infective element, and Cornevin,
Hess and others attribute the disease in pigs to the germ of
erysipelas. Stengel has produced purpuric disease in animals
by inoculation of-the extravasated blood from human scurvy
patients. Miiller and Babes found a slender bacillus and strepto-
cocci in the tissues of scorbutic gums. The bacillus was present
in the mouth of non-scurvy persons. Borutrager found cocci in
the spleen. Berthensen alleges that after complete recovery the
disease does not attack the same person a second time, which, if
confirmed, will go far to establish a bacteridian origin. There
is considerable presumption of the existence of a microbian cause,
the efficiency of which is dependent on the unhygienic conditions
above stated, while these unwholesome conditions are equally
non-pathogenic in the absence of the microbe.

Lesions. ‘The blood is black and incoagulable or clots loosely,
rigor mortis is slight, changes may be found in the number and
character of the white and red blood globules, but are not constant,
there is usually an excess of sodium salts and deficiency of
potassium ones, and there is marked petechiation of the skin,
mucosz and serosze. The bone marrow may be abnormally red and
the bones fractured at the epiphyses, or carious. The addition of
the gum lesions makes the case characteristic. The gums are soft-
ened, swollen, red and uneven, with hemorrhagic discoloration,
erosions, necrotic areas and ulcers.

Symptoms. Anorexia or fastidious appetite, prostration, de-
bility and sluggish indifferent movements, are followed by the
local lesions on the skin and gums. On the skin appear petechie,
and extravasations, which often implicate the bristles, so that
they may be shed or pulled out with ease, the bulbs appearing
dark and bloodstained (bristle rot). These may be followed by
necrotic sloughs, and deep ulcers that are slow to heal. The
gums are red and swollen, with hemorrhagic spots, and bleed on
the slightest touch. Erosions, sores and ulcers are not uncom-
mon, the tongue is dry and furred, and the mouth exhales a feetid
odor. The teeth may become loose in their sockets. Swelling of
the joints, from hemorrhage or effusion, may be noticed, and
lameness or stiffness from muscular or intermuscular extravasation.
Blood effusions into the anterior or posterior chamber of the eye
have been noticed, and paralytic or comatose symptoms from

570 Veterinary Medicine.

.

similar effusions on the brain. In the absence of improvement
the patient becomes more and more debilitated and exhausted,
and death may be preceded by profuse exhausting diarrhcea.

Prognosis is unfavorable in advanced cases, and when the
faulty regimen cannot be corrected.

Treatment, ‘The first consideration is to correct the unwhole-
some conditions of life, purify the building and its surronndings,
and allow a free range on a pasture. Subject each patient to a
thorough soapy wash, and if possible allow clean running water
in which a bath may be taken at will. Access to green food and
invertebrates (slugs, larve, etc.) is important, or a varied diet of
grain, middlings, bran, roots, fruits, tubers, cabbage, silage, etc.,
must be furnished. Iron and bitters (nux vomica, gentian), are
useful and sometimes small doses of arsenite of soda solution, or
cream of tartar are useful. Acorns or horsechestnuts are recom-
mended. For the mouth a wash of potassium chlorate, soda
biborate, or potassium permanganate may be resorted to. Fried-
berger and Frohner advise for the dog extract of meat in wine.

In the case of fat pigs it is more profitable to butcher at once,
as soon as early symptoms appear.

In pigs or puppies brought up by hand, as in babies, the true
course, is to discard milk substitutes and give sweet new milk,
preferably of the genus to which the patient belongs. The im-
portant elements of cleanliness and outdoor life must not be
forgotten.

GOITRE. BRONCHOCELE. ENLARGEMENT OF THE
THYROID.

Definition. A non-inflammatory enlargement of the thyroid
gland, independent of known microbes or parasitism.

Causes. Goitre is an endemic disorder in man and beast,
though it may occur sporadically during or after .a debilitating
disease, or in animals that are overworked or out of condition.
As occurring endemically all accessory factors that undermine
the general health must be admitted as potent factors, though in-
sufficient of themselves to develop the malady in the absence of

Gottre. Bronchocele. Enlargement of the Thyroid. 571

the specific cause. Thus in Europe women suffer more than
man, being more confined indoors and being less muscular and
vigorous. In New York the new born offspring of ewes, kept in
close confinement during winter, may be all goitrous, while those
of flocks, having a free run through the whole season, escape.
Gurlt has seen the same in’ goats. Apart from debilitating
diseases New York horses and cattle develop the greater number
of cases in winter, the period of confinement and idleness.
House dogs suffer more than hounds. 3

Poor diet has a similar effect. In Europe where the disease is
very prevalent in the underfed peasant population, it is rare among
the highly fed domestic animals. Bouley says it is excessively
rare in animals even in the localities in which it prevails in man,
and though mentioned by Lydtin, Johné, Haubner and others it
is not as a common affection. In New Vork and Pennsylvania
on the other hand it is rare in the well-fed human population,
and very common in horses, mules, cattle, sheep, swine and dogs.
I have known congenital goitre to prove fatal to a new-born
dromedary in Central Park, New Vork. ‘The long, severe, win-
ter, close confinement, and impure air, doubtless as much as the
spare diet, contribute to this prevalence among the animals in New
York.

Intestinal worms and other parasitisms must be accepted as
secondary factors, the development of goitre often going on sim-
ultaneously with the increase of the parasites.

Heredity is claimed as a cause by Moller and others, and doubt-
less a weak constitution transmitted from parent to offspring, is
more susceptible. Apart from this the exposure of both to a
common specific cause is the main factor in its production.

Locality. ‘This must be accorded a first position in the causa-
tion of goitre, so far at least asit occurs endemically and enzootic-
ally. In England it has prevailed, in man, on the limestone hills
of Derbyshire, and Gloucester (Cotswold); in Europe. it is com-
mon in the Alps, Pyrenees, Savoy, Styria, Silesia, in the Black
Forest and in the Rhone Valley ; in Asia it prevails in the Hima-
layas, the Altai Mountains, the hills of China, and in the Pun-
jaub ; in South America it is seen in the valley of the Oronoco ; in
North America in Saskatchewan, Ontario, Michigan, Ohio, Penn-
sylvania, New York, Vermont, Virginia and Alabama. A large

572 Veterinary Medicine.

number of these localities lie on magnesian limestone or are
supplied with water that has percolated through this, so that at one
time the excess of magnesia and the lack of iodine were held to
be the main causative factors. This contention cannot be sus-
tained in all cases, so that the disposition is, at present, to
attribute the disease to some unknown poison. This unknown
poison may be present in districts apart from the magnesian lime-
stone, yet the disease is so frequently seen upon this formation
that its presence must always be looked upon with suspicion as a
probable bearer of the poison, and waters bearing its products are
unsuited to the victims of goitre.

Pathological Anatomy. Sometimes the swelling of the gland
which appears during catarrh or pharyngitis will subside on
recovery. In other cases it remains as a distinct hypertrophy.
This is usually an increase of the parenchyma and dilatation of
its follicles with an albuminous fluid (hypertrophic goitre.) ‘This
may affect one lateral lobe or both. In other cases the fibrous
tissue mainly increases and the gland becomes hard and resistant
(fibrous goitre). In other cases the individual follicles become
distended, and may even break into each other, forming a large
cavity or several with liquid contents (cystic goitre). In other
cases there is a great increase of the vascular network of the gland
so that blood alone is obtained on puncture (varicose goitre).
Tumors of all kinds may be found in the gland, thus encysted
adenoma, sarcoma and melanoma in horses, carcinoma in old
dogs.

Symptoms. In horses there may be swelling of one lateral lobe
of the gland or of both, reaching individually the size of a hen’s
egg or the fist, or larger. Cadeac cites cases that weighed 4 lbs.
In dogs, cattle, sheep and especially in swine, the two lobes are
much more closely connected, and the disease affecting both,
together with the commissure, the whole may be resolved into
one uniform swelling, much larger than in the horse relatively to
the size of the animal, often covering the whole front of the neck,
and extending into the chest. Cadeac mentions cases in the dog
in which the mass weighed 4 lbs.

The smaller swellings appear in the solipeds on the two sides of
the larynx, and in other animals more in front. They are
mobile, but rise somewhat with the larynx in swallowing, and are

Gottre. Bronchocele. Enlargement of the Thyroid. 573

usually covered by loose, movable skin. ‘The consistency of the
swelling varies; some are soft, elastic or pitting on pressure,
others fluctuate and still others are firmand resistant. Old cases
that have become calcified may even feel bony. In dogs it will
sometimes pulsate like an aneurism.

Functional secondary troubles are rare in solipeds. In the
other animals the goitre may compress the pharynx or gullet
causing dysphagia, or the larynx, trachea or recurrent nerves
causing more or less wheezing or dyspneea. Asphyxiais not un-
common in new born sheep, and goats, and Johné and the present
writer haye seen cases in dromedaries. The soft embryonic
tracheal rings had been so compressed from side to side that respir-
ation became impossible, Honert records a case of asphyxia in
an adult horse. Cases of roaring in adult horses and mules and of
asphyxia in adult dogs are also on record. Warz records the ob-
literation of the jugular in a dog, and Cadeac cedema of the lips
and face.

Tne course of goitre is usually slow, extending over years, yet
in young dogs it may make a very rapid progress. It will often
stand still for a time, and later start a new growth under a fresh
access of the cause. Spontaneous disappearance is rare.

Prevention. This is especially important in localities in which
goitre is enzootic, and embraces careful attention to the general
health, the avoidance of overwork, exhaustion, indoor life, lack
of exercise, impure air, faulty feeding, starvation, and water from
the goitrous soils. Rain water is preferable.

Treatment. First remove the various cattses, and secure the
best hygiene. Ifa change to a non-goitrous district can be had,
avail of it. °

Among medicinal agents iodine holds the foremost place. It
may be given internally as potassium iodide, alone, or along
with tincture of iodine, and applied locally as iodine ointment
rubbed into the skin, or tincture of iodine painted on the surface.

Of surgical measures the simplest and best is the injection of
iodine into the diseased thyroid. The nozzle of a hypodermic
syringe is inserted into the gland, preferably into the largest

‘cyst or follicular mass, and the liquid drawn off as fully as pos-
sible. It is then injected with the following mixture : compound
solution of iodine one part, distilled water two parts. The

574 Veterinary Medicine.

amount may vary with the size of the goitre. In cases of
moderate size 1% dr. to 1 dr. is suitable. There is usually some
resulting inflammation, which may be met by a wet compress
around the throat. A second and third injection may be made
if necessary, when the effects of the preceding one have passed
off. In simple forms it is very successful. For dogs Moller
recommends from 5 to 15 drops of undiluted tincture of iodine
at an injection. In other cases he used a watery solution of
papain (1:10) to be left in for 48 hours. The thyroid was then
soft and, on incision, discharged its digested parenchyma as a
milky fluid, and favorable healing followed. ;

The removal of the diseased lobe has been. successfully ac-
complished in horses, the reservation of the other lobe, or even of
the connecting commissure, being sufficient to prevent the occur-
rence of tetany. From the extreme vascularity of the organ it is
important to ligature the arteries before attempting the removal.

In the other domestic animals in which the commissure is prac-
tically obliterated and the two lobes confluent in goitre, the ex-
- cision of the mass is liable to be followed by tetany, dropsy
(myxoedemia), stunted development, anzemiaormarasmus. Ifa
portion of the gland is left these results do not follow. Grafting
of a portion of healthy gland may correct the tetany. The hyper-
trophy of the gland may sometimes be arrested by ligature of its
nutrient arteries, and without the dangers above named. This
may be combined with the internal and external use of iodine.

EXOPHTHALMIC GOITRE.

Definition. A complex disorder manifested by hypertrophy of
the thyroid, excessive bulging of the eye-balls out of the orbits,
cardiac palpitations or tardy heart action and other nervous or
trophic disorders.

Cadiot records a case in a horse, in low condition, with painful
cedematous swelling of one fore foot, and swellings in other parts
of the body, great enlargement of the. left lobe of the thyroid,
tumultuous heart action with beats 70 to 80 per minute, and
strong visible pulsations in the superficial arteries. There was

Rachitis. Rickets. 575

no leukzemia and no exophthalmia. The patient died on the
third day. ;

Jeswejenko records that of a four year old English thoroughbred
which after a race showed anorexia, weakness, thirst, rapid
pulse, palpitations, conjunctivitis, enlarged thyroid and after
fourteen days exophthalmia with thyroid pulsations. It died in
the fourth week, anzemic and exhausted. A second case ina 7
year old bitch recovered in three months under treatment with
iodine.

Roder gives the case of a cow with palpitations, abnormally
strong pulsations, thyroid hypertrophy and double intense ex-
ophthalmia. This persisted for four years.

RACHITIS. RICKETS.

Definition. Lesions and pathology ; gastro-intestinal disorder, hepatic,
splenic and renal congestion and hypertrophy, lessened blood salts, dilated
arteries, hypereemia of bone, deep red marrow, blue articular cartilage, soft-
ening of epiphyseal cartilage and under the periosteum, with hyperplasia,
decrease of lime salts, bending of bone, loose periosteum ; sclerosis in re-
paired cases. Causes : appears as if infection, lack of lime salts in food, in-
constant, free phosphorus, glycero-phosphoric acid, lactic acid, oxalic,
acetic and formic acids, heredity, bad air, crowding, damp soils, cold, con-
finement, darkness, infection, toxic matters. Symptoms: unthrift, thin
neck, arched or hollow back, drooping pelvis, weariness, stiffness, recum-
bency, limbs not plumb, tender, swollen, puffed joints, enlarged epiphyses,
bent shafts, or spiue, brittleness. Swine fed on potatoes or corn, ‘‘ snuffles’’,
breaking teeth, diarrhcea, bronchitis, skin eruptions, arthritis. Cattle,
epiphyseal swellings bow legs, crooked back. Dogs, bow legs. Goats
Birds, knotted thickening of bones, flexibility. Fever, colics, indigestion.
Lameness shifting, intermittent, relapsing. Paraplegia. Treatment,
hygienic, vigorous breeding animals, nutritious rations, rich in earthy salts,
well-balanced, from sound land, rich abundant milk without excess of fat,
avoid spoiled food, adapt cow’s milk to foal or puppy, fresh air, sunshine.
damp soils, antacids, lime water, laxatives, bitters, phosphates, bone dust,

phosphorus.

Definition. A constitutional disease of young afimals, asso-
ciated with disorders of digestion, nutrition, assimilation, and
sanguification, and especially characterized by softening and dis-
tortion of the bones.

576 Veterinary Medicine.

Lesions and Pathology. Apart from the bones there does not
seem to be an absolute constancy in the lesions. ‘I‘here is nsually,
however, a period of ill-health and faulty nutrition before the
lesions in the bones can be recognized. Thus, there may be
gastric or intestinal congestion, or catarrh, indigestion, constipa-
tion alternating with diarrhcea, enlargement of the liver, spleen
and kidney with hyperemia, and according to V Jaksch, a
diminution of the salts of the blood. Beneke found that the
arteries are dilated throughout the entire body, but the heart does.
not always participate in this distension. The arterial dilatation
is very marked in the pulmonary artery, yet the lungs are rela-
tively small. In the bones there is a well marked hyperzemia,
most prominent beneath the periosteum, in the cancellated tissue, .
the line of junction of the epiphysis and diaphysis, and near the
articulating surface. The contents of the cancelli are of a deep
red, and the color shines through the articular cartilage giving it
a bluish tinge. The shaft of the bone does not escape, but like
the epiphysis and epiphyseal cartilage may be soft and yielding to-
pressure, and cut readily with the knife. ;

At both points the process of growth is increased and its area
extended, but it is not completed by the full deposition of earthy
salts, and the softening is not confined to the new tissues, but
extends into the subjacent bone as well.

The chemical composition of the bone is profoundly altered, the
organic basis, at times amounting to 65 per cent., as compared to-
33-30 per cent in the normal bone. ‘The softened bone, yielding
under the weight of the body, bends out of shape at the epiphy-
seal cartilage, or even elsewhere, giving rise to bow legs, devia-
tion of the joints inward, or other distortion. The periosteum is.
red, thickened, the seat of exudate and easily torn from the
bone.

The bones are often thickened by new deposit under the perios-:
tem and especially at the junction with the epiphyses. Old
cases of distortion, the result of rickets, do not necessarily show
a deficiency of earthy salts, as these are restored in case of repair
and they may even be found in excess of the normal, increasing
the hardness of the bone.

Causes. This disease does not seem to have been recognized in
Great Britain until the beginning of the 17th century, the period of.

Rachitits. Rickets. 577

England’s early activity on the sea, and the begintting of exten-

. Sive commerce and manufactures. From that time it has been
increasingly and extensively prevalent. Yet it has not been
shown to be propagated by any specific germ, nor to have extend-
ed in line with the introduction and use of new food products like
the potato. It appears to be traceable rather to unwholesome con-
ditions of life and a reduction of the general tone and nutritive
vigor.

A deficiency of earthy salts in the food has been a natural and
favorite explanation, and the ill-health that is thereby brought
about is often an important factor. Vet rachitis occurs independ-
ently of such a condition.

In Roloff’s experiments, pigs fed on aliment deficient in lime
salts, suffered from bone softening, while the control animals on
food rich in lime salts remained well. The diseased animals
further recovered on a diet, rich in lime. Voight, Chossat, Milne-
Edwards, Lehman, Bousaingault, Heitzmann, etc., had similar
experimental results, and the effects were shown in goats, sheep
and dogs, in curvature, shortening, swelling of the costal carti-
lages and joints and contracted pelvis. Growing pigs have often
been found to suffer in this way when placed on an exclusive diet
of maize. The great improvement often secured in feeding an ex-
‘cess of calcareous phosphates tends to corroborate the hypothesis.
Wagner found that food rich in lime salts, and the administration
of small doses of phosphorus, rendered the epiphyses of the grow-
ing bones more compact. Kassowitz, on the other hand, found
that an excess of phosphorus caused absorption from the bone
substance and an irritable inflammation of the osseous tissue.
Schneidemtihl has seen the disease in calves raised on milk, poor
in lime, the product of emaciated cows ; in pigs getting only po-
tatoes and swill, and in puppies that were denied bones. It is
common in pigs on an exclusive diet of maize. Yet it is most de-
structive in many breeding studs where the alimentation is rich
and generous. It must be admitted that as a concurrent cause,
the paucity of lime salts and phosphates is a powerful factor, and
that in supplying the bone ash, and improving the nutrition,
these often prove of great value. Their privation is, however,
not an essential condition of rachitis.

Free phosphorus. Ziegler and Kassowitz emphasize the hy-

37

578 Veterinary Medicine.

pereemia of the cancellated tissue, and Wagner shows that this
condition can be induced by excess of phosphorus, but this excess
of phosphorus has not been found in the blood in ordinary cases,
and is not likely to occur in a great number of young, at the same
place and time, irrespective of food, as has been shown in breed-
ing studs in New Jersey, in the South and West. In particular
cases excess of phosphorus may operate, but it cannot be looked
on as universal or essential.

The presence of glycero-phosphoric acid is alleged by Trasbot,
but there is no proof of its constancy in rachitis, nor would its
presence explain the real cause of the disease.

Lactic acd in the system. Tactic acid, in vitro, dissolves the
calcareous salts of the bones. Trasbot alleges that it opposes the
precipitation of lime in the form of tribasic phosphate, as found
in bone. Siedamgrotzky and Hofmeister found that the salts of
the bone were lessened under the administration of lactic acid.
Heitzmann and Baginsky showed that by restricting the lime in
food and giving lactic acid, by the mouth or subcutem, the lime
salts in the bone were lessened relatively to the organic basis.
It should be noted that an exclusive diet of buttermilk is liable
to cause an attack of arthritic rheumatism. Lactic acid is, un-
doubtedly a cooperative factor in. certain cases, but though often
found in the diseased bone and urine of rachitic children (Ragsky, °
Morehead, Simon, Lehmann), it is not shown to be constant.

Oxalic acid. Acetic acid. Formic acid. Beneke found oxalic
acid in the urine in many cases of rachitis and attributed to it the
removal of the lime salts. Others have made the same charges
on acetic and formic acids which are sometimes found in the
diseased bone.

It is quite plain that the process of normal ossification is easily
disturbed, and that the same agent (lime, phosphorus) will assist
or hinder according as it is present in small or large amount, and
that certain chemical agents like organic acids may act injuriously
even in the presence of an abundance of bone salts.

Fleredity. Rickety parents have often rickety offspring, the
weak somatic cells, failing in both cases to build healthy, strong
tissues, but as a rule also, both have been condemned to live in
similar unwholesome surroundings.

Unhygienie Conditions. Schneidemiihl notes that in anitnals

Rachitis. Rickets. 579

as in man, bad ventilation, close impure air, crowding, damp im-
pervious soils, and cold, are found more or less in places where
rachitis prevails. By lowering the general health and tone, these
debilitate the tissue cells and impair nutrition and growth.

Confinement has a manifest influence. Rickets prevails in
children in the great manufacturing cities, where the exclusion
of sunlight and the breathing of impure air rob the system of its
vigor. The children of soldiers in India kept in close barracks
are largely rickety, while the more poorly fed native children
outside escape. Wild beasts in confinement are often rachitic,
unlike their fellows of the forest. Colts in confined stables
suffer while those in the fields and yards remain healthy. Swine
in Sweden in close pens and fed on potatoes alone suffer
(Stockfleth ).

Darkness usually coincides with confinement and it is note-
worthy that deep sea fishes, living in comparative darkness, have
usually cartilaginous skeletons.

Infection. Certain facts seem to point to a direct infection, as
coéperating with the debilitating conditions above named. The
advent of the disease in England about 1700: its frequency in
English swine on the European continent (Schneidemiihl) ; and
its enzootic prevalence in different parts of America, give seeming
support to the doctrine.

Dr. W. L. Williams has seen it appear on an Illinois farm
twenty years after reclamation from virgin prairie, prevail for ten
years and then disappear. ‘There was a remarkable coincidence
of recurrent ophthalmia, and disease of the bones and joints
(navicular disease, spavin, splints, ring bones, etc.)

In most of these cases the trouble occurred on low, damp
or impervious soils, agreeing with rickets in children, which
avoids the Alps or hilly districts, and abounds in valleys or bot-
tom lands.

Symptoms. ‘The colts show a lack of thrift and though there
may be no lack of growth or size, they have a rough coat, a poor
development of the neck, arching of the back and drooping pel-
vis. The chest may seem to sink between the scapule. They
move stiffly with swaying of the limbs, or even staggering and
are easily wearied or lacking in endurance. They lie a great
portion of their time or even persistently, refusing torise. When

580 Veterinary Medicine.

up they do not hold the limbs plumb, but allow them to deviate
one way or another in an unsightly way. ‘There is liable to be
swelling of important joints of the limb, (knee, hock, stiffle, fet-
lock), which are tender to pressure and kept partly flexed. The
ends of the ribs are often enlarged. Bending of the long bones
(tibia or radius), and deviations of the back or sternum from
the straight line are significant. Thickening of the ends of the
bones, or in the region of the epiphyseal cartilages are largely
diagnostic. ‘The bones are easily fractured. In swzne fed on
potatoes, corn, etc., besides the affections of the limbs, the thick-
ening of the bones and swelling of the joints, especially the
hock and pastern, there is enlargement of the nasal and maxil-
lary bones so as to seriously obstruct breathing (‘‘Snuffles’’).
The teeth suffer and break readily and in the general break down
diarrhcea, bronchitis or skin eruption appears and the subject
falls into marasmus and perishes. In the necropsy arthritis is
commonly found. In cattle beside the epiphyseal swellings, the
bow legs and joint enlargement, the back becomes crooked, ver-
tically or laterally. The same general symptoms appear in dogs
in which bow legs are a very prominent feature. Goats suffer
badly and mostly remain recumbent.

Birds suffer most, showing knotty thickening of the bones of
the legs and wings, and flexibility of the bones generally but
above all of the keel of the sternum, which is usually badly dis-
torted from sitting on the perch. ,

In all alike there are usually a few days of fever, followed by
indigestion, colics, anorexia, and a general air of illness. "Then
appear the lameness, stiffness and swelling of bones and joints.
Any joint may suffer, shoulder, elbow, knee, hips, stifle, hock,
or fetlock. The lameness may shift as in rheumatism, it may
intermit, occurring periodically, or it may advance uninterruptedly
to a fatal issue. Paraplegia is common and appears to be due at
times to pressure on the spinal nerves by the diseased vertebrz.
Before this becomes complete, the animal may walk with the
whole digits and metatarsi in contact with the ground, and the
softened crumbling calcis may project through the skin forming
an unsightly sore which soon becomes septic. The same happens
at times to the point of the elbow.

Treatment. ‘The most important, are the hygienic considera-
tions. Reject weak or cachectic animals from breeding, and those

Rachitis. Rickets. 581

that have been rachitic to a marked degree, as their progeny are
likely to show the same weakness. Change the ration giving one
that is well balanced and rich in nutritive matters and earthy salts.
Clover, alfalfa, and a generous grain diet may serve as an example
for herbivora, and a fair allowance of meat and bones for dogs.
Food from land that has apparently contributed to the disease in
other cases is best avoided. If the land is poor, sandy, or desti-
tute of earthy salts and phosphates, so much the more is it to be
suspected and set aside. In the case of sucking animals it
should be seen that the milk is rich and abundant, and that it is
not too rich in fat, nor otherwise calculated to disagree and in-
duce indigestion, Above all soured or otherwise fermented milk
should be withheld, and any buckets or troughs used in feeding
should be regularly washed, scalded and disinfected. In case
colts, or dogs are being raised on cow’s milk it may be requisite
to dilute it with one third its volume of barley water, or solution
of gum arabic, and to sweeten with sugar. Lime water with
each meal is valuable in counteracting acidity, and fermentation,
and in furnishing lime which may be absorbed in part.

In prevention and treatment alike, fresh air and sunshine must
never be neglected and in warm weather, an outdoor life, night
and day is of the greatest value. At the same time cold storms,
damp beds, or any condition which may induce chill must be ex-
cluded. Close stalls, pens, or kennels must be absolutely for-
bidden.

Among medicinal agents antacids are often essential on account
of the acid condition of the ingesta, lime water will often suffice,
but if there is manifest constipation calcined magnesia three times
a day on an empty stomach so as to counteract costiveness will
often serve a good end. ‘The atony of the bowel may be further
met by small doses of strychnia. Other bitters may be used if
this has little effect. Small doses of phosphate of soda, or bone
dust have been long lauded in the affection, and probably act
beneficially as a tonic as well as a food material. Phosphorus in
minute doses tends to increase the deposit of earthy salts and
consolidate the bones. Large doses induce hyperzemia of the
epiphyseal ligament and even favor fracture. A grain of phos-
phorus daily may be given in olive oil or better in cod liver oil
which acts as a valuable tonic, Dieckerhoff recommends the in-
tratracheal injection of the solution of phosphorus in olive oil.

BRAN DISEASE: SHORTS DISEASE: BRAN RACHITIS.

Miller’s horses. Bran and middlings as fodder. Torpid bowels, impac-
tion, indigestion, colic, early fatigue and perspiration, stiffness, lame-
ness, epiphyseal swelling, facial bones swell and soften symmetrically,
teeth drop, dyspnoea. Ashof bran. Treatment.

A curious form of rickets has been observed, especially in
miller’s horses as a result of an excessive consumption of bran
or middlings. It is characterized by torpor of the bowels, impac-
tion, indigestion, slight colics, early fatigue and profuse per-
spiration under slight exertion followed by stiffness, lameness,
enlargement of the bones in the region of the epiphyseal cartilage
(near knee or hock), or of the bones of thé face. The superior
and inferior maxillary bones are symmetrically enlarged, the
teeth are shed, mastication becomes difficult and theré may bé
some dyspnoea and snuffling. ‘This resembles the ‘‘snuffles’’ in
pigs on an exclusive diet of Indian corn or potato and Fried-
berger and Frohner seek to explain both, by the lack of lime and
phosphorus in the food. But wheat bran has 5.1 per cent. of
ash, and middlings 2.3 per cent. as compared with wheat flour
1.7 per cent. or oats2.7 percent. Putz onthe contrary attributes
the disease to the excess of phosphorus in the bran acting as the
free phosphorus in lucifer match factories in causing necrosis of
the jaw. But the phosphorus in bran occurs as phosphate of
lime which has no such action on the bone and one must infer
that the phosphoric acid is set free by some acid developed per-
haps in the intestinal fermentations. This is, however, as yet
unproved.

The ¢veatment of this affection consists in the suspension of the
bran and the expulsion of offensive accumulations and products
from the bowels, followed by a course of tonics and the general
treatment for rickets.

582

OSTEOMALACIA (MALAXOS SOFT) : CAOHEXIA OSSIFRAGA ;
FRAGILITAS OSSIUM: ‘‘ THE CRIPPLE:’’ ‘‘ THE STIFF-
NESS.’’

Definition. Disease of the mature. Decalcifying in cancelli and Canals
of Havers. Dairycows. Heavymilkers. Perverted appetite. Limed soils,
sandy or limestone. Low, damp, soils rich in organic matter. Cultivation.
Wateryfood. Plethoric. Debilitated. Cold. Changeof locality improves.
Microbes. Toxins. Lesions: vary with stage, congestion of marrow, ex-
cess of cells and fat, osteoclasts, exudates, friability of bone, distortions
and fractures in pelvis and elsewhere. Symptoms: low condition, project-
ing bones, rongh coat, perverted appetite, stiffness, decubitus, swaying
limbs, inappetence, drying of milk, fever, bed sores, sloughs, sepsis, pus in-
fection, fractures. Duration, 2 to 3 monthsandupward. Enzootic. Prog-
nosis, varies with enzootic, and stage ; best in recent cases, occurring, spo-
radically. Treatment: according to cause, rich, generous diet, grain, salt
bitters, cod-liver-oil, apomorphia, wholesome pasturage, intensive culture
change water, dry up milk, dry stables, pure air, sunshine. Slaughter.
Local derivatives,

Definition. A softening and fragility of the bones of adult
animals, in connection with solution and removal of the earthy
salts.

This is essentially a disease of mature animals and is thus
easily distinguished from rachitis, in which the lesions are due to
a faulty development of young, growing bone. In osteomalacia,
too, the decalcifying proceeds most actively in the walls of the
Haversian canals and cancelli, while in rachitis it progresses
especially under the periosteum and in and around the epiphyseal
cartilage.

The disease is found most commonly in dairy cows, but soften-
ing of the bones or mature animals has also been seen in horses
and other animals. Dieckerhoff, who quotes cases in mature
horses, adduces similar instances in colts under a year old, oc-
curring enzootically, and without the specific lesions of rachitis.
Seven out of sixteen broke their femurs in October, 1886, all kept
on the same place, in good box stalls, and well cared for. Landois.
found in bones an abnormal amount of fat, ossein, water and lime
salts. Grawitz found no material change in the cancellated tissue.

583

584 Veterinary Medicine.

In one district in Jutland, Stockfleth found an extraordinary
number of broken legs as the result of castration of colts, which
had not shown the thickening or distortions of rachitis.

Causes. ‘The disease is particularly common in cows which yield
a calf every year, and especially in heavy milkers, in which re-
spect it agrees with the osteo-malacia of woman. ‘The heavy de-
mands upon the system for the nourishment of the foetus and the
supply of milk, undoubtedly lay the system open to attack, if they
do not directly cause thedisease. Anearly and usually a persistent
feature of the malady is a depraved appetite, the causes of which
may be read upin Vol. II. The statements there made, require
some qualification inasmuch as osteo-imalacia is at times found on
limestone soils with hard, calcareous water, and on rich, alluvial
valley soils abounding in both clay and lime (Sarginson, Le-
clainche), as well as on barren sands and granite soils deficient in
both lime and phosphorus. It may evén appear on virgin or
mucky soils after liming, which had been free from the trouble
up to that time (Thorburn). ‘The decomposition of the abun-
dance of organic matter, hastened by the quick-lime, has evident-
ly been a contributing cause.

The excess of organic matter in the soil seems to be a consider-
able factor. Both Thorburn and Sarginson mention the ‘‘ mossy ”’
soils and waters, and in Lanarkshire, Scotland, and Westmore-
land, England, where they practised, black muck and peats
abound. ‘This is corroborated by the prevalence of the disorder
in the damp lowlands of Belgium and Jutland, in the Swiss val-
leys, on the damp lands of New Jersey and the Carolina seaboard,
and generally on damp pastures with rank, watery herbage.

When land has been better cultivated and enriched by ma-
nure, the disease has in many cases disappeared. ‘This has been
observed in England (Sarginson), Wurtenberg, Switzerland, etc.
(Leclainche).

Succulent, watery food (potatoes, turnips), have been quoted
as causes, as also rank, watery grasses, deficient in nutritious
solids, but such food has invariably come from habitual osteo-ma-
lacia soils. On the rich, cultivated soils of the Lothians, Scot-
land, cattle are fed in large numbers on turnips alone, and osteo-
malacia and pica are alike unknown. It is often noticed that the
fodder grown on particular (osteo-malacia) soils will cause the

Osteomalacia. 585

disease when fed elsewhere, so that the inference is that some agent
derived from these soils, and which is destroyed or rendered harm-
less by cultivation, is carried in the food. It cannot be a mere
defect of nutritive matter, as this could be counter-balanced by
the simple expedient of consuming a larger ration. Leclainche
has seen the disease in its worst form in herds which received a
rich and varied ration, while it spared adjacent herds that were
kept on rather short rations. Even young plethoric animals suf-
fered badly, though having all they would eat of natural fodders
(hay) from districts where the disease was unknown, and in ad-
dition grain, linseed cake, cooked legumes and bread. In two
neighboring stables, where the stock were kept in identical con-
ditions, receiving the same food, in equal quantity, one was deci-
mated by the malady, while the other was spared (Leclainche).

The affection often prevails on the higher lands, which beside
having the poorer soils, are specially exposed to cold storms and
frosts, so that chill enters as an accessory condition. In West-
moreland, England, the river Eden divides the affected from the
sound lands ; the victims are found on the west bank which re-
ceives the cold, east winds, and not at all on the east bank where
the warm, soft, west winds prevail. Thorburn noticed that
the majority of cases start in spring, when the animals, debilitated
by the winter’s seclusion, are exposed to severe vicissitudes of
temperature and driving storms, to the strain of parturition, a
fresh, heavy milk yield, and moulting.

‘The presence of a contagion has been suggested, but if this
exists it must be habitually introduced in the food or water rather
than transmitted from victim to victim. The healthy will often
stand beside the diseased for an indefinite length of time without
injury, and in certain recent cases a change to an uncontaminated
farm, or an abundant ration drawn from such sound soil, will se-
cure immediate improvement and recovery in a few weeks. In
view of such prompt recoveries it would be quite as reasonable
to suspect some ptomaine:or toxin taken in with the food. The
question of a microbe or a microbian poison is as yet a mere
hypothesis.

Cows become more susceptible with advancing age, and
Dengler alone claims to have seen the disease in calves. ‘This is

586 Veterinary Medicine.

unfavorable to the idea of immunity, and rather favors that of
debility or cachexia.

Lesions. ‘These are confined to the bones. Decalcification in
the Haversian canals and cancelli, reduces the bony tissue toa thin
soft plate. Vetthe condition is not constant. Grawitz found no
special dilatation of the canals or cancelli in colts. Nessler and
others found decrease of the lime salts, Bibra and Grouven de-
tected no marked change, and Hoffmann and Begemann found
an actual excess of phosphates. Doubtless the specimens se-
lected and the stage of the disease, whether in active progress or
during convalescence, may somewhat explain discrepancies. The
fat cells increase in the cancelli, with more or less hyperemia,
and even blood staining as the disedse advances, the bone cells
become less branching, and there may be gelatinoid’ exudates.
The resistanc: of the bone is diminished, it may be’ indented
with the finger, or scraped off with the nail, or cut with a knife.
It breaks under a slight strain, and is easily crushed under the
weight of the animal so that fractures and distortions of all kinds
are met with. .In breeding cows the earliest and most marked
lesions are in the pelvic bones, but fractures of the bones of the
limbs are common.

Symptoms. Poor condition or even emaciation, with very
visible projection of the bonesiscommou. ‘The coat is rough, the
skin tense, inelastic and hide bound, appetite variable, sometimes
impaired, and nearly always perverted so that the patient will
lick the manger continually or pick up and chew all sorts of ob-
jects, bones, leather, articles of clothing, pieces of wood or iron,
stones, etc. ‘The amount of food consumed may, however, be up
to the normal. The most marked feature is the difficulty and
stiffness of locomotion. The patient lies most of the time, rises
languidly and with difficulty and moves the limbs as if each were
a rigid post without joints. The hocks will knock together, and
the restricted movements of the joint are often attended by crack-
ing. Yet appetite, temperature and yield of milk may remain
normal.

Later appetite and milk secretion fail; temperature rises a de-
gree or two, the animal refuses to rise, remaining down twelve
to twenty-four hours at a time, and rising first on the hind parts,
and remaining on the knees for a length of time, moaning and

Osteomalacia, 587

indisposed to exert herself further. Many cases at this stage
begin to improve and may get well in five or six weeks. Some
will remain down for several weeks and finally get up and re-
cover. With constant decubitus however, the animal falls off
greatly, becoming emaciated and weak, the appetite may fail
altogether, and the patient is worn out by the persistent fever,
nervous exhaustion and poisoning from the numerous bad sores.
Abscesses, sloughs and fistulae are common over the bony prom-
inences.

It is in these last conditions above all that fractures and dis-
tortions of the pelvic bones and less frequently of the bones of the
legs occur. They occur earlier as well in connection with falls,
‘blows, crowding by their fellows and sudden active movements
of various kinds.

The disease may advance for two or three months, and in case of
pelvic fractures and distortions, there may be permanent lameness,
and dangerous obstruction to parturition, even though the bones
should acquire their normal hardness through the deposition of
lime salts.

It has been noted that the disease is usually confined to well de-
fined areas, and that even in these it has its periods of abatement
and recrudescence so that given years are osteo-malacia years. In
the department of l Aube, France, Leclainche, particularly noted .
the enzootics of 1865-6, 1870, 1875-6, and 1883-4.

Prognosis. 'The gravity of the affection varies greatly under
different conditions. Some outbreaks are mild while others are
very severe, and the prognosis must vary with this gravity.
Again at the decline of an enzootic the disease is more benign and
less ruinous. A case in.its very earliest stage is much more
hopeful, than one that is far advanced, with bones extensively
softened or even broken, digestion and assimilation badly im-
paired, and infecting sores and sloughs on different parts of the
body. Isolated cases are usually much milder than when the af-
fection has gathered strength enough to determine an enzootic.

Treatment. ‘This will vary with the predominance of the
causes, essential or accessory. In some cases the’ suspension of
the injurious food and a rich alimentation on well grown fodders
from sound lands will meet every need. Green clover, alfalfa,

588 Veterinary Medicine.

and other leguminous products, ground oats, beans, peas, linseed
cake, rape cake, cotton seed and vetches may be especially named.
Even animal food may be availed of, and cases are recorded in
which cows have themselves hunted for snails and frogs and de-
voured them greedily. The free access to common salt, and a
liberal supply of bone meal are helpful. Iron and bitter tonics,
(gentian, quinine, salicine, nux, copperas, tincture of iron) and
cod liver oil, in pint doses daily, have been found advantageous.
Apomorphia has been found especially valuable in correcting the
preverted appetite, and stimulating digestion.

Where it is. feasible to move the affected herd from the un-
wholesome pasturage or locality to one in which the aliment is
rich and the disease unknown, success usually follows the change’

On poor, uncultivated lands where the disease appears yearly,
or at short intervals, intensive culture with heavy manuring, and
the heavy feeding of the herd on grain products, linseed cake,
etc., will often banish the trouble.

Care should be taken to change the water as well as the food.

Finally every drain upon the system should be lessened or
stopped. The milk may be dried up and the animal should not
be bred. Sweet, dry buildings, pure air, sunshine and grooming
are important auxilliaries,

In severe outbreaks, in high conditioned animals, the owner
often consults his interest, in sending the victims to the butcher
as soon as the affection shows itself and before time has been
allowed for the inevitable emaciation and loss.

Some, on osteo-malacia lands, have profited by changing the
entire herd every two years, as they become rapidly worn out
under successive attacks.

As local derivatives, oil of turpentine, hot vinegar, tincture of
iodine and biniodide of mercury have been employed. Open
sores are treated with antiseptic lotions, creolin, lysol, carbolic
acid, iodine lotions, iodoform, etc.

RAREFYING OSTEITIS. OSTEOPOROSIS. OSTEOMA-
LACIA OF THE HORSE. BIG HEAD.

Definition. Distinction fromrachitis. Process of rarefaction, cell pro-
liferation, congestion, solution of earthy salts and fibrous matrix, osteo-
clasts, Howship’s lacune. Dried bone light, spongy, friable, though
enlarged in repaired cases, dense, heavy. Face lesions. Dyspncea. Drop-
ping teeth. Causes: micrubian hypothesis, disturbance of bone nutrition,
faulty food, lack of bone salts, cellar stables, floor on ground, malaria, cold
damp soils, city life, early life, breed, asses and mules, breeding. \ Nature.
Symptoms: illness, inappetence, lifelessness, early fatigue and perspiration,
stiffness, lameness, distortions, stumbling, knuckling, arthritis, tender
puffed joints, thickened softened bones, facial swellings, narrowing of in-
termaxillary space, chisel teeth, difficult mastication, shedding teeth,
emaciation, marasmus. Phosphates in urine when disease is active. Re
lation to exostosis. Prevention and treatment. Hygienic, move from cellar
stable, or ground floor, secure air space under floor, ventilation, warmth,
sunshine, grain feeding, pasture, change food, rest, salicylates, salicin, salol,
phenacetin, blisters, phosphates, bone dust, phosphorus, bitters, iron,
barium chloride.

Definition. A form of osteomalacia occurring in the mature
as well as in the growing horse, characterized by the absorp-
tion of earthly salts from the walls of the cancelli and Haver-
sian canals with excessive production of the organic basis and
cell elements and enlargement, softening, lightness and fragility
of the bones.

It differs from rachitis essentially in this that while the latter
attacks the young growing bone at the chief seats of growth,
under the periosteum and in the epiphyseal ligament, and there-
fore especially on the surface of the true bony tissue, osteo-
porosis attacks the formed and often the mature bone in its interior,
producing attenuation of the walls of its vascular canals and
cancellar cavities and increase of their fibro-cellular contents.
Both result in enlargement of the bone, but in rachitis this is
determined - largely by deposition on the surface while in os-
teoporosis it takes place by expansion from within. The fur-
ther distinction that rachitis appears enzootically and osteopor-
osis sporadically applies only to localities in which the latter is

589

590 Veterinary Medicine. ,

not common. At different points on Long Island, in New Jersey
and on the rich soils in the Mississippi valley and on the At-
lantic and Gulf coasts, osteoporosis often prevails enzootically
and has its recrudescences like rachitis.

The process of rarefaction and softening may be thus stated.
In the Haversian canals and narrow spaces there is an active pro-
liferation of cells and increase of vascularity, with a gradual solu-
tion and removal, not only of the earthy salts, but also of the
fibrous matrix in the walls of these spaces. As in the normal
changes in bone, the absorption appears to be effected through
the large cells or osteoclasts grouped around the blood vessels. In
the osseous tissue, which abuts on the vascular tissue, are to be
found excavations, simple or irregular, (Howship’s lacunse),
containing granular cells and the larger osteoclasts. In a similar
manner bone is softened and absorbed in connection with tubercle,
or the pressure of tumors, aneurisms, actinomycosis. In case of
recovery, repair takes place by the disposition of new bone, so
that the enlarged and rarefied bone may in the end become harder
thanbefore. ‘This applies especially tothe cancellated bone. On
the articular ends of the affected bones, the granulation’ tissue
makes its way into and through the cartilage of incrustation with
resulting active disease of the joint.

The condition of the’ bone is well illustrated in the dried or ma-
cerated specimen. Taken from a bad case in the active stage of
the disease, it crumbles under pressure and weighs as light as a
sponge, whilst from an advanced or recovered case, it is hard and
resistant, and weighs as much more than the normal bone as it
exceeds it in bulk. The morbid rarefaction usually affects the
whole skeleton. more or less, yet in perhaps the majority of cases,
the change is greatest in the bones of the face, and the resulting
distortions are usually symmetrical on the two sides. It may
show mainly in the maxilla, which is thickened to twice or even
five times its normal thickness, it may show in rounded, general
swelling of the nasal and superior maxilliary bones and those
around the orbit, or it may involve the turbinated bones the
vomer and even the cartilaginous nasal septum. Loosening and
evulsion of the molar teeth is common and snuffling breathing
may occur as in rachitis affecting the nasal bones of dogs and
swine.

Rarefying Osteitis, etc. 59!

Causes. We arestill in the dark as to the essential cause of
rarefaction of bone. There is a growing tendency to suspect a
microbian origin, and many facts are held to point in that direc-
tion. It seems to have been unknown in England in the early
part of the 19th century, and is not noticed by Blaine, Vouatt,
Percivall nor other of the early writers. In Varnell’s cases the
same man had two farms not far apart and equal in soil, drain-
age and stabling, stocked with horses bred from the same parents
with the same kind and amount of feed and work, yet on one
farm six cases of osteoporosis occurred, and on the other not a
Single case. McNeil, in charge of street car stables, found the
disease destructively prevalent in the best appointed stables and
absent from others in the worst hygienic condition. In a
superior stable with 220 horses he had 47 cases in two years, and
in a fine stable with 100 horses he had 26 cases in the same
length of time. In the poorer stables, the horses bred in the
same way on all kinds of soil and with no difference in feeding
nor management escaped. It is the common experience in
Europe and America that a farm or district, which has been
previously free from the disease suddenly has an outbreak in
enzootic form, and this will last for a year or two, then remit
only to appear with its old force after an interval of some years.
Even during the active prevalence of the disease on one or on
several adjacent farms, others in the immediate vicinity, and.
differing in no appreciable way, geologically, hydrostatically, in
buildings, food, water, general management nor work, complete-
ly escape. Berns, Hoskins and other city veterinarians have
noticed, that it was almost the rule, that a fresh horse put in the
stall of one that had suffered from osteoporosis soon contracted
the disease.

W. LL. Williams noticed on two different farms in Central Illi-
nois, on which the disease suddenly appeared, that for years after
the comparative subsidence of the affection there was an unusual
prevalence of spavins, splints, ring-bones and other diseases of
the bones. Meyer has noticed that cases sent from Cincinnati into
the country, and that have got well, will succumb to the affection
if brought back into the city stables in which they originally
contracted it.

All of this points very strongly to one of two things ; either
a pathogenic germ in the system of the affected animal ; or

592 Veterinary Medicine.

the presence of a pathogenic microbe in the stable, water, or
other part of the environment, the toxic products of which are
taken into the animal system.

But as yet no specific pathogenic microbe has been demonstrat-
ed so that this doctrine must still be held as a mere plausible hy-
pothesis.

Many veterinarians with long experience in such cases abso-
lutely deny contagion. ‘The hypothetical contagion undoubtedly
extends slowly, and uncertainly from animal to animal, probably,
like actinomycosis, taking place mainly through the soil, or some
outside medium, rather than by direct contact ; or a special sus-
ceptibility on the part of the individual animal may be necessary
to render it efféctual.

Accessory Causes can be spoken of more confidently but even of:
these no one, nor small group, can be advanced as essential.
The process of bone-nutrition is readily disturbed by a variety
of conditions, and such disturbances may easily become the
occasion of weakening the resisting power and mayhap of ad-
mitting the hypothetical microbe to get in its pathogenic work.

Faulty food has been a favorite explanation. A lack of lime
in the soil and fodder seems, at times, to have had a baneful ef-
fect, if only, in lowering the general tone and impairing the
nutrition. Yet we see osteoporosis on limestone soils (New
York, etc.), and in animals generously fed on grain. ‘The same
remarks apply to phosphorus and phosphates. Their deficiency
apparently contributes to the production of the disease, and yet
under other conditions, their abundance is no barrier to its de-
velopment. ‘The excess of free phosphorus produces osteitis and
it isheld by some that an over-abundance of phosphates acts in the
same way. It has been sought to incriminate a too nitrogenous
diet in some cases, and in others one too rich in fat or carbhy-
drates. The many cases in Philadelphia and Pennsylvania were
mostly in animals that had been well fed and were in good con-
dition when attacked (Marshall).

Special food may be the direct cause, bran diet has been already
noted. Hinebauch found an acute osteitis with bone softening
and arthritis in horses fed on millet, green, partially matured
and ripe. Horses elsewhere have fed on millet, without such
results, but not perhaps, in the same environment, nor in

Rarefying Ostettis, etc. 593

presence of the hypothetical microbe. Millet is not the sole nor
common cause of osteoporosis, but there is reason to suspect that
it is at times an important accessory cause.

Of all prejudicial conditions none is to be so dreaded as un-
wholesome stables. Of 200 cases reported by Berns, in Brooklyn,
almost all were in cellar stables or those with floors laid on the
soil. Meyer finds that ‘‘most all cases can be traced to an un-
wholesome atmosphere, or gases arising from vaults, sewers, cel-
lars, filthy streams, or from a hollow space under the floor.’
Harbaugh says every case was stabled in damp, ill-drained, un-
ventilated and badly lighted buildings. The worst outbreak was
ina basement with a damp wall, on one side, and none suffered ex-
cept those that stood next to this wall. The horses standing on
the opposite side, which was on a level with the ground outside,
escaped. Removal from a cellar stable to the floor above, put a
sudden stop to the appearance of new cases. James, of St.
Louis, found 20 successive cases in a stable on a dirt floor, and
Jasme, of Charlestown, finds nearly all his many cases on earth
floors in malarial regions.

Malaria has been blamed, especially by southern observers, ac-
customed to se¢ the disease on the warm alluvial seaboard and
river bottoms. ‘That this environment predisposes to the disease,
by undermining the health, is doubtless the case, but in spite of
occasional remissions in the symptoms, malarial germs cannot be
set down as the constant cause. One of the worst cases I ever
saw, with every bone in the body soft, spongy and light, developed
at Inglis Green laundry, Edinburgh, where malaria is absolutely
unknown, but where the brook received large quantities of
chlorine.

Cold is an undoubted factor, though the disease is most prevalent
in our warm southern states. Many veterinarians have noticed its
coincidence with rheumatism, in which cold is so often the dom-
inating accessory cause. Some have even suspected that it isonly
a modified type of the rheumatic condition. Hinebauch found
his cases of millet disease in cold basement barns, or with leaking
roofs, so that the floor and bedding were constantly wet. He
found that cold always aggravated the disease, and bad air even
more so, while salicylates seemed to have a marked curative in-

fluence.
38

594 Veterinary Medicine.

Damp soils should be named in this connection. ‘These not
only chill the air by evaporation, and condense the cold dews at
night, contributing to produce the extremes of hot noon day and
cold night temperature, with corresponding disturbances of the
bodily health, but they favor the preservation of the infinitesimal
forms of life (bacteria, protozoa) and therefore of the hypothet-
ical microbe of the disease.

City life is a most potent cause. Berns tells us that hundreds
of horses die yearly in Brooklyn of osteoporosis, and that if sent
early to the country a large proportion recover. The same is true
of New York City and Philadelphia. Of Cincinnati, Meyer says
that he has failed to find a case more than five miles outside the
city limits, and that cases sent to the country make a partial or
complete recovery. Ifreturned to their former city stables, nearly
all contract the disease anew within a year. ,

Many cases, however are found in the country and often with-
ina circumscribed area. These indicate, asin the city cases, a
localized cause, bacteridian or otherwise.

Larly life predisposes, the majority of cases taking place before
the sixth or seventh year, yet the disease occurs at all ages up to
twenty years and over.

Breed does not seem to make a material difference, and though
Shetland ponies have acquired a bad reputation, their propensity
to become fat and soft, their too often idle, pampered life, and the
confined quarters in which they are frequently kept, account for
much of the mortality.

Asses and mules habitually escdpe, even in the South, where the.
latter animal is so numerous and often so poorly kept. In Hine-
bauch’s millet disease, the mules suffered more than the horses.

Breeding horses, male and female, have often acute attacks and
die early. The drain on the system and confinement seem to act
injuriously.

Nature. Until we know the essential cause or causes of osteo-
porosis, we must’be in doubt as toits pathology. Weare even de-
barred from pronouncing authoritatively upon the essential iden-
tity or difference of the various forms of softening, or rarefaction
of bone. In obedience to the clinical manifestations and struct-
ural changes, rachitis, fragilitas osseum and osteoporosis have
been separately described, but we cannot positively say that they

Rarefying Ostettis, etc. 595

are not all due to one essential cause, manifesting itself different-
ly according to the activity of trophic processes in the bones of
the victim. In the growing foal the active developmental pro-
cesses in the epiphyseal ligament and periosteum may determine
that the symptoms shall be pre-eminently those of rickets, yet we
often see these complicated by the facial and other lesions of os-
teoporosis. Both may be the result of one etiological factor, or
there may be a complex disease resulting from the presence of
two. Again in the pregnant cow in which the relaxation of the
ischio-pubic symphysis and pelvic ligaments means a pro-
found change in the bone nutrition at this point, the presence of
the hypothetic microbe, or other essential factor, may determine
a decalcifying and fragility of the pelvic bones generally. Again
in the mature male and non-breeding female, in the absence of
the disturbing conditions of nutrition just named, the vascular
elements in the Haversian canals and cancelli may determine the
simple rarefaction and expansion of the bone which characterizes
osteoporosis. When present in the bone in any of these condi-
tions, acids doubtless fulfill an important réle in the decalcifying
and softening process, but behind these it may be surmised that
there is an unknown cause or causes, which it is for the bacteri-
ologist, chemist or botanist to discover.

Symptoms. ‘These are largely the same as in brain disease.
‘There may be first a period of illness, with poor appetite, lack of
spirit and energy, early perspiration and fatigue, or if at large,
leaving the herd, soon followed by some stiffness of gait and lame-
ness, which may be intermittent, disappearing under exertion, or
shifting from one joint or limb to another after the manner of
rheumatism. Sometimes it shows in stiffness of the neck, so that
the patient finds difficulty in lowering the head to graze ; in
others the back and loins are stiff and arched so that the animal
has difficulty in rising and turns slowly and painfully ; in still
other cases the dorsal and lumbar vertebrz are depressed so that
the back is hollow. Even before the manifestation of lameness,
the affected limb may stand forward at the fetlock or knee, the
gait is clumsy and awkward, and the patient may suddenly
stumble and fall, showing little or no power of prompt recovery of
balance. A horse, and especially a young horse, with this habit
of stumbling is always to be suspected. The long bones of the

596 Veterinary Medicine.

limbs tend to enlarge or thicken, and this is likely to be more
uniform than in rachitis, and not to be confined so much to the
epiphysis. The implication of the stifle, hock or other joint,
with marked synovial distention, and mobility or dislocation of the
patella, is common and may be the earliest manifestation of illness.
‘The bones of the face usually show early changes. The superior
maxillary and nasal bones, beneath the zygomatic spine and
infra orbital foramen and along the line of the molar alveoli be-
come especially bulging and rounded, the other facial and cranial
bones suffering to a lesser degree. In the lower jaw, also, the
disease predominates along the region of the molar alveoli, and
the loosening of the molars permits them to deviate inward so
that the grinding surfaces come perceptibly nearer to the median
line, and the outer half of the tooth is rapidly worn while the
inner edge projects as a sharp cutting ridge (chisel teeth).

For the same reason, the softening branches of the lower jaw
deviate inward, tending to still further destroy the due approxi-
mation of the upper with the lower molars, and to diminish the
breadth of the intermaxillary space. The great thickening of the

‘rami of the maxilla tends still further to reduce the intermaxillary
furrow.

Fractures and detachment of tendons and ligaments are com-
mon results of the rarefaction, a portion of the bone often remain-
ing adherent to the tendon.

Cary gives the following statistics of fifteen cases: lame in the
fore limbs 11 (mostly shoulder), in hind limbs 11 (mostly hip
and stifle), stiff in loins 8, unable to rise without aid 3, had in-
dented ribs 4, had shifting lameness 8, had chronic indigestion
6; mares 5 ; geldings 8 ; mules 2; ages were—one 3 years, five
6 years, three 7 years, one 8 years, two 9 years and three 10 years.

When the bones are enlarged their softness and friability may
be shown by pricking with a needle, which will often freely
penetrate the rarefied bony tissue. It should be first rendered
antiseptic by dipping in strong carbolic acid.

From the first the general health fails, there is difficulty in
mastication, digestion is more or less impaired, nutrition is im-
perfect and muscular flabbiness, weakness and wasting advance
more or less rapidly. In advanced cases emaciation is often a
marked feature.

Mareyying USteltts, er. 597

Examination of the urine gives valuable indications, though
the results obtained have been supposed to be contradictory.
While rarefaction of the bone is advancing rapidly the urine is
charged with an excess of phosphates in ratio with the activity
of the morbid process. When on the other hand the disease has
come to a standstill and the process of repair in the rarefied
bones has begun, the absence of phosphates is no less character-
istic. A patient therefore may show greatly enlarged and soft-
ened bones with persistent lameness, and yet the urine may
show little or no phosphate. ‘The phosphaturia may, therefore,
be made the basis of a reasonable prognosis. Excess of phos- .
phates indicates an active pathological process, with an uncer-
tain outcome, while the absence of phosphates indicates an arrest
of rarefaction and holds out good hope of recovery.

I have long observed the same in cases of obstinate and in-
tractable spavins, splints, ringbones and other bone diseases.
Phosphaturia bespeaks a faulty nutrition of the bone and ex-
plains the failure of remedial measures, while lack of phosphates
in the urine, or a reduction to the normal amount is likely to be-
come a guarantee of improvement under local treatment. The
treatment however, must be first constitutional to correct the
condition of malnutrition and then local to correct the osteitis.

Prevention and treatment. Asin rachitis hygienic measures
give the most uniformly good results. ‘The change of stable is
especially demanded from a cellar or basement stable, one with
joists laid on the ground or one with an earth floor saturated
with urinary and feculent products. In different cases an en-
zootic has been arrested, coincidently with the removal of the
stock to the floor above, and in others with the removal of the
filth saturated earth beneath a ground floor, and the laying of a
new floor with ample space beneath for the free circulation of
air. In the same line would be thorough drainage of the site
and to carry off liquid manure to a weil ventilated receptacle.
Exposure to cold and wet is to be sedulously avoided as greatly
favoring the onset of the disease, and hurrying the milder cases
into a fatal activity. Free air and sunshine are all important
and it is the universal experience that city cases taken early dnd
sent to dry, sunny pastures, mostly recover, or at least undergo
marked amelioration. The fact that certain cases originate dur-

598 Veterinary Medicine.

ing an open air life does not invalidate this position but merely
shows that other pathogenic conditions may be too potent to be
overcome by this hygienic one.

‘A liberal allowance of sound grain is essential to success, even
in the case of patientssent to pasture. ‘Those that have recovered
or improved at pasture, should be retained in the country and on
no account returned to the same city stables in which they con-
tracted thedisease. Even in the country a different stable should
be secured if possible:

Any food that has manifestly contributed to the disease, should
be withheld (bran, millet, musty or fermented food or that drawn
from particular fields). .

Overwork must be forbidden, and indeed any work at all dur-
ing the active stage of the disease. The victim should also be
withdrawn from breeding, at least until it has fully recovered the
normal consistency of its bone. "

In cases aggravated by cold or wet, or which show the rheu-
matic propensity to shift from place to place, sodium salicylate in
ounce doses several times a day may appear to benefit, and as a
germicide this may be tried on allcases. Salicin, salol, or phen-
acetin may be used as substitutes. Where the disease has been
largely localized, blisters have appeared to be beneficial.

Phosphates and phosphorus have been lauded by German
veterinarians, but in other hands, and when: the morbid process
was active they have proved useless, or even hurtful. Bone dust
or phosphate of lime or soda may be freely used at any time and
appears to act as a general tonic, beside supplying lime and phos-
phoric acid which may possibly be availed of for bone nutrition.
Phosphorus and phosphorated oil in excess always softens the
bone and much more so when this process is already excessive.
In small doses (gr. } to 4) and after the process of rarefaction
has ceased, it is valuable in hastening bone consolidation and
fitting the patient to return to work.

Bitters, iron and other tonics are valuable in improving the
general tone and indirectly the bone nutrition.

Cary had prompt improvement in connection with intravenous
injection of barium chloride once a week for four weeks, and }
oz. doses of sodium salicylate thrice a day. It remains to be
seen whether or not this is generally applicable,

OSTEO-MALACIA IN OTHER ANIMALS.

The internal softening and rarefaction of bones in mature
animals has been noted in dogs by Pillvax and Roll, in lambs by
Haubner, in pigs by Haubner and Anaker, and in goats by differ-
ent observers. The genuineness of these cases has been ques-
tioned by Cadiot and Leclainche, by Virchow and by others, but
in the present uncertainty as to the dividing lines between rare-
faction, rachitis and other diseases, they deserve notice in this con-
nection.

In dogs the lesions are mostly in the young and are largely ra-
chitic, yet the enormous swelling of the facial bones, and especial-
ly of the superior maxillary in the comparatively mature animal
suggests osteo-malacia. As in rachitis there are usually impair-
ed digestion, unthriftiness, slow, stiff movements and lack of life
and vigor.

In goats Virchow believes the disease to be neither rachitic
nor osteo-malacia, basing his opinion on the lesions in the bones:
“On the maxillary bones of goats there are often found peculiar
formations in which the parts that have already assumed osseous
structure, have failed to fix the earthy salts. "The tumor, which
forms a circumscribed swelling on the upper or lower maxillary
bone, is soft and easily cut with the scalpel, with at certain points
only, ahard resistant material. Itis a simple osteoid chondroma,
though veterinarians for some reasons associate it with rheuma-
tism.’’ Profuse salivation is present.

In lamés it is according to Haubner an atrophy with
destructive ulceration of the bones of the face, complicated by
purulent infiltration of the medullary spaces. ‘‘The incisors,
and later the molars,.fall one by one, because of the changes
in the alveoli, the gums swell, become violet, red, and ulcerate,
the ulcers extending through the hard palate into the nose, and
causing a highly offensive discharge from both nose and mouth.

In pigs the disease has been mainly seen in connection with in-
sufficient or unwholesome food, and badly balanced rations, and -
especially with fermented swill and an exclusive maize diet. The
symptoms are shown in the limbs and face, especially (‘‘snuffles’’ ),
as noted under rachitis.

Prevention and treatment are to be sought in avoidance of the
obvious causes, and in applying the same line of tonic treatment
as in the larger animals.

599

INDEX.

ABNORMAL conditions of the hair,
458, 536.
Abrasions, 459.
Abscess behind eye, 352.
of brain, 125.
of spine, 176.
Acariasis, 462.
Acetone in urine, 200.
test for, 200.
Acne, 345.
in horse, 514.
Acromegaly, 133.
Acute eczema in dogs, 502, 505.
in solipeds, 485.
keratitis, 380.
myelitis, 156.
Adenoma of the gland of Harder, 359.
Akinesis, 2
Albinism, 4or.
Albumen in urine, 2o1.
test for, 201.
Alcoholic intoxication, 147.
Alimentary origin, eczema of, in cat-
tle, 492.
Allantoin, 201.
Alopecia areata, 534.
congenita, 534.
postpartem, 534.
Alterations in glands and ducts,
structural, 458.
Amaurosis, 444.
Amblyopia, 444.
Amyloid kidney, 248.
Anesthesia, 9.
Analgesia, Io.
Anal sphincter, 21
Aniline poisoning, 148.
Animal parasites, 458.
Ankyloblepharon, 339.
Anophthalmos, 448. :
Aperture in iris, congenital, 4o1.
Aphthous conjunctivitis, 373.
fever, ag
Apoplexy, 84.
P Facetral, 84.
of spinal cord, 170.
Arteria hyaloidea, persistent, 438.
Arthritis, rheumatic,in horse, 546.
urica, 564.

Articular rheumatism in cattle, 552.
in the dog, 557.
in horse, 546.
in sheep, 555.
in swine, 555.

Artificial eye, 451.

Astragalus Mollissimus, 135.

Ataxia, 5, 167.

Atheroma, 427.

Atresia of lachrymal puncta, 353.

Atrophy of eye, 444.
degenerative, of nerves, 6.
of ovary, 282.
of the eyeball, 448.
of nerves, Igo.

BACILLUS diphtherize avium, 374.

Bacteria in encephalitis, 97.

Baldness, congenital, 534.

Balking, 26.
jurisprudence of, 28
treatment of, 30

Bed sores, 530.

Big head, 589.

Bile in urine, 202.

Birds, gout in, 564.

Black cataract, 398

Bladder, anomalies of, 263.
atony of, 260.
eversion of, 262.
hernia of, 263.
parasites, 261
rupture of, 262.
spasm of neck of, 261.
tumors of, 261.

Blebs, 456.

Blennorrheea, 368.

Blepharadenitis, 345.

Blepharitis, 342.

Blepharophymosis, 339..

Blepharospasm, 339.

Blind staggers, 69.

Blisters, 456.

Bloody sweat, 528.

Boil, 454, 532.

Brain, abscess of, 125.
concussion of, 80,
congestion of, go.
cortical lesions of, 13.

Brain, pressure on, 13.

602

Brain, tumors of, 128.
Bran rachitis, 582.
Bright’s disease, acute, 222.
Bronchocele, 570.
Buckwheat erythema, 472.
Bulbar paralysis, 134
Bulle, 456.
in horse, ox, pig and dog, 517.
Buphthalmos congenitus, Hydroph-
thalmos or, 429.
Burns, 462.
CACHEXIA OSSIFRAGA, 583.
Calculus of prostate, 280.
renal, 249.
Callositas, 457.
Callosities, necrotic, 457.
Calorica, dermatitis, 483.
Caloricum, erythema, 470.
Calving fever, 301.
Cancer of prostate, 280.
Canker, 525.
Canthoplasty, 339
Capsule of lens, opacity of, 430.
Carbon disulphide poisoning, 150.
Carbuncle, 456
Carbunculus, 456.
Cardiac accelerating centre, 21.
inhibition, 15.
Carpus, chronic eczema of, 490.
Caruncle, lachrymal, diseases of the,
358.
Casts, composition of urinary, 203.
in urine, 203.
Catalepsy, 36.
Cataract, 395, 430.
anterior capsular, 430, 431.
anterior polar, 430.
black, 398, 430.
blood pigment on capsule, 431.
capsular, 430.
cortical, 430.
diabetic, 430.
discission, 435.
immature or unripe, 430.
lenticular, 430.
mature or ripe, 430.
nuclear, 430.
polar, 430.
posterior capsular, 430.
posterior polar, 430.
ripe, mature or, 430.
senile, 430, 431.
soft, in the young, 435.
suction of lens, 437.
traumatic, 430.
unripe, immature or, 430.
Catarrhal conjunctivitis, simple acute,
362. :

Index.

Catarrh of the urethra, 264.
Catheterization, 266.
of bitch, 269.
of bull, 268.
of cow, 269.
of dog, 268.
of horse, 266.
of mare, 268,
of ram, 268.
Cattle, alimentary eczema of, 492.
chronic eczema in, 498.
moist eczema of the tail, neck,
chine and dewlap, 497.
Central canal of the spinal cord, di-
latation of, 180.
Centre for dilating pupil, 21.
Cerebellar disease, 133.
Cerebellum, 17.
Cerebral cortex, lesions of, 13.
hzemorrhage, 84.
hypereemia, go.
Cerebro-spinal lesions in rheumatism,
546.
meningitis, 118.
Cervical lateral columns, transverse
section of, 21. ;
Cervix vesicze, imperforate, 263.
Chafing, 468.
intertrigo of, 468.
Chalazion, 346.
Chapped heels in horse, 518.
Chaps, 457.
Chloroform, action on dog, 23.
Choked disc, 442.
Cholesteatomata, 129.
Cholesteatoma of spine, 175.

| Chondroma of spine, 176.

Chorea, 63.

Choroid, detachment of the, 405.
rupture of the, 405.
tumor of, 405.

Choroiditis, 404.
suppurative form, 405.

Chronic eczema of the back in dog,

5°97,

keratitis, 384.

Cicatrices, 457.

Clapped wool, 499.

Coloboma iridis, 401.
palpebrarum, 338.

Compression of spinal cord, 175.

Concussion of the brain, 80.

Congenital aperture in iris, 4o1.
baldness, 534.
hydrophthalmos or buphthalmos,

429. .
Conical cornea, 390.
Conjunctiva, burns of, 362.

LIUCA,

Conjunctiva, dermoid tumor of the,
377.
lipoma of, 377.
Conjunctiva, melanosis of, 377.
neoplasms of the, 377.
polypus of, 377.
wounds of, 361.
Conjunctival sac, foreign bodies in
the, 360. :
Conjunctivitis, aphthous, 373.
catarrhal, simple acute, 362.
chronic, 366.
diphtheritic, in birds, 373.
follicular, 376.
in herbivora, infectious, 370
phlyctenular, 373.
purulent, 368.
variolous, 372.
Constitutional diseases, 538.
vice, maladies due to a, 462.
Contagious pustular dermatitis, 514.
Convulsions, 61. .
Convulsive twitching, 66.
Cornea, conical, 390.
Cornez, ectasia, 390.
xerosis (epithelialis), 378.
Cornea, foreign bodies in, 380.
inflammation of the, 380.
opacity of, 386.
pigment spots on, 386.
tumors of the, 390.
ulcer of, 387.
wounds of the, 379.
Corneal staphyloma, 389.
Cornu cutaneum, 457.
Corpora nigra, cysts of, 325.
quadrigemini, 16.
Corpus striatum, 17.
Cortical localization, 17.
Cotton seed, poisoning with, 383.
Cracks, 457.
Cracked heels in horse, 518.
Creatinin in urine, 200.
test for, 200.
Crevasses, 457.
Cripple, 583.
Crossed hemiplegia, 3.
Crura cerebra, 16.
Crustee, 456.
Crusts, 456. aoe
Cryptogams in encephalitis, 97.
Cutaneous eruptions in sheep, 499,
500.
haemorrhage, 528.
hypertrophy, 531.
Cutaneum, cornu, 457..
Cyanuric acid, 199.
Cyclitis, 395, 402.

0U5

Cystic ovary, 289.
Cystitis acute catarrhal, 257.

acute croupous, 257.

chronic catarrhal, 258.
Cystitis, in dog, 259.

in ox, 259.

Cysts of the iris and corpora nigra,
403.

DACRYO-ADENITIS, 353.

Dacryo-cystitis, 355.

Dandruff, 456

Degeneration, Walier’s law of, 7.

Delirium, 30.

Dermatitis, 462, 474.

calorica, 475.

contagious pustular, 514.

erythematous, 467.

from mechanical injury, 474.

medicamentosa, 475.

traumatica, 474.

Venenata, 475.
Dermatoneurosis, 475.
Dermatomata, 457.

Dermatosis, microbian, 462.

parasitic, 462.

Dermoid cysts of ovary, 293.:
tumor of the conjunctiva, 377.
Detachment of the choroid, 405.

of the retina, 441.

Diagnosis of skin diseases, 460.
Diphtheritic conjunctivitis in birds,

373
Diplococcus (streptococcus) pmneu-
moniz equina, 399.
Disc, choked, 442.
Diseases of the nervous system, I.
of the skin, 455.
urinary organs, Igo.
skin, diagnosis of, 460.
skin, general causes of, 458.
Disease, white skin, 472.
Dislocation of the globe of the eye,

49.
of the lens, 437.

Dog, acute eczema of the, 502.
chronic eczema in the, 506.
myelitis in, 161.

Dogs, acute eczemas in, 502.

Double pupil, gor.

Dropsy of cerebral ventricles, 110.
of eyelids, 343.

Dry keratitis, 378.

Ducts and glands, structural altera-

tions of skin, 458.

Dyskinesis, 5.

EarTHY phosphates, test for, 198.

Eclampsia, 61.
of nursing bitches, 62.

604

Ectasia (bulging) of the sclera, 391.
cornez, 390.
Ectropion, 348.
Eczema, 476.
acute general, 497.
acute, in solipeds, 477.
acute, of the dog, 502, 505,
caudal, 505.
chronic, in cattle, 498.
chronic, in the dog, 506, 507.
chronic, of the carpus and tarsus,
482.
chronic, of the head in solipeds,
478.
impetiginous, 500, 505, 516.
interdigital, 505.
in sheep, 499.
in swine, 500.
of alimentary origin in cattle,

of elbow and hock in dog, 507.
of head, ears, etc., 507.
of the back in dog, 507.
malt, 484.
moist, chronic, at the mane and
tail, 479.
moist, of the pasterns in the ox,
488.
moist, of the tail, neck, chine
and dewlap of cattle, 497.
potato, 484.
rubrum, 503.
acute, in dogs, 497.
Egg impaction in oviduct, 295,
Electric shock, 80.
Elephantiasis, 523
pachydermia, 458.
Embolism of spinal cord, 170.
Emphysema of eyelids, 344.
Encanthis, 358.
Encephalic congestion, 90.
lesions, 13.
Encephalitis calorica, 98.
from bacterial products, 97.
from cryptogams, 97.
from exertion, 98.
from lead, 99.
from narcotics, 96.
from parasites, 99.
from poisons, 99.
from travel, 98
from tumors, 99.
treatment of, 107.
Encephaloid of spine, 176.
Encephalon, pressure on, 13.
Endocarditis in rheumatism, 536.
Entropion, 347.
Epilepsy, 47.

Index.

Epilepsy, jurisprudence of,
partial, 48.
treatment of, 58.
Episcleritis, 391.
Epispadias, 264.
Epithelial xerosis, 378.
Erosions, 457. °
Eruptions, cutaneous, in sheep, 492.
distillery waste, 462.
granular skin, in swine, 494.
of nervous origin, 7.
Erythema, 455, 467.
buckwheat, 472.
caloricum, 470.
from irritants, 472.
solar, 470.
Er; thematous dermatitis, 467.
Essential oils, action on dog, 23.
Ewes, neurasthenia in pregnant, 179.
Excrescences, 457.
Exophthalmic goitre, 574.
Exopthalmos, 340, 428.
Extraction, linear, of the lens, 436.
Eye, artificial, 451.
defects, blemishes, etc., 320.
diseases of, 318.
desirable features of, 318.
dislocation of the globe of, 449.
Eyeball, atrophy of, 448.
Eyelash turned in, 346.
Eyelids adherent to bulb, 341.
deficiency of, 338.
dropsy of, 343.
emphysema of, 344.
inability to close, 340.
inflammation of, 342.
narrow opening between, 339.
organic union of, 339.
seborrhcea of, 345.
tumors of, 350.
wounds of, 335.
Eyelid, tubercle of, 346.
turned in, 347.
turned out, 348.
Eye, systematic inspection of, 322.
FACE, convulsive twitching of, 66.
Fagopyrism, 472.
Falling sickness, 47.
Fallopian tubes, inflammation of, 294.
ae! degeneration of the kidney,
246.
Female generative organs, diseases
of, 281,
Filaria heemorrhagica, 528.
Fish skin disease, 532.
Fissures, 457.
Fistula of lachrymal sac, 354.
recto-vesical, 263.

57-

Lndex.

Follicular conjunctivitis, 376.
Foreign bodies in the conjunctival
sac, 360.
in the cornea, 380.
in the iris, 400.

Fracture of the orbit, 350.

Fragilitas ossium, 583.

Furuncle, 456.

Furunculus, 456, 532.

GADFLY, panic from, 24.

Gangrene, cutaneous, 530.

Generative organs, diseases of fe-

male, 281.

Genital centre, 21.

Giantism, 133.

Glands and ducts, structural altera-

tions in skin, 458.

Glaucoma, 424.
acute inflammatory, 426.
secondary, 426.
simple, 426.

Glioma of spine, 176,

Globe of the eye, dislocation of, 449.

Glomerulitis, 227.

Glucose in parturition fever, 310.
in urine, 202.
test for, 202.

Glycogenic centre, spinal, 21.

Glycosuria, 202.

Goitre, 570.
congenital, 571.
cystic, 572.
exophthalmic, 574.
fibrous, 572. :
hypertrophic, 572.
its distribution, 571.
varicose, 572.

Goll, column of, 21.

Gout, 564.

Granular skin eruption in swine, 502.

Grapes, 524. x

Grease, 522.

Growth, horny, 457.

Harr, abnormal conditions of, 456.
nodular swelling of, 536.
splitting of, 536.

Hallucinations, 11, 22.

Harder, gland of, adenoma of the,

‘ 359-

Hare eye, 340.

Heematidrosis, 528.

Heematopedesis, 528.

Heematorrachis, 170.

Heematuria, 202, 206.
prevention of, 210.
treatment of, 210.

Heemoglobinuria, 202.

<

Hemophilia, 528.

605

Hemorrhage, cutaneous, 528
into spinal cord, 170.
on ovary, 284.
retinal, 441.
Hippuric acid, 199.
Hippuric acid, test for, 200.
Head, covulsive movements of, 67.
Health, nervous control in, 1.
Heart lesions in rheumatism, 544.
Heart exhaustion, 39.
treatment of, 4o.
papules, 509.
Hemianeesthesia, 3.
Hemiplegia, 3.
Hemispasm, 4.
Hernia of ovaries, 281.
Hordeolum, 345.
Horny growth, 457.
Horsepox, 516, 525.
Hyaloidea, persistent arteria, 438.
Hydrocephalus, chronic, 110.
jurisprudence of, 116,
treatment of, 116.
Hydro-metra, 298.
Hydronephrosis, 250.
Hydrophthalmos or buphthalmos
- congenitus, 429.
Hymen, imperforate, 300.
Hyperesthesia, 8.
cutaneous, 8,
muscular, 8.
to cold, 8.
visceral, 9.
Hyperalgesia, Io.
Hyperkinesis, 4.
Hyperplasize, 457.
Hyperplasia of the skin, 533.
Hypertrophy, cutaneous, 531.
of the prostate, 276.
Hypospadias, 264.
Hypoxanthin, 201.
ICHTHVOSIS, 532.
Immobility, 110.
Impetigo, 479.
digital, 522.
of pigs, 501.
Incodrdination, 5.
in cerebellar disease, 133.
Indican in urine, 199.
test for, 199.
Infection in osteomalacia, 585.
in osteoporosis, 59I.
Inferior columns, transverse section
of, 20.
Inflammation of the cornea, 380.
of the optic nerve, 442.
of the sclera, 391.
Inhibition, cardiac, 15.

606

Inhibition, respiratory, 15.
Insolation, 39.
Internal ophthalmia, 392.
Intertrigo, 468.
of chafing, 468.
Iridis, coloboma, 4or.
Iris, congenital aperture in, 4or.
cysts of the, 403.
foreign bodies in the, 400.
prolapse of the, 392.
tuberculosis of, 402.
Iritis, simple, 397.
symptomatic or metastatic, 399.
Irritants, animal, 462.
erythema from, 473.
external, maladies from, 462.
ingested, maladies due to, 462.
vegetable, 462.
Irruption, vesicular in pigs, 493.
Itching, 9
KERACELE, 457.
Keratitis, acute, 380.
chronic, 384.
dry, 378.
Keratoconus, 390.
Keratoglobus, 390.

Kidney, acute congestion of, in car-

nivora, 220.
in cattle, 216.
in horse, 211.
in sheep and goat, 218.
in swine, 219.
treatment, 215.
amyloid, 248.
atrophy of, 243.
fatty degeneration of, 246.
hypertrophy of, 242.
lardaceous, 248.
waxy, 248.

LacHyRMAL caruncle, disease of, 358.

tumors of, 358

gland, disease of, 352.
puncta, obstruction of, 353.
sac, catarrh of, 355.

fistula of, 354.

Lachrymo-nasal duct, stenosis of, 357.

Lactic acid in rickets, 578.
Lagophthalmos, 340.

Limbs, disorderly movements of, 69.

Lead poisoning, 141.

Lens, dislocation of the, 437.
linear extraction of the, 436.
opacity of the, 430.

Leucin in urine, 201.
test for, 201.

Leucoma, 386.

Leucorrheea, 309.

Lichen, 509. ©

Index.

Lightning stroke, 82.
Linear extraction of the lens, 436.
Lipoma of spine, 176.
Lips, flapping of, 68.
Localization in ass’s brain, 17.
in dog’s brain, 18.
of nervous lesions, 12.
of nervous troubles, 17.
‘Loco”’ poisoning, 135.
Luxatio bulbi, 449.
MacuLa, 386.
Macule, 455.
Maladies, skin, due to a constitu-
tional vice, 462.
due to ingested irritants, 462.
due to toxic products of the sys
tem, 462.
from external irritants, 462.
Malanders, 490.
Malt disease, 492.
Mange, red, 503.
Medulla, disease of, 134.
Megrims, 69.
Meibomian glands, disease of, 345.
Melanoma of the brain, 130.
of spine, 175.
Mellituria, 200.
Membrana nictitans, hypertrophy of,
359.
lesions of, 359.
tumors of, 359.
Membrane, persistent pupillary, 402.
Meningitis, cerebro spinal, 118.
tubercular; -127.
Meningo encephalic congestion, go.
Meningo-encephalitis, 94.
Meningo myelitis in the dog, 161.
Metastatic iritis, symptomatic or, 399.
Microbes in nervous disease, 2.
in parturition fever, 306.
in udder, 307.
Microbian dermatosis, 462.
Microphthalmos, 448.
Milk fever, 301.

* poisonous in nervous disorder, 8.
Millet disease, 592. F
Modified secretions of skin, 458.
Moist eczema, chronic at the mane

and tail, 479.

of the pasterns in the ox, 488.
of sheep, 499.
Monoplegia, 3.
cerebral, 4.
Monospasm, 4.
Moonblindness, 406
Motor disorders, 2.
tracks in brain, 14.
Muscular balance, lack of, 452.

tHE

Muscular rheumatism in cattle, 554.
rheumatism in the dog, 558.
rheumatism in horse, 550
sense tract, 21.

Musty fodder in encephalitis, 97.

Mydriatics, 333.

Myelitis, 156.
chronic, 167.
in the dog, 163.

Myosin coagulated under heat, 41.

Myxoma of the brain, 131.

NEBULA, 386.

Necrotic callosities, 457.

Neoplasms of brain, 128,
of the conjunctiva, 377.

Nephritis, 221.
acute, 223.
chronic, 236.
interstitial, 227.
purulent, 230.
suppurative, 227.
treatment, 227.
tubular, 227.

Nerve, optic, inflammation of the,

442.
optic, paralysis of the, 444.

Nerves, atrophy of, Igo.

Nerve trunk, pressure on, 9.

Nervous centres, respiratory, 14.
disease, diagnosis of, 2.
disease, microbes in, 2.

* disease, symptoms of, 2.
disorders, diagnosis of, 12.
functional, 13.
structural, 12.
lesions, destructive, 12.
organs, irritation of, 12.
system, diseases of, I.

‘Nettle rash, 475. .

Neuralgia, 186.
of ovary, 283.

Neurasthenia in pregnant ewes, 181.

Nenuritis,- 183.
ascendens, 443.
descendens, 443.
optic, retro-bulbar, 443.

Neurosis, 458.

Nicitans, membrana, lesions, 359.

Nigra, corpora, cysts of, 403.

Nitro-benzol poisoning, 451.

Nodules, 455, 548. ;

Nose, rhythmic movements of, 68.

Nystagmus, 454.

‘OBLIQUE focal illumination of the

eye, 326.

‘Occluded pupil; 402

OGphoritis, 286.

uy]

Opacity of the cornea, 386.

of the lens or its capsule, 430.

of the vitreous, 439.
Ophthalmia, enzootic, 370.

internal, 392.

periodic, 406.

of solipeds, recurrent, 406.
Ophthalmoscope, 330.
Optic nerve, inflammation of the, 442.

paralysis of, 444.
Optic neuritis, retro bulbar, 443.
Optic thalmus, 17.
Orbit, fracture of, 350.

periostitis of, 352.

tumors of, 352.

wounds of, 351.
Oscillatory movement of the eye, 454.
Osteomalacia, 583, 589.

in pigs, dogs, goats and lambs,

599.

of the horse, 589.
Osteoporosis, 589.

treatment of, 597.
Ovarian cysts, 289.

tumors, 294.
Ovaries, absent, 282.

atrophy of, 282.

- hernia of, 281.
supernumerary, 283.
undeveloped, 282.

Ovary and womb, malposition of, 281.
dermoid cysts of, 293.
hemorrhage on, 284.
inflammation of, 286.
irritable, 283.

Oviduct, diseases of, 295.:
egg impaction in, 295.
eversion of, 295.
imperforate, 295.
inflammation of, 297.
polypus of, 295.

Oxalic acid in rickets, 578.
in urine, 200.
test for, 200.

Ox, moist eczema of the pasterns, 486.

Oxtropis Lamberti, 135.

PACHYDERMIA, §3I.
elephantiasis, 531.

Pain, insensibility to, to.

| Palpebral fissure, widened, 340.

Panic, 23.
treatment, 24. ,
Panophthalmitis, 392, 405, 423.
enucleation, 424.
Papilloma of spine, 178.
Papulze, papules, 455.
Pareesthesia, 9.
Paralysis, 2, 177.

608

Paralysis, local, ‘4.
of ocular muscles, 452.
of the optic nerve, 444.
sensory, 9
Paraplegia, 3.
Parturient apoplexy, 301.
Parturition collapse, 301.
fever, 301.
Parturition fever, prevention, 313.
fever, treatment, 315.
paresis, 301.
Parasites, animal, 458.
of the bladder, 261.
of the kidney, 250.
vegetable, 458.
Parasitic dermatosis, 462. '
Paresis, 2.
Pasterns, moist eczema of, in the ox,
496.
Pemphigus, 517.
Pericarditis in rheumatism, 545.
Perinephritis, 232.
Perineuritis, 183.
Periodic ophthalmia, 406.
Periodphoritis, 286.
Periostitis of orbit, 352.
Persistent arteria hyaloidea, 438.
pupiNary membrane, 4o2.
Perspiratory centre, 16.
Phenol in urine, 200.
test for, 200.
Phlyctene, 456.
Phlyctenular conjunctivitis, 373.
Phosphates in rickets, 578.
in urine, 198.
in urine in osteoporosis, 597.
Phosphorus in rickets, 577.
Phymata, 457. .
Phthiriasis, 462.
Phthisis bulbi, 446.
Physical properties of urine, 192.
Pigs, impetigo of, 501.
vesicular irruption in, 501.
Pilous cysts of ovary, 291.
Pimples, 453.
Pinguecula, 375.
Pitchy affection, 501.
Pituitary body, hypertrophy of, 133.
Pityriasis in dog and cat, 513.
in cattle, 513.
in horse, 511.
Pleuritic lesions in rheumatism, 545.
Plumbism, 141.
Podagra, 564.
Poisoning by aniline, 148.
by carbon disulphide, 150.
with cotton seed or cotton seed
. meal, 383.

Index.

Poisoning by lead, 141.
by ‘ loco’’, 135.
by nitro-benzol, 149.
Poliomyelitis, 156.
Polypi of oviduct, 295.
Polyuria, of nervous origin, 8.
Pons, 16.
Potato eczema, 492.
Prickly heat, 509.
Prolapse of the iris, 392.
Prostate, abscess of, 271.
cancer of, 280.
cysts of, 280.
hyperzemia of, 269.
hypertrophy of, 276.
tuberculosis of, 279.
Prostatic calculus, 280.
Prostatitis, acute, 269.
chronic, 273.
follicular, 270.
interstitial, 271.
Pruritus, 9.
Psammomata of the brain, 131.
Pseudo paralysis; 4.
Psychic peculiarities, 10.
symptoms, Io.
Pterygium, 378.
Ptosis, 339, 342.
Pupil dilatation, 21.
double, 391.
occluded, 402.
Pupillary membrane, persistent, 402.
Purkinje-Sanson images, 329.
Pus in urine, 203.
Pustulz, pustules, 456, 487.
Pustular dermatitis, contagious, 514.
Pyelitis, 233.
Pyelonephritis, 233.
Pyometra, 298.
QUITTOR, 525.
RACHITIS, 575.
from bran, 582.
Rain rot, 499.
Rarefaction of bone, 589.
Rarefying osteitis, 589.
Rash, 455.
Recto-vesical fistula, 263.
Recurrent ophthalmia, jurisprudence,
422.
micro biology, 412.
of solipeds, 406.
Red mange, 503.
Reflex action, 5.
increased, 6
morbid, 5.
tonic spasm, 6.
Renal calculus, 249.
parasites, 250.

Index.

g

Renal calculus, pelvis, inflammation
of, 233.
tumors, 250.
-Respiratory tract, 21.
inhibition, 15.
nerve centers, 14.
Restiveness, 26.
Retina, detachment of the, 441.
Retinal hemorrhage, 441.
Retina, tumors of, 441.
Retinitis, 440.
Retro bulbar abscess, 352.
optic neurititis, 443.
Rheumatism, 538.
articular in cattle, 552.
in the dog, 557.
in horse, 546.
in sheep, 555.
in swine, 555.
blood changes in, 544.
cerebro spinal lesions in, 546.
chronic articular, in horse, 550.
heart lesions in, 544. .
infection, theory of, 542.
lactic acid, theory of, 540.
muscular, in cattle, 554.
muscular in dog, 558.
muscular in the horse, 551.
muscular in swine, 555.
neuropathic theory of, 541.
nodosities in, 548.

prevention and treatment of, 559.

theory of chill, 539.

Rickets, 575.
basement, stables in, 579.
confinement in, 579.
damp soils in, 579.
food experiments, 577.
infection in, 579.
lactic acid in, 578..
on poor soils, 577.
treatment of, 580.

Rime, 565.

Rocking hind quarters, 69.

Rodent eczema, 499.

Rouget, 462.

Rubrum, eczema, 503.

Rupture of the choroid, 405.

SALLENDERS, 490.

Salpingitis, 294.

Sarcoma of spine, 177.

Scabs, 456.

Scales, 456.

Scars, 457.

Sclera, ectasia (bulging) of the, 391.
inflammation of the, 391.
wounds of the, 391.

Scleroderma, 502.

609

Scletosis, 5.
of spinal cord, 167.

Scorbutus, 567.

Scratches, 518.

Scurvy, 567.

Seborrhoea, sor.
of digital region, 522.

Secretions, modifications of, 7.
modified, skin, 458.

Sensory and motor tracts in brain, 14.

symptoms, 8

Sheep, cutaneous eruptions in, 500.
eczema in, 499.

Shorts disease, 582.

Simple iritis, 397.

Sitfasts, 457.

Skin, chronic thickening of 531.
discolorations of, 455.
diseases, diagnosis of, 460.
external causes of, 4538.
internal causes of, 459.
general causes of, 458.
diseases of the, 455.
treatment of, general principles

of, 463.
disease, white, 472.
gangrene of 530.
hyperplasia ot, 532.
hypertrophy, 531.
spots of, 455.
ulceration of, 530.

Softening of the brain, 84.

Solar erythema, 470.

Spasm, 4.
centre, 15. *
clonic, 4.
of eyeballs, 4.
of sphincter vesicze, 261.
paraplegic, 4
tetanic, 4.
tonic, 4.

Spasms, 61.
general, 4.
local, 4.

Sphincter ani, centre, 21.
vesicz, centre, 21.

Spina bifida, 173.

Spinal arteritis, 170.
caries, 174.
cord, congestion of, 155.
cord, cross hemi- section, 20.
cord, inflammation of, 156.
cord, lesions and phenomena, 22,
cord "4 longitudinal vertical sec-
tion, 20.
hoemorrhage, 172.
hemiplegia, 3.
hypereemia, 155.

610

Spinal arteritis, lesions, 14.
lesions, localizations in, 20.
meningitis, 118, 162.
sclerosis, 167.

Spine, slow compression of, 177.

Squama, 456.

Squamee in horse, 511.

Squinting, 452.

Squint, spasmodic or spastic, 453.

Staggering, 5.

Staggers, 69.
cerebral, 94.

Stalk disease, 492.

Stampede, 23.

Staphyloma, corneal, 389.

Starvation mange, 492.

Static refraction, 332.

Steatosis of the kidney, 246.

Stenosis of lachrymo nasal duct, 357.

Stiffness, 583.

Strabismus, 552.

Streptococcic dermatitis, 522.

Streptococcus pneumonize equina,

399.
Stricture of the urethra, 266
Structural alterations in glands and
ducts, 458.
St. Vitus dance, 63.
Stye, 345.
Sunstroke, 39.
Superior columns, 21.
transverse section of, 20.
Swine, eczema in, 500.
aantaed eruption in, 502.
Symblephaton, 341.
Symptomatic or metastatic iritis, 399.
Synechia, anterior, 394.
posterior, 394.
Syringomyelia, 180.
TaRsuSs, chronic eczema of, 490.
Tenderness, 10.
Tetany, 153.
Thalmus, 17.
Thermic fever, 39.
treatment of, 46.
Thrombosis of spinal cord, 170.
Thyroid enlargement, 570.
Timidity, 23.
Titubation, 5.
Tongue, abnormal movements of, 68.
Tonic spasm, 4.
Torpor, 11.
Toxic products of the system, mala-
dies due to, 462.
Toxins in nervous disease, 2.
Traumas, 462.
Traumatica, dermatitis, 482.
Trembling, 4.

Index.

Tremor, 4.

Trichiasis, 346.

Trichorrhexis nodosa, 536.

Trophic spinal tract, 21.
symptoms, 6.

| Tubercle of eyelid, 346.

of prostate, 277.
of womb, 300.
Tuberculae, 455.
Tubercular disease of spine, 174.
"meningitis, 127.
Tuberculosis of the iris, 403.
Tumor, dermoid of the conjunctiva,

377. .
Tumors of eyelids, 350.
of Kidney, 250.
of orbit, 352.
of ovary, 294.
of the brain, 128.
of the cornea, 390.
of the lachrymal caruncle, 358.
of the retina, 441.
of the vagina, 301.
Tyrosin in the urine, 201.
test for, 201.
ULCER, 457.
of the cornea, 387.
Ulceration of the skin, 520.
Ulcerations of nervous origin, 7.
Urachus, persistent, 263.
Urea, 199.
test for, 199.
Ureteritis, 254.
Urethral anomalies, 263.
Urethra, foreign bodies in, 266.
imperforate, 263.
injuries of, 251.
stricture of, 266.
wounds of, 264.
Urethritis, acute catarrhal, 264.
Uric acid. 199.
test for, 199.
Urinary calculus, 249.
Urinary disease, general symptoms
of, 204.
Urinary organs, disease of, 192.
Urinary secretion, 192. j
nervous control of, 193.
Urine, acetone in, 200.
albumen in, 201.
bile in, 202.
blood in, 202.
casts in, 203.
chemical changes in morbid, 196.
chemical reaction of, 198.
color of morbid, 195.
consistency, 197.
creatinin in, 200.

Urine, epithelium in, 202.
glucose in, 202.
indican in, 199.

odor of morbid, 197.
opacity of morbid, 197.
oxalic acid in, 200.
pathological, 195.
phenol in, 200,
phosphates in, 198.
physical properties, 194.
purulent, 226.

pus in, 203.

Urine, sodium chloride i in, 198.

specific gravity of, 197.
translucency, 196.
viscid, 197.

Urticaria, 502, 516, 475.

Uterine tubercle, 300,
tumors, 299.

Vacina, tumors of, 301.

Vaginitis, 300.

Variola, 462.

Variolous conjunctivitis, 372.

Vaso motor nervous centre, 15.

spinal centre, 21.

tract, 21.
Vegetable parasites, 458.
Venenata, dermatitis, 475.
Vertigo,’ 69.

aural, 72.

cardiac, 71.

cerebral, 74.

Index. 61t

Vertigo, embolic, 71.
essential, 75.
from venous obstruction, pte
gastric, 71.
nasal, 75.
optic, 72.
pulmonary, 71.
toxic, 75.
treatment, 78.
Vesical parasites, 261.
Vesiculz, 456.
Vesicular irruption in pigs, 50r.
Vetch, action on dog, 23.
Vice, II, 33.
constitutional, maladies due to
a, 462.
jurisprudence of, 34.
treatment of, 35.
Violence, II.
Vitreous, opacity of the, 439.
WATCH EYE, 401.
Weaving, 68.
White face and foot disease in horses,
470.
White skin disease, 472.
Womb, dropsy of, 298.
pus in, 298.
tumors in, 299.
Wounds of the cornea, 379.
of the sclera, 391.
XANTHIN, 201.
Xerosis cornez (epithelialis), 378.

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