ff

SRELARARRARTE ELA

PHAR

TTT

Library

OF THE

Mew Work State Veterinary College

AT

Cornell University

2112

Cornell University Library
SF 919.F92t

Text-book |

I

3 192

TT
4 003 359 076 vet

|

Cornell University

Library

The original of this book is in
the Cornell University Library.

There are no known copyright restrictions in
the United States on the use of the text.

http://www.archive.org/details/cu31924003359076

TEXT-BOOK OF
GENERAL THERAPEUTICS

FOR VETERINARIANS

BY
EUGEN FROHNER

PRIVY COUNCILLOR AND PROFESSOR OF SPECIAL PATHOLOGY AND THERAPEUTICS IN THE
VETERINARY COLLEGE AT BERLIN

AUTHORIZED TRANSLATION FROM THE FOURTH REVISED
GERMAN EDITION

BY
LOUIS A. KLEIN

PROFESSOR OF PHARMACOLOGY AND VETERINARY HYGIENE IN THE SCHOOL OF VETERINARY
MEDICINE AT THE UNIVERSITY OF PENNSYLVANIA, AND DEAN OF THE FACULTY

PHILADELPHIA & LONDON
J. B. LIPPINCOTT COMPANY

NUS Sf,

Copyright, 1914, by J. B. Lippincort Company
se NEW YORK STATE
F72t VETERINARY COLLEG

LID ARY

PRINTED BY J. B. LIPPINCOTT COMPANY
AT THE WASHINGTON SQUARE PRESS
PHILADELPHIA, U. S. A.

TRANSLATOR’S PREFACE

Tre popularity of Fréhner’s General Therapeutics among
veterinarians to whom it is accessible in German and the lack of a
similar work in English suggested this translation, which it is
hoped will prove equally as serviceable to American and English
veterinarians. A few additions which have been made to the text,
most of them of an explanatory character, have been placed
between brackets ({]). The German regulations governing dis-
infection for the different infectious diseases have been included in
the translation; while they do not have the force of law in this
country, the methods they describe, with some allowance for differ-
ences in conditions, are also applicable here. The etymological
footnotes explaining the derivation of the terms referring to
therapeutic action have been omitted. In the descriptions of the
therapeutic uses of the individual drugs, the names used in the
United States Pharmacopceia and in the United States Dispensa-
tory have been employed, and these have been followed, wherever
it seemed desirable, by the common or English name. Non-
official drugs are indicated by an asterisk (*). Doses are given in
the metric system, as in the original, with the equivalent in the
apothecaries’ system.

Louis A. Kuen.

PHILADELPHIA, July, 1914.

PREFACE TO THE FOURTH EDITION

In the new edition of General Therapeutics the chapters on
chemotherapy, protective vaccination, and disinfection have been
rewritten. The “therapia sterilisans magna” of Ehrlich has become
of great importance to veterinarians, although at the beginning of
its introduction the judgment concerning it was too optimistic
(contagious pneumonia!). Considerable development has also
occurred in the last ten years in the field of protective vaccination.
The more complete vaccination statistics now available make pos-
sible a more exact judgment concerning the value or worthlessness
of the different immune sera. More recent observations have
compelled a partial modification of our views in regard to disinfec-

' tion; this is especially true in respect to preliminary disinfection

and its relation to cleaning. The new German veterinary sanitary
' Jaw has been included in the revision. The reader will also find
numerous changes and improvements in other chapters.

E. FROHNER.
BERLIN.

PREFACE TO THE FIRST EDITION

Arter I had written special text-books on Pharmacology,
including pharmacognosy and pharmaceutical chemistry, on Pre-
scription Writing, and on Toxicology, there remained as a final
task, in my restricted department of instruction, General Thera-
peutics. The present book is therefore a supplemental and con-
cluding volume to the first three.

The presentation of the fundamentals of general therapeutics
will always remain a difficult undertaking. No department of
medicine undergoes such frequent changes in methods and opinions
as therapeutics. A permanent system of general therapeutics
cannot be set forth, especially in our own day, in which great
changes have occurred in the domain of general pathology, the for-
mer absolute domination of the cellular pathology being to some
extent shaken by the developments in serum therapy and the old
humoral pathology again appearing in the scheme. On the con-
trary, the discussion must rather be limited to a presentation and
interpretation of the present status of the knowledge concerning the
subject. This applies especially to the two modern questions of
the day in general therapeutics—namely, disinfection and vac-
cination. But there are several other questions which at this
time have not been definitely settled; for instance, the nature of the
antipyretic, diuretic, expectorant, cholagogue, and derivative
actions. To find the correct middle ground in the midst of all this
uncertainty is not easy. If there is in anything an imminent
temptation to present an extreme optimistic or pessimistic con-
ception, it is certainly the case with general therapeutics. At any
rate, it is always commendable in a text-book prepared for students
and young veterinarians to accept the positive rather than the
negative stand-point in doubtful cases. To fill a studious young
man at the outset with nihilistic views concerning the efficacy of
this or that therapeutic method appears to me to be more hazard-
ous than if one in good faith presented some particular curative
system perhaps in a somewhat too optimistic light. There will be
an opportunity in practice later to test everything and to retain the
best. But if the practitioner, on account of preconceived opinions

brought with him from school, excludes one and another curative
vii

viii PREFACE TO THE FIRST EDITION

method from this test, there will necessarily result a narrowness in
therapeutic methods.

Asecond difficulty in the preparation of a text-book on general
therapeutics is the abundance of material. One must here choose
between a broad, voluminous discussion or a short, concise pres-
entation. Iam fully aware of the advantages and disadvantages
of the two plans. I decided that this book should be as concise
as possible, because, for one reason, among others, we already have
in our veterinary literature a large and valuable text-book on
therapeutics (Ellenberger), in which the assistance of nature in
healing and the history of therapeutics especially are given a large
amount of space. Therefore, I have limited my discussion of the
subject to a presentation of artificial assistance.

There are yet to be subjoined some observations concerning the
relations between veterinary curative methods and those of human
medicine. There can be no doubt that in veterinary medicine we
have derived very many, if not the most, of our therapeutic con-
ceptions from human medicine. But it may not also be known
that there are several curative methods peculiar to veterinary
medicine, as, for instance, blisters, the actual cautery, lactagogues
and ruminatorics; and that some methods, as vaccination and dis-
infection, are much more extensively employed in veterinary
than in human medicine. The prophylactic measures also show,
as is well known, a greater stage of development, especially in
reference to combating epidemics (sanitary laws), in the domain
of veterinary medicine than in that of human medicine, in which
in our day preparations were first made for the formulation of sani-
tary laws. On the other hand, different highly developed curative
methods in human medicine can never obtain practical considera-
tion in veterinary medicine,—for example, pneumotherapy, bal-
neotherapy, climatotherapy, mechanotherapy, orthopedics, sug-
gestive therapy, etc. Those who are interested in these subjects
must be referred to the text-books on General Therapeutics by
Ziemssen, A. Hoffman, and others.

Finally, in justification of the introduction of the numerous
etymological footnotes into the book, I may remark that on
account of the strangeness of many of the therapeutic terms a short
explanation seemed to me to be necessary in the interest of students.

BERLIN. E. FROHNER.

CONTENTS

PAGS

INTRODUCTION (iwiiiered's & ones casei oa Ss asia Riewlel as G-ciaielemaleierde-med kena 1
THe HIsToRY OF THBRAPEUTICS.............0cccc cece ec eececceeees 9
1, Hippocrates, . 2.044 cs0a oe end ea deen evne saan ee ewes ei cue 10

2. GANOD as sssicice Sichdusns iavete = etaragty ave ee aha viaacd an Risuslercenn 12

DB. PATA COLAUB er soisisices vac ahd bs 414.9404 acecela.o aera dl abeinie-g a bavatnl doe aera 14

By BOCTRRAVE inwii'scnis cs joni d ghia. d-dinbel 2 Way comes ES wreiecsie aes 17

9. BOWE) 2 oce dais vs wine me edaiie ede calawinescdes 18

G. Rademacher sisted tales cages deen ln esiec sae eens eeage 19

“7. The Homeopathy of Hahnemann.................2020-- 19

8. The Cellular Pathology of Virchow..................0005 21

9. The Serum Therapy of von Behring....................- 22

10. The Chemotherapy of Ehrlich...................0000 00 23

GENERAL THERAPEUTICS OF THE DISEASES OF THE ORGANS OF DIGESTION 25

I. GeneraL THERAPEUTICS OF THE DISEASES OF THE StomaAcH 25

1. Dietetic Treatment............ 0... ccc cece eee 29
2. Medicines. (Stomach Remedies. Stomachics).......... 29
83. Mechanical Treatment..............00 2.0 c cece neces 33
4. Operative Treatment........... 0c. cee eee eee eee eee 34
11s BMETIGS xjancnne ss vine heeds eae Se ee eens eae Wed Re 34
III. GeneraL THERAPEUTICS OF THE DISHASES OF THE INTESTINES 38
1. Dietetic Treatment........ 00... 0c eee eee cee eee eee 40
2. Cathartics. Laxatives............ 00 cee eee eee eee eee 40
3. Constipating Remedies. Styptics....................4. 48
4. Mechanical and Operative Treatment.................. 51
IV. Genera, THERAPEUTICS OF THE DISEASES OF THE LIVER... 52
1. Cholagogues. Stimulants to Bile Secretion.............. 54
2. Dietetic and Mechanical Methods..................... 55

GENERAL THERAPEUTICS OF THE DISEASES OF THE ORGANS OF CIRCU-

I, GENERAL THERAPEUTICS OF THE DISEASES OF THE Heart... 56
Cardiacs. Heart Remedies............02.eeee cece ee eecee 57

x CONTENTS

II. Genera, THERAPEUTICS OF THE DisEasEs OF THE BLoop... 60
Dietetic Method. Blood-forming Remedies. Blood Plastics. 63

III. GeneraL THERAPEUTICS oF THE DISEASES OF THE BLOoD-

VESSBLS esas Fae a Sine zane eee eee As Ree ee 64
‘1. Methods of Arresting Hemorrhage...........--------- 66

2. Vasomotor Stimulants. | Drugs that Contract Blood-
VOSSElS hack k wana Dev galas Meng AAG acres wae wee SH 71
3. Vasodilators. Agents that Dilate Blood-vessels........ 72

IV. GENERAL THERAPEUTICS OF THE EXUDATES AND TRANSUDATES.
RESORBENTS: 0.2.35 dedi donde ROR ee MRCS ANS b PERE eZ 73
Resorbing Medicines. Resorbents ...............-02+-+00> 76
GENERAL THERAPEUTICS OF FEVER...........00-00 see eect eters 80
Medical Antipyretics........ Salen ate eaaelesee i Wocaaget te ma GRD eau ea 84
GENERAL THERAPEUTICS OF THE DisEaSES OF THE NERVOUS System.. 88
Drugs Acting on the Nerves. Neurotics. Nervines......... 90
1. Stimulants to the Nervous System. Excitants......... 93
2. Drugs that Calm the Nerves. Sedatives.............. 97
3. Narcosis and Anzsthesia............. 0.002 e ee eee eee 101

GENERAL THERAPEUTICS OF THE DisEASES OF THE RESPIRATORY APPA-
RATUS) weg. esctoed bea sien same pea Hee es eee ee wee ee alee 103
Expectorants is s<sceeve4 views cae men eda sed Ves wed bs eee eas 107
GeneraL THERAPEUTICS OF THE DisEASES OF THE Urinary Oraans. 112
Diuretics: scats sa seman guauisiaie tare hibe sa wae eee hes eee 113
GENERAL THERAPEUTICS OF THE DisEASES OF THE GENITAL ORGANS. 118
+ Eecbolics. Abortivess:: 6.3 sedccauwes sveveuseseesaiseeess 119

. Drugs that Stimulate the Sexual Impulse. Aphrodisiacs.... 120
. Drugs that Depress the Sexual Impulse. Anaphrodisiacs.... 121
. Drugs that Increase Milk Secretion. Galactagogues....... 122
. Drugs that Depress Milk Secretion. Antigalactagogues.... 127

aor WN &

GENERAL THERAPEUTICS OF THE GLANDS (DIAPHORETICS AND SIALA-
GOGUES)........... Bahia sed asayel arene caceyneas Saat pea eratulalgn tt 128
1. Drugs that Stimulate the Secretion of Sweat. Diaphoretics. 129
2. Drugs that Stimulate the Secretion of Saliva. Sialagogues. . 131

GENERAL THERAPEUTICS OF THE DISEASES OF METABOLISM.......... 133
1. Plastic Remedies. Plastics.......... eS eee 134
2. Nutrients. Roborants................0.cc eee eee eee ees 137

3. Reducing Remedies. Antiplastics................0..0000- 138

CONTENTS xi

GenzeRaL THERAPEUTICS oF DisHasES OF THE EYE..............6+: 141
1. Pupil-dilating Remedies. Mydriatics..................00 141
2. Pupil-contracting Remedies. Myotics..................-. 142
GENERAL THERAPEUTICS OF THE SKIN AND Mucous Mremsranes.... 143
1. General Therapeutics of the Diseases of the Skin........... 144
2. Cutaneous Irritants. Acrics........... enieacie fe auto Poneto 146
Bs | Castes sxaiccicng oa tad oc seGradsledad vauedaus ae oeieny ea weet. 152
4. Firing. Cauterization............ 00... cece cece ceca ceees 156
5, ASTIN BONUS oa S555 crs aed sid Saeee Sepia Ae ee se 157
Drues tHat Kitt Parasires. ANTIPARASITICS...........-..00ee00: 160
1. External Antiparasitics. Antepizoa....................0- 160
2. Worm Remedies. Anthelmintics.................00000005 165
DISINFECTANTS. ANTISEPTICS.........0. 00 cece cece e cece eeceeeeaes 169
1. Disinfection in General. ............ 0.0 ccc cece eee ee eee 169
2. Disinfection for Infectious Animal Diseases................ 183

I. Supplement A to the Instructions of the Federal
Council, December 25, 1911 (Disinfection in Infec-

bows Diseases) si... ace cede ed whe se ses Pa eieradaeane 184
II. The Most Important Disinfectants for Animal Infections 201
8. Disinfection of Wounds............0ccceeeee tec ececeeeeee 209
4. Internal Antiseptics............ 0. ccc cece cece ener cena 213
5. The Conservation of Animal Products..................4- 214
ANTIDOTES shut cued Sad es Gab tone e td hse Bae aie eaalble dns 216
VACCINATION. IMMUNIZATION. INOCULATION.........-..0+2+eeeeeee 225
1. Immunity, Mitigation, and Methods of Inoculation......... 225
2. The Different Varieties of Vaccination.................... 235
I. Protective Vaccination.............. eee ee eee eee 236
Veterinary Police Regulations Concerning Vaccina-
HON eens wiaree te tee ae se era Glens geal wE es 237
Protective Vaccination for the Different Animal
TAPOCEIORAG 53 i. 5i5:i5, Sa auarecs Syhasand oA ined aa Rg BSS eats 3% 237
"II. Curative Vaccination..........0.c.ceeceeeneeeeaes 252
III. Diagnostic Inoculation................0 0c eee scene 254
Water AS A REMEDY. HYDROTHERAPY...........e cece cece eet ceeees 265
MASSAGB. ond oon bere ee ES eG Meee NOES Baa eee oe See eee 276

xii CONTENTS

IBLEEDING byes sisidvia cg loca dd Ries cae MAGEE Oa ee eros. 4 286
GENERAL THERAPEUTICS OF THE ORGANS OF LocomoTIon (MuscLas,

Trnpons, NERVES, ARTICULATIONS, BONES)............0eeeeeeees 288

INDIFFERENT REMEDIES. MECHANICALS..........--0eeseccececeesees 290

hss PHOLEC VES vac. <susis aa wehG ea ota av Aue ab ateuse wasionee ateuesens 290

2; HimOlients sos iecsere Sree Po owen 4 ds Behe New balck e euidians 291

3. Cleansing Remedies. ............ 20... cece eevee eee eeeee 292

AiR AS A REMBDY 506600 05 sees: od reek Seater EG eda ERS EY EH ee earte 295

TEXT-BOOK OF
GENERAL THERAPEUTICS
FOR VETERINARIANS

INTRODUCTION

Natural and Artificial Healing.—In the healing of disease two
possibilities are to be considered. The disease is healed by the
curative forces of nature without the assistance of medicines
(natural healing), or artificial—i.e., medical—healing processes
are necessary (artificial healing). Whether a disease can be left to
nature’s powers or whether medical treatment is expedient or neces-
sary is the question which the therapeutist must first consider
carefully in every case. What may be healed by nature? What
may be healed by medical treatment? To these questions may be
added a third: What is usually incurable?

1. What May be Healed by Nature?—The answer to this
question may be based upon clinical observations and experi-
mental investigations in general surgery and pathology. In sur-
gery as well as in pathology it has been demonstrated repeatedly
that the natural healing force and the regenerative capacity of the
individual tissue cells and organs are extraordinarily great. The
spontaneous healing of wounds and fractures of bones, the reactive
protective processes of the body in inflammation (local leucocy-
tosis) and in fever (general leucocytosis), the spontaneous checking
of hemorrhage, the organization of a thrombus, the encapsulation
of purulent areas and of foreign bodies, the restoration of epi-
thelium and of nerve-fibres, the formation of anastomoses, anky-
loses (spavin, ring bone), and nearthroses, the throwing off of gan-
grenous parts, the resorption processes in pneumonia and pleurisy,
the compensatory processes of the heart, kidneys, liver, and lungs,

the spontaneous healing and natural immunity of the infectious
, 1

2 INTRODUCTION

diseases (aphthous fever, strangles, influenza, contagious pneu-
monia), the spontaneous recoveries from colic in numerous cases,
and many other natural healing and corrective processes verify
this statement.

A clear insight into the nature of spontaneous healing is afforded
by a study of the processes of inflammation. While the inflam-
matory changes were formerly regarded as harmful and were com-
bated with remedies that reduce inflammation, especially cold, it is
now known that inflammation is a healing reaction and should
not be opposed but favored. Just as fever, pain, cough, vomiting,
diarrhcea, and other disease phenomena exert a natural healing
tendency in removing and combating the cause of disease, so do
the processes attending inflammation constitute a natural elimi-
native and healing process. The dilation and hyperemia of the
vessels; the change in the capillary walls by which they become
permeable; the out-wandering of the white blood-cells (local
leucocytosis) and the exudation of blood-plasma into the tissues;
the removal of endotoxins from the inflamed area by phagocy-
tosis; the proliferation of the autochthonous connective-tissue
cells; the liquefaction and resolution of the solid inflammatory
products by enzymes (lysins) ; the occurrence of toxin-binding, neu-
tralizing antitoxins, of bacteria-destroying humoral and leucocytic
bactericides (bacteriolysins), of bacteria-clumping agglutinins, and
of opsonins which prepare the bacteria to be taken up by phagocy-
tosis; the leucocytosis of the blood (lymphocytes, neutrophiles,
eosinophile leucocytes); positive and negative chemotaxis; the
regeneration of the injured tissue-cells by increased growth of
cells; proliferation of tissues and capsule formation—all these are
nothing more than protective and healing processes directed
against the causes of disease, especially bacteria, and to the regener-
ation of the injured tissue, such regeneration occurring in living,
healthy animal bodies through the adaptability and reproductive
powers of the cells. These natural eliminative and regenerative
processes should not be disturbed by improper treatment, but
should be regarded as natural healing processes and not only
favored but even stimulated under certain circumstances.

INTRODUCTION 3

2. What May be Healed Artificially?—The problem of artificial
assistance consists above all in supporting, promoting, and acceler-
ating the natural healing processes. Natura sanat medicus curat.
Disinfected, ligatured, and bandaged wounds, reduced bone frac-
tures, and incised abscesses heal better and more rapidly than when
left entirely to nature’s efforts. This is also true of the artificial
removal of fluid exudates (hydrothorax, ascites, acute hydro-
cephalus, laminitis), and of the medicinal treatment of heart weak-
ness and dangerously high fever, pulmonary congestion, cerebral
hyperemia (phlebotomy), and numerous other diseases.

In many cases natural healing entirely fails to remove the dis-
ease. Then it is only curable through artificial methods. Sur-
gery and obstetrics are especially rich in examples of this kind.
To this class of cases belong most of the neoplasms and parasitic
diseases, especially mange, deviations in the position of the foetus
and of the gravid uterus, invaginations and incarcerations of the
intestines, hernis and prolapses, ulcers and fistule, urinary calculi,
foreign bodies in the stomach and intestines, tympanites of the
rumen and intestines, wounds of the carotid artery, etc.

3. What is Incurable?—The answer to this question will depend
upon the present extent of medical knowledge. There is a large
number of diseased conditions which are incurable in spite of all
discoveries and therapeutic progress, and which will probably
remain so in the future. A dead tissue or organ cannot be replaced
in its original form. Incurable also are atrophic conditions,
chronic hydrocephalus, chronic interstitial nephritis and hepatitis,
ankyloses, many neoplasms in internal organs, fractures of the cer-
vical, dorsal, and lumbar vertebre, atrophy of the optic nerve,
detachment of the retina, emphysema of the lungs, progressive
atrophy of the posterior crico-arytenoid muscle (roaring), general-
ized carcinomatosis, sarcomatosis, tuberculosis, and actinomycosis,
echinococcus disease, glanders, and rabies. In the large domestic
animals (horses, cattle) fractures of the upper bones of the extrem-
ities, severe pelvic fractures, purulent inflammation of the large
joints, and perforating wounds of the intestines are, as a rule,
incurable. Many diseased conditions are curable in man that are

4 INTRODUCTION

incurable in animals, because in the treatment of animals the
external conditions necessary to healing are not obtainable in the
same degree asin the treatment ofman. For instance, many bone
fractures in horses and cattle are incurable because a fixation dress-
ing cannot be applied to the part affected. Some operations can
not be performed on large animals because of the difficulty of main-
taining asepsis. Furthermore, the task of the veterinarian is
essentially different from that of the physician. Frequently, the
purpose of veterinary therapeutics is not the healing of disease,
but to make the animal serviceable. A horse with an ampu-
tated leg is, indeed, healed, but is not serviceable. Neurectomy,
on the other hand, does not heal ring bone or spavin, but it
makes the horse again serviceable. Even economical considera-
tions (value of the animal, time required for treatment) often
govern the veterinary therapeutist.

Remedies and Medicines.—The remedies which may be used
in the treatment of disease are numerous and various. The term
remedy does not signify the same thing as medicine or drug; the
latter is only a special form of the former. There is not always,
as is frequently incorrectly assumed by the laity, a sharp contrast
between medical and drugless treatment (so-called natural method).
On the contrary, the same therapeutic effect produced by drugs
may frequently be obtained from other, non-medical remedies,—
e.g-, through mechanical methods. In general, dietetic, chemical
(medicines), mechanical (massage, hydrotherapy), thermic (heat,
cold), electrical (electrotherapy), and operative measures are to be
considered as therapeutic remedies. Also of importance as healing
factors are rest, movement, and exercise. Disinfection, inocula-
tion, and sanitary police regulations are of especial value in com-
bating infectious diseases.

If, after the use of this or that therapeutic measure, the disease
is cured, this is not in itself proof that the treatment applied was the
cause of the cure. Post hoc is not propter hoc. On the contrary,
every recovery should be considered candidly and objectively to
determine what share in the cure is to be credited to the healing
powers of nature and what part was played by the therapeutic

INTRODUCTION 5

measures employed. The observance of this rule is very neces-
sary, especially in veterinary therapeutics. Fallacious, speculative
conclusions from meagre casuistic material, and unjustifiable com-
mendation and overrating of new remedies are in veterinary medi-
cine almost more common than in human medicine.

Healing Methods.—General therapeutics differs considerably
from special therapeutics and pharmacology. The latter con-
siders in a detailed manner the actions and uses of the individual
medicines in the different diseases. General therapeutics em-
braces the different views concerning the treatment of diseases
and the action of remedies in general. Out of the sum of indi-
vidual observations it constructs certain general rules and laws,
on which are based the employment and systematic grouping of
the curative agents. Such a consideration of the healing agents
naturally leads to the formulation of the so-called healing methods.
General therapeutics can therefore be defined as the study of the
healing methods.

Thenumber of healing methods has been large from theremotest
times. From an entirely general standpoint there are usually
distinguished as special healing methods the direct, indirect, and
derivative, the local and general, the causal, radical, and symp-
tomatic, the empirical, statistical, rational, and physiological, and
the prophylactic, expective, abortive, and vital. Concerning the
nature of these methods, the following may be stated:

1. The direct healing method consists in the direct or imme-
diate application of the remedy to the disease (indicatio morbi).
A direct therapeutic process, for example, is the employment of
antiseptics, antiparasitics, and antidotes—the bacteria, parasites,
and poisons concerned being directly influenced. Other examples
are the use of caustics and many operations (extirpation of tumors,
removal of foreign bodies).

2. The indirect healing method attacks the disease through the
medium of the circulation and the nervoussystem. Itis, therefore,
also called the general method. This method includes the dietetic
medicines, which influence disease through nutrition and metab-
olism; the resorbents and derivatives, which act through the

6 INTRODUCTION

circulation; and cutaneous tritation, which operates reflexly
through the nervous system upon the distant disease process. The
derivative action is also regarded as an independent healing method.
This action can be attained through the operation of cutaneous
stimulation, cathartics, diuretics, diaphoretics, sialagogues, and
bleeding. By far the greater number of cases of all diseases are
treated by the indirect method, because only in isolated cases can
the therapeutic measures be applied directly to the disease.

3. The causal method attacks not the disease itself but the
cause, €.g.,in the infectious diseases, the bacteria; in poisonings, the
poison. To this extent it agrees with the direct method. With
reference to its value, it must be observed that the removal of the
cause is only possible in certain diseases (surgical measures, anti-
sepsis, antiparasitics, antidotes, emetics, cathartics). Further-
more, after the removal of the cause the disease frequently does
not cease, e.g., rheumatic diseases after the removal of the cold
irritant; and finally, in many diseases the cause is either not acces-
sible (distomatosis, echinococci) or is not known (ultravisible virus,
epilepsy, diabetes mellitus).

4. The radical method is directed against the root or source of
the disease and not merely to the removal of the associated dis-
turbances. As the definition indicates, the radical method is
related partly to the causal and partly to the direct (local) method.
Goitre and actinomycosis may be treated indirectly through the
medium of the blood stream with iodine. The radical method
consists in the operative removal of the diseased parts. In a simi-
lar manner are herniz and urinary calculi treated radically,—i.e.,
by operation. Unfortunately, there are only a small number of
diseases in which complete restoration can be attained by the
radical method.

5. The symptomatic or palliative method is directed against
neither the cause of the disease nor the disease itself, but only
against the symptoms of the disease. In the infectious diseases,
for example, the fever is treated, in laryngeal catarrh the cough, in
gastric catarrh the vomiting, in intestinal catarrh the diarrhcea, in
brain diseases the psychic excitement and convulsions, in lameness

INTRODUCTION 7

the pain (neurotomy). Practical experience teaches that in very
many cases treatment must be confined to this method.

6. The rational or physiological method is based upon scientific
observations and experimental investigations of the cause, nature,
and pathogenesis of the different diseases, and the action of the
individual medicines. The therapeutist seeks to explain scientifi-
cally the action of his remedies upon the basis of the contempo-
raneous knowledge of therapeutics. Inflammation and the infec-
tious diseases, for instance, are caused by the action of micro-
organisms and are therefore treated with antiseptics; the diseases of
the heart with drugs whose physiological action upon the heart
has been exactly investigated (digitalis).

7. The empirical healing method is, in contradistinction to the
rational, based upon practical experience only, without the nature
of the disease and the action of the remedies being considered
scientifically in connection with each other. This method includes
the former common employment of potassium nitrate, calomel,
phlebotomy, and the other so-called antiphlogistics in the inflam-
matory diseases. It should be the endeavor of scientific thera-
peutics to extend the rational method more and more and to reduce
empiricism. On the other hand, it must not be overlooked that
our knowledge of the nature of disease and of the action of healing
remedies is not yet so complete that the empirical method can be
dispensed with entirely. Furthermore, many valuable thera-
peutic measures, which are at this time regarded as rational, were
discovered in a purely empirical manner (massage, hydrotherapy,
folk-medicines). The statistical healing method is in a certain
sense a subdivision of the empirical. It is based upon the statis-
tical demonstration of the effectiveness of a remedy or a cure.

8. The expectant or waiting method leaves the mastery of the
disease to the healing powers of nature and resorts to medication
only when the automatic regulation of the body fails. It conforms
in part to the dietetic method, and is very properly practised more
in recent times than formerly. Especially in the infectious dis-
eases with a typical course (influenza, contagious pneumonia,
strangles, foot-and-mouth disease) is therapeutic interference

8 INTRODUCTION

indicated only when certain abnormal complications appear (very
high fever, heart weakness, diarrhoea, etc.). The same principle
also applies to catarrh of the upper air-passages, gastric catarrh,
intestinal catarrh, and to numerous surgical conditions (distor-
tions, tendinitis, spavin, etc.).

9. The prophylactic method is, strictly speaking, not a curative
method, but a process of preventing the occurrence of disease and
its extension to healthy animals. Nevertheless, it is of great impor- _
tance (‘Prevention is better than cure”’). It consists in attention
to hygiene, dietetics, rational breeding and feeding, disinfection,
and the sanitary police measures for controlling disease.

10. The abortive method combats disease in its initial or for-
mative stage. Emetics and calomel appear to have an abortive
effect against certain infectious diseases (canine distemper, swine
erysipelas) in consequence of their action in removing the cause of
the infection from the body. In poisonings an abortive cure can
be spoken of in the same sense. This is also true of arecoline and
phlebotomy in laminitis and in cerebral inflammation, likewise of
amputation of the tail in tetanus resulting from infection of a
wound in the tail. On the other hand, the claim that contagious
pneumonia of horses is influenced by the intravenous injection of
salvarsan, in the sense that inflammation of the lungs does not
develop or that complications and secondary diseases do not
occur, does not appear to have been proved.

11. The conservative method aims at the greatest possible con-
servation of the diseased organ. In veterinary surgery it has a
certain importance (preservation of cutaneous flaps in abraded
wounds and also in wounds of the wings of the nostrils and of the
eyelids).

12. The vital method (vital cure, indicatio vitalis) concerns
itself with the preservation of life when it is suddenly threatened in
the course of a disease. It is really asymptomatic method (trache-
otomy in pharyngitis and cedema of the glottis; bleeding in cedema
of the lungs; puncture of the pleural cavity, peritoneal cavity, the
rumen, intestines, and bladder when collections of fluids or gas
threaten life).

THE HISTORY OF THERAPEUTICS

Tue history of therapeutics, or medicine, extends far back
into the remotest antiquity. The earliest traditions are derived
from Indian (Upavedas, Agurveda, Susrutah des Dramoantari),
Egyptian (Isis, Osiris, Horus, Harpocrates, priest medicine), and
Hebraic (Moses, Levites, prophets, Essenes) literature. Very old
also is the Chinese medicine (Ching de chung Ching). But the
real scientific therapeutics begins only with the Greeks, with
an introductory period which may be designated as the philo-

sophical (Thales of Miletus, Pythagoras, Alemzon, Empedocles,

Anaxagoras, Democritus). The Grecian medicine was also in the
beginning a “priest medicine.” The so-called Asclepiade were
associations of priests, purported to be founded by Aésculapius the
god of medicine, who held temple-polyclinics in which they prac-
tised their secret medical art, which was transmitted by oral com-
munication, Out of one of these temples of Asclepiade at Cos
came Hippocrates (400 3.c.), the founder of Grecian medicine.
His teachings, the humoral pathology, entirely dominated Grecian
and later also Roman medicine; its influence extended even through
the middle ages into modern times (sixteenth and seventeenth cen-
turies). The writings of Galen (131-200 a.p.), which were regarded
as medical dogma of Biblical authority throughout the entire
middle ages, a period of not less than fifteen hundred years, are
nothing more than an amalgamation of the medicine of Hippoc-
rates with the philosophy of Plato. The Arabian school (900-
1000 a.p.) introduced by Rhazes and Avicenna, and the so-called
Monks’ medicine, especially the school at Salerno (about 1100
A.D.), were also founded upon the teachings of Hippocrates. The
Arabian school also included the new factors of alchemy and
spiritualism.

In the sixteenth century, Paracelsus (1493-1541) began the
actual reformation of the Galenic and Hippocratic teachings.

Believing chemistry to be the basis of therapeutics, he created his
9

'

10 GENERAL THERAPEUTICS FOR VETERINARIANS

system of chemiatrics or iatrochemistry, but, as he was strongly
under the influence of the spiritualism of the Arabian school, his
ideas in part acquired a mysticism. The scientific foundation of
modern therapeutics was laid in the period from the sixteenth to
the eighteenth century by exact anatomical, pathological, phys-
iological, and clinical-pharmacological investigations. | Prominent
in this work were Vesalius (1514-1564), Fallopius (1523-1562),
Malpighi (1628-1694), the founder of modern anatomy and his-
tology; Morgagni (1682-1771), the creatorof pathological anatomy;
Harvey (1578-1657), the discoverer of the circulation of the blood
and founderof physiology ; Ambroise Paré (1517-1590), the reformer
of surgery, and Sydenham (1624-1689), the master of practical
clinical medicine.

A special position in the modern history of therapeutics is held
by Boerhaave (1668-1738), the founder of the modern humoral
pathology (hematopathology); Brown (1735-1788), the author of
Brownianism; Rademacher (1772-1849), the author of the experi-
ence or empirical method; Hahnemann (1755-1843), the father of
homeopathy, and also several discoverers of natural healing
methods, especially Hufeland (1762-1836), Schénlein (1794-1864),
and Priessnitz (1799-1851).

The history of modern therapeutics in the nineteenth and twen-
tieth centuries lacks the prominent, central character of former
periods, because it consists of the special history of the several
branches into which medicine has been divided. Of general cura-
tive methods, only three are of importance: the cellular therapy of
Virchow, the serum therapy of von Behring, and the chemotherapy
of Ehrlich. The first locates the disease and also the healing
powers in the cells, the second uses the therapeutic action of the
immune bodies of the blood-serum (antitoxins), and the third
treats certain infectious diseases (protozoa, trypanosomes, spirilla)
with specific chemical substances.

1. HIPPOCRATES

Biographical.—Hippocrates was born in the year 460 B.c., on
the island of Cos, in Asia Minor, the son of Heraclides, one of the

HISTORY OF THERAPEUTICS 11

Asclepiadz and a teacher in the medical temple school at Cos. He
was a contemporary of Pericles. He travelled in Asia Minor,
Greece, Scythia, and Lybia and resided subsequently in Thes-
saly, where he died in Larissa in 364 (3757). He published
the medical secrets of the priests of the Asclepiade and his own
experiences in several books (Aphorisms, Prognostics, Epidem-
ics, Treatment of Inflammatory Diseases, Wounds of the
Head, Herniz). His expression, “ Life is short, art is long, oppor-
tunity fleeting, experience deceptive, judgment difficult,” is well
known. :

The Theory of Hippocrates.—The humoral pathology of Hippoc-
rates attributed all diseases to changes in the fluids of the body.
The body contained four cardinal fluids or humors: the blood, the
mucus, the yellow and the black bile. The normal mixture of these
four fluids (7.e., health) is the crasia, while an unequal mixture
generates disease, or dyscrasia. The problem of therapeutics is
to change dyscrasia into crasia. This can be accomplished in three
ways: 1, by removal of the superfluous fluid—e.g., of the blood
by phlebotomy, of the bile by cholagogues, of mucus by drugs that
increase the secretion of mucus (derivative, depletive method); 2,
by altering or rendering harmless the superfluous fluid in the body
by cooking, ripening, or transforming,—pepsis, coctio, maturatio,
alteratio (alterative method); 3, by restoring deficient cardinal
fluids (dietetic method).

In addition to the crasia theory, Hippocrates also formulated a
crisis theory. According to this latter theory the fever reaches the
crisis or turning point on certain so-called critical days. The
seventh day especially was regarded as the critical day and as the
proper time for therapeutic interference. Depleting drugs espe-
cially were administered on these days to increase the critical elimi-
nations. Cathartics and emetics, especially the vegetable drastics
(veratrum, euphorbium, daphne), were used for their derivative
action. Phlebotomy was employed to reduce fever only in strong
and full-blooded individuals. In addition to the external reme-
dies, he assumed the presence of an internal, primitive healing force
which induces the crisis.

12 GENERAL THERAPEUTICS FOR VETERINARIANS

Aristotle, also of a family of Asclepiade; lived from 384 to 322 8.c.; was
teacher of Alexander the Great; pupil of Plato; founder of natural history and
comparative anatomy; teacher of the elementary qualities; discovered the
nerves and gave the aorta its name.

Herophilus and Erasistratus, celebrated anatomists of the Alexandrine
school (time of the Ptolemies). Herophilus discovered the sensibility of the
nerves, the finer anatomy of the eye, distinguished between systole and
diastole, and named the duodenum. Erasistratus discovered the lymph-
vessels and healed liver abscesses by operative incision.

2. GALEN

Biographical.—Claudius Galenus was born in Pergamos, 131
A.D., during the reign of the Emperor Hadrian. He was the son of
a builder. After pursuing a course of study in philosophy, he
studied four years in the school of the Pergamonic physicians. He
then visited Smyrna and Corinth, Asia Minor and Palestine, and
finally the at that time celebrated medical school at Alexandria,
where anatomy especially had flourished from ancient times and
where alone the dissection of the human body was permitted. In
addition, toxicology was there thoroughly taught. Poisons and
antidotes at that time formed the chief part of pharmacology.
Returning to Pergamos in 159, he was appointed physician to the
gladiators. In 165 he received an appointment under the Emperor
Marcus Aurelius in Rome, where he gave lectures on physiology and
prepared the royal electuary, a mixture of 62 drugs. The prescrip-
tion was written by Andromachos, the physician of Emperor Nero,
and was obtained from the Alexandria school. In 180 Galen was
the physician of Emperor Commodus, and in 193 of Emperor Sep-
timius Severus. He died in the year 200 .a.p. His numerous writ-
ings, in all about 500, were destroyed in great part through the
burning of the Temple of Peace in the reign of Commodus. Eighty-
three medical works were preserved, among them the writings on
“Healing Methods,” ‘Critical Days,” ‘Functions of the Parts of
the Human Body,” “Combination and Force of the Simple Medi-
cines,” and “Differentiation of the Different Varieties of Pulse.”

The teachings of Galen were later acknowledged even by the
church; doubt of their correctness was regarded as sacrilege. His

HISTORY OF THERAPEUTICS 13

dogmas received a consideration only equalled by that given to the
Bible, and because of this were a serious hindrance to the develop-
ment of medicine for the succeeding fifteen hundred years. When
the students of medicine explained that dissection was necessary to
discover the errors of Galen, the church forbade the opening of
human bodies and stated that Galen never could have erred and
that dissections were therefore not only unnecessary but would be
reprehensible.

_ Pergamos, his native city, had golden medals struck in honor of
Galen, and he was for other reasons well aware of his position, as is
shown by the following statement: ‘“‘ Hippocrates indeed had made
something of a track and broken the path, but I have smoothed it
and made it passable, as Emperor Trajan did with the military
roads in the Roman Empire.”

The Galenic Theory.—The humoral pathology of Hippocrates,
with its four cardinal fluids and the crasis and crisis theories, was
the nucleus of the Galenic system of medicine. In addition to dys-
crasia, Galen regarded as causes of disease changes in the so-called
elementary qualities (heat, cold, dryness, and moisture). Natural,
primary forces of the body were attraction, adhesion, secretion
(apocritical), and elimination. He assumed that every medicine
possessed specific elementary qualities. In his anatomical and
physiological studies he came very close to the discovery of the cir-
culation of the blood. He was convinced that respiration served
to maintain the body heat; he compared tbe respiration with
combustion and contended that the flame and animal life were
supported by the same constituents of the atmosphere. These
constituents he called “‘air spirits,”’ and, after they were taken
into the blood, “life spirits” (spiritus vitalis). Fever was an
unnatural change in the temperature. ‘The lightest form of
fever, the “ephemeral,” occurred when only the “air spirits”
were embarrassed. If the blood and fluids were affected, there
arose “septic” or putrid fever. When the heart and solid parts
of the body became hot, then the fever was “hectical.” <A
fever continuing one day was due to mucus; three days, to yellow
bile; four days, to black bile.

14 GENERAL THERAPEUTICS FOR VETERINARIANS

Arabian Medicine.—Its foundation was the theories of Hippocrates and.
Galen. Added ‘to these were the new elements of chemistry and pharmacy.
As alchemists, the Arabian physicians discovered analysis, synthesis, distil-
lation, sublimation, precipitation, preparation of salts, and the manufacture
of alcohol. They were also believers in spiritualism, and considered medi-
cines as the bearers of a spirit, to which their power was due. The most
celebrated Arabian physicians were Rhazes (923 a.p.) and Avicenna (978 A.D.).
. Rhazes was first a teacher of medicine and philosophy in Bagdad, later director
of the lazaretto in Ray. His works were: ‘‘On the Healing of Diseases,”
“Aphorisms,” and “Antidotes.” They contain the earliest discussion of
smallpox. Medicines mentioned are: mercurial preparations, copper sul-
phate, arsenic, nitrate of potash. Avicenna, a native of Bokhara, studied
in Bagdad, was private physician to the prince of Ray and later Vizier in
Hamadan. On account of an insurrection be fled to Ispahan, dressed as a
monk. To his chief works he gave the name of ‘‘Canons”; they contained
nearly everything concerning the entire subject of medicine and attained a
wide circulation in Europe. His catalogue of medicines was very extensive
(rhubarb, silver, gold, many plants).

Monks’ Medicine.—From the sixth to the sixteenth century, a period of
one thousand years, in Italy, Germany, France, and other countries of western
Europe, medicine was almost exclusively in the hands of the monks, who
conducted special medical schools. Of the latter the most celebrated was the
school at Salerno, from the tenth to the thirteenth century, a Neapolitan
Benedictine cloister, where pharmacy, pharmacology, and dietetics especially
were taught (Regimen sanitatis Salerni, Antidotariam minus, De simplici
medicini, Eros). Another Neapolitan cloister school was the one at Monte
Casino. In France, in the thirteenth century, was the school of Montpellier,

which later developed into the University. i

3. PARACELSUS

Biographical.—Philippus Aureolus Theophrastus Bombastus ab
Hohenheim, called Paracelsus, was born near Zurich in 1493, the
son of a physician. He studied in Basel and travelled in almost all
the countries of Europe. In 1527 he became professor of physics,
medicine, and surgery in Basel and also city physician, but left
there secretly a year later on account of differences with the munic-
ipal authorities. After that he lived an unsettled, wandering life
in a number of cities in Alsace, Bavaria, Wiirtemburg, Austria,
Switzerland, and other lands, until, at the age of 48 years, he died
in 1541, in Salzburg, where he was buried. Besides a large number

HISTORY OF THERAPEUTICS 15

of philosophical and theosophical works he wrote numerous medical
books. Of the latter the most important are: “Commentary on
the Aphorisms of Hippocrates,” the “Three Great Books on the
Treatment of Wounds,” “The Hospital Book,” the “Seven Books
on Open Wounds,” “Lectures on Wounds,” ‘Minor Surgery,”
“The Bath of the Priests,” ‘Booklet on the Pestilence in the City
of Stertzingen,” “On the Gout,” “On Syphilis.” Opinion con-
cerning the influence of Paracelsus as a reformer of medicine was
formerly very much divided. Disregarding his personal short-
comings, with which his pupils especially reproached him, and his
inclination toward mysticism, there can be no doubt that Para-
celsus, by his thorough refutation of the crasia theory and humoral
pathology of Hippocrates and Galen, and through his own new,
chemiatric system, exerted a very great effect. upon the develop-
ment of medicine.

The Theory of Paracelsus.—The so-called chemiatric, chemical
or spagyrical system of Paracelsus was the first to associate the
chemical properties of medicines with their action upon the body.
He called these properties ‘“‘virtue and force in medicines.” In
opposition to the humors and elementary ‘substances of Galen, he
attributed life and disease to organic processes within the body, and
spoke of a “vita propria”’ of the organs. Chemistry, in his opinion,
was the foundation of all therapeutics. We owe to him the intro-
duction into the materia medica of several important chemicals,
especially iron and its compounds, the preparations of antimony,
sulphur, copper, zinc, and sodium nitrate. He also gave exact
indications for the use of the mercurial preparations. His chief
remedy was opium in the form of a tincture, called after him Tinc-
tura Paracelsi. In place of the formerly exclusively used decoc-

tions, he used tinctures, extracts, and essences. He also called
attention to numerous chemical combinations that were incom-
patible, and was the first to discuss the composition and action of
mineral waters. His efforts in the domain of surgery were also con-
siderable. He was the first to declare that the surgeon should also
be a physician. Pus, he said, was a ‘‘natural balsam” which fav-
ored cicatrization, and its healing action should not be interfered

16 GENERAL THERAPEUTICS FOR VETERINARIANS

with by the excessive use of salves or plasters. In his philosophical
writings two terms frequently occur which are used in modern
natural ‘science: macrocosmus and microcosmus. The first term,
as he used it, indicated nature as a whole, the latter the separate
individuals.

Vesal.—Andreas Vesal (Vesalius), founder of modern anatomy, was born
in Brussels in 1514, but had to flee from Belgium on account of his activity in
anatomical work. He studied in Paris under Sylvius, held in Italy the posi-
tion of demonstrator of anatomy, and in 1537 was called by the Republic of
Venice to be professor of anatomy at Padua, after he had published his cele-
brated work ‘‘De corporis humani Fabrica libri septem” in 1535. Subse-
quently he was private physician to Karl V and Philip II in Madrid. Con-
demned to death by the Spanish inquisition as a magician or conjurer, he was
pardoned by Philip II to take a penitential journey, and died in 1564 on a
pilgrimage to Jerusalem. Vesal opposed the theory of Galen, and demon-
strated, among other things, that Galen’s anatomy was founded upon the
ape and not upon man.

Fallopius.—Gabriel Fallopius, pupil and successor of Vesal, was born in
Modena in 1523, and from 1547 on was professor of anatomy and surgery
in Ferrara, Pisa, and Padua. He wrote ‘“‘Observationes Anatomice” in
1561 and discovered the Fallopian canals in the temporal bone.

Malpighi.—Marcellus Malpighi, 1628-1694, discovered the capillary cir-
culation and laid the foundations of the microscopical anatomy of animals
and plants (Malpighian corpuscles of the kidneys). He was professor of
anatomy in Bologna, Pisa, and Messina, and, at the time of his death, private
physician to Pope Innocent XII.

Morgagni.—Giambattista Morgagni, founder of pathological anatomy,
pupil of Valsalva, born in Forli in 1682, was called in 1711 to the University
at Padua to the chair formerly held by Vesal. Here he attracted numerous
students from all lands, especially Germany. In 1761 he issued, in five books,
his famous work: ‘De Sedibus et Causis Morborum.” His name is a part
of several anatomical terms (Morgagnian liquor between the lens and its
capsule, Morgagnian cavity). He died in 1771, 89 years old.

Harvey.—William Harvey, founder of physiology, pupil of Fabricius ab
Aquapendente, born in Folkstone in 1578, elected professor of anatomy in
London in 1615, discovered the circulation of the blood in 1628. He was the
author of the conclusion ‘“‘omne animal ex ovo,” and showed that, contrary
to Galen, the blood was not one of four fluids, but the only vital fluid (“humor
cardinalis’’). ;

Ambroise Paré.—Ambroise Paré, founder of modern surgery and obstet-

HISTORY OF THERAPEUTICS 17

rics, lived in Paris from 1517 to 1590, and became known through his use of
ligatures on the blood-vessels in operations.

Sydenham.—Thomas Sydenham, 1624 to 1689, physician in London,
reformed practical clinical medicine, bringing it back to the methods of nature
and of experience. Symptoms of diseases were regarded by him as the effort
of nature to eliminate the disease materials. The tincture of opium was
named after him Tinctura Sydenhami.

4. BOERHAAVE

Biographical.—Herman Boerhaave was born inthe Netherlands
in 1668, the son of aclergyman. He becameprofessorof medicine,
botany, and chemistry in Leyden, where he published his cele-
brated works: ‘“ Institutiones medice in usum annue exercitionis”
(1708) and “Aphorismi de cognoscendis et curandis morbus”
(1709). In addition to these, he published the ‘“‘Elementa chemiz”’
(1718). He died in 1738. His best-known pupil was van Swieten
(1700-1722), the private physician of the Empress Maria Theresa
and the founder of the Vienna school.

The System of Boerhaave.—Boerhaave can be regarded, to a
certain extent, as the founder of the modern humoral pathology,
since he pointed to the chemical changes in the composition of the
blood as the cause and essence of disease. His humoral pathology
is therefore a hemato-pathology. The treatment recommended by
him was the removal from the blood of the injurious substances or
irritants by means of cathartics, diuretics, disinfectants and resol-
vents. He assumed the presence of different kinds of harmful
irritants in the blood: acid, alkaline, salty, fatty and glutinous.
In his opinion organic life consisted of motion. Fever he regarded
as the effort of life to overcome death (compare the concurrence of
this view with the modern idea that fever is a protective reaction
against the infectious material). Worthy of note also is his concep-
tion of inflammation, which he regarded as a complete stasis of
blood in the smaller vessels. .

F. Hoffmann.—Founder of the so-called iatromechanical or mechanico-
dynamic school; born in Halle 1660; professor in Halle 1694; private physician
to King Frederic I and professor in Berlin 1708 to 1712; died in Halle in 1742.
His name is preserved in the preparation introduced by him known as “Hoff-

mann’s drops,”
2

18 GENERAL THERAPEUTICS FOR VETERINARIANS

Stahl.—Founder of the chemical phlogiston theory and the spiritual
theory (principal work: Theoria medica vera, 1701); expective method of
treatment. Born in Ansbach in 1660, professor in Halle 1694; private physi-
cian to King Frederic William I in Berlin 1716; died 1734. Stahl’s ointment
for burns and Stahl’s pills perpetuate his name.

Albrecht von Haller.—Physician, anatomist, physiologist, botanist, and
poet. Discoverer of the irritability of the muscle fibres. Born in Bern 1708;
professor in Géttingen 1736; president of the Royal Society of the Sciences.
Died in Bern 1777.

5. BROWN

Biographical.—F. Brown was born in Bumbe,England, in 1735.
At first a linen weaver, he later studied theology and medicine and
was a physician in London. His principal work, ‘‘ Elementa medi-
cine,” was written in 1780. He died in London in 1788. His
most celebrated follower was the Italian, Rasori (died 1837).

Brown’s Theory.—Brown was the founder of the so-called
Brownianism, which was in direct opposition to the humoral pa-
thology and attributed all disease to a deficiency or excess of stim-
uli or excitability. A medium degree of stimulation or excitability
constituted health, Disease was due to either an increase of the
excitability (sthenia) or a decrease (asthenia). Medicines also
were sthenic, 7.e., strengthening (alcohol, camphor, arnica), or
asthenic, i.e, weakening (bleeding, hunger). The one-sided
Brownian theory was later transformed by Réschlaub into the so-
called ‘stimulation theory” and by Rasori into the theory of
“contra-stimulus” (irritant and counter-irritant). These two
modifications of Brownianism are also only of historical interest.

Hufeland.—An opponent of Brownianism, he contrasted the vital forces,
vis vitalis, with the natural healing forces, vis nature medicatriz, and promoted
especially the antipyretic method of treatment (cold-water applications).
His chief work was entitled ‘“Makrobiotik,” published in 1796. Born in
Langensalza in 1762, he died in 1836 in Berlin, where he was a professor and
private physician to King Frederic William ITI.

Schénlein.—Founder of the expective method of treatment. He regarded
disease as an independent process which must be allowed to run its course.
He taught medicine from the stand-point of the natural sciences and intro-
duced methods of clinical examination. The foundations were laid by him
of the so-called natural-history school and the later physiocratic or natural

HISTORY OF THERAPEUTICS 19

healing method (in contrast to the technocratic or artificial healing method).
He was born in Bamberg in 1793, was a professor and clinician in Wirzburg,
Zurich, and Berlin from 1839 to 1859, and died in 1864.

6. RADEMACHER

System of Treatment.—Rademacher (born in 1772 in Hamm,
physician in Goch, on the lower Rhine, died 1849) is the founder of
the system of treatment based on experience, or the empirical
method. In his work, “Rechtfertigung der Erfahrungsheillehre
der alten scheidekiinstigen Geheimirzte, ’’ heassumes, entirely upon
empirical grounds, the existence of specific relationsbetween certain
medicines and certain individual organs. Diseases he divided into
two classes: ‘‘organic diseases’’ and “universal diseases,” and he
also recognized two corresponding divisions of medicines: ‘organic
remedies”’ with local action and “universal remedies” with multi-
ple action. He tested the effect of the individual organ remedies
and universal remedies upon the different diseases and named the
disease after the remedy found to be effective. The local diseases,
for example, were named: digitalis disease of the heart, chelido-
nium disease of the liver, and antimony disease of the lungs, while
the universal diseases were called: copper disease, iron disease,
saltpeter disease. In this way he caused the diagnosis to be based
upon the therapeutics. While the fundamental thoughts of the
Rademacher system concerning the importance of experience and
the specific local action of drugs may be acceptable, his nomen-
clature and many of his conclusions certainly are not. Hisinflu-
ence upon therapeutics was therefore only temporary.

Natural Healing Method.—The author of the natural healing method—
i.e., the drugless treatment of disease with water, diet, heat, exercise, rest, air,
and dressing—was Priessnitz (1799-1851). With reference to his method, see
chapter on hydrotherapy. In addition, the following are also to be mentioned

as followers of the natural healing method: Schroth (dry diet, dry-bread
cure), G. Jager (wool), Lahmann (cotton wool), and others.

7. THE HOMGEOPATHY OF HAHNEMANN

Biographical.—_Samuel Hahnemann, the founder of home:-
opathy, was born in Meissen in 1755. He practised medicine in

20 GENERAL THERAPEUTICS FOR VETERINARIANS

Kothen from 1820 to 1835, when he moved to Paris, where
he died in 1843. Hahemann came into prominence with his
new doctrine in 1796. His chief works were: ‘“ Organon der
rationellen MHeilkunde” (1810) and “Reine Arzneimittel-
lehre”’ (1811).

Hahnemann’s Theory.—Disease, according to Hahnemann,
consists of the symptoms only. The treatment of disease, there-
fore, consists of combating and removing the symptoms (symp-
tomatic method). Certain drugs produce in the healthy organism
symptoms like those caused by disease. Digitalis, for example,
produces symptoms exactly similar to those of heart disease. In
the treatment of any disease, therefore, a drug should be used that
will produce in a healthy organism symptoms similar to those
observed in the particular disease; in heart disease, for instance,
digitalis. Hence the motto of homceopathy: Similia similibus
curantur.

Hahnemann further maintained that every drug acted the more
powerfully the more it was diluted. For this reason a drug should
always be administered in extreme dilution, 7.e., in the smallest
dose possible. Moreover, only one drug should be used at a time.
Allopathy, according to Hahnemann, acts contrary to the purpose.
There are three forms of homceopathic preparations: Triturates,
dilutions, and pellets. A triturate of one part of the drug and 99
parts of milk sugar is called the first triturate; one part of the first
triturate with 99 parts of milk sugar forms the second triturate, and
soon. Similarly, the first dilution or potence is a solution of one
part of thedrugin99 parts of alcohol, the second dilution or potence
a solution of one part of the first dilution in 99 parts of alcohol, ete.
With these dilutions the pellets, which are made of milk sugar, are
moistened.

The charlatanism of the homceopathic theory is not without
effect upon thelaity even to-day. However, it is more tobe deplored
that Hahnemann has found many followers in medical circles. If,
on the one hand, the so-called newer homceopathy has sought to
coincide more with modern investigation, and if, on the other hand,
serum therapy in many respects has assumed a homceopathic char-

HISTORY OF THERAPEUTICS 21

acter, this cannot change the judgment concerning the homceo-
pathic fundamental of potency or dilution, which is far too incon-
sistent to be accepted by the healthy human understanding.

Isopathy.—A variety of homceopathy, which treated “like with like”
(equalia equalibus curantur), e.g., the use of roasted proglottides against
‘tape-worms and the administration of powdered pieces of carcinoma in the
treatment of carcinoma. The preparations of the modern organotherapy
(thyroid gland against goitre, prostate against diseases of that gland,
ovaries in ovarian diseases, spermatozoa in impotence) and also vaccination
(Jennerization) show a close relation to the old isopathy.
Mesmerism.—Mesmer, the originator of mesmerism or the theory of
animal magnetism, was a physician in Vienna and Paris (1734 to 1815). He
claimed to be able to cure disease by touch and stroking, through a ‘“‘magnetic
force” that passed from him to the patient. Mesmer was the forerunner, on
the one hand, of the fraudulent spiritualism, and, on the other, of hypnotism
(suggestion), which in recent times has become an important therapeutic
factor for man.

8. THE CELLULAR PATHOLOGY OF VIRCHOW

Definition of Cellular Pathology.—According to Virchow, there
are no general or universal diseases. On the contrary, the patholo-
gist finds in every diseased body a considerable, indeed, as a rule,
by far the greater part of the organsnormal. A diseased body, in
which every part is changed, is never seen. The diseased or the
inert portion includes only a part of the body. The question that
confronts the physician is: where is the disease (ubi est morbus)?
and he ‘must be able in every case to point out the location of the
malady in the body (principle of localization). The scientific inves-
tigation with reference to the situation of the disease (Sedes morbi)
is extended to the tissues and finally to the cells of the organs which
show the actual areas of disease (cellular pathology).

In some diseases, especially many nervous diseases and intoxi-
cations, visible anatomical changes are not present in the organs or
cells. Nevertheless, the localization of the disease in such cases
must be established upon a physiological or chemical basis, even in
the absence of anatomical alterations which can be demonstrated
by the usual methods.

22 GENERAL THERAPEUTICS FOR VETERINARIANS

As a basis for treatment, Virchow’s theory requires that medi-
cines must exert a local action upon the diseased organ or its cells
(cellular therapy, localized therapy).

9. THE SERUM THERAPY OF VON BEHRING

Definition of Serum Therapy.—The etiological investigation of
the infectious diseases begun by Pasteur and Koch resulted in an
etiological therapy, which was first used by Lister in surgery (anti-
septic treatment of wounds). This etiological principle was intro-
duced in internal medicine especially by von Behring. His system,
because of its specific, pronounced humoral pathological character,
is the direct opposite of the cellular pathology theory. According
to von Behring, in the course of infectious diseases in the animal or
human body chemical bodies are formed, especially in the blood-
serum, which can be employed not only as protectives but also as
curative agents against these diseases. The so-called antitoxins
are specific antidotes to the poisons (toxins) and bacteria of these
diseases; some neutralize chemically the poisons formed by the
pathogenic bacteria (antitoxic action), others destroy the patho-
genic organisms (bacteriolytic action). They form the foundation
of the modern serum therapy or isotherapy. Recently, isotherapy
has developed in two different directions, which are to be dis-
tinguished as isotherapeutic and homceotherapeutic principles
in the restricted sense. Isotherapy uses the so-called isobodies for
immunization, 7.e., the same agent which causes the disease to
be combated: the bacteria themselves. It includes Jenner’s
method of vaccination against smallpox, Pasteur’s system of
anthrax vaccination, and von Behring’s protective vaccination
against tuberculosis. Homeceotherapy does not use the living or
killed organisms, but the toxins or antibodies produced by them,
and may therefore be called isotoxic therapy. To this division
belong von Behring’s diphtheria serum, tuberculin and mallein,
tetanus, swine erysipelas and hog cholera serum, etc. For more
extensive details of serum therapy see the chapter on immunity
and vaccination.

HISTORY OF THERAPEUTICS 23

10. THE CHEMOTHERAPY OF EHRLICH

Definition of Chemotherapy.—Formerly, the pharmacology of
medicines was tested only on healthy animals, and only drugs which
produced symptomatic effects were included in the tests. Medi-
cines which act specifically were tested rarely (quinine against
malaria, mercury and iodine against syphilis). The new experi-
mental therapeutics produces certain infectious diseases artificially
in experimental animals and studies the action of curative agents
upon these diseased animals. Specific medicines are also produced
synthetically for use in the treatment of certain infectious diseases.

Ehrlich has shown experimentally that the specific relations of
the curative agent to different parts of the body, its so-called tropic
properties, may be very different. A distinction must be made
between the organotropic action, 7.¢., the relation to certain organs
(neurotropic action, etc.), and the parasitotropic action, which is
exerted not upon the animal body itself but upon the parasites
present in the body. In serum therapy, products of the body act
as protective agents in a purely parasitotropic manner and without
any organotropic effect. Since the body and its cells are not influ-
enced by these protective substances, serum therapy excels any
other method of treatment in those cases to which it is applicable.
But serum therapy cannot be employed in some of the infectious
diseases, ¢.g., in malaria, trypanosomiasis, and spirillosis. In such
cases, chemical antiparasitic remedies must be used (chemotherapy
instead of serum therapy). These chemical substances, however,
are mostly poisons, which are not only harmful to the parasites
but also to the organism (parasitotropic and organotropic action).
In chemotherapy, only such medicines can be used as will kill the
parasites without doing any considerable harm to the body. Cor-
rosive sublimate, carbolic acid, and arsenic are not suitable on
account of their strong organotropic action. On the other hand,
the extremely poisonous organotropic action of arsenic can be re-
duced by certain synthetical combinations and the parasitotropic
action relatively increased. The first of these synthetic, chemo-
therapeutic, arsenical preparations were atoxyl (sodium arsanil-

24 GENERAL THERAPEUTICS FOR VETERINARIANS

icum), an amino derivate of phenyl arsin, an organically com-
bined arsenious acid, and arsacetin, an acetyl compound of atoxyl.
The knowledge that only the trivalent arsenic group exerts a
poisonous effect upon the cells of the body led by degrees to syn-

_ thesis of arsenophenylglycin and salvarsan, organic arsenical prep-
arations with a predominant, parasitotropic, specific action against
syphilis and spirillosis. A remedy with a similar action against
trypanosomes is trypanred. The complete and immediate sterili-
zation of the organism with parasitotropic chemical substances is
termed by Ehrlich therapia sterilisans magna.

GENERAL THERAPEUTICS OF THE DISEASES OF THE
ORGANS OF DIGESTION

I. GenreraLt THERAPEUTICS OF THE DISEASES OF THE STOMACH

Pathology.—The diseases of the organs of digestion in our
domestic animals are more varied and therefore more difficult to
treat than those of man, especially the diseases of the stomach.
While gastric ulcers and carcinoma of the stomach are generally
rare in animals and the nervous dyspepsia so frequent in man prob-
ably does not occur at all, the therapeutics of stomach diseases in
veterinary medicine is very complicated because the anatomical
arrangement of the stomach is different in the several species of
animals. The ruminants, especially, with their peculiar gastric
apparatus, are in a separate class from the animals with a single
stomach. Among the latter there exists again a considerable dif-
ference between the gastric digestion of the herbivora (horse), car-
nivora (dog, cat), and omnivora (swine). Other peculiarities are
observed in the gastric apparatus of fowl.

The most important and the most frequent diseases of the
stomach in animals are those occurring in connection with feeding
(absolute and relative overfeeding, impaction of the rumen, acute
tympanites, spoiled feed). The therapeutics is therefore first of all
prophylactic (diet). In most cases the anatomical changes are
confined to the mucous membrane (acute and chronic gastric
catarrh, gastritis). However, in cattle all three layers of the
stomach wall are very frequently affected (traumatic gastritis). In
some animal species, parasitic diseases of the stomach are of impor-
tance (stomach-worm disease). Poisons also are not infrequently
the cause of stomach diseases (irritants and irritant narcotic poi-
sons). The stomach is also very often affected secondarily in
general infectious and constitutional diseases.

Physiology.—The physiological processes concerned in gastric

digestion are partly mechanical and partly chemical. Therefore,
25

26 GENERAL THERAPEUTICS FOR VETERINARIANS

the therapeutics of diseases of the stomach will vary according to
whether the disturbance of digestion originates in the muscular
action and innervation of the stomach wall, in the gland secretions
and chemical properties of the gastric juice, or in decomposition of
the stomach contents. Accordingly, treatment may be required
for the muscles, the glands, or the contents. From a therapeutic
standpoint, the following physiological facts are of importance:

1. MscHanism oF THE Stomacu.—In the horse, as well as in
the other domestic animals with a single stomach (dog, hog, cat),
the pylorus and cardia close immediately after a meal, and remain
closed for a time. Then, the muscular layer in the stomach wall
begins to contract, the pylorus is opened simultaneously, and the
contents of the stomach are gradually emptied into the intestines.
A part of the food and water ingested at this time, likewise of any

- medicines administered, pass directly into the intestines without
detention in the stomach. This explains why medicines given by
the mouth are sometimes surprisingly prompt in their action
(cathartics, acetanilid, anthelmintics). The opening of the pylorus
appears to be caused reflexly by the stimulant action of the gastric
juice secreted and collecting in large amount. In addition, stimuli
originating in the duodenum also operate to empty the stomach.
In a similar way, other stimulants (alcohol, veratrum, oil of tur-
pentine and spices) act reflexly through the intestines as well as the
stomach and accelerate the opening of the pylorus and the empty-
ing of the stomach.

The normal period of retention of food in the stomach differs
greatly with the kind of food, the method of feeding and the ani-
mal species, as well as with the individual. in horses, after a _
small meal of oats, the passage of the contents of the stomach into
the intestines begins in 2 to 3 hours and continues for more than 12
hours. Drinking water during or immediately after eating hastens
the passage of the material in the stomach into the intestines.
Water alone or fluid medicines, on the contrary, pass through the
stomach of the horse very quickly; part in a few minutes. Exer-
cise, especially trotting, retards the emptying of the stomach of the
horse.

DISEASES OF THE DIGESTIVE ORGANS 27

In ruminants (cattle, sheep, goats), the mechanism of the
stomach is especially complicated. Solid food and medicines pass
into the rumen and reticulum and often remain, especially in the
rumen, several days. Medicines should therefore not be admin-
istered to cattle in solid form if a prompt effect is desired. On the
other hand, fluids or fluid medicines pass in part directly through
the omasum and abomasum into the intestines, where they are
rapidly absorbed and act promptly; the greater part, it is true,
passes into the reticulum and thence into the rumen. Rumination
results from the muscular activity of the rumen and reticulum and
the pressure of the inferior abdominal muscles. The necessary
conditions for the occurrence of rumination are a medium-full
rumen and a certain amount of fluid in the rumen and reticulum.
When the rumen is over-full or empty, or when the contents are dry,
rumination ceases. The correction of these defects, especially sup-
plying water when the contents of the rumen are dry, is of great
therapeutic importance in disturbances of digestion. For the same
reason, evacuating medicines which also stimulate gland secretions
(arecoline, pilocarpine) are to be preferred to the mere muscle
stimulants (eserine, barium chloride) in the treatment of impaction
of the rumen. ;

The innervation of the stomach consists of the vagus and the
sympathetic nerves and the automatic gastric centres—one each
for opening and for closing the pylorus and the cardia. The motor
centre (vagus) is situated in the corpora quadrigemina; the inhibi-
tory centre (sympathetic) in the spinal cord. Contraction of the
stomach wall may be produced by stimulation of the vagus nerve,
or reflexly by stimulation of the gastric mucous membrane (stimu-
lant stomachics). The secretion of gastric juice is influenced by
the vagus.

2. CHEemIstRY oF Gastric Dicrstion.—The principal con-
stituents of the gastric juice are hydrochloric acid, secreted by the
glands of the fundus, and pepsin, secreted by the glands of the
fundus and of the pylorus. Other ferments, rennet, a fat-splitting
ferment, and a lactic acid ferment, are also present in the stomach.
The function of the gastric juice is a double one. Of first impor-

28 GENERAL THERAPEUTICS FOR VETERINARIANS

tance is the antiseptic and antizymotic action of the hydrochloric
acid. In consequence of the presence of this substance the gastric
juice is a natural protective agent against abnormal fermentative
and putrefactive processes, and likewise against pathogenic bac-
teria. These facts are of the greatest therapeutic importance
(prophylactic, causal, radical treatment of disease). It is also
worthy of note that the antiseptic protective action of hydrochloric
acid may be obtained from other acids, as lactic, acetic and phos-
phoric. The proteolytic or peptonizing action of the gastric juice,
or of the pepsin, is only of secondary consideration therapeutically.
Moreover, the digestion of proteids is not an exclusive physiological
function of the stomach, but can be entirely accomplished by the
pancreatic ferment (trypsin) and in part by the enzyme of the intes-
tinal juice (erepsin). The proteolytic action of pepsin in the
stomach occurs only when the contents are acid (hydrochloric,
lactic, acetic acid). The optimum acidity is 0.2 per cent. If the
acidity is less than 0.1 per cent. or more than 0.6 per cent. peptoni-
zation is inhibited. Accordingly, the average therapeutic dose of
hydrochloric acid for the horse is 15 grams [one-half ounce], figuring
the volume of the stomach to be 15 litres [15 quarts]. Absorption
is relatively slight in the full stomach, especially in the stomach of
the horse and in the first three stomachs of ruminants, and is
limited to fluids or dissolved food and medicines. It is more rapid
in the empty stomach of the fasting animal, especially in the
stomach of dogs and in the abomasum of ruminants. These facts
should be considered in administering medicines. On the other
hand, of no special therapeutic importance are the different periods
of gastric digestion in the horse (proteolytic pepsin digestion, amy]-
olytic action of the saliva, mixed digestion) or the fact that in
ruminants only maceration (rumen) and amylolytic (saliva) diges-
tion occurs in the first three stomachs and proteolytic digestion in
the fourth. More important is the fact that the contents of the
stomach are arranged in layers and that no mixing takes place.

Therapeutic Methods.—Diseases of the stomach may be
treated in several different ways. The methods most used are the
dietetic, the medical, the mechanical, and the operative.

DISEASES OF THE DIGESTIVE ORGANS 29

1. DIETETIC TREATMENT

Since the greater portion of the diseases of the stomach in the
domestic animals is due to abnormal properties in the food or to
excessive feeding, the most important task of the veterinarian is the
regulation of the diet. Sound, easily digested food, given in small
quantity and at frequent intervals, is a primary requisite—green
fodder, hay, carrots, molasses, etc., for herbivora; milk, raw meat,
mucilaginous soups for dogs. In some cases, especially in colic of
the horse, impaction of the rumenin cattle and acute gastric catarrh
in the dog, it is advisable to withhold food entirely. Dogs must be
deprived of water also sometimes; in morbid conditions of the
stomach these animals drink large quantities of water and per-
sistent vomiting results. These methods, by resting the affected
parts, bring about complete recovery in many cases. Work ani-
mals should have bodily rest in addition, because severe exertion
or exercise reduces or entirely suppresses gastric digestion.

2. MEDICINES. (STOMACH REMEDIES. STOMACHICS)

Synonyms: Digestives in a restricted sense, peptics, ruminatorics,
anti-dyspeptics, antemetics, antacids, neutralizants, absorbents, suppletives;
stimulants to the appetite, improvers of the digestion, acid-combating,
stimulants to rumination.

Classification.—According to their action and composition, the
stomachies are divided into the following groups:

(a) PrystoLocicaL Stomacuics.—These are normally con-
tained in the gastric juice and when decreased in quantity or absent
are supplied artificially. They are: acidum hydrochloricum and
pepsinum. It is best to administer both together, as it is not prac-
ticable to determine in animals if one or the other is absent. They
can be used in the treatment of all diseases of the stomach and in
all disturbances of digestion in the course of febrile and general dis-
eases with the exception of the rarely occurring gastric ulcers
(calves). In veterinary practice hydrochloric acid is most com-
monly used.

The dose of hydrochloric acid for cattle is 15-30, 3ss to 3];
horses, 10-20, 3ijss to 3v; calves, sheep, goats and swine, 1-2,

30 GENERAL THERAPEUTICS FOR VETERINARIANS

mxv to xxx; dogs, cats and fowl, 0.1-0.5, mj to vij. Of pepsin,
the dose for horses is 5~10, 3j to 3ijss; dogs, 0.1-1, grs. jss to xv.
Phosphoric acid or lactic acid may be used in place of hydrochloric
acid.

(b) Satine Stomacuics stimulate the secretion of hydrochloric
acid, dissolve collections of mucus upon the gastric mucous mem-
brane, and at the same time combat fermentation. The most
important are sodii chloridum, sodii bicarbonas, sodii sulphas and
*Carlsbad salts.1 They are the best remedies for chronic gastric
catarrh.

The dose of sodium chloride, sodium bicarbonate, sodium sul-
phate and Carlsbad salts for cattle is 50-100, 3jss to ij; horses,
25-50, 3vj to xij; sheep and goats, 2-5, grs. xxx to 3j; dogs, 1-2,
grs. xv to xxx.

(c) Brrrer Sromacuics (AMARA).—In disturbances of gastric
digestion these improve the appetite, increase the secretion of
gastric juice, stimulate reflexly the contraction of the stomach wall
and prevent or check fermentation. The alleged negative results
obtained in experiments with bitter stomachics on healthy indi-
viduals and outside of the animal body do not disprove their favor-
able effect upon disturbances of digestion. Gentiana and aloe are
the most important of those used in veterinary medicine. Others
are: *condurango, cinchona, *absinthium, taraxacum, calumba,
*centaury, *menyanthes, *centaurea, quassia, *cetraria, *achillea,
[nux vomica], and strychnina. Asa rule, the amara are adminis-
tered in small doses.

The dose of aloes as a stomachic for cattle is 5-10, 3j to ijss;
horses, sheep and goats, 2-5, grs. xxx to 3j; dogs 0.1-0.5, grs. jss to
vij. Of gentian, absinthe and the other vegetable amara, except
nux vomica and strychnine, the dose for cattle is 25-50, 3 vj to xij;
horses, 10-25, 3ijss to vj; sheep and goats, 2-5, grs. xxx to 3].
The tinctures of these drugs are usually administered to dogs, the

* [Not official in the U. S.]

1 [The formula for artificial Carlsbad salts, Sal Carolinum factitium, is as
follows: Sodium sulphate 22 parts, sodium bicarbonate 18 parts, sodium
chloride 9 parts, and potassium sulphate 1 part.]

DISEASES OF THE DIGESTIVE ORGANS 31

dose being 5 to 10 drops. Strychnine is also administered [in Ger-
many] in the form of the tincture to dogs, calves, and lambs. [In
the United States, where the tincture of strychnine is not official,
tinctura nucis vomicz is prescribed as a bitter stomachic in the
following doses: for horses and cattle, 4-25, 3j to vj; dogs, 0.3-1,
mv to xv.] Oxgall, fel bovis, is obsolete; it is also harmful, as it
precipitates pepsin. Condurango is alleged to be a specific for
gastric carcinoma.

In the old therapeutics there were superfluous subclasses of the
bitter stomachics: Amara vera or pura (gentian), A. mucilag-
inosa (cetraria), A. aromatica (absinthe), A. salina (magnesium
sulphate), A. adstringentia (cinchona), A. tetanica (strychnine),
A. cathartica (aloe).

(d) Aromatic Stomacuics.—These stimulate the activity of
‘the glands of digestion, the appetite and the peristalsis of the
stomach. To this class belong rheum, calamus, anisum, foenic-
ulum, carum and *fructis juniperi; also sinapis alba and nigra,
*angelica, valeriana and aurantii amari cortex.

The dose of rhubarb as a stomachic for horses and cattle is
10-25, 3ijss to vj. Of the other aromatics mentioned, the dose
for cattle is 25-50, 3vj to xii; horses, 10-25, Jijss to vj; sheep
and goats, 2-5, grs. xxx to 3j; dogs, 0.5-2, grs. vij to xxx.
Rhubarb is given to dogs in the form of the tincture, the dose
being 4, 3).

(e) Stimutant Stomacuics.—The most important of these is
alcohol, which is also antiseptic; in addition, the group includes the
pungent spices: piper and capsicum, likewise the new remedy,
*orexin, All these substances cause hyperemia of the gastric
mucous membrane, abundant secretion of gastric juice, increased
peristalsis and a more rapid emptying of the stomach. They are
contra-indicated in severe affections of the stomach.

The dose of alcohol as a stomachic for horses and cattle is 25-50,
3vj to xij; dogs, 2-5, mxxx to 3j. The dose of the peppers for
cattle is 10-20, 3ijss to v; horses, 5-10, 5] to ijss; swine, 1-2, grs. xv
to xxx; dogs, 0.1-0.2, gr. j to iij.

(f) Distnrectanr Sromacuics.—These are used in fermenta-

32 GENERAL THERAPEUTICS FOR VETERINARIANS

tion and decomposition of the stomach contents, also in infectious
gastric catarrh and against parasites (stomach worms, larve of the
bot fly). To this class belong acidum hydrochloricum, creolin,
creosotum, naphthalenum, bismuthi subnitras, quinina, iodum,
oleum terebinthinz and carbonei disulphidum.

Of these, the most important in veterinary medicine are hydro-
chloric acid and creolin. Both may be given to cattle and horses
in doses of 10-25, 3ijss to vj; sheep and goats, 0.5-1, mvij to
xv; dogs, 0.1-1, mj to xv; fowl, 0.1-0.25, mj to iij. The
dose of carbon disulphide (bot fly larvee) for horses is 10, Jijss,
repeated four times at intervals of one hour.

(g) Narcotic Stomacuics (ANTEMETICS) are prescribed in
painful affections of the stomach and in persistent vomiting. The
sedative remedies are opii pulvis, cocaine hydrochloridum and
menthol.

Opium is most frequently used. Dose for horses and cattle, 5-
25, 3j to vj; dogs, 0.1-0.5, grs. j to vij. [Of the tinctura opii,
the dose for horses and cattle is 30-60, 3j to ij; dogs, 0.2-2,
miij to xxx.]

(h) AnTacrps (AcCID-NEUTRALIZING STOMACHICS, ABSORBENTS).
—These combine with abnormal acids or an excess of normal acids
in the stomach and neutralize excessive amounts of hydrochloric
and lactic acids or abnormal acids (fatty acids, carbonic acid,
poisonous acids). To this group belong sodii bicarbonas, potassii
bicarbonas, soap, liquor calcis, calcii carbonas precipitatus,
*sodium, *potassium, magnesii oxidum, magnesii carbonas, aqua
ammoniz and ammonii carbonas.

Soap is an important absorbent for carbolic acid especially;
lime water for oxalic and sulphuric acids, and the other substances
mentioned above for hydrochloric, lactic and the fatty acids, ete.
The dose is ad libitum except for sodium, potassium, and the oxide
and carbonate of magnesia. Of the latter, the dose for horses and
cattle is 5-25, 3] to vj; sheep and goats, 1-2, grs. xv to xxx; dogs,
0.2-1, grs. iij to xv.

(i) Rumrinatorics.—The drugs that stimulate rumination are
emetics, muscle stimulants, and drastic stimulants of the gastric

DISEASES OF THE DIGESTIVE ORGANS 33

mucous membrane. Those most commonly used are antimonii et
potassii tartras, veratrum, ipecacuanha, alcohol, *veratrina, areco-
line hydrobromidum, physostigmine salicylas or sulphas [eserinel],
*eseridin tartras, pilocarpine hydrochloridum or nitras, oleum
terebinthine, *tabacum, colchici semen, ammonii carbonas and
aqua ammoniz.

In cattle practice, the most important ruminatorics are tartar
emetic, veratrum, veratrin and arecoline. Doses: Tartar emetic,
for cattle, 10-20, 5ijss to v. Powdered veratrum or the tincture,
for cattle, 5-10, 3i to ijss; sheep and goats, 0.5-2, grs. vij to xxx.
Oil of turpentine, cattle, 25-50, 3vj to xij; sheep and goats, 2-5,
mxxx to 3j. Veratrin and eserine, for cattle, 0.1-0.2, grs. 14%
to 3. Arecoline, for cattle, up to 0.05, gr. 34.

In carnivora, an emetic not rarely acts as a good stomachic.

3. MECHANICAL TREATMENT

In ruminants, the rumen is situated in the left flank and is in
contact with the abdominal wall when greatly distended. It can
therefore be very easily massaged. Massage, or kneading, of the
rumen is of the greatest importance in the treatment of digestive:
disturbances in cattle, especially impaction of the rumen, acute
tympanites and all atonic conditions of the musculature of the
rumen. It stimulates reflexly the muscular contractions of the
rumen, which under normal conditions occur about twice a minute.
In dogs, the stomach when full also lies close to the abdominal
wall and can also be massaged. It is not possible, however, to
massage the stomach of the horse, because even when full it can
not be palpated through the abdominal wall.

Of the other mechanical methods, the most important is the
introduction of the cesophageal sound in ruminants and of the
stomach tube in horses to remove gas and the fluid contents of the
stomach. Electrotherapy and hydrotherapy are not usually em-
ployed on animals. The emetics also act in a mechanical manner
in emptying the stomach of its contents (see p. 34).

[For several years, American veterinarians have been using soft

rubber tubes to remove gas from the stomach of horses and to
3

34 GENERAL THERAPEUTICS FOR VETERINARIANS

wash out the stomach. There are two types of these tubes: one
is passed through the mouth and the other is introduced into the
cesophagus by way of the inferior meatus of one of the nasal cavi-
ties, a flexible rattan stilet being inserted into the tube before it is
passed, and withdrawn after the tube is in position.

Tn the small animal clinic at Copenhagen, Prof. Hansen washes
out the stomach of dogs, as well as other parts of the alimentary
canal, by injecting per rectum a 0.9 per cent. solution of sodium
chloride at body temperature, the posterior part of the body being
elevated. After 2 to 3 litres are injected into small dogs and up
to 9 litres in large dogs, the fluid, mixed with alimentary matters, is
vomited. The injection is continued until the fluid is vomited
clear. The method has been in use in the small animal clinic at the
University of Pennsylvania for the last two years. In toxic,
hemorrhagic, and catarrhal enteritis and in icterus the results are
very satisfactory.]

4, OPERATIVE TREATMENT

In acute tympanites of ruminants puncture of the rumen is in
most cases necessary to remove the gas. The rumen may at the
same time be irrigated with water or fluid medicines introduced
through the cannula. Gastrotomy is resorted to to remove foreign
bodies from the stomach of dogs (stones, coins, balls, corks) and
cattle (metallic foreign bodies in the reticulum, abnormal collec-
tions of food and poisonous plants in the rumen). Finally, dis-
eases of the stomach may be treated indirectly by operation, as by
the extraction of diseased teeth in the dog.

II. Emetics

Synonyms: Vomitives, vomitories, nauseosa, nauseotics.

Method of Action.—Vomition results, according to some, from
an active, primary contraction of the stomach; according to others,
from the passive compression of the stomach by the convulsive
contraction of the inferior abdominal muscles and the diaphragm.
The cardia being relaxed at the same time and the pylorus closed,

DISEASES OF THE DIGESTIVE ORGANS 35

the contents of the stomach are forced upward and forward.
Vomiting is under the control of the centre of vomition (a paired
centre situated in the region of the calamus scriptorius). This
centre can be directly stimulated through the blood and indirectly
by stimulation of peripheral parts of the body, especially the
stomach. Emetics which can cause vomiting by acting through
the blood and stimulating the vomiting centre without necessarily
coming in contact with the stomach are called central or general
emetics. Apomorphine is a good example of this variety. Those
that cause vomiting reflexly by irritating the gastric mucous mem-
brane are called local or topical emetics. Examples are copper
sulphate, zinc sulphate, tartar emetic. Some emetics operate both
ways, ¢.g., emetin. - Pathology teaches that vomiting may also be
caused reflexly by the irritation of numerous peripheral parts out-
side of the stomach, as the mucous membrane of the base of the
tongue, the throat, cesophagus, intestines, uterus, pelvis of the
kidney and gall ducts, and the terminations of the auricular branch
of the vagus (otorrhcea). Centric vomiting may also occur in dif-
ferent diseases of the brain and in uremia. Finally, stimuli applied
to centres related to the centre of vomition appear to pass readily
over the latter. Hydrocyanic acid, which stimulates the respira-
tory centre, may exert a similar action upon the centre of vomition.
The drugs that have a specific stimulant effect upon the vagus
centre (digitalis, squill, strophanthus) may also stimulate the
vomiting centre.

The effects of vomiting upon the stomach and other organs of
the body are very extensive. In the first place, the stomach,
cesophagus, pharynx and to a certain extent the buccal cavity are
emptied. The peristaltic movement of the stomach wall is
increased through the contraction of the gastric musculature.
Intestinal peristalsis is also increased, being stimulated reflexly by
the contraction of the stomach. Emetics which exert an espe-
cially pronounced action upon the intestines are called emeto-
cathartics. A further effect of vomiting is the reflex stimulation
of the secretion of the stomach and intestinal juices and of the
bile. The contraction of the inferior abdominal muscles exerts

36 GENERAL THERAPEUTICS FOR VETERINARIANS

compression upon all of the organs in the abdominal cavity. In
consequence of this, the elimination of bile and pancreatic secretion
is accelerated and a certain amount of blood is expressed out of
the large vessels and organs of the posterior part of the abdomen,
these organs becoming anemic while the neighboring organs
become hyperemic. During vomiting the pulse and respiration
are accelerated, metabolism is increased, and there is also at the
same time increased activity of the sweat glands and the mucous
glands of the bronchial membrane. The forced expiration occur-
ring during vomiting increases the expectoration of secretions from
the bronchi and lungs. The nervous system in general is stimu-
lated, but it is questionable if the irritability of the muscles is
decreased. Finally, the nausea that precedes a ee has an
alterative effect upon the gastric nerves. Emetics which pro-
duce a pronounced and long-continued nausea are called nauseat-
ing emetics (apomorphine).

Uses.—The diverse and wide-spread effects of emetics demon-
strate that the use of emetics has unwisely been discredited. In
veterinary medicine, they are indispensable in the treatment of
certain diseases; in other diseases practical experience, in confirma-
tion of the aforementioned physiological effects, has shown that
they are of decided value. The most important indications for the
employment of emetics are the following:

1. The removal of excessive quantities of food, foreign bodies,
and poisons from the stomach and cesophagus.

2. To empty the stomach of decomposing or fermenting food,
and of collections of mucus in gastric catarrh.

3. Licking-disease of cattle and wool-eating of sheep are most
promptly cured by emetics. This is also true of other forms of
depraved appetite (eating of sand by horses).

4. The removal of stasis of bile (icterus).

5. The removal of infectious material from the stomach
in infectious diseases. For example, in the early stages of
canine distemper and erysipelas of swine an emetic is indicated.
In such cases emetics act as alteratives (so-called abortive
_ treatment).

DISEASES OF THE DIGESTIVE ORGANS 37

6. Expectoration of inflammatory products from the respiratory
tract, especially in young dogs affected with distemper.

7. The removal of blood stasis in the liver and other organs in
the posterior part of the body.

Emetics are contraindicated in very weak animals, gastric
ulcers, inflammation of the stomach, advanced pregnancy, hernize
and certain diseases of the heart and blood vessels (aneurism).

Emetics.—1. Apomorphinz hydrochloridum. This is the best
emetic for dogs. The dose subcutaneously is 0.002-0.01, gr.
1/40 to 1/8. As a specific against licking-disease in cattle and
wool-eating in sheep, it is used subcutaneously in doses of 0.1-0.2, _
grs. jss to iij. Cats as a rule require ten to twenty times the dose
for the dogs, ‘Apomorphine usually does not cause vomiting in
swine.

2. Veratrina. The most important emetic for swine. Dose:
0.02-0.03, gr. 14 to 1/3, in alcohol, subcutaneously. In place of
veratrin subcutaneously, veratrum may be administered per os or
per rectum. Dose for swine, 0.5-2, grs. viij to xxx; dogs, 0.05-0.2,
grs. 34 to iij.

3. Ipecacuanha. An emetic for cats, dogs, and swine. Dose
for dogs and swine, 1-3, grs. xv to xlv; cats, 0.25-0.75, grs. iij to x.
[Vinum ipecacuanhe, on account of its stimulating properties, is a
valuable emetic in canine and feline practice. Dose for dogs, 1-4,
mxv to 3j; cats, one-half the quantity.]

4. Antimonii et potassii tartras. Tartar emetic, an emeto-
cathartic; therefore suitable only for robust animals (swine, large
dogs). Dose for swine, 1-2, grs. xv to xxx; dogs, 0.1 to 0.3, grs.
jss to jv. Vinum antimonii is also useful and is given to dogs in
teaspoonful to tablespoonful doses.

5. Cupri sulphas. A specifie emetic in phosphorus poisoning.
It unites with the phosphorus to form phosphor-copper, which is
not poisonous. Dose for dogs, 0.1-0.3, grs. jss to jv.

Emetics like mustard, table salt, ammonium carbonate, and
zinc sulphate, which were formerly much used by the laity, are
now prescribed only in emergency.

For antemetics, see the chapter on stomachics,

38 GENERAL THERAPEUTICS FOR VETERINARIANS

III. Genera THERAPEUTICS OF THE DISEASES OF THE
INTESTINES

Pathology.—The diseases of the intestines most frequently
requiring treatment are acute and chronic intestinal catarrh, very
often associated with gastric catarrh; constipation; colic, with its
numerous anatomical causes (impaction, displacements, etc.); the
different forms of enteritis, and helminthiasis (tape worms, round
worms). More rarely, foreign bodies and neoplasms are present
in the intestines, which are also affected secondarily in many of the
infectious diseases. The incurable chronic intestinal catarrhs,
which are especially frequent in cattle and dogs, and some cases of
chronic gastric catarrh are not merely a superficial, disease of the
epithelium but a severe parenchymatous affection of the intestinal
glands, accompanied by atrophy of the latter and formation of new
connective tissue; the pathological processes being analogous to
those of chronic nephritis. These circumstances explain the
fruitlessness of treatment.

Physiology.—The cause of the normal peristaltic movements of
the intestines is the reflex stimulation of the intestinal nerves by
the intestinal contents. In addition to a number of automatic
centres in the intestinal wall (plexus myentericus), there are also
constrictor and dilator nerve apparatuses. The accelerator nerve
is the vagus (cranial); the inhibitory nerve is the splanchnic
(spinal). Stimulation of the vagus causes intestinal contraction.
Stimulation of the splanchnic (morphine) retards or inhibits intes-
tinal contraction; paralysis of the splanchnic (atropine) increases
the intestinal movements. The average time required for food to
pass through the digestive tract is 3 to 4 days for horses and cattle,
sometimes double this period and more for the latter; for dogs
12 to 15 hours; swine 24 to 36 hours.

The reaction of the contents of the anterior part of the intes-
tines is acid, because of the presence of the acid from the stomach.
The small intestines are therefore relatively poor in bacteria. In
the large intestines, and in herbivora even in the ileum, the reac-
tion is alkaline in consequence of the neutralization of the gastric

DISEASES OF THE DIGESTIVE ORGANS 39

juice by the bile, pancreatic juice and intestinal secretions, all of
which are alkaline. Intestinal digestion takes place principally
in the small intestines. In the large intestines a further digestion
takes place, and here also occur, especially in the cecum, in addi-
tion to the resorption of the fluid and dissolved substances, fermen-
tative and putrefactive processes (indol, skatol, phenol, cresol,
fatty acids, amido acids, ammonia, carbon dioxide, hydrogen,
hydrogen sulphide, and other products of the decomposition of
albumin and cellulose). In contrast with the small intestines, the
large intestines, on account of the alkaline reaction and the ab-
sence of oxygen, are a place for the incubation of anaérobic bacteria
(colon bacillus, bacillus putrificus—decomposers of albumin).
The bile and the pancreatic juice are the most important of the
digestive secretions, the intestinal juice possessing only a slight
amylolytic and at times a proteolytic action. The bile possesses
antitoxic and antiseptic properties (immunization in infectious
diseases, removal of poisons from the blood). It also prepares
the fats for absorption in the intestines and operates as a stim-
ulant to peristalsis of the large intestines. The pancreatic
juice contains proteolytic (trypsin), amylolytic and fat-splitting
ferments.

In regard to intestinal absorption it is to be noted that the -
nutrient substances in solution and the fats are absorbed by the
activity of the intestinal epithelium and the contraction of the
villi, assisted by the amoeboid functions of the leucocytes (phago-
cytosis). The water-soluble substances are also taken up by dif-
fusion. When the intestinal epithelium is desquamated over a
considerable area, as in catarrh, or when the intestinal villi are
paralyzed, as in inflammation, then absorption is distributed or
entirely suppressed.

Therapeutic Methods.—The diseased intestine may be influ-
enced in several ways. The mucous membrane may be treated
directly with demulcents, narcotics, astringents, antiseptics or
stimulants. The glands may be acted upon by pilocarpine or
arecoline; the muscles by eserine or barium chloride; the nerves by
morphine. Treatment of the intestinal contents is also very impor-

40 GENERAL THERAPEUTICS FOR VETERINARIANS

tant and is accomplished by dieting and by the administration of
cathartics, intestinal styptics, disinfectants and anti-ferments.
The principal therapeutic methods are similar to those used in the
treatment of diseases of the stomach, namely: dietetic, medical
(cathartics, styptics), mechanical and operative,

1. DIETETIC TREATMENT

Fasting, or a diet of non-irritating, easily digested food, will
serve, more than anything else, to alleviate a catarrhal or inflamed
mucous membrane. Green fodder, bran, or linseed meal is best
for horses; raw meat, milk, eggs, and mucilaginous soups for dogs.
When catarrh is present in the intestines, the stomach is fre-
quently healthy and the appetite is very good. This must be
remembered so that overfeeding will be avoided. Taking a large
quantity of food at one meal is not to be permitted,

\

2. CATHARTICS. LAXATIVES

Synonyms: Purgatives, drastics, lenitives, eccoprotics, aperients, aperi-
tives, evacuants, peristaltics, osmotics.

Classification.—For the purposes of general therapeutics it is
best to divide the cathartics into three groups according to the
intensity of their action: mild, medium and strong. Although
these different degrees of action may be obtained with the same
cathartic by simply varying the dose, and although the intensity
of action may vary with the species, yet for practical reasons and
because it affords a better conception of the large number of
cathartics, it is desirable to classify these drugs in the three fol-
lowing groups:

(a) Drastics, very powerful cathartics, which operate on the
horse in doses of a few grams, decigrams and even centigrams.
This group includes arecoline, eserine, pilocarpine, tartar emetic,
calomel, podophyllum, croton oil, gamboge, jalap, colocynth and
barium chloride.

(b) Purcativss, cathartics of medium strength, laxatives in
the restricted sense. In this group are included aloes and the saline

DISEASES OF THE DIGESTIVE ORGANS 4]

purgatives: sodium sulphate, potassium sulphate and magnesium
sulphate; also, fructus rhamni cathartice, frangula and cascara
sagrada.

(c) Laxatives or Lenitives, mild cathartics, which must be
given in very large doses and most of which do not operate upon
horses and cattle. This group includes castor oil, senna, sulphur,
manna, tamarind, syrup, honey, glycerin, and the fixed oils.

Theories Regarding Catharsis.—The question of how and in
what manner catharsis is brought about after the administration
of a cathartic has been answered in many different ways. A num-
ber of theories have been proposed by Liebig, Buchheim, Aubert,
Voit, Hay, Brieger, Radziejewski, and others. From these we
learn that catharsis is not a simple process but a very complicated
action resulting usually from several factors operating together.

(a) According to Liebig, the neutral salts operate principally
in-a purely physical manner, 7.e., in accordance with the laws of
osmosis. Water passes from the blood, which is poor in salts,
into the intestines, which contain a large amount of salt. The
“animal membrane”’ separating the blood from the intestinal con-
tents is the intestinal mucous membrane. If a solution of Glauber’s —
salt or epsom salt is placed in an isolated loop of the small intestine
the latter will be filled to distention in a few hours with a clear
yellow, alkaline fluid. At the same time the mucous membrane
will retain its normal pale color. The fluid which passes from the
blood into the intestines operates as a stimulant to peristalsis and
diarrhoea, occurs.

(b) On the other hand, Buchheim asserts that the neutral salts
produce catharsis by retarding or suppressing absorption of intes-
tinal fluids in consequence of their slight diffusibility. The more
slowly and least diffusible salts, sodium sulphate, potassium sul-
phate and magnesium sulphate, therefore, possess a cathartic
action in contrast with the rapidly and readily diffusible sodium
chloride. Other cathartics, especially the drastics, probably re-
tard absorption by paralyzing the intestinal epithelium and villi.

(c) Peristalsis is reflexly stimulated and accelerated through
the direct stimulation of the nerves in the intestinal mucous mem-

42 GENERAL THERAPEUTICS FOR VETERINARIANS

brane by most of the cathartics, including calomel, aloes, rhubarb,
sulphur and especially the neutral salts. The latter operate in at
least three different ways. Proof of their stimulant action is
found in the fact that very dilute solutions, which could not gener-
ate an osmotic stream, produce diarrhoea. Radziejewski studied
experimentally the influence of cathartics upon peristalsis by
means of intestinal fistule in dogs and found that the peristaltic
movements of the intestines and the flow of fluid through the
fistulee were considerably increased after the administration of
laxatives. Intestinal peristalsis may be stimulated reflexly from
the stomach by some drugs; croton oil, for example, will produce
diarrhea while it is yet in the stomach. Acceleration of peri-
stalsis causes a more rapid discharge of the intestinal contents. On
account of the decreased absorption of the intestinal fluids, the
discharges are thin and fluid; they are the unchanged contents of
the small intestines.

(d) Increased secretion of the intestinal glands with increase
of the intestinal fluids and acceleration of peristalsis. The most
important representatives of this group are arecoline and pilo-
carpine, specific gland stimulants. The neutral salts also stimu-
late the intestinal glands during their elimination from the blood,
thus making their action a four-fold combination. Intestinal
secretion is also stimulated reflexly by those drugs which irritate
the mucous membrane, especially the drastics.

The intestinal fluids, including the secretions of the mucous
glands, Lieberkiihn’s and Bruner’s glands, the pancreas and liver,
can only be increased in sufficient amount to produce diarrhea
when the blood is rich in water. As Hay has pointed out, fluid
bowel discharges are not produced by the neutral salts, even in
large doses, when animals have been without water for several
days and have received only dry feed. This observation agrees
with the well-known experience of veterinarians that a horse or
cow which has received a cathartic must be permitted to drink a
large quantity of water in order to accelerate the action of the
drug and increase its effect.

(e) Transudation and exudation of blood-serum as a cause of

®

DISEASES OF THE DIGESTIVE ORGANS 43

collection of fluid and increased peristalsis occur as the result of
the action of any of the irritant cathartics which produce hyper-
zemia, catarrh or inflammation in the intestinal mucous membrane.
In this group are included croton oil, tartar emetic, colocynth, jalap,
gamboge and other drastics. These drugs should not be prescribed
in acute inflammatory conditions of the intestines.

(f) Intestinal tetanus, with rapid expulsion of the intestinal
contents, is the cause of the cathartic action of eserine, nicotine
and barium chloride and partly also of arecoline and pilocarpine.

(g) Paralysis of the splanchnic, the inhibitory nerve of the
intestines, results in the acceleration of peristalsis. Atropine acts
~ in this manner.

(h) Lubrication of the intestinal walls mechanically accelerates
the passage of the intestinal contents. This is the mode of action
of the fixed oils, but in part only of castor oil.

Results of Catharsis.—Scarcely any other action of drugs is
accompanied by so many local and general effects as catharsis,
To begin with, the intestinal canal is emptied of whatever it may
contain: normal contents, fermented or decomposed food, calculi,
concrements, poisons, inflammatory products, parasites or infec-
tious materials. Secondly, peristalsis is accelerated and the
secretions of the intestinal glands increased. Some cathartics,
as aloes, rhubarb, colocynth and podophyllum, at the same time
increase the secretion of bile; these are called the cholagogue
cathartics. The withdrawal of fluid from the blood into the intes-
tines has the effect of condensing the blood, in consequence of
which the blood absorbs fluids from the tissues (hydragogue
cathartics). The volume of the blood is decreased by the loss of
fluid and the blood-pressure is lowered. The distribution of blood
is materially changed and the body temperature is lowered. While
the intestinal mucous membrane and the other abdominal organs
are rich in blood, especially after the administration of drastics,
the more distant organs, as the brain, lungs and skin, are corre-
spondingly poor in blood, the blood being diverted from the latter
to the intestines. The activity of the kidneys is at first increased
by some cathartics; for example, diuresis is increased a few hours

44 GENERAL THERAPEUTICS FOR VETERINARIANS

after the administration of the neutral salts. Usually, however,
the secretory activity of the kidneys is reduced by cathartics.
This is also the case with the sweat glands. Another effect of the
increased secretion of the intestinal glands is the elimination of
infectious material, metabolic products and poisons from the
blood. Emptying the intestinal canal withdraws nourishment
and more or less disturbance of the appetite, and digestion is also
associated with catharsis. Finally the drastics, like cutaneous
irritants, by irritating the sensory nerves in the intestinal mucous
membrane exert reflexly a general stimulant action upon the
nervous system, affecting the animal as well as the vegetative
functions. In this action the principle of counter irritation plays
an important rdéle.

Use of Cathartics—On account of their manifold action
cathartics are employed in the treatment of a large number of dis-
eases.

1. Constipation and depressed peristalsis in the course of
intestinal catarrhs, constipation-colic in horses, fecal stasis in dogs,
and high fever with suppressed intestinal secretions.

2. Overfeeding of herbivora; also the presence of foreign
bodies, poisons, parasites, bacteria, and toxins in the intestines.

3. Diarrheeas and gastric catarrhs due to fermenting food-
masses or infectious materials in the intestines. These conditions
occur in dysentery, canine distemper, influenza of horses, swine
erysipelas and fowl cholera. Calomel is especially indicated in
these conditions because it is also disinfectant.

4, Liver diseases, especially catarrhal icterus.

5. Hypereemia and inflammation of the lungs, pleura, brain,
spinal cord, skin (urticaria), pododerm (laminitis; arecoline) and
udder (mastitis). In these conditions cathartics are used for their
derivative and antiphlogistic effects.

6. Dropsical conditions; also to assist the resorption of fluid
and solid exudates. ;

7. Acute and chronic nephritis, and uremia. The compensa-
tory increase in the secretions of the intestinal glands relieves the
kidneys in these conditions.

DISEASES OF THE DIGESTIVE ORGANS 45

8. In obesity, gout and increased sexual impulse to withdraw
nourishment and reduce bodily strength.

9. Prophylactically, against parturient apoplexy and azoturia.

10. To prepare cryptorchids for operations; also animals for
intestinal operations (laparotomy).

Cathartics are contraindicated in severe non-infectious in-
flammation of the stomach or intestines, in very weak, anemic
animals, in advanced pregnancy, in peritonitis (extension of the
inflammation over the whole peritoneum by the increased peri-
stalsis), and in prolapse of the rectum. When a cathartic is abso-
lutely necessary in any of these conditions castor oil or calomel
should be used. On account of the elimination of cathartics
in the milk, neutral salts or other indifferent substances should be
given to milk cows instead of aloes.

The Individual Cathartics—1. Physostigmine salicylas.
Physostigmine sulphas. Eserine. An important cathartic for
the horse in constipation colic. Operates within a half hour.
Also used in combination with pilocarpine. Contraindicated in
excessive distention and paralysis of the intestines, engorgement of
the stomach, tympanites, spasmodic colic, pregnancy and dyspnoea.
Dose for the horse, 0.05-0.1, gr. 34 to jss, subcutaneously.

2. Arecoline hydrobromidum. Arecoline combines the action
of physostigmine (eserine) and pilocarpine, is cheaper, more stable
and is effective in smaller dose. Especially valuable in laminitis,
colic and inflammation of the brain. Dose for the horse, 0.05-0.08,
gr. 3¢ to j.

3. Aloe. Aloes. A cathartic for horses and cattle in impaction
colic, chronic intestinal catarrhs, inflammation of the brain and lami-
nitis; also a cholagogue. It has the disadvantage of operating
slowly: 18 to 36 hours after administration. Dose for the horse,
25-50, 3vj to xij; for cattle, 40-60, 3x to 5ij. [Dose of aloin for
the horse, 8-12, 3ij to iij; produces less dulness, nausea and grip-
ing than aloes and is more prompt in action.]

4. The neutral salts: Sodii sulphas, magnesii sulphas, and *sal
Carolinum factitium (artificial Carlsbad salts). Mild and slow
acting cathartics; used alone or to assist other cathartics, as aloes,

46 GENERAL THERAPEUTICS FOR VETERINARIANS

arecoline and eserine, in constipation and colic, and to produce a
derivative action. They are at the same time diuretics and chola-
gogues. For cattle, they are in general somewhat too weak, and in
horses their action occurs only after 1 or 2 days. They are too bulky
for dogs. ‘The dose of sodium sulphate, magnesium sulphate
and Carlsbad salts for horses is 250-500, Ib. ss to j; for cattle,
500-1000, Ib. j to ij; sheep and goats, 25-50, 3 vj to xij ; swine, 25-50,
3vj to xij; dogs, 10-25, Zijss to vj; cats and fowl, 2-5, 3ss to j.

5. Hydrargyri chloridum mite. Calomel. The most impor-
tant cathartic for dogs and swine; best intestinal disinfectant; may
also be given in inflammatory and ulcerous conditions of the intes-
tines; should not be administered to cattle and should be used on
horses with caution. Dose as a laxative, for swine, 1-4, grs. xv to
3]; dogs, 0.2-0.4, grs. iij to vj; cats, 0.1, grs. jss; fowl, 0.05-0.2, grs.
34 to iij.

6. Antimonii et potassii tartras. Tartar emetic. A good Jaxa-
tive for horses and cattle, especially in colic and-parturient apoplexy
and to produce a derivative action upon the intestines; should not
be given to weak animals. Dose for horses, 2-10, 3ss to ijss; cattle,
10-20, Jijss to v; sheep 0.5-2, grs. vij to xxx; calves, 0.3-0.5, grs. iv
to vij.

7. Oleum ricini. Castor oil. A mild cathartic for all the
domestic animals, but especially for dogs; may also be given in
inflammation of the intestines; contraindicated in phosphorus
and cantharides poisoning. Dose for dogs, 15-60, 3 ss to ij; horses,
250-750, Oss to jss; cattle, 500-1000, Oj to ij; foals, calves, sheep
and goats, 50-250, 3 jss to viij; swine, 50-100, 3jss to iij; cats and
fowl, 10-30, Zijss to 31.

[8. Oleum lini. Linseed oil. In the United States linseed oil
is more commonly used as a cathartic for horses and cattle than
castor oil. Dose same as castor oil.] :

9. Oleum tiglii, Croton oil. The most powerful drastic
cathartic for the horse; other drugs are more desirable; contrain-
dicated in all cases of intestinal inflammation and for weak and
sensitive animals. Dose for horses, 0.6-1.5, mx to xx; cattle, 1-2,
myxv to xxx; dogs, 0.07-0.12, mj to ij.

DISEASES OF THE DIGESTIVE ORGANS 47

10. Rheum. Rhubarb. A very mild cathartic for dogs and
cats, the catharsis being followed by constipation. Also a stom-
achic and cholagogue. Dose for dogs, 5-15, 3j to iij; cats and
fowl, 2-5, 3ss to 3j. [Of Tinctura rhei, the cathartic dose for the
dog is 1 to 2}4 tablespoonfuls; cats, 14 to 1 teaspoonful.]

11. Senna. A cathartic for the small domestic animals, espe-
cially swine. Dose for swine, 10-25, Jijss to vj; dogs, 5-15, 3j to
ij; cats, 2-5, 3ss to j; fowl, 1-2, grs. xv to xxx.

12. Cambogia. Gamboge. A drastic cathartic for swine and
dogs. Dose for swine, 2-4, 3ss to j; dogs, 0.2-1, grs. iij to xv.

13. Jalapa. Jalap. A drastic cathartic, cholagogue and
hydragogue for the small domestic animals. Dose for swine, 5-15,
3] to iij; dogs, 0.5 to 4, grs. vij to 3}.

14. Podophyllum. A powerful drastic cathartic and chola-
gogue. The dose should be gauged cautiously. Dose for dogs,
0.1-0.25, grs. jss to iijss.

15. Colocynthis. Colocynth. Action same as podophyllum.
Dose for swine, 8, 3ij; dogs and cats, 0.2-2, grs. iij to xxx.

16. *Syrupus rhamni cathartice (N.F.). Action the same as
podophyllum and colocynth. Dose for dogs, 1 to 2 tablespoonfuls.

17. Tabacum. Tobacco. Used formerly in colic in horses in
the form of smoke clysters.

18. *Barii chloridum. Quickest acting cathartic when injected
intravenously. Dose for the horse, 0.5-1.25, grs. vij to xviij, the
latter for large horses. A heroic and very toxic colic remedy;
must be used with caution in heart weakness (given in fractional
doses, 0.25-0.5, grs. iij to vij, at 15-minute intervals).

19. Sulphur sublimatum, S. preecipitatum, S. lotum. Sulphur.
Rarely used now asa cathartic. Dose for swine, 10-25, 3ijss to vj.

20. Manna. A mild cathartic. Dose for dogs, 10-50, 3ijss to
xij.

21. Glycerinum. Glycerin. Used in the form of clysters.
An uncertain cathartic.

Patients, especially horses and cattle, should be prepared for the
action of a cathartic; feed should be withdrawn and plenty of
drinking water given. If there is no action within the usual time

48 GENERAL THERAPEUTICS FOR VETERINARIANS

the animal should be given exercise at a walk. Usually, the dose
should not be repeated. During catharsis the animal should be
protected from cold and overexertion. These statements apply
especially to aloes and croton oil. Generally, only one cathartic is
given, as eserine, arecoline, calomel, aloes or castor oil. Sometimes
several are given, one after another, when the first one fails to
operate. In the Berlin medical clinic, for example, in cases of sim-
ple constipation-colic of the horse, arecoline is first administered.
If, after an hour, no action occurs, then eserine is injected. If
the eserine also fails to operate in an hour (intestinal obstruction),
then an aloes pill is given. Two aloes pills, one shortly after the
other, are dangerous and should not be given. In some cases sev-
eral drugs are combined; for example, aloes with sodium sulphate,
or croton oil with castor oil. Tartar emetic and aloes should not
be administered at the same time (poisoning),

3. CONSTIPATING REMEDIES. STYPTICS

Synonyms: Enterostyptics, antidiarrhcecs, obstruents, antidysenterics,
anticathartics, anexosmotics, astringents, protectives.

Actions and Uses.—The constipating drugs, which in their
action are directly opposed to the cathartics, operate to check
diarrhoea in several ways: by reducing increased sensibility of the
intestinal mucous membrane; by depressing the increased peri-
stalsis; by contracting the hyperemic and swollen mucous mem-
brane, and finally by inhibiting abnormal fermentation which
may be the cause of intestinal irritation. These drugs are accord-
ingly divided into the following groups:

(a) Demutcent Sryprics (PRorectives).—Linseed, althxa,
acacia, compound acacia powder (N.F.), tragacanth, *salep,
*mallow, emulsions, mucilaginous food materials (mucilage of oats
and rye, rice water). The vegetable mucilage contained in these
substances covers the inflamed and abnormally sensitive intestinal
mucous membrane, preventing the intestinal contents from coming
into direct contact with it and protecting it from irritation. The
drugs in this group of styptics are only mildly constipating and are

DISEASES OF THE DIGESTIVE ORGANS 49

indicated only in slight diarrhoea or in the beginning of the condi-
tion. They are frequently combined with styptics of the other
groups.

(b) Narcotic Sryprics.—Opium, morphine, and codeine.
These anzsthetize the intestinal mucous membrane and thereby
prevent the reflex stimulation of peristalsis. They also stimulate
the splanchnic nerve, the inhibitorynerveof theintestines. Opium
is the most valuable antidiarrhceic and should be prescribed as
early as possible and in sufficient quantity in every severe case of
diarrhoea, dysentery, and enteritis. It is frequently administered
with mucilaginous drugs.

(c) AstrincENT Sryprics.—Tannin or tannic acid, *tanno-
form, *tannalbin, *tannigen, *tannopin (the last three very expen-
sive); the tannin-containing vegetable astringents: oak bark,
cinchona bark, rhubarb, nutgall, *catechu,? rhatany, *tormen-
tilla root, salvia leaves, uva ursi, *folia juglans, red wine, *coffee
and *roasted acorns; the metallic astringents: alum, iron sulphate,
lead acetate, argentic nitrate, zinc oxide, argilla, and lime water.
These drugs operate by constricting the blood vessels of the hyper-
zemic and inflamed intestinal mucous membrane, by contracting
the latter and expressing the fluids, and by the formation of a scab
of tannin or metallic albuminate. The metallic astringents are
the most constipating, while the vegetable astringents are fre-
quently ineffective in severe diarrhoea, especially in horses and
cattle, even in very large doses.

(d) Antiseptic Sryptics.—Calomel, *creolin, tar, creosote,
bismuth subnitrate and salicylic acid. These operate by sup-
pressing or destroying the bacteria of fermentation and infectious
materials in the intestinal canal which cause diarrhoea by their
decomposition products. Dysentery and other infectious diar-
rhoeas especially are effectively treated with creolin, calomel or
salicylic acid. Even anthrax in cattle has been cured many times
by creolin.

Drugs.—1. Opium. An excellent styptic for all domestic

2 [Replaced by gambir in U. S. Pharmacopezia, 1900.]
4

50 GENERAL THERAPEUTICS FOR VETERINARIANS

animals in dysentery, intestinal catarrh and enteritis. Dose for
horses, 5-20, 3j to v; cattle, 10-25, Zijss to vj; sheep, goats, foals,
calves, and swine, 1-3, grs. xv to xlv; dogs, 0.1-0.5, grs. jss to vij;
cats, 0.05-0.2, gr. 34 to iij; chickens, 0.1, grs. jss; pigeons, 0.05, gr.
34. Dose of Tinctura opii ten times these quantities. *Pantopon
is an artificial mixture of the alkaloids of opium.

2. Acidum tannicum. Tannic acid or tannin. A styptic for
the lighter diarrhceas of mycotic, toxic, and infectious origin.
Dose for horses, 5-15, 3j to 3jv; cattle, 10-25, Zijss to vj; sheep
and goats, 1-2, grs. xv to xxx; dogs, 0.1-0.5, grs. jss to vij; fowl,
0.01-0.05, gr. 1/8 to 34. Dose of the tannin-containing vegetable
drugs, Quercus (oak bark), etc., for horses and cattle, 25-50,
3vj to xij. The action of *tannalbin, *tannopin, *tannoform, and
the other newer preparations is similar to that of tannic acid. The
dose of tannoform for horses and cattle is 10-25, 3 ijss to vj; calves
and foals, 5-10, 3] to ijss; dogs, 1-2, grs. xv to xxx.

3. Rheum. Rhubarb. A valuable antidiarrhceic in dysentery
of sucklings, especially white scours of calves and foals. Dose for
horses and cattle, 25-50, 3vj to xij; calves and foals, 5-10, 3] to
ijss; dogs, 1-2, grs. xv. to xxx; lambs, fowl and cats, 0.5-1, grs.
vijtoxyv. Of tinctura rhei, the dose for dogs is 14 to 1 teaspoonful.

4. Alumen. Alum. A mild styptic in diarrhcea and intes-
tinal hemorrhage. Dose for horses and cattle, 10-25, Jijss to vj;
dogs, 0.5-2, grs. vij to xxx.

5. Ferri sulphas. Iron sulphate. A more powerful styptic,
especially for infectious diarrhceas, dysentery, fowl cholera, and
gastric and intestinal hemorrhages. Dose for horses, 10-25,
3ijss to vj; dogs, 0.1-0.5, grs. jss to vij; fowl, 0.05-0.2, grs. 34 to iij.

6. Liquor calcis. Lime water. A good styptic in diarrhcea of
sucklings, dysentery and intestinal ulcers. Dose for calves, 14 to
1 pint; dogs, 1 to 2 tablespoonfuls. Calcii carbonas pracipitatus
(precipitated calcium carbonate) has a similar action. [Dose for
horses and cattle, 30-60, 3j to ij; dogs, 0.6-4, grs. x to 3j.]

7. Plumbi acetas. Lead acetate. A very powerful styptic in
persistent diarrhoea; must be administered to cattle cautiously.
Dose for horses, 2-10, 3ss to ijss; cattle, 1-5, grs. xv. to 3j; sheep,

DISEASES OF THE DIGESTIVE ORGANS 51,

goats, and swine, 0.3-1, grs. jv to xv; dogs, 0.05-0.3, grs. 34 to iv;
cats and fowl, 0.01-0.05, grs. 1/8 to 34.

_ 8. Argenti nitras. Silver nitrate. The most powerful
styptic. Specific for intestinal ulcers. Dose for horses and cattle,
0.5-2, grs. vij to xxx; sheep, goats and swine, 0.05~-0.1, grs.
34 to jss; dogs, 0.01-0.05, grs. 1/8 to 34; fowl and cats, 0.01-0.02,
grs. 1/8 to 14.

9. *Creolin. A specific against all diarrhceas of mycotic and
infectious origin, calf cholera and diarrhoea of pigs. Dose for
horses and cattle, 10-25, Zijss to vj; calves, sheep, goats, and
swine, 0.5-1, mvij to xv; dogs, 0.5-1, mvij to xv; fowl, 0.1-0.25,
mjss to jv. Naphthalenum and resorcinol (resorcin) may be
used in the same doses.

10. Hydrargyri chloridum mite. Calomel. A styptic in the
dysenteric type of diarrhcea in the dog. Dose, 0.03-0.1, grs.
1/3 to jss. Not to be administered to cattle, sheep or goats.

11. Bismuthi subnitras. Bismuth subnitrate. A disinfectant
styptic for all of the domestic animals. Dose for horses, 5-15,
3j to jv; dogs, 0.25-1, grs. jv to xv.

12. Acidum salicylicum. Salicylic acid. An important dis-
infectant styptic in calf cholera. Dose, 1-5, grs. xv to 3] in alco-
holic solution. ;

4. MECHANICAL AND OPERATIVE TREATMENT

The depressed peristalsis of constipation and colic may be
stimulated reflexly by mechanical means. Massage of the ab-
domen, which is especially valuable in coprostasis in dogs; the
application of irritants to the skin; exercise; the manual emptying
of the rectum; infusions of water and rectal clysters (soap, oil,
glycerin, suppositories), and massage of the intestines per rectum
in colic in horses all operate in this manner.

Operative measuresinclude puncture of the intestines with trocar
and cannula (flatulent colic), enterotomy (foreign bodies in dogs),
laparotomy (invagination and incarceration of intestinal loops
in cattle), and the reposition of the displaced colon in horses by
rolling as in torsion of the uterus. The operative treatment of

52 GENERAL THERAPEUTICS FOR VETERINARIANS

herniz, invaginations and prolapse of the intestines is a chapter
in itself.

The physical treatment of colic in horses is especially important.
Rectal examination and treatment has always received great con-
sideration in the clinics and from judicious practitioners. (See the
text-books on special pathology and therapeutics.)

Carminatives. Gas-expelling Drugs.—The name carminative is used to
designate a group of drugs which remove flatulence from the intestines. Ab-
normal fermentation of the intestinal contents produces collections of gases
(carburetted hydrogen, hydrogen, hydrogen sulphide, carbonic acid) which
cause flatulence and tympanites, with painful distention and tetanic contrac-
tion of the intestinal wall (flatulent colic). In horses the gaseous collection
occurs especially in the large intestines; in cattle, in the rumen; in the small
domestic animals, in the small and large intestines. Three varieties of carmin-
atives are recognized, as follows:

(a) Antispasmodics: This group includes the ethereal oils—caraway,
fennel, anise, chamomile, peppermint, melissa, valerian, angelica, garlic, and
asafetida; also chloral hydrate, ether and spirit of ether. The aromatics
(caraway, chamomile, peppermint, etc.) possess antispasmodic and antifermen-
tative properties and are the most used carminatives. Dose for the horse,
10-25, 3ijss to vj; cattle, 25-50, 3vj to xij; dogs, 0.5-1, grs. vij to xxx. Dose
of the ethereal oils: horses, 1-5, nyxv to 3j; dogs, drop doses. Ether is a
good carminative for horses and dogs. Dose for horses, 25-50, 3vj to xij;
dogs, 2-5, 38s to j (internally).

(b) Gas absorbents: Compound rhubarb powder, magnesium oxide,
lime water, ammonia water. Pulvis rhei compositus is an important carmina-
tive (absorbent) for sucklings.

(c) Anti-ferments: *Creolin, calomel and naphthalin. Creolin is given
to horses and cattle in doses of 10-25, 3ijss to vj; calves, sheep and goats,
0.5-1, mvij to xv.

IV. GENERAL THERAPEUTICS OF THE DISEASES OF THE LIVER

Pathology.—The therapeutic importance of diseases of the liver
in animals is relatively slight compared to man. Of most fre-
quent occurrence and of greatest practical importance are the
parasitic diseases, especially distomatosis (liver rot) and echino-
coccus cysts, but these cannot be treated directly, and can. at best
only be influenced by prophylactic measures. This is also true of

DISEASES OF THE DIGESTIVE ORGANS 53

cirrhosis of the liver and acute yellow atrophy (lupinosis). Gall-
stones, abscesses, ruptures, and carcinoma are rare and as a rule are
incurable. There remains for practical therapeutics only icterus,
which is frequently presented for treatment, especially in dogs.

Physiology.—The physiological functions of the liver are not
entirely understood. In addition to the secretion of bile (digestion
of fat) and the production of glycogen (regulation of carbohydrate
metabolism), the liver appears to be active in the removal of poi-
sons from the body. This function is exercised chiefly in the
excretion of toxic substances formed in the body (auto-intoxication),
but poisons and drugs are also eliminated. In addition, antitoxic
substances appear to be formed in the liver to protect and immu-
nize the body against infectious diseases; an example of this is the
immunizing action of the bile in rinderpest. Finally, important
transformations and metabolic processes take place in the liver
(disintegration of red blood-cells, formation of urea and uric acid,
decomposition of alkaloids). On the other hand, recent investiga-
tions cast doubt upon the antiseptic properties formerly attributed
to bile by which it was assumed to prevent putrefaction in the
intestines (only the free bile acids exert a disinfectant action upon
the intestinal contents).

Therapeutic Methods.—In icterus and in circulatory disturb-
ances of the liver (acute and passive hyperemia, hepatitis), the
liver can be affected either by stimulation of the secreting liver
cells, or by removal of mechanical obstructions to the outflow of
bile, or by regulating the circulation of blood in the organ. Cathar-
tics and intestinal disinfectants act as prophylactics by protecting
the liver from harmful material in the intestines. The liver also in
some diseases possesses a pronounced capacity for self-protection
and for compensatory processes (compensatory hypertrophy in
distomatosis). ,

The methods of treatment most frequently used are the
medical (cholagogues), dietetic and mechanical. The operative
methods used in human medicine for gall-stones, abscesses,
wounds, and echinococci are of no practical importance in
veterinary medicine.

54 GEENRAL THERAPEUTICS FOR VETERINARIANS

1. CHOLAGOGUES. STIMULANTS TO BILE SECRETION
Synonyms: Hepatics, hepatic stimulants, liver remedies.

Actions and Uses.—Cholagogues increase the secretion of bile
by direct action upon the gland cells of the liver and in part by
reflex stimulation from the stomach and intestines. They are
used in all diseases of the liver in which the secretion of bile is
decreased, as in icterus. According to the investigations of
Rutherford (British Medical Journal, 1877), which have been
recently amplified and confirmed by Ellenberger, Baum, Doyon,
Dufour, Wissogradow and others, twe classes of cholagogues must
be recognized: (a) those which produce a laxative effect simul-
taneously with their action upon the liver and (b) those which
operate exclusively upon the liver.

(a) The cholagogue laxatives are rhubarb, aloes, podophyllum,
jalap, colocynth, gamboge, colchicum, arecoline, pilocarpine,
eserine, euonymus, leptandra, baptisin, sodium sulphate, potas-
‘sium sulphate, sodium phosphate, Carlsbad salts and potassium
bitartras.

(b) The simple cholagogues are sodium bicarbonate, sodium
salicylate, aspirin (acetyl-acidum salicylicum) and other salicy-
lates, benzoate of soda, ipecac and nitric acid.

Calomel, epsom salts, castor oil and croton oil, which were
formerly valued as cholagogues, are on the contrary depressants
of bile secretion in consequence of their strong stimulant effect
upon the intestinal glands. They are therefore designated as anti-
cholagogues. Lead acetate also decreases the secretion of bile.

Drugs.—1. Rheum, aloe, sodii sulphas, sal Carolinum facti-
tium N.F. (artificial Carlsbad salts), etc. For doses, see under
CatTuHaRrtics, pages 44, 45.

2. Ipecacuanha. Ipecac. Dose for swine and dogs, 1-3, grs.
xv to xlv.

3. Sodii salicylas. A very good cholagogue. Dose for horses
and cattle, 25-75, 3vj to Zijss; swine, 2-5, 3ss to j; dogs, 0.25-2,
grs. jv to xxx. *Aspirin is given in the same doses.

4, Acidum nitricum. Given to dogs in drop doses, diluted.

DISEASES OF THE DIGESTIVE ORGANS 55

Concerning the cholagogue action of the emetics, see page 34.
Bile secretion is also increased by large quantities of water and by a
meat diet. The bile acids also have a cholagogue action, which
explains the former use of bile (fel bovis). According to recent
investigations, Carlsbad water only renders the bile more fluid and
does not increase the secretion of bile proper.

2. DIETETIC AND MECHANICAL METHODS

In dogs affected with icterus, as in man, the secretion of bile
may be increased by a diet of meat and milk and by the adminis-
tration of large quantities of water. The latter facilitates the
reabsorption from the intestines into the blood of the bile salts,
which have a cholagogue action (Schiff).

The circulation of blood in the liver is mechanically stimulated,
directly or indirectly, by exercise, massage of the liver (applied in
dogs under the right ribs), cutaneous irritation, cold infusions into
the intestines, emetics and cathartics.

GENERAL THERAPEUTICS OF THE DISEASES OF THE
ORGANS OF CIRCULATION

I. GENERAL THERAPEUTICS OF THE DISEASES OF THE HEART

Pathology.—Therapeutically, the most important heart dis-
eases of the domestic animals are chronic endocarditis (valvular
insufficiency) and cardiac dilatation (heart weakness) of horses,
cattle and dogs. On the other hand, the most frequent heart dis-
ease of cattle, traumatic pericarditis, due to the passage of metallic
foreign bodies from the reticulum through the diaphragm to the
pericardium and heart, is practically not affected by therapeutic
measures. Chronic endocarditis leads to valvular insufficiency,
with secondary compensatory hypertrophy, and later to cardiac
dilatation. In the horse and dog there is usually an insufficiency of
the mitral valve; in cattle, more frequently an insufficiency or
stenosis of the tricuspid. Acute cardiac dilatation and cardiac
degeneration occurs frequently in all the domestic animals, but
especially in the horse and dog. It is manifested by cardiac weak-
ness and is usually associated with infectious diseases: contagious
pneumonia, foot-and-mouth disease, septicemia; sometimes with
overexertion (horses). Fatty degeneration of the heart is fre-
quently observed in dogs and swine.

Physiology.—The action of the heart consists of a rhythmical
contraction and relaxation of the cardiac muscle (systole, diastole,
pause). During systole the blood is under positive pressure; dur-
ing diastole it is under a negative pressure, corresponding to the
sucking of a pump. The pause, or period of rest, is especially
important because it affords opportunity for the recuperation of
the heart. The valves serve to regulate the flow of blood. The
cardiac muscle is innervated by the vagus, the inhibitory nerve, and
by the sympathetic, which is the accelerator nerve; in addition,
there are also automatic intracardial centres. The heart muscle
and the nerves as well can be therapeutically stimulated by me-
chanical, chemical, thermic and electrical stimuli. On the other

56

1

DISEASES OF THE ORGANS OF CIRCULATION 57

hand, paralysis of the heart can result from numerous causes, such
as cardiac poisons, disease and overexertion of the myocardium,
deficiency of oxygen, insufficient nourishment, and the collection
of carbon dioxide and other products of decomposition. The
cardiac muscle possesses in a high degree the capacity to accom-
modate itself to changed relations resulting from disease. An
example is the compensatory hypertrophy of valvular insufficiency.
The recognition of this compensation as a natural healing process
and not something to be combated by therapeutic measures is of
primary importance in the rational treatment of heart diseases.

Therapeutic Methods.—Disturbances of the pumping mech-
anism of the heart may result from disease of the muscular appa-
ratus, the nervous system, the valvular mechanism or the nutritive
blood-vessels. The treatment required will depend upon the con-
dition present. Drugs affecting the muscles or the nerves, me-
chanical methods or vasodilators may be indicated. The compli-
cated mechanical, thermic and electrical methods of human medicine
(change of climate, baths, hydrotherapy, electrotherapy, inhalation
of compressed air) are not applicable in veterinary medicine. In
the latter, treatment of cardiac diseases is limited mainly to the use
of medicines. The rest treatment can be applied to animals as to
man; in cardiac weakness the heart can be protected by reducing
or abolishing work and exercise. In certain conditions, as obesity
in dogs, systematic exercise and dietetic treatment may be insti-
tuted. Regarding the latter, decreasing or regulating the drinking
water, thereby reducing the amount of fluid in the blood and
decreasing the work of the heart, is of practical importance (Oertel’s
method). In dogs, as in man, food that is too bulky can be
avoided (milk diet). The operative treatment of cardiac diseases,
as puncture of the pericardium in pericarditis, is hardly worth con-
sidering.

CARDIACS. HEART REMEDIES

Synonyms: Polysphygmics, bradysphygmics, heart stimulants, heart
tonics, heart sedatives.

Classification.—The cardiacs are classified according to their
action. There are three groups: stimulants, tonics and sedatives.

58 GENERAL THERAPEUTICS FOR VETERINARIANS

1. The cardiac stimulants are camphor, hyoscine (scopolamine),
atropine, caffeine, veratrine, alcohol, ether, ammonia, ammonium
carbonate and some of the ethereal oils (valerian, arnica). These
act in part by paralyzing the vagus, the nerve of inhibition, cen-
trically or peripherally; in part by stimulating the sympathetic
nerve and the vasomotor centre, and in part by stimulation of the
heart muscle.

2. The cardiac tonics are digitalis, strophanthus, squill, spar-
teine, adonidin and convallamarin. These stimulate the vagus
centrically and peripherally, and also the heart muscle.

3. The cardiac sedatives are potassium bromide, chloral hy-
drate and potassium iodide. These act in part by depressing the
cardiac centre in the medulla oblongata and in part by depressing

‘the cardiac muscle.

Uses.—1. The cardiac stimulants are prescribed in all cases of
acute heart weakness such as may occur in the course of acute
heart diseases, febrile infectious diseases and poisoning; also in
syncope. The most important symptoms of heart weakness are a

‘weak or imperceptible, very frequent or slow pulse; in the begin-
ning a throbbing heart beat, which is later weak or imperceptible; '
indistinct heart sounds, dyspnoea, cyanosis of the mucous mem-
branes, collapse.

2. The cardiac tonics are specific for chronic heart diseases,
particularly valvular defects in the stage of insufficiency. They
increase the force of contraction of the heart muscle, slow and
regulate the rate of contraction, increase the length of the pause
between beats, and increase the blood-pressure. They are indi-
cated when the pulse is abnormally rapid, irregular and weak, and
the heart is beating tumultuously. On the other hand, they are
contraindicated in valvular insufficiency when compensatory
hypertrophy has occurred, in cardiac hypertrophy, in palpitation
and in all cases in which the pulse is strong or the heart beat abnor-
mally slow (bradycardia).

3. The cardiac sedatives are prescribed in cardiac excitement
of nervous origin, particularly palpitation.

Drugs.—1. Digitalis. The most important cardiac for val-

DISEASES OF THE ORGANS OF CIRCULATION 59

vular insufficiency without compensation. Dose of the leaves for
horses and cattle, 2-5, 5ss to j; dogs, 0.05-0.2, grs. 34 to iij. Dose
of the leaves as an antipyretic for horses, 5-10, 3j to ijss.

2. Camphora. A powerful stimulant for all kinds of heart weak-
ness. Used subcutaneously in the form of spiritus camphorz or dis-
solved in olive oil (1:9 or 1:4). The stronger camphorated oil (1:4)
is indicated in contagious pneumonia of horses especially; it is
injected subcutaneously in single doses of 50-150, 3jss to v; daily
doses of 100-250, 3 iij to viij. The doses heretofore were too small.

3. Caffeina. Caffeine. One of the best cardiacs in acute
heart weakness; acts very quickly when given subcutaneously;
specific antidote against heart poisons. Dose of *caffeinz sodio-
salicylas (N.F.) for horses and cattle, 5-10, 3j to ijss; large dogs,
0.5-2, grs. vij to xxx; small dogs, 0.1 to 0.5, grs. jss to vij. Also
administered in the form of coffee.

4, Tinctura strophanthi. A substitute for digitalis. Dose for
horses, 4-15, 3] to jv; dogs, 2 to 16 drops. Strophanthin, the
active principle, produces necrosis when injected subcutaneously.

5. Atropinze sulphas and hyoscinze hydrobromidum (scopo-'

‘lamine). Very strong stimulants in heart weakness in the course
of heart diseases, infectious diseases and poisoning. Act very
quickly when injected subcutaneously. Dose of atropine sulphate
for horses and cattle, 0.05-0.1, grs. 34 to jss; dogs, 0.01-0.05, gr.
1/8 to 34. Dose of hyoscine (scopolamine) hydrobromide one-
tenth that of atropine sulphate.

6. Veratrina. Veratrin. A powerful stimulant in the heart
weakness of fever. Dose for horses and cattle, 0.05-0.2, grs. 34 to
iij, subcutaneously in solution in alcohol; dogs, 0.001-0.005, gr.
1/70 to 3/40.

7. Alcohol. An excellent stimulant in all weak conditions of
the heart. Dose for horses and cattle, 25-50, 3 vj to xij; sheep and
goats, 10-20, Zijss to jv; dogs, 2-5, 3ss to j. Dose of spiritus vini
gallici (brandy) for horses and cattle, 50-150, 3jss to 3v; dogs,
tablespoonful.

8. Ether. The same. Dose for horses and cattle, subcu-
taneously, 10-25, 3 vj to xij; dogs, 0.5-2, mvij to xxx.

60 GENERAL THERAPEUTICS FOR VETERINARIANS

9. Ammonii carbonas. Ammonium carbonate. A good and
cheap stimulant in heart weakness. Dose for cattle, 20-50, 3jv to
xij; horses, 10-25, Zijss to vj; sheep, goats and swine, 1-2, grs.
xv to xxx.

10. Valeriana. Valerian. An old but good stimulant; used
in the form of tinctura valerianze. Dose for horses and cattle,
20-50, 3jv to xij; sheep and goats, 2-5, 3ss to 3j; dogs, 0.2-2,
myiij to xxx; cats and fowl, 0.1-0.5, mjss to vij.

11.. Potassii iodidum. Potassium iodide quiets the heart and
reduces blood-pressure in hypertrophy and palpitation. Dose for
horses and cattle, 5-15, 3j to jv; dogs, 0.25-1, grs. iij to xv; cats,
0.1-0.2, gr. jss to tij.

12. Potassii bromidum and chloralum hydratum. Sedatives in
palpitation of the heart. Dose for horses and cattle, 20-50, 3 jv to
xij; dogs, 1-2, grs. xv to xxx.

II. GENERAL THERAPEUTICS OF THE DISEASES OF THE BLOop

Pathology.—The diseases of the blood consist in a defect in
the formation of the blood. The total quantity may be decreased
(anemia, pernicious anemia) or, as more rarely happens, in-
creased (plethora); the number of white blood-cells may be greatly
increased (leukemia), the number of red cells may be considerably
decreased (oligocythemia), or the water content of the blood may be
increased (hydremia). Perniciousanzemia isaspecially severeform
of anzemia with characteristicmorphological changes in the red blood-
cells (poikilocytosis, macrocytosis, microcytosis). In addition to
these primary diseases of the blood, anemia and hydremia very fre-
quently occur secondarily in chronic disturbances of nutrition and in
infectious diseases (chronic gastro-intestinal catarrb, tuberculosis,
carcinoma cachexia, distomatosis) and after loss of blood. An ab-
normal thickening of the blood in consequence of the elimination of
water occurs in heat stroke and in profuse diarrhoea. Finally, the
blood shows severe parenchymatous and chemical changes in fever
(see the chapter on fever) and after the operation of poisons such
as potassium chlorate, paraldehyde, snake venom, carbon monox-
ide, saponin, ricin and other ferments; also in infectious diseases.

DISEASES OF THE ORGANS OF CIRCULATION 61

Physiology.—The blood transports the oxygen and the fluid
and solid nutrients (albumin, fats, carbohydrates, salts, and water)
to the tissues and organs and carries away the decomposition
products of metabolism, especially the carbon dioxide (lungs) and
the fluid and solid excretions (kidneys, liver, intestinal glands,
cutaneous glands). The most important morphological elements
of the blood are the red and white corpuscles (the blood-platelets
are regarded by some as products of the decomposition of the
white blood-cells, by others as hemoglobin-free bodies from the
interior of the red blood-cells). The red blood-cells (erythrocytes
without nuclei) are derived from the red bone marrow. They are,
on account of the hemoglobin they contain, the carriers of oxygen
and form about one-third of the volume of the blood. A cubic
millimetre of horse’s blood contains seven to eight’ million red
blood-cells. The white blood-cells (leucocytes) originate in part
from the red marrow of bone (granular leucocytes) and in part
from the lymph glands and spleen (lymphocytes without granula-
tion). They are much less numerous than the red blood-cells,
there being only one white .corpuscle to 350 red; one cubic milli-
metre of horse’s blood contains 9,000 leucocytes. Their functions
are manifold: fat resorption in the intestines, emigration, phago-
cytosis, immunization in inflammatory and infectious diseases and
histogenetic activity in healing of wounds and in cicatrization.

The reaction of the blood is alkaline (KHCO;), corresponding
to a 0.2 to 0.4 per cent. soda solution. The most important chemi-
cal constituents are the proteids: hemoglobin, serum albumin,
serum globulin, nucleo-albumin, albumoses, peptone, lecithin and
protagon; the fats: stearin, palmatin and olein; the carbohydrates:
grape sugar and glycogen; the pigments: hemoglobin and bili-
rubin; and the salts: sodium, potassium, calcium, magnesia, iron
and ammonium combined with chlorine, carbonic acid, phosphoric
acid and sulphuric acid. The potassium salts are contained in the
blood-cells, the sodium salts in the blood-serum. In herbivora the
carbonates, in carnivora the phosphates, predominate.

The quantity of the blood is equal to about one-thirteenth of
the body weight; the relative amount is greatest in the horse (one-

62 GENERAL THERAPEUTICS FOR VETERINARIANS

tenth) and least in swine (one-twentieth). The distribution of the
blood is of importance in therapeutics. While the body is at rest
~ one-fourth of the blood is contained in each of the following sec-
tions: the heart and large blood-vessels; the liver; the muscles; the
other organs; but during work the muscles contain up to two-—
thirds of the total quantity.

Therapeutic Methods.—The quantity, composition and dis-
tribution of the blood in disease can be affected in very different
ways. The dietetic method supplies to the diseased blood Blood-
forming substances (blood plastics) of all kinds (proteids, iron,
salts). The chemical method combats infectious agents contained
in. the blood by the introduction of arsenical preparations into the
blood stream (chemotherapy); serum therapy acts in the same
manner. The mechanical method seeks to influence blood forma-
tion indirectly by systematic stimulation of the muscles (muscle
therapy, training, massage). The operative method consists in
the introduction of fresh, healthy blood (transfusion) and the
removal of diseased blood (phlebotomy).

Transfusion, i.e., the direct or indirect transfer of blood from a
healthy individual to the blood stream of a diseased individual,
appears theoretically to be very rational. In practice, however,
it has not proven satisfactory. The transfusion of non-defibrin-
ated blood is dangerous to life (fibrin emboli), and the transfusion
of defibrinated blood has at times been attended with serious
disturbances (rigors, albuminuria, anaphylaxis). The effects of
the transfusion of animal blood (lamb’s blood) into man consist of
hyperemia and serous infiltration of the internal parts of the body,
high transfusion fever and a change in the composition of the
blood. Experience in human medicine has also taught that the
danger from excessive bleeding is not so much from the decrease of
red blood-cells as from the volume of the blood being insufficient to
fill the heart and vessels, and for this reason the injection of a
simple physiological salt solution, subcutaneously or intravenously,
will save life in such cases.

In regard to the effect of phlebotomy on the blood, practical
experience and scientific investigation are not in accord. Small,

DISEASES OF THE ORGANS OF CIRCULATION 63

daily bleedings are supposed to stimulate blood formation and
increase the red blood-cells in chlorosis of man. Some have
reported unfavorable results from phlebotomy in anemia. The
only undisputed indication for phlebotomy is plethora.

DIETETIC METHOD. BLOOD-FORMING REMEDIES. BLOOD
PLASTICS

Synonyms: Hematics, hematopoietics, hematinics, erythrotics, hyperi-
notics, euplastics.

Actions.—Blood-forming agents may act directly or indirectly.

1. The direct blood plastics are substances which are normal
constituents of the blood: albumin, peptone, iron, potassium salts,
sodium chloride, phosphates, sulphur, meat extract, fat. They
supply directly to the blood the constituents which are absent in
disease.

2. The indirect blood plastics are not normal constituents of the
blood, but improve the condition of the blood by increasing me-
tabolism, assimilation and nutrition. The most important indirect
blood plastic is arsenic. Others are alcohol, phosphorus, and mer-
cury in very small doses, and the alkalies.

In practice, it is important that the blood plastics be adminis-
tered in a form which can be readily absorbed and in small, re-
peated doses. The iron salts and arsenic especially are to be given
with great care as to the dosage.

Drugs.—1. Ferrum. Iron. The principal remedy in anemia,
hydremia and leukemia. The preparations most commonly used
in veterinary medicine are: ferri reductum (reduced iron), ferri
sulphas, *tinctura ferri pomata (N.F.). The numerous newer and
more costly iron preparations, and also the new albumin prepara-
tions, are not necessary in veterinary medicine. Dose of reduced
iron and iron sulphate for horses and cattle, 1-5, grs. xv to 3j;
dogs, 0.02-0.2, ‘grs. 14 to iij; sheep, 0.5-1, grs. vij to xv. Dose of
tincture ferri pomata for dogs, 10 to 20 drops. Concerning the
absorption of iron preparations, see text-books on pharmacology.

2. *Meat extract. This acts as a hematopoietic by supplying
blood salts, potassium salts and phosphates. Dose for dog, 2-10,
3ss to Zijss.

64 GENERAL THERAPEUTICS FOR VETERINARIANS

3. Potassii bicarbonas. Potassium bicarbonate is used as a
blood plastic in anzmia. Dose for horses and cattle, 25-100, 3 vj
to $iij; sheep, 2-5, 3ss to j; dogs, 0.5-2, grs. vij to xxx.

4. Sodii chloridum and sodii phosphas. Sodium chloride and
sodium phosphate are used as blood plastics in chronic disturb-
ances of nutrition. Doses same as potassium bicarbonate.

5. Sulphur sublimatum, sulphur precipitatum, sulphur lotum.
Sulphur is used as a blood plastic in specific blood diseases. Dose
for horses and cattle, 2-5, 3ss to 3j; sheep, 0.5-1, grs. vij to xv;
dogs, 0.05-0.2, grs. 34 to iij.

6. Arseni trioxidum. Arsenic. A valuable blood plastic in all
blood diseases and chronic disturbances of nutrition. Dose for
horses and cattle, 0.1-0.5, grs. jss to vij; sheep, 0.005-0.01, gr.
3/40 to 1/8; dogs, 0.001-0.005, gr. 1/70 to 3/40. The dose of
liquor potassii arsenitis (Fowler’s solution) for horses and cattle is
10-50, Jijss to xij; sheep, 0.2-0.5, miij to vij; dogs, 0.1-0.2, mjss
to iij.

III. Genzrat TuHerapeutics or Diszases oF THE BLoop-
VESSELS

Pathology.—The diseases of the blood-vessels which call for
therapeutic interference are wounds and tears or ruptures (arterial,
venous and capillary hemorrhage), circulatory disturbances
(anzemia, active and passive hyperemia, thrombi, emboli), inflam-
mation (arteritis, phlebitis), dilatations (varices, aneurisms) and
neoplasms (angiomas, endotheliomas). The pathological changes
may involve the vessel walls, the vasomotor nervous system or the
vessel contents, 7.e., the blood (quantity, distribution, property,
coagulation, blood-pressure, circulation).

Physiology.—Of the three layers of the blood-vessel wall the
most important is the middle one, the muscular layer, which is the
motor organ for the constriction of the vessel. This layer is absent
from the capillaries, the walls of which consist of only contractile
endothelial cells. The nerves of the vessels (vasomotors) are
situated centrally as well as peripherally. The principal vessel
centre (vasomotor centre) is located in the medulla oblongata;

DISEASES OF THE ORGANS OF CIRCULATION 65

there are additional centres in the spinal cord. The peripheral
nerves which are connected with these centres possess in part the
function of contracting (vasoconstrictors, pressors) and in part
of dilating (vasodilators, depressors) the blood-vessels. The
peripheral vessels also appear to possess independent vasomotor
ganglion cells.

The vasomotor nervous apparatus can be stimulated or de-
pressed by agents acting centrically or peripherally. The direct
centric stimulants (vasoconstrictors) are digitalis, strychnine,
nicotine and carbon dioxide; insufficient oxygen in the blood has
the same effect. The depressants or vasodilators are alcohol,
ether, chloroform and amyl nitrite. Contraction and dilation of
the vessels are also produced directly or indirectly (reflexly) by
different agents acting peripherally (mechanical, chemical, thermic,
and electrical stimuli applied to the skin or mucous membranes).
Adrenalin is believed by some to cause vasoconstriction by centric
stimulation, others attribute its action to a peripheral stimulant
effect upon the vessels.

Contraction of the vessels increases while dilatation decreases the
blood-pressure. The normal blood-pressure in the carotid artery
is equivalent to 150 millimetres of mercury; in the aorta to 200 to
250 millimetres. The greatest increase in blood-pressure is pro-
duced by increase of the heart action and contraction of the blood-
vessels simultaneously (digitalis, strophanthus). An increase in
blood-pressure also occurs when areas supplied by the larger vessels
are shut off from the circulation and when there is any interference
with the circulation of the blood in the larger arteries (insufficiency
of the aortic valves, thrombosis of the pelvic or femoral arteries).
In the latter conditions the continued high blood-pressure results
in a compensatory hypertrophy of the heart.

The rate of flow of the blood in the carotid artery of the horse
is, on the average, 300 millimetres. It is dependent upon the
activity of the heart, the contraction of the blood-vessels and the
depth of respiration (aspiratory effect of deep inspiration). ‘

The causes of the coagulation of the blood have not been satis-
factorily explained. The fibrin which is in solution in the blood

5

66 GENERAL THERAPEUTICS FOR VETERINARIANS

may be precipitated as a calcium-albumin compound through the
cooperation of three factors: 1. Fibrin ferment (a product of the
decomposition of white blood-cells). 2. The fibrinogens. 3.
The fibrinoplastic substances: fibrinogen and paraglobulin.

Therapeutic Methods.—Wounds and the consequent hemor-
rhage are the conditions which most frequently affect the blood-
vessels, and for this reason the method of arresting hemorrhage
will first be considered. Other therapeutic methods are concerned
with the contraction and dilation of the blood-vessels (see also the
antiphlogistic and resorbent methods).

1. METHODS OF ARRESTING HEMORRHAGE

Spontaneous Arrest of Hemorrhage.—By this is understood
the cessation of bleeding as a result of a natural process, in con-
tradistinction to the artificial arrest of hemorrhage by therapeutic
measures. It is especially observed in capillary and parenchy-
matous hemorrhage, and also occurs when small arteries and veins
are wounded. It is due principally to the coagulation of the blood,
but retraction of the vessel wall and narrowing of the lumen of the
vessel are also important factors. The coagulation of the blood
forms a thrombus, which closes the opening in the vessel and some-
times extends into the interior. As the blood-pressure is very low
in the capillaries and small veins, the formation of thrombi and the
resulting arrest of hemorrhage can occur very quickly. But in
large vessels, especially arteries, thrombi are not formed at all or
only when the heart has become weak and the blood-pressure has
been considerably lowered by severe hemorrhage, so that the
coagulated blood is not washed away by the outpouring blood.
In severe hemorrhage the blood, in an effort to rehabilitate itself,
takes up numerous white blood-corpuscles, which increase its
coagulability and thus assist in the spontaneous arrest of bleeding.
This is the explanation of the fact, established experimentally,that
stallions castrated without any precautions against bleeding do not
die from loss of blood. Generally, however, not more than one-
third of the total quantity of blood can be lost without causing
fatal cardiac and cerebral paralysis. The blood regenerates itself

DISEASES OF THE ORGANS OF CIRCULATION 67

quantitatively rather rapidly by the resorption of the lymph con-
tained in the tissues and the fluids present in the stomach and
intestines. The new-formed blood is at first very rich in water,
while the red blood-corpuscles are few in number. The latter are
replaced slowly.

The exact nature of the processes concerned in the formation of
the thrombus is not entirely understood. In the spontaneous
arrest of hemorrhage a white thrombus is generally present, formed
by the aggregation of white blood-corpuscles and blood-platelets,
and differing essentially from the usual products of coagulation,
which consist of fibrin inside or outside of the body. The subse-
quent history of the white thrombus varies, depending upon
whether infectious materials gain entrance toit ornot. Ifitremains
free from infection, organization takes place; 1.e., a firm connective
tissue develops, which is supplied with nutrient vessels, and which
closes the wounded vessel with a solid and permanent cicatrix.
The cells of the thrombus do not actively participate in the process;
they play only a passive réle, being gradually repressed by the new-
formed tissue. The formation of new connective tissue results
from the growth of the vessel endothelium. The endothelial cells
of the intima proliferate and are transformed into spindle-shaped
and variously formed cells which extend toward the centre of the
thrombus, grow into it and around it, and later are changed into
fibrillar connective-tissue cells, the thrombus being thus finally
compressed and replaced by firm connective tissue. At the same
time, as a result of budding of the vasa vasorum, new vessels are
formed in the thrombus and it becomes vascularized. About four
weeks after the injury, in the smaller vessels, the thrombus is trans-
formed into a mass of cicatricial connective tissue permeated with
capillaries, which subsequently becomes more solid in consequence
of contraction and the atrophy of the newly formed blood-vessels.
More rarely, calcification of the thrombus occurs (so-called vein
stones or phleboliths). The interruption to the circulation result-
ing from the thrombus is overcome by the establishment of a col-
lateral circulation while the arterial branches situated centrally and
peripherally to the thrombus and their vasa vasorum are dilated.

68 GENERAL THERAPEUTICS FOR VETERINARIANS

Sometimes a passage for the blood is later opened through the
centre of the organized thrombus, or the blood-vessels of the cica-
trix become dilated and permit the blood to flow through.

Artificial Arrest of Hemorrhage.—This aims to close the bleed-
ing blood-vessel either by pressure or by aiding coagulation. The
most important methods used for this purpose are:

(a) Ligation or BLEEDING VESSELS.—The ligature is the only
thing which will quickly and surely stop bleeding from the larger
arteries and veins. The bleeding vessel is grasped with clamp
forceps and tied with silk thread. If the vessel cannot be isolated,
then the tissue surrounding it is included in the ligature (ligation
en masse), a needle being used to carry the thread around through
the tissues. When neither of these methods is applicable because
of the deep situation of the bleeding vessel, then the ligature must
be placed at some accessible point situated centripetal to the point
of hemorrhage (ligation by continuity); e.g., in hemorrhage
from one of the arteries in the interior of the head the carotid
is ligated.

(b) CoMPRESSION OF THE VESSELS BY SUTURE OR BANDAGE,
asa, rule, checks parenchymatous and capillary hemorrhage. Some-
times strong pressure upon the bleeding vessels can be obtained
by tamponading a wound. Bleeding may be checked tempo-
rarily by pressure with the fingers or hand (digital compression), or
by applying an elastic tubing (Esmarch bandage) or a rubber
bandage (Martin’s bandage) between the wound and the heart.
Methods of arresting hemorrhage peculiar to veterinary medicine
are the use of clamps and of the emasculator in castration. The
formerly employed tourniquet (a compress fastened with a girdle)
and the so-called acupressure (compression by a needle inserted in
the tissues in a transverse direction, laterally and above or below
the bleeding vessel) are now scarcely used.

(c) Torsion OF THE BLEEDING VESSEL loosens the intima and
media, which roll inward, and also draws the adventitia together,
narrowing or closing the lumen of the vessel. Torsion is carried out
in two ways: the bleeding vessel is grasped with the clamp forceps
and revolved on its axis for some time, or the surrounding soft

DISEASES OF THE ORGANS OF CIRCULATION 69

parts, including the vessel, are twisted (torsion of the spermatic
cord).

(d) Hzar in the form of the hot iron or the thermo-cautery is
an effective hemostatic in many cases of parenchymatous hemor-
rhage. The opening in the bleeding vessel is closed by a scab,
which acts as an aseptic bandage (cautery in amputation of the
tail). Coup (ice, cold water, ether spray) is less reliable; it checks
hemorrhage by contracting and narrowing the small blood-vessels.
Hot water at a temperature of 45 to 50° C. is recommended as a
good hemostatic for parenchymatous bleeding. Even live steam,
100 to 120°C. (?), has been directed into the uterine cavity for
several minutes in persistent hemorrhage from the uterus in woman
(so-called vaporization of the uterus, atmocausis, zestocausis).

- (e) Drucs (hemostatics, styptics, antihemorrhagics, astrin-
gents, agglutinatives, rophetics) are used in external parenchy-
matous and in internal hemorrhages. They are ineffective in
external arterial and venous hemorrhages; in these cases surgical
methods (ligature, compression) are of greater service. The mode
of action of the styptics differs with the different drugs. Some
cause a contraction of blood-vessels, with narrowing of the lumen,
by direct action upon the muscular layer of the blood-vessel wall.
In this way, for example, nitrate of silver reduces the lumen one-
half. The contraction of the vessels reduces the amount of blood,
slows the circulation and finally causes stasis. Other drugs arrest
hemorrhage by causing coagulation of the blood, directly or indi-
rectly, and closing the lumen of the bleeding vessel by the resulting
thrombus. The solution of chloride of iron acts in this way.
Some drugs operate in both ways; e.g., tannic acid and ergot.
Blood coagulation is also favored by decrease of blood-pressure.
Some drugs act in a purely mechanical way by agglutinating the
bleeding surface (agglutinative styptics), or by absorbing the
blood (rophetic or spongy styptics, ¢e.g., sponge). For practical
purposes styptics are divided into two groups: local and general.

1. Local or topical styptics serve to arrest hemorrhage upon the
skin, accessible mucous membranes and, when administered by
inhalation, in the lungs. The most important are: solution of

70 GENERAL THERAPEUTICS FOR VETERINARIANS

ferric chloride, tannic acid, nitrate of silver, chloride of zinc, lead
acetate, alum, antipyrine, adrenalin (suprarenin), creolin, creosote,
oil of turpentine, ether and aceticacid. To this group also belong
the agglutinative styptics: acacia, tragacanth, colophony, col-
lodion, starch, chalk and plaster of Paris; also the rophetic styptics:
sponges, absorbent cotton and pengamar djambi (long, silky hairs
from East Indian ferns, official in Austria as palece hemostatica)
which were formerly much used but which have become obsolete
since the introduction of asepsis.

2. General styptics operate internally after absorption into the
blood. The most important are ergot, hydrastis, lead acetate,
tannic acid and alum. Digitalis, adrenalin (suprarenin), oil of
turpentine and other ethereal oils, acids and sodium chloride also
operate internally as hemostatics. Subcutaneous injections of
white gelatin, which is recommended as a general styptic, should
be used with caution (tetanic convulsionsin man). The internal
styptics are employed in hemorrhages from the uterus, kidneys,
bladder, intestines, stomach, liver, spleen, lungs and brain. In
gastric and intestinal hemorrhages the action of most of these is,
strictly speaking, a local one (tannic acid, lead acetate, alum, sul-
phate of iron, solution of ferric chloride). In general, the action of
the internal styptics is very uncertain, except the effect of ergot
and hydrastis upon hemorrhage from the uterus.

Drugs.—1. Ergota. Ergot. Specific against uterine hemorrhage.
[Dose of fluidextractum ergote for horses and cattle, 15-30, 3ss
to 3j; sheep, goats and swine, 4-8, 3] to ij; dogs, 24, 3ss to j.]

2. Hydrastis. A specific against hemorrhages from the uterus
and abdominal organs. [Dose of fluidextractum hydrastis for
horses and cattle, 8-30, 3ij to 31; sheep and swine, 4-8, 31 to ij;
dogs, 0.3-4, mv to 3i.]

3. Acidum tannicum. Tannic acid or tannin. A styptic in
gastric, intestinal and renal hemorrhage; external hemostatic.
Dose for horses and cattle, 5-25, 3i to vj; sheep and goats, 1-2, grs.
xv to xxx; dogs, 0.1-0.5, grs. iss to vij. Quercus, cinchona,
krameria, *tormentilla, uva ursi, *catechu and galla have the
same action.

DISEASES OF THE ORGANS OF CIRCULATION 71

4. Plumbi acetas. Lead acetate. A good hemostatic in
gastric hemorrhage. Used empirically in hemorrhage from the
lungs, kidneys, bladder and uterus. Dose for horses, 2-10, 38s to
ijss; cattle, 1-5, grs. xv to 3i; dogs, 0.05-0.2, grs. 34 to iij.

5. Alumen. Alum. A styptic in intestinal hemorrhage.
Dose for horses and cattle, 10-25, 3ijss to vj; dogs, 0.5-2, grs.
vij to xxx.

6. Liquor ferri chloridi. Solution of chloride of iron. Exter-
nal styptic, undiluted, or with collodion 1 : 10, upon wounds; 1 to 5
per cent. solution in water on mucous membranes; in 1% per cent.
solution by inhalation in hemorrhage from the lungs. Internally,
in gastric hemorrhage, freely diluted.

7. *Creolin. External stypticin operations in 3 per cent.solution.

2. VASOMOTOR STIMULANTS. DRUGS THAT CONTRACT
BLOOD-VESSELS

Synonyms: Angiosthenics, vaso-astringents, vaso-constringents.

Actions.—A contraction of the blood-vesseis (arteries, capil-
laries, veins) can be produced by influences acting either upon the
nerves, the musculature of the vessels, or the blood. The various
organs concerned are the vasomotor centre in the medulla oblon-
gata, similar centres in the spinal cord, and the peripheral vaso-
constrictor nerves; all of which can be stimulated directly and
reflexly. Contraction of the blood-vessels causes a decrease in the
amount of blood in the tissues they supply and an increase in the
blood-pressure. Other vasoconstrictor drugs act by coagulating
the blood or by withdrawing fluid. Vasomotor constrictors are
divided into two groups: external and internal. The most impor-
tant external vasoconstrictors are silver nitrate, lead acetate,
copper sulphate, zinc sulphate, zine chloride, bichloride of mercury,
iron sulphate, alum, tannic acid, adrenalin (suprarenin), chalk
and also mild cutaneous irritants. The most important internal
vasoconstrictors are ergot, hydrastis, digitalis, caffeine strophan-
thus [atropine, strychnine and cocaine].

Uses.—The vasomotor stimulants are used to arrest hemor-
rhage (see previous chapter); to overcome hyperemia, stasis and

72 GENERAL THERAPEUTICS FOR VETERINARIANS

other circulatory disturbances in external and internal organs; to
combat swellings, exudations, transudations, catarrhs, polyuria,
ptyalism and hyperhidrosis; in the treatment of aneurisms, vari-
cose veins and angiomas; to increase blood-pressure, and in the
treatment of cardiac weakness. (See also chapters on astringents
and antiphlogistics.)

Drugs.—1. Argenti nitras. Silver nitrate. The strongest
astringent in inflammation of the skin and mucous membranes;
best remedy in ulcers and burns; used in 5 to 10 per cent. solution
in water or alcohol; as a salve, 1 : 10; in substance in pencil form;
also in 1% to 2 per cent. solution as an eye water.

2. Zinci sulphas. Zinc sulphate. Important astringent in the
treatment of eye diseases; used in 14 to 2 per cent. solution in
water (conjunctivitis). On other mucous membranes it is used in
1 to 5 per cent. solution. In inflammatory and eczematous condi-
tions of the skin, zinc sulphate and zinc oxide are used in the form
of the powder and ointment.

3. Liquor plumbi subacetatis dilutus. Lead water. Goulard’s
water. Frequently used as an astringent in inflammation of the
skin, burns, eczema and catarrhs of mucous membranes.

4. Cuprisulphas. Copper sulphate. Astringent in diseases of
the eye and in foot rot.

*Adrenalin—A constituent of the suprarenals which has
vasoconstrictor properties and which acts locally in a dilution
of one to ten million. Used locally; a few drops of a solution of
adrenalin chloride in physiological salt solution (1: 1000).

For other vasomotor stimulants see the previous chapter on
hzmostatics; also chapters on astringents and antiphlogistics.

3. VASODILATORS. AGENTS THAT DILATE BLOOD-VESSELS

Synonyms: Angio-asthenics, vasodilatants.

Actions and Uses.—The vasodilators produce a dilation of the
blood-vessels by causing a relaxation of the blood-vessel wall
through depressing or paralyzing the vasoconstrictors or stimulat-
ing the vasodilators. They bring about an increased supply of
blood, decrease of blood-pressure, slowing of the circulation, and,
after prolonged action, stasis of blood with transudation of serum.

DISEASES OF THE ORGANS OF CIRCULATION 73

The most important vasodilators are amyl nitrite, sodium nitrite,
nitroglycerin, morphine, chloroform, chloral hydrate, potassium
bromide, alcohol, ether, some of the ethereal oils; also heat and
powerful cutaneous irritants.

The practical use of the vasodilators is very limited in veteri-
nary medicine. They are prescribed, for instance, in cerebral
anzemia (syncope), and also in some brain diseases which are attrib-
uted to a circumscribed vascular spasm in the brain, as in eclamp-
sia and epilepsy. They are recommended in nervous asthma of
the dog (nitroglycerin). In human medicine, the vasodilators .
are also prescribed in spasm of the coronary arteries of the heart
designated as angina pectoris.

Drugs.—1. Amylis nitris. Amyl nitrite. May be given
experimentally in eclampsia of suckling bitches; also by inhalation
inasthma. [Dose for dogs, 0.03-0.2; m1/3 to iij.]

2. Nitroglycerin. The same. [Dose of spiritus glycerylis
nitratis, formerly spiritus glonoini, for dogs, 0.06-0.13, mj to ij.]

3. Sodiinitris. Thesame. Dose for dogs, 0.1-1, grs. iss to xv.

For other drugs, see the chapter on sedative neurotics.

IV. GeneraL THERAPEUTICS OF THE EXUDATES AND TRANSU-
DATES. RESORBENTS

Pathology.—The diseased conditions in which the resorbents
are indicated are solid and fluid inflammatory exudates, blood
extravasations, transudates, cedemas in the body cavities and
tissues, and inflammatory swellings and thickenings of the skin,
subcutis, tendons, tendon sheaths, muscle, periosteum, bones and
lymph glands. Hyperplasia of the thyroids (goitre) and of the
lymph glands, actinomycosis, sediments, poisons and obesity are
also treated with resorbents. On the other hand, trué neoplasms,
as carcinomas, sarcomas, lipomas and fibromas, cannot be removed
with resorbents.

Physiology.—The remova: of collections of pathological fluids
and of other pathological products from the organs and tissues
results from the operation of the physiological processes concerned
in the normal resorption of lymph and parenchymatous fluids.

74 GENERAL THERAPEUTICS FOR VETERINARIANS

These complicated processes are dependent upon the laws of
filtration, diffusion, capillarity, imbibition and phagocytosis.
Primarily concerned in the processes are the blood and lymph
vessels and the white blood-corpuscles, while normal resorp-
tion is influenced secondarily by cardiac activity (blood-
pressure), respiration (blood aspiration) and exercise (muscular
contraction).

The physiological activity of the blood and lymph vessels in
resorption takes place in the capillaries and at the origin of the
lymph vessels (interstitial and perivascular lymph spaces and
canals, lymph stomata). The dissolved constituents of the lymph
and parenchymatous fluids are absorbed into the blood and lymph
channels according to physical laws. Active blood circulation,
increased blood-pressure, accelerated cardiac action and a decrease
in the quantity of the blood exert a favorable influence by increas-
ing the filtration pressure. In a similar manner, the aspiratory
effect of respiration upon the blood stimulates the circulation, while
the respiratory movements of the diaphragm markedly stimulate
the resorbent activity of the diaphragmatic pleura and of the peri-
toneum (lymph stomata). Finally, the activity of the muscles
and their coverings (fascize, aponeuroses) exerts a great influence on
physiological resorption through their continued alternate con-
traction and relaxation (pressure and aspiration).

Tn addition to the resorbent mechanism of the blood and lymph
vessels, the white blood-corpuscles play an important réle in resorp-
tion. Their part consists in taking up the undissolved constituents
of the lymph and parenchymatous fluids (phagocytosis) and on
the decomposition and solution of solid tissue masses (histol-
ysis). The phagocytic and digestive activity of the leucocytes
is a very important factor in the resorption of pathological
products.

The degree of the resorption activity of the individual organs is
very different. Resorption is very rapid and intense through the
serous membranes with their thin layer of endothelium, their
numerous lymph stomata and the underlying extensive plexuses
of blood and lymph vessels (pleura, peritoneum, pericardium, pia

DISEASES OF THE ORGANS OF CIRCULATION 75

mater,synovial membranes of the articulations and tendon sheaths,
tunica vaginalis, iris) Even more pronounced is the resorption
power of the lungs with their extraordinary superficial area, their
very rich supply of blood and lymph vessels, the thin epithelium
of the alveoli with the numerous stomata, and the continuous
aspiratory effect of their inspiratory activity. The resorption
activity of the mucous membranes differs with their anatomical
structure. It is most active in mucous membranes with ciliated
(trachea, bronchi) and cylindrical epithelium (intestines, pyloric
portion of the gastric mucous membrane, uterus); less active in
mucous membranes with pavement epithelium (mouth, pharynx,
cesophagus, cardiac portion of the gastric mucous membrane,
bladder). The capacity for resorption is least in the unbroken
skin, which is only permeable to volatile substances (ether, alcohol,
ethereal and alcoholic solutions, chloroform, carbolic acid, ethereal
oils and mercury), and also for fats (salves) and soaps when they
are rubbed in under pressure. On the other hand, the exposed
rete malpighii and corium, with their extensive system of lymph
and blood vessels, possess high resorption powers. This is also
true of muscle and connective tissue.

Therapeutic Methods.—Fluid and solid pathological products
may be removed by supporting or assisting the physiological proc-
esses of resorption by mechanical, thermic, chemical (medicines)
and electrical methods, or by operative interference. In addition,
dietetic, specific and indirect (derivative) methods may also be
employed. Those most used are the dietetic, mechanical (exer-
cise, massage), medical (resorbent, rubifacient, derivative and
specific drugs) and operative methods.

The dietetic method seeks to bring about the resorption of
pathological collections by withholding food (hunger cure) and
water (dry cure), by regulating the relative proportion of nutritive
substances (reducing treatment) and by increasing metabolism
(work).

The mechanical methods are, principally, exercise and massage
(see those chapters).

One of the important surgical methods is the artificial pro-

76 GENERAL THERAPEUTICS FOR VETERINARIANS

duction of hyperemia and inflammation by the application of
irritant ointments and by firing (see that chapter).

The derivative method consists of the employment of cathartics
(eserine, aloes, salts), sialagogues and diaphoretics (arecoline,
pilocarpine), and diuretics (digitalis, strophanthus, diuretin,
agurin).

Specific resorbents are iodine and potassium iodide (goitre,
actinomycosis), mercury and salvarsan (syphilis in man); also the
chemical antidotes for poisons.

The operative methods consist in removing pathological. fluids
by puncture and incision, phlebotomy, etc.

The following group of medicines are usually given the special
designation of resorbents in general therapeutics, although the mode
of action of the individual drugs is in many instances very
different.

RESORBING MEDICINES. RESORBENTS

Synonyms: Resolvents; discutients; anti-plastics; alterants; dissolving,
disintegrating, liquefying, absorbing medicines.

Action and Uses.—Resorbents or resolvents are drugs that
bring about an absorption, solution, liquefaction, disintegration or
removal of disease products from the tissues or body cavities,
chiefly through the medium of the lymph system. None of them
exert any direct influence upon the processes of absorption in the
lymph vessels, but only indirectly accelerate in different ways the
absorption of pathological products present in the body. Some
operate by increasing the general metabolism (alkalies), others
by causing an outwandering of white blood-corpuscles with the
resulting phagocytosis and histolysis (tincture of iodine, blisters),
and still others by destroying the infectious agents and killing the
pathological tissue cells and instituting a degenerative meta-
morphosis of the same (potassium iodide, iodoform, mercury, sal-
varsan). Additional modes of action are: by transforming solid
pathological products into a fluid and more readily resorbable
form (sodium chloride); by increasing the arterial blood supply
(acrics); by causing a thickening of the blood and consequent

DISEASES OF THE ORGANS OF CIRCULATION 77

absorption of fluid from the tissues (cathartics, diuretics), and by
stimulating the blood circulation (digitalis). The important
resorbents are the following:

1. The iodine preparations, potassium iodide, tincture of
iodine and iodoform, which are used internally as well as exter-
nally. Internally, iodine has a paralyzing and lethal effect upon
pathological cell collections, especially the cells of goitre, the cells of
the lymph glands, and white blood-corpuscles, causing them to
rapidly undergo fatty and granular degeneration, after which they
are resorbed and disposed of through the process of metabolism.
In addition, iodine has a specific action against actinomycosis
(but not against botryomycosis) and the neoplasms of tertiary
syphilis of man. In chronic metallic poisonings, iodine acts inter-
nally as a resorbent by combining with the almost insoluble metals
(mercury, lead) and forming the more soluble and more easily
absorbed iodides. When applied externally, the absorbent action
of iodine results from the production of an erysipelatous-like
inflammation, with outwandering of leucocytes (local leucocytosis
and phagocytosis), the absorption of masses of pathological
exudates by these cells, and the liberation of enzymes and
histolysis.

2. The alkalies (sodium chloride, sodium bicarbonate, sodium
sulphate, Carlsbad salts and ammonium chloride) dissolve and
liquefy the solid inflammatory products, catarrhal secretions and
croupous exudates upon the mucous membranes, serous mem-
branes, in the lungs, liver and other internal organs; increase me-
tabolism, thus increasing resorption; increase diffusion through the
animal membranes, especially the vessel walls; stimulate the secre-
tory and excretory activity of the glands, and neutralize and dis-
solve acids which collect in the body and are precipitated in dis-
eased conditions (uric acid). Externally, the alkalies (soda,
potash, lye, soap) also act as resorbents by softening and dissolving
the products of chronic inflammation of the skin.

3. Sulphur acts indirectly as an absorbent by stimulating
metabolism and increasing the secretions of the glands (liver,
cutaneous glands, mucous glands). It is therefore usually em-

78 GENERAL THERAPEUTICS FOR VETERINARIANS

ployed to absorb chronic exudates in lymphadenitis and also in
chronic metallic poisonings. The extent of the resorbent action
of the antimony salts (black sulphide of antimony, sulphurated
antimony) is not definitely known.

4. The mercury salts were formerly regarded as especially
active resorbents (antiplastics). A specific resolvent action has
been demonstrated for the mercurials only in connection with
secondary syphilis of man. The much-boasted absorbent action of
gray mercurial ointment is due to the massage and antiseptic effect.
The antiplastic properties of calomel are to be attributed to its
laxative action. It has been scientifically established that mer-
cury (corrosive sublimate) only in repeated minimum doses in-
creases metabolism, in consequence of which it probably also
stimulates resorption. Similar knowledge exists with regard to
arsenic.

5. In addition, the cathartics, especially arecoline and aloes,
the diuretics, the diaphoretics, the sialagogues, and the cutaneous
irritants act indirectly as stimulants to resorption.

Drugs.—1. Potassii iodidum. Potassium iodide. A specific
against. goitre, actinomycosis and lymphomas; a resorbent of
blood extravasations in the brain, inflammatory exudates upon
serous membranes, in the lungs, etc., also in chronic metallic poison-
ings. Dose for horses and cattle, 5-15, 3i toiv; sheep, goats and
swine, 1-2, grs. xv to xxx; dogs, 0.25-1, grs. ii] to xv; cats and fowl,
0.1-0.2, grs. iss to iij.

2. Iodoformum. An internal resorbent in goitre, lymphomas
and tuberculosis. Dose for horses and cattle, 2-5, 3ss to j; dogs,
0.05-0.2, grs. 34 to iij.

3. Tinctura iodi. Tincture of iodine. Exclusively an exter-
nal resorbent in surgical affections: exostoses, periostitis, tendinitis,
tendovaginitis, etc.

4, Sodii chloridum, Sodii bicarbonas, sodii sulphas, *sal
Carolinum factitium (Carlsbad salts). Resorbents to dissolve
solid exudates in the body, solvents of mucus in catarrhs, stimu-
lants to metabolism in obesity. Dose for cattle, 50-100, 3 iss to iij;
horses, 25-50, 3vj to xij; sheep and goats, 2-5, 3ss to i; swine,

DISEASES OF THE ORGANS OF CIRCULATION 79

2-5, 3ss to i; dogs, 1-2, grs. xv to xxx; cats and fowl, 0.5-1, grs.
vij to xv.

5. Ammonii chloridum. Ammonium chloride. A resorbent in
bronchitis and croupous pneumonia, croupous pleuritis, peri-
tonitis, etc. Dose for cattle, 10-25, 3ijss to vj; horses, 8-15, 31
to iv; dogs, 0.2-1, grs. iij to xv.

6. Sulphur lotum, sulphur precipitatum, sulphur sublimatum.
Sulphur. Metabolic stimulants in chronic exudates. Dose for
horses and cattle, 2-5, 3ss to j; dogs, 0.05-0.2, grs. 34 to iij.

GENERAL THERAPEUTICS OF FEVER

Nature of Fever.—By the term fever is understood a symptom-
complex, in which the general condition is disturbed in several
respects. The most important changes are elevation of the body
temperature, increased frequency of the pulse, change in the dis-
tribution of the blood and of the blood-pressure, alteration of the
composition of the blood and derangement of the digestive, respi-
ratory and nervous apparatuses. Increase of the body tempera-
ture is not the only symptom of fever.

The exact processes concerned in the generation of fever are not
entirely understood. Like inflammation, fever is to be regarded
as a natural reaction of the body designed to protect it against
invading disease-producing agents. In this connection, the most
important réle seems to be played by the formation of antitoxins
(antibodies) on the one hand, and by the heat centre in the brain
on the other. The antitoxins neutralize the bacterial poisons
(toxins) with the augmentation of albumin decomposition and
increase of metabolism. The heat centre regulates the uniform
distribution of heat and also the generation of heat in the body
(calorific centre). When the heat centre is stimulated the body
temperature rises; when it is depressed or paralyzed the tempera-
ture falls. The centre may be stimulated in several ways: trau-
matically, by puncturing with an instrument or wounding it other-
wise (heat puncture in rabbits); thermically, by high degrees of
heat (heat stroke, sun stroke); chemically, by numerous chemical
substances (toxins, ferments, mallein, tuberculin); or reflexly, by
pain (so-called nervous fever). On the other hand, the heat centre
may be depressed and the body temperature lowered by trau-
matic (destruction of the centre), thermic (cold) and chemical
(acetanilid, antipyrine) influences.

Causes and Forms of Fever.—The causes of fever are various.
Bacteria are most frequently the cause (wound fever, infectious

fever). Not rarely, however, fever occurs without the inter-
80

GENERAL THERAPEUTICS OF FEVER 81

vention of bacteria from the resorption of products resulting from
the disintegration of the blood (aseptic fever).

1. In wound fever, the formation of antitoxic substances is

accompanied by increased metabolism, disturbance of heat regu-
lation and stimulation of the heat centre, the result of the resorp-
tion of dissolved bacterial toxins and certain chemical substances
from the wound secretion. Wound fever is therefore to be re-
garded as a resorption fever. When the materials absorbed are
bacteria or toxins produced by the bacteria in the wound the
term septic or bacterial fever is used (infectious fever, intoxication
fever, septicemia, pyemia). In a large number of cases, fever is
associated with entirely benign wounds like those following castra~
tion, and non-infected wounds such as subcutaneous bone frac-
tures and blood extravasations. Fever in these cases probably
occurs from the resorption of the ferment-like decomposition
products of the blood and tissues, the action of which upon the
blood and the nervous system is similar to that of the bacterial
toxins. A fever of this character is called aseptic or ferment fever.
These active chemical substances are blood and tissue ferments
(fibrin ferment, histozyme), organic toxins arising from the decom-
position of the tissue cells (nuclein from the nuclei of the white blood-
cells, free hemoglobin) and sometimes also glandular secretions.
' 2. The infectious fever of the acute infectious diseases (con-
tagious pneumonia, strangles, canine distemper, foot-and-mouth
disease, etc.) is produced in the same manner as wound fever,
the infection and intoxication of the blood occurring usually
through the respiratory or gastro-intestinal mucous membrane.

3. As non-bacterial fevers there are yet to be mentioned ner-
vous fever (very painful conditions), rheumatic fever (diseases due
to chilling), inanition fever (anzemia), also the fever of heat stroke,
fatigue (restraint of horses), and overheating (long rides, casting).

Physiology of Heat.—Animal heat arises from the activity of the
body cells, especially the muscle and gland cells, chiefly from
the burning up (oxidation) of the carbohydrates. The constancy
of the normal temperature is maintained by the regulating activity

of the heat centre in connection with the vasomotor nervous sys-
6

82 GENERAL THERAPEUTICS FOR VETERINARIANS

tem (vasoconstrictors, vasodilators) and the sweat glands. The
heat centre, situated in the region of the corpus striatum, regu-
lates heat production and heat dissipation. Increased dissipation
of body heat is brought about by dilation of the cutaneous blood
vessels and increased secretion of sweat, while contraction of the
cutaneous vessels decreases heat dissipation. The regulation of
heat dissipation through the skin is of great importance to the
body in health as well as in fever because by far the greatest
amount (84 per cent.) of heat produced in the body is given off
through the skin.

Therapeutic Methods.—The very complicated disease process
known as fever can be treated in various ways.

1. The antiseptic, or the causal method, is to be preferred to all
others when the microérganisms causing the fever are accessible
to the direct action of antiseptics. This is the case in wound
fever. The most important points in connection with the treat-
ment of surgical fever are thorough disinfection of wounds, in-
cision of abscesses and phlegmona, amputation of necrotic masses,
drainage, change of dressings and irrigation. On the other hand,
the antiseptic method cannot be used in the treatment of the
acute, febrile, infectious diseases (influenza, strangles, canine
distemper, aphthous fever, etc.) because the microédrganisms which
have invaded the blood usually cannot be destroyed by an anti-
septic without danger to the animal body. The action of salvarsan
in contagious pneumonia of horses, of quinine in malarial fever and
of salicylic acid in articular rheumatism are exceptions. Immu-
nity against some infectious diseases can be obtained by pro-
tective vaccination (prophylactic method); this is especially true
of swine erysipelas, anthrax, black leg [and hog cholera]. Fur-
thermore, cutaneous irritation, by increasing the physiological ©
production of antitoxins in the body, operates in a certain sense
antiseptically. ,

2. The expective or dietetic method omits the use of anti-
pyretics entirely. The fever of the acute infectious diseases,
when running a typical course, is usually not to be combated, but
is rather to be regarded as a natural healing process or a protective

GENERAL THERAPEUTICS OF FEVER 83

reaction of the body against the invading microdrganisms, which
are rendered harmless by the high temperature and the increased
formation of antitoxins. In addition, attention must be called
to the harmful effects of many antipyretics upon the digestion
and the nervous system.

So long as the infectious fever does not deviate from its typical
course and the nervous system, the heart and the digestive organs
are not endangered by an excessively high or a very long con-
tinued fever, the expective method is entirely rational. It must,
however, be abandoned immediately whenever, because of the
type, height or continuance of the fever, the general condition,
especially the activity of the heart and brain and the appetite for
food, is disturbed.

3. The symptomatic treatment of fever by the use of anti-
pyretics, cardiac stimulants, nerve stimulants, digestive tonics,
derivatives (cathartics, diaphoretics, sialagogues, diuretics) and
cutaneous irritants is of the most practical importance in veterinary -
medicine in the treatment of the febrile infectious diseases. Among
the different symptoms of fever, a considerable rise of temperature
is the most significant and the most dangerous to life. Temper-
ature-reducing drugs (see below) are therefore of first importance
inthe treatment of fever. In addition, in severe disturbance of the
cardiac functions and of the nervous system the administration of
cardiacs and nerve excitants is also indicated (see those chapters).
The cathartics empty the intestinal canal (infectious material),
hasten the elimination of infectious material and toxins from the
blood by stimulating the intestinal gland secretions, overcome the
constipation frequently present in fever, and also reduce tempera-
ture. Reduction of temperature together with a change in the
distribution of the blood is produced by cutaneous irritants (oil of
mustard, Priessnitz dressing). Phlebotomy, formerly employed
for its derivative action, has passed out of use.

4. The bath treatment of fever (thermic method, hydrotherapy)
in the form of cold baths (20-30° C.) is an important method in
human medicine, especially in the treatment of abdominal typhus.
In veterinary medicine, for technical reasons, this method, as a

84 GENERAL THERAPEUTICS FOR VETERINARIANS

rule, cannot be used. Simple washing or douching with cold
water, also wrapping in cold wet sheets, is without considerable
value.

MEDICAL ANTIPYRETICS

Synonyms: Antifebrilics, antithermics, febrifuges, antitypics, anti-
typosics, antiperiodics.

Actions.—The reduction of temperature by antipyretics is
brought about in very different ways. The action of most of them
is very complicated. According to the mode of action, they may
be divided into the following groups:

1. Depression of the heat centre in the brain, when it is excited
by fever, with consequent reduction of temperature, appears to be
the dominant action of the modern antipyretics: antipyrine,
acetanilid, aspirin, phenacetin, salipyrin, lactophenin, pyramidon,
etc. They are to be regarded accordingly as narcotics for the heat
centre (or the vasomotor centre ?). This property is in agreement
with the fact that antipyrine, aspirin, etc., also exert a narcotic
effect upon other parts of the nervous system, especially in neu-
ralgia and also in the production of local narcosis; the temper-
ature also falls in morphine and chloroform narcosis. The rapid
action of the modern antipyretics is in great contrast to that of the
other antipyretics, the fall of temperature beginning as early as
10 to 20 minutes after administration, and can only be explained
through the action of a promptly functionating heat-regulating
centre. Digitalis, the action of which is essentially different, does
not reduce temperature until the twelfth to the twenty-fourth
hour. The action of the modern antipyretics upon the calorific
centre may be demonstrated experimentally. Given to animals
with fever resulting from septic infection, antipyrine immediately
reduces the temperature so long as the heat centre remains intact.
After section of the brain back of the corpus striatum, however,
antipyrine has no influence on the temperature.

2. Increasing heat dissipation through the skin. Those anti-
pyretics which by stimulating the vagus centre increase blood-
pressure and which by regulating the distribution of the blood

GENERAL THERAPEUTICS OF FEVER 85

bring blood from the centre of the body to the periphery, where
it can more readily give off its heat to the surrounding atmosphere,
reduce the temperature of the body by increasing the dissipation
of heat through the skin. The same effect is obtained by other
drugs which act upon the cutaneous blood-vessels through the
vasomotors (paralysis of the vasomotor centre). The antipyretics
which operate by increasing blood-pressure include particularly
digitalis and strophanthus. Dilation of the cutaneous blood-vessels
is a part of the antipyretic action of alcohol, and also of the mod-
ern antipyretics in so far as they depress the anterior portion of the
calorific centre (vasomotor ganglion cells for the cutaneous vessels).

3. By decreasing metabolism, partly by retarding the giving
off of oxygen by the red blood-corpuscles to the tissues (internal
respiration) and partly by depressing the oxidation processes in
the cells of the tissues, alcohol, quinine and hydrocyanic acid cause
a reduction of body temperature. The acids act as antipyretics by
reducing the alkalinity of the blood and thus decreasing its oxida-
tion capacity.

4. By inhibiting and destroying the fever-producing micro-
organisms, camphor, salicylic acid, quinine, alcohol, arsenic,
salvarsan (organic arsenical compound), some of the modern anti-
pyretics and vigorous cutaneous irritation (increased formation of
antitoxins) bring about a fall of temperature.

A peculiarity of many antipyretics is that they only reduce the
increased temperature of animals in a febrile condition and do
not lower the normal body temperature of animalsin health. This
is readily explained with regard to those antipyretics which reduce
temperature by destroying the fever-producing organisms, since
in the healthy body there are no such organisms to destroy. The
modern antipyretics, which operate as cerebral sedatives, exert a
more pronounced narcotic influence upon the heat centre or upon
the vasomotor centre irritated by fever than upon the normal heat
centre. Those antipyretics which act by decreasing metabolism
can lower the body temperature in normal as well as in febrile ani-
mals, as has been demonstrated by experiments with large doses of
alcohol and quinine. In individual cases, the modern antipyretics

86 GENERAL THERAPEUTICS FOR VETERINARIANS

also reduce normal temperature; this has been demonstrated by
Fréhner, especially in connection with acetanilid (Monatshefte
fir prakt. Tierheilkunde, 1893).

Antipyretics.—1. Acetanilidum. Acetanilid. The cheapest
and most powerful modern antipyretic. Dose for horses and
cattle, 20-40, 3v to x; dogs, 0.25-1, grs. iij toxv. *Aspirin has a
similar action. (The patented name aspirin is to be avoided and
the chemical name, acidum acetyl-salicylicum, used in prescrip-
tions, as the drug costs one-third less under this name.)

2. Antipyrina. Antipyrine. A very effective but costly anti-
pyretic. Prescribed under the chemical name, pyrazalonum
phenyl dymethylicum, it costs one-half less than under the pat-
ented name antipyrine. A specific against muscular and articular
rheumatism. Dose for horses and cattle, 15-25, Ziv to vj; large
dogs, 2-4, 3ss to j; small dogs, 0.5-1, grs. vij to xv; cats, 0.2-0.5,
grs. iij to vij.

3. Acetphenitidinum. Phenacetin. A very good modern anti-
pyretic. Dose, same as for acetanilid. *Lactophenin and *sali-
pyrin have a similar action.

4. Camphora. Camphor. A specific antipyretic for septic
fever and fever with heart weakness. Best used subcutaneously
in the form of spiritus camphoree or camphor oil [*oleum cam-
phoratum: camphor 1, olive oil 10; *oleum camphoratum fortior:
camphor 1, olive oil 4]. The doses heretofore given of these prep-
arations were much too small. The single dose of oleum cam-
phoratum fortior for the horse, subcutaneously, is 50-150, 3iss to
v; daily doses, 100-250, 3 iij to viij.

5. Digitalis. A superior antipyretic in severe infectious fever
with cardiac weakness (contagious pneumonia, etc.). Dose (not
to be repeated) for horses, 5-10, 31 to ijss; dogs, 0.2-0.5, grs. ij
to vij.

6. Acidum salicylicum. Salicylic acid. A specific against
acute muscular and articular rheumatism; not effective in septic
and pyemic fevers. Dose of salicylic acid and sodii salicylas for
horses and cattle, 25-75, 3vj to Zijss; swine, 2-5, 3ss to j; ee
0.25-2, grs. iv to xxx.

GENERAL THERAPEUTICS OF FEVER 87

7. Alcohol. A valuable antipyretic in many fevers, especially
‘septic and pyemic fevers. Acts at the same time as a stimulant
to the brain and heart and also as a food (economizes tissue waste).
Dose for febrile horses and cattle, 100-200, 3 iij to vjss, every two
hours; sheep, goats and swine, 25-100, 5 vj to 3iij; dogs, 25-50,
3vj to xii; cats, 2-5, 3ss to j. Dose of brandy (spiritus vini
gallici) two to three times these quantities.

8. Quinina. Quinine. Specific against ‘tesecuttant fever.
Unreliable in contagious pneumonia, influenza, canine distemper,
articular rheumatism, etc. Dose of quinine sulphas for horses and
cattle, 10-25, Jijss to vj; dogs, 0.25-1, grs. iij to xv.

GENERAL THERAPEUTICS OF THE DISEASES OF THE
NERVOUS SYSTEM

Pathology.—Of the diseases of the brain, spinal cord, and pe-
ripheral nerves, those of especial therapeutic consideration are acute
inflammation and hyperemia of the brain, Bornas’s disease of
the horse, epilepsy and eclampsia, sturdy or gid, cerebrospinal
meningitis, inflammation of the spinal cord, trotting disease of
sheep, and the spinal paralyses; also paralyses of the peripheral
nerves, especially the optic, facial, trigeminus, suprascapular and
radial. The central nervous system is also frequently affected
secondarily in the course of infectious diseases (canine distemper,
tetanus, contagious pneumonia, strangles, tuberculosis, dourine),
in poisoning (strychnine, lead, alcohol, red poppy, equisetum) and
in wounds (fracture of the skull or vertebre, hemorrhage, con-
cussion, contusion).

Physiology.—The most important part of the brain physio-
logically and therapeutically is the cerebral cortex. This is, in
the first. place, the location of the psychic functions (consciousness,
memory, intelligence, volition). In the cerebrum are situated the
motor, sensory, optic and acoustic cortical areas. The most of
these cortical centres manifest a specific relation to certain drugs.
They may also be stimulated by mechanical, thermic and electrical
stimuli, and by the will. The corpus striatum is the chief seat of
the heat centre. In the corpora quadrigemina and optic thalamus
is the pupillary centre, by which stimuli acting upon the retina
are transmitted reflexly to the oculomotor nerve (pupillary mo-
tion). In addition, the middle brain (corpus striatum, optic thala-
mus) contains centres for the codrdination of movement, which
also originate forced movements. The cerebellum contains the
centre for the muscle sense and the equilibrium of the body (centre
of equilibrium); its extirpation produces cerebellar ataxia. The
semicircular canals are to be regarded as static organs for the

movement and carriage of the head. Ganglion cells form the
88

DISEASES OF THE NERVOUS SYSTEM 89

anatomical foundation of all of the nerve centres (psychic, auto-
matic, reflex activity).

The medulla oblongata also contains a large number of impor-
tant vital centres. These centres can also be influenced thera-
peutically by specific drugs. Especially noteworthy are the respi-
ratory, vasomotor, vagus, salivary, sweat and diabetic centres,
and the centres of vomition and swallowing.

In the spinal cord are the paths of conduction of the motor
(inferior column) and the sensory nerves (superior column) of the
extremities; also the centres for the uterus, the vessels, the sweat
glands, the discharge of urine, the erection of the penis and for the
sphincter muscle of the anus.

The peripheral nerves have sensory, motor, secretory, vaso-
motor, trophic (?), reflex-stimulating and reflex-inhibiting func-
tions. Especially important in therapeutics are the reflex func-
tions (centripetal, centrifugal nerves; reflex movement, reflex
inhibition, reflex secretion). All peripheral nerves, but especially
the sensory nerves of the skin and mucous membranes, and all
parts of the central nervous system possess reflex powers,—1.e.,
the ability to transmit a centripetal stimulus to a reflex centre
and out over a centrifugal path without the intervention of con-
sciousness (coughing, sneezing, pupillary contraction, vascular
contraction, vascular dilation, perspiration, vomiting, increased
peristalsis, tendon reflexes).

The intrinsic chemical constituents of the brain and nerves
are the phosphorus-containing protagon and lecithin, cerebrin,
and other proteids. Resting nerve substance is alkaline in reac-
tion; the active, acid (lactic acid and other products of fatigue).
Natural sleep is brought about by the action of the fatigue prod-
ucts on the albumin of the ganglion cells in a manner similar to
that of morphine and chloroform narcosis; anemia of the brain
occurs secondarily.

Therapeutic Methods.—1. On account of the varied and inti-
mate relations between the nervous system and a large number of
drugs, the medical treatment of nervous diseases is a prominent
feature of the therapeutics of nervous diseases. The action of

90 GENERAL THERAPEUTICS FOR VETERINARIANS

drugs, it is true, is in most instances only indirect and symp-
tomatic, and is either sedative or stimulant. If, for example, the
psychic excitement in the course of inflammation of the brain is
relieved by morphine, the disease process itself, 7.e., the inflam-
mation of the cerebral membranes, remains unaffected. There
are, however, also cases in which there is a direct influence exerted
by the drug upon diseases of the nervous system (morphine in
eclampsia, potassium bromide in epilepsy, strychnine in amaurosis,
physiological antidotes).

2. The derivative method is also partly medical. It consists
in the employment of the cathartics, sialagogues and diaphoretics,
blisters and phlebotomy (indicated in cerebral congestion).

3. Electrotherapy is also of value in veterinary medicine, espe-
cially in canine practice, for the treatment of peripheral and spinal
paralyses. The faradic current stimulates the spinal cord reflexly
in the same manner as cutaneous irritation; the constant current
acts directly, like the drugs acting upon the central nervous
system.

4. Massage is an important mechanical method, especially for
peripheral paralyses (tapotement). ,

5. Hydrotherapy is practicable only to a limited extent in
veterinary medicine (cold douche, ice poultice, Priessnitz dressing).

6. Operative treatment is undertaken in sturdy or gid and
fractures of the skull (trepanation) ; also in the form of neurotomy.

Finally, there is the rest treatment (protection from external
stimuli, quiet and dark stall), and the dietetic (green food in cere-
bral inflammation in the horse), the expective (cerebral hemor- '
rhage) and the prophylactic methods. The hypnotic and sug-
gestive treatment, very important in human medicine, cannot be
used on the domestic animals.

Drvues AcTING ON THE Nerves. NeEurotics. NERVINES

Classification.—The drugs used in the treatment of diseases
of the nervous system may be classified according to the part upon
which they act as well as according to the character of the action.
Grouped according to the part acted upon, there are drugs acting

DISEASES OF THE NERVOUS SYSTEM 91

upon the brain (cerebralics, encephalics), upon the spinal cord
(spinalics), and upon the peripheral nerves (peripheric nervines).
Besides this anatomical division, the classification based upon
physiological principles is of special practical importance in thera-
peutics; according to action, there are drugs which are stimulating
(excitants) and others which are quieting (sedatives) to the nerv-
ous structures. Finally, there may be a combination of the two
methods of classification. In this way the following subdivisions
have been formed:

I. Cerebralics. These are again subdivided into drugs which
act upon the cerebrum, upon the medulla oblongata and upon the
twelve cranial nerves. Those drugs which have a relation to the
cerebellum, e.g., alcohol and aspidium, are of no special practical
consideration in this connection.

1. The drugs acting upon the cerebrum are divided according
to the location and character of their action into the following
groups:

(a) Excitants to the cortical psychic centres: alcohol, ether,

caffeine, nicotine, cocaine and apomorphine.

(b) Excitants to the motor centres: atropine, camphor, picro-
toxin and lead salts.

(c) Sedatives for both kinds of centres: potassium bromide
and chloral hydrate.

(d) Hypnotics (drugs that produce sleep): morphine, chloral
hydrate, sulphonal, trional, veronal, medinal, isopral
and adalin.

(e) Narcotics and anzsthetics in the restricted sense: chloro-
form, ether and chloral.

2. For the medulla oblongata there are:

(a) Excitants in general: veratrine, atropine, hyoscine (scopo-
lamine), caffeine, strychnine, camphor and ammonium
salts.

(b) Sedatives in general: morphine, potassium bromide and
chloral hydrate.

(c) Excitants to the respiratory centre: atropine, hyoscine
(scopolamine) and. strychnine.

92

GENERAL THERAPEUTICS FOR VETERINARIANS

(d) Excitants to the vasomotor centre: caffeine, theobromine,
theocine and digitalis.

(e) Depressor to the vasomotor centre: amyl nitrite.

(f) Excitants to the vagus centre: digitalis and strophanthus.

(g) Excitants to the centre of vomition: apomorphine and
emetine.

3. The specifics for the cranial nerves are:

(a) Olfactory: strychnine.

(b) Optic: strychnine, quinine, santonin, aspidium and amyl
nitrite.

(c) Oculomotor: the mydriatics—atropine and hyoscine (scopo-
lamine) ; the myotics—eserine, pilocarpine and arecoline.

(d) Trochlear (and abducens): santonin.

(e) Trigeminus: strychnine, aconitine and ¢ocaine.

(f) Facial: strychnine.

(g) Auditory: quinine, salicylic acid and cannabis indica.

(h) Glossopharyngeal: apomorphine and atropine.

(i) Vagus: atropine, hyoscine (scopolamine), the digitalis
group, strychnine and veratrine.

(k) Hypoglossal: strychnine.

In addition, atropine, ergot, cocaine and amyl nitrite are

specific for the sympathetic, and atropine and morphine for the
splanchnic nerves.

I. Spinalics are divided, according to their action, into:

(a) Tetanics: strychnine and cornutine (lumbar cord).
(b) Sedatives: morphine, potassium bromide and chloral
hydrate.

Ill. Peripherics. These are classified according to the func-

tions of the peripheral nerves as follows:

(a) Motor excitants: camphor and eserine.

(b) Motor sedatives: curare and conine.

(c) Sensory excitants: veratrine and cutaneous irritants.

(d) Sensory sedatives or local anzsthetics: cocaine, adrenalin,
novocaine, anzsthesin, eucaine B, tropacocaine, alypin,

DISEASES OF THE NERVOUS SYSTEM 93

stovain, propesin, dipropesin, subcutin, zycloform,
orthoform, nirvanin, acoin, holocain, antipyrine, men-
thol and ether; also morphine and hydrocyanic acid.
For the purposes of general therapeutics, division of the neu-
rotics simply into stimulants and sedatives is most desirable.
Both classes of drugs operate by producing a, specific change in the
nerve albumins, consisting especially in the formation of double
combinations, as morphine albuminate, strychnine albuminate
and bromide albuminate. Some of these combinations are less
susceptible to stimuli (morphine albuminate) than the original
nerve albumin. In some instances, changes in the composition
and in the distribution of the blood also participate in the action.

1. STIMULANTS TO THE NERVOUS SYSTEM. EXCITANTS

Synonyms: Analeptics, stimulants, euphorics, exhilarants, tetanics,
spasmodics, spinants, hyperkinetics, epileptifacients, antiparalytics; exciting,
stimulating, restorative, invigorating medicines.

Uses.—The nerve stimulants are employed in the treatment of
the various disease conditions of the nervous and muscular systems
which are inaugurated with general or local weakness or paralysis
of these systems or of individual parts: brain, spinal cord, periph-
eral and sympathetic nerves; also the skeletal muscles, heart,
intestinal musculature, etc. The most important of these dis-
eases are:

1. Psychic depression in the course of severe febrile conditions,
e.g., influenza and contagious pneumonia of the horse, canine dis-
temper, catarrhal fever of cattle, swine erysipelas, fowl cholera and
septic and pyzmic conditions.

2. General weakness in the course of acute and chronic dis-
eases, ¢€.g., parturient paresis of cattle, anemia, leukemia, after
difficult parturition, following overexertion, after internal and
external hemorrhages, and in fall of body temperature.

3. Heart weakness in the course of infectious diseases, ¢.g.,
contagious pneumonia and malignant aphthous fever.

4. Brain diseases in the stage of depression: acute inflam-
mation of the brain, chronic hydrocephalus, cerebral anemia,
vertigo, syncope, cerebral apoplexy and cerebral paralysis.

94 GENERAL THERAPEUTICS FOR VETERINARIANS

5. Pareses and paralyses of the cranial nerves, especially
incipient paralysis of the optic (amblyopia and amaurosis), recur-
rent (roaring in horses), facial (paralysis of the lower lip), trigem-
inus (paralysis of the muscles of mastication), and hypoglossal
(paralysis of the tongue).

6. Spinal paralyses. These include the different forms of
weakness of the loins; spinal meningitis and myelitis; concussions,
hemorrhages, traumatic affections of the spinal cord, paralytic
conditions of the posterior quarters, and paralyses of the bladder,
rectum, penis and tail. Of the infectious diseases which are com-
plicated with spinal paralyses, canine distemper, contagious pneu-
monia and dourine of horses, and trotting disease of sheep may be
mentioned.

7. Muscle paralyses. These are chiefly observed in the horse
in the course of azoturia, after casting, in inflammation of the
muscles and in some poisonings (lead).

8. Paralyses of peripheral nerves. Of these, paralyses of the
facial, radial, subscapular, sciatic, tibial, peroneal and obturator
nerves are to be especially mentioned.

9. Paralytic conditions in regions supplied by the sympathetic.
To this class belong pareses of the muscular wall of the rumen in
ruminants and of the intestinal canal in horses.

10. Poisonings. In most poisonings the use of an excitant is
necessary because in the later stages paralytic symptoms appear
which must be treated symptomatically. Here may be especially
mentioned poisonings from phosphorus, arsenic, mercury, lead,
carbolic acid, alcohol, chloroform, colchicum, opium and morphine,
red poppy, agrostemma githago, chick pea, taxus, digitalis, aloes,
lupines, equisetum, cantharides, snake bites and toxins (meat and
mushroom poisoning).

Drugs.—In veterinary practice, the most frequently used
excitants are the alkaloids (which are the most powerful stimulants),
alcoholic and ethereal preparations, ethereal oils and inorganic
compounds. The most important are given below in the order of
their strength:

1. Strychnina. Strychnine. The principal remedy in spinal

DISEASES OF THE NERVOUS SYSTEM 95

motor paralyses, pareses and paralyses of the posterior quarters,
paralysis of the recurrent nerve (roaring), paralysis of the bladder,
penis, tail and rectum, amblyopia and amaurosis, lead paralysis,
and chloroform, chloral hydrate and other narcotic poisonings.
The dose of strychnine sulphas internally and subcutaneously
(not intratracheally) is one-tenth of a milligram for each kilogram
of body weight; therefore, the dose for horses is 0.05-0.1, grs.
34 to iss; cattle, 0.05-0.15, grs. 34 to ij; sheep and goats, 0.005, gr.
3/40; swine, 0.002-0.005, gr. 1/40 to 3/40; dogs, 0.001-0.003, gr.
1/70 to 1/25; cats, 0.0005-0.001, gr. 1/140 to 1/70; fowl, 0.0002-
0.0005, gr. 1/340 to 1/140.

2. Veratrina. Veratrin. The chief remedy in fatigue and
paralyses of the striated and smooth musculature of the body; also
a very powerful excitant to the entire nervous system. It is used
principally in cattle practice, in which it is employed especially in
the treatment of antepartum paralysis, exhaustion after parturi-
tion, parturient paresis and atony of the musculature of the rumen.
In addition, it is frequently prescribed in heart weakness and in
conditions of collapse, especially in the course of narcotic poison-
ings. The subcutaneous dose of veratrin in alcoholic solution
for horses and cattle is 0.05—0.2, grs. 34 to iij; sheep and goats,
0.01-0.02, gr. 1/8 to 14; dogs, 0.001-0.005, gr. 1/70 to 3/40; cats,
0.001, gr. 1/70. . The crude drug, veratrum, and tinctura veratri
(dose per os for horses and cattle 5-10, 3i to ijss) are less frequently
used than the alkaloid because of their slower action.

3. Atropine and hyoscine (scopolamine). These are among the
strongest nerve stimulants and are specific in heart weakness,
threatened respiratory paralysis, and in poisoning by chloroform,
morphine, eserine, arecoline and pilocarpine. Dose of atropine
sulphas for horses and cattle, 0.05-0.1, gr. 34 to iss; sheep and
goats, 0.01-0.05, gr. 1/8 to 34; swine, 0.01-0.03, gr. 1/8 to 1/3;
dogs, 0.005-0.05, gr. 3/40 to 34; cats, 0.002-0.005, gr. 1/40 to 3/40.
The dose of hyoscinze hydrobromidum subcutaneously is one-
tenth these quantities: horses and cattle, 0.01-0.05, gr. 1/8 to 34;
dogs, 0.005, gr. 3/40.

4. Caffeina. Caffeine. A specific against heart weakness,

%

96 GENERAL THERAPEUTICS FOR VETERINARIANS

incipient cedema of the lungs, spinal paralysis, conditions of col-
lapse, parturient paresis, and poisoning by morphine, chloroform,
alcohol and toxins. The subcutaneous or internal dose of *caf-
feinz sodio-salicylas, N.F., for horses and eattle is 5-10, 5i to
ijss; large dogs, 0.5-2, grs. vij to xxx; small dogs, 0.1-0.5, grs. iss to
vij. An infusion of coffee or tea may be used instead of caffeine.

5. Physostigmine (eserine), pilocarpine, arecoline. Stimu-
lants in relaxation and paralysis of the musculature of the stomach
and intestines, especially in cattle and horses. Physostigmine
(eserine) is also a myotie (pupillary contraction). The dose of
physostigmine salicylas and physostigmine sulphas subcutan-
eously for horses is 0.05-0.1, grs. 34 to iss; cattle, 0.1-0.2, grs. iss to
iij. Dose of pilocarpine hydrochloridum for horses, 0.5, grs. vij;
cattle, 0.5-0.8, grs. vij to xii. Arecoline hydrobromidum is
given to horses in doses of 0.02-0.08, grs. 14 toi.

6. Camphora. Camphor. One of the most valuable stimu-
lants for the brain and heart in all conditions of psychic depression,
stupor, collapse, heart weakness and exhaustion in the course of
febrile infectious diseases, severe constitutional affections and
narcotic poisonings. It is usually administered subcutaneously
to all the domestic animals in the form of camphor oil [camphor 1,
olive oil 10; also camphor 1, olive oil 4] or camphor spirit. The
single dose of oleum camphoratum fortior [camphor 1, olive oil 4]
for horses is 50-150, 3iss to v; dogs, 5-10, 3i to ijss; cats, 1-5,
mxv to 3i.

7. Alcohol and ether. In small doses both are strong stimu-
lants to the brain and the other parts of the nervous system; also to
the heart and digestion. Given subcutaneously or by the mouth
in all conditions of weakness or collapse occurring in the course of
severe infectious diseases and in inanition, in pronounced exhaus-
tion following parturition and hemorrhage, in severe poisonings
and in threatened cerebral and cardiac paralysis. Dose of alcohol
for horses and cattle, 25-50, 3vj to xij; sheep and goats, 10-20,
3ijss to iv; swine, 5-10, 3i to ijss; dogs, 2-5, 3ss toi; cats and fowl,
1-2, mxv to xxx. Dose of ether one-half. Alcohol dilutum,
spiritus vini gallici, vinum album, vinum rubrum, *beer and

DISEASES OF THE NERVOUS SYSTEM | 97

Spiritus ztheris may also be used as stimulants in corresponding
doses.

8. Ammonium compounds. These are very powerful excitants
to the brain, heart and intestines in all weak conditions in the
course of infectious diseases and poisonings, and are sometimes
used in the treatment of cattle and the smaller ruminants and
dogs. Aqua ammoniz, diluted with plenty of cold water, is given
to cattle in doses of 10-30, 5ij to 3i; ammonii carbonas: cattle,
20-50, 3v to xij; sheep and goats, 2-5, 3ss to i; spiritus ammonize
aromaticus: dogs, 0.3-0.4, mv to 3i.

9. Potassium salts. These are stimulants to the heart, brain
and muscles and are most frequently given to dogs in the form of
meat extracts in all weak conditions. Dose, 2-10, 3i to ijss.

2. DRUGS THAT CALM THE NERVES. SEDATIVES
Synonyms: Sedantics, narcotics, anzsthetics, temperantics, anodynes,
analgics, analgesics, hypnotics, somniferics, soporifics, ebriantics, paralyzants,
paregorics, antitetanics, antispasmodics, anticonvulsives, antiepileptics, anti-
neuralgics, anti-asthmatics, antodontalgics; soothing, benumbing, narcotizing,
anesthetizing, pain-alleviating, convulsion-alleviating drugs; drugs that
produce sleep.

Uses.—The nerve sedatives are used to overcome conditions of
psychic, sensory, and motor excitement in the different parts of
the nervous system; also in operations. The diseased conditions
in which they are indicated are, in general, the following:

1. Psychic excitement in the course of diseases of the brain
and severe febrile general affections, including acute cerebral
hyperemia, acute and subacute inflammation of the brain in the
stage of excitement, erethistic affections in the course of chronic
hydrocephalus, the cerebral form of canine distemper and psychic
disturbances in the course of contagious pneumonia, strangles,
malignant catarrhal fever, tuberculosis, gid (stage of immigration),
and septicemia.

2. Cerebral convulsions in the form of epilepsy, eclampsia,
catalepsy, chorea, epileptiform convulsions and forced movements.

These occur either as primary diseases or secondarily in the course
7

98 GENERAL THERAPEUTICS FOR VETERINARIANS

of inflammation of the brain, canine distemper, contagious pneu-
monia, cerebrospinal meningitis, tuberculosis, strangles, and in
invasion of the brain by parasites (ccenuri, echinococci).

3. Spinal convulsions. The rigid cramp of tetanus and the
convulsions occurring in the course of spinal meningitis, cerebro-
spinal meningitis, and trotting disease of sheep may be mentioned as
examples. A disposition to take fright readily is also an indica-
tion of spinal excitement.

4, Excited conditions of the peripheral nerves. The sensory
nerves are in a condition of excitation in the different painful con-
ditions of external and internal organs: colic, cough, neuritis,
hyperesthesia, pruritis, nymphomania, satyriasis; the motor
nerves, in peripheral muscular spasms, cramp of the sphincters,
straining after prolapse, spasms of the stomach, intestines and
uterus, and palpitation of the heart.

5. Poisonings. The most important intoxications accom-
panied by symptoms of excitation, and which are therefore to be
combated with sedatives, are poisoning by strychnine, veratrin,
atropine, hyoscine, aconitin, nicotine, cocaine, apomorphine, lead,
Hering’s lake, alcohol, red poppy and aspidium.

6. Finally, the sedatives are used to prepare animals for opera-
tions (see the chapter on general and local narcosis, p. 101).

Classification—The sedatives are divided into several sub-
divisions, according to the purposes for which they are used, as
follows:

1. Sedatives in a general sense. These include potassium
bromide, chloral hydrate, [cannabis indica], opium, morphine,
codeine, peppermint, matricaria and valerian.

2. Hypnotics: sulphonal, trional, veronal, medinal, adalin,
hypnone, morphine and codeine.

3. Narcotics or anzsthetics, which are again divided into
general and local. General: chloroform, [chloral], ether, ethyl
bromide, etc. Local: cocaine, adrenalin, novocaine, anzsthin,
eucaine B, alypin, tropacocaine, stovain, propsesin, subcutin,
zycloform, orthoform, holocain, nirvanin, antipyrine, morphine,
ether, menthol, freezing mixtures, etc. Some of the local anes-

DISEASES OF THE NERVOUS SYSTEM 99

thetics produce first a powerful local irritation and are therefore
called anesthetica dolorosa.

4. Antispasmodics: potassium bromide, chloral hydrate, mor-
phine and the ethereal oils.

In human medicines there are also other subdivisions; the
antodontalgics, or toothache remedies (chloroform, cocaine, adren-
alin, dilute carbolic acid, alcohol, brisk embrocations upon the
gums and caustics for the dental pulp), the anti-asthmatics, or
asthma remedies (chloroform, morphine, amy] nitrite, and lobelia),
and the antineuralgics, or neuralgia remedies, (morphine, anti-
pyrine, menthol, migrainine, etc.).

Drugs.—1. Morphine. This is the chief narcotic in operative
surgery in dogs; also, a sedative in all conditions of psychic excita-
tion; a local and general anesthetic in painful conditions, espe-
cially colic and cough; a specific antispasmodic in eclampsia of
suckling bitches, and an antidote in poisoning by atropine, hyos-
cine and strychnine. The dose of morphine sulphas, subcuta-
neously, for colic in horses is 0.3-0.6, grs. iv to ix; as a narcotic in
dogs, 0.02-0.15, grs. 14 to ij. Opium was formerly used instead of
morphine. The treatment of colic in horses with large doses of
tincture of opium (250, 3viij) did not prove satisfactory in the
Berlin clinic. [American veterinarians have found cannabis
indica of more value than opium in controlling pain in colic in
horses. The fluidextractum cannabis indice is given by the mouth
in doses of 15, 3ss, repeated every half hour, or in single doses of
4, 3i, intravenously.] Several derivatives of opium and mor-
phine: codeine, heroin, dionine, peronine, etc., are recommended
as hypnotics and sedatives.

2. Potassii bromidum. Potassium bromide is a_ specific
against epilepsy, epileptiform convulsions, tetanus, strychnine
poisoning and eclampsia; sedative in all conditions of excitation
of the brain, in nymphomania, cough and palpitation of the
heart. Single doses for horses and cattle, 20-100, 3v to 5iij;
sheep and swine, 2-5, grs. xxx to 31; dogs, 0.25-2, grs. iij to xxx;
cats, 0.25-0.5, grs. iij to vij; fowl, 0.1-0.2, grs. iss to iij.

3. Chloroformum. A valuable narcotic in operations on horses;

100 GENERAL THERAPEUTICS FOR VETERINARIANS

antispasmodic in eclampsia, tetanus, strychnine poisoning, and
prolapse of the uterus and rectum; local anesthetic. Dose by
inhalation for horses, 50-150, Jiss to 3v. Ethyl bromide is also
recommended for inhalation narcosis.

4. Chloralum hydratum. Chloral hydrate. A valuable nar-
cotic in operations on horses; given before casting in the form of
clysters (75-125, Zijss to 3jv, in warm, mucilaginous fluid).
Hypnotic and sedative in all conditions of psychic excitation and
painful affections. Specific antidote against strychnine tetanus;
antispasmodic in tetanus, eclampsia, convulsions of canine dis-
temper and straining after prolapses. Single doses for horses and
cattle, 25-50, 3vj to xij; dogs, 0.5 to 5, grs. vij to 31; sheep, goats
and swine, 2-5, 38s toi; cats and fowl, 0.25-2, grs. ii] to xxx. Chlor-
alformamidum, *acetal, *somnal, *bromal hydrate, butyl-chloral
and many other new preparations are recommended as substitutes
for chloral.

5. ther. Ether. In large doses, a narcotic for operations,
frequently in combination with chloroform. An antispasmodic
in spasmodic colic and a local anesthetic. Dose for cats as an
inhalation narcotic, 20-30, 3v to 3i. As an antispasmodic, in-
ternally, for horses and cattle, 25-50, 3 vj to xij; dogs, 2-5, 3ss to i.
Alcohol in large doses is also used as a sedative in prolapse of
the uterus and rectum. Horses and cattle receive 500~1000,
Oi to ij, of spiritus vini gallici (brandy) [or one-half to one pint
of alcohol].

6. Cocaine hydrochloridum. The most valuable local anes-
thetic, especially in the treatment of the eye; also a local anes-
thetic in operations (Schleich’s endermatic method and subcuta-
neously), and an unexcelled agent in the diagnosis of lameness in
the horse (0.2, grs. iij, subcutaneously over the nerves on the inside
and outside of the fetlock joint, etc., at the place for neurectomy).
As substitutes for cocaine, the following have been recommended:
*adrenalin, *novocaine, *anesthesin, ‘*alypin, *stovain, *pro-
pesin, *subcutin, *zycloform, *orthoform, *eucaine, *acoine,
*holocain, *nirvanin, *tropacocaine and others, but they are not
necessary in veterinary medicine.

DISEASES OF THE NERVOUS SYSTEM 101

7. Sulphonmethanum. Sulphonal. A good hypnotic for the
dog. Dose for large dogs, 2-4, 3ss to j; small dogs, 0.5-2, grs.
vij to xxx. Other hypnotics for animals are sulphonethylme-
thanum (trional), *tetronal, *veronal, *medinal, *adalin, *aceto-
phenone (hypnone), zthylis carbamas (urethane) and *amylene
hydroxide.

8. Ethereal oils. Many of these in large doses possess anti-
spasmodic powers and are for this reason used in spasmodic colic;
also used sometimes as local anesthetics. The most important
drugs containing these oils are matricaria, valeriana, mentha
piperita and asafcetida. Dose of these aromatic drugs for cattle,
50-100, Jiss to 5iij; horses, 25-50, 3vi to xij; given in infusion.
One of the ethereal oils is oleum terebinthina.

9. Acidum hydrocyanicum. Used chiefly as a sedative for the
sensory nerves of the larynx (cough). [Dose of acidum hydro-
cyanicum dilutum for horses and cattle, 1.3-4, mxx to 3i; dogs,
0.06-0.8, mi to v.] Aqua amygdale amare (bitter-almond
water), a preparation containing hydrocyanic acid, is given to
horses and cattle in doses of 10-50, 3ijss to 3iss; dogs, 0.5~3,
mvij to xlv,

3. NARCOSIS AND ANAISTHESIA

General Narcosis.—The narcotizing of animals for the purpose
of performing operations without pain may be general or local.
Different drugs are used to produce narcosis in animals of the
different species. Chloroform is in general suitable only for horses
and is not entirely without danger for these animals. The use of
chloroform on dogs, cattle, sheep, goats and cats is not recom-
mended on account of the dangerous complications it produces
(paralysis of respiration, convulsions, tympanites, vomiting and
traumatic pneumonia). Chloral hydrate is the best narcotic for
horses and is to be preferred to chloroform and morphine espe-
cially; given per os it produces narcosis very rapidly, per rectum
somewhat more slowly; the narcosis is of medium degree, but is
sufficient for most operations; chloral may also be employed for
animals of other species. Morphine is adapted for use as a general

102 GENERAL THERAPEUTICS FOR VETERINARIANS

narcotic for dogs, injected subcutaneously; less suitable for
horses; ruminants are strongly excited by morphine. Ether is used
as a narcotic for cats [in the surgical clinic at Copenhagen it is
used for cattle; it is also frequently used for dogs].

Local Anzsthesia.—The principal local anzsthetic for all
domestic animals is cocaine (ophthalmology, cutaneous injections in
the form of infiltration anesthesia, subcutaneous injection, lumbar
injection, rectal mucous membrane, nasal mucous membrane, etc.).
More frequently than for therapeutic purposes, cocaine is injected
subcutaneously in horses for diagnostic purposes (differential
diagnosis of lamenesses). The local action of cocaine is assisted,
and its toxicity is at the same time decreased, by the addition of
adrenalin (suprarenin) to the cocaine solution. The newer local
anzsthetics: novocaine, tropacocaine, holocain, acoin, eucaine B,
anesthesin, alypin, stovain, nervanin, orthoform, zycloform, pro-
pesin, etc., have, with the exception of alypin, not displaced
cocaine. Ethyl chloride has replaced ether as a local anesthetic.
Anesthesia by cold (compressed carbonic acid) is little used in
veterinary medicine.

The history of general and local anesthesia has been written by
Regenbogen (Monatshefte fiir praktische Tierheilkunde, Bd. xx,
1909).

GENERAL THERAPEUTICS OF THE DISEASES OF THE
RESPIRATORY APPARATUS

Pathology.—Of the numerous diseases of the respiratory organs,
those which are the object of veterinary treatment include nasal,
laryngeal and bronchial catarrh; the more severe forms of rhini-
tis, laryngitis, tracheitis and bronchitis; cedema of the glottis,
cedema of the lungs, roaring, active and passive hyperemia of the
lungs, the different forms of inflammation of the lungs, emphysema
of the lungs and pleuritis. More rarely parasitic diseases (lung
worm epidemics, pentastomes, cestrus larve) and tumors (nasal
cavity, larynx) are presented for treatment. On the other hand,
secondary inflammatory processes occur very frequently in the
respiratory mucous membrane in the course of infectious diseases
(strangles, contagious pneumonia, influenza, canine distemper,
malignant catarrhal fever, etc.).

Physiology.—The natural protectives of the respiratory organs
are the layer of mucus which covers the mucous membrane and
the ciliated epithelial cells of the membrane, the cilia of which
carry out by their movement any foreign bodies which may enter.
At the same time, the air passages with their extensive surface and
recesses serve to warm the air and filter out the dust. Finally,
for the forcible removal of foreign bodies and disease products
there are certain defensive reflexes (sneezing, coughing).

The pulmonary respiration, to which the cutaneous respiration
can be to a certain degree compensatory, consists of an interchange
of gases between the blood and the external air (carbon dioxide,
oxygen). This gaseous interchange is facilitated by the continual
change of air (inspiratory diaphragmatic contraction, expiratory
lung elasticity), the extensive surface of the lungs (in the horse 100
times the body surface) and the very thin diffusion membrane
(alveolar walls). In diseases of the lungs, these principal factors
of respiration are more or less interfered with (pneumonia, em-
physema).

103

104 GENERAL THERAPEUTICS FOR VETERINARIANS

The automatic respiratory centre in the medulla oblongata can
be stimulated directly and indirectly by different stimuli, espe-
cially drugs. Insufficient oxygen and excess of carbon dioxide in
the blood (anemia, venous hyperemia, muscular activity), febrile
temperature, and atropine, scopolamine and other drugs act as
direct stimulants. Indirectly, or reflexly, the respiratory centre is
stimulated by stimulation of the peripheral ends of the vagus nerve
(regulating nerve of respiration) in the lungs, the cutaneous sensory
nerves (painful trauma, inflammation, cold), the superior laryngeal
nerve (cough), the trigeminal, olfactory and other peripheral
nerves. The artificial stimulation of the respiratory centre is very
important, for example, in chloroform asphyxia (atropine, scopo-
lamine, slapping the skin in the region of the flanks, cold douches).

Therapeutic Methods.—1. In the treatment of diseases of the
organs of respiration, the most important therapeutic measure is a
provision for a supply of pure air. Good ventilation of the stable
or, when possible, keeping the patient in the open air (pasturing,
bivouac, staking) is alone sufficient to effect a cure in many cases.
This is especially true of the catarrhal and infectious diseases of
the organs of the chest. Experience in the Prussian army has in
numerous instances shown the favorable effects of bivouacking in
summer, particularly in contagious pneumonia in horses. Moist
air (warm winds) is also very healing in catarrhs of the respiratory
mucous membrane; it promotes the liquefaction of the catarrhal
secretions. In contrast with this is the drying and heat-extracting
influence of cold winds. With the air therapy should be combined
proper care of the skin (cutaneous respiration).

2. Drugs may be employed for different purposes. Of special
consideration are the so-called expectorants, 7.e., drugs which
promote the throwing off, or expectoration, of abnormal sub-
stances from the respiratory tract (see'p. 107). Also of importance
are the derivative (cathartics, diuretics and sialagogues) and the
symptomatic methods (narcotic cough remedies) of treatment,
the use of stimulants to the respiratory centre, and the astringent,
antiseptic and antiparasitic methods (catarrhs, infectious dis-
eases, lung worm epidemics).

DISEASES OF THE RESPIRATORY APPARATUS 105

3. The inhalation method (steam, medicinal solutions, powders,
gas) has for its purpose the local treatment of the diseased respi-
ratory mucous membrane. It has fallen into disuse because recent
experiments have shown that vapors, when inhaled with the usual
inhalation apparatus, do not reach the alveoli of the lungs but are
held back by the nasal septum, the posterior wall of the throat,
the epiglottis and the vocal cords. With the very complicated
respiratory apparatuses (Bulling’s, Siegle’s, Wassmuth’s and
Schenk’s) used in human medicine, by which the medicament is
divided into a very fine spray, the vapor only reaches the alveoli
when it is aspirated through the mouth and does not arrive in that
part of the respiratory tract when inhaled through the nose. On
account of their complicated structure and cost, these apparatuses
are of no practical value in veterinary medicine. Inhalations of
oxygen (contagious pneumonia of horses) have not proven of
value in the treatment of animals. Chloroform and ether are
given by inhalation for their general effects.

4. The hydropathic method and the method of cutaneous irri-
tation are very effective in different ways. The stimulant effect
upon the cutaneous respiration, the reflex stimulant action upon
the respiratory centre, the derivative effect upon pulmonary
inflammation and pleuritis, and the anodyne action (cough) and
antipyretic effect of the Priessnitz dressing and rubefacients or
vesicants (oil of mustard in alcohol applied to the chest walls)
are especially worthy of mention.

5. The operative method includes phlebotomy (pulmonary
congestion), tracheotomy (inspiratory dyspnoea in consequence of
nasal, pharyngeal and laryngeal stenosis), thoracocentesis (hydro-
thorax, empyema) and extirpation and cauterization of neoplasms
in the nasal cavities and larnyx.

6. The prophylactic method aims to prevent diseases of the
respiratory organs by increasing the resistance of the skin and
respiratory mucous membranes to the influence of cold, which in
many cases is the single cause of the disease (exercise and work,
accustoming to cold temperatures, pasturing). With horses, it is
especially important to avoid decreasing the resistance of the skin

106 GENERAL THERAPEUTICS FOR VETERINARIANS

by blanketing in the stable. Hot-house breeding has the effect of
making the breed too refined (predisposition to tuberculosis and
other lung diseases). Finally, isolation and veterinary police
control are of great prophylactic importance in dealing with the
infectious diseases.

Inhalations in the Treatment of Domestic Animals.—In spite of numerous
experimental investigations very divergent views still prevail regarding the
therapeutic value of inhalations for man and animals, also concerning the
effectiveness of inhalation apparatus and especially on the question as to how
far and in what amount inspired medicines penetrate into the respiratory
tract. The first scientific investigations on the subject were made in 1858 by
Sales-Giron with an inhalation apparatus in which, with the assistance of a
compression pump, the medicated fluid was forced under three to four atmo-
spheres pressure through a very fine outlet against a solid plate and thus
divided into a very fine spray. In experiments with this apparatus, Pietra-
Sanda and Briau did not succeed in introducing the inhaled medicine beyond
the larynx and therefore concluded that when it was used the sprayed fluid
would not generally arrive in the deeper parts of the lungs. New apparatuses
were constructed by Siegle, Bergson, Mathieu, Bulling and Wassmuth in which
the fluids were sprayed by compressed air or were vaporized by heat. Experi-
ments with these apparatuses did not give uniform results, as will be seen
from the following:

Sanger (Minch. med. Woch., 1901) denies the possibility of sprayed fluids
penetrating to the deeper parts of the respiratory tract. Upon the basis of
experiments with the Siegle apparatus on phantom lungs, he does not believe
that any of the fine droplets of sprayed fluids reach the bronchi or pass beyond
the larynx when given by inhalation with this apparatus. Consequently, he
regards the inhalation of fluids in fine spray as of no therapeutic value. Seige
(Dissertation, 1905), on the other hand, concluded from physical investiga-
tions with the Bergson-Siegle apparatus that the inhalation-stream can pene-
trate to the deeper parts of the lungs (no experiments were made upon animals),
Emmerich (Miinch. med. Woch., 1901) tested the apparatuses of Bulling
and Wassmuth on dogs with inhalations of boric acid solution and brine and
found the boric acid in the deeper parts of the respiratory tract (margins of
the lungs) after the dogs were destroyed; he is of the opinion that nothing
reaches the alveoli when the ordinary inhalation apparatus is used and that
the medicament reaches these parts only when it is administered in the form of a
fine spray with a specially constructed apparatus. Afterinhalations of gentian
violet solution with Bulling’s apparatus, von Schrétter (Minch. med. Woch.,
1903) found the pigment in the smallest bronchi and in the alveoli; he regards
the newer apparatuses very favorably.

DISEASES OF THE RESPIRATORY APPARATUS 107

Péschel (Dissertation, 1905) made a very extensive investigation of the
subject of inhalation, using different apparatuses (ordinary spray apparatus,
apparatuses of Schenk and Bulling) on dogs, rabbits, chickens and pigeons,
and reached the following conclusions: Vapors and gases penetrate to the
deepest sections of the respiratory apparatus. When powders are inhaled
through the nose the greater part is precipitated in the nasal cavities; when
inhaled through the mouth they reach the deepest parts of the respiratory
apparatus. Fluids in fine spray, when given by inhalation through the nose
with Bulling’s or with the ordinary apparatus, do not enter the nasal cavities
but are precipitated in the nostrils; when inhaled through the mouth with
the ordinary apparatus they penetrate to the pharynx and larynx and the
upper fourth of the trachea, while with Bulling’s apparatus they reach the
lower third of the trachea. Consequently, the inhalation of fluids in fine spray
is indicated only in diseases of the cesophagus, larynx and trachea. The
investigations of Freund (Berl. tierarztl. Woch., 1907) on horses and dogs
with the inhalation apparatuses of Siegle, Bulling and Wassmuth have also
furnished proof that when coarsely sprayed solutions are inhaled through the
nose they are precipitated just within the nostrils, while fluids in fine spray
reach only the pharyngeal cavity and at times the upper part of the trachea.
In dogs, fluids in fine spray, when inhaled through the mouth, penetrate to
the large and small bronchi but never to the alveoli. Kaestle (Zeitschr. fir
physik. u. diatet. Therapie, 1907-1908) attributes the conflicting views to
differences in the arrangement of the experiments. With the new apparatuses,
he has succeeded at every attempt in introducing finely sprayed fluids into
respiring lungs down to the bronchi and probably also into the alveoli,

EXPECTORANTS

Synonyms: Promoters of expectoration, chest remedies, mucus-dissolv-
ing remedies, cough remedies, pneumatics, bechics, sternutatorics, errhines,
ptarmics. .

Definition—The general term expectorants is applied to a
group of drugs which possess the property of promoting the expec-
toration of disease products from the respiratory apparatus (ex-
pectore). These products are usually mucus, masses of catarrhal
purulent and croupous exudates, croupous membranes, pus,
blood, dead lung tissue, foreign bodies and parasites, which may be
located in the lungs, bronchi, trachea or larynx. More rarely,
snuff or other substances that cause sneezing (sternutatorics,
errhines) are used to empty the nasal cavities.

108 GENERAL THERAPEUTICS FOR VETERINARIANS

Action.—To understand the action of expectorants, it must be
remembered that the body is provided with certain protective
arrangements by which it is possible for foreign bodies entering
the air passages to be removed without the assistance of medi-
cines. These physiological expectorants are cough, the outward-
directed movement of the cilia of the epithelial cells and, some-
times, sneezing. As a result of catarrhal swelling of the mucous
membrane or the deposit of thick, viscid mucus and masses of
exudate, the activity of the ciliated epithelium is reduced or sup-
pressed. The same effect is produced when the cilia are involved
by excessive catarrhal desquamation, inflammatory infiltration
or ulceration, and also when they are paralyzed by the products
resulting from the decomposition of the retained bronchial con-
tents (fatty acids). Cough, also an important natural healing
force, is sometimes suppressed or abolished by general bodily
weakness or by paralytic conditions of the sensory nerves of the
mucous membrane (necrosis of the lungs, severe laryngitis).
Cough and the movement of the cilia can both be artificially
stimulated by certain expectorant drugs. These, however, are
not the only methods of action of expectorants; there are several
others. In general, the methods of action of the expectorants are
as follows:

1. Stimulation of the ciliated epithelium. The principal reme-
dies are ammonium chloride and other ammoniacal preparations:
ammonium carbonate, ammonia water and aromatic spirit of
ammonia. Most of the stimulant expectorants also increase the
activity of the cilia.

2. Stimulant (cough-producing) expectorants. These stimu-
late either the peripheral sensory nerves of the mucous membrane
or the respiratory centre. They include tar, creosote, turpentine
oil, camphor, benzoin, balsam of Peru, emetine, ipecac, senega and
quillaja. Turpentine oil at the same time decreases the secretions
of the respiratory mucous membrane and suppresses the abnormal
secretion of mucus.

3. Increase of the gland secretions dissolves mucus and
thereby assists expectoration. Gland secretions are increased by

DISEASES OF THE RESPIRATORY APPARATUS 109

the following drugs: apomorphine, [terpin hydrate], pilocarpine,
arecoline, the antimony salts, sulphur, the alkalies and numerous
aromatics.

4. Liquefaction of mucus, chemically or mechanically, is
brought about by all of the alkalies and ammoniacal preparations;
also by sweet and mucilaginous substances and water (inhalation).

5. The following act as antiseptics or as antiparasitics in putrid
decomposition of the contents of the bronchi and bronchiectases,
and when bacteria or parasites are present (tuberculous bron-
chitis, canine distemper, strangles, strongylus, syngamus trachealis) :
creolin, creosote, tar and turpentine oil.

6. A narcotic effect (allaying cough, bechics) is exerted upon
the irritated respiratory mucous membrane by morphine, codeine,
heroin, hydrocyanic acid, potassium bromide and other narcotics;
also by mucilaginous and sweet substances.

7. The emetics operate as expectorants in a purely mechanical
way (see p. 35).

Uses.—The expectorants are the most important drugs in the
treatment of the different diseases of the respiratory apparatus.
They are prescribed in bronchitis, tracheitis, laryngitis, catarrhal
and croupous pneumonia, bronchiectases, cavities in the lungs,
pulmonary gangrene, croupous laryngitis, tracheitis and bronchitis,
mycotic and verminous pneumonia and all infectious bronchial
and pulmonary diseases; also to remove blood, pus, dust and other
foreign bodies from the air passages. The errhines (sternutatorics)
are used in diseases of the nasal cavity, especially in cestrus larve
disease of sheep. In dry catarrhs, and also when viscid, sticky,
inflammatory products are present (dry rales), the gland stimu-
lants and the mucus-liquefying expectorants are generally pre-
scribed, while the stimulant (cough-producing) expectorants and
ciliary stimulants are employed when large collections of fluid
disease products are present in the air passages (moist rales).

Drugs.—1. Ammonii chloridum. Ammonium chloride is used
as an expectorant in the later stages of bronchial catarrh, ca-
tarrhal and croupous pneumonia, canine distemper, strangles,
etc.; stimulates the movement of the cilia, liquefies the mucus

110 GENERAL THERAPEUTICS FOR VETERINARIANS

and increases the secretion of the glands. Dose for cattle, 10-25,
3ijss to vj; horses, 8-15, 3ij to 3ss; sheep, goats and swine, 1-2,
grs. xv to xxx; dogs, 0.2-1, grs. iij to xv; cats, 0.1-0.3, grs. iss to iv;
fowl, 0.05-0.2, grs. 34 to iij.

2. Apomorphinz hydrochloridum. Apomorphine is a superior
expectorant for the liquefaction of viscid masses of mucus in
bronchial catarrh, catarrhal pneumonia, canine distemper, etc.
Dose internally for dogs, 0.001-0.003, gr. 1/70 to 1/25 (up to 0.03,
gr. 1/3, per day) ; horses, 0.02-0.05, gr. 14 to 34.

3. Ipecacuanha. Ipecac. A good expectorant for small ani-
mals in catarrhal pneumonia, bronchitis and canine distemper.
Dose for dogs, 0.01-0.05, gr. 1/8 to 34. Dose of pulvis ipecac-
uanhz et opii (Dover’s powder), 0.5-2, grs. vij to xxx.

4, Senega and Quillaja. Stimulant expectorants in asthenic
bronchitis and catarrhal pneumonia. Dose for dogs in infusion,
0.5-1.5, grs. vij to xxij; sheep, goats and swine, 1-2, grs. xv to xxx;
cats, 0.2-0.5, grs. iij to vij.

[5. Terpini hydras. Terpin hydrate. In small doses, in-
creases the secretions of the bronchial mucous membrane; large
doses inhibit the secretions. Dose for the dog, 0.1-0.5, grs.
jss to vij.]

6. Antimonii et potassii tartras. Tartar emetic. An expec-
torant for vigorous animals in bronchial catarrh and broncho-
pneumonia. Doses for cattle, 2-5, 3ss to 31; horses, 0.5-2, grs.
vij to xxx; sheep, goats and swine, 0.1-0.2, gers. iss to iij; dogs,
0.01-0.05, gr. 1/8 to 34; cats, 0.005-0.01, gr. 3/40 to 1/8. [Dose
of vinum antimonii for dogs, 5 to 10 drops; cats, one-half.]

7. *Antimonium sulphuratum, Kermes mineral. *Anti-
monii sulphidum, black sulphide of antimony. Expectorants in
bronchitis, canine distemper and strangles. Doses for horses
and cattle, 10-25, Jijss to vj; sheep and swine, 1-2, grs. xv to xxx;
dogs, 0.05-0.5, grs. 34 to vij.

8. Sulphur lotum, sulphur precipitatum, sulphur sublimatum.
Sulphur. An old expectorant in chronic catarrh. Dose for
horses, 2-5, 3ss to i.

9. Sodii chloridum, sodii bicarbonas, sodii sulphas, *sal Caro-

DISEASES OF THE RESPIRATORY APPARATUS 111

linum factitium N.F. (artificial Carlsbad salts). Mucus-dis-
solving alkalies; used in bronchial catarrhs and in catarrhal and
croupous pneumonia. Dose for cattle, 50-100, 3iss to iij; horses,
25-50, 3vj to Jiss; sheep and goats, 2-5, 3ss to i; dogs, 1-2, grs.
xv to xxx.

10. Anisum, foeniculum, carum, *juniperus and other aro-
matics. Good expectorants in mild bronchitis. Dose for cattle,
25-50, 3 vj to Jiss; horses, 10-25, 3ijss to vj.

11. Oleum terebinthine, pix liquida, creosotum, *creolin,
balsamum peruvianum, benzoinum, camphora and terebinthina.
Stimulant expectorants, and at the same time disinfectant, in
chronie bronchitis, bronchiectasis and pulmonary gangrene.
‘ Dose for horses and cattle, 10-25, Zijss to vj; dogs, 0.1-1, grs.
iss to xv.

12. Glycyrrhiza and extractum glycyrrhize, saccharum and
syrupus. Mild stimulant ,and solvent expectorants. Dose, ad
libitum.

. 13. Morphine sulphas. Morphinesulphate. A specific cough
remedy for dogs. Dose, 0.01-0.05, gr. 1/8 to 34; usually
combined with hydrocyanic acid in the form of aqua amygdalz
amarz. Dose of the latter for dogs, 0.5-3, mvij toxlv. Codeinz
phosphas or codeinz sulphas is still better than morphine. Dose,
three times that of morphine.

GENERAL THERAPEUTICS OF THE DISEASES OF THE
URINARY ORGANS

Pathology.—Among the diseases of the urinary organs, those
of the kidneys are rather rare in the domestic animals, which is
entirely contrary to the relation of these diseases to man. Ex-
cluding pyelonephritis, which occurs frequently in cattle but is
scarcely accessible to treatment, the only condition affecting the
kidneys of practical importance in veterinary therapeutics is
nephritis, parenchymatous and interstitial. The latter especially,
* which develops into contracted kidneys, is at times the object of
treatment in horses and dogs. Diseases of the bladder are much
more frequent in the domestic animals. In dogs, simple catarrh
of the bladder is most commonly met with, while purulent and
hemorrhagic cystitis are the forms of inflammation usually pre-
sented in horses and cattle. Cystic calculi and paralysis of the
bladder occur frequently in all species. On the other hand, tumors
occur only in isolated cases.

Physiology.—The function of the kidneys is the secretion of
urine. Different parts of this work are performed by certain parts
of the kidneys. The water and the inorganic salts are secreted
by the glomeruli; the proper constituents of the urine, especially
the urea and uric acid, are secreted by the epithelial cells of the
convoluted tubules. The action of the latter cells is an active,
specific secretion, while in the glomeruli a purely mechanical filtra-
tion process is associated with the action of the epithelial cells.
In addition to the water of the urine, bacteria and blood also pass
through the walls of the glomeruli in healthy and diseased kidneys.
The quantity of urine excreted increases with the rise of blood-pres-
sure and decreases with the fall of the same. Direct or reflex
stimulation of the splanchnic causes contraction of the renal
blood-vessels and increase of blood-pressure, and a consequent
increase of the secretion of urine. The reaction of the urine of
herbivora is alkaline (calcium carbonate) ; of carnivora, acid (phos-

112 ,

DISEASES OF THE URINARY ORGANS 113

phates). The bladder is provided with a double set of muscles
(sphincter vesicze, detrusor uring) ; the motor centre for the bladder
is in the lumbar cord.

Therapeutic Methods.—Different methods can be used in the
treatment of diseases of the kidneys.

1. Acting upon the secreting epithelium may be regarded as the
direct method. It consists in the stimulation of the depressed
urinary secretion and is essentially medical. See the diuretics
(caffeine, theobromine, theocine, diuretin, agurin).

2. Acting upon the renal circulation (blood-vessels, blood,
blood-pressure, nervous system) has also the effect, but indirectly,
of increasing the secretion or filtration of urine (digitalis, water,
milk, alkalies, reflex cutaneous irritation).

3. The derivative method relieves the diseased ieidneys by
increasing the secretions of the intestinal (cathartics), cutaneous
(diaphoretics, baths) and salivary (arecoline, pilocarpine) glands.

4. A disinfectant action can probably be exerted upon the kid-
neys and also upon the bladder by the use of salicylic acid, tannic
acid, uva ursi, etc. This is denied by some.

5. Abnormality in reaction can be removed by the administra-
tion of alkalies and acids.

6. Rest of the diseased renal tissues is obtained by bodily quiet
and a certain diet (food poor in albumin and producing little urea;
milk especially).

7. The operative method includes the removal of cystic cal-
culi and local treatment of the bladder; also the excision of dis-
eased kidneys.

DIURETICS
Synonyms: Hydragogues, litholytics, lithothryptics.

' Actions.—The normal secretion of urine in the kidneys (phys-
iological diuresis) occurs as a result of the codperation of various
factors, of which the most important are the secretory activity of
the renal epithelium, the blood-pressure, the blood content of the
glomeval: and the diffusion activity of the renal parenchyma.

114 GENERAL THERAPEUTICS FOR VETERINARIANS

In normal conditions, all these factors are operating at nearly their
full functional capacity and for this reason, when diuretics are
administered to healthy animals, the secretion of urine is either not
increased at all, or only slightly or temporarily. On the other
hand, in diseases in which there is decreased activity of the gland
cells, low blood-pressure, poor blood supply or blood stasis in the
kidneys, or depression of the diffusion activity of the renal tissues,
the depressed secretion of urine may be increased by numerous
drugs. The diuretics operate in different ways, corresponding to
the complicated processes which are concerned in physiological
diuresis. According to their mode of action, the diuretics may be
divided into the following groups:

1. Specific stimulants for the secreting renal epithelium: caf-
feine, theobromine, theocine, diuretin, agurin, calomel, salicylic
acid, milk sugar and alkalies. The action of these diuretics is
independent of cardiac activity; they increase the secretion of
urine even when the blood-pressure is considerably depressed.

2. Circulatory diuretics: digitalis and strophanthus. In con-
sequence of the increase of blood-pressure in the glomeruli of the
kidneys produced by these drugs there occurs, in a purely physical
manner, an increased filtration of blood-serum through the walls of
the glomeruli into the excretory uriniferous tubules. This group
of diuretics is most effective in diseases of the heart accompanied by
low blood-pressure.

3. Stimulant diuretics (acrics) produce an active hyperemia,
and in consequence an increased secretion of urine. This group
includes alcohol and a series of ethereal oils, resins and balsams:
turpentine oil, turpentine, juniper berries, oil of juniper, balsam of
Peru, balsam of copaiba, petroselinum (parsley), ononis, ligus-
ticum, mustard, black pepper, capsicum, colchicum, cantharides
and alcohol.

4. Saline diuretics accelerate diffusion in the kidneys, in-
crease the water content of the blood and, at the same time, mildly
stimulate the renal epithelium. They include: sodium chlo-
ride, sodium and potassium bicarbonate, sodium and potassium
nitrate, sodium and potassium acetate, potassium chlorate,

DISEASES OF THE URINARY ORGANS 115

potassium tartrate and bitartrate, sodium salicylate and lithium
carbonate. ;

5. Mechanical diuretics, which promote the secretion of urine by
flushing out the renal tubules, are: water, milk, and also the
organic acids, acetic, citric, tartaric, etc., which by their oxidation
increase the water content of the blood.

Uses.—The diuretics are employed therapeutically for many
different purposes, the principal of which are the following:

/ 1. The resorption of fluid collections in the body in general
dropsy, ascites, hydrothorax, hydropericardium, anasarca, cedemas
and hydremia; also fluid inflammatory exudates occurring in the
course of pleuritis, peritonitis, serous polyarthritis, pneumonia and
acute and chronic hydrocephalus. The diuretics employed in
these diseases, which bring about a decrease of the fluids of the
body, especially the blood, and thus cause a reabsorption of fluid
transudates and exudates, were formerly called hydragogue
diuretics.

( 2. Flushing the renal tubules, the pelvis of the kidneys and
the bladder in nephritis, pyelitis and cystitis. In the course of
parenchymatous (catarrhal) nephritis, oliguria or even anuria
may result from the obstruction of the straight and convoluted
efferent renal tubules with urinary casts, desquamated epithelium,
fibrinous exudate or blood. These conditions may be overcome
by washing the obstructions out of the kidneys. Collections of
pus and masses of exudate in the pelvis of the kidneys-and in the
bladder can be removed in the same manner. Irritant diuretics,
however, are to be avoided.

3. The derivation of blood to the kidneys when distant organs
are hyperemic or inflamed (brain, lungs, pleura, intestines, liver).

4, Solution of urinary sediments in the pelves of the kidneys
and in the bladder. For this purpose, the alkalies are used.
They neutralize the uric acid and form urates of sodium, potas-
sium, calcium and lithium, which are soluble in water.

5. The removal of bacteria, toxins, poisons and metabolic
products (uric acid in gout) from the body.

6. To relieve the heart in cardiac diseases. By increasing the

116 GENERAL THERAPEUTICS FOR VETERINARIANS

elimination of water from the blood, the diuretics reduce the vol-
ume of the latter and thus diminish the work of the heart.

Drugs.—1. Caffeina. A specific diuretic in all dropsical con-
ditions; to be preferred to digitalis in dropsies not of cardiac origin
(cirrhosis of the liver, contracted kidneys, hydremia), in which
digitalis is ineffective. Dose of *caffeinze sodio-salicylas N.F.,
subcutaneously, for horses and cattle, 5-10, 3i to ijss; large dogs,
0.5-2, grs. vij to xxx; small dogs, grs. iss to vij. It has no cumu-
lative effect; can therefore be given for a long time. *Theo-
bromine and *theocine have the same action.

2. *Diuretin. A very good diuretic; a combination of theo-
bromine with sodium salicylate. Because of the close relationship of
theobromine to caffeine, it has the same action and uses as caffeine.
Large dogs may be given up to 5, 3i, inone day. *Agurin, a com-
bination of theobromine with sodium acetate, has the same action.

3. Hydrargyri chloridum mite. Calomel. A good diuretic
in cardiac dropsy; to be preferred to digitalis in many cases. Dose
for dogs of medium size, 0.1, grs. iss, three times daily.

4, Acidum salicylicum, sodii salicylas. Salicylic acid,
sodium salicylate. Diuretic, especially in muscular and articular
rheumatism; also probably disinfectant for the kidneys, renal
pelvis and bladder. Dose for horses and cattle, 5-10, 3i to ijss,
two to five times daily; dogs, 0.1-0.5, grs. iss to vij (small doses).

5. Digitalis. The oldest and a very valuable diuretic in car-
diac dropsy. Dose for horses and cattle, 2-5, 3ss to i; dogs,
0.1-0.3, grs. iss to iv. Scilla has the same action.

6. Strophanthus. A powerful diuretic in cardiac dropsy; acts
more promptly than digitalis. Dose of tinctura strophanthi for
horses, 10-25, 3ijss to vj; dogs, 10-25 drops.

7. Oleum terebinthine. Turpentine oil. A strong and cheap
diuretic for dropsy of all kinds. Dose for horses and cattle, 10-25,
3ijss to vj; sheep and goats, 2-5, 3ss to j; dogs, 0.2-0.5, myiij to vij.

8. *Juniperus. Juniper. A good, mild diuretic in mechanical
as well as inflammatory dropsies. Dose for cattle, 50-100, 3 iss to
5 iij; horses, 25-50, 3-vj to xij; sheep, goats and swine, 2-5, 3ss to j.
Dose of oleum juniperi, same as oil of turpentine.

GENERAL THERAPEUTICS OF THE GLANDS 117

9. Balsamum peruvianum. Balsam of Peru. A good diuretic
and a disinfectant for the kidneys and bladder. Dose for horses
and cattle, 10-25, Jijss to vj; sheep, goats and swine, 1-2, grs.
xv to xxx; dogs, 0.1-1, grs. iss to xv.

10. Diuretic species. Diuretic teas of *ononis, *ligusticum
and *juniperus; used in dropsies in dogs and eats. Infusions of
25 parts of the drug in 300of water are given in tablespoonful doses.

11. Sinapis alba, sinapis nigra. Mustard. Mild diuretics.
Dose for cattle, 50-100, 3 iss to iij; horses, 20-50, 3v to xij; dogs,
0.2-2, grs. iij to xxx.

12. Capsicum, Piper, Cubeba. Stimulant diuretics; use cau-
tiously; contraindicated in inflammation of the kidneys. Dose for
cattle, 10-25, Zijss to vj; horses, 5-15, 3i to iv; swine, ea grs.
xv to xxx; dogs, 0.2-0.5, grs. iij to vij.

13. Potassii nitras. Potassium nitrate. A good saline diu-
retic in kidney and bladder affections, also in general dropsy. Dose
for cattle, 10-25, Zijss to vj]; horses, 8-15, 3ij to iv; swine, 1-2, grs.
xv to xxx; dogs, 0.2-0.5, grs. ij to vij.

14. Potassii chloras. Potassium chlorate. A disinfectant
diuretic in catarrh of the bladder. Dose for horses and cattle,
5-10, 3i to ijss; sheep and goats, 1-2, grs. xv to xxx; dogs, 0.1-1,
grs. iss to xv.

15. Potassii acetas, sodii acetas. Potassium acetate, sodium
acetate. Uric acid solvents. [Dose for horses and cattle, 15-30
5 ss to i; dogs, 0.3 to 1.3, grs. v to xx.]

16. Sodii chloridum, sodii bicarbonas, potassii bitartras.
Sodium chloride, sodium bicarbonate, potassium bitartrate. Mild
diuretics, which render the urine alkaline and neutralize acidity.
Dose for horses and cattle, 25-100, 3 vj to 3iij; sheep, goats and
swine, 2-5, 3ss to j; dogs, 0.5-2, grs. vij to xxx.

17. Sodii boras. Borax. A mild diuretic, also disinfectant to
the bladder and kidneys. Dose for horses and cattle, 10-25,
Zijss to vj; dogs, 1-2, grs. xv to xxx.

18. Saccharum lactis. Sugar of milk. A modern diuretic in
cardiac dropsy. Dose for dogs, 25-100, 3vj to Jiij, daily. Milk
diet.

GENERAL THERAPEUTICS OF THE DISEASES OF THE
GENITAL ORGANS

General Considerations.—Of the diseases of the genital organs,
the most important are the affections of the uterus and udder.
The diseased conditions to which the uterus is liable, especially
before, during and after parturition (dystocias, parturient. paresis,
puerperal septicemia, catarrh of the uterus), are so numerous and
so widely different that it is difficult to outline general principles for
their treatment. This is also true of the diverse conditions which
affect the udder. There are, however, several groups of medicines
which are usually given special consideration in the general thera-
peutics of the diseases of the genital organs. These are the
ecbolics (uterines), the aphrodisiacs, and the galactagogues.

With regard to the physiology of the uterus, it is to be observed
in connection with the action of the ecbolics that the important
nerve centre of the uterus (principal centre, centre of parturition) is
situated in the lumbar cord at the first and second lumbar vertebre.
The uterus may be stimulated directly and indirectly, centrally
and peripherally, by mechanical, chemical, thermic and electrical
stimuli. Mechanical stimuli include pressure and blows from with-
out, introduction of foreign bodies into the uterus (the hand, sounds,
instruments, injected fluids, air), escape of the amniotic fluid, death
of the foetus, specific uterine catarrh in infectious abortion, hyper-
emia and anemia. Chemical stimuli are the specific uterine drugs
(ergot, hydrastis, gossypium and amenyl), and an excess of carbon
dioxide in the blood. The thermic stimuli are cold (e.g., reflexly
from the stomach) and heat (fever, hot vaginal injections). Con-
tractions of the uterus may also be produced by electrical stimula-
tion of the centres, the sacral plexus and the ischiatic nerve.

Concérning the milk secretion, it is to be noted that the gland
cells actively participate in the formation of the specific milk con-
stituents and that the process is not exclusively one of transuda-
tion, desquamation of epithelial cells and fatty metamorphosis.

The casein and the milk sugar are formed entirely in the gland
118

DISEASES OF THE GENITAL ORGANS 119

cells; the fat is in part derived from the blood. The milk secre-
tion is under the influence of secretory and vasomotor nerves.
The quantity and composition are influenced by numerous other
factors, as feed, breed, age, lactation period, time of day, work, and
exercise and individuality. On this account, the chemical com-
position is very variable. The average water content is 87.5 per
cent.; the average per cent. of dry matter is 12.5, including 3.3 per
cent. fat, 4 per cent. protein, 4.5 per cent. sugar and 0.7 per cent.
salts. The reaction is amphoteric, due to the presence of alkaline
and acid salts. Curdling of milk may result from different causes
(rennet ferment, lactic acid ferment, acids, mastitis).

1. ECBOLICS. ABORTIVES

Synonyms: Uterines, ectrotics, amblotics, pellentics, odinegogues, par-
turefacients, emmenagogues, abortive medicines, expelling, foetus-expelling
medicines.

Actions and Uses.—Drugs exerting a specific action upon the
uterus produce either a contraction or hyperemia of that organ,
The result of the action differs with the condition of the uterus. If
the uterus is in the act of contracting upon the foetus to expel it—
i.e.,if the period of pregnancy has terminated and labor has begun,
—then the ecbolics increase the force of the contractions and
hasten the expulsion of the foetus. This is the only purpose for
which they are of value in veterinary therapeutics. They are
therefore administered not before but (1) during parturition, after
the beginning of labor pains, to stimulate insufficient uterine con-
tractions in difficult parturition, also in relaxation of the muscles
of the uterus, and (2) after parturition, to produce contraction of
the relaxed puerperal uterus and thereby cause the more prompt
expulsion of the foetal membranes.

The ecbolics will also cause abortion when the full term of
pregnancy is not completed. The abortion results either from
the contraction of the muscles of the uterus, or from pronounced
hyperemia of the uterus with hemorrhage into the foetal mem-
branes and into the mucous membrane of the uterus. But the
abortive action of drugs is always accompanied by other effects

120 GENERAL THERAPEUTICS FOR VETERINARIANS

dangerous to life and for this reason they are no longer used thera-
peutically to bring about abortion. Instead, mechanical methods
are employed exclusively to produce an artificial abortion or pre-
mature birth: forcible dilation of the cervix, puncture of the foetal
membranes, insertion of an elastic bougie between the uterus and
the membranes, injections between the uterus and fcetus, hot
uterine douches, tamponading the vagina, etc. ‘

The ecbolics also act upon the empty uterus, causing contrac-
tion of the uterus in metritis and checking uterine hemorrhage.
Neoplasms of the uterus (myomas) are favorably influenced.
Promotion of menstruation by the so-called emmenagogues is only
of value in human practice in the treatment of the different men-
struation anomalies of women.

Drugs.—1. Ergota. Ergot. An excellent ecbolic in difficult
parturition and in retention of the foetal membranes; also a styptic
in uterine hemorrhage, and a specific against myomas of the uterus.
Dose for cattle, 25-50, 3.vj to xij; horses, 10-25, Jijss to vj; sheep,
goats and swine, 2-5, 3ss to j; dogs, 0.5-2, grs. vij to xxx; cats,
0.2-1, grs. iij to xv; fowl (retention of eggs), 0.2-0.5, grs. iij to vij.

2. Hydrastis. An ecbolic for weak labor and uterine hemor-
rhages. [Dose of fluidextractum hydrastis for horses and cows, 8-30,
31j to 31; sheep and swine, 4-8, 31 to ij; dogs, 0.3-4, mv to 3i.]

2. DRUGS THAT STIMULATE THE SEXUAL IMPULSE
APHRODISIACS

Synonym: Erotics.

Actions and Uses.—Artificial stimulation of the sexual impulse
is required in phlegmatic, fat or diseased males and females when
the sexual desire is below normal. Relaxation and weakening of
the body as a result of irrational feeding or stabling, previously
existing disease, overexertion, breeding too young, breeding too
frequently, masturbation, and the different diseases of the genital
apparatus are the usual causes.

The action of aphrodisiacs is exerted in different ways. Liberal
feeding of foods rich in nitrogen and the iron preparations operate
in a purely dietetic way; fat and phlegmatic animals, on the con-

DISEASES OF THE GENITAL ORGANS 121

trary, require the withdrawal of food, cathartics and metabolic
stimulants. The specific erotics produce a hyperemia, blood
infiltration, and increased turgescence, and, in consequence, a
highly stimulated condition of the ovaries and testicles and the
vaginal or urethral mucous membranes. Yohimbin, cantharides,
the acrid spices, alcohol, santonin, the ethereal oils, resins and
balsams operate in this way.

Drugs.—* Yohimbin. A specific against breeding-impotence
in bulls and stallions and decreased sexual impulse and sterility in
cows and mares. Only chemically pure preparations should be
used, the so-called veterinary preparations being avoided; very
expensive (114 grains, 75 cents). Dose per os for horses and
cattle, 0.05, gr. 34; dogs, 0.001-0.002, gr. 1/70 to 1/40; subcu-
taneously for horses and cattle, 0.02-0.05, gr. 14 to 34; sheep, goats
and swine, 0.005-0.01, gr. 3/40 to 1/8; dogs and chickens, 0.0005-
0.001, gr. 1/140 to 1/70; canary birds, 0.0001, gr. 1/660.

2. Cantharis. Cantharides. An aphrodisiac for cows in which
cestrum is abnormally weak; administer cautiously. Dose for cows,
2-5, 3ss toi, per day; horses, 0.5-2, grs. vij to xxx. Doseoftinctura
cantharidis for cows, 20, 3v; horses, 10, 3ijss; dogs, drop doses.

3. Piper, Capsicum, Cubeba, Zingiber Santonica, etc. Dos
for cattle, 10-25, 3ijss to vj; horses, 5-15, 3i to iij.

4. Alcohol. In small repeated doses; horses and cattle, 20-50,
3v to xij, (20-150, 3v to 3v, spiritus vini gallici; 14 to 1 liter,
Oi to ij, vinum album).

5. Santoninum. Santonin. Dose for horses and cattle, 10-25,
Jijss to vj.

*Juniperus, carum, matricaria, aloe and other drugs are also
used as erotics, but their action is uncertain.

3. DRUGS THAT DEPRESS THE SEXUAL IMPULSE
ANAPHRODISIACS
Synonyms: Antaphrodisiacs, anterotics.
Actions and Uses.—An excessive sexual impulse (nympho-

mania, satyriasis) occurs most frequently in cows (bulling) in
consequence of pathological changes in the genital organs, espe-

122 GENERAL THERAPEUTICS FOR VETERINARIANS

cially the ovaries and uterus. In stallions, the sexual desire is
increased in cryptorchids and masturbators. The action of the
anterotics consists of a soothing effect upon the nerves of the sexual
organs. All sedative neurotics are therefore anaphrodisiacs, par-
ticularly potassium bromide, chloral hydrate, and morphine. A
restricted diet and cathartics may also be prescribed in addition.
Acertain and permanent removal of abnormal sexual impulsecan be
accoroplished asarule only by operative methods (castration, crypt-
orchid operation, ovariotomy, rectal compression of ovarian cysts).

Drugs.—1l. Potassii bromidum. Potassium bromide. A very
good anaphrodisiac, especially for nymphomania in cows. Dose
for horses and cattle, 20-50 (up to 150 per day), 5v to xij (up to
3v per day); dogs, 0.25-2 (up to 10 per day), grs. iv to xxx (up to
3ijss per day); cats, 0.25-0.5 (up to 2 per day), grs. iv to vij (up
to grs. Xxx per day).

2. Chloralum hydratum. Chloral hydrate. Uses and doses
same as potassium bromide.

3. Morphine sulphas. Morphine sulphate is not always relia-
ble, especially for cattle; recommended in combination with chloral
hydrate. Dose, subcutaneously, for horses, 0.5, grs. vij; dogs,
0.02-0.1, grs. 14 to iss.

Mild laxatives, bleeding, hunger and exercise also have ante-
rotic effects.

4. DRUGS THAT INCREASE MILK SECRETION
GALACTAGOGUES

Synonyms: Lactics, galactics, stimulants to milk secretion.

Actions and Uses.—The so-called milk defects, which are due
to abnormal feeding, gastro-intestinal catarrh and other diseased
conditions, udder diseases and various external influences, are of
especial practical consideration in cattle practice. Those best
known are agalactia (absence of milk), watery milk, excessively
fat milk, premature curdling, failure of milk to ‘‘ butter,” putrid,
soapy and slimy (viscid) milk, blue, red and yellow milk.

The latter defects are due to external infection and are there-
fore to be combated with antiseptics. With reference to the

DISEASES OF THE GENITAL ORGANS 123

action of the specific galactagogues, a distinction must be made
between those which act upon the general condition and those
which act directly upon the udder. Drugs belonging to the first
category are called indirect galactagogues and those of the second
direct galactagogues. Since the greater number of the milk defects
result from digestive disturbances and general diseases, an im-
provement in the milk secretion can be brought about indirectly by
treating these diseases. The indirect galactagogues include par-
ticularly the aromatics, bitters and alkalies, which by their gastric
action promote digestion and in consequence increase the forma-
tion of the milk constituents. Cutaneous stimulation, directly
applied to the udder, stimulates the gland secretion reflexly, and is
therefore also an indirect galactagogue. It is well known that
frequent milking increases the milk production by stimulating the
secretory nerves of the gland. This is also true of electric stimula-
tion, as has been demonstrated by faradization of the udder.
Rubbing the udder with stinging nettle, as is done in many coun-
tries (goat herds in Verona), has the same effect. On the other
hand, the antimony preparations and sulphur are direct galacta-
gogues, as might be expected from their stimulant action upon the
other glands of the body. The effect of these drugs in increasing
the milk secretion is probably the result of direct action upon the
secreting cells of the udder. To what extent other galactagogues
stimulate milk secretion by increasing the blood-pressure (see the
experiment by Réhrig below) or by acting upon the secretory
nerves of the gland has not at this time been determined with cer-
tainty. But it is probable that with the secretion of milk, as
with the similar secretory processes of diuresis and diaphoresis, it
must be assumed that medicines operate in several ways to in-
crease the activity of the udder.

Experimental Investigations of the Actions of the Galacta-
gogues.—The knowledge concerning the action of medicines upon
the milk secretion, quantitatively and qualitatively, is far less com-
plete than that relating to the other secretions, e.g., diuresis. In
the first place, a distinction must be made between the popular, em-
pirical views regarding the action of certain drugs upon the secre-

124 GENERAL THERAPEUTICS FOR VETERINARIANS

tion of milk and the conclusions based upon exact pharmacological
experiments. In veterinary medicine, the following drugs have
been for a long time regarded as galactagogues: the different aro-
matics, particularly fennel, anise, caraway, juniper berries, corian-
der, dill, fine-leaved water hemlock, pimpinella, calamus, the
bitter stomachics (yarrow and gentian), sulphur, the neutral salts,
the antimony preparations (sulphurated antimony, antimony),
and others. These drugs are the chief constituents of the popular
milk powders. In human medicine, the leaves of polygala vul-
garis, galega officinalis and the castor-bean plant are recognized
as galactagogues, while iodine, belladonna, quinine and alum, to-
gether with external applications of opodeldoc, are chiefly used as
anti-galactagogues. According to Niebuhr, in many sections of
Germany oil of rosemary, a constituent of opodeldoe, is rubbed on
the udder of cows to reduce the milk secretion with good results.
Applications of oil of hemp have a similar effect. The results of
experiments with the individual galactagogues and anti-galacta-
gogues are very contradictory. The most important of these
investigations are the following:

Experiments to test the power of iodine to reduce the milk
secretion were made by Labourdette (Gazette des Hépitaux, 1856).
He found that after the administration of potassium iodide to
cows, goats and asses, the milk secretion was at first somewhat in-
creased (1/10 to 1/8), then rapidly decreased, and finally in the
course of 2 to 3 months, under the continued action of potassium
iodide, ceased entirely, the experimental animal becoming very
much emaciated. When daily doses of 3 to 6 grams of potassium
iodide were given, the milk contained up to 14 gram per liter, and
the drug could be demonstrated in the milk 12 days after the
administration of the last dose. A slight, primary increase in the
milk secretion after the administration of potassium iodide was
also observed by Lewald. Bouley (Bulletin de l’Académie, 1859)
reported a long series of experiments with potassium iodide in
which the milk was not changed quantitatively and was otherwise
in good condition, but after curdling it had a rubber-like elasticity
and plasticity. Stumpf demonstrated that 5 grams of potassium

DISEASES OF THE GENITAL ORGANS 125

iodide daily caused a considerable decrease of the milk secretion in
goats in consequence of a disturbance of the gland function. Alco-
hol (up to 100 c.c.) and alcoholic drinks (1-2 liters of beer) pro-
duced no change in the quantity of milk secreted by goats, but
increased the relative fat content. Morphine, pilocarpine and
lead salts had no effect on the quantity or quality of the milk.
Salicylic acid appeared to increase somewhat the quantity of milk
and the sugar content. Réhrig, in his experiments on goats (Vir-
chow’s Archiv., Bd. 57), observed no alteration of the milk secre-
tion even after very large doses of morphine (up to 1.2). On the
other hand, he reports a considerable acceleration in the milk
secretion after the administration of jaborandi leaves (pilocarpine),
a result which is disputed by other experimenters (Partsch, Heiden-
hain) who obtained negative results in similar experiments. After
the administration of drugs which increase blood-pressure (strych-
nine, caffeine, digitalis), Rohrig observed an increase in the quan-
tity of milk, while the amount was decreased when drugs were
given which reduce blood-pressure (potassium bromide, chloral
hydrate, etc.). According to Feser (Jahresbericht der Miinchener
Tierarzneischule, 1885, 1889 and 1890), the milk secretion of healthy
cows was slightly increased after the injection of eserine and pilo-
carpine; a greater increase occurred in his experiments with eseri-
din. Feeding experiments conducted by him, in which the milk
of these cows was fed to swine, demonstrated that milk from cows
treated with eserine could be fed to swine without any disad-
vantage whatever. Hess, Schaffer and Bondzynsky (Landw.
Jahrb. der Schweiz, 1888) tested the effect of fennel, calamus,
anise, caraway, Juniper berries and gentian upon the milk secretion
of healthy cows and goats and found that even very large doses of
these drugs had no real influence upon the quantity or quality of
the milk. The drugs mentioned were not perceptible in the milk
through any change of taste or odor. Only in the case of fennel,
the odor of the drug was observed in an alcohol-ether extract of
the milk. Fréhner’s own experiments (Monatshefte fiir prak-
tische Tierheilkunde, 1891) with sodium bicarbonate, sulphur, sul-
phurated antimony, juniper berries, atropine and pilocarpine on

126 GENERAL THERAPEUTICS FOR VETERINARIANS

six healthy cows of different breeds, namely, Dutch, Dithmarsch,
Simmenthaler, Swiss, Wilstermarsch and Shorthorn, and on two
healthy goats, were also entirely negative. Fingerling (Landw.
Versuchstat., 1907) found in his experiments with goats that odor-
ous and tasty substances increased the secretion of the milk gland,
while others do not; for instance, the addition of oil of fennel or of
sodium chloride to mixed feed increases the fat per cent. as well
as the quantity of milk, but the addition of arsenic has no effect.
According to Kronacher (Berl. Tierarztl. Woch., 1910) the milk
secretion is increased by yohimbin.

The explanation of the contradictory results of these experi-
mental investigations is perhaps to be found in the following cir-
cumstances, It is to be noted first of all that the experiments of
all of the investigators were made on healthy animals. In practice,
however, the galactagogues are not administered to healthy but to
diseased animals. As is well known, the action of a drug upon
a healthy animal is often different from its action on a diseased
animal. The failure of a drug to act on healthy animals does not
prove it to be ineffective on diseased animals. This very impor-
tant principle has often been overlooked in therapeutics. The
value of the bitters as stomachics, for example, would have to be
denied, if this principle is not accepted, because they have an indif-
_ ferent effect on normal digestion. Empiricism teaches that the
bitters possess a superior gastric action only in disturbed digestion, *
and this is confirmed by clinical experiments. An entirely similar
condition exists with regard to the antipyretics, which, as is well
known, only reduce an elevated and not the normal body temper-
ature. It should not, therefore, be assumed that the galacta-
gogues are without effect in disturbed lactation because of the nega-
tive results of experiments on healthy animals. Furthermore,
some observers have actually obtained positive results from the
administration of galactagogues to healthy animals.

Drugs.—1. *Antimonii sulphidum. Black sulphide of antimony.
A much-used galactagogue in agalactia of cows and goats. Dose
for cows, 10-25, 3ijss to vj; goats, 1-2, grs. xv to xxx.

2. Sulphur lotum, sulphur precipitatum, sulphur sublimatum.

DISEASES OF THE GENITAL ORGANS 127

Sulphur. Combined with the previous drug in milk powders.
Dose for cows, 2-5, 3ss to j; goats, 0.5-1, grs. vij to xv.

3. Anisum, foeniculum, carum, *juniperus. Empirical galacta-
gogues in different milk defects. Dose for cattle, 25-50, 3vj to
xii; goats, 2-5, 3ss to j.

4. Sodii chloridum, sodii bicarbonas. Sodium chloride,
sodium bicarbonate. Galactagogues in all milk defects, the latter
especially in premature curdling; usually combined with those
previously mentioned. Dose for cattle, 50-100, 3 iss to iij; goats,
5-10, 31 to ijss.

5. DRUGS THAT DEPRESS MILK SECRETION
ANTIGALACTAGOGUES

Synonyms: Antigalactics, lactifuges, alactics.

Actions and Uses.—An excessive production of milk occurs in
some animals, especially non-pregnant bitches in cestrum, which at
times requires therapeutic interference. A cessation of the milk
flow may be desired in cows for purely economical reasons, as when
the animal is to be fattened for the butcher. Artificial reduction
of the milk secretion also becomes necessary in mares and bitches
when lactation persists after the death or removal of their offspring.
As antigalactagogues, laxatives, potassium iodide, tannin and alum
may be tried, in addition to reducing the feed and gradually
increasing the intervals between milking and finally stopping.
Local applications of oil of rosemary or oil of hemp to the udder are
also recommended for cattle. The action in the first case is an
inhibitory effect upon the secretion and in the latter probably a
derivative effect (see p. 124).

Drug.—Potassii iodidum. Dose for horses and cattle, 5-15,
31 to iv; dogs, 0.25-0.5, grs. iv to vij.

GENERAL THERAPEUTICS OF THE GLANDS (DIA-
PHORETICS AND SIALAGOGUES)

Physiology.—The glands, especially the sweat, salivary and
- mucous glands, are, as secretory organs, of great importance in
therapeutics because their physiological activity can be artificially
increased for curative purposes. This physiological activity con-
sists in the secretion of water, and also of specific and pathological
constituents, which are eliminated from the body with the gland
secretions. The secretion is the result of an active function of
the gland cells, which is under the influence of specific secretory
nerves, and is not a mere filtration. For this reason drugs acting
specifically upon the glands (arecoline, pilocarpine) are required
to artificially stimulate the gland secretion, while drugs which only
increase the blood-pressure (digitalis) and thereby promote filtra-
tion are without effect. The gland secretions are indirectly influ-
enced, however, by the quantity and quality of the blood and its
tate of flow, and also by the dilation and contraction of the blood-
vessels (vasomotor nervous system).

The sweat glands are especially well developed in the horse.
The general sweat centre is situated in the medulla oblongata,
and there are also special centres for the anterior extremity in the
end of the cervical cord and for the posterior extremity in the
lumbar cord. The secretory fibres pass from the centres to the
sweat glands by way of the motor nerves. The secretion of sweat
can be increased by direct stimulation of the centres (increase of the
body temperature, fever, diaphoretics) or by reflex stimulation (cu-
taneous irritation, various thermic and electrical stimuli, increased
muscular activity). The most important constituents of normal
sweat in addition to water (97.5 to 99.5 per cent.) are urea, volatile
fatty acids (formic, acetic, butyric, caproic and caprylic acids) and
salts (sodium chloride, potassium chloride, sodium and potassium
phosphate, sodium and potassium sulphate and calcium, magne-

sium and iron compounds). The average amount of sweat secreted
128

GENERAL THERAPEUTICS OF THE GLANDS 129

daily by horses at work is 10 to 20 liters; this amount can be in-
creased three-fold with arecoline or pilocarpine. The salivary
glands (parotid, submaxillary, sublingual, glands of the cheeks,
lips snd gums) are connected with nerve centres in the medulla
oblongata and brain. Their peripheral secretory nerves are the
facial, sympathetic and glossopharyngeal; vasomotor and motor
nerves are also present. The secretion of saliva is increased directly
by the stimulation of the salivary centres and nerves (arecoline,
pilocarpine) and reflexly by the ingestion of food, by mechanical,
chemical, thermic and electrical stimulation of the mucous mem-
brane of the mouth and stomach; also by stimulation of thesplanch-
nic nerves. The constituents of saliva, in addition to water
(98 to 99.5 per cent.), are ptyalin, albumin, mucin and salts (so-
dium chloride, sodium carbonate, phosphates, sulphates, potas-
sium sulphocyanide). ‘The normal salivary secretion of the
horse amounts to 10 to 40 liters; by artificial stimulation with are-
coline and pilocarpine this quantity can be obtained in a few hours
(laminitis).

1. DRUGS THAT STIMULATE THE SECRETION OF SWEAT
DIAPHORETICS

Synonyms: Hidrotics, sudorifics, diapnoics.

Actions.—The drugs which stimulate the secretion of sweat
cause an increased evaporation (diapnoics) or an increase in the
amount of visible, watery sweat secreted by stimulation of either
the peripheral nerves of the sweat glands, the sweat centres in the
medulla or the secretory cells of the glands; by depression of the
inhibitory nerves, or by dilation and relaxation of the cutaneous
vessels and consequent hyperemia of the skin. Those which
operate upon the nerves or cells of the sweat glands (hidrotics)
may be designated as direct diaphoretics. To this group belong
arecoline, pilocarpine and ammonium acetate. Indirect dia-
phoretics, which first produce hyperemia of the skin and then
increased diaphoresis (sudorifies), include warm water internally
and moist heat externally. Finally, sweating is also stimulated
eetezly by emetics.

130 GENERAL THERAPEUTICS FOR VETERINARIANS

The effects of increased secretion of sweat upon the organism
are very numerous. The most important is the loss of water from
the body. This causes, like diuresis and catharsis, a resorption
of fluids contained in the tissues or body cavities. At the same
time there is a derivation of the blood from the internal organs to
the skin, with increased dissipation of heat from the latter and a
consequent fall of the internal temperature (critical sweat of
febrile diseases). The secretory activity of the kidneys is re-
lieved, the excretion of urea and other metabolic products through
the skin is increased and the body weight is reduced, while the
activity of the heart is lessened because of the decrease in the vol-
ume of the blood. Moreover, bacteria and their toxins, grape
sugar, bile pigments, drugs and poisons (mercury, lead, iodine,
bromide) are eliminated from the blood through the sweat.

Uses.—Since the introduction of pilocarpine and arecoline, the
diaphoretics are of greater therapeutic importance in veterinary
medicine, especially in equine practice. The most important dis-
eases in which they are indicated are the following:

(a) Dropsical conditions in the course of heart, lung, liver and
kidney diseases, particularly hydrocephalus, ascites, hydrothorax,
and hydropericardium, pleuritic and peritoneal exudates, and
exudative inflammation of the articulations.

(b) Laminitis and articular and muscular rheumatism.

» (c) Diseases of the kidneys, especially oliguria, anuria and
uremia occurring in the course of severe inflammation of the kid-
neys.

v (d) Chronic poisonings (mercury, lead).

(e) Tetanus, cerebrospinal meningitis, parturient apoplexy.

Drugs.—1. Pilocarpine. In large doses, a powerful dia-
phoretic; specific in Jaminitis in horses, also in muscular rheu-
matism; superior resorbent for all dropsies, transudates and exu-
dates, particularly in acute hydrocephalus of the horse. Dose of
pilocarpinz hydrochloridum (subcutaneously) for horses is 0.5-0.8
(!), grs. vij to xii (!). The hidrotic action will be promoted by
rubbing and warm, moist (vinegar) coverings. A rather expensive
drug.

GENERAL THERAPEUTICS OF THE GLANDS 131

2. *Arecoline. Also a powerful diaphoretic and a specific
against laminitis; to be preferred to pilocarpine because less expen-
sive (compare the dose) and more stable. Dose of *arecolinz
hydrobromidum for the horse (subcutaneously), 0.05-0.1, grs.
34 to iss.

3. Hot infusions of the aromatics: matricaria, *flores tili,
*sambuci flores, mentha piperita, and *melissa. These dia-
phoretics of the old therapeutics are still sometimes employed,
é.g., in rheumatic colic of the horse. Their diaphoretic action is
due principally to the warm water which the infusions contain.
They are still very commonly used in human medicine.

4. Washing the skin with vinegar and then applying a Priess-
nitz dressing. A very good method of assisting the action of pilo-
carpine and arecoline.

5. *Ammonii acetas is sometimes prescribed internally as a
diaphoretic. Dose for the horse, 10-25, Jijss to vj. [Liquor am-
monii acetatis, spirit of mindererus, contains about 7 per cent. of
ammonium acetate. Dose for the horse, 60-120, 3ij to iv; dogs,
8-30, 3ij to viij.]

2. DRUGS THAT STIMULATE THE SECRETION OF SALIVA
SIALAGOGUES

Synonyms: Sialics, ptyalogogues, masticatives, masticatorics.

Actions and Uses.—Of the drugs known at this time, only pilo-
carpine and arecoline really possess a pronounced specific effect
upon the salivary glands. These drugs stimulate the peripheral
nerves of the salivary glands and the salivary centre and thereby
increase the secretion of saliva to a great degree and for some
time, even when given in small doses. Eserine and muscarine are
similar in action but much weaker.

The effects resulting from an increased secretion of saliva are
very similar to those produced by diaphoresis. Of special impor-
tance in therapeutics is the circumstance that a large amount of
water is withdrawn from the body, the blood therefore becoming
thicker and the resorption of transportable fluids in the body being
thereby promoted. A horse, for example, will lose 20 to 30 liters

132 GENERAL THERAPEUTICS FOR VETERINARIANS

of water in a short time. Sialagogues are consequently specific for
all dropsies, transudates and fluid exudates. They have an abor-
tive action against laminitis (arecoline), act ‘as derivatives in dis-
eases of the brain and kidneys and serve to eliminate poisons from
the body.

Antisialagogues are drugs which reduce an abnormally in-
creased secretion of saliva (salivation). The most important are
atropine and hyoscine (scopolamine). The same drugs also at the
same time reduce an abnormally increased sweat secretion and are
therefore called antihidrotics. To the latter class belong also
agaricin and camphoric acid.

Drugs.—1. Pilocarpinze hydrochloridum. Specific sialagogue in
dropsical conditions. Dose (1/5 the diaphoretic dose): horses,
0.1-0.2, grs. iss to iij; cattle, 0.2-0.4, grs. iij to vj; sheep and goats,
0.01, gr. 1/8; dogs, 0.005-0.02, gr. 3/40 to 14. Use cautiously
when heart disease is present.

2. *Arecoline hydrobromidum. Also a specific sialagogue;
especially effective in laminitis and acute hydrocephalus. The
dose of arecoline is five to ten times less than that of pilocarpine;
for horses, 0.02-0.05, grs. 14 to 34.

GENERAL THERAPEUTICS OF THE DISEASES OF
METABOLISM

Physiology.—The treatment of the so-called metabolic dis-
eases (diabetes mellitus, obesity, gout, chronic disturbances of
nutrition) must be based upon the physiology of metabolism.
Metabolism can be influenced principally in a dietetic way. The
chief nutritive materials used for this purpose are albumin, fat and
the carbohydrates, in addition to water and salts.

In reference to albumin, physiology teaches that the more
albumin that is introduced into the body the more is decomposed.
Feeding albumin in abundance therefore only increases the total
albumin decomposition and does not increase the amount stored up.
A real strengthening of the body, 7.e., an increase in the amount of
organic albumin, does not result from a pure albumin diet, con-
trary to the usual assumption. Such a diet only temporarily in-
creases the amount of circulating albumin in the blood. If organic
albumin is to be stored up in the body, which is the object aimed at
in the treatment of chronic disturbances of nutrition, then fats
or carbohydrates must be given with the albumin. The presence
of fats and carbohydrates limits the albumin decomposition in
both healthy and diseased animal bodies.

The fat taken into the body is partly stored up and partly
decomposed. The fat deposited in the body is derived principally
from the fat in the food and only to a slight degree from the al-
bumin. In emaciation, therefore, the deposition of fat can be
attained only by feeding an increased amount of fat and not by
increasing the albumin in the diet. On the contrary, reduction
can be obtained in obesity by an exclusively albuminous diet (Bant-
ing treatment) or by withdrawing fat and carbohydrates from the

ration.
133

134 GENERAL THERAPEUTICS FOR VETERINARIANS

The carbohydrates serve in the first place as heat-producing
material for the body (exercise). Increased ingestion of carbo-
hydrates decreases the decomposition of albumin and fat. They
are consequently an important dietetic material in the treatment
of chronic disturbances of nutrition accompanied by emaciation
(with the exception of obesity and diabetes mellitus, in which the
carbohydrates should be withheld as completely as possible).

A stimulating influence upon metabolism is exerted by mus-
cular activity and exercise (increased oxidation of carbohydrates
and fats, not the albumins), cutaneous irritation, salts (sodium
chloride, sodium bicarbonate, sodium sulphate), alcohol, and
arsenic and phosphorus in small doses. See also therapeutics of
the glands.

In the general therapeutics of the diseases of metabolism, the
remedies are usually divided into plastics, antiplastics (removal of
fat) and nutrients.

1. PLASTIC REMEDIES. PLASTICS

Synonyms: Nutrients, euplastics, antatrophics, antidepertitorics; foods,
blood plastics, bone plastics.

Definition and Classification.—Plastics are substances which
participate directly or indirectly in the construction and building
up of the animal body. They can be subdivided into blood
plastics (see p. 63), bone plastics, muscle plastics, etc., correspond-
ing to the individual organs. They can also be classified as foods
and medicinal plastics. .

(a) The foods (dietetic remedies in the restricted sense) are
naturally the most important plastics. In therapeutics, less con-
sideration is given to the food as such than to an effort to supply
the usual food in the most readily digestible form (sick diet).
Horses affected with certain diseases, for instance, are given oats
which have been ground or crushed, or are fed steamed oats; car-
nivora are given meat finely ground; young animals are fed eggs,
leguminous meals containing dextrin (children’s flour); muci-
laginous gruels, roasted meal, etc., are fed in intestinal catarrh.
See the text-books on dietetics.

DISEASES OF METABOLISM 135

(b) The medicinal plastics correspond essentially to the foods
in composition and consequently consist of albumin, fat, carbo-
hydrates and salts. The most important are meat extract, cod
liver oil, sugar, starch flour, milk sugar, peptone, iron salts, cal-
cium salts, phosphorus, phosphates, sulphur, potassium salts,
sodium chloride and other salts. A former special subdivision of
the medicinal plastics was the peptic plastics, which included
pepsin and hydrochloric acid. These are referred to under physi-
ological stomachics (page 29). Arsenic is an indirect plastic.

Uses.—The plastics are employed to improve nutrition in all
acute or chronic diseases which are accompanied by emaciation or
tissue reduction and especially by anemia. These changes are
most frequently observed in chronic constitutional diseases, par-
ticularly anemia, pernicious anemia, leukemia, rachitis, osteo-
malacia and diabetes mellitus. They also occur in many chronic
debilitating diseases, ¢.g., tuberculosis, worm cachexia, chronic
gastric and intestinal catarrh and carcinomatosis. Considerable
emaciation takes place in all acute febrile diseases in which metab-
olism is greatly increased, especially in the acute infectious dis-
eases (contagious pneumonia, canine distemper, aphthous fever).

Plastics are contraindicated in obesity, which on the contrary
is to be combated with antiplastics. (See the section on anti-
plastics, p. 138.)

Drugs.—1. *Meat extract. A valuable blood plastic in anemia
and leukzmia in consequence of its content of blood salts (potas-
sium phosphate, iron); also a general plastic in chronic disturbance
of nutrition in carnivora. It has no particular nutritive value
because it does not contain albumin, carbohydrates or fats. Dose
for dogs, 2-10, grs. xxx to Jijss.

2. Oleum morrhue. Cod liver oil. On account of its content
of free fatty acids and easily digested fat, an important plastic in
rachitis and anemia and following exhausting diseases. Doses
for horses and cattle, 100-500, 3iij to Oi; sheep, goats and swine,
50-100, 3 iss to iij; dogs, 10-50, Jijss to 3 iss; fowl, 2-5, nyxxx to 31.

3. *Peptone. A substitute for albumin; plastic in chronic dis-
turbances of nutrition in carnivora. Dose for dogs, 10-25, 3ijss

136 GENERAL THERAPEUTICS FOR VETERINARIANS

to vj; cats, 5-10, 31 to ijss. Other nutrient preparations are:
somatose, nutrose, nutrol, mutase, eucasin, roborin, eulactol,
sanose, sanatogen, aleuronat, alkarnose, protogen, tropon,
globon, ete.

4, Ferrum. Iron. A specific in anemia and leukemia; admin-
istered in small frequently-repeated doses in the form of ferrum
reductum, ferri sulphas, tinctura ferri chloridi and other iron
preparations (see p. 63). The blood coloring matter itself is also
used in the form of *hemoglobin, *hematol, *hematogen, *tre-
fusia, damholid, etc.

5. Calcii phosphas precipitatus. Precipitated calcium phos-
phate. A specific against rachitis and osteomalacia; usually em-
ployed in the form of the so-called bone precipitate. Dose for
cattle, 25-50, 3vj to xij; horses, 10-25, Zijss to vj; calves, foals,
sheep, swine and goats, 5-15, 3i to jv; dogs, 0.5 to 5, 3ss to j; fowl,
1-2, grs. xv to xxx. Calcii carbonas precipitatus and liquor calcis
are also used.

6. Phosphorus. A specific against rachitis and osteomalacia;
also a plastic and a stimulant to the bone tissue. Usually com-
bined with cod liver oil. Dose for horses and cattle, 0.01-0.05, gr.
1/8 to 34; sheep and swine, 0.002-0.005, gr. 1/40 to 3/40; dogs,
0.0005-0.002, gr..1/140 to 1/40; cats and fowl, 0.0005-0.001, gr.
1/ 140 to 1/70.

7. Sulphur precipitatum, sulphur lotum, sulphur sublimatum.
A general plastic (sulphur content of the tissue albumins). Dose
for horses and cattle, 2-5, 3ss to j; dogs, 0.05-0.2, grs. 34 to iij.

8. Potassii bicarbonas. Potassium bicarbonate. A blood
plastic (blood-corpuscles). Dose for cattle, 50-100, 3iss to iij;
horses, 25-50, 3vj to xij; sheep, goats and swine, 2-5, 3ss to ij;
dogs, 0.5-2, grs. vij to xxx.

9. Sodii chloridum. Sodium chloride. The plastic most used
in animal husbandry; a muscle, blood and gland plastic (blood-
plasma). Dose, same as potassium bicarbonate.

10. *Sal Carolinum factitium N.F. Artificial Carlsbad salts.
In small doses (same as sodium chloride), increases metabolism
and is in consequence a good plastic.

DISEASES OF METABOLISM 137

2. NUTRIENTS. ROBORANTS

Synonyms: Tonics, confortatives, confortants; invigorating, strength-
ening medicines. ;

Definition and Uses.—The nutrients differ from the foods in
that they are not constituents of the animal body, but they corre-
spond to the foods in action in that they relieve disturbances of
nutrition and metabolism and strengthen the body. Some of
them act as substitutes for the proper food and therefore serve
to economize tissue waste. They form a group of drugs which
stand between the plastics and excitants. The former designa-
tion of tonics is incorrect because the nutrients do not increase
the tension of the tissues, as the muscles for instance, but stim-
ulate metabolism and the specific functions of the cells, and
act upon the muscles in the same manner as upon the nerves and
glands.

The roborants of importance in veterinary medicine include
alcohol, which on the one hand in consequence of its oxidation to
carbonic acid and water saves the carbohydrates and fats of the
tissues, and on the other hand stimulates the functions and the
metabolism of the cells of the body, especially those of the brain,
heart, skeleton muscles and glands. Wine, beer, brandy, cognac
and other fluids containing alcohol act in the same manner as
alcohol. Other very important roborants are coffee and other sub-
stances containing caffeine (tea, cocoa). Arsenic is also very fre-
quently used as a roborant.

The diseased conditions in which the nutrients are used are the
disturbances of nutrition and conditions of weakness which occur
in the course of chronic and acute diseases and after difficult par-
turition and severe hemorrhage.

Drugs.—1. Alcohol. The best roborant in the weak condi-
tions occurring in the course of febrile infectious diseases (con-
tagious pneumonia); in convalescence following severe acute or
chronic diseases; in cachectic conditions, and after difficult par-
turition, hemorrhages, etc. At the same time, it economizes tissue
waste and acts as an excitant. Given in repeated small doses:

138 GENERAL THERAPEUTICS FOR VETERINARIANS

-horses and cattle, 25-50, 3-vj to xij; dogs, 2-5, 3ss toi. Dose of
spiritus vini gallici double these quantities. Wine (vinum album,
vinum rubrum) and beer are administered in quart (horses and
ae and tablespoonful (dogs) doses.

. *Caffea. Coffee. A superior excitant for weakness and
ene of the brain, spinal cord, heart and the muscles of the
body.

3. Arseni trioxidum. angen A roborant in chronic nutri-
tive disturbances and in conditions of inanition, especially in gen-
eral emaciation, anemia, rachitis, osteomalacia and chronic eczema.
Dose for horses and cattle, 0.1 to 0.5, grs. iss to vij; sheep and
swine, 0.01-0.05, gr. 1/8 to 34; dogs, 0.001-0.005, gr. 1/70 to 3/40
(2 to 10 drops of liquor potassii arsenitis).

3. REDUCING REMEDIES. ANTIPLASTICS

Synonyms: Dysplastics; reducing treatment, abstinence treatment,
hunger cure.

Actions.—The antiplastics are used exclusively to combat and
overcome obesity or corpulence, 7.e., an abnormal collection of fat
in the subcutaneous connective tissue, liver, heart, body cavities,
etc., resulting from too intensive feeding with insufficient exercise or
work. The antiplastics are usually divided into two groups: the
dietetic and medicinal.

Dietetic Reducing Methods.—These consist of methodical,
rational feeding and regulation of the diet, i.e., the supplying of
suitable foods and the partial or complete withdrawal of certain
nutritive substances and foods. The simplest reducing method,
which usually suffices for animals, is the hunger or abstinence cure.
This method is applied by entirely withholding food from the
over-fat animal for a time or by reducing the amount of food given.
Work and exercise at the same time will be of assistance in obtain-
ing the desired results. This method, however, is not applicable
to all cases. In advanced obesity, in which the body is deficient in
albumin, the abstinence cure will increase the weakness. In other
cases, the method cannot always be carried out (ill-behaving

DISEASES OF METABOLISM 139

dogs). For these reasons, the modern dietetic reducing methods
used on man possess a, certain importance in veterinary medicine,
especially in canine practice. The most important of these
methods are the following:

(a) The Banting‘ cure. This consists of the use of a purely
albuminous diet, the only food permitted being fat-free meat.
Carbohydrates and fat are omitted entirely. As a consequence,
in order to meet the carbon requirements of the body, the fat
stored up in the tissues is drawn on and oxidized. Great care
must be exercised in using this method. If continued too long,
until after the tissue fat is used up, the tissue albumin will be
attacked and will be reduced in spite of the increased ingestion of
albumin.

(b) The Ebstein? reducing method. In this method only the
carbohydrates are excluded from the food, the use of fat as well as
albumin being permitted. The fat is given to bring about an
early appeasement of the appetite and thus decrease the total
amount of food ingested.

(c) The Oertel? reducing method. This method is based
essentially upon the withholding of water; albumin, fat and carbo-
hydrates are all permitted. In addition, an effort is made to
increase the amount of work performed. This method is espe-
cially adapted to the treatment of fatty degeneration of the heart.
In consequence of the withdrawal of water, the blood is decreased
in volume and the resistance to the heart is thereby reduced. The
simultaneous artificial increase of cardiac activity exerts a fat-
reducing and strengthening effect upon the heart muscle.

Medical Reducing Remedies.—These are secondary in impor-
tance to the dietetic methods. They involve the use of cathartics,
especially Glauber’s salt. The frequently repeated rapid emptying

1W. Banting, an Englishman suffering from obesity, was treated by his
physician, Dr. Harvey, by the method formerly known as the “ meat
method,” and published his experiences in 1863 in a book entitled ‘‘ Letter
on Corpulence Addressed to the Public.”

2 Ebstein, late professor of medicine in Gottingen.

3 Oertel, late professor of medicine in Munich.

140 GENERAL THERAPEUTICS FOR VETERINARIANS

of the intestinal contents removes from the body a quantity of
nutritive materials and the excess of body fat must finally serve as a
substitute. At the same time, through the specific action of the
alkalies, the metabolism of the body is accelerated and the oxida-
tion of the fat is thereby increased. Most frequently, Glauber’s
salt is used in the form of Carlsbad salts. The treatment of
obesity with potassium iodide (chronic iodism) and with prepara-
tions of the thyroid gland (iodothyrin) is dangerous.

GENERAL THERAPEUTICS OF DISEASES OF THE EYE

Pathology.—In the treatment of the different diseases of the
eye numerous therapeutic methods come into consideration. Dis-
eases of the lids, conjunctiva and cornea are treated with anti-
septics (boric acid, salicylic acid, chlorine water, quinine), as-
tringents (zinc sulphate, silver nitrate), caustics (copper sulphate,
oxide of mercury, cauterization) and narcotics (cocaine, eucaine,
alypin, anesthesin, orthoform); also by operation (entropion
operation), massage (corneal opacity), hydrotherapy, etc. In
paralysis of the optic nerve, excitants (strychnine) and electro-
therapy are employed. Finally, there is a group of medicines
which are usually designated as eye remedies in the restricted
sense. These are the pupil-dilating (mydriatics) and the pupil-
contracting (myotics) agents.

1. PUPIL-DILATING REMEDIES. MYDRIATICS

Actions and Uses.—The artificial dilation of the pupil by
atropine, scopolamine (hyoscine) and homatropine is the result of
paralysis of the oculomotor nerve the motor nerve of the sphincter
of the pupil. The mydriasis is usually produced by the direct or
local action of the drug by introducing the latter into the con-
junctival sac; dilation of the pupil by the internal administration
of the mydriatic is of no practical value.

The purposes for which mydriatics are used are very variable.
Therapeutically, they are employed in iritis to prevent or loosen
adhesions of the iris to the capsule of the lens. For this reason,
they are of the greatest importance in the treatment of periodic
ophthalmia in the horse. They are also used to prepare the eye for
some operations, especially the cataract operation and iridectomy.
They are not less important for diagnostic purposes, when it is
desired to examine the interior of the eye, the artificial dilation of
the pupil facilitating the examination of the interior with the

ophthalmoscope. In this way turbidity of the vitreous humor
141

142 GENERAL THERAPEUTICS FOR VETERINARIANS

and of the lens, detachment of the retina and other internal eye
diseases are more readily recognized.

Drugs.—1. Atropine sulphas. The most frequently used
mydriatic in periodic ophthalmia, iritis and in operations on the
eye; 1 to 2 per cent. solution. For diagnostic purposes a weaker
solution is used (14 to 1 per cent.).

2. Hyoscine hydrobromidum. A more powerful mydriatic;
therefore used when atropine does not suffice; solution, 0.2 to 0.5
per cent.

3. Homatropine hydrobromidum. A mydriatic used for diag-
nostic purposes. The pupillary dilation disappears more rapidly
than when produced by atropine or hyoscine, but occurs much
more slowly. Very expensive.

Newer mydriatics are *mydrol, *mydrin, *eumydrin and
*euphthalmine (very expensive),

2. PUPIL-CONTRACTING REMEDIES. MYOTICS

Actions and Uses.—The myotics, of which arecoline and pilo-
carpine may be mentioned as the most important, cause a narrow-
ing of the pupil by contraction of the sphincter muscle of the pupil,
the latter action resulting in consequence of stimulation of the
oculomotor nerve. Myosis is of value therapeutically because by
the contraction of the iris synechia of the latter with the capsule
of the lens will be loosened. Adhesions of the iris occurring in
periodic ophthalmia, for instance, are treated alternately with
atropine (mydriasis) and eserine (myosis). Eserine is also em-
ployed to reduce the internal pressure of the eye in glaucoma.

Drugs.—1. Physostigmine sulphas. Eserine. A myotic in
synechia of the iris, periodic ophthalmia, adhesion of the iris and
prolapse of the iris; 14 to 1 per cent. solution.

2. *Arecoline hydrobromidum. Used in the same manner as
physostigmine.

GENERAL THERAPEUTICS OF THE SKIN AND MUCOUS
MEMBRANES

Physiology.—The skin and mucous membranes are in the first
place protective organs, guarding the body against external influ-
ences. The skin especially being exposed to numerous and varied
insults must possess a resistant structure and a particularly strong
regenerative capacity. This is actually the case, as is demon-
strated most markedly in the healing of wounds. (See the chapter
of general surgery on primary and secondary healing of wounds.)
No loss of tissue is more readily replaced by natural healing
than epithelium or epidermis. In many cases, natural healing
alone removes the defect.

In addition to their protective action, the skin and mucous
membranes have other important physiological functions. These
latter include secretion (water, mucus, urea, salts, bacteria,
toxins, gases), respiration (cutaneous respiration), regulation of
heat (evaporation, radiation) and reflex action. The reflex ac-
tivity of the skin and mucous membranes is of the greatest impor-
tance in therapeutics because of the numerous specialized nerve-
end apparatuses they contain and also because of the manifold
relations of the skin to the internal organs (central nervous sys-
tem, circulatory apparatus, respiration, kidneys, gastro-intestinal
canal, metabolism). (See the chapter on the so-called cutaneous
irritant or derivative method.)

Therapeutic Methods.—The many different diseases to which
these structures are liable, together with the extensive relations of
the skin to the internal organs, combine to make the therapeutics
of the skin and mucous membranes a very comprehensive subject.
Wounds, inflammation, eczemas, catarrhs, infections, parasites,
tumors and many other disease conditions call for numerous special
methods of treatment. Of these, the antiseptic (including disin-
fection) treatment of wounds, the antiparasitic method of treat-
ment and hydrotherapy, as well as the diaphoretic method of

143

144 GENERAL THERAPEUTICS FOR VETERINARIANS

treating internal diseases, must be discussed in special chapters.
The operative treatment of tumors and wounds must also be
omitted from this section. For the prophylactic method (harden-
ing of the skin to cold, care of the skin, clipping), the reader is
referred to the text-books on hygiene and dietetics. There re-
main to be considered of the general therapeutic methods the
cutaneous irritant method, the caustics, firing and the astringent
method. In addition, the treatment of the diseases of the skin
will be reviewed in a general way.

1. GENERAL THERAPEUTICS OF THE DISEASES OF
THE SKIN

Eczema.—The very diverse and essential differences in the
individual diseases of the skin render a discussion of the subject in
a general way very difficult. Leaving out of consideration those
skin diseases belonging to the domain of surgery (dermatitis,
tumors, ulcers, phlegmona, erysipelas, foreign bodies, gangrene,
acne and furunculosis) and the acute infectious exanthemas (pox,
aphthous fever, swine erysipelas), there still remains of the skin
diseases in a restricted sense a group of dermatoses known under
the name of eczema which are of great practical importance. In
special pathology, a distinction is made between parasitic and
non-parasitic eczema. For the treatment of parasitic eczema
(mange, herpes, lice, fleas) the antiparasitic method is employed,
This is described in detail in another place (p. 160). The non-
parasitic eczema appears, as is well known, in many different
forms. There are recognized erythematous, papular, vesicular,
pustular, crustaceous, squamous, seborrheeic, sycosiform, acute
and chronic eczema. The treatment of the several forms is very
different. Next to the causal method, which consists in removing
and combating the cause (removal of external irritants, cleaning,
disinfection), the symptomatic treatment of the local alterations is
the most important. The derivative and internal treatment of
eczema with cathartics and arsenic, formerly employed, has been
abandoned and replaced by the local treatment. The local treat-

SKIN AND MUCOUS MEMBRANES 145

ment of eczema differs with the form, degree and age of the dis-
ease. Chronic eczema especially requires treatment essentially
different from the acute. In the one case a stimulant, sometimes
even caustic, treatment is necessary (tar in chronic eczema), while
in the other protective remedies are indicated (protective and indif-
ferent medicines in acute eczema). Again, other cases require the
application of desiccants (silver nitrate, zinc oxide, tannin), emol-
lients (fats, soaps, glycerin), and anodynes (narcotics). In addi-
tion, the mechanical remedies (rubbing, massage) and hydro-
therapy (baths, poultices) are also employed.

Drugs.—1. Pix liquida. Tar. The best remedy in chronic
eczema; contraindicated in acute eczema; used in the form of tar
spirits,! tar salve? and tar liniment.? *Creolin acts the same as
tar. Modern substitutes for tar are: *ichthyol, *thiol, *tumenol,
*thigenol, *lithyol, pyrogallol, *anthrasol, *anthrarobin, *empyro-
form, *lenigallol and petrosulphol.

2. Zinci oxidum. Zinc oxide. A good protective and desiccant
in acute eczema; used in powder, ointment [unguentum zinci
oxidi], paste and gelatin. Plumbi oxidum, acidum tannicum,
*tannoform, bismuthi subgallas, amylum, sevum preparatum
(prepared suet), kaolinum and calcii carbonas precipitatus have
the same action.

3. Argenti nitras. Silver nitrate. The best desiccant, pro-
tective and disinfectant in acute moist eczemas; used in ointment
or in solution in water or alcohol (5 to 10 per cent.).

4. Soaps. Sapo mollis (alkaline) is used as a stimulant in
chronic eczema alone or in combination with tar; contraindicated
in acute eczema. *Potassa sulphurata (liver of sulphur) has the
same action, but is more powerful. The neutral soaps’ have a
cleansing and softening action.

5. Glycerinum. Glycerin. An emollient in squamous and
crustaceous eczemas; contraindicated in acute eczemas (stimulant
action). Iodine and glycerin combined have a desiccant action.

[! Pix liquida 3i, alcohol 3x.
2 Pix liquida 3i, adeps 3x.
3 ad Hapids sapo mollis, aa 5iv; alcohol 5ij.]

146 GENERAL THERAPEUTICS FOR VETERINARIANS

6. Fats, oils, paraffin ointment, petrolatum, lanolin (adeps
lane hydrosus). Protective, indifferent substances, replacing the
cutaneous fat, in acute eczemas; exert a disintegrating action in
chronic skin exudates. Pastes (zinc, starch, petrolatum), gly-
cerin gelatin (zinc gelatin), plasters (lead plaster, salicylic soap
plaster) and varnishes are similar in action.

7. Arseni trioxidum. Arsenic. Used internally as an alter-
ative in the form of liquor potassii arsenitis (5 to 10 drops for dogs;
5-10, 31 to ijss, for horses). More modern arsenical preparations
are salvarsan and atoxyl.

2. CUTANEOUS IRRITANTS. ACRICS

Synonyms: Derivants, epispastics, rubefacients, vesicants, pustulants,
suppuratives, irritants, erethistics, dermerethistics; acrid, stimulating, irri-
tating, derivative medicines; digestive medicines in a surgical sense; blisters.

Actions.—The term acrics is used to designate those drugs
which act as irritants to the skin and mucous membranes and to all
organs in general which contain nerves and blood-vessels, produc-
ing hyperesthesia and pain together with hyperemia and inflam-
mation. In the restricted sense the term includes only the cuta-
neous irritants. The effects resulting from the action of the acrics
correspond exactly to the changes produced in the skin by other
causes of inflammation (traumatic, thermic and infectious irri-
tants). Numerous investigations concerning the production of
inflammation by acrics have been made since those of Cohnheim,
among which the work of Leber is especially worthy of considera-
tion. In the purely aseptic inflammation, produced by cantharides
or croton oil and not by bacteria, the following changes are to be
observed: First, the vessels are dilated reflexly, producing hyper-
semia, redness, swelling and increased temperature in the affected
part of the skin or mucous membrane. Then follows an exudation
of plasma (serum) from the blood. Soon after this there is an
emigration of leucocytes through the cement substance of the endo-
thelium. The principal cause of this emigration is not the amce-
boid movement of the leucocytes, the increased blood-pressure nor

SKIN AND MUCOUS MEMBRANES 147

the greater penetrability of the vessel walls, but the chemotactic
action of the chemical irritants, which attracts the leucocytes, sets
up the amceboid movement and causes them to wander out to the
chemotactic centre (cantharides, croton oil). The emigrated leu-
cocytes act as phagocytes (Metschnikoff) and also produce a diges-
tive enzyme which transforms the disease products into albumoses
(propeptones) and by this action liquefies them (histolysis). The
term digestives, formerly applied in surgery to those drugs which
stimulated suppuration, was therefore entirely warranted. The
bacteria-free pus produced by the digestives possesses a strong bac-
tericidal action. There is also probably an increased local forma-
tion of antitoxins in consequence of stimulation of the tissue cells
by the acrics. (See the chapter on hydrotherapy.) According to
the force of the chemical irritation, different degrees of cutaneous
inflammation are produced: hyperemia, vesicle and pus formation.
Another, although smaller, division of cutaneous irritants acts like
the caustics by coagulation or solution of the albumin of the tissues.
(See the following chapter on caustics.)

The skin and mucous membranes differ very greatly in their
sensitiveness to the acrics. The reason for this is to be found in
the difference in the covering epithelium. The horny, dry, dead
cells of the epiderm protect the skin against the action of dry,
solid irritants, so that it is indifferent, for example, to sublimate,
silver nitrate, arsenic and even to phosphorus in the dry condi-
tion, but when these substances are applied to the tender, moist
cells of the mucous membrane, with its covering of fluid, they are
immediately dissolved and penetrate the membrane. On the
other hand, the skin is more susceptible than the mucous mem-
branes to some of the fluid irritants, especially those which are
volatile. Turpentine oil, for instance, is less irritant to the tracheal
and intestinal mucous membranes than to the external skin because
the mucous membranes are covered with a protective layer of
mucus which the ethereal oil, not being miscible with water,
cannot penetrate, while it is quickly imbibed by the dry cells
of the epiderm and can also rapidly pass through the same in the
gaseous form.

148 GENERAL THERAPEUTICS FOR VETERINARIANS

Classification.—The cutaneous irritants are usually divided
into the following four subdivisions:

1. Rubefacients: Turpentine oil, camphor, tincture of arnica,
tincture of capsicum, oil of juniper, oil of rosemary, ammonia
water, tincture of iodine, Priessnitz dressing, massage.

2. Vesicants: Cantharides, oil of mustard.

3. Pustulants: Tartar emetic, croton oil, euphorbium.

4. Suppurants: Biniodide of mercury, bichromate of potassium.

Uses.—The cutaneous irritants are of essentially greater prac-
tical consideration in veterinary medicine than in human thera-
peutics. They are employed with advantage in internal medicine
as well as in surgery for the most varied purposes. The most
important diseases in which they are used are the following:

1. Subacute and chronic inflammations, including chronic
eczema, also contusions of the skin, the subcutis and the under-
lying tendons, tendon sheaths, joints, muscles and bones. Strong
cutaneous irritation, such as may be produced by briskly rub-
bing in tincture of iodine, cantharides ointment or biniodide of
mercury ointment, exerts a healing effect in all these surgical condi-
tions. An artificial inflammation is generated in the skin which
extends to the underlying parts, converting the chronic inflamma-
tion into the acute form, which runs a more rapid course; acceler-
ating, like firing, the absorption of the exudate and, in painful
inflammation of the articulations, hastening the ankylosis and
thereby removing the pain and lameness. The method of opera-
tion of epispastics has been more exactly studied in connection with
tincture of iodine. When the latter substance is painted upon the
skin an erysipelatous-like inflammation with cedema formation is
produced, which is accompanied by outwandering of the white
blood-cells (local hyperleucocytosis), formation of enzymes, lique-
faction of the tissue albumins and softening of the solid disease
products (histolysis). Resorption of the inflammatory exudate
follows.

2. Acute inflammations of the lungs, pleura, and peritoneum.
The cutaneous irritants first of all draw blood from the internal
organs (derivative action). In exudative pleurisy (contagious

SKIN AND MUCOUS MEMBRANES 149

pneumonia), for instance, briskly rubbing the corresponding chest
wall with oil of mustard will produce an intense hyperemia and
swelling of the skin, which results in a corresponding withdrawal of
blood from the pleura. In the same manner, the skin may derive
blood from other internal organs, as the intestines, brain, kidneys.
In addition, the formation of antitoxins will be increased in conse-
quence of the stimulation of the nutrition of the body cells.

3. Fever. The cutaneous irritants operate to reduce fever by
drawing a larger amount of blood to the skin and consequently
increasing the dissipation of heat, like digitalis. They also in-
crease the formation of antitoxins in the body, thereby promoting
the natural healing reaction in febrile diseases. By the appli-
cation of mustard spirit in contagious pneumonia, for example,
not only is a derivative action obtained but the temperature is also
considerably reduced. At the same time, the heart-beat is slowed.

4. Diseases due to chilling, especially rheumatic colic. The
cutaneous irritants (turpentine oil, spirit of camphor) operate in
these cases like the diaphoretics, stimulating the evaporation from
the skin and regulating the disturbed distribution of the blood
(hyperzemia of the central organs, anemia of the skin).

5. Relaxation and paralysis of the gastric and intestinal mus-
culature. The peristaltic movements of the stomach and intes- .
tines may be stimulated reflexly by irritation of the sensory
nerves of the skin. The epispastics are therefore very valuable
peristaltics in atony and paresis of the gastro-intestinal wall, par-
ticularly in the course of constipation colic, tympanites and chronic
gastro-intestinal catarrh.

6. Spinal paralyses (lumbar weakness, lumbar paralysis).
The stronger cutaneous irritants act here partly as stimulants to
the paralyzed nervous system and partly as derivatives. For the
same reasons, they may also be employed in cerebral and periph-
eral paralyses. In other cases, according to the principles of
counter-irritation, the epispastics will depress a pathologically
increased nervous activity (hyperssthesia).

7. Diseases of the kidneys. Because of the ability of the skin
to assume in a compensatory way the functions of the kidneys,

150 GENERAL THERAPEUTICS FOR VETERINARIANS

cutaneous irritants afford relief to the kidneys in anuria and
uremia occurring in the course of inflammation of the kidneys.

8. In surgery, the so-called digestives, particularly turpentine
oil, aloes and Peru balsam, are used in the form of solutions,
ointments, plasters and tampons to promote the suppuration and
granulation of wounds, ulcers and abscesses (bactericidal and sol-
vent action of sterile pus).

Zschokke, in an excellent article (Ueber die Wirkungsweise der Deri-
vantien, Monatshefte fiir prakt. Tierheilkunde, vol. ix, 1898), strongly
recommends the retention of the derivants, i.e., the cutaneous irritants, lini-
ments, blisters and firing, in veterinary medicine. According to him, they are
indispensable in numerous diseases. He refers to the widespread view that
the cutaneous irritants only act by forcing the patient to keep the diseased
part as quiet as possible, and points out that the local effects are stimulation
of phagocytosis (resorption, disinfection) and an increased formation of anti-
toxins locally (disinfection) as a result of stimulation of the nutrition of the
tissue cells. The general action of the derivants in febrile diseases is also due
to the formation of antitoxins, which combat fever and even abort infectious
diseases. In phlegmona especially, an effective disinfection, with phagocy-
tosis and a rapid disappearance of the bacteria, is obtained from “blisters,”
as has been demonstrated experimentally in horses by Bossi (Il nuovo Erco-
lani, 1891).

An historical study of the action of “blisters” was published by Gramm-
lich in the Zeitschrift fiir Veterindrkunde (1898). See also Kiinnemann’s
Festrede tiber die Wirkung der hautreizenden Mittel (1907),

Drugs.—1. Oleum terebinthine. Turpentine oil is frequently
used as a rubefacient in chronic muscular rheumatism, colic,
chronic articular and tendon lamenesses, cedematous swellings
of the skin, contusions of the joints, weak and paralytic condi-
tions, etc.; usually diluted, 1 : 10-20, with alcohol, spirit of cam-
phor or oil; also injected subcutaneously to produce derivative
abscesses (so-called fixation abscesses) in infectious diseases.

2. Spiritus camphor. Spirit of camphor. Also a frequently
used epispastic, alone or combined with turpentine oil. A stronger
action is exerted by the application of camphora in substance.

3. Tinctura arnice. Much used by the laity as a stimulant
and resolvent in rheumatism and contusions. Tinctura capsici has

SKIN AND MUCOUS MEMBRANES 151

the same action and is sometimes, in addition to the previously
mentioned drugs, a constituent of the so-called restitution fluid.

4, Tinctura aloes. An old veterinary digestive for granulating
wounds and ulcers of the hoof.

5. Aqua ammoniez. Ammonia water. Usually used in the
form of a liniment, 1 part to 4 of oil. A brisk epispastic in chronic
arthritis, inflammation of the tendons and muscular rheumatism.

6. Tinctura iodi. Tincture of iodine. A powerful resolvent,
especially in periostitis, arthritis, periarthritis, tendinitis and
tendovaginitis. Like ammonia water, it occupies a position
between the rubefacients and the vesicants.

7. Cantharis. Cantharides. The ointment‘ is frequently
used as a vesicant for horses and cattle in chronic exostoses (spavin,
ring bone, splint), inflammations of joints, tendons and tendon
sheaths, chronic rheumatic lameness, contusion swellings, etc.
Cantharides plaster® and cantharides oil® have the same action,
but tinctura cantharidis and collodium cantharadatum are some-
what weaker and are employed in canine practice.

8. Oleum sinapis volatile. Oil-of mustard. A valuable
derivant in pleurisy, pneumonia, peritonitis and meningitis; used
on horses in 4 to 6 per cent. alcoholic solution; cattle, 10 to 20 per
cent.; dogs, 2 per cent. Mustard plasters are also frequently used.

9. Hydrargyri iodidum rubrum. Biniodide of mercury. A
most powerful epispastic; specific for long-standing inflammations
of the joints, bones and tendons, especially spavins, ring bones,
splints, galls and induration of tendons; used on horses in concen-
trations of 1:4 to 5 of lard or cantharides ointment. Potassii di-
chromas has the same action (1 : 10 to 20 for horses).

10. Antimonii et potassii tartras. Tartar emetic. A derivant
for cattle and swine in ointment (1 : 4).

[4 Powdered cantharides 2 parts, digested for ten hours with 2 parts each
of peanut oil and lard; yellow wax 1 part, turpentine 2 parts, mixed; euphor-
bium 1 part.]

{® Colophony and turpentine, 6 parts of each, melted together; add, after
partial cooling, powdered cantharides 3 parts, powdered euphorbium 1 part.

6 Cantharides 3 parts, digested ten hours with 10 parts of peanut oil;
express and filter.]

152 GENERAL THERAPEUTICS FOR VETERINARIANS

11. *Euphorbium. A very irritant epispastic; used in old,
chronic surgical affections of the joints, tendons and bones; used on
cold-blooded horses and cattle either alone 1 : 10-15 of lard, or as
an addition to cantharides ointment (1 : 10-20). .

12. Oleum tiglii. Croton oil. Also a very powerful irritant;
used in obstinate chronic rheumatism, arthritis, tendinitis, paresis,
etc.; also as a derivant in inflammations of internal organs; must be .
used cautiously. The concentration for horses is 1 : 30; cattle,
1 : 5-10; swine, 1 :2-5; dogs, 1 : 50-100. It is diluted with olive
oil, turpentine oil or cantharides ointment.

3. CAUSTICS
Synonyms: Corrosives, cauterics, escharotics, catheretics.

Actions.—While the cutaneous irritants produce only the alter-
ations of inflammation, without injuring the vitality of the tissues,
the caustics cause the death of those living tissues with which they
come in contact. The caustic action of the individual drugs is
brought about in very different ways and on this basis the following
groups of caustics are classified (concerning firing, the actual
cautery, see p. 156).

1. Caustic acids: Nitric, hydrochloric, sulphuric, acetic, chlor-
acetic, lactic and salicylic acids and formaldehyde. Of these, the
mineral acids and lactic acid operate by coagulating the albumin;
they unite with the albumin, forming insoluble acid albuminates,
thereby bringing about the precipitation and death of the dis-
solved living albumins. Nitric acid, especially, forms with the
organic albumin a yellow acid albuminate (xanthoproteic acid,
nitrogen compound). The organic acids, particularly acetic acid,
also unite with the tissue albumin to form acid albuminates, but
these compounds are soluble and are only precipitated when the
solution is neutralized. The caustic action of sulphuric acid is
due to its strong affinity for water, which it withdraws from the
tissues, the latter being carbonized. Salicylic acid and formalde-
hyde are peculiar in their action, producing a keratolytic effect, or
cornification. :

SKIN AND MUCOUS MEMBRANES 153

2. Caustic alkalies: Caustic potash, caustic soda, caustic lime,
Vienna paste. These dissolve the organic albumin by taking up
water and forming soluble alkaline albuminates. Their eschar
or slough is mostly moist, deep and diffuse, extending into the
surrounding tissue, a contrast to the dry, circumscribed, superficial
eschar of the mineral acids.

3. Metallic caustics: Zinc chloride, corrosive sublimate, potas-
sium chromate, chromic acid, iron chloride, iron sulphate, copper
sulphate, zinc sulphate, silver nitrate, antimony trichloride,
arsenic, lead acetate and nitrate, biniodide of mercury, oxide of
mercury, copper acetate, potassium permanganate. These metal-
lic compounds act by forming an insoluble metallic albuminate, at
the same time setting free the acid components (sulphuric acid,
nitric acid, chlorine, iodine). Some of them, in addition, act also
by oxidation; these include the oxygen-containing caustics, chromic
acid and permanganate of potash, which give off oxygen, and also
arsenic, which first takes up oxygen and then gives it off. The
halogens, chlorine, bromine, iodine, absorb the hydrogen of the
tissues, in consequence of which oxygen in the nascent state (in
addition to hydrochloric acid) is set free.

The degree of the caustic action differs with the chemical
nature of the individual drugs and also with the concentrations
employed. A distinction is made between a superficial scab forma-
tion and a deeper cauterization. The inorganic acids, silver
nitrate, copper sulphate, zinc sulphate, iron sulphate and lead |
nitrate act superficially, while formaldehyde, the caustic alkalies,
sulphuric acid and chromic acid have a deep action. The caustic
effect upon the skin is much weaker than upon the mucous mem-
branes because of the protective layer of horny epidermal cells.
The dry caustics, especially the metallic salts, act upon the skin
generally only when they come in contact with fluids. The color
of the eschar differs very much. Nitric acid produces a yellow
eschar; hydrochloric acid, a gray; sulphuric acid, brown or dark
gray; chromic acid and formaldehyde, yellow, becoming brown
and finally black; acetic acid, white; silver nitrate, at first white,
then gray and finally black.

154 GENERAL THERAPEUTICS FOR VETERINARIANS

Uses.—The caustics are used to remove neoplasms when they
cannot be removed by operation. In general, their use has
diminished very much with the progress of surgical technic, but in
veterinary medicine there are still several forms of neoplasms for
which caustics are preferred to operation on practical or economical
grounds. In canker of the frog especially cauterization with for-
maldehyde is frequently employed instead of operating because of
its greater simplicity and convenience. In addition, caustics are
sometimes used in the treatment of fistule and ulcers, and also to
regulate the healing of wounds, especially to remove exuberant
granulations (silver nitrate), The expediency of the earlier
method of treating hernia with caustics may be left in abeyance.
On the other hand, caustics are indicated in infected and poisoned
wounds, particularly potassium permanganate, iron chloride and
chromic acid in snake bites.

Form.—The caustics are used in different forms, partly alone
and partly in combination with other substances (caustic pastes,
pencils, points, bougies, sounds, cords, ligatures, crystals and
powders).

Drugs.—1. Liquor formaldehydi. Formaldehyde. The strong-
est caustic; very penetrating caustic action (be cautious); best
caustic in canker of the frog.

2. *Fuming nitric acid. A frequently employed and valuable
liquid caustic in veterinary medicine; used in the treatment of
canker of the frog and to remove warts and small neoplasms.

3. Acidum sulphuricum. A very strong caustic; used in the
treatment of shoe boils, canker of the frog and other neoplasms;
use cautiously.

4. Acidum trichloraceticum. Trichloracetic acid. A good
but rather expensive caustic for canker of the frog, warts and
granulations.

5. *Vienna paste. A mixture of equal parts of caustic lime
[calx] and caustic potash [potassii hydroxidum] with sufficient
alcohol to make a paste; very powerful caustic for canker of the
frog and carcinoma.

6. Zinci chloridum. A strong caustic; used in ulcers, fistule,

SKIN AND MUCOUS MEMBRANES 155

relaxed granulations, canker of the frog and carcinoma in the form
of caustic paste or pencils.

7. Hydrargyri chloridum corrosivum. Corrosive sublimate.
The strongest metallic caustic; used in the form of crystals, powder,
paste (1 : 1-5 flour), salve (1 : 1-10), solution (1 : 3-10 alcohol or
collodion), bougies or caustic ligature. Hydrargyri iodidum ru-
brum has the same action.

8. Chromii trioxidum. [Formerly official in U.S. as chromic
acid.]} A powerful, painful caustic for canker of the frog, car-
cinoma, and other neoplasms in solution, salve, paste (1 : 1-5) and
bougies; superior alterative action in scratches of long standing
(10 per cent. solution in water). A specific in snake bites.

9. Arseni trioxidum. Arsenic. An old caustic in breast boils,
shoe boils, canker of the frog, carcinoma, quittor, etc., in the form
of sticks, paste, salve and solution.

10. Argenti nitras. Silver nitrate. A mild, superficial caustic
(escharotic) for granulations, fistule and ulcers, chromic conjunc-
tivitis and very small warts; used in pencil form.

11. Cupri sulphas. Copper sulphate. A caustic in ophthal-
mology; used for granular and pannus growths on the conjunctiva,
also employed in fistule and ulcers. *Cuprum aluminatum has the
same action and uses (copper pencil).

12. Ferri sulphas. Iron sulphate. A mild caustic for ulcers
and fistule, canker of the frog, the foot lesions in foot-and-mouth
disease and chronic affections of mucous membranes. Used in
powder or in concentrated solution.

13. Plumbi acetas. Lead acetate. A mild caustic for canker
of the frog. Plumbi nitras has a similar action.

14. Ferri chloridum. Iron chloride. A caustic for canker of
the frog and relaxed granulations. A specific against the virus of
rabies and snake bites.

15. Hydrargyri oxidum flavum. Yellow oxide of mercury. A
mild caustic for wounds and ulcers (1 : 10); also used as a caustic
in ophthalmology (1 : 15-25).

16. Potassii permanganas. Potassium permanganate. A spe-
cific caustic for snake bites.

156 GENERAL THERAPEUTICS FOR VETERINARIANS

4. FIRING. CAUTERIZATION

General.—Firing is one of the oldest methods of treatment and
specifically a veterinary remedy, which cannot be dispensed with
even to-day, despite the large number of similarly acting chemical
substances (caustics). It is, on the contrary, among the most valu-
able of surgical aids. As a rule, wrought cautery irons of various
forms (knife, hatchet, button, conical form, etc.) are used in firing,
in addition to which Paquelin’s platinum cautery apparatus is
used in clinics and on small animals. There are several varieties
of firing: superficial (point and line firing), percutaneous, perforat-
ing (spavin firing) and subcutaneous. (See the text-books on
operative surgery.)

Actions.—The effects of firing are very numerous:

1. The immediate result is a local destruction of tissue. The
heat first coagulates the albumin, then follows the formation of an
eschar and carbonization. Associated with this action is the dis-
infecting and hemostatic effect of the hot iron.

2. A hyperemia and inflammatory reaction develops in the
region immediately surrounding the cauterized area. The circu-
lation of blood and resorption are stimulated in consequence. An
extensive outwandering of white blood-cells, local hyperleucocy-
tosis, phagocytosis and histolysis occurs, similar to that which
follows the rubbing in of tincture of iodine (see p. 148).

3. The pronounced irritation of the cutaneous nerves acts
reflexly upon the nervous system. Firing consequently operates
like a powerful cutaneous irritant (principle of cutaneous irritation
and counter irritation).

4, The eschar which results from firing exerts, sheen: to the
usual acceptation, a mechanical pressure upon the underlying
tissues and promotes, like massage, the resorption of the patho-
logical products (?).

Uses.—1. The most important indications for the employment
of the firing iron are the chronic inflammatory conditions of the
bones, joints, tendons and tendon sheaths: spavin, ring bone, ex-
ternal spavin (rehbein), curb, splints, chronic arthritis, tendinitis,
tendovaginitis and articular galls. While the firing iron should

SKIN AND MUCOUS MEMBRANES 157

be used only on the chronic inflammatory affections of the
tendons and tendon sheaths after treatment with hydropathic
dressings, massage and blisters has proven ineffective, it may be
employed primarily in the aforementioned bone and deforming
articular inflammations, especially spavin, ring bone and splints.
The effect of firing on all these conditions consists essentially in
the conversion of a chronic inflammation into a more rapidly pro-
gressing acute process. The reactive inflammation set up in the
affected bone, tendon or articulation brings about a more rapid
resorption of the inflammatory products, promotes the inflam-
matory reproductive processes, and in joints hastens ankylosis,
in consequence of which the pain and lameness are removed
(spavin, ring bone).

2. The firing iron is used for operative purposes on fistule, neo-
plasms and ulcers; as a hemostatic, particularly in amputation of
the tail, and for the disinfection of infected wounds (rabies, an-
thrax, glanders, snake bites).

3. It is also employed as an excitant, although more rarely, in
the treatment of paralytic conditions of the spinal cord and periph-
eral nerve branches (parturient apoplexy, spinal and peripheral
paralyses).

5. ASTRINGENTS

Synonyms: Exsiccants, coagulants, tonics; contracting, drying, tanning,
albumin-coagulating, condensing, toning remedies.

Actions and Uses.—The term astringents is used to describe
drugs which exert a contracting, drying, condensing action upon
the skin and mucous membranes. They are most frequently em-
ployed in catarrhs of the mucous membranes, with excessive
catarrhal secretion or extensive swelling of the mucous membrane,
e.g., in catarrhs of the intestinal, buccal, pharyngeal, bronchial,
conjunctival, bladder, uterine, vaginal and preputial mucous mem-
branes, and in prolapses of the vagina, uterus and rectum. They
are also used in inflammatory, eczematous and ulcerous processes
of the skin; in otorrhcea; as injections in fistule and serous sacs;

158 GENERAL THERAPEUTICS FOR VETERINARIANS

to check parenchymatous bleeding, and, empirically, in galactor-
rhea, polyuria and nephritis.

In their method of action they are very different. Some cause
a contraction and narrowing of the capillaries with consecutive
anemia (metallic salts), thus overcoming inflammatory hyperemia
of the skin and mucous membranes and decreasing the secretions.
Others combine with the albumin, mucus, and gelatin-containing
" substance of the secretions of the skin and mucous membranes
and form a solid precipitate and produce, like the caustics, a super-
ficial condensation and desiccation of the tissues, forming a kind
of scab or protective covering (tannin). A third group operates
by withdrawing water and shrinking (alcohol), and a fourth
group purely mechanically through compression (collodion).
Most of the astringents possess a disinfectant action and, in
the stronger concentrations, are caustics. (See the chapter on
caustics.)

Drugs.—1. The metallic astringents: alum, aluminum acetate,
ferric chloride solution, iron sulphate, lead acetate and nitrate,
silver nitrate, corrosive sublimate, zinc chloride and sulphate,
copper sulphate, zinc oxide, bismuth nitrate, subnitrate, subsali-
cylate and subgallate, aluminum hydroxide, calcium carbonate and
lime water.

2. Tannic acid, tannoform and the tannin-containing vegetable
astringents: white oak bark, cinchona, rhubarb, nutgall, catechu
[replaced by gambir in U. §. P.], rhatany root, tormentilla root,
salvia, uva ursi, folia juglandis, coffee and roasted acorns.

3. Alcohol and all alcoholic liquids (tinctura aloes, tinctura
myrrhe, tinctura iodi).

4. Iodine, especially in combination with alcohol (iodine tinc-
ture) and glycerin.

5. Tar, creolin, creosote and other related substances.

6. Ethereal oils, balsams and resins (turpentine oil, turpentine,
Peru balsam).

7. Glycerin and sodium chloride (withdrawal of water).

8. Collodion (mechanical compression) and other pressure
agents.

SKIN AND MUCOUS MEMBRANES 159

9. Ergot, hydrastis, cocaine and adrenalin. (The latter con-
tracts the vessels of the conjunctiva and iris.)
10. Cold in the form of ice or cold applications.

Antiphlogistics.—A series of medicaments which it was formerly custom-
ary to use in inflammatory conditions of all kinds were classified in the old
therapeutics under the name of antiphlogistics, or remedies which combat
inflammation (refrigerants, temperants). In this group were included the
astringents, bleeding and other methods of local bloodletting, hydrotherapy
(Priessnitz), cold, mercury and potassium nitrate. Inflammations due to
infection are now treated with antiseptics (carbolic acid, iodoform, camphor,
alcohol, salicylic acid, calomel). Astringents with antiseptic action are also
employed (silver nitrate, copper sulphate, lead acetate, alum, tannin, cold).
Moreover, inflammation is not a disease but, like fever, is to be regarded as
a reactive natural healing process which in itself does not need to be combated.

Drugs which have an action opposed to the antiphlogistics were formerly
classified as calefacients, 7.e., heating agents. They are indicated in abnormal
sinking of the body temperature (freezing, loss of blood, last stages of poison-
ing and infectious diseases). In addition to the external and internal employ-
ment of heat (warm bandages, warm drinks), the calefacients also include
caffeine, which rapidly increases the temperature from 0.5 to 1°C. Small
doses of alcohol exert a similar effect.

Anticatarrhalics.—All of the drugs used in the treatment of catarrhs were
formerly classified as anticatarrhalics. The group included particularly the
astringents, expectorants, antiseptics and resorbents (alkalies).

Antidyscratics.—The terms antidyscratics, alterants and metasyncritics
wereused in the older therapeutics todesignate a series of so-called blood-purify~
ing medicines which were employed empirically in the treatment of different
dyscrasias and cachexias. The group was further subdivided into antiscrofu-
lous, anticarcinomatous, antisyphilitic, antiscorbutic, antarthritic, anti-
rheumatic. Arsenic, mercury, iodine, phosphorus, sulphur, antimony, the
alkalies and the so-called “‘wood-drinks” for man (sarsaparilla, sassafras)
were regarded as alterative drugs. The action which is really obtained from
these drugs is partly specifically antiseptic (mercury, iodine), partly resorbent
(arsenic) and partly diuretic or diaphoretic (alkalies, hot water).

DRUGS THAT KILL PARASITES. ANTIPARASITICS

1. EXTERNAL ANTIPARASITICS. ANTEPIZOA

Synonyms: Antiscabious, antipsorics, antipediculous, antiphthiriacs;
mange remedies.

Parasites of the Skin.—The numerous epizoa infesting the
skin of the domesticated animals which are to be combated with
antiparasitic remedies may be divided into two groups: animal and
vegetable. The animal parasites include the mange mites, of
which there are four species: sarcoptes, dermatocoptes, dermato-
phagus and dermatoryctes; the acarus mites [demodex follicu-
lorum], fleas, lice, hair and feather insects [mallophage], ticks,
forest flies, bird mites, harvest mites, cestrus larve, gad flies,
flies and gnats; also the different bird mites: feather-follicle
mites, feather-quill mites, feather mites, pigeon mites, etc. Of
the vegetable skin parasites, the most important are trichophyton
tonsurans (herpes) and achorion Schonleinii (favus).

Action of the Antiparasitics—The antiparasitic medicines
operate upon the skin parasites by different processes. Some
apparently act like the specific nerve poisons, stunning and para-
lyzing the parasites. To this group belong the ethereal oils, nico-
tine, veratrin, carbolic acid, creolin and other aromatic substances
of the benzol series, and hydrogen sulphide. Other antiparasitics
act like the caustics, particularly the mercurial and arsenical
preparations. If, for example, a louse is removed from the skin
after the application of mercurial ointment and examined under
the microscope, there is observed a corrosive inflammation of the
digestive tract which is manifested by a bloody, profuse diarrhcea.
The alkalies, soda lye, potash lye, caustic lime and soap, dissolve
the external chitinous layer of the mange mites. Finally, some
agents operate in a mechanical way by closing the air canals, as
occurs, for instance, in the use of fatty oils on ticks.

Classification.—The external antiparasitics may be divided
160

ANTIPARASITICS 161

either according to their action into mange remedies, remedies
against fleas, lice, ticks, gad flies, etc., or according to their chemical
composition. The chemical subdivisions include antiparasitics
from the group of ethereal oils: Peru balsam, styrax, turpentine
oil, oil of anise, oil of caraway, flores pyrethri, petroselinum; alka-
loidal antiparasitics: nicotine, veratrin, cevadilla seed, staphy-
sagria; benzol derivatives: creolin, lysol, bacillol, carbolic acid,
tar, creosote, salicylic acid, naphthalin, naphthol; metallic remedies:
mercurial preparations, arsenic, sulphur; alkalies: soap, soda,
potassium, caustic potash, caustic soda, caustic lime. The first
mentioned form of classification is most suitable for practical
therapeutics; according to this method the antiparasitics are
divided into the following groups:

Mange Remedies.—The most important are creolin, tobacco,
arsenic, corrosive sublimate, Peru balsam, carbolic acid, tar, creo-
sote, lysol, bacillol, sulphur, soap, soda, potassium, lime. The fol-
lowing baths or “dips” are used in the treatment of sheep scab:

1. Fréhner’s bath. Apply creolin liniment (creolin 1, alcohol
1, green soap 8) three to five days, then bathe twice in 214 per
cent. creolin solution.

2. Gerlach’s bath. (a) Preparatory bath: potash 2, lime 1,
water 50. (b) The mange bath proper: 3 per cent. tobacco
decoction (Roloff’s modification: 5 per cent. tobacco decoction).

3. Ziindel’s bath: crude carbolic acid 1.5, lime 1, soda 3, soft
soap 3, water 260. A modification of this bath is to use 2 per
cent. tobacco decoction in place of the water.

4. Tessier and Matthieu’s bath: arsenic 1 to 1.5, iron sulphate
or alum 10 to 15, water 100.

{Lime and sulphur dip: Mix 8 pounds of unslaked lime and 24
pounds of flowers of sulphur, add 30 gallons of water and boil for
not less than two hours. Allow sediment to settle, draw off the
clear liquid and dilute up to 100 gallons. Use at a temperature of
100 to 110° F. and keep each sheep in the dip two minutes, ducking
its head at least once; repeat in 10 days.

Tobacco and sulphur dip: Take one pound of tobacco leaves
for each 6 gallons of dip desired, place in a covered boiler, cover

162 GENERAL THERAPEUTICS FOR VETERINARIANS

with cold or lukewarm water and let stand 24 hours; bring to a
boil the evening before using, and let stand over night. Take 1
pound of flowers of sulphur for each 6 gallons of dip desired and
mix in a bucket with water to the consistency of gruel. When
ready to use, strain the tobacco infusion, expressing the liquid
from the tobacco leaves; mix the infusion with the sulphur gruel,
and add sufficient water to make the desired quantity of dip.
Use ata temperature of 100 to 110° F. and keep each sheep in the
dip two minutes, ducking its head at least once; repeat in 10 days.
Extracts of tobacco and nicotine solutions are on the market which
may be used in place of the tobacco leaves, thus simplifying the
preparation of the dip. These substances should be used in a
quantity which will produce a mixture containing not less than
five one-hundredths of one per cent. of nicotine and 2 per cent. of
flowers of sulphur.]

Remedies against Acarus Mites [Demodex].—Peru balsam,
creolin, corrosive sublimate, sulphurated potash, cantharides oint-
ment, oil of caraway, formaldehyde, bisulphide of carbon.

Remedies against Lice.—Mercurial ointment, creolin, lysol,
bacillol, arsenic, tobacco, corrosive sublimate, insect powder,
stavesacre seeds, cevadilla seeds, white hellebore, aniseed. These
are also employed against the hair parasites [mallophage].

Remedies against Fleas.—Persian insect powder.

Remedies against Feather Parasites.—Oil of anise, insect
powder, petroselinum, Peru balsam, creolin. The same remedies
are used against the other skin parasites of birds.

Remedies against Ticks.—Olive oil, turpentine oil, carbolic
acid in oil, creolin in oil.

[Arsenic has been found very effective for destroying ticks on
cattle. The solution is prepared as follows: 25 gallons of water are
placed in a caldron and brought to a boil; 24 pounds of sodium car-
bonate are added and dissolved by stirring; 8 pounds of arsenic are
then added and the mixture stirred until it is dissolved. The fire
is then drawn and when the solution has cooled down to 140° F.,
one gallon of pine tar is slowly added and thoroughly mixed with
the solution by stirring. Sufficient water is at once added to make

ANTIPARASITICS 163

the total volume of the solution 500 gallons. The regulations of
the Bureau of Animal Industry require that when the solution is to
be used as a dip for cattle which are to be shipped out of the
quarantined area 25 pounds of sodium carbonate and 10 pounds of
arsenic shall be used for each 500 gallons. In tick eradication, the
solution is applied as a spray or in the form of a dip or bath,
repeated every two or three weeks.]

Remedies against Forest Flies.—Creolin, tobacco, mercurial
ointment.

Remedies against Cstrus Flies.—Tar, creolin, asafcetida,
petroleum. ,

Remedies against Herpes and Favus.—Salicylic acid, creolin,
creosote, tincture of iodine, tar, mercurial ointment, ammoniated
mercurial ointment, corrosive sublimate, carbolic acid.

Drugs.—1. *Creolin. Creolin (creolinum anglicum) is the most
used antiparasitic. In the treatment of sheep scab it is applied
for several days in the form of a 10 per cent. liniment: creolin and
sapo mollis, 1 part of each, alcohol 8 parts. This is followed by a
bath or dip in a 24 per cent. solution of creolin, which is repeated
in 8days. Against sarcoptic mange of the horse and dog, a 10 per
cent. liniment of creolin, soap and alcohol is also employed. A 10
to 15 per cent. alcoholic solution is used against acarus [demodectic]
mange. Washings with 3 per cent. solution in water are em-
ployed against lice, forest flies, etc. Creolin ointment is used
against herpes, chicken mange and ticks. Birds infested with
vermin may be sprayed with a 1 per cent. solution of creolin in
water or given a bath in a warm 4 per cent. creolin solution, fol-
lowed by a bath in water. *Lysol! and *bacillol' have a similar
action.

2. Pixliquida. Tar. A very good remedy against horse mange
in the form of Vienna tar liniment: pix liquida and sulphur sub-
limatum, 1 part of each; sapo mollis and alcohol, 2 parts of each;
also used against mange of dogs, herpes, etc., in ointment or in
alcohol (1 : 10).

- P Liquor cresolis compositus, which is official in the U. S., is essentially
the same as these compounds.]}

164 GENERAL THERAPEUTICS FOR VETERINARIANS

3. Creosotum. Creosote. A good but very poisonous remedy
against mange of the dog and horse in the form of creosoted oil
(1 : 10).

4, Phenol. Carbolic acid. A remedy against sheep scab,
usually in combination with tobacco.

5. *Tabacum. Tobacco. A remedy against sheep scab and
mange in horses. The tobacco dip or bath for scab or mange is a
decoction of 714 kilograms [20 pounds] of tobacco in 250 liters [250
quarts] of water, to which is added 1 kilogram [2.68 pounds] each of
pure carbolic acid and potash. A 1 to 5 per cent. decoction of
tobacco or of tobacco-lye is also used against lice, fleas, etc.

6. Arseni trioxidum. Arsenic. The strongest but also the
most poisonous remedy against scab in sheep and mange in horses.
The arsenical dip or bath for sheep is ordinarily a 1 per cent. solu-
tion (combined with potash, alum, iron sulphate or aloes). Asa
wash for mange in the horse a 1 per cent. solution of arsenious
acetate is used.

7. Hydrargyri chloridum corrosivum. Corrosive sublimate.
A very powerful but also extremely poisonous antiparasitic against
mange mites, acarus, herpes, lice, etc.

8. Unguentum hydrargyri. Mercunal ointment. A good
remedy against lice. Formerly used also against sheep scab.

9. Balsamum Peruvianum. Peru balsam. A good and mild but
expensive mange remedy for dogs; used undiluted or in alcohol
(1:1to10). A specific against acarus [demodectic] mange. The
modern substitutes for Peru balsam: *perugen (artificial Peru
balsam), *peruskabin and *peruol (synthetic benzyl benzoate)
have a similar action.

10. Sulphur lotum, sulphur precipitatum, sulphur sublima-
tum. Sulphur. A specific against mange of cats in the form
of Helmerich’s ointment (2 parts sulphur, 1 part potash, 10 parts
lard).

11. *Potassa sulphurata. Liver of sulphur. A specific against
acarus mange in the form of 1 to 2 per cent. baths.

12. *Insect powder. The most used remedy against fleas,
feather insects, and fowl mites.

ANTIPARASITICS ; 165

13. Oleum anisi. Principal remedy against vermin of house
birds; sprinkled or sprayed in 1 per cent. solution. Oleum cari has
the same action.

14. Oleum terebinthine. Oilofturpentine. A specific against
ticks.

15. Acidum salicylicum. Salicylic acid. A specific against
herpes in 5-10 per cent. solution in alcohol. .

16. Alkalies. These are used to assist the action of mange
baths or dips.

2. WORM REMEDIES, ANTHELMINTICS

Synonyms: Vermifuges, antentozoa, antitenics; worm-expelling, worm-
destroying remedies; tapeworm remedies.

Intestinal Worms.—Not all entozoa can be expelled from the
body by medicines. Distome and echinococci in the liver and
lungs, cysticerci and trichine in the muscles, giant palisade worms
(Eustrongylus gigas) in the pelvis of the kidneys, strongylus arma-
tus in aneurisms in the anterior mesenteric artery, coenuri in the
brain, and some intestinal worms are not accessible to medi-
caments. But most of the intestinal worms can be effectively
removed by medicines. The parasites of the digestive apparatus
of greatest importance are:

1. Tapeworms: tenia cucumerina, serrata, marginata, ccen-
urus and echinococcus, and bothriocephalus latus in dogs; tenia
perfoliata, plicata and mamillana in horses; tenia expansa and
ovilla in sheep; tenia expansa, denticulata and alba in cattle;
tenia expansa in goats; tenia crassicollis and elliptica in cats;
tenia infundibuliformis, etc., in birds.

2. Round worms: ascaris megalocephala in horses, ascaris
marginata in dogs, ascaris mystax in cats, ascaris lumbricoides i in
cattle and swine, heteracis inflexa, etc., in birds.

3. Palisade worms: strongylus armatus and tetracanthus in
the intestinal canal of the horse; strongylus contortus in the abo-
masum of sheep? (stomach-worm disease); dochmius trigonoceph-
alus in the intestine of the dog.

[? Also affects calves in the southern part of the United States.]

166 GENERAL THERAPEUTICS FOR VETERINARIANS

4, Seat-worms: oxyuris curvula, vivapara and mastigodes in
horses; oxyuris vermicularis in the dog.

5. Spiroptera sanguinalenta in the stomach of the dog.

Another entozoén of the digestive apparatus is the gastrus
larva, which is found in the stomach of the horse and which is
resistant to most of the worm medicines. The entoparasites of the
respiratory apparatus which are at least partially accessible to
treatment include: cestrus ovis in the nasal cavities and nasal
sinuses of sheep; strongylus filaria in sheep (lung-worm disease),
strongylus micrurus in calves, strongylus paradoxus in swine; pen-
tastomum tenioides in the nasal cavities of the dog; syngamus
trachealis in fowl. In addition to these, vegetable parasites
(moulds, actinomyces) also occur in the air passages.

Action of Worm Remedies.—The anthelmintics are generally
regarded as specific nerve poisons which kill the entozoa imme-
diately or which temporarily stupefy and paralyze them, in conse-
quence of which they become detached from the intestinal mucous
membrane and are in part expelled and in part digested. Accord-
ing to their chemical properties, anthelmintics may be classified as
ethereal oils (turpentine oil, oleoresin of aspidium, oleum tanaceti) ;
alkaloids (areca nut, pomegranate bark) ; glucositic acids (santonin,
mallotoxin, kosin, filicic acid); benzol derivatives (creolin, tar, creo-
sote, picric acid, naphthalin, benzine) and metals (arsenic, tartar
emetic, copper oxide). For therapeutic purposes, it is most desir-
able to classify the anthelmintics according to the species of worms
against which they are used, as follows:

Tapeworm Remedies: kamala, aspidium, oleoresin of aspid-
ium, areca nut, kousso, pomegranate bark, copper oxide, potas-
sium picrate.

Round-worm Remedies: tartar emetic, arsenic, santonin,
santonica, turpentine oil.

Remedies against Lung Worms: turpentine oil, creolin, tar.

Remedies against Oxyuri: garlic, vinegar, soap, [quassia].

Remedies against Gastrus Larve [Bots]: bisulphide of carbon.

Against strongylus armatus and tetracanthus, also dochmius,
spiroptera, and other intestinal worms in the horse, one of the

ANTIPARASITICS 167

aforementioned round-worm remedies is used; in dogs, one of the
tapeworm remedies.

Drugs.—l. *Kamala. A tapeworm remedy for dogs. It is
also a drastic cathartic and the simultaneous administration of a
purgative is therefore not necessary. Dose for large dogs, 5-15,
3i to iv; small dogs, 2-5, grs. xxx to 31; cats and chickens, 1-2,
grs. xv to xxx; pigeons and parrots, 0.5-1, grs. vij to xv.

2. Oleoresina aspidii. Oleoresin of aspidium. A very effective
but very poisonous teniacide. Dose for large dogs, 2-5, grs. xxx
to 31; small dogs, 0.2-1, grs. iij to xv.

3. *Areca. Areca nut. Betel nut. A very good remedy
against tapeworms and round worms. Dose for horses, 100-200,
5 iij to vj; dogs, 5-10, 31 to ijss; sheep, 5-19, 3i to ijss; swine, 5-15,
3i to iv; chickens and geese, 2-4, grs. xxx to 3i; pigeons, 0.5-1, grs.
vij to xv.

4, Antimonii et potassii tartras. Tartar emetic. A valuable
anthelmintic against tapeworms and round worms of horses.
Dose, 10-15, 3ijss to iv, per day in the drinking water for 2 to 4
days.

5. Oleum terebinthine. Oil of turpentine. A very good
remedy against round worms in horses (50, 3 iss).

6. Arseni trioxidum. Arsenic. The same. Dose for horses,
1-3, grs. xv to xlv.2 The new arsenical preparations, *Atoxyl and
*“Salvarsan, have proven effective remedies against trypanosomes
and spirilla.

7. Santoninum. Santonin. A specific against round worms
of horses and dogs. Dose for dogs, 0.05-0.2, grs. 34 to iij.

8. Carbonei bisulphidum. Bisulphide of carbon. A remedy
against gastrus larve and round worms in horses. Dose, 8-12,
3ij to iij, in capsules, every hour until 4 doses have been given.

These eight remedies are sufficient for veterinary practice.
The patient should be prepared for the anthelmintic by being
starved a day before the medicine is administered. A few hours
after the anthelmintic is given a purgative should be administered,

( Gerlach reported that 20 grains of arsenic caused acute diarrhoea in a
horse.—Finlay Dun, Veterinary Medicines, 10th ed., p. 274.]

168 GENERAL THERAPEUTICS FOR VETERINARIANS

except in the case of kamala and tartar emetic. To assist the
action of the worm remedy, salted meat is given to carnivora, and
sugar beets, carrots and. raw potatoes to herbivora.

Other anthelmintics are: Cusso (dogs, 10-25, 3ijss to vj),
granatum (dogs, 5-50, 3i to xij), pelletierinze tannas (dogs, 0.2-0.4,
grs. lij to vj), *tanacetum (horses and cattle, 50-100, 3 iss to iij),
*cupri oxidum (horses, 2-15, grs. xxx to Jiijss; dogs, 0.05-0.1, grs.
34 to jss; sheep, 0.5-1, grs. vij to xv), *acidum picricum and
*potassii picras (lambs, of the former, 0.1—0.2, grs. jss to iij; of
the latter, 0.51, grs. vij to xv) ,chloroformum (dogs, 1-4, mxv to3i),
*creolin, naphthalenum, pix liquida,creosotum, benzinum, *petro-
leum, *absinthium, asafcetida, *allium and pepo.

‘DISINFECTANTS. ANTISEPTICS

Synonyms: Aseptics, colyseptics, antizymotics, antifermentatives, anti-
putrids, conservants, preservants; putrefaction and fermentation-combating
remedies; conserving remedies, preserving remedies.

1. DISINFECTION IN GENERAL

Historical.—The practical application of disinfection, 7.e., the
destruction of pathogenic or putrefactive bacteria or the preven-
tion of their growth, is very old. In this connection, it is only
necessary to mention the unrivalled technique used by the ancient
Egyptians in embalming the body. The scientific foundation
of disinfection, however, is of more recent date. The new era
began with the investigations of Pasteur concerning the yeasts and
with the work of Lister, who in 1867 for the first time studied the
effect of disinfection upon the healing of wounds and introduced
carbolic acid as a disinfectant. The further development of dis-
infection is closely connected with bacteriology and its more recent
experimental discoveries, with which the names of Pasteur and R.
Koch especially are associated. The first fundamental work of the
latter was published in 1881 (Ueber Disinfektion, Mitteilungen aus
dém Kaiserl. Gesundheitsamte, 1881). From this time on the
knowledge of disinfection is so intimately related to bacteriology
that to a certain degree it forms a part of that subject. And since
the science of bacteriology is in a state of continual progressive
development, it naturally follows that the present principles of
disinfection may undergo certain changes in the future. To
direct attention to the incomplete and unsettled condition of our
present knowledge and conception of disinfection at the oustet is
one of the most important tasks of general therapeutics. It conse-
quently follows that a conclusive statement of our knowledge of
disinfection cannot be made. This is the less feasible because the
infectious agents of some of the important plagues (foot-and-mouth
disease, contagious pneumonia of horses, influenza, pox, etc.) have
not as yet been demonstrated bacteriologically, and the knowledge

concerning disinfection for these diseases will, therefore, have to be
169

170 GENERAL THERAPEUTICS FOR VETERINARIANS

subsequently entirely revised on a scientific basis. Nevertheless,
the investigations which have been made up to this time have
furnished a series of important viewpoints concerning general
and special disinfection which may be regarded as a permanent
acquisition and as a preliminary foundation for a rational
and scientific system of disinfection. ‘The foundation of the
modern antisepsis and disinfection must be explained first of
all. This explanation will include the meaning of the different
terms, antisepsis and asepsis, colyseptics (inhibit development)
and antiseptics (destroy bacteria); the methods of bacteriological
investigation; the differences in the individual bacteria and dis-
infectants; the differences between bacilli and spores; method of
action, form, concentration, application and properties of the indi-
vidual medicines; the relation of the animal body or the infected
object to the disinfectant; the codperation of certain factors
(temperature, light); the importance of cleaning and preparation,
_and the time and continuance of the disinfectant action.

Antisepsis and Asepsis.—Starting with the conception that
- infection of wounds could be prevented by the employment of
antiseptics—7.e., drugs which destroy bacteria—and by a carefully
applied dressing, Lister in 1867 recommended carbolic acid in con-
nection with the dressing named after him as a method of dis-
infecting wounds. Lister’s dressing was applied as follows: After
the wound was cleaned with a 2 to 5 per cent. solution of carbolic
acid in water, and theair aboveit disinfected with aspray of the car-
bolic acid solution, it was covered with a piece of carbolized silk or
cotton (protective); over this was laid a thick layer of carbolized
gauze or cotton, which was covered with a pieceof imperviouscotton
material (mackintosh), and over all was placed a bandage of moist
carbolized gauze. In Germany, the Lister dressing was intro-
duced into general use between 1872 and 1875. Later, the car-
bolic spray was omitted and the dressing simplified. In 1880,
iodoform was substituted for carbolic acid and the dry bandage
took the place of the moist. Subsequently, iodoform was re-
placed in part by corrosive sublimate, creolin, lysol, tannoform,
tincture of iodine, and other disinfectants.

DISINFECTANTS. ANTISEPTICS 171

In recent times the use of antiseptics has been limited in human
surgery and for a time they were even given up entirely. Schim-
melbusch and others contended that the development of germs in a
wound could not be prevented with certainty by disinfectants
even when they were applied as early as one minute after the
infection; disinfection was therefore not only ineffective, but also
harmful, because it irritated the tissues and increased the wound
secretions. In place of the antiseptic wound treatment, the aseptic
method was proposed. Antiseptic fluids are not employed in the
latter method, but the wound is kept as dry as possible by means of
sterilized tampons, or is irrigated only with sterile water or sterile
physiological salt solution, and then covered with sterilized dress-
ing material. The latter is sterilized in a special apparatus by
prolonged (20 to 30 minutes) exposure to live steam of at least
100°C. Inasimilar manner, the instruments are made germ-free.
.They are most certainly sterilized, however, by prolonged boiling
in a 1 to 2 per cent. soda solution. Especial care is given to the
disinfection of the operator’s hands. After the nails are thor-
oughly cleaned, the hands are carefully brushed with soap and
warm water, then washed with warm sublimate, carbolic acid or
creolin solution and finally rinsed with 50 per cent. alcohol or soap
spirit. Care is also taken to keep aseptic the entire operating
room, the operation table, the clothing of the patient, operators,
assistants and attendants, all of the utensils used and the area
surrounding the wound (field of operation). Mull masks for the
mouth and nose of the operator are even used.

The aseptic treatment of wounds was regarded as an important
advance in human surgery because it left the healing of the wound
to the natural protective forces of the tissues (leucocytes, blood-
serum) and only guarded against external disturbances. More
recently, after Henle and others had shown that, contrary to
Schimmelbusch, local disinfection of wounds within the first hours
is very effective, and after it had been proven by statistics that the
results of the aseptic method were in no way more favorable than
the antiseptic, numerous surgeons changed from the purely aseptic
method to antisepsis (disinfection of the skin with tincture of

172 GENERAL THERAPEUTICS FOR VETERINARIANS

iodine). Moreover, disinfection of the hands was difficult and
uncertain and the introduction of sterilized operating gloves did
not improve conditions.

The aseptic method is not very well suited to veterinary sur-
gery. To this I have already directed attention in another place
(General Surgery). In veterinary practice, old infected wounds
are usually met with and for these thorough antisepsis is necessary
rather than asepsis. For fresh operation wounds in the domestic
animals the aseptic method is only exceptionally applicable, as for
example in a clinic; and even in well-equipped veterinary hospitals
the greatest difficulties are encountered in maintaining asepsis,
especially in horses, as a dressing can be applied only in a very
limited number of cases and infection of the wound during the
operation frequently cannot be avoided even with the greatest
care. Moreover, in addition to the contact infection, the air in-
fection (dust, hair) is of great import, and against this asepsis
has proven powerless. For these reasons, antisepsis is to be
preferred in veterinary practice to asepsis as the more certain
method.

Colyseptics and Antiseptics.—A pathogenic or putrefactive
microérganism can be made harmless in two ways. Its vital
activity can be destroyed or its development can be prevented.
In the first instance the action is antiseptic; in the latter, colyseptic.
Drugs with antiseptic properties are naturally more valuable than
those which have only a colyseptic action. Therefore, a strong
antiseptic action is the first essential in a good disinfectant; it
must not only prevent the development and multiplication of
pathogenic bacteria but must destroy their vitality. As a general
tule, the antiseptics exert only a colyseptic action when sufficiently
diluted. On the other hand, there are several disinfectants which
are only colyseptic in the strongest concentration and have no
antiseptic action or only a very weak one.

The division of the disinfectants into antiseptics and tolys
septics is only possible upon the basis of bacteriological experi-
ments. In order to test the colyseptic properties of a substance,
bacteria capable of development are placed upon a suitable culture:

‘

DISINFECTANTS. ANTISEPTICS 173

media which has been previously impregnated with the drug under
examination. If the bacteria fail to develop characteristic col-
onies upon the media (gelatin, bouillon, etc.), then it is to be
assumed that the presence of the drug has prevented the growth of
the organisms. However, it cannot be concluded from the experi-
ment that the vitality of the organisms is destroyed. This fact is
only established when a pathogenic organism which has been thus
treated is inoculated into a suitable experimental animal and no
infection is produced. Only in the latter case can antiseptic proper-
ties be attributed to the drug. Non-pathogenic bacteria are
tested by permitting them to dry upon silk threads and placing
the threads in a solution of the substance under test. After a
time the threads are removed from the solution, washed in water,
and placed upon suitable culture media. If the substance being
tested actually possesses antiseptic properties no growth will occur.

Relative Rank of the Disinfectants—In the beginning, the
individual disinfectants were tested bacteriologically in an en-
deavor to discover a drug which would destroy all known bacteria
when greatly diluted, but it was found that there is no such uni-
versal disinfectant. On the contrary, it was observed that specific
antiseptics are required to destroy individual species of bacteria,
just as certain antipyretics are required for the different types of
fever. For instance, corrosive sublimate is the most powerful
disinfectant for the virus of anthrax, but has only a very weak
action on tubercle bacilli and is much less effective than other
drugs (creolin, lysol, aleohol, formaldehyde) for superficial dis-
infection of the skin. Carbolic acid is relatively ineffective against
the tetanus bacillus, rabies virus, anthrax spores and tubercle
bacilli. Therefore, in disinfection the different drugs and bac-
teria must to a certain extent be considered individually. In a
general way, it can only be said that in the case of those micro-
organisms which exist in two different forms, namely, the con-
tinuous (spore) and vegetative (bacillus), the spores require much
more powerful antiseptics than the bacilli. Here, again, the
individual species of spores and bacilli show considerable differ-
ences in their ability to resist the action of the same drug. It is,

174 GENERAL THERAPEUTICS FOR VETERINARIANS

therefore, difficult to make up a comparative table of the individual
drugs. It can only be stated in a very general way that the strong-
est disinfectants, which also destroy spores, are corrosive sublimate
and the silver salts (silver nitrate); chlorine, bromine and iodine;
creolin, lysol and some of the other newer cresol preparations;
formaldehyde and wood tar. Contrasting with these are the
weaker antiseptics, which kill only the spore-free bacteria: coal
tar, carbolic acid, salicylic acid, aniline dyes, boric acid, calcium,
lyes and acids. Iron sulphate and sulphuric acid, formerly highly
valued as antiseptics, possess almost no antiseptic properties.
The aforementioned disinfectants are arranged in the following
table according to the dilutions in which they are efficient, the
dilutions given being the average of the different bacteriological
observations;

Spore-free material.
Spore-

Colyseptic Antiseptic containing
action. action. material.

Corrosive sublimate 1 : 1,000,000 1: 50,000 1: 1000
Silver nitrate 1 : 75,000 1 : 5000 ?
Halogens (chlorine, bromine, iodine)
Cresols (creolin, lysol) 1 : §000-25,000 1: 5000 1:50
Formaldehyde
Salicylic acid
aaa ial ah ala 1: 1000 1: 100 0
Boric acid
Calcium
Iron sulphate 1:50 1:3 0
Sulphuric acid 0 0 0

Resistance of the Individual Infectious Agents.—This is very
variable. Many infectious agents are very readily destroyed by
disinfectants. Asa consequence, for many of the infectious diseases
the employment of the weaker disinfectants (lime, soap, tar) is
sufficient. This is due in part to the fact that many of the patho-
genic organisms do not form spores. The infectious agents which
are easily destroyed are the anthrax bacilli, the bacilli of swine
erysipelas, the bacteria of hemorrhagic septicemia of cattle, the
bacteria of fowl cholera, and the virus of foot-and-mouth disease,
vesicular exanthema, pox and rinderpest. On the other hand,

DISINFECTANTS. ANTISEPTICS 175

anthrax spores, tubercle bacilli, tetanus spores, black leg spores,
and the contagion of lung plague and rabies are destroyed with
difficulty. For the purposes of practical disinfection, the more
important infectious diseases can therefore be classified in two
groups, the one including those for which a mild disinfectant is
sufficient and the other those which require a strong disinfectant.
The following groups are arranged on this basis:
A. Requiring strong disinfectants:

Anthrax spores.

Tetanus spores.

Tubercle bacilli.

Black leg spores

Lung plague virus.

Rabies virus.

B. Requiring mild disinfectants:

Anthrax bacilli.

Swine erysipelas bacilli.

Glanders bacilli.

Bacteria of hemorrhagic septicemia.

Foot-and-mouth disease virus.

Pox and rinderpest virus.

Staphylococci and streptococci occupy a position between
these two classes. They are much easier to destroy than spores
and spore-containing bacilli, but are considerably more resistant
to disinfectants than the spore-free organisms. For these reasons,
it is necessary to use the more powerful disinfectants (corrosive
sublimate, creolin, tincture of iodine) in the antiseptic treatment
of wounds in order to destroy the pus cocci (staphylococcus
pyogenes, streptococcus pyogenes).

Method of Action of the Disinfectants.—It has already been
stated that infectious material may be rendered ineffective either
through destruction of its vitality or through inhibition of its
development. In either case the method of action may be very
different. In general, disinfection is the result of the following
processes:

1. By coagulating the bacterial albumins (mycoproteins) the

176 GENERAL THERAPEUTICS FOR VETERINARIANS

metallic salts, particularly corrosive sublimate and silver nitrate,
act as antiseptics (formation of a precipitate of metallic albumi-
nate). Formaldehyde acts in the same manner.

2. A specific toxic action, narcotic to a certain extent, is attrib-
uted to the benzol derivatives, especially the cresols (creolin,
lysol, tar, creosote) and carbolic acid.

3. By oxidation, potassium permanganate (KMn0,), potassium
chlorate (KCI10;), hydrogen peroxide (H2O2), and other drugs act
as disinfectants.

4. Reduction (withdrawal of hydrogen). Chlorine and many
chlorine compounds operate by reduction. Corrosive sublimate,
zinc chloride and iron chloride, for example, act in part in this way.
The chlorine withdraws hydrogen from the bacteria, thus breaking
up and decomposing the albumin molecules, while the chlorine
and hydrogen combine to form hydrochloric acid; the chlorine
also decomposes the water, setting free nascent oxygen, which
oxidizes the bacteria.

5. Through a change of the reaction, most antiseptics act as
disinfectants, especially the acids and acid chlorides (also the
acid-reacting corrosive sublimate). Bacteria grow upon a weakly
alkaline or neutral culture media and merely a change of reaction
is sufficient to retard their development. Growth is also effected
by a considerable increase of the alkalinity (alkalies).

6. By dissolving the cell membrane, alkalies, organic acids
(vinegar) and soaps operate as disinfectants.

7. Precipitation. Corrosive sublimate and the other metallic
salts (iron sulphate) precipitate the bacteria from the fluids in
which they are suspended.

8. Absorption. Freshly heated charcoal absorbs gases and
acts as an antiseptic and deodorizer.

9. Withdrawal of water. Concentrated salt solutions (e.g.,
sodium chloride) and glycerin act in this way. Finally, a purely
mechanical fixation is produced by certain substances like oil
paints, tar and pastes.

As will be seen from the foregoing, the method of action of
a disinfectant may often be multiple. Corrosive sublimate, for

DISINFECTANTS. ANTISEPTICS 177

example, operates by coagulating albumin, by its acid reaction,
by precipitation and by the action of its chlorine.

Disinfectants and the Infected Objects.—The results obtained
by experiments in bacteriological laboratories cannot be applied
to disinfection in practice without further consideration (compare
iodoform!). Between the destruction of bacteria in artificial
cultures and the disinfection of a living body, a wound, a stable
or a manure pit there frequently exist very considerable differ-
ences. Therefore, in practice it is well to consider the inter-action
between the disinfectant and the object to be disinfected; both,
the disinfectant as well as the object, may under certain circum-
stances suffer changes in consequence of opposing influences
which will entirely defeat the purposes of the disinfection.

For the living body, the first point to be determined is whether
the disinfectant is poisonous or non-poisonous. Strictly speaking,
there is no disinfectant which is strongly antiseptic and at the
same time absolutely non-toxic for the animal body. It is rather
the rule that the toxicity of a disinfectant increases with the
strength of its antiseptic power, as is observed especially in con-
nection with corrosive sublimate. But if the term poisonous is
used in the ordinary sense, and is to be understood to mean harm-
ful results from small quantities of the disinfectant, or from weak
dilutions used in the usual way for practical disinfection, then it
can be said that there are disinfectants which are not poisonous.
As examples, boric acid, salicylic acid, aluminum acetate and
creolin may be mentioned. In regard to the former denials of
the non-toxicity of the latter drug, the investigations of von
Behring and experiences in practice agree that creolin may be
employed as a disinfectant without any danger of poisoning. As
poisonous antiseptics may be mentioned carbolic acid, creosote,
the free cresols, corrosive sublimate, formaldehyde, chlorine,
bromine and iodine. Corrosive sublimate is the most poisonous;
it is forty times as poisonous as carbolic acid. According to von
Behring, the toxicity of a disinfectant for the animal body may be
calculated from the action of the drug upon anthrax bacilli sus-

pended in blood-serum; most disinfectants are five to seven times
12

178 GENERAL THERAPEUTICS FOR VETERINARIANS

more poisonous for the animal organism than for anthrax bacilli.
Poisoning from antiseptics results from their internal, subcutaneous
and epidermatic use, especially from the use of corrosive sublimate
to disinfect the uterus of the cow and carbolic acid to disinfect
wounds of cats. Disinfection with chlorine and bromine is very
dangerous for man and animals.

The blood exerts a very strong modifying influence upon the
disinfectant action of many antiseptics. Corrosive sublimate, for
example, destroys anthrax bacilli in blood only in a concentration
of 1 : 2000 and after prolonged action, while it destroys the same
organism in water immediately and in a dilution of 1 : 50,000.
The cause of this surprising difference is to be found in the fact
that the albumin in solution in the blood is precipitated by the
sublimate in the form of albuminate of mercury, which retards
the penetration of the sublimate into the deeper layers of the blood.
Similar observations have been made in connection with silver
nitrate, carbolic acid, creolin and other drugs. While creolin is
effective against anthrax bacilli in bouillon in a dilution of 1 : 10,-
000, a concentration of 1: 200 is required to destroy anthrax
bacilli in blood-serum. Since in the disinfection of wounds one
has to do in part with blood disinfection, these relations should
be given consideration in the antiseptic treatment of wounds and
blood should be as completely removed from the wound as
possible.

In using disinfectants upon the skin or upon wounds, it must
be remembered that many of them are caustic in strong concen-
tration (sublimate, silver nitrate, carbolic acid) and are always
irritant, even in weak solution (sublimate, formaldehyde). This
consideration led to the substitution of asepsis for antisepsis in
human medicine (see p. 170). Moreover, only a superficial dis-
infection can be obtained, since the disinfectants as a rule do not
operate deeply (alcohol is an exception). A superior disinfectant
for superficial disinfection of the animal body and one which is
to be preferred to corrosive sublimate as well as carbolic acid is,
according to von Behring, the English creolin. This is also true
of formaldehyde and dilute alcohol (disinfection of the hands).

DISINFECTANTS. ANTISEPTICS 179

Iodoform undergoes a peculiar decomposition when it comes in
contact with pus; iodine is set free, and this free iodine is the cause
of the antiseptic action of iodoform.

In the disinfection of stables, many forms of decomposition
occur. This is especially the case with corrosive sublimate when
it comes in contact with organic or albuminous substances, excre-
ment, urine, and water. The disinfection of dried infectious
material is particularly difficult; a detailed discussion of this
point will be found in a succeeding section. The effective dis-
infection of infected dung and liquid manure is very difficult
because the organic constituents and gases (HS, NH;) decom-
pose some antiseptics; e.g., corrosive sublimate. Other disinfec-
tants quickly lose their effect because they form ineffective com-
binations (change of caustic lime to acid phosphates, silver nitrate
to silver chloride, salicylic acid to sodium salicylate).

Continuance of the Action of Disinfectants.—The rapidity of
its disinfectant action is of essential importance in considering
the value of any antiseptic. The shorter the action, the stronger
usually must be the concentration. It is desirable in practice to
continue the action of a quickly acting disinfectant as long as
possible upon the object to be disinfected. Antiseptic irrigations
of old wounds especially must be continued for a long time (for
Y hour and over). Disinfection of stables with autan must
continue seven hours. In disinfecting with chlorine and bromine
a 24-hour action is necessary.

In general, a good disinfectant should destroy the bacteria.
acted upon within a few minutes. This standard cannot be
complied with absolutely, particularly not in connection with the
spore-containing bacteria, which always require a much longer
time for destruction than the spore-free organisms. While carbolic
acid, creolin, formaldehyde and corrosive sublimate in suitable
concentrations destroy anthrax bacilli at once or at most within
a few minutes, they show the following relations to anthrax spores:

Formaldehyde (2 per cent.) kills anthrax spores after 7 hours.

Corrosive sublimate (17 per cent.) kills anthrax spores after
1 day.

180 GENERAL THERAPEUTICS FOR VETERINARIANS

Creolin (3 per cent.) kills anthrax spores after 2 days.

Carbolie acid (5 per cent.), anthrax spores were not killed after
20 days.

Influence of Temperature.—The disinfectant power of a drug
can be considerably increased by the simultaneous operation of
high degrees of temperature. For this reason, it is recommended
that disinfectant fluids be employed as warm as possible. This
applies particularly to the disinfection of the hands (warm water
and soap and sublimate solution). Anthrax bacilli are destroyed
at 3° C. by a 1: 25,000 solution of sublimate, while at 36° C.
they are destroyed by a four times weaker dilution, 1: 100,000.
Anthrax spores, which are not destroyed with certainty after 20
days by a 5 per cent. solution of carbolic acid at ordinary tempera-
tures, are killed after 3 hours’ exposure to the carbolic acid solu-
tion at 37°C. Live steam kills them within the same period, and
formalin vapor (1-2 per cent.) at 70° C. after 5 minutes. Soda is
entirely ineffective against these organisms at the ordinary tem-
perature, but a 114 per cent. solution at higher temperatures will
destroy them as follows:

At 80-88° C. after 10 minutes.

At 77° C, after 15 minutes.

At 75° C. after 20 minutes.

At 70° C. after 30-60 minutes (von Behring).

Influence of Concentration.—The stronger the concentration
the more effective in general is the disinfectant action of the anti-
septic. An exception to this rule is creolin, which is most efficient
in concentrations which favor the formation of a complete emul-
sion, especially 2-3 : 100; 10 to 20 per cent. solutions are not rela-
tively as efficient because the greater part of the creolin is not
emulsified and is therefore not entirely effective. The influence of
concentration upon the action of an antiseptic is shown by the
following figures:

Corrosive sublimate 1:100 kills anthrax spores after 80
minutes.

Corrosive sublimate 1 : 200 kills anthrax spores after 2 hours.

Corrosive sublimate 1 : 400 kills anthrax spores after 4 hours.

DISINFECTANTS. ANTISEPTICS 181

Corrosive sublimate 1 : 1000 kills anthrax spores after 24 hours
(von Behring).

Influence of the Form of the Disinfectant.—The different
conditions of aggregation exert a definite influence upon the degree
of antiseptic action. Solid, insoluble bodies possess no disinfec-
tant action because they cannot penetrate the mass to be dis-
infected. Disinfectants in solution in water are most effective.
Alcoholic solutions are also very effective when the solvent is
alcohol diluted with water. On the other hand, solutions in oil
are not effective, as was demonstrated by Koch in connection
with carbolized oil. Disinfectants in the gaseous form are very
unreliable, except formaldehyde. Koch was the first to demonstrate
the inefficiency of sulphurous acid, which was formerly so highly val-
ued as a disinfectant. The practical value of chlorine and bromine
in the gaseous form has been placed in great doubt by von Behring.
Even calcium chloride is disinfectant in slight degree in the gaseous
form only when the object to be disinfected is moist, when the bac-

teria are entirely superficial and when 11% per cent. by volume of
free chlorine is developed in the area to be disinfected. Many other
superior antiseptics are not suitable for practical use because they
are not soluble in water. These include, first of all, the ethereal oils,
which in alcoholic solutions possess a very high disinfectant action.
The behavior of iodoform, which is in powder form, is peculiar; it be-
comes antiseptic only after it is decomposed and iodine is set free.

Time of Disinfection—In many cases it is very important
that the disinfection be undertaken within a certain time. This
applies especially to the disinfection of wounds. Fresh wounds
are much easier disinfected than old, suppurating wounds. The
prompt use of a suitable disinfectant (tannoform) on fresh wounds
will prevent suppuration. On the other hand, the disinfection of
old wounds is difficult and frequently impossible on account of
the bacteria having penetrated deeply into the tissues. In an-
thrax, tetanus and rabies, disinfection should be undertaken at the
earliest possible moment after the diagnosis is made, especially

* in anthrax, in order to prevent the easily destroyed bacilli from
developing the highly resistant spores.

182 GENERAL THERAPEUTICS FOR VETERINARIANS

Preliminary Preparation.—A thorough cleaning is an indis-
pensable preliminary preparation for disinfection. This will
make the infectious material more accessible to the antiseptic,
so that a relatively simple and mild disinfectant will be sufficient,
or it may entirely remove the infection. Water and soap alone
are often sufficient for disinfection. The aseptic treatment of
wounds was based entirely upon a careful cleansing of the wound,
the instruments and the hands, and the exclusion of infection.
Infected rooms, walls and other objects may be disinfected by
thorough washing with warm water and soap. A preliminary
disinfection must, however, precede the cleaning when disease-
producing organisms may be scattered by the cleaning, or when
the dirt cannot be collected in such a manner as to exclude the
possibility of spreading the infection; in addition, when the clean-
ing is done without a preliminary disinfection those doing the
work are in danger of infection. In these exceptional cases the
work should be done in the following order: first, preliminary
disinfection; second, cleaning; third, thorough final disinfection.

Cost of Disinfection.—In every disinfection the question of
cost is an important consideration. In the interest of agriculture,
the veterinarian is obliged to adopt the cheapest possible method
of disinfection. For instance, the free use of iodoform, ichthargon,
glutol or protargol by the veterinarian in the treatment of wounds
must be regarded as a luxury. The use of silver nitrate as a dis-
infectant in outbreaks of disease is forbidden by its high cost.
Carbolic acid must also be regarded as a relatively expensive
disinfectant. A 5 per cent. solution of carbolic acid is ten times
as costly as the much more powerful 1 per cent. corrosive sublimate
solution and 3 per cent. creolin solution. Properly carried out,
chlorine and bromine disinfection is very expensive. The cheap-
est disinfectants, and therefore the easiest to obtain, are lime,
soda, potassium, soap and tar. Other cheap disinfectants are
corrosive sublimate, creolin, lysol, solveol, solutol, bacillol and
cresol-sulphuric acid. In the following table is given the present
average wholesale price per pound of the most frequently used
antiseptics or disinfectants:

DISINFECTANTS. ANTISEPTICS 183

PRO BING, cyacene eee egeyes bboawaekeus per Ib. $0.08
CREOIM, saccesesa ents ad eev dase aenogy oeber IDs 65
VSO 3 tiny s wsad pcs mated wee te pe aoiig ai eee ehais perlb. 67
Carbo atid 52 itaotnateunejuek ep aus perlb. 15
Corrosive sublimate..................... per lb. .69
Tannoform..................0 000.0000. per oz 35
Todoform...................0000 cece eee per lb. 4.55
PROtareol: aus del ek pene whee aoe peroz. 1.25
ATISCOl iyo. santa dnteon aie Badcaiies aes peroz. 1.80
Ichthargon...................00.000000. peroz. 3.00

Properties of Disinfectants.—The results of disinfection will depend upon
other factors of importance. These include the quality and purity of the
disinfectants. When calcium chloride is stored its chlorine content decreases
and it finally becomes ineffective. Burnt lime, when exposed to the air,
is gradually changed to the ineffective calcium carbonate. Calcium chloride
and burnt lime must therefore be used in as fresh condition as possible. In
regard to creolin, Henle and von Behring have demonstrated that the German
creolin, in contrast with the English creolin, possesses no disinfection action
worth mentioning. Finally, an effort should be made to carry out every
disinfection with as little inconvenience as possible, avoiding all unnecessary
disturbance of agricultural operations.

2. DISINFECTION FOR INFECTIOUS ANIMAL DISEASES

General.—Disinfection for the different infectious diseases of
animals is regulated by the German veterinary sanitary law of
June 26, 1909 (Supplement A to the instructions of the federal
council of December 25, 1911), the law of February 25, 1876,
concerning the spread of infectious materials by the transporta-
tion of cattle over railroads, and the regulations of the federal
council based on this law and issued June 20, 1886, with the
modification of July 26, 1899 (the disinfection with 5 per cent.
carbolic acid solution is not only required, as formerly, for anthrax,
rinderpest and foot-and-mouth disease, but also for glanders,
swine plague and hog cholera); also by the more recent regulations
with reference to fowl cholera (February 2 and July 4,1899) and the
announcement of the federal council of July 16, 1904 (substitution
of a 3 per cent. solution of the cresol-sulphuric acid mixture for the

184 GENERAL THERAPEUTICS FOR VETERINARIANS

5 per cent. carbolic acid solution), by the rinderpest law (April 7,
1869), and by the military-veterinary instructions for the service
horses of the army. These laws and regulations contain definite
instructions concerning cleaning and disinfectant agents (water,
soap water, soda lye, freshly-slaked lime, calcium chloride, solu-
tions of carbolic acid and cresol, cresol-sulphuric acid mixture,
corrosive sublimate, formaldehyde, fire), methods of cleaning and
disinfecting, and the procedure to be followed in the different
infections (anthrax, rabies, glanders, foot-and-mouth disease,
lung plague, sheep-pox, swine erysipelas, swine plague, hog cholera,
tuberculosis, mange, fowl cholera, fowl pest and rinderpest).

I, SUPPLEMENT A TO THE INSTRUCTIONS OF THE FEDERAL
COUNCIL, DECEMBER 25, 1911 (DISINFECTION IN
INFECTIOUS DISEASES)

Regulations for Disinfection in Infectious Diseases
I. Guneran

§ 1. Cleaning and disinfection is to be done according to these regulations
under the observation and direction of the official veterinarian and under
police supervision. -

§2. The disinfection process includes cleaning and disinfection. The
cleaning must regularly precede the disinfection; this does not forbid a pre-
liminary disinfection before beginning the cleaning (see §5, No. 10; §6,
subdivision 2).

II. Crzanina

§ 3. Persons must wash with warm water and soap the hands and other
parts of the body which may have been soiled; in case of necessity these parts
rust also be subjected to a preliminary disinfection (§ 5, No.10). The clothing
and foot-gear, when not changed, are to be brushed with soap and water to
remove attached dirt.

§ 4. Animals are to have the surface of the body, especially the hoofs and
claws, cleaned of attached dirt by careful washing or some other suitable
process. When necessary the hoofs and claws are to be trimmed out.

§ 5. Stables and other places of accommodation are to be treated as
follows: ‘

1. Manure and other gross dirt, straw, feed residue, straw packing, and
similar substances are to be removed and disposed of according to Nos. 9
and 10. Only the upper layer need be removed from the manure piles in

DISINFECTANTS. ANTISEPTICS 185

sheep and cattle stables when in the judgment of the official veterinarian this
is sufficient and when the veterinary sanitary regulations will permit.

2. Wood utensils, racks and mangers and board linings are to be taken
out as far as is necessary. Wood-work with a torn or splintered surface must
be removed to a sufficient extent to obtain a smooth surface. The pieces of
wood removed and all decaying or rotten wood, or wood cae is otherwise
unsuitable for use, are to be burned.

3. From clay walls a layer of sufficient depth is to be ae Damaged
or loose parts of the plaster or rough-cast on the walls are to be removed and
disposed of in the same manner as the manure.

4. Loose paving and planks in the floor are to be removed. The earth
under the flooring which is wet with excretions must be dug out, and the
material removed is to be disposed of in the same manner as the manure.
Stone and sound wood-work in which the moisture has not penetrated deeply
can be again used after the damaged parts have been removed.

5. In tightly joined (impervious) floors, in case of necessity, the damaged
places in the binding material or in the material itself, or cracks in the latter,
can be scraped out and the spaces, after thorough cleaning and disinfection,
can be filled in with new material. Similar conditions in the walls, pillars,
stall partitions, pits, troughs, gutters and canals may be treated in the same
manner.

6. Lime or earth floors (puddled clay and the like) should have the upper
layer removed and the moist places dug out. The part removed is to be
treated like the manure. ,

7. Earth and sand floors, in so far as they are wet with excretions, are to
be removed to the depth of at least 4 inches.

8. The ceiling, walls, fittings (mangers, troughs, racks, posts, sities
stalls, doors, door posts, windows, etc.), floor, manure gutters, canals, troughs
and pits are to be thoroughly cleaned by scouring with hot soda solution (a
solution of at least 8 pounds of washing soda to 100 quarts of hot water) or
hot soap solution (8 pounds of soft soap dissolved in 100 quarts of hot water).
The cleaning is only to be regarded as complete when all excretions from dis-
eased or suspected animals and all dirt have been removed and everything
has an entirely clean appearance. When necessary, scouring sand may be
used with the hot soda or soap solution. The cleaning must include all parts
of the stable and other places where animals are kept. Special attention is
to be given to depressions in the floor, corners, niches, joints, cracks, scratches,
etc. In stables and other compartments, the ceilings are cleaned first, as
a Tule, then the walls and interior fittings and lastly the floors, manure
gutters, etc.

When the official veterinarian considers it unnecessary, stable ceilings and
the upper parts of the walls which have not been soiled with the eliminations

186 GENERAL THERAPEUTICS FOR VETERINARIANS

from diseased animals need not be scoured with the soda or soap solution, but
may be cleaned by thoroughly spraying with hot soda or soap solution or with
hot water. Where hot soda or soap solution or hot water cannot be ob-
tained in sufficient amount, water under strong pressure from a water sup-
ply pipe or from a fire hose, garden hose or some similar arrangement may be
used, if in the judgment of the official veterinarian it will answer the purpose.

9. The manure and other dirt removed in cleaning, the straw, feed
residue and other substances (see Nos. 1 to 7), blood, stomach and intestinal
contents and other offal from slaughtered, dead and diseased or suspected
animals are to be collected together upon the infected premises. In cases where
the collection of the manure upon the infected premises is impossible or
undesirable it may, with official veterinary approval and with proper care,
be collected in a suitable place outside of the infected premises.

The soiled water from cleaning is to be collected in the manure pit or in
some other general container on the infected premises.

10. When the manure and other dirt, the straw, feed residue, etc., removed
in cleaning, and the dirty fluids from cleaning, cannot be collected on the
infected premises or in another suitable place without danger of spreading
the infection, then, if it is necessary to render those materials harmless, a
preliminary disinfection must precede the cleaning, a suitable disinfection
fluid being applied (§ 11 and §§ 15 to 27). In these cases, care should be taken
that the manure and other dirt, straw, feed residue, dirty water, etc., are not
placed even temporarily, before the final disinfection, in locations where the
contaminated water may drain into other premises, where the materials
are accessible to strange persons or animals, or where the fluids can flow into
springs, water courses or other sources of water supply.

A disinfection is also to precede cleaning when there is danger that the
persons doing the cleaning may be infected without previous disinfection, as
in anthrax and glanders (§§ 15, 18).

§6. (Subdivision 1.) Utensils, clothing, and other objects are to be
treated in the following manner:

1. Combustible articles of little value are to be burned.

2. Wood stable and driving equipment (feed boxes, buckets, brooms,
forks, shovels, etc., feed carts, wagons, sledges, harness parts, wood shoes,
etc.) are to be thoroughly scoured with hot soda or soap solution.

3. Utensils of iron and other metals (chains, rings, forks, shovels, curry-
combs, bits, muzzles, troughs, other feeding and watering vessels and other
vessels, cages, etc.) are, in so far as they cannot be disinfected by fire (part III),
to be thoroughly cleaned and then washed with hot water.

4, Leather and rubber articles (halters, girths, bridles, draught harness,
saddles, straps, cushion covers, leather shoes, dog collars, whips, etc.) are to
be scrubbed with soap and water.

DISINFECTANTS. ANTISEPTICS 187

5. Articles of cloth or vegetable fibres (blankets, girths, halters, ropes,
cushion covers, pieces of clothing, bed covers, etc.) are to be freed from dirt
by scrubbing with soap and water.

6. Hair, wool, feathers, cushion packing, and similar substances are to
be spread out in a thin layer and exposed to the air for three days, being turned
as often as possible.

(Subdivision 2.) Under the conditions described in § 5, No. 10, a pre-
liminary disinfection of utensils, clothing and other objects is necessary.

§ 7. The cleaning of railroad stock pens and similar places, slaughter
houses, ships and ferries is to be carried out as directed in §§ 5 and 6.

§ 8. Stock-yards are to be cleaned by first collecting the manure dropped
by the animals; then paved places are to be thoroughly cleaned with brooms
and washed with water, and unpaved places are to be raked and harrowed
level. Where necessary, the apparatus for tying-up is to be washed with
water.

§ 9. Roads (alleys) are to be cleaned in the same manner as the stock-
yards.

§ 10. Places in pastures where animals stand (exercise places, milking
stations, etc.) are to be cleaned in the same manner as the stock yards.

III. Disinrection
1. Disinfectants

§11. (Subdivision 1.) The following are used as disinfectants:

1, Freshly slaked lime. This is obtained as follows: freshly burned
lime is placed, without breaking up or powdering, in a capacious vessel and
covered with about half the quantity of water; under these circumstances it
breaks up into a powder with the generation of considerable heat and gas.

2. Milk of lime. This is used in concentrated and dilute form.

Concentrated milk of lime is prepared by adding slowly, with continual
stirring, three liters [3 quarts] of water to one liter [1 quart] of freshly slaked
lime.

Dilute milk of lime is prepared by adding slowly, with continual stirring,
20 liters [20 quarts] of water to one liter [1 quart] of freshly slaked lime.

If freshly slaked lime cannot be obtained, then the milk of lime is prepared
by mixing with each liter of slaked lime, as it is found in a lime pit, 3 or 20
liters of water. In such cases, however, care must be taken to previously
remove the upper layer of lime, which is changed by the influence of the atmos-
phere.

The milk of lime is to be shaken and stirred before it is used.

8. Calcium chloride solution. The calcium chloride should possess a
pronounced odor of chlorine and should be stored in tightly stoppered bottles
and protected from light. The solution is prepared by adding to each liter

188 GENERAL THERAPEUTICS FOR VETERINARIANS

[quart] of calcium chloride, slowly and with continual stirring, 3 or 20 liters
[quarts] of water (concentrated and dilute calcium chloride solution). The
solution is in every case to be freshly prepared immediately before using.

4. Dilute cresol water (2.5 per cent.!). This is prepared by adding to
50 c.c. [12 drams] of liquor cresolis compositus sufficient water to make 1
liter [1 quart] and mixing thoroughly.

5. Carbolic acid solution (about 3 per cent.). This is prepared by adding
to 30 c.c. [1 ounce] of liquefied carbolic acid (phenol liquefactum) sufficient
water to make one liter [1 quart] of disinfectant fluid, and mixing thoroughly.

6. Cresol-sulphuric acid solution. In the preparation of the solution, 2
parts by volume of crude cresol are mixed at ordinary temperature with 1
part by volume of crude sulphuric acid and the mixture is allowed to stand
for at least 24 hours. Then for each 30 c.c. [ounce] of the mixture sufficient
water is added to make a liter [quart] of disinfectant fluid, and thoroughly
mixed. The solution must be used within 3 months.

When the solution is to be used to disinfect places in the open (court-
yards, stock-yards, etc.) in cold weather, sodium chloride (0.5 to 1 kilogram
{1.3 to 2.6 pounds] to each 10 liters [10 quarts]) may be added to prevent
freezing, being thoroughly mixed in by stirring.

Stables, yards, utensils, etc., which have been cleansed with soda or soap
solution must be thoroughly washed with water to remove the remaining soda
or soap before the cresol-sulphuric acid solution is applied. i

7. Corrosive sublimate solution (1/10 percent.). Thissolutionisprepared
by dissolving in each liter [quart] of water 1 gram [15 grains] of corrosive sub-
limate and 1 gram [15 grains] of sodium chloride with a small amount of red
coloring matter, or colored tablets, containing 1 gram [15 grains] of sublimate,
may be used.

Stables, yards, utensils, etc., which have been cleansed with soda or
soap solution must be washed with water to remove any remaining soda or
soap before being disinfected with the sublimate solution. Disinfections in
which large quantities of sublimate solution are used, as the disinfection of
stables, yards, etc., can only be done under veterinary or police supervision.
In disinfecting with sublimate solution, especially in disinfecting cattle stables,
it is recommended that the disinfected surfaces and objects be washed after
24 hours with a 14 per cent. solution of sulphurated potassium.

8. Formaldehyde solution (about 1 per cent.). This is prepared by adding
to each 30 c.c. [ounce] of commercial formaldehyde solution (formalin) sufficient
water to make 1 liter [quart] of the disinfectant solution, and mixing thoroughly.

1In swine plague and hog cholera a 6 per cent. cresol water is used. In-
stead of 50 c.c. [12 drams] of liquor cresolis compositus, 120 c.c. [4 ounces]
are required for each liter [quart].

DISINFECTANTS. ANTISEPTICS 189

9. Steam in apparatuses which have been examined by experts when
erected and at regular intervals afterward and found satisfactory.

In addition, steam from a steam boiler may be employed for small vessels
with one opening, like milk cans, provided the steam is used under pressure
and is introduced directly into the vessel. The interior of the vessel is first
exposed to the live steam and then the hoops, bands and external wall, the
latter especially in wood vessels.

10. Boiling in water or in 3 per cent. soda or soap solution (see § 5, No. 8).
The fluid must be put on the fire cold, the objects completely immersed and
the boiling continued for at least a quarter hour. The vessel must be covered.

Milk buckets, milk cans and other milk vessels, instead of being sub-
jected to the boiling process described, may be treated in the following manner:

(2) The vessel is laid in boiling-hot water or in boiling-hot soda solution
or dilute milk of lime for at least 2 minutes, all parts of the vessel
being covered by the fluid.

(b) The external and internal surface of the vessels, the handles and
covers are scrubbed with boiling-hot water or boiling-hot soda
solution.

11. Thorough singeing and heating with fire or a suitable flame

12. Burning.

(Subdivision 2.) The disinfectants described in Nos. 4 to 7 are to be used
as hot as possible.

(Subdivision 3.) According to further regulations of the government,
other disinfectants and methods, which have been tested in regard to their
effectiveness and practical application, may be employed in addition to those
mentioned above.

2. Choice of Disinfectant and Method of Application.

§ 12. The choice of the disinfectant (§ 11) and the method of application
will depend in general upon the resistance of the infectious agent, the facility
with which it is carried by intermediate bodies and the special conditions

- existing in each case.

§ 12. In epizodtics, the infectious agent of which is easily destroyed and
which is spread by the diseased animals, it will be sufficient to clean and then
whitewash with dilute milk of lime or calcium chloride solution the ceiling,
walls, posts, pillars, stalls, doors, floors, gutters and equipment. Iron parts
are to be wiped with dilute cresol water or carbolic acid solution. Wood and
stone and glazed tiles are to be treated in the same manner.

§ 14. (Subdivision 1.) In epizodtics of which the infectious agent is
difficult to destroy, or when there is great danger that the disease may be
further spread by intermediate objects, the following process is to be followed:

1. The bedding, manure, other dirt, feed residue, etc., removed in clean-

190 GENERAL THERAPEUTICS FOR VETERINARIANS

ing is to be collected together and either burned, buried, plowed under, or
rendered harmless by composting or by mixing with a suitable disinfectant.

The compost piles containing the manure, straw, feed residue and similar
material should be placed so that susceptible animals and unauthorized
persons cannot walk over them, dirty fluids flow from them to other premises,
strange persons have access to them, or washings from them contaminate
springs, water courses or other sources of water supply. The materials should
be thoroughly mixed in the proportion of two parts of manure to three of
straw, moderately moistened, and loosely piled in large heaps for three weeks.
After being piled in a heap, the manure is moistened with water or urine
(about 10 to 15 quarts to 1 square yard of manure). The remainder of the
process is as follows: A layer of non-infected manure, straw or turf about
10 inches deep, 5 to 6 feet broad and as long as desired is first placed upon
the ground and upon this the manure to be disinfected is piled in a heap 4
feet high with sloping sides. The surface of the heap is covered with a layer
of non-infected manure, straw, leaves, turf or other loose material four inches
deep, and over this is placed a layer of earth of the same thickness. After
remaining three weeks in this condition the manure may be removed without
danger. ,

Manure and bedding material which has not been composted and which
is required to be rendered harmless (see §§15 to 27) must be removed
from infected premises in tight wagons without the employment of sus-
ceptible animals from other premises. In case of necessity, the manure,
bedding material, etc., must be wet down in layers with concentrated milk
of lime, unless the character of the infection requires the use of another
disinfectant.

When the method of storing the manure which is permitted is such that
there is danger of the infectious material being spread by contaminated water
flowing into other premises, by the manure being accessible to strange persons
or animals, or by springs, streams or other water supplies being contaminated,
then the manure is to be treated with concentrated milk of lime in the stalls
before it is removed to the place of storage.

2. Liquid manure and dirty water, in so far as they are not used in the
composting of manure (No. 1), are to be disinfected with lime, concentrated
milk of lime, calcium chloride or concentrated solution of calcium chloride.
At least 1 part by volume of lime or calcium chloride or 3 parts by volume of
concentrated milk of lime or concentrated calcium chloride solution are to
be used to each 100 parts of liquid manure or dirty water. The mixture must
be thoroughly stirred and allowed to stand for at least 2 hours.

3. Feed and straw stored in the rooms to be disinfected are to be removed
without harm in so far as the regulations do not provide that they be disposed
of in another manner (§§ 15 to 27).

DISINFECTANTS. ANTISEPTICS 191

4. Ceilings and walls, fittings (mangers, troughs, pillars, posts, stalls,
doors, door posts, windows, etc.), floors, gutters, canals, troughs and pits
are to be whitewashed with dilute milk of lime or calcium chloride solution
or brushed or thoroughly sprayed with dilute cresol water, carbolic acid,
formaldehyde, corrosive sublimate or cresol-sulphuric acid solution.

Tron parts are to be treated with dilute cresol water or with carbolic acid
solution.

5. Impervious paving or floors in court yards, railroad stock pens, slaughter
houses, stock-yards, roads (streets), ships and ferries are to be washed or
sprayed in a suitable manner with dilute milk of lime or calcium chloride
solution or other disinfectants (§§ 15 to 27). In cold weather the pavements
are washed with cresol-sulphuric acid solution containing sodium chloride
or are sprinkled with powdered, freshly-slaked lime.

The same process may be used for court yards, stock-yards, roads, streets
and farm stock pens which have a paving that is pervious or which are unpaved.

6. Earth and sand floors which are not moistened with the excretions of
diseased or suspected animals, including earth and sand under floors removed
according to § 5,4 to 7, and the manure piles in sheep and cattle stables which
are not removed in cleaning are to be sprayed with concentrated milk of lime
or sprinkled with freshly slaked lime until the ground and manure are covered
with a thick layer of lime.

7. Wood utensils, including vehicles and sleds used to haul cadavers,
cadaver parts, straw, manure and the contents of the stomach and intestines
of animals which have been killed or slaughtered, are, in so far as they cannot
be burned, to be singed, or washed with dilute cresol water, carbolic acid,
formaldehyde, cresol-sulphuric acid or corrosive sublimate solution.

8. Utensils of iron and other metals are to be exposed to the action of
fire for a short time or washed with dilute cresol water, carbolic acid or for-
maldehyde solution.

9. Articles of leather, especially foot-gear, and rubber are to be carefully
and repeatedly wiped with cloths which have been saturated with cresol water,
carbolic acid or corrosive sublimate solution.

10. Linen, hemp (jute), cotton and woolen articles, clothing and bed
covers, hair, wool, feathers, feed sacks, cushion stuffing, etc., which cannot
be burned, or which are not required to be disposed of in another manner in
certain diseases (see §§ 15 to 27), are to be laid for 24 hours in dilute cresol
water, carbolic acid, corrosive sublimate, or formaldehyde solution, or dis-
infected by boiling or in a steam apparatus.

Pieces of clothing which are only slightly soiled may be disinfected by
moistening and scrubbing with dilute cresol water, carbolic acid, corrosive
sublimate or formaldehyde solution.

11. Animals are to be washed with a proper disinfectant (see §§ 15 to 27),

192 GENERAL THERAPEUTICS FOR VETERINARIANS

especially when in places in which the skin and hoofs or claws may have been
soiled with manure or other excretions.

12. Hands and other parts of persons are to be thoroughly brushed with
dilute cresol water, carbolic acid or corrosive sublimate solution and after
about five minutes washed with warm water and soap.

(Subdivision 2.) The government may permit deviations from the proc-
esses described in Nos, 1 to 12,

IV. Meruops PREscRIBED FOR THE DIFFERENT DISEASES
Anthraz

§ 15. 1. Persons who have come in contact with the bloody excretions.
from an infected or suspected animal, or who have assisted in bloody opera-
tions on such animals or in the slaughtering or destruction of the same, or
who have assisted in the opening or removal of the cadavers, shall immediately
wash and disinfect thoroughly the hands and other parts of the body which |
may have been soiled, also soiled clothing and foot-gear.

2. As soon as an infected or suspected animal dies, is killed, recovers or
is removed from its stall, the cleaning and disinfection must be immediately
begun. This must include the stall in which the animal stood, the place where
it died or was killed, and, where the disease is of frequent occurrence, certain
parts of the stable or the entire stable, as the official veterinarian may in his
judgment determine; also floors, walls, posts, pillars, stall divisions, mangers,
racks, troughs, etc., stable and slaughtering utensils, clothing and foot-gear
of the attendants and other objects which are contaminated with eliminations,
blood or offal of infected or suspected animals or which may be assumed to be
otherwise infected with the organisms of anthrax; stored feed or straw which
diseased or suspected animals may have come in contact with or which may be
assumed to have been otherwise infected; vehicles and vessels used to remove
cadavers or parts of the same, offal, manure, etc., and, when necessary, con-
taminated places in the pasture, burial and storage places and water troughs.

3. The disinfection is carried out as directed in § 14 and the cleaning is
preceded by a preliminary disinfection (see §5, No. 10; § 6, subdivision 2).
As disinfectants, calcium chloride, dilute and concentrated calcium chloride
solutions, corrosive sublimate or formaldehyde solutions are to be used.
Special attention should be given to the solids and fluids liberated in killing,
especially the bloody eliminations from diseased or suspected animals and
their cadavers and blood. This material, together with the bedding, feed
residue, manure, the earth removed from unpaved floors and articles of little
value, is to be disposed of like the cadavers (see the directions for the harmless
removal of the cadavers). Liquid manure contaminated with blood or bloody
eliminations from diseased or suspected animals is to be disinfected with
calcium chloride or solution of calcium chloride (§ 14, subdivision 1, No. 2).

DISINFECTANTS. ANTISEPTICS 193

4. Stores of feed or straw which contain anthrax organisms, or which
there is reason to believe may be infected, may be disinfected by steam in
suitable apparatus or by exposure to sufficient heat through other methods.
If this is not possible, the feed and straw is to be burned or buried, unless
permission is given by the sanitary authorities to use it for animals which
have undergone vaccination for anthrax,

Black Leg and Hemorrhagic Septicemia

§ 16. For black leg and hemorrhagic septicemia the methods described
in § 15 are employed, except the preliminary disinfection specified in No. 3,

Rabies

§17. 1. Immediately after the death or destruction of a diseased or sus-
pected animal, the place occupied by it, especially the floors, walls, mangers,
racks, troughs, partitions, posts, pillars, and stalls contaminated by it, and
the utensils and other objects with which it has come in contact, shall be
cleaned and disinfected as directed in § 13.

2. In rabies of the dog and cat, the bedding, muzzle, collar, leash, blanket,
utensils and other objects which have been used by the diseased or suspected
animal shall be burned or rendered harmless in some other way. Dog houses
of wood, straw, reeds or similar material are to be burned; those of other
material are to be cleaned and disinfected as directed in § 13.

Glanders

§ 18. 1. Persons who have come in contact with diseased or suspected
animals, cadavers or cadaver parts, are to immediately clean and disinfect
their hands. Water, soap and suitable disinfectants (dilute cresol water,
carbolic acid or corrosive sublimate solution) are to be at hand for this pur-
pose in infected premises.

2. As soon as an infected or suspected animal is removed from its stall,
the latter and all equipment and utensils used for the diseased or suspected
animal are to be immediately cleaned and disinfected, except in so far as the
latter are to be used for other diseased animals.

3. Before the removal of the quarantine restrictions, certai parts of the
stable or the entire stable, as in the judgment of the official veterinarian may
be necessary, the utensils and equipment (mangers, racks, posts, pillars, stall
partitions, buckets and other stable apparatus, tie ropes, halters, harness,
saddles, cleaning implements, covers, housing, clothing and foot-gear of the
attendants, wagon poles, chains, water troughs, shoeing places, etc.) and
other objects which have been in contact with diseased or suspected ani-
mals, their eliminations, cadavers or cadaver parts are to be cleaned and
disinfected; also, any contaminated places in the pastures.

13

194 GENERAL THERAPEUTICS FOR VETERINARIANS

4. The disinfection is to be carried out according to § 14 and the cleaning
is to be preceded by a preliminary disinfection. Any of the disinfectants
mentioned in § 11, subdivision 1, may be employed. Special attention must
be given to objects contaminated with nasal discharge, secretions from cutane-
ous ulcers, manure and urine from diseased or suspected animals. Manure,
straw, feed residue, etc., may be composted and the urine or other elimina-
tions from diseased or suspected animals treated with a disinfectant.

Foot-and-Mouth Disease

§19. 1. The attendants of diseased or suspected animals in infected
premises, persons who have engaged in the slaughter or transportation of
such animals or in the removal of the bedding or the plowing under of the
manure, and other persons who have come in contact with suspected or dis-
eased animals in infected premises or who have visited stables in which such
animals have been placed, must, before leaving, change or clean and disinfect
the clothing and foot-gear and also clean and disinfect the hands and other
parts of the body which may be contaminated.

2. Utensils, vehicles, vessels and other articles which have come in con-
tact with diseased or suspected animals or their eliminations and which must.
be used outside of the infected premises during the continuance of the disease
are to be cleaned and disinfected before being removed from the infected
premises. Milk cans which must be removed from the infected premises for
use outside during the prevalence of the disease are to be disinfected, after ~
being emptied, as directed in § 11, subdivision 1, Nos. 9 and 10.

3. When manure is removed from infected stables it is to be composted
on the premises or in some other suitable place from which the infection can-
not spread (§ 14, subdivision 1, No. 1), or, if this is impracticable, concen-
trated milk of lime is to be poured over it before it is removed from the stable.

4. Urine and manure from ruminants and swine can be removed from
premises during the prevalence of the disease only under the most pressing
circumstances and with the permission of the sanitary authorities. The
material must not be hauled with cattle from other premises. The liquid
manure must be removed in tight vessels and the wagons used to haul manure
which has not been composted must also be tight. If the material is hauled
over public roads and the roads cannot be closed while the hauling continues,
then the manure is to be wet with concentrated milk of lime. Manure which
was not composted before removal is to be immediately plowed under or
composted. In the latter case, when the packing process is completed access
of ruminants and swine should be prevented.

5. At the final disinfection, which is to be carried out as directed in § 11,
the places occupied by diseased or suspected animals (stables, yards, exercise
yards, bull stalls, breeding stalls, shoeing places, etc., stock pens, stock-yards

DISINFECTAN TS. ANTISEPTICS 195

and roads); the places used to store manure, cadavers and cadaver parts;
the watering trough and its surroundings; harness; wagon poles; utensils
used in attending to the diseased or suspected animals (watering buckets,
milk pails, milk stools, milk cans, manure forks, shovels, etc.); feed sacks;
skin, horns, claws, wool and other animal products which may be infected
either because of their origin or place of storage, and the clothing and foot-
gear of the attendants are to be cleaned and disinfected. Special attention is
to be given to objects which have been contaminated with saliva or manure
from diseased or suspected animals. Skin, horns, claws and other raw animal
products are to be disinfected by complete drying or by immersion for 24
hours in dilute milk of lime or through treatment with other disinfectants.
Wool may be removed from the infected premises if it is packed in closed
sacks.

6. Feed and straw which have been stored in infected stables or which
have been otherwise contaminated by the eliminations from diseased or
suspected animals cannot be removed from the infected premises but must
be used there or rendered harmless.

7. At the final disinfection, the claws of cattle from the infected stable
are to be trimmed and the animals are to be cleaned and disinfected (§ 4 and
§ 14, subdivision 1, No. 1).

8. Finally, at the final disinfection all of the attendants employed on the
premises which were infected and all persons who otherwise came in contact
with diseased or suspected animals are to clean and disinfect the hands and
arms and any other parts of the body which may have come in contact with
the animals.

9, Any of the disinfectants named in § 11, subdivision 1, may be used.

Lung Plague

§ 20. 1. The attendants who have cared for diseased or suspected animals,
persons who have been engaged in the slaughter or transportation of such
animals, and other persons who have come in contact with diseased or sus-
pected animals or who visit stables in which such animals are kept, must,
before leaving the infected premises or slaughter place, change the clothing
and foot-gear or clean and disinfect the same, and must also clean and dis-
infect the hands and the other parts of the body which may have come in
contact with the diseased animals.

2. During the prevalence of the disease on infected premises, in case of
the removal of a diseased or suspected animal from its stall or from the stable,
the stall and its fittings and the utensils used in caring for the animal must
be at once cleaned, and disinfected in accordance with the directions in § 13.
Feed residue contaminated by the expired air of the animal must be burned
or treated in the same manner as the manure and bedding.

196 GENERAL THERAPEUTICS FOR VETERINARIANS

3. Manure and bedding must be removed from infected premises to the
field and plowed under without the use of cattle from other premises. If
it cannot be plowed under at once, it must be piled up in heaps and cattle
must not be permitted to come in contact with it for at least 2 weeks.

4, At the final disinfection, the infected stable and other compartments
on the infected premises which have been occupied by diseased or suspected
animals or their cadavers, the equipment and utensils which have come in
contact with such animals, and the clothing and foot-gear of the attendants
are to be cleaned, and disinfected as directed in § 13.

5. Feed and straw stored in the infected stables or over such stables
above a loose ceiling must not be removed from the premises after the disease
has been stamped out. These materials may be used for horses, swine or sheep,
but must be placed where cattle cannot come in contact with them. If they
cannot be disposed of in this way, they are to be treated in the same manner
as the manure.

Sheep-pox

§ 21. 1. The attendants who have cared for diseased or suspected sheep
in infected premises, those persons who have been engaged in shearing, slaugh-
tering or transporting such animals, and other persons who have come in con-
tact with diseased or suspected animals or who visit stables in which such
animals are kept, must, before leaving the infected premises, change or clean
and disinfect their clothing and foot-gear and must also clean and disinfect
the hands and other parts of the body which may have come in contact with
the diseased animals.

2. The manure is to be permitted to remain in the stable until the final
disinfection. If it is necessary to remove it, then it is to be composted (§ 14,
subdivision 1, No. 1) on the premises or in some other suitable place from
which the infectious material cannot spread; or, if this is not possible, it must
be wet with concentrated milk of lime before removal. Manure which cannot
be composted on the premises can only be removed with the permission of the
sapitary authorities; it must be hauled to the field in tight wagons and imme-
diately plowed under or composted. In the latter case, access of strange
sheep must be prevented until the composting is finished.

3. At the final disinfection, the stables and other compartments in which
diseased or suspected animals have been kept, the equipment and utensils
which came in contact with such animals or their eliminations, and the clothing
and foot-gear of the attendants are to be cleaned and disinfected. Any of
the disinfectants named in § 11, subdivision 1, may be used in the disinfec-
tion, which is to be carried out as directed in § 14.

4. Feed and straw stored in infected stables or over such stables above
a loose ceiling are to be thoroughly aired and used only on the infected premises
or rendered harmless.

DISINFECTANTS. ANTISEPTICS . 197

Dourine and Vesicular Exanthema
§ 22. No disinfection is required for dourine and vesicular exanthema.
Mange [Scab]

§ 23. 1. During the treatment of the diseased or suspected horses or
sheep, or of sheep flocks in which the disease exists, the stables, hurdles,
equipment, utensils, blankets, cleaning implements and other objects which
have come in contact with such animals are to be cleaned and disinfected.
When the animals are treated by dipping, the cleaning and disinfection is to
be carried out at each dipping. If the animals are treated by hand applica-
tions, the cleaning and disinfection is to be repeated at shorter or longer inter-
vals according to the degree of the disease. After the completion of the
curative treatment, the final disinfection is to be made.

2. Stables or other compartments and hurdles used by horses or sheep
affected with mange before slaughter, or before treatment was begun, must
be immediately cleaned and disinfected after the diseased animals are
removed.

3. The disinfection is carried out as directed in §14. As disinfectants,
dilute cresol water, carbolic acid solution or lime are to be used. Special
attention is to be given to all objects with which the diseased or suspected
animals have come in contact (mangers, racks, posts, pillars, stalls, tie ropes,
halters, harness, saddles, cleaning instruments, blankets, housing, clothes of
attendants, wagon poles, etc., in connection with horses; hurdles, racks,
mangers, posts, sheep folds, sheep shears, shovels, manure, clothing and foot-
gear of the attendants, etc., in connection with sheep).

4, The manure from the infected stables is to be removed to the field
and immediately plowed under. If the latter cannot be done at once, the
sheep are to be kept away from the manure until the work is finished.

[The regulations of the U. S. Bureau of Animal Industry (B. A. I. order
No. 143) regarding disinfection for cattle mange and sheep scab are as follows:

Regulation 28. Cars and other vehicles, yards, pens, sheds, chutes, etc.,
which have contained diseased cattle shall be cleaned and disinfected in the
following manner: Remove all the litter and manure and then saturate the
interior surfaces of the cars and woodwork, flooring, and ground of the chutes,
alleys, and pens with a 5 per cent. solution of pure carbolic acid in water,
with sufficient lime to show where it has been applied.

Regulation 37. Cars and other vehicles, yards, pens, sheds, chutes, etc.,
that have contained diseased sheep shall be cleaned and disinfected in the
following manner: Remove all litter and manure and then saturate the in-
terior surfaces of the cars and the woodwork, flooring, and ground of the
sheds, alleyways, and pens with a solution containing 5 per cent. of pure

198 GENERAL THERAPEUTICS FOR VETERINARIANS

carbolic acid or with a solution containing 2 per cent. of cresol. When cresol
is used it must be mixed with soft soap in order to render it easily soluble in
cold water.]

Swine Plague and Hog Cholera

§ 24. 1. Manure, bedding, feed residue, etc., removed from infected
pens are to be composted (§ 14, subdivision 1, No.1). If this is not feasible,
then these materials are to be burned or buried with the cadavers of animals
which die or are destroyed. The rejected parts of slaughtered diseased ani-
mals are also to be buried or burned and the offal, including the water used
to wash the meat and viscera, is to be rendered harmless.

2. The passageway between the pens, the place before the stable door, the
entrance to the yard and the roads to the stable and on the farm are to be
cléaned and disinfected with dilute calcium chloride solution or 6 per cent.
cresol water at least every 8 days during the continuance of the disease.

3. Utensils, vehicles, vessels and other articles which have come in con-
tact with diseased or suspected animals or with their eliminations are to be
disinfected before being removed from the premises.

4. At the final disinfection the places in which the diseased or suspected
animals have been kept (pens and adjoining compartments such as the feed-
cooking room, exercise place, yard, breeding pen, stock-yards, railroad stock
pens, etc.), the utensils (buckets, forks, shovels, troughs, etc.) used in caring
for and in slaughtering such animals, the vehicles and sleds used to haul the
cadavers, straw, manure and other offal, the clothing and foot-gear of the
attendants, feed sacks and other articles which have come in contact with
diseased or suspected animals or which there is reason to assume may be
infected, are to be cleaned and disinfected. Special attention is to be given
to objects contaminated with the manure, urine and blood of diseased or
suspected animals. The manureand straw are to be removed from therooting-
place and the superficial layer of earth is to be removed, after which, if pos-
sible, the surface of the ground is to be thoroughly saturated with dilute
calcium chloride solution or with 6 per cent. cresol water, then raked or har-
rowed until level and repeatedly saturated with the disinfectants named.
New swine brought on to the premises are to be kept away from the rooting-
place as long as possible. Earth removed from the floors and other places is
to be removed to fields not accessible to swine and buried or plowed under.

5. The disinfection of the pens and other compartments used by diseased
or suspected animals is to be carried out according to the directions in § 14.
As disinfectants, dilute calcium chloride solution or 6 per cent. cresol water
are to be used.

[The regulations of the U.S. Bureau of Animal Industry (B. A. I. order 143)
contain the following regarding disinfection for hog cholera and swine plague:

DISINFECTANTS. ANTISEPTICS : 199

Regulation 45. Cars and other vehicles and pens or yards which have
contained interstate shipments of diseased or exposed swine shall be cleaned
and disinfected as soon as possible after unloading. Cars that have contained
interstate shipments of swine shall not be removed until the inspector has
ascertained the condition of the live animals and either released the cars or
given notice that they shall be cleaned and disinfected. Cleaning and dis-
infection shall be done by first removing all litter and manure and then satu-
rating the interior surfaces of the cars and the woodwork, flooring, and ground
of the chutes, alleys, and pens with a 5 per cent. solution of pure carbolic
acid in water, or with a solution containing 2 per cent. of cresol. When
cresol is used it must be mixed with soft soap in order to render it easily soluble
in water. (Subsequently, it wasfound that a 3 per cent. solution of the official
liquor cresolis compositus was more efficient than the carbolic acid solution.)]

Swine Erysipelas

§ 25. 1. When swine erysipelas is present, the cleaning and disinfection
includes, as a rule, the pen occupied by the diseased or suspected animal;
when several cases occur a certain portion of the building or the entire build-
ing occupied by swine is to be disinfected, as in the judgment of the official
veterinarian may be necessary; also, the equipment, utensils and other ob-
jects which have come in contact with diseased or suspected animals or their
excretions, cadavers or cadaver parts. The pen occupied by the diseased or
suspected animals, a’ portion of the building or the entire building, as may
be required, is to be cleaned and disinfected immediately after the death,
slaughter or removal of all the swine, or within 6 days after the last case of
the disease. ;

2. The disinfection is to be made as directed in §13.° Any of the disin-
fectants named in § 11, subdivision 1, may be employed.

Fowl Cholera and Fowl Pest

§ 26. 1. The coops and other compartments occupied by diseased or
suspected fowl, the cages, other containers and transportation crates, the run,
baths or swimming pools, the utensils and other objects which have come in
contact with such fowl, their excretions, cadavers or cadaver parts, and the
places where such fowl have been slaughtered are to be cleaned and disinfected
as prescribed in §14. Any of the disinfectants named in § 11, subdivision 1,
may be employed.

2. Special attention must be given to the eliminations of diseased or sus-
pected fowl and to blood escaping at the slaughter of the same. This offal
is to be carefully collected and buried or burned with the cadavers, together
with the litter, manure, feathers, feed residue, earth removed from unpaved
floors and from the run, and all other objects of slight value which are con-
taminated with manure or blood. Rejected parts of slaughtered, diseased or

200 GENERAL THERAPEUTICS FOR VETERINARIANS

suspected fowl and other slaughter offal are to be rendered harmless by being
burned or buried. Offal of such a nature that it cannot be burned must be
collected together and thoroughly mixed with an equal amount of milk of
lime and then buried. The surface layer of earth is to be removed from the
runs and the ground is then to be wet with concentrated milk of lime. Lime
or concentrated milk of lime is to be mixed with the water in the swimming
pools or baths in the same manner as it is mixed with liquid manure (§ 14,
No. 2, subdivision 1); after 24 hours the water is to be removed and the sides
and bottom of the pool or bath disinfected with concentrated milk of lime.

3. Large quantities of manure may be composted. Feathers in dry condi-
tion may be removed from infected premises packed in closed sacks, with the
’ approval of the sanitary authorities.

Tuberculosis

§ 27. 1. Immediately after cattle in which tuberculosis is established
according to law or in which its presence appears probable are removed, the
stalls occupied by them are to be cleaned and disinfected.

2. The cleaning and disinfection, as a rule, includes the stall, but in the
event of the occurrence of several cases, or if the diseased or suspected animal
has occupied different stalls in the stable, then the official veterinarian may
require the cleaning and disinfection of a portion of the stable or the entire
stable, as he may consider necessary. In every case the equipment, utensils
and other objects contaminated by the elimination of the animal are to be
cleaned and disinfected, especially the manger, feed vessels, racks, water
troughs, the alleys and walls adjoining the stall, the floor, and the cleaning
and milking utensils.

3. The disinfection is to be carried out according to §13. Milk pails
and other milk vessels are to be disinfected by steam, by boiling or by
scrubbing with boiling hot water or boiling hot soda solution (see § 11, sub-
division 1, Nos. 9 and 10).

[Southern Cattle Fever

The regulations of the U. 8. Bureau of Animal Industry (B. A. I. order .
143, amendment 4) require that cars which have carried cattle from the
quarantined area shall be cleaned and disinfected as follows: “Remove all
litter and manure from all portions of the cars, including the ledges and
framework outside; wash the exterior and interior of the car until clean and
saturate the entire interior surface, including the inner surface of the car
doors, with the disinfecting material.”

Boats which have carried cattle from the quarantined area must be cleaned
and disinfected as follows: ‘‘Remove all litter and manure from the decks,
stalls, and all other parts of the boat occupied or traversed by such cattle,
and from the portable chutes or other appliances or fixtures used in loading

DISINFECTANTS. ANTISEPTICS * 201

and unloading same, and wash them until clean, and saturate the entire sur-
face of the decks, stalls, or other parts of the boat occupied or traversed by
the cattle, or with which they may have come in contact or which have con-
tained litter or manure, with the disinfecting material.”

Yards, pens, chutes, and alleyways used by cattle from the quarantined
area must be cleaned and disinfected as follows: ‘Empty all troughs, racks,
or other feeding or watering facilities and wash them until clean; remove all
litter and manure from the floors, posts, or other parts and wash them until
clean, and saturate the entire surface of the fencing, troughs, chutes, floors,
walls, and other parts with the disinfecting material.

“As materials for the disinfection of cars, boats, pens, chutes, and alley-
ways which have contained cattle of the quarantined area one of those indi-
cated below shall be used. (1) A mixture made with not more than 114 pounds
of lime and 14 pound of pure carbolic acid to each gallon of water. In lieu of
the pure carbolic acid required to make this solution a proper quantity of so-
called ‘crude earbolic acid’ of known strength (but not less than 25 per cent.
pure) may be used, sufficient to make a disinfecting solution containing 5 per
cent. of the pure acid. (2) Any coal-tar creosote dip permitted in the official
dipping of sheep for scabies, provided the same is used at one-fifth the
maximum dilution (five times the minimum strength) specified for dipping
sheep.

“The litter and manure removed from cars, boats, or other vehicles, and
from pens, chutes, alleyways, or other premises or inclosures which have
contained cattle of the quarantined area, shall not be so located or stored
that they come in contact with cattle in course of interstate transportation
unless disinfected by one of the methods specified below. (1) It may be
disinfected by saturating it with any disinfecting material specified in the
preceding paragraph of the strength and composition indicated therein,
except that the lime may be omitted. (2) It may be stored without disinfec-
tion during the period from February 1 to October 31, inclusive, of each year;
when stored as above indicated, the storage space shall be tightly inclosed and
so situated or so surrounded by cattle-proof fences or other structures that
no cattle other than cattle of the quarantined area may approach closer to it
than 15 feet.’’]

Il. THE MOST IMPORTANT DISINFECTANTS FOR ANIMAL
INFECTIONS

Calx.—Lime. Freshly slaked lime (caustic lime) is a good and
easily prepared disinfectant for spore-free bacteria. It is also the
cheapest disinfectant. Anthrax spores and tubercle bacilli are,
however, not killed by lime. It is used in the form of a powder,

202 GENERAL THERAPEUTICS FOR VETERINARIANS

concentrated milk of lime (1 : 3) and dilute milk of lime (1 : 20),
the concentrated solution being applied as a whitewash, and
the dilute solution being used to disinfect the floors and also
as an addition to manure and urine. A single application of
dilute milk of lime (1 : 20) kills the bacteria of fowl cholera, a
triple application (1 : 20) destroys the bacilli of glanders; a single
application of concentrated milk of lime (1 : 3) kills the bacilli of
swine erysipelas, the hog cholera bacillus, the anthrax bacilli
and typhoid fever bacilli. Lime operates only in its free state as
a caustic; it loses its disinfectant properties as soon as it combines
with acids; the carbonate, phosphate, sulphate and nitrate of
lime are ineffective. It must be added to the substances to be
disinfected (manure, urine) in sufficient quantity to make the
reaction of the mixture strongly alkaline, because, under certain
conditions, the growth of microérganisms is facilitated if the
reaction of an acid substance is rendered neutral or only weakly
alkaline. Since the preparation of milk of lime from burned lime
is somewhat difficult and complicated, lime from lime pits may be
used, but the upper layer should first be removed.

Special consideration has been given to the disinfection of
manure from slaughter houses and cattle yards with lime, espe-
cially the composting of manure with and without lime. With the
exception of anthrax, black leg, glanders, rinderpest and rabies,
in which it is best to burn the manure, in all other cattle infec-
tions the manure can be certainly, simply and cheaply disinfected
with a fresh, dilute milk of lime and without injuring its agricul-
tural value. In composting without lime, a temperature suffi- .
ciently high (60 to 70°C.) is developed to exert a disinfectant
action upon the organisms of swine erysipelas, fowl cholera,
glanders, contagious pneumonia, strangles, tuberculosis, hemor-
rhagic septicemia, etc., provided care is taken to have the manure
moderately moist (straw: manure—3: 2), piled rather loosely and
covered with material that conducts heat poorly (Pfeiler, Bobtz).

Calx chlorinata. Chloride of lime. This is more powerful
than lime; in a solution of 1 : 3 it kills even anthrax spores. It is
therefore superior to lime for whitewashing walls, washing floors,

DISINFECTANTS. ANTISEPTICS 203

etc., in infectious outbreaks; also, for the destruction of infectious
material difficult to destroy, especially as a cheap disinfectant for
anthrax spores and for the disinfection of urine. According to
Hansen (Monatshefte fiir prak. Tierheilkunde, 1912) the addition
of 0.2 per cent. of calcium chloride to liquid manure is a certain

‘and cheap disinfectant and is not harmful to vegetation and
does not destroy the fertilizing value. Chloride of lime is uncer-
tain against glanders and tuberculosis. A 1 per cent. solution
kills the bacteria of fowl cholera, swine erysipelas and hog cholera
and the bacilli of anthrax in one minute. Freund recommends the
use of a 5 per cent. filtered solution of chloride of lime for the disin-
fection of railroad cars; the process is very complicated (spraying
with a pumping apparatus under 114 atmospheres pressure).
The formerly much used chlorine gas, in the presence of sufficient
moist air and in strong concentration (1 per cent. by volume),
will destroy all air-dried microdrganisms within 24 hours, but
for practical disinfection it is of no value because the necessary
concentration is difficult to obtain and is very costly. The proc-
ess of chlorine disinfection is also very complicated and dangerous.
The same applies to bromine.

Lyes. The antiseptic effect of the lyes was formerly over-
valued; their disinfection power is about equal to lime. Soda lye,
potash lye, soda and potash are in general of the same value.
Ammonia, on the other hand, is three to five times weaker. Con-
centrated solutions of these substances kill the bacteria of fowl
cholera and swine erysipelas and glanders and anthrax bacilli.
Anthrax spores and tubercle bacilli, on the other hand, remain
intact. An objection is the caustic action of solutions of the re-
quired concentration. Boiling hot soda solution possesses a very
high disinfection power.

Soaps. The disinfectant value of soaps depends upon their
alkali content; the ordinary soft soap is therefore the most power-
ful. The action is increased by using boiling-hot soap water.
The latter kills the more readily destroyed infectious agents and
at the same time has a cleansing effect which assists the action of
the stronger antiseptics. A 10 per cent. solution of the ordinary

204 GENERAL THERAPEUTICS FOR VETERINARIANS

soft soap (or of ordinary washing lye) will kill anthrax spores in
10 minutes if heated to 80°C. Heating the soap solution (and
the soda solution) to 50° C. is not sufficient.

Acids. They are in general poor antiseptics, but are coly-
septics (inhibit development of bacteria). Sulphuric acid does not
kill anthrax spores in 1 per cent. solution even after 20 days’
action; its irritant effect upon the skin and mucous membranes is
also objectionable. The experiments with acid turf litter (foot-

‘and-mouth disease) therefore proved unsatisfactory. On the
other hand, a combination of hydrochloric acid (2 per cent.) with
sodium chloride (10 per cent.) is a strong disinfectant; this “ pick-
ling fluid” disinfects anthrax and black leg hides with certainty.

Hydrargyri chloridum corrosivum. Corrosive sublimate. The
strongest and quickest disinfectant for all bacteria, especially all
spore-forming microérganisms (anthrax spores), with the excep-
tion of tubercle bacilli; odorless, very cheap and easily and con-
veniently transported (sublimate tablets). Anthrax spores are
destroyed with certainty and quickly only by sublimate. A 1:1000
solution destroys all of the organisms of the infectious diseases,
including anthrax spores. The disinfectant action is increased by
the use of warm solutions. The decomposition of the sublimate
by ordinary water may be prevented by the addition of sodium
chloride (sublimate tablets) or organicacids. When the disinfection
is done carefully, the poisonous properties of sublimateare of no con-
sideration, not even in the disinfection of cattlestables (subsequent
washing with 14 per cent. solution with sulphuretted potash).

Phenol. Carbolic acid. A weak disinfectant (100 times
weaker than sublimate, 10 times weaker than creolin, lysol, etc.);
ineffective against anthrax spores. On the other hand, the glanders
bacillus and the less resistant bacteria (anthrax bacilli, etc.) are
quickly killed by a 2 per cent. solution. A 5 per cent. solution is
necessary to destroy tubercle bacilli. The odor of carbolic acid
is unpleasant and is transmitted to the meat and milk (poisoning
of man). Carbolic acid disinfection is also relatively expensive.

Cresol. (*Creolin, *lysol, *bacillol.) A very effective and
cheap disinfectant; far superior to carbolic acid ; effective against

DISINFECTANTS. ANTISEPTICS 205

anthrax spores and rabies virus. Anthrax bacilli are destroyed
by asolution of 1 : 5000. Used in 1 to 3 per cent. solution in water.
For extensive disinfection, especially of railroad cars, Fischer and
Koske (Arb. aus d. Kais. Gesundheitsamt, 1903) recommend a 3
per cent. solution in water of a mixture of 2 parts of cresol and 1
part of sulphuric acid as more effective and cheaper than *lysol or
*liquor cresolis saponatus. Cresol-sulphuric acid solution to which
sodium chloride is added only freezes when the temperature falls
to 17 to 8.6°F., which makes it especially suitable for. winter
disinfection (Kraut, ibid., 1907).

Pix liquida. Tar. An excellent disinfectant covering. Wood
tar kills all pathogenic microérganisms, including anthrax spores
and tubercle bacilli. Coal tar destroys with certainty the bacilli
of anthrax, glanders and swine erysipelas, etc.

‘Liquor formaldehydi. Formaldehyde is recommended as a
gaseous disinfectant for closed compartments, especially railroad
cars; very high disinfectant power. A certain disinfectant action,
however, can only be obtained by the employment of complicated
apparatus (lamps). On account of the volatility of formaldehyde,
the compartment to be disinfected must be made air tight (im-
possible with cattle cars). Furthermore, the disinfectant action is
only superficial, and anthrax spores are not destroyed. The process
is very expensive (a compartment of 100 cubic metres requires the
action of 500 grams of formaldehyde, or 114 liters of the official so-
lution for 314 hours). Disinfection with fluids, 2 to 214 per cent.
of formaldehyde, has the same disadvantages and is also injurious
to health. See the investigations of von Perkuhn concerning the dis-
infection of stables with formaldehyde vapor by means of Lingner’s
apparatus (Monatshefte fiir prakt. Tierheilkunde, 1905).

*Autan. This preparation, which is used in a new method of
formaldehyde disinfection, is in the form of a dry powder contain-
ing a quantity of formaldehyde with alkaline peroxides; formalde-
hyde vapor is liberated when water is added. Contradictory
results have been obtained in the investigations of this new material
and the experiments are not yet concluded (a newer and, it is
alleged, an improved preparation). The same conditions are

206 GENERAL THERAPEUTICS FOR VETERINARIANS

necessary for autan as for formaldehyde (see above), especially
the complete sealing of the compartment, and a temperature not
under 10°C. is also required (not always possible with railroad
cars). In addition, autan is also expensive. According to Léffler
(Zeitschr. f. Vetkde., 1909), the organisms of swine erysipelas, hog
cholera, strangles, fowl cholera, anthrax and tuberculosis are
readily destroyed by autan. The disinfection must continue 7
hours, the compartment must be completely seated and litter and
manure must be removed.

Chinosol. This preparation is very active in inhibiting the
development of bacteria, but has only a slight antiseptic action.
It is ineffective against anthrax spores; very expensive, gives an
unpleasant odor to the animal body, is not absolutely non-toxic
and cannot be used for the disinfection of iron objects, manure,
etc., because it is decomposed by iron and alkaline substances.

Herat.—1. A glowing heat acts the strongest (disinfection of
chains and other iron objects).

2. Burning is the best method of rendering anthrax and black
leg cadavers harmless; a burning process which has proven satis-
factory in practice has been described by Lothes and Profé (Fort-
schritte der Hygiene, 1904).

3. The disinfectant action of dry heat is generally overrated.
Spore-free bacteria are killed by dry heat of 100°C. In the usual
method of employing dry heat (oven), however, 100° C. of heat
does.not penetrate the object of disinfection because dry air is a
poor conductor of heat. Spore-containing bacteria (anthrax
spores) require much higher degrees of heat (140° C.) operating
for hours. The spores contain an almost water-free albumin,
which it is very difficult for the dry heat to penetrate. With the
employment of the hot air sterilizer (oven, 140° C.), the heat in
the interior of the object to be disinfected is usually insuflicient.
After 3 hours’ exposure to 140° C. in a hot air sterilizer, a wool-
covered ball showed a temperature of only 35° C. in the centre.

4, Boiling water kills spore-free bacteria in a short time (boil-
ing the milk in foot-and-mouth disease). Heating milk for 20
minutes at 65° C. kills tubercle bacilli, colon bacilli, streptococci

DISINFECTANTS. ANTISEPTICS 207

and staphylococci (pasteurization). Anthrax spores withstand
boiling temperature. Since the heat only penetrates large, solid
objects slowly, it is recommended that the boiling be continued for
at least one hour. Boiling water is not a certain disinfectant when
used in the disinfection of stables because it cools rapidly when
spread out on cold surfaces. In disinfecting by boiling, the water
containing the object to be disinfected is placed upon the fire cold
and is allowed to remain for at least 14 hour after boiling begins;
the vessel is to be covered.. The German veterinary sanitary laws
require that when foot-and-mouth disease is present milk shall be
disinfected by boiling, and that in the case of tuberculosis it shall
be sufficiently heated, 7.e., heated over an open fire until it repeat-
edly boils, exposed to live steam at 85° C., or heated in a water bath
at 85° C. for a minute or at 70° C. for a half hour. The action of
hot fluids is especially effective when a disinfectant is added.

5. Live steam of a temperature of 100° C. is the most effective
form of disinfection by heat (sterilizing apparatus) and should
therefore be preferred, when convenient, to boiling; has not only
a superficial but also a deep action. Anthrax spores and tubercle
bacilli are killed in 5 minutes. The best results are obtained with
an atmospheric pressure of about one-tenth. It is important that
the temperature be not permitted to fall below 100° C., and that
an abundant supply of steam be introduced into the apparatus
in order that the air (poor heat conductor) will be expressed as
completely as possible (apparatuses of Henneberg, Rohrbeck,
Lautenschlager, etc.). Disinfection with steam is most suitable
for blankets and clothing; on the contrary, leather articles (saddles,
girths, halters) are spoiled. Stables, railroad cars and large com-
partments in general cannot be disinfected with steam on account
of its rapid cooling. In using steam on railroad cars, it was found
that the highest temperature of the steam at the outlet tube was
90-95° C.; slightly removed from the outlet tube (4 inches) the
temperature was only 60° C., 40 inches distant 50° C., 80 inches
distant 20° C., while 16 to 20 feet distant the temperature was
raised only a few degrees (Redard and Colin). A temperature of
100° C. cannot be attained in a stable even with steam from

go hi« 4
he ae

(

1 |

208 GENERAL THERAPEUTICS FOR VETERINARIANS

- boilers carrying 8 atmospheres pressure (Kramell, Zeitschr. f.
Vet., 1901). On the other hand, milk cans and other small vessels
are surely disinfected with live steam under moderate pressure
(Junack, Monatshefte f. prakt. Tierheilk., 1904). The addition
of a slight quantity of a chemical disinfectant increases the effec-
tiveness of steam considerably; hides and leather articles (saddles)
which will only bear steam at 70° C. are disinfected in a relatively
short time by steam at 70° C. containing 1 to 2 per cent. of for-
maldehyde, even anthrax spores being destroyed in 5 minutes
(von Esmarch, Hygien. Rundschau, 12 Bd.).

Cold cannot be used for disinfection. Very low temperatures
(— 100° C.) do not destroy anthrax spores. Even the bacteria of
fowl cholera, which are rather easily destroyed, resist a tempera-
ture of —4°C.

Mecuanicat Disinrectants.—1. Burial is a very important
method of disposing of infected carcasses, cadaver parts, manure,
etc. (see the regulations for anthrax, rabies, glanders and lung
plague). Bacteriological investigations have shown that the
earth is free from bacteria at a depth of 5 feet, provided the
excavation is not made in the neighborhood of houses, stables,
manure pits, wells, etc., and does not reach the ground water.
Most of the pathogenic bacteria, except anthrax spores and tuber-
cle bacilli, die very soon in buried cadavers. Anthrax spores,
however, retain their virulence many years and tubercle bacilli
for several months (cholera and typhoid fever bacilli in human
bodies die in 2 to 3 weeks after burial). Investigations have shown
that the earth of cemeteries containsno more bacteria than the earth
of cultivated fields at an equal depth. On account of the possibility
of buried spores being disseminated (earth worms, moles), itisrecom-
mended that anthrax carcasses be buried in cemented pits.

2. Drying in the air has a very slight disinfectant action. An-
thrax spores retain their virulence in dry places for years, and most of
the more readily destroyed bacteria die only after several weeks.

8. Light assists the disinfectant action of the antiseptics.
Spores appear to be more susceptible to light than the bacilli.
Anthrax spores are killed by sunlight in 5 hours, while the bacilli

DISINFECTANTS. ANTISEPTICS 209

are destroyed only after 30 hours (Arloing, Roux). Tubercle
bacilli are killed by direct sunlight in a few hours and by diffuse
daylight in a few days (R. Koch). The contagion of rinderpest is
affected in the same manner (Theiler). Direct sunlight exerts a
powerful disinfectant action upon coli bacilli and the organisms
of swine plague, hog cholera, swine erysipelas and fowl cholera,
while diffuse daylight also possesses disinfectant properties but
in less degree (Neumark, Dissertation, 1907). Perhaps this
explains the milder course and less frequent occurrence of some
of the infectious diseases in the summer (contagious pneumonia).
From the foregoing it follows that the admission of light into dark
stables and the airing of blankets essentially assist disinfection.

Other mechanical methods include: whitewashing or painting
(lime, calcium chloride, tar, varnish, paint, lacquer), which
covers and fixes the bacteria and prevents their increase; scouring,
cleansing, washing, sweeping, wiping, rubbing (rubbing the car-
pet with bread), exclusion of air (closing a room before disinfec-
tion) and above all washing with soap. The latter is sufficient
in many cases, especially for infectious material that is readily
destroyed.

3. DISINFECTION OF WOUNDS

The Most Important Antiseptics for Wounds.—The general
statements already made (p. 170) are to be considered in connec-
tion with the choice and judgment of the individual antiseptics
employed in the treatment of wounds. In the first place, atten-
tion is to be given to the different disinfectant values of the individ-
ual antiseptics and to the resistance of the microérganisms con-
cerned in wound infection to these agents. As already mentioned
on page 175, the resistance of these organisms lies about midway
between that of the anthrax and black leg spores, which are diffi-
cult to kill, and that of the easily destroyed anthrax and swine
erysipelas bacilli. The staphylococci and streptococci especially
cannot be destroyed by the milder disinfectants, but require the
more ‘powerful antiseptics (corrosive sublimate, creolin, lysol,
tannoform, carbolic acid, tincture of iodine, aluminum acetate,

silver nitrate). Other points to be considered are the degree of
14

210 GENERAL THERAPEUTICS FOR VETERINARIANS

toxicity of the disinfectant, its irritant effect upon the wound, its
decomposition by the wound secretions, the duration of its action
upon the wound, the concentration and form, the price, and the
stage of healing in the wound. In general, the rule to follow is to
choose the most effective disinfectant which can be used in solu-
tion or in powder and which at the same time is the least irritant,
the least liable to decomposition, the least poisonous and the
cheapest; and to apply it to the wound as early as possible (tanno-
form!) and to permit it to operate as long as may be practicable.
A thorough cleansing should precede the disinfection. The aseptic
treatment of wounds has already been discussed on page 171.
In regard to the most important antiseptics for the treatment of
wounds, the following may be mentioned: :

Hydrargyri chloridum corrosivum. Corrosive sublimate. A
powerful but poisonous antiseptic. A 1 to 1000 solution quickly
destroys all microérganisms concerned in wound infection. It
may be used as a wound disinfectant on all animals except rumi-
nants. It is especially poisonous for cattle and it should not be
used on these animals. In contact with albuminous wound secre-
tions, corrosive sublimate is in part precipitated in the form of
albuminate of mercury and in part decomposed (formation of
mercuric oxychlorides). These decompositions, however, do not
essentially affect the antiseptic action of the sublimate qualita-
tively; and, furthermore, they can be prevented by the addition
of sodium chloride, hydrochloric acid or acetic acid. The advan-
tages of corrosive sublimate are its strong disinfectant properties,
its lack of odor, cheapness and convenience (sublimate tablets).
Its disadvantages are its high toxicity, especially for cattle; its
strong irritant action, especially upon the mucous membranes of
the eye (ophthalmology) and uterus (obstetrics), and its rapid
formation of an amalgam with instruments.

*Creolin, *lysol! and other cresol compounds. The antiseptic
action of cresol preparations is very powerful and rapid. A 3 per
cent. solution destroys all of the organisms concerned in wound infec-
tion immediately. The disinfectant action of cresol is ten times

[! The official liquor cresolis compositus is very similar.]

DISINFECTANTS. ANTISEPTICS 211

stronger than that of carbolic acid; it possesses deodorizing prop-
ties and is relatively non-toxic. Its disadvantages are the odor,
the irritant effect of strong solutions upon the mucous membranes
and the partial turbidity of the solutions.

Phenol. Carbolic acid has a relatively good antiseptic action.
A 3 per cent. solution kills most of the organisms concerned in
wound infection after prolonged action. It is less effective, how-
ever, against tetanus bacilli, rabies virus, tubercle bacilli and
anthrax spores. Castration clamps transmitted tetanus 18 months
after they were infected, although they were immersed for five
minutes in a 4 per cent. carbolic acid solution. The advantages
of carbolic acid are that it does not decompose and is constant
in its composition. The disadvantages are the odor, high price and
the irritant and poisonous properties, the latter especially for cats.

Iodoformum. Iodoform. An excellent, mild antiseptic, which
stimulates granulation; may be employed in the form of ether
solution (1 : 5-10). The disadvantages are its odor, high price,
toxicity for dogs (licking) and insolubility in water. Similar
preparations, which are much more expensive and therefore not
adapted to veterinary practice, are *loretin, sozoiodol, *losophan,
*jodophen, *europhen, *aristol, *iodoformin, *iodoformogen, iodol,
*iodine trichloride (very unstable), and others.

*Tannoform. The best remedy known at this time for form-
ing aseptic scabs, and also a dry antiseptic. Applied early to
fresh wounds, it prevents suppuration (healing under a scab).
It is to be preferred to iodoform, especially for horses, on account
of its stronger antiseptic action, lack of odor and lower cost. The
other condensation products of formaldehyde, *glutol, *amylo-
form, etc., are more expensive and less constant in their action
than tannoform. Liquor formaldehydi in 1 to 2 per cent. solution
is a strong disinfectant but very irritant to wounds; in concen-
tration it is a strong caustic (caution!).

Tincturaiodi. Tincture of iodine has been employed recently to
disinfect the skin in place of the older and more complicated process
(method of Grossich), being simply painted on the field of operation.

Argenti nitras. Nitrate of silver is an excellent wound remedy.

212 GENERAL THERAPEUTICS FOR VETERINARIANS

It possesses a high disinfection value (a 1 to 1000 solution destroys
pus cocci), is an important regulator of abnormal granulations and
covers the wound with ascab (silver scab). This is also true of the
other very expensive silver preparations (*actol, *itrol, *protargol).

*Aluminum acetas. Acetate of aluminum. An excellent, non-
poisonous antiseptic in 2-8 per cent. aqueous solution (also con-
tained in Burow’s mixture?) ; preferred on account of its cheapness
to the more expensive substitutes *alumnol, *tannal, *gallal,
*sozal, *boral, *saluminal, *kutol, etc.

Alcohol. An important disinfectant for the hands of the
operator and for the skin of the operation field; acts best in 50
per cent. solution in water or sublimate solution (absolute alcohol
has only a weak antiseptic action). Soap spirit? is also recom-
mended. The alcoholic tincture of aloes [tinctura aloes] is an ex-
cellent antiseptic and stimulant to granulation for old wounds.

Acidum salicylicum. Salicyclic acid is a very mild antiseptic,
but is non-toxic, odorless and non-irritant; used especially in
ophthalmology, also to wash out internal organs. Thioform
(dithiosalicylate of bismuth) is recommended as a substitute for
iodoform, especially because it is odorless and non-toxic (but is
very expensive).

Bismuth salts. Like tannoform, these are employed as desic-
cant, astringent, dry antiseptics, but are very expensive. Those
most frequently used are bismuthi subnitras, subsalicylas, sub-
gallas (dermatol),and dithiosalicylas (thioform),and *airol (iodized
dermatol). The latter in the form of airol paste‘ is an excellent
substitute for dressings and bandages for wounds; it is aseptic,
non-irritant, easily applied, adhesive, plastic and dries quickly.

Acidum boricum. Boric acid is a mild, non-toxic, odorless
antiseptic without pronounced action (ophthalmology). Sodii
boras, *magnesii boras, *boral, *antipyonin, *rotterin, *anti-
septin, *borol and other preparations containing boric acid act in
the same manner.

[? Alum 5 parts, lead acetate 10 parts, water 250 parts.]
[? Equal parts of green soap and alcohol.]
[* Airol, glycerin and acacia, each 1 part, argilla 2 parts.]

DISINFECTANTS. ANTISEPTICS 213

Zinci chloridum. Chloride of zinc is a caustic, alterative anti-
septic (2 to 8 per cent. solution) of relatively weak disinfection
power (a regulator of abnormal granulations).

Potassii permanganas. Permanganate of potassium is a mild
antiseptic; specific against snake bites and rabies virus.

Camphora. Camphor is a powerful antiseptic, especially for
“flabby” granulations and phlegmonous, ulcerative and necrotic
processes (camphor spirit bandage). Oleum terebinthine, tere-
binthina (old hoof remedy), thymol, oleum eucalypti, balsamum
peruvianum and other ethereal oils act in the same manner.

Pix liquida. Tar. An excellent antiseptic, especially for
wounds on the hoof and claws; wood tar is better than coal tar.

Liquor chlori compositus. Chlorine water. A strong antiseptic;
specific against rabies virus and snake bites; used in ophthalmology.

*Pyoctanin. A powerful antiseptic. Disadvantage: blue stain.

4, INTERNAL ANTISEPTICS

A number of infectious diseases may be effectively combated
by the internal use of antiseptics. The antiseptics used for this
purpose include some of the specifics: salicylic acid, the principal
remedy in acute articular rheumatism; quinine, the specific for
malaria; mercury, salvarsan and iodine as specifics for syphilis
of man, salvarsan and atoxy] as specifics against trypanosomes and
spirilla, and salvarsan in contagious pneumonia of horses (“Ther-
apia sterilisans magna”’); also creolin, whichis very effectiveagainst
anthrax in cattle and horses; creosote, as an internal remedy in
tuberculosis; calomel, salicyclic acid, bismuth salts, tannin and
boric acid as intestinal disinfectants in dysentery, influenza,
canine distemper, swine erysipelas, fowl cholera and mycotic and
infectious inflammations of the intestines; and tar and oil of
turpentine in infectious and parasitic affections (lung worm dis-
ease) of the respiratory tract. Infectious materials in the blood
are also destroyed through serum therapy (see the chapter on
protective vaccination and methods of immunization). In internal
antisepsis, even more than with external antisepsis, care must
be taken to avoid a general poisoning of the body.

214 GENERAL THERAPEUTICS FOR VETERINARIANS

5. THE CONSERVATION OF ANIMAL PRODUCTS

Methods of Conservation.—The conservation of organic
animal substances has for its purpose the prevention of the decom-
position, putrefaction and fermentation processes which occur, as
a rule, after the death of the animal organs. This is accomplished
by the destruction of the microérganisms concerned in the de-
composition and fermentation processes and by preventing the
access and development of additional organisms. In most cases
the conservation concerns meat and milk; in addition, cadavers,
hides and other parts of the carcass also require attention. Since
the microérganisms concerned can only multiply in an atmosphere
with a certain oxygen content and a certain amount of moisture,
within certain temperature limits, and upon proper nutritive
media, they may be destroyed in different ways in addition to the
employment of antiseptics.

1. The conserving agents which act antiseptically correspond
essentially with the disinfectants. Usually, several substances
are used together to increase the conserving action. A distinction
must be made between the non-toxic agents, which can be used to
conserve meat and milk, and the toxic substances, which serve to
preserve parts of cadavers. The non-toxic meat and milk preser-
vatives are: sodium chloride, potassium nitrate (salting, pickling),
sodium phosphate, sodium acetate, vinegar, sugar, glycerin,
smoking and hydrogen peroxide. The mixtures of conserving
agents must not contain toxic substances or those which are not
entirely non-toxic (boric acid, salicylic acid, sulphurous acid,
fluoride of soda, ammonium acetate, formalin, potassium per-
manganate). Poisonous preservatives for parts of cadavers are
corrosive sublimate, arsenic, hydrocyanic acid, creosote, carbolic
acid, methyl alcohol, chloroform, ether, acetone, chloral, copper
sulphate, zinc sulphate, iron sulphate, zinc chloride, copper chloride,
aluminum chloride, iron chloride, alum and _hyposulphites.
Wickersheimer’s conserving fluid for cadavers (arsenic 10 grams,
sodium chloride 25 grams, potassium nitrate 12 grams, potash 60
grams, methyl alcohol 1 liter, glycerin 4 liters, water 10 liters)
is well known.

DISINFECTANTS. ANTISEPTICS 215

2. Exclusion of air. This very simple method of conservation
is usually used in connection with previous heating (sterilization,
pasteurization). The simple exclusion of air is obtained by the
different paints (lacquer, oil paints, tar, sealing wax, resin) and
by the application of a layer of fat, oil or sugar (sardines, goose-
liver pie, sweet conserves). Cotton and asbestos stoppers prevent
the entrance of the bacteria contained in the air; this method is
used principally in bacteriological technique. Finally, the air can
be expelled by carbon dioxide (canned meat).

3. High and low temperatures have a conserving action when
they are considerably above or below 4 to 45° C., the optimum
temperatures necessary for the development of microérganisms.
Sterilization is the process of heating to 100° C. or over. Pasteur-
ization is the process of heating to 65 to 100° C. Temperatures
of high degree in the form of boiling-heat (frequently with simul-
taneous or subsequent exclusion of the air), hot air and live steam
are essentially more effective than lower temperatures; they are
especially used in the preparation of canned meats (corned beef).
Lower temperatures in the form of freezing or storage in cooling-
rooms, ice cellars and refrigerators are less effective because the
spores are not destroyed but only hindered in their development
and also because some of the bacteria are only temporarily be-
numbed. Substances conserved in this manner therefore undergo
decomposition very rapidly when they are removed from the in-
fluence of the cold, since the microérganisms contained in them
immediately begin to multiply. This has been the experience with
the cold-storage rooms in slaughter houses and with the over-
sea transportation of meat.

4. Withdrawal of moisture is attained by drying, either
through the use of the sun’s heat (codfish) or through artificial
heat (carna pura, meat meal). In the preparation of meat meal,
the meat, after the removal of the fat and bones, is finely chopped
and dried in an oven at 60° C., after which it is finely powdered
and enclosed in cans. The so-called condensed milk is also pre-
pared by withdrawing water (evaporated to one-fourth the volume),
and sugar is added to better preserve it.

ANTIDOTES

Synonyms: Antitoxics, antagonistics, antagonists.

Classification.— Medicines which are employed in different
poisonings are called antidotes. They are of different kinds and
operate in different ways. The following groups may be distin-
guished: (1) The mechanical or physical antidotes; (2) the chem-
ical antidotes; (3) the physiological (dynamic, organic, consti-
tutional and empirical) antidotes or antagonists, and (4) the
symptomatic method of treating poisoning.

1. The physical or mechanical antidotes operate in a purely
mechanical way by removing the poison from the body: emetics,
cathartics, diuretics, diaphoretics, sialagogues, washing out the
stomach (horse, dog), bleeding, transfusion, artificial respiration;
or by enveloping the poison and preventing its absorption or
contact with the mucous membrane: protective antidotes (albu-
min, milk, oil, mucilaginous substances).

Of special practical importance are the emetics, which are
immediately administered to the proper animals (dogs, swine and
cats) in all fresh cases of poisoning. The most important emetics
are apomorphine (dogs, 0.002-0.01, gr. 1/40 to 1/8; cats, 0.02-0.05,
gr. 14 to 34, subcutaneously), veratrin (swine, 0.02-0.03, gr. 14
to 1/3, subcutaneously), veratrum alba (swine, 1-2, grs. xv to xxx;
dogs, 0.1-0.2, gr. 1/8 to 4, per os or in clyster), ipecac (swine and
dogs, 1-3, grs. xv to xlv; cats, 0.25-0.75, grs. iij to xj), tartar
emetic (swine, 1-2, grs. xv to xxx; dogs, 0.1-0.3, grs. iss to iv;
cats, 0.05-0.2, grs. 34 to iij), copper sulphate in phosphorus
poisoning (swine, 0.5-1, grs. vij to xv; dogs, 0.1-0.5, grs. iss to vij;
cats, 0.05-0.2, grs. 34 to iij), zinc sulphate (swine, 0.5-1, grs. vij
to xv; dogs, 0.1-0.3, grs. iss to iv),and finally the household emetics,
sodium chloride (dogs, 1 to 2 teaspoonfuls), mustard (dogs, 1 to 2
teaspoonfuls in a glass of warm water), snuff (dogs, a pinch in
a tablespoonful of water), ete. Of the cathartics, eserine (0.05-
0.1, grs. 34 to iss, for horses) and arecoline (0.05-0.08, gr. 34 to 1,
for horses) are especially suitable on account of their rapid action;
others are aloes (horses, 25-50, 3vj to xii; cattle, 50-75, Siss to

216

ANTIDOTES 217

ijss); castor oil (horses, 250-500, Oss to i; cattle, 500-1000, Oi to
ij; sheep and goats, 50-250, 3iss to viij; swine, 50-100, 3 iss to iij;
dogs, 15-60, 5ss to ij; cats and fowl, 10-80, Jijss to 31), which,
however, is to be avoided in phosphorus, arsenic and cantharides
poisoning (sclution of the poison); calomel (swine, 1-4, grs. xv to
31; dogs, 2-4, grs. xxx to 31; cats and chickens, 0.1, grs. iss);
Glauber’s and Epsom salts (in lead poisoning, also a chemical anti-
dote). The diuretics, diaphoretics and sialagogues have a much
weaker evacuating action and are therefore employed only in
chronic poisonings. The protective antidotes are used principally
in poisonings by caustics to protect the gastric mucous membrane
and to prevent absorption. Those used most frequently are milk,
albumin (egg albumin alone or shaken up with water), mucilages
(linseed, barley, oat and quince mucilage, acacia, decoctions of
althza root, mallow leaves and salep, tragacanth mucilage), fats
and oils (lard, butter, peanut oil, olive oil, rape oil, poppy-seed oil,
almond oil, castor oil, emulsions). The fatty oils, however, are
contraindicated in phosphorus and cantharides poisoning because
they promote the resorption of these substances; this is also true
of milk or any compound which contains fat.

2. The chemical antidotes prevent poisoning by decomposing
the poison or by changing it into a compound which is non-toxic
or less poisonous. The simplest example of a chemical antidote
is presented by the caustic alkalies and acids, which in combining
lose their opposing alkaline and acid characteristics and form
neutral salts which are not caustic (potash lye, soda lye, caustic
lime, ammonia, carbonate and bicarbonate of soda and of potas-
sium, and soap on the one hand, and sulphuric, hydrochloric,
nitric, acetic and oxalic acids on the other hand). This group also
includes sodium chloride, the specific antidote for silver nitrate,
which it transforms into silver chloride (the administration of
sodium chloride in corrosive sublimate poisoning is harmful
because it promotes the resorption of the sublimate); iron, iron
hydroxide and iron oxide, the antidotes for arsenic (formation of
arsenate of iron, which is only slightly soluble), hydrocyanic acid,
mercury and copper salts; potassium ferrocyanide, the antidote

218 GENERAL THERAPEUTICS FOR VETERINARIANS

for copper poisoning (non-poisonous ferrocyanide of copper) and
for caustic iron salts, e.g., iron chloride (formation of ferrocyanide
of iron); copper salts, the important antidote for phosphorus
poisoning (formation of insoluble phosphorus copper), magnesia
oxide and magnesia carbonate, the antidotes for acids (formation
of salts of magnesia), arsenic and metallic salts (decomposition) ;
iodine and the iodides, the antidotes for the alkaloids in general
(precipitation) and for chronic metallic poisonings (formation of
metallic iodides, which are more soluble and therefore more readily
eliminated from the body); potassium bromide, which combines
with iodine and iodoform, forming potassium iodide; sulphur and
potassium sulphide (hydrogen sulphide), antidotes for mercury,
lead, copper, tartar emetic and arsenical poisonings (formation
of insoluble metallic sulphides); sulphuric acid and its salts,
specific antidotes for lead poisoning (formation of insoluble lead
sulphate), carbolic acid poisoning (formation of non-poisonous
potassium sulphocarbolate), calcium poisoning (formation of
plaster-of-Paris) and barium poisoning (formation of barium sul-
phate); the calcium salts (lime water, calcium carbonate, chalk,
snail shells, oyster shells, egg shells, marble, sepia stones, sugar
lime), antidotes for oxalic acid poisoning (calcium oxalate is
insoluble and consequently not poisonous); tannic acid and the
plants which contain it (oak bark, cortex salicis, salvia leaves,
coffee, tea, acorns, nutgall, ink, cinchona, catechu, rhatany root,
tormentilla, walnut tree leaves), important antidotes for poison-
ing by alkaloids and glucosides (formation of slightly soluble or
insoluble tannates), also for poisoning by the metallic salts, espe-
cially tartar emetic, lead acetate, silver chloride and iron sulphate
(formation of metallic tannates); ammonia, chlorine and potas-
sium permanganate, local antidotes for snake bites and insect
stings; old oil of turpentine and ozone water, antidotes for phos-
phorus (oxidation to phosphoric acid), albumin, antidote for the
metallic salts (formation of metallic albuminates), caustic acids
(formation of serum albumins) and chlorine, bromine and iodine
poisoning; gelatin and gum, antidotes for metallic poisonings
(sublimate poisoning), alum and tannic acid poisoning (formation of

ANTIDOTES 219

precipitates); fatty oils, antidotes for poisoning by alkalies and
acids (formation of soap); starch, antidote against iodine (blue
color), and animal charcoal, antidote for alkaloids and metals.
3. The physiological or dynamic antidotes are not directed
against the poison itself but against its action (antagonists), and
are administered for the purpose of producing an action which
will counteract the effect of the poison (stimulation—paralysis).
A distinction must be made between a single, or simple, and a
multiple, or mutual antagonism. The antagonism is single when
the one poison only suppresses but does not reverse the action of
the other; it is multiple when a reciprocal or mutual suppression
takes place. We also speak of a true (direct) and an apparent
antagonism, depending upon whether both poisons act upon one
and the same organ (nervous system, muscles, glands) or upon
different organs; curare, for instance, is only an indirect antag-
onist of strychnine because it does not act upon the spinal cord,
as does strychnine, but upon the peripheral nerves of the muscles.
The occurrence of a true multiple antagonism is in general question-
able. A paralyzing antidote like atropine can, it is true, overcome
the stimulant action of another poison, e.g., the action of eserine
upon the oculomotor nerve (mydriasis, myosis), but on the other
hand a paralysis of the oculomotor nerve (mydriasis) produced by
atropine cannot be overcome by eserine (myotic). The important
physiological antidotes are: (a) Atropine and hyoscine (scopo-
lamine) as antidotes against morphine, chloroform and chloral
hydrate. The antagonism is multiple but in part indirect. The
paralytic action of morphine on the brain is overcome directly by
the psychic stimulation produced by the atropine; on the other
hand, the paralytic effect of the morphine on the heart is overcome
by the stimulant action of the atropine indirectly, the atropine
stimulating the nerve centres of the heart, while morphine para-
lyzes the heart muscle itself. (b) Atropine as an antidote against
pilocarpine, eserine, arecoline, muscarine and nicotine poisoning.
(c) Potassium bromide, chloral hydrate, chloroform and ether as
antidotes against the tetanics, strychnine and picrotoxin. (d) Amyl
nitrite as an antagonist against the vasoconstrictors, suprarenin

220 GENERAL THERAPEUTICS FOR VETERINARIANS

[adrenalin] and ergot. Caffeine as an antidote against morphine,
chloroform and alcohol.

4. The symptomatic antidotes are used to treat individual
symptoms of poisonings. Symptoms of paralysis are combated
by excitants (camphor, ether, alcohol, wine, caffeine, coffee, tea,
veratrin, strychnine, atropine, scopolamine, ammonia, carbonate
of ammonia); painful colics by morphine and other narcotics;
diarrhoea by styptics; constipation by laxatives; persistent vomit-
ing by opiates; high fever by antipyretics; cramps by sedatives,
and subnormal temperatures by caffeine.

Antidotes for the Different Poisons.—Aconite. Emetics, tan-
nie acid, iodine, animal charcoal, atropine, digitalis, artificial
respiration, excitants.

Alcohol. Coffee, caffeine, ammonia, ammonium carbonate,
camphor, atropine, scopolamine, cold applications to the head,
warm coverings.

Alkalies, caustic. Vinegar, dilute acids (hydrochloric, sul-
phuric, phosphoric, tartaric and citric acids), fatty oils, milk,
emulsions, mucilaginous substances, morphine.

Aloes. Opium, tannic acid, mucilaginous substances.

Alum. Albumin, milk, gelatin solution, lime water, magnesium
oxide, ammonia, laxatives.

Ammonia. Dilute acids, vinegar vapor, fats, oils, milk, muci-
laginous substances, tracheotomy.

Anilin. Emetics, laxatives, excitants.

Arecoline. Atropine, hyoscine (scopolamine).

Arsenic. Emetics, iron preparations, iron hydrate [ferri
hydroxidum cum magnesii oxido, U. 8. P.], *ferric saccharate,
magnesium oxide, animal charcoal, sulphur, liver of sulphur,
sulphide of iron, albumin, milk, mucilage, excitants. Alkalies and
fatty oils (castor oil) are to be avoided.

Atropine (belladonna, henbane, stramonium). Emetics, tan-
nic acid, morphine, pilocarpine, eserine; for the psychic excite-
ment, chloroform, chloral hydrate, sulphonal, potassium bromide.

Barium. Dilute sulphuric acid, sodium and potassium sul-
phate, magnesium sulphate, emetics, atropine.

ANTIDOTES 221

Brine. Plenty of water, mucilage, oil, excitants, sedatives.

Cantharides. Mucilaginous substances, opium, excitants; no
fatty oils.

Carbolic acid. Emetics, wash out the stomach, sulphates,
dilute sulphuric acid, soap water, sugar lime, albumin, milk, oil,
excitants (ether, camphor, caffeine, hyoscine).

Carbon disulphide. Fresh air, excitants.

Carbon monoxide. Fresh air, inhalation of oxygen, infusion
of physiological salt solution; excitants, artificial respiration,
stimulation of the skin.

Chick-pea. Tracheotomy, strychnine, veratrin, caffeine, atro-
pine, cutaneous stimulation, laxatives.

Chlorine and calcium chloride. Sodium or magnesium sub-
sulphate, inhalations of hydrogen sulphide and ammonia (diluted);
internally, aromatic spirit of ammonia; albumin, mucilage.

Chloroform, chloral hydrate, or ether. LExcitants, especially
atropine, hyoscine (scopolamine), strychnine, veratrin, caffeine,
ammonia, ammonium carbonate, cutaneous stimulation, cold
douches, artificial respiration.

Chromic acid. Albumin, magnesium oxide, excitants.

Cocaine. Tannic acid, iodine, chloral hydrate.

Colchicum. Emetics, tannic acid, iodine (Lugol’s solution),
opium, morphine, mucilage, warm moist coverings, excitants.

Conium. Emetics, laxatives, veratrin, strychnine, caffeine,
atropine, ether, camphor, ammonium carbonate, tannic acid.

Convallaria. Tannic acid, excitants, camphor, ether. _

Copper. Laxatives, emetics, albumin, potassium ferrocyanide,
powdered iron, magnesium oxide, animal charcoal, excitants.

Corn cockle. Laxatives, tannic acid, mucilage, excitants.

Creosote. Emetics, mucilage, dilute sulphuric acid, sodium
sulphate, magnesium sulphate, soap, excitants.

Croton oil. Mucilage, albumin, opium, excitants.

Cystisus. Emetics, laxatives, excitants.

Darnel. Laxatives, ether, camphor, atropine, caffeine, cu-
taneous stimulation.

Digitalis. Emetics, tannic acid, camphor, ether, atropine,

222 GENERAL THERAPEUTICS FOR VETERINARIANS

scopolamine, caffeine, aromatic spirit of ammonia, wine, cutaneous
stimulation.

Equisetum. Laxatives, camphor, ether, caffeine, atropine,
hyoscine (scopolamine), veratrin, cutaneous stimulation.

Ergot. Emetics, laxatives, chloral hydrate, amyl nitrite,
tannic acid, symptomatic treatment.

[Ether. See CHLoRoFoRM.]

Fungi. Enmetics, laxatives, excitancs, symptomatic treatment.

Glauber’s salt. Mucilage, opium, camphor, ether.

Hellebore. Tannic acid, opium, excitants.

Hydrochloric acid. Dilute alkalies, albumin, mucilage, oil,
opium.

Hydrocyanic acid. Emetics, hydrated oxide of iron, hydrogen
peroxide, potassium permanganate, cobalt nitrate, atropine, arti-
ficial respiration, excitants, cold douches.

Hydrogen sulphide. Fresh air, ether, camphor, inhalation of
chlorine, excitants, cutaneous stimulation, bleeding, physiological
salt solution subcutaneously.

Illuminating gas. Fresh air, inhalation of oxygen, cutaneous
stimulation, artificial respiration.

Insect stings. Wash with ammonia water, chlorine water,
alcohol, lead water.

Iodine and iodoform. Starch, flour water, albumin, potassium
bromide, sodium bromide, sodium and potassium bicarbonate,
sodium hyposulphite, excitants, emetics, laxatives.

Lead. Emetics, laxatives, dilute sulphuric acid, sodium sul-
phate, potassium sulphate, magnesium sulphate, sulphur, hydro-
gen sulphide, tannic acid, albumin, milk, symptomatic treatment
(opium, morphine). In chronic lead poisoning, potassium iodide.

Lupine. Change of feed, preparation of the poisonous lupines,
dilute acids (no alkalies!), castor oil.

Male fern. Laxatives, excitants.

Mercurialis. Emetics, albumin, milk, opium, tannic acid.

Mercury. Albumin, milk, powdered iron, sulphur, sulphur-
ated potash, hydrogen sulphide, magnesium oxide, symptomatic
treatment; in chronic poisoning, potassium iodide.

ANTIDOTES 223

Mine gas. Fresh air, artificial respiration, cutaneous stimu-
lation, cold douches, excitants.

Morphine. Atropine, hyoscine (scopolamine), caffeine, coffee,
tea, cutaneous stimulation.

Muscarine. Atropine, hyoscine.

Mushrooms. Laxatives, demulcents, excitants, cutaneous stim-
ulation, tannic acid, iodine (atropine in poisoning by agaricus
muscarius). ,

Nicotine. Laxatives, tannic acid, iodine solution, animal
charcoal, excitants, ramenotomy.

Nitric acid. Dilute alkalies, albumin, mucilage, oil, opium.

Oleander. Laxatives, mucilage, tannin, excitants.

Opium. Atropine, hyoscine, caffeine, laxatives, excitants.

Oxalic acid. Lime water, sugar lime, chalk, magnesium oxide,
excitants, diuretics.

Petroleum. Enmetics, cutaneous stimulants, ether, camphor,
wine, ammonium carbonate, caffeine, artificial respiration.

Phosphorus. Emetics, laxatives, old oil of turpentine, copper
sulphate, copper salts in general, potassium permanganate, cobalt
nitrate, hydrogen peroxide, excitants, infusion of physiological
salt solution; fats and fatty oils are to be avoided.

Physostigmine. Atropine, hyoscine (scopolamine), sympto-
matic treatment.

Pilocarpine. Atropine, hyoscine, agaricin, excitants.

Poppy (wild). Laxatives, tannic acid, opium, morphine, chloral
hydrate, potassium bromide, cold shower bath upon the head,
clysters.

Potassium chlorate. Emetics, infusion of physiological salt
solution, excitants.

Potassium nitrate. Mucilaginous substances, oil, ether, alco-
hol, wine, camphor, ammonium carbonate, cutaneous stimulation.

Ptomaines. Emetics, laxatives, tannic acid, iodine water,
animal charcoal, calomel, ether, camphor, caffeine, atropine,
wine, ammonia, symptomatic treatment.

Ranunculus. Emetics, laxatives, tannic acid, excitants.

Sabina. Mucilaginous, demulcent remedies, opium, morphine.

224 GENERAL THERAPEUTICS FOR VETERINARIANS

Santonin. Emetics, laxatives, ether, chloral hydrate, camphor,
wine, symptomatic treatment.

Silver Nitrate. Emetics, albumin, sodium chloride, dilute
hydrochloric acid.

Snake venom. Locally, chlorine water, calcium chloride solu-
tion, iron chloride, solutions of potassium permanganate, am-
monia, carbolic acid or creolin; internally, alcohol in large doses,
ether, camphor, atropine, caffeine, hyoscine (scopolamine), aro-
matic spirit of ammonia.

Sodium chloride. Plenty of water, mucilage, oil, ether, cam-
phor, atropine, caffeine, antispasmodics when indicated.

{Sodium sulphate. Mucilage, opium, camphor, ether.]

Solanine. Tannic acid, laxatives, excitants.

Strychnine. Chloral hydrate, chloroform, potassium bromide,
ether, sulphonal, morphine, artificial respiration, tannic acid,
iodine water, emetics, irrigation of the stomach.

Sulphuric acid. Dilute alkalies, lime water, soda, magnesium
oxide, chalk, mucilage, oil, excitants.

Tannic acid. Albumin, gelatin, mucilage, laxatives.

Tartar emetic. Tannic acid, sodium carbonate, dilute acids,
sulphur, sulphurated potash, opium, albumin, mucilage, excitants.

Tobacco. See NicorTine.

Turpentine oil. Mucilaginous substances, opium, excitants.

Veratrin. Tannic acid, iodine, opium, sedatives, demulcents,
excitants.

(Veratrum. See HELLEBORE.]

Verdigris. Albumin, potassium ferrocyanide, powdered iron,
magnesium oxide.

Vinegar. Soap water, soda water, chalk, calcium carbonate,
magnesium oxide, milk, excitants.

Yew tree. Laxatives, excitants, atropine, hyoscine, caffeine,
veratrin, strychnine, camphor, ether, alcohol, ammonia, iodine
(Lugol’s solution).

Zinc. Albumin, mucilage, milk, tannic acid, opium, sodium
and potassium carbonate and bicarbonate, sulphurated potassium,
excitants.

VACCINATION. IMMUNIZATION. INOCULATION

1. IMMUNITY, MITIGATION, AND METHODS OF
INOCULATION

Immunity.—It was early observed that after recovery from
certain infectious diseases the animal or human body was pro-
tected against a new infection. This protection against infection
is called immunity and the animal endowed with this property of
insusceptibility is said to be immune or refractory. to a specific
infection. There are different varieties of immunity. Species
immunity is the natural insusceptibility of an entire animal
species to certain infectious diseases. For example, cattle are
immune to glanders, the horse to lung plague and rinderpest, the
dog and the cat to swine erysipelas, man to fowl cholera, the rab-
bit to black-leg, and almost all species of animals to syphilis,
scarlet fever, and measles. The immunity may even be limited
to certain breeds of a species. The Algerian sheep, unlike the
other breeds, are alleged to be immune to anthrax. The German
native swine and the Yorkshire swine are much less susceptible
to erysipelas than the other breeds; compared with field mice,
house mice and white mice are immune to tuberculosis and gland-
ers. This variety of immunity is due to certain unknown proper-
ties peculiar to the species and breeds, Individual immunity
tefers to the insusceptibility of single individuals of the same
animal species to this or that infection to which the members of
the species are susceptible. It is frequently observed in an out-
break of foot-and-mouth disease in cattle, or of contagious pneu-
monia, influenza and strangles of horses, that a large percentage
of the animals in a stable remain free from infection.

Both of the aforementioned varieties of immunity, species

and individual immunity, fall under the general term of natural
15 225

226 GENERAL THERAPEUTICS FOR VETERINARIANS

immunity, which is also called inherited immunity. It is due to
an inherited special property of the body cells and the blood
which cannot be transmitted to other animal species. An acquired
immunity, on the other hand, is established after an animal has
passed through a single attack of a certain disease and lasts for a
certain time (immunity after recovery). This variety of immunity
may follow an attack of pox, anthrax, lung plague, foot-and-mouth
disease, strangles, canine distemper, black leg, swine erysipelas,
etc., and also scarlet fever, measles, typhoid fever and diphtheria
of man.

The acquired immunity is to be attributed to the presence of
specific substances in the body (blood, blood-serum) which reduce
the susceptibility of the organism to the infectious agents which
caused the disease. These immunizing substances either neutral-
ize the toxins formed by the invading bacteria (antitoxic action,
toxic immunity) or they destroy the pathogenic bacteria them-
selves (bactericidal action, bacterial immunity). In contrast to
natural immunity, acquired immunity may be transmitted from
one animal species-to another (pox from cattle to man).

Finally, two varieties of acquired immunity are recognized,
the active and the passive. The active immunity is acquired
spontaneously by an animal in passing through an attack of the
particular disease (natural or artificial infection). This immunity
can be increased by a repetition of the infection and can usually
be made more continuous. It is due to the formation in the blood-
serum of antibodies (antitoxins, bacteriolysins, bactericides). The
passive immunity is produced by the artificial introduction of the
antitoxins (secondary immunity). It is only of short duration
because the antibodies artificially introduced are soon used and
none are formed to replace them, as occurs in active immunity
(inoculation of blood-serum in contagious pneumonia of horses,
foot-and-mouth disease, rinderpest, and swine erysipelas). In vacci-
nation against swine erysipelas the swine are passively
(serum inoculation) as well as actively (inoculation of bacilli)
immunized.

VACCINATION. IMMUNIZATION. INOCULATION 227

Practical experience having taught that an acquired immunity
often existed, attempts were early made, by intentionally intro-
ducing infection, to produce an artificial protection against a
subsequent infection. This variety of insusceptibility is called
artificial immunity and the process of artificial infection is termed
vaccination. The first vaccination for the purpose of producing
an artificial immunity was Jenner’s vaccination of man with cow
pox (1796).!_ In veterinary medicine, vaccinations of this char-
acter were early undertaken (sheep pox, lung plague, rinderpest,
foot-and-mouth disease). In more recent times, great scientific
and practical interest has been manifested in the production by
vaccination of artificial immunity against anthrax and black leg,
rabies, swine erysipelas, swine plague, tuberculosis, calf cholera,
chicken cholera, contagious pneumonia of horses, and tetanus.
Vaccination has become a valuable method of combating the infec-
tious diseases and is a species of internal disinfectant and anti-
dotal treatment.

Causes of Immunity.—The explanation of the establishment
of immunity has always been one of the most difficult therapeutical
problems, Only in recent times has light been thrown on the
intricate question by histological, bacteriological, and: chemical
inquiries. But a conclusive investigation has not been made, nor
has an entirely satisfactory explanation of the causes and nature
of immunity been discovered.

The best-known theories at this time are the serum theory of
von Behring and the phagocytic theory of Metschnikoff. The
first has his supporters chiefly in Germany, the latter in France.
The truth may indeed lie between the two; namely, that the serum
and the phagocytes both act as protectives of the body against
infectious materials.

1 Jenner’s celebrated paper, which appeared in London in 1798, bore the
title: ““An Inquiry into the Causes and Effects of the Variole Vaccine, a
Disease Discovered in Some of the Western Counties of England, Particularly
Gloucestershire, and Known by the Name of Cowpox.’”’ Jenner’s discovery
has become the greatest therapeutic fact of all times.

228 GENERAL THERAPEUTICS FOR VETERINARIANS

1. The serum theory of von Behring locates the immunizing
substances in the cell-free blood-serum. Under the influence of
‘ the pathogenic microérganisms the body cells produce chemical
substances with disinfectant properties (antibodies, alexins, im-
mune proteins) which destroy the bacteria (bactericidal action)
either by dissolving (bacteriolysins), clumping (agglutinins), or
precipitating (precipitins) them, or which neutralize their toxins
(antitoxins) or facilitate phagocytosis (opsonins). Artificially
inoculating the antitoxins in the form of the blood-serum of
immune animals into healthy animals produces in the latter
passive immunity; if the material is injected into diseased animals
recovery occurs (von Behring’s law; serum therapy). These anti-
toxins have not up to this time been isolated in their pure state.
According to von Behring, this is not possible principally because
they are not an antitoxin material but an antitoxic force similar
to the magnetic force of iron (!). Von Behring has differentiated
in vaccination the isotherapeutic (inoculation of the bacteria
themselves, Jennerization, cow pox vaccination, vaccination
against tuberculosis of cattle) and the homeeotherapeutic principle
(inoculation of the specific serum in diphtheria, swine erysipelas,
tetanus) (see p. 22).

Modifications of the serum theory have been formulated by
Buchner, Ehrlich, Brieger, Emmerlich, Wassermann, Lorenz, and
others. According to Buchner, the antitoxic body is an enzyme
with a ferment-like action

2. The phagocytic theory of Metschnikoff is, on the contrary,
a cellular theory, which places the immunizing force in the white
blood-cells (leucocytes, phagocytes). In infectious diseases, these
cells remove the invading infectious agents and their pathogenic
products from the blood by taking them within the cell body
(leucocytosis, phagocytosis). In local infection (inflammation),
they leave the blood-vessels in the form of wandering cells or pus
cells in order to take up the infectious material (positive chemo-
tropism or positive chemotaxis). In addition to this higher sus-
ceptibility of the cells, there also occurs through adaptation an

VACCINATION. IMMUNIZATION. INOCULATION 229

indifference of the cells toward the infectious material, in conse-
quence of which the cells avoid the pathogenic bacteria (negative
chemotropism or chemotaxis). “Living cells, governed by their
susceptibility, approach pathogenic microbes or flee from them;
take them within the cell body or allow them to lie free.”’ The
Metschnikoff theory received considerable support from the dis-
covery by Pfeffer of the law of the chemotropism of vegetable
cells (attraction or repulsion by certain chemical substances).
The behavior of the white blood-cells in inflammation, which is
analogous to the chemotaxis of plant cells, was first demonstrated
by Leber.

Other Theories.—1. The Exhaustion Theory (Pasteur). The first at-
tempt to explain the cause of immunity was made by Pasteur. In his studies
of fermentation he observed that the ferment organisms became ineffective
after a certain time, when they had used up a certain quantity of the nutritive
material from the nutrient solution, and he concluded that the pathogenic
organisms likewise withdraw from the invaded body certain substances indis-
pensable to their development, so that the body is in a certain sense exhausted
and microérganisms invading the body later fail to find suitable nutritive
material. Similarly, the so-called soil exhaustion is observed after long—
continued planting of the same fodder crop.

2. The Aggressin Theory (Bail). Aggressins is the term used by Bail
to describe the bacterial products which are formed, especially at the point.
of infection, to assist the bacteria in the combat between them and the leuco-
cytes. The aggressins possess negative chemotactic properties, as a result.
of which theleucocytes arerepelled. They are found especially in the cedema
at the point of infection (in anthrax) and in peritonitic and pleuritic exu-
dates. The injection of such ‘aggressive exudates” produces active im-
munity. The blood-serum of an actively immunized animal contains.
passively immunizing “anti-aggressins.”

3. The Opsonic Theory (Wright). According to Wright, the specific
action of serum is due to opsonins, in addition to antitoxic and bactericidal
substances. Opsonins are protective substances which promote phagocytosis
by making the bacteria more readily digestible by the leucocytes (bacterio-
tropic substances). ;

4, The Assimilation Theory (Baumgarten). The blood of immune animals
contains no antitoxins (no onehas demonstrated them!), but is so changed
chemically that the pathogenic organisms can no longer develop in it. (See
the colyseptic action of the disinfectants.)

230 GENERAL THERAPEUTICS FOR VETERINARIANS

5. According to Much (Immunitatswissenschaft, 1911), a distinction
must be made between toxin bacteria and endotoxin bacteria in considering
the immunizing processes occurring in the different infectious diseases.

I. The toxin bacteria remain at the point of infection (tetanus, diph-
theria, sausage poisoning) and act pathogenically by the excretion of poisons
(bacterial poisons or toxins), The antitoxins are the antidotes, which appear
in the blood-serum in consequence of the presence of the toxins. The anti-
toxic serum acts against the toxins as well as against the bacteria.

II. The endotoxin bacteria spread through the body (septicemia, strepto-
cocci) and exert a pathogenic effect not only through the toxins excreted but
also through the cell substances of the bacteria (endotoxins) when they dis-
integrate in the animal body. They are not counteracted by antitoxins, but
the substances which protect the body against these organisms are: 1, normal
humoral bacteriocidins, z.e., the bactericidal substances which are present in
solution in every normal serum (serum substances); 2, normal leucocytic
bacteriocidins, 7.e., the bactericidal substances in solution which originate
from the leucocytes (plasma substances); 3, specific humoral bacteriocidins,
which appear in the serum in the later stages of the infection—these three
protective substances destroy the living organisms; 4, the poisonous substances
of the endobacteria, the endotoxins, are destroyed through phagocytosis by
the leucocytes, while phagocytosis is again stimulated by the bacteriocidins.

The Weakening (Mitigation) or Attenuation of the Infec-
tious Materials.—In every protective or curative vaccination it
is important that the infectious material be used in a weakened,
mild (mitigated), diluted (attenuated) form, since the unweak-
ened, unattenuated virus will produce a severe or fatal infection.
The methods and manner of attenuation are very different. The
most important, arranged in historical order, are the following:

1. The introduction of a small quantity of the infectious
material. The greater the number of a pathogenic organism in
the body the more pronounced the effect; therefore, in vaccination
care must be exercised that only a minimum quantity of the
infectious material is inoculated, otherwise the original disease
will be produced in undiminished strength.

2. The selection of a different entrance point for the infec-
tious material. Under ordinary conditions the contagion of most
infections is taken in through the internal organs, especially the
respiratory and digestive apparatus. This has been demonstrated

VACCINATION. IMMUNIZATION. INOCULATION 231

in connection with lung plague, foot-and-mouth disease, rinderpest,
pox, swine erysipelas, chicken cholera and other diseases. If the
contagion of these diseases is introduced into the body through
another channel, for example through the skin or subcutis, it will
be brought in contact with essentially different living conditions
and it will also be absorbed very slowly and in very small quantity.
This method of attenuation was formerly employed exclusively
in veterinary medicine and possesses for the present and for the
future of vaccination a continuing importance. At the present
time, for instance, the contagion of pox and of foot-and-mouth
disease is inoculated in the skin or mucous membrane (cutaneous),
and that of lung plague, black leg, swine erysipelas, rinderpest,
etc., is injected subcutaneously for the purpose of diminishing the
course of the disease. Furthermore, a place for the inoculation
is selected as far removed from the heart as possible in order that
the resorption will be very slow (end of the tail, tip of the wing,
ear).

3. The influence of the higher degrees of temperature. Every
organism has its optimum and its maximum temperature. Higher
degrees of temperature weaken the vital energy and finally destroy
the organism. It is therefore possible to diminish the toxic effect
of the different infectious materials by the use of a certain degree
of heat. The reduction of the virulence by heating for 10 to 15
minutes at 50 to 55° C. was first demonstrated by Toussaint in
connection with the anthrax bacillus. The heating process is of
great practical importance in Pasteur’s protective anthrax vacci-
nation, in which one part of the anthrax bacilli is exposed for 24
days to a constant temperature of 42° to 43°C. (first vaccine)
and the other part to the same temperature for only 12 days
(second vaccine). The animals to be protected are first inoculated
subcutaneously with the greatly attenuated first vaccine and 10
to 12 days later with the less attenuated second vaccine; they
suffer only a mild form of the disease and acquire an immunity.
Other infectious materials (black leg, pox) can also be treated in
a similar manner.

232 GENERAL THERAPEUTICS FOR VETERINARIANS

4. Desiccation. Just as with high degrees of heat, the viru-
lence of some contagions is reduced by drying (withdrawal of
water). This method of mitigation has been of practical use in
Pasteur’s rabies vaccination, also in black leg vaccination (Kitt)
and in part in cow pox inoculation (vaccination). In the Pasteur
process small pieces of the spinal cord of a rabbit affected with
rabies are suspended in bottles and dried; to hasten desiccation
the bottom of the bottle is covered with small pieces of caustic
potash and at the same time the bottles are held constantly
at a temperature of 20°C. By this method the virulence of the
rabies virus is weakened so that after 1 to 2 days’ drying 7 days
are required for it to produce its effects; after 3 to5 days’ drying,
8 days; after 6 to 9 days’, 15 days, etc. As the weakest material
is first. injected subcutaneously and stronger material at each
successive injection, the vaccinated animals (and man) gradu-
ally acquire an immunity.

5. The influence of disinfectants. The addition of anti-
septics to cultures of bacteria also reduces their virulence. For
this purpose carbolic acid, potassium chromate, iodine trichloride,
oxygen and other disinfectants have been used in anthrax, tetanus,
pox, diphtheria, etc. Sunlight and certain physical factors (high
atmospheric pressure) also appear to have an attenuating effect.

6. The progressive inoculation of material of increasing
virulence. By inoculating first weakened, then more virulent, and
finally infectious material which has not been attenuated, the
organism gradually becomes accustomed to the contagion. This
process is employed in Pasteur’s rabies and anthrax vaccination,
in Lorenz’s swine erysipelas vaccination (first serum, then culture
inoculation), in Koch’s vaccination for rinderpest (first bile, then
virulent blood), and in other infections. In vaccination for swine
erysipelas and rinderpest the weakened and the strong vaccine
have been inoculated at the same time (simultaneous inocu-
lation).

7. Long-continued cultivation of the infectious material. As
was first shown by Pasteur, the virulence of a pathogenic organ-

VACCINATION. IMMUNIZATION. INOCULATION 233

ism decreases with its continued cultivation on artificial culture
media. The anthrax bacillus especially progressively decreases
in virulence with long-continued cultivation (see Pasteur’s
vaccination -process) and finally loses its virulence altogether.
Similar observations have been made in connection with the con-
tagion of chicken cholera, lung plague, pox and other infectious
diseases.

8. The passage of the infectious material through the bodies
of animals of another species. The inoculation of some infec-
tious materials into animals of a different species has the effect
of modifying their virulence. Best known in this respect is the
inoculation of cattle with the virus of pox of man and the re-
inoculation of man with the considerably attenuated virus thus
obtained (cow pox vaccination of Jenner). A similar effect is
obtained by the same process with the virus of rabies (monkeys,
rabbits), swine erysipelas, tetanus and diphtheria of man (horses,
rabbits), anthrax and black leg (sheep, goats, horses) and also
in other diseases.

The Different Methods of Vaccination.—According to the
part of the body into which the infectious material is injected,
the following methods of vaccination are distinguished:

1. Thecutaneous or endermatic vaccination consists of a super-
ficial wounding of the epidermis of the skin and exposing the
deeper layers of the rete malpighii. By no means must the wound
extend to the subcutis. The vaccination is carried out with a
vaccination lancet or needle in such a manner as to avoid bleeding
if possible. A flow of blood will wash the infectious material off
the skin. Cutaneous vaccination is used for foot-and-mouth
disease, sheep pox and small pox of man. Corresponding to the
cutaneous method is the mucous membrane vaccination, in which
there is only a superficial wounding of the epithelium, the sub-
mucosa being avoided; cattle are vaccinated for foot-and-mouth
disease upon the mucous membrane of the mouth. Vigorous
rubbing of the mucous membrane is sufficient to wound it super-
ficially. Corneal vaccination is also included in the term cutaneous.

234 GENERAL THERAPEUTICS FOR VETERINARIANS

2. The subcutaneous or hypodermatic vaccination is carried
out with a Pravaz injection syringe or by incising the skin and
forming a pocket (mice, guinea-pigs, rabbits, pigeons, chickens).
These methods are used for anthrax, black leg, lung plague,
swine erysipelas, swine plague and hog cholera, chicken cholera,
and rinderpest, in the diagnosis of glanders, for serum inocula-
tion and for the injection of tuberculin and mallein.

3. The interstitial or intramuscular inoculation consists in the
injection of the vaccine into the interstitial tissues or muscles.
It is therefore an essentially deeper vaccination than the sub-
cutaneous and is employed, for example, for the purpose of diag-
nosing black leg, rabies, and tuberculosis. Ostertag prefers the
intramuscular injection to the intraperitoneal for the bacterio-
logical demonstration of udder tuberculosis (milk) for the reason
that the disease can be diagnosed in the inoculated guinea-pigs
as early as ten days after the injection (nodules of the size of a
pea in the neighboring lymph glands).

4, The intravenous vaccination introduces the infectious ma-
terial directly into the blood stream. The needle of the syringe
is inserted into the vein and the vaccine is injected in the same
manner as drugs are injected intravenously. This method is used
in the protective vaccination against tuberculosis of cattle (bovo-
vaccine, Tauruman) and was formerly recommended in black leg
and lung plague.

5. The intracranial inoculation is used only for the purpose of
diagnosing rabies. It consists in trephining the skull-cap of rab-
bits and introducing the suspected material under the dura by
means of a specially constructed curved needle. Analogous
methods are the intracerebral (injection into the brain) and the
lumbar injection (subdural injection in the lumbar region).

6. The intraperitoneal inoculation has attained a great im-
portance in the diagnosis of tuberculosis. It consists in the injec-
tion of suspected milk into the peritoneal cavity of guinea-pigs
and is carried out simply by means of an ordinary injection syringe.
The result of the inoculation, however, is only to be expected 3 to

VACCINATION. IMMUNIZATION. INOCULATION 235

5 weeks after the injection (tuberculosis of the peritoneum and the
abdominal organs). This method can also be used in the diag-
nosis of glanders (guinea-pigs).

7. The intra-ocular inoculation consists in introducing the
infectious material by means of a fine injection needle through the
cocainized cornea into the anterior chamber of the eye. It is
used for the purpose of diagnosing rabies (rabbits, dogs) and also
to obtain pure cultures of the tubercle bacillus (rabbits).

8. Galactiferous inoculation is the term used to designate
injections through the teat canal into the udder by means of
canula-like needles or milk tubes (mastitis bacteria).

9. “ Feeding inoculation ” is the feeding of infectious material
to experimental animals (tuberculosis, anthrax, chicken cholera,
swine plague, hog cholera). Intra-intestinal infection is the injec-
tion of the material into the intestines.

2. THE DIFFERENT VARIETIES OF VACCINATION

Purposes of Vaccination—While formerly, vaccination was
almost exclusively applied to healthy individuals for the purpose
of producing immunity to a possible subsequent infection (pro-
tective vaccination), it has been more recently employed for other
purposes. First of all, mention must be made of the curative vacci-
nation, which has latterly occupied a place in the foreground of
therapeutic interest. Its object is to render assistance to the indi-
vidual in which infection has already taken place (post-infection
vaccination), while protective vaccination is employed before infec-
tion (pre-infection vaccination). In addition, vaccination is fre-
quently resorted to to establish a diagnosis. This diagnostic vac-
cination has for its object neither protection nor healing but the
production of the disease in question as rapidly and in as definite
form as possible, or the generation of fever (tuberculin, mallein) for
the purpose of establishing the presence of disease. Accordingly,
the following varieties of vaccination may be recognized:

(a) Protective vaccination (pre-infection inoculation).

(b) Curative vaccination (post-infection inoculation).

(c) Diagnostic vaccination.

236 GENERAL THERAPEUTICS FOR VETERINARIANS

rs
I. Prorective VaccinaTION

Varieties.—Depending upon how long before the outbreak of
an infectious disease the vaccination is made, three varieties of
protective vaccination are recognized: protective vaccination in
the restricted sense, prophylactic vaccination, and emergency
vaccination.

Protective Vaccination in the Restricted Sense.—This is the
vaccination of all animals in healthy regions and stables, at a
time when the disease is not present, for the purpose of immunizing
them against a possible subsequent outbreak of the disease. A
good example of this variety of protective vaccination is the vacci-
nation of man against smallpox. In veterinary practice, protec-
tive vaccination against sheep pox (ovination) was formerly
employed; i.e., all of the sheep in a district were vaccinated al-
though there was no outbreak of the disease. On account of the
great danger of introducing, spreading and to a certain extent of
artificially breeding the infection when vaccination is applied
under these circumstances, this variety of protective vaccination
has been abandoned.

Prophylactic Vaccination.—This is also called precautionary
vaccination (preventive vaccination) and is used in disease-free
stables when the animals are threatened by an infectious disease
which has broken out in the neighborhood and which may soon
attack them. Prophylactic vaccination is especially important
for those regions in which on account of local or agricultural condi-
tions an infection is stationary (anthrax, black leg, lung plague,
swine erysipelas, swine plague, rinderpest, sheep pox) and where
because of the conditions an effective protection is not to be
expected from the operation of veterinary police measures.

Emergency Vaccination—This is the vaccination of animals
which are yet healthy but which are in an infected stable (premises,
herd), and is employed most frequently in connection with foot-
and-mouth disease. It is indicated: (1) when the infection of
the healthy animals can not be prevented; (2) when it is assured
that the artificially inoculated animals will acquire a mild form of

VACCINATION. IMMUNIZATION. INOCULATION 237

the disease; (3) when private and ‘general interests will be bene-
fited by the disease passing through the herd as rapidly as possible
(shortening the period of continuance of the infection and conse-
quently reducing the restrictions of police regulations and the
economical disadvantages). When emergency vaccination is re-
quired by law (sheep pox) it is called compulsory vaccination.
Permitting the infection of contagious pneumonia and influenza to
spread among a lot of horses by not separating the healthy from
the sick has an effect similar to that of emergency vaccination.

Veterinary Police Regulations Concerning Vaccination

The only legal regulations in Germany concerning vaccination
refer to lung plague, sheep pox, and swine erysipelas. The German
veterinary sanitary law of June 26, 1909, in § 23, mentions the
vaccination of susceptible animals among the measures which may
be instituted for protection against infectious diseases. § 51 pro-
vides that vaccination for lung plague can be undertaken only
under official direction. §56 contains the same restrictions re-
garding vaccination of sheep for pox and forbids protective vacci-
nation particularly. On the other hand, when the presence of
pox is established the vaccination of all animals in the flock is
required by § 53 (emergency vaccination). Under § 54, the vacci-
nation of all flocks threatened by the disease and of all sheep in
the same section can be officially required (precautionary vacci-
nation) when sheep pox has obtained a great extension, or when
there is danger that it will invade neighboring flocks. § 60 provides
that when swine erysipelas becomes widespread the vaccination
of the endangered swine of a herd, of a locality or of a large dis-
trict may be ordered (precautionary vaccination). It is left with
the government to determine when and under what conditions
vaccination may be undertaken in other cases.

Protective Vaccination for the Different Animal Infections

Anthrax. Two methods of vaccination deserve special consideration:
Vaccination according to Pasteur with attenuated cultures, and vaccination
according to Sobernheim with serum and cultures.

238 GENERAL THERAPEUTICS FOR VETERINARIANS

1. Vaccination AccorpiIna To Pastrur.—The first protective vaccina-
tions were made in 1880 by Toussaint, who heated defibrinated anthrax blood
at 50-55° C. for 10 to 15 minutes and then used it immediately as a vaccine.
Pasteur demonstrated in 1881 that immunity could be produced by attenu-
ating the bacilli. Further investigations showed that the virulence of the
anthrax bacilli could be reduced by very numerous and different methods:
heat (Pasteur, Toussaint, Chauveau), compressed oxygen (Chauveau and
Wosnessenski), antiseptics (Chamberland and Roux), sunlight (Arloing).
The bacilli can also be weakened by cultivating them upon the blood of vacci-
nated sheep (Metschnikoff) or in the bodies of frogs (Lubarsch). Pasteur
produced his vaccine by cultivating the bacilli at 42-43° C. in an atmosphere
of oxygen for 24 days for the first or weaker vaccine and for only 12 days for
the second or stronger vaccine. The animal is first vaccinated with the first
vaccine and 10 to 14 days later with the second vaccine. The technique of the
vaccination according to the Pasteur method is as follows: The vials sent
out from the Pasteur laboratory must be used at once, the entire contents
being withdrawn at one time; they must not be opened until immediately
before the vaccination. A syringe holding one gram and divided into eight
divisions is used to make the injections. Each time before being used the
syringe must be carefully cleaned and disinfected. The lymph vial contain-
ing the first vaccine is thoroughly shaken, opened and the syringe filled
directly from it. One-eighth of the contents is then injected subcutaneously
on the inner side of the right thigh of the sheep to be vaccinated, and the open-
ing made by the needle is closed with the thumb. After 12 to 14 days, the
second vaccination is made with the second vaccine in the same manner.
One-fourth of the contents of the syringe is injected in vaccinating cattle,
the first vaccine being injected in back of the right shoulder and the second
vaccine in back of the left shoulder; the hair is clipped before the injection
is made. Cows in advanced pregnancy and lambs and calves should not be
vaccinated. ;

The results of the Pasteur vaccination are as follows: For sheep it is
not to be recommended. Very frequently it produces, especially in sheep,
only a very slight immunity or none at all, and in the most favorable cases
the immunity lasts only one year, so that it is necessary to vaccinate yearly.
Moreover, the mortality resulting from the vaccination is often very great,
sometimes amounting to 10 to 15 per cent. after the second vaccination.
The Pasteur vaccines are also very inconstant, being at one time too strong
and at another too weak, according to whether they have been kept at a tem-
perature nearer to 42 or 43°C. Sometimes the vaccine shows a return of
virulence, especially when it has been attenuated quickly at a high tempera-
ture; on the other hand, the virulence may be entirely lost. when the vaccine

VACCINATION. IMMUNIZATION. INOCULATION 239

is kept too long. Then again, the same vaccine will not answer for all sheep,
since the different breeds differ in their susceptibility to the same vaccine.
Finally, the cost of vaccination, which is not inconsiderable, must also be
taken into account. According to the favorable results obtained in France
and Hungary, the vaccination of sheep can only be recommended in an experi-
mental way when a good vaccine is available in regions in which the disease
is stationary and is attended with regular and considerable losses (at least
over 2 per cent.).

For cattle, the Pasteur protective vaccination has a certain value only
in badly infected anthrax districts. It is not suitable for use in other sections
on account of the uncertainty and short duration of the immunity, the losses
resulting and the agricultural disadvantages (illness of vaccinated animals),
but especially because of the great danger of the infection of non-vaccinated
animals and man. The second vaccine contains strongly virulent bacilli.
Horses bear the vaccination very badly. :

2. PROTECTIVE VACCINATION ACcoRDING To SOBERNHEIM.—The method
of Sobernheim consists of the inoculation of serum followed by the injection of
anthrax cultures (simultaneous vaccination); horses and cattle receive on
one side of the body 5 c.c. and sheep 4 c.c. of immune serum and five minutes
later upon the other side 0.5 c.c. and 0.25 c.c. respectively of an attenuated
anthrax bouillon culture of the virulence of the Pasteur second vaccine. In
1904, 75,000 cattle were vaccinated in the Argentine Republic with a loss of
only 1 in 1000; up to this time the results in Prussia have been less favorable.
On the other hand, curative vaccination with the serum in so far as it
has been tested has given very favorable results, corresponding with the
results from the earlier intravenous and subcutaneous injection of immune
serum.

Lung Plague.—The oldest and most important method of vaccination is
that of Willems (1851). The material for inoculation is obtained from an
animal in the first stages of the disease. The animal is slaughtered and the
diseased areas are removed from the fresh lungs. This diseased tissue is
subjected to gentle pressure to express the lymph, which is allowed to coagulate
and is then filtered through clean linen. The inoculation is made on the dorsal
surface of the tail 8 to 10 cm. from the tip, the injection being made into the
subcutaneous tissue in one or two places 1 to 2 cm. apart, after clipping the
hair. The lymph must be clear, of a wine-yellow color, and must not be taken
from necrotic lungareas, but only from placeswhich are in the stage of hepatiza-
tion. On the average, the vaccination is effective in 75 to 90 per cent. of the
cases. After 1 to 4 weeks there appears at the point of inoculation an inflam-
matory swelling which is not larger than a hen’s egg when the course is normal;
in addition, a mild fever and a slight increase in the respiration is observed.

240 GENERAL THERAPEUTICS FOR VETERINARIANS

If the lymph is not entirely pure, there is an extensive swelling of the whole
tail with necrosis of the tip, accompanied by very high fever and symptoms
of septicemia and pyemia. The same effects are produced when the inocula-
tion is made into the dewlap or at the root of the tail, for which reason these
places are to be avoided. When the tail becomes highly inflamed, an unfav-
orable termination must be combated by free incisions into the swelling,
antiseptic treatment, and, finally, by amputation of the necrosed end. The
deaths always average from 1 to 3 per cent., while 5 to 15 per cent. lose the
end of the tail. Sometimes, after 6 to 8 weeks, a second inoculation is made
above the point of the first injection.

According to Nocard, cultures of the microdrganism of lung plague are
better suited for inoculation than the lymph; it is more certain and milder.
The vaccine, an 8-day bouillon culture, is injected subcutaneously at the tip
of the tail in doses of 0.15 to 0.5 c.c.; the immunity should continue 2 years.

In addition to the caudal vaccination, intravenous vaccination was under-
taken by Thiernesse, Defays, Bouley, Degive, Sanderson and others, 2 c.c.
of the lymph being injected directly into the jugular. The results were very
good and more certain than those from caudal vaccination; in one case inflam-
mation of the lungs, with marmoration, was produced. The vaccination with
secondary calf lymph according to Pasteur has not proven satisfactory.

With regard to the value of vaccination, there is no agreement. The
advocates of vaccination base their claims upon the well-known fact that
after recovering from an attack of the disease cattle are immune for life.
Vaccination sets up a specific local inflammatory process exactly similar to
that which takes place in the lungs in lung plague and generates an immunity
of the entire body. In addition, vaccination shortens the course of the plague
in a stable. The losses after caudal vaccination are declared to be entirely
inconsiderable. Haubner calculates that 1 to 2 per cent. die, while 5 to 10
per cent. lose the end of the tail. In Holland, where 60,000 cattle were vacci-
nated in 1878-79, the mortality amounted to 0.66 per cent. The favorable
results obtained in the Spdling district of Holland, in the province of Saxony,
in the duchy of Anhalt and in Australia are presented as proof of the value of
vaccination. To these are added the positive results obtained by Schiitz and
Steffen. A further extension of the disease through vaccination is denied.
Moreover, compared with the great pecuniary losses attending the slaughter
method of controlling the disease, vaccination is by far the cheapest; while
the value of sanitary laws, however stringent, is disputed. The following
statistics are presented: Degive computed the results of vaccination in several
countries from 1850 to 1883 and found that of 6705 vaccinated animals only
2.7 per cent. contracted the disease, and that of 2453 non-vaccinated animals
26.9 per cent. became infected, although both classes of animals were similarly

VACCINATION. IMMUNIZATION. INOCULATION 241

exposed to the disease. According to Piitz, the number of animals affected
with lung plague in Holland was reduced by vaccination from 6079 in 1871
to 2227 in 1875, 951 in 1877, 157 in 1879 and, finally, 11 in 1882. In Hasselt,
where 200,000 cattle were vaccinated with good results during the period
from 1850 to 1880, the losses regularly increased when vaccination was omitted.
Rochebrune relates that for years the Moors in Senegambia have vaccinated
their cattle against lung plague with good results by sticking the point of a
knife into the lungs of a slaughtered animal and then incising with the knife
the skin of the animal to be vaccinated in the region of the nostrils.

The opponents of vaccination point out that a positive case of immuniza-
tion by vaccination has not been demonstrated up to this time. Even the
friends of vaccination are not in a position to state how long the immunity
continues, whether 14 or 1 or 2 years; others who favor vaccination speak
only of partial action and immunization and therefore vaccinate several times.
The specific character of the vaccination swelling is disputed, since an entirely

. similar swelling arises after the inoculation of pus or milk. Furthermore, the
vaccination has in no case produced a lung plague pneumonia, the principal
criterion of the disease, while this alteration occurs even in those cases in
which the infection is transmitted intra-uterine from the mother to the fcetus.
The results of vaccination are dependent upon the method and time of inocu-
lation and upon the quality of the vaccine. Animals already immune were
also frequently vaccinated and the previously acquired immunity attributed to
the effects of thevaccine. The disease hasbeen introduced and artificially prop-
agated by vaccination. The losses from vaccination are under certain circum-
stances very considerable; the mortalityisfrequently very great, even at times
exceeding the usual fatalities from the disease itself. Inthe preamble to the
German Imperial veterinarysanitarylawsthelosses from vaccination are given
as 2 to 4 per cent.; theend of the tail is lost in 25 percent. of thecases according
to the observations of a French vaccination commission, in 10 to 15 per cent.
according to Degive. In addition there are the economical disadvantages,
decrease of the milk secretions, emaciation, etc. The disease often spreads
in spite of vaccination, while in other cases it subsides without vaccination;
many animals have the disease without showing perceptible symptoms. In
those countries in which vaccination was most extensively practised the
‘disease is not yet on the decline. In England, for example, and in France and
Belgium, in which vaccination was obligatory, as well as in the province of
Saxony, the disease still exists. In other countries, for instance Holland, the
repression of the disease is perhaps not the result of vaccination but of the
simultaneous enforcement of veterinary police measures, especially slaughter.
In Belgium, according to Oemler, the number of cases of lung plague increased
from 1481 in 1867 to 2800 in 1878 in spite of vaccination, but after that date,

16

242 GENERAL THERAPEUTICS FOR VETERINARIANS

in consequence of the strict enforcement of veterinary police regulations, the
number of cases rapidly decreased, until in 1880 there were 1781 and in 1883,
1187 cases. A compilation made by Kitt shows that in England the number
of cases decreased only with the adoption of stringent protective regulations
in 1878 from 4590 to 2144 in 1879 and to 1200 in 1882. In Bavaria, following
the introduction of the Imperial veterinary sanitary laws, the number of cases
decreased from 846 in 1846 to 281 in 1883. In Baden, where from 1870 to
1880 0.2 per cent. of all the cattle died yearly from lung plague, there was
not a single case in 1885.

The answer to the question as to the value of vaccination for lung plague
depends principally upon whether it is to be used only for immunizing individ-
ual animals or to combat an outbreak of the disease in a herd or in a district.
In this connection the following statements can be made: (1) Vaccination,
as a Tule, confers a high degree of immunity upon individual cattle. (2) The
value of vaccination as a veterinary police measure for combating lung plague
is, on the contrary, doubtful. Experience has many times taught that not
all vaccinated cattle acquire an immunity, but that about 2 per cent. remain
susceptible to the disease. These apparently immune cattle, when they subse-
quently suffer a latent attack of the disease, are a continuous source of infec-
tion for healthy animals, especially in regions where the traffic in cattle is
extensive (province of Saxony). Furthermore, lung plague sometimes runs
such a mild course that no symptoms of disease are apparent and the recogni-
tion of the disease in time for the vaccination of the herd is not possible. The
length of the period of incubation also often prevents a prompt diagnosis or
early vaccination. As a method of combating the disease, slaughter of the
infected herds is much more reliable than vaccination.

Rabies.—Pasteur announced in 1884 that the virus of rabies could be
gradually weakened by inoculating it from the dog into a monkey and then
successively from monkey to monkey. Virus attenuated in this way and in-
jected subcutaneously or under the dura mater, after trepanation of the
cranial cavity, does not produce rabies in the dog, but on the contrary renders
the apimal immune to artificial or natural infection with the disease. Subse-
quently, Pasteur published another method of immunization in which the
dried spinal cord of a rabid animal is used as the vaccine. The spinal cord of
a rabbit affected with rabies is removed under aseptic precautions up to the
lower end of the cerebellum, together with all of its coverings, and cut into
pieces 6 cm. long, which are suspended on threads in bottles. The bottoms
of the bottles are covered to a depth of 1.5 cm. with small pieces of caustic
potash and their openings are closed with cotton plugs. They are kept at a
constant temperature of 20°C. After 3 to 4 days, the pieces of spinal cord
are dried into ribbon-like, very friable strips, the toxicity of which gradually

VACCINATION. IMMUNIZATION. INOCULATION 243

decreases with the continuance of the drying. For example, rabbits develop
rabies after 7 days when they are inoculated with material which has been
dried 24 to 28 hours; after 8 days, when the material has been dried 3 to 5
days; after 15 days, when the drying has continued 6 to 9 days. Animals
(horses, dogs) and man are made immune to rabies by injecting them first
with a very weak virus, then with a slightly more virulent virus, and so on,
until at last a very strong virus is injected. After this, the full strength rabies
virus can be injected without harm. This method of vaccination has proven
of value also as a curative remedy when applied to human individuals bitten
by rabid dogs (post-infection vaccination). Other methods of vaccination
for rabies (diluted virus, intravenous injection of brain substance, serum
inoculation, simultaneous vaccination) have been published by Hégyes,
Helman, Babes, Galtier, Protopopoff, and others.

Foot-and-mouth Disease.—<As early as the beginning of the nineteenth
century (Buniva), and very frequently since then, vaccination in the form of
emergency vaccination has been effectively employed to induce the regular
extension and to shorten the course of foot-and-mouth disease in large herds
(Ercolani, Brauell, Renner, Hoffmann, Wirtz, Spinola, Hertwig, Lewes,
Brandes and others). Emergency vaccination is a measure entirely worthy
of recommendation, because it not only causes a more rapid extension of the
disease through a herd and consequently permits an earlier removal of the
sanitary police regulations, but the vaccination disease frequently runs a
milder course and is confined to the mouth. The emergency vaccinations
made in the last ten years in numerous herds in almost all sections of Germany
have mostly been accompanied by good results; their influence was most
favorable when the vaccinations were made at the first appearance of the
disease. Of the vaccinated animals, 50 to 80 per cent. became infected on the
average; the others proved themselves to be immune. Emergency vaccination
is only contraindicated in the malignant form of foot-and-mouth disease, in
which the vaccination disease may be dangerous. d

The technique of the vaccination is very simple. The saliva of an affected
animal is placed in the mouth of the animal to be vaccinated at a point where
the mucous membrane has been previously rubbed, or it is inoculated with a
lancet anywhere in the skin; impregnated threads can also be drawn under the
skin of the ear or tail. Swine are inoculated on the nose with a syringe and
needle. Fever occurs 24 hours after the inoculation; on the third day the
vesicles appear, and healing of the ulcers begins from the sixth day on. The
course of the vaccination disease is in general milder than that of the natural
infection.

With reference to the protective vaccination with blood-serum, the investi-
gations are not yet concluded. Hecker’s vaccine and “seraphthin,” intro-

244 GENERAL THERAPEUTICS FOR VETERINARIANS

duced by Léffler in 1899, did not answer the purpose. It is doubtful if the
sera employed by Nocard and Léffler on cattle (2 to 3 weeks’ immunity),
sheep and swine (3 to 8 weeks’ immunity) will prove of practical value. A
method of protective vaccination suitable for practice is not yet known.
Léfler’s serum (1912) is not adapted to general use because of the high price
(about $7 per animal), the complicated process (four vaccinations) and the
short duration of the effect.

Sheep Pox.—lIn the first half of the nineteenth century, entire flocks of
sheep were subjected to protective vaccination against sheep pox (ovination)
each year, with the assistance of special vaccination institutes, whether an
outbreak of the disease was threatened or not. This regulation proved to be
very objectionable. Not only did the protective vaccinations establish per-
manently infected flocks, in which the disease became stationary, but the
infection spread from these flocks to the adjoining regions, the danger of
healthy animals being infected by vaccinated individuals being exceedingly
great. In several countries, for example in Prussia and Austria, the spread
of the disease went hand in hand with the protective vaccination. On the
other hand, emergency vaccination is worthy of recommendation, and is
therefore included in the requirements of the German sanitary laws (§ 53).
Emergency vaccination is employed only in those flocks in which the disease
has already broken out. Not only does it cause the disease to run a quicker
course, inducing a more rapid extension of the infection through the
flock and consequently an earlier removal of the sanitary police restric-
tions, but the disease itself is of a milder type and usually only local, so
that frequently there are no deaths and usually not more than 2 per cent.
die. Only when all external factors are unfavorable, the losses excep-
tionally reach 10 per cent. In addition to emergency vaccination, precau-
tionary or prophylactic vaccination may also be employed when an extensive
outbreak of sheep pox prevails in the neighborhood of healthy flocks and the
situation is such that there is great danger of these flocks being infected (§ 54).

The vaccine, or “ovine,” can only be obtained from sheep with normally
‘developed pox and in which the disease runs a benign course. The lymph
must be entirely clear and limpid, neither turbid nor purulent; it is therefore
usually collected from the vaccinated sheep on the 10th to the 12th day after
the vaccination, or 6 to 8 days after the eruption. The vaccinated sheep must
be kept separate from the sheep from which it was inoculated, and the sheep
to be vaccinated must not be permitted to come in contact with the infected
sheep from which the material for inoculation is obtained, otherwise infection
may take place spontaneously at the same time. The inoculation may be
made on the inner surface of the ear, 4 cm. from the tip, or better on the under
surface of the tail, 10 to 12 cm. from the anus. In the latter case the animal

VACCINATION. IMMUNIZATION. INOCULATION 245

must be laid down. Vaccination on the ear is not entirely without danger on
account of the proximity of the eye. The instrument used is either a fine and
pointed vaccinating needle with a spoom-like excavation, or a vaccination
lancet. In vaccinating an entire flock, it is an advantage, when time will
permit, to make a preliminary or test vaccination of six to twelve animals.
The vaccinated sheep show an entirely regular pox exanthema which is limited
to the point of vaccination, and very mild general symptoms. The pox become
ripe on the tenth day after vaccination. Exceptionally, the pox do not
develop at the point of vaccination but in the surrounding area (accessory
pox); very rarely, a general eruption of pox is observed following the vaccina-
tion eruption (secondary pox). The after-treatment consists in protecting
the vaccinated animals from unfavorable weather and providing them with
suitable food. In addition, an examination of the flock should be made in
ten to twelve days and those animals again vaccinated in which Ain first
vaccination was not effective.

In place of ovination, serum vaccination, serum therapy and simultaneous
inoculation with immune serum and virulent lymph are also recommended
(France, Roumania).

Rinderpest.—1. Tar Otp Suscuranzous Mxrtxop.—On the steppes of
Russia, where this form of vaccination was practised as early as the middle
of the eighteenth century, it was formerly employed as a prophylactic measure;
but only in the form of emergency and precautionary vaccination, never as
protective vaccination, because of the great risk of spreading the disease by
the latter. At the present time there are four vaccination institutes in Russia
(Kharkov, Karlovka in Poltava, Bondarewka in Kherson, and Salmysch in
the Orenburg government), but vaccinationis falling more and more into disuse.
In Germany and the other European countries, except Russia, emergency
vaccination is not permitted, because in them veterinary police measures,
i.e., slaughter, are much more effective and certain and because the mortality
from the vaccination of ordinary cattle is much too high. The mortality
among the cattle of the steppes from vaccination is only about 10 per cent.,
while among the other breeds it is 36 per cent. Toward the end of the out-
break favorable results from vaccination are relatively more frequent. The
technique of the vaccination is simple. A clean sponge is placed in the nostril
and permitted to remain there until it has absorbed its fill of nasal mucus,
when it is removed and the contents expressed into a small glass vessel, which
is closed. A drop of this material is then injected under the = of the neck
with a Sticker syringe.

2. Bie InocunaTion Accorpine To Kocu.—During his investigations
into the cause of rinderpest in South Africa (Kimberley) in 1897, Koch found
that the bile as well as the blood-serum of cattle that had passed through an

246 GENERAL THERAPEUTICS FOR VETERINARIANS

attack of the disease possessed immunizing properties. The bile vaccination
consists simply of a single subcutaneous injection into healthy cattle of bile
(10 c.c.) from cattle affected with rinderpest or which have passed through an
attack of the disease. Six to 10 days after vaccination, an immunity is estab-
lished which continues 4 to 6 months. The local effect consists of a hard swell-
ing of the size of the fist, which disappears after a few weeks. Protective
vaccination with bile is of extraordinary value in infected regions. Kohlstock,
who introduced Koch’s method of vaccination into German Southwest Africa,
recommends a double vaccination of bile and rinderpest blood (emergency
vaccination). This double vaccination was later approved by Koch. Accord-
ing to Kolle, Koch’s bile method has the disadvantage that the animal is
susceptible to infection for a whole week after vaccination. Furthermore, it
is necessary to slaughter 3 to 7 diseased or recovered animals to obtain sufii-
cient bile to vaccinate 100 cattle. The mixture of bile and glycerin proposed
by Edington is without value, as the addition of the glycerin reduces the
degree as well as the continuance of the immunity. According to Hutcheon,
Koch’s bile vaccination method has been abandoned entirely in Cape Colony
on account of its great imperfection.

3. Serum Vaccrination.—This method requires 100 c.c. of blood-serum
and produces only a passive immunity of short duration. It may be used to
separate an infected region from a rinderpest-free region by creating a broad
immunized area around the infected region. It has preference over the bile
vaccination in that it is effective in the incubation period of rinderpest.

4. Smruttangovs Vaccination.—Kolle and Turner recommend the simul-
taneous injection of 1 ¢.c. of virulent rinderpest blood upon one side of the
body and the injection of 15 to 40 c.c. of serum upon the other. This method
confers an immunity for five months. Koch and Theiler have raised the
objection against the simultaneous method that piroplasme (infectious hemo-
globinuria) and trypanosomes may be inoculated with the rinderpest blood
in regions infected with these parasites.

Black Leg.—1. Tae Lyons Meruop of vaccination was discovered by
Arloing, Cornevin, and Thomas. In 1880 and 1885 they vaccinated intra-
venously, but with great losses. They therefore later selected the subcutis at
the end of the tail as the point of vaccination, because they had found that the
black Jeg virus when introduced here produced only a temporary harmless
swelling but nevertheless established subsequently a complete immunity.
The slight reaction at this point is explained, in their opinion, by the density
of the connective tissue and the low temperature existing there, both of which
conditions prevent the spread of the black leg bacilli through the connective
tissue spaces. In addition, they also weakened the black leg virus before
injection by exposing it to high degrees of temperature. The preparation of

VACCINATION. IMMUNIZATION. INOCULATION 247

the vaccine and the process of vaccination according to Arloing’s method
(Lyons method) is as follows: 40 grams (1 part) of diseased muscle tissue is
quickly dried at 33° C. and uniformly mixed with 80 grams (2 parts) of water.
The entire amount is then divided into 12 parts of 10 grams each, each part
is placed in a suitable flat dish and dried for 6 hours in a thermostat. One-
half is kept at a temperature of 100° C. in order to obtain the weaker-acting
first vaccine, and the other half is exposed to a temperature of 85°C. to
produce the stronger second vaccine. The vaccination is carried out in two
sections, the first with the weaker and the second with the stronger vaccine.
The dried brownish crust in the plates is used in the vaccination; this material
can also be stored for a long time. For the first vaccination, 0.1 gram of the
material which was heated at 100°C. is triturated in a disinfected mortar
with 5 grams of water, the contents of a 5-gram Pravaz syringe. The mixture
is then filtered through, a clean piece of linen and the filtrate is drawn up into
the syringe, the piston of which is marked off in half-cubic centimetres and
provided with a movable disk to be used in measuring the dose. The quantity
of the vaccine injected into each animal is 0.5 c.c., so that the syringe will
hold sufficient for 10 animals.

The point of the first vaccination is the under surface of the tail, three
hand-breadths from the tip. After the hair is clipped, the trocar which accom-
panies the syringe is inserted obliquely through the skin and passed up-
wards between the skin and bones about 8 cm.; it is then removed, the canula
of the syringe introduced through the same wound and the vaccine, after
being mixed by shaking the syringe, is slowly injected. To prevent the vac-
cine from flowing out, the point of entrance is compressed and the injected
fluid is pressed upward with the thumb. If any bleeding occurs, the injection
is delayed until the hemorrhage is checked, or another place is chosen. Finally,
a rubber bandage 2 cm. in width is placed upon the point of injection and
allowed to remain four hours for the purpose of preventing the escape of
the vaccine. In this way, it is said, 20 to 25 animals can be vaccinated in an
hour, the animals being held by three assistants. Ten days after the first
vaccination, the animals are vaccinated with the second or stronger vaccine.
The second vaccination is carried out in the same manner as the first except
that the injection is made only two hand-breadths from the tip. The most
favorable season for vaccination is spring, or the close of winter. The vacci-
nation is not followed by any sequelez. The vaccination experiments carried
out in different countries (France, Switzerland, Austria, Germany) have
established that the Lyons method of protective vaccination undoubtedly
reduces the mortality from black leg very considerably.

2. Taz Munica Mersop of vaccination, or Kitt’s method, consists of
a single subcutaneous injection on the under surface of the tail. The vaccine

248 GENERAL THERAPEUTICS FOR VETERINARIANS

solution is prepared from powdered muscle which has been attenuated by
exposure to live steam at 97° C. (or by heating for six hours at 85 to 90° C.).
More recently, pieces of muscle of different origin are used in preparing the
vaccine (polyvalent vaccine).

3. Tae BuackLeGINE oF THomas.—Silk or cotton threads containing
black leg spores are inserted subcutaneously (back of the shoulder in calves)
and permitted to remain. The method is recommended as very simple and
effective and has given satisfactory results in Germany (North Dithmarsch).

Swine Erysipelas—1. THz Lorenz Meruop of vaccination and the
analogous Susserin consists in the simultaneous injection of immune serum
(passive immunization) and bouillon cultures of swine erysipelas bacilli (active
immunization). The inoculation is made at the base of the ear, where
5 c.c. of serum and 0.5 c.c. of the culture are injected subcutaneously at
the same time (simultaneous vaccination). The immunity established by
the vaccination continues about half a year. Simultaneous vaccination has
proven very trustworthy in Germany as a protective and curative remedy.
Recently, instead of the double inoculation only the serum is injected in many
instances.

2. Tas Pasteur Meruop comprises twoinjections of attenuated cultures
of swine erysipelas bacilli (premier and deuxiéme vaccine) on the inner sur-
face of the thigh at intervals of 10 to 12 days; the first the weaker and then
the stronger vaccine (attenuated by passing through rabbits). This method
established a high and long-continuing immunity, but is not without danger
(extension of the disease, sometimes great losses).

Hog Cholera.—By the use of 10 to 20 c.c. of immune serum, obtained
from swine highly immunized artificially, a passive immunity is established
which begins during the period of incubation and lasts several weeks. The
immune serum also has a curative effect on diseased animals. By the simul-
taneous injection of immune serum (20 c.c.) and virulent blood (1 to 2 c.c.)
an active immunity is produced which lasts for months; this method, however,
appears to be not without danger, because a part of the vaccinated swine
become affected with hog cholera and eliminate the virus of the disease.

[In the United States, 20 c.c. of serum are injected for each 50 pounds of
body weight both in the serum alone and in the simultaneous method of
vaccination.]

Swine Plague.—The several vaccines recommended for swine plague
(Septizidin, Supto], Euman, bivalent and polyvalent serum) have not proven
reliable in practice.

Calf Pneumonia.—The views concerning the value of the different immune
sera (Septizidin, polyvalent serum) are divided and contradictory.

Calf Cholera.—The serum vaccination of new-born calves with polyv-

VACCINATION. IMMUNIZATION. INOCULATION 249

alent coli serum (Jensen) is effective, but the protective vaccination of cows
in advanced pregnancy has, on the contrary, proven to be without value.

Fowl Cholera.—1. Prorecrive VAccINATION witH ATTENUATED CUL-
ruRES AccorDING To PastruR.—In 1880, Pasteur recommended the vaccina-
tion of healthy individuals with cholera bacilli attenuated by cultivation as
the most effective method of combating fowl cholera. He found that vacci-
nation with a weakened (mitigated) vaccine produced only a local swelling
at the point of inoculation and that the muscle tissue beneath underwent
necrosis without suppuration. The vaccinated bird was sick, indeed, but did
not die and became immune to the disease. Some chickens, however, required
2 to 3 vaccinations with mitigated vaccine before they acquired an immunity.
Pasteur therefore introduced a double vaccination, first injecting a very weak
vaccine (premier vaccine) and then a stronger one (deuxiéme vaccine). The
bacilli were attenuated by keeping them for 3 to 10 months under conditions
which permitted the entrance of air, whereby, according to Pasteur’s theory;
their virulence was reduced by the oxygen of the air. Protective vaccinations
were made according to this method by Cagny, Hess, and Kitt, and the results
were very unfavorable (spread of the disease, fatal cases). ‘

2. Serum Vaccination has been of doubtful value in Prussia, but in
Denmark very favorable results have been obtained.

Contagious Pneumonia of Horses.—The first serum vaccinations were
made by Hell in 1892. The vaccinations made the same year in the Prussian
army to test the new process were, however, without effect, since the disease
occurred with the same intensity in the vaccinated horses as in those which
had not been vaccinated, while many horses which were not vaccinated did
not take the disease (P. Mil. V. B., 1892). The reports concerning the vacci-
nations made in the army with blood-serum in 1893 are very contradictory
(P. Mil. V. B., 1893). In 1894, vaccinations were made in four regiments.
The results did not speak favorably for the vaccination; it neither shortened
the course of the disease nor reduced the virulence. The isolated favorable
results were only apparent and are to be explained by the benign character
of the infection (P. Mil. V. B., 1894). In 1895 the serum vaccinations were
also without effect, although every horse received 200 grams of serum in four
days; 10 weeks after the vaccinations 10 horses in one squadron became ill
with contagious pneumonia, some being very severely affected (P. Mil. V. B.,
1895). On account of these results the vaccinations were discontinued in the
army in 1896. In 1898 Tépper made a report of his experiences with blood-
serum vaccinations and stated that the horses became immune 6 to 8 weeks
after the injection of the serum. He also stated that the disease usually pre-
vailed in the stable 4 to 6 weeks before the vaccinations were begun and that
after the vaccinations it was always immediately checked. Not less than 150

250 GENERAL THERAPEUTICS FOR VETERINARIANS

grams of blood-serum must be injected and it must be obtained from horses
in the same stable which had recovered from the disease and which had been
free from fever for at least 3 to 6 weeks. As Topper did not make his vacci-
nations until 4 to 6 weeks after the appearance of the disease, Schwarznecker
pointed out that it was very questionable whether the cessation of the out-
break was due to the vaccinations or to the natural course of the epizodtic.
The Prussian military report for 1898 shows that the protective vaccination
with blood-serum is of no practical value. Contagious pneumonia did not
prevail as long in those divisions of the army in which no vaccinations were
made as in those in which the horses were vaccinated. In the winter of 1898-
99, Tréster made serum injections in 17 batteries and 6 squadrons; each horse
receiving 50 grams of serum. The vaccinations caused an immediate pause
of 5 to 36 days in the progress of the epizootic, but the effect did not last and
was insufficient, since the epizodtic was not extinguished. This brief protec-
tion, according to Tréster, is only of value in the case of a mobilization, when
it may be desirable to protect a large number of horses from infection for a
a few days. All attempts to cure horses affected with contagious pneumonia
by vaccination with serum have failed. Further experiments were made by
Tréster in 1899 on 58 horses with a larger quantity of serum (500 ¢.c., in two
portions, injected into the breast). The results of this experiment, by no means
extensive, seemed to Tréster to justify the conclusion that the injection of
such large doses produced asufficient immunity, although the amount of serum
required was very difficult to obtain. In 1900 and 1901, he vaccinated 784
and 635 horses respectively with 100 to 150 grams of active blood-serum;
some of the vaccinations were effective (40 days immunity) and some were not.
In May, 1900, 518 horses in Dragoon Regiment No. 21 were vaccinated by
him and no effect was observed on the spread of the disease; 195 of the vacci-
nated horses developed extensive swellings and abscesses and some of them
were not fit for service for 14 days. Mieckley vaccinated 200 horses with 200
grams of serum each in the Beberbeck stud in 1900. The results were nega-
tive. In spite of the vaccination, 113 horses became affected with contagious
pneumonia, and of these 14 died.

In the light of these experiences there can remain no doubt that serum
vaccination for contagious pneumonia is of no value.

Cow Pox Vaccination of Man (Vaccination).—Since 1796 the lymph of
cow pox (vaccine) has been used for the protective vaccination of man against
smallpox (variola). Three kinds of vaccine are recognized: original, human,
and animal. The original vaccine is the lymph obtained from natural cow
pox, which was used in the beginning of vaccination; the human vaccine is
obtained from cow pox produced artificially on children, and the animal
vaccine is obtained from calves, At the present time, almost all vaccinations

VACCINATION. IMMUNIZATION. INOCULATION 251

are made with animal vaccine. The animal lymph is obtained in the following
manner: Healthy calves (especially steer.calves) one-fourth to one-half
year old, which have passed the tuberculin test, are inoculated with human
vaccine in special vaccine institutions (100 to 200 punctures or crucial inci-
sions upon the shaved and cleaned skin of the abdomen). On the fifth day the
lymph is collected from the pox which have developed with special instru-
ments (clamp forceps, capillary tubes, lancets, spatule, glass plates) and
conserved (exclusion of air in glass tubes, glycerin, thymol, salicylic acid,
drying). The principal advantage of animal over-human lymph is the certain
avoidance of the transmission of disease from the vaccinated children to those
subsequently vaccinated (syphilis, tuberculosis, acute exanthemas). The
immunity established by vaccination continues for about ten years; after
this time a re-vaccination is necessary.

Tuberculosis.—For the protective vaccination of cattle against tuber-
culosis von Behring, in 1902, recommended the intravenous injection of living
human tubercle bacilli into calves 3 to 6 weeks old (Jennerization, Bovovac-
cine). First, 0.004 gram of tubercle bacilli suspended in 4 grams of water is
injected into the jugular vein, and later 25 times the quantity of tubercle
bacilli, 0.01 gram, suspended in 4 grams of water, is injected. [In 1902,
Pearson and Gilliland published a report of their experiments in which they
had demonstrated that it was possible to immunize cattle against tuberculosis
(Phila. Med. Journal, Nov. 2, 1902). These experiments were begun Sep-
tember 29, 1900. They used living tubercle bacilli of the human type,
injecting 0.004 of dried. tubercle bacilli suspended in salt solution intrave-
nously and four weeks later twice this quantity.] A similar method of vaccina-
tion was recommended by Koch and Schiitz (Tauruman), who claimed that
a single intravenous injection of 0.01 to 0.03 gram of tubercle bacilli from
human sources or of attenuated bacilli from cattle would immunize cattle
against highly-virulent tubercle bacilli of bovine origin. These methods of
protective vaccination have not proven of practical value because only a
temporary immunity is established. The use of vaccine material containing
virulent tubercle bacilli is also attended with several disadvantages: the
infection of the vaccinated calves with tuberculosis, the infectiousness of the
meat and milk of the vaccinated animals for man (excretion of virulent tubercle
bacilli in the milk), the danger of the vaccination to the veterinarian, the
transformation of chronic calf pneumonia into the acute form, and other
dangerous vaccination accidents (embolic pneumonia, apoplectic death,
severe febrile disease, emaciation, etc.). Antiphymatol and tuberculosan
have proven equally inefficient.

Strangles.—The serum treatment of strangles (protective vaccination,
curative vaccination) has not proven reliable in Germany. Experience with

252 © GENERAL THERAPEUTICS FOR VETERINARIANS

the different preparations of serum has been unsatisfactory, especially in the
Prussian remount depots and in east Prussia. In Denmark, on the other hand,
the protective action of subcutaneous injections of dead strangles cocci [bac-
terin] and the curative effect of polyvalent serum have attained a great repu-
tation. Frébner’s experience with the Danish serum confirms the reports
of its curative value. Protective vaccination’ (active immunization with
cocci) has been recently recommended in Germany.

II. Curative Vaccination

Character.—While by protective vaccination a certain time
before the entrance of infection an immunity is obtained (pre-
infection vaccination), the purpose of curative vaccination (post-
infection vaccination) is to accomplish the same result after
infection has taken place. The first attempt to heal an already
infected body by vaccination was made by Pasteur in his experi-
ments in the cure of rabies (1885). Then followed the experiments
of Koch, von Behring, [Pearson and Gilliland], Kitasato and others
with tuberculosis, tetanus, diphtheria, pneumonia, anthrax, swine
erysipelas, etc.

Curative Vaccination in Rabies.—According to Pasteur, human
beings who have been bitten and infected with rabies may be
subsequently immunized by vaccination if they are inoculated in
a systematic manner with attenuated virus. A piece of the dried
spinal cord of a rabbit 2 to 3 em. long (see p. 242) is rubbed up
with sterile bouillon, forming an emulsion, of which 14 to 34
c.c. is immediately injected under the skin of the abdomen. In
the beginning a very weak vaccine is injected, and at each suc-
ceeding injection a somewhat stronger vaccine is used. Pasteur’s
work was confirmed by Contani, Metschnikoff, Ullmann, Bujwid,
Bardach, R. Koch and others. It was not accepted, however, by
von Frisch, Hégyes, de Renzi, Bordoni-Uffreduzzi and others.

Curative Vaccination in Swine Erysipelas.—In the use of swine
erysipelas serum in protective vaccination, very many cases have
been observed in which swine affected with erysipelas have ap-
parently been cured when the serum was injected early, 6 to 12
hours after the appearance of the first symptom, and in large
(10 to 30 c.c.) and repeated doses.

VACCINATION. IMMUNIZATION. INOCULATION 253

Curative Vaccination in Tetanus.—The curative action of
tetanus antitoxin in tetanus of man was discovered by von Behring
in 1896. Since that time it has been frequently employed in
veterinary medicine in tetanus of horses. At first its action as a
curative agent appeared to be favorable, but later the failures
increased to such an extent that it is now used only in isolated
eases. In the Prussian army, from 1896 to 1907, 129 horses
affected with tetanus were treated with the antitoxin and 85,
or 66 per cent., died. During the years previous to the use of
the serum the mortality was as follows: in 1881, 55 per cent.;
1882, 57 per cent.; 1884, 65 per cent.; 1885, 62 per cent.; 1887,
67 per cent.; 1888, 66 per cent.; 1892, 65 per cent. In the light of
these figures it cannot be said that the use of the antitoxin in the
years from 1896 to 1907 exerted a favorable influence upon the
disease.

Recently, it was announced that the preparations of anti-
toxin heretofore used were too weak and that the material had been
employed in insufficient quantity. It was also stated that the
antitoxin must be injected as early as possible, immediately after
the diagnosis is made, preferably intravenously, and the injec-
tions repeated until improvement occurs. Sawamura (Bern, 1909),
in experiments with rabbits affected with tetanus ascendens endo-
neural, found that their life was saved when the antitoxin was
injected not later than 17 hours after the appearance of the first
tetanic symptom. In order to test the value of this new antitoxin,
Fréhner obtained 500 c.c. of it from Marburg in the summer of
1910. The cost of the 500 c.c. was twenty-five dollars, five dollars
per dose (100 c.c.). Without selection, the first two cases of
‘tetanus entered in his clinic were treated with the antitoxin accord-
ing to the accompanying directions, while the third and fourth
cases received no treatment. Both of the horses which received
the antitoxin immediately after the diagnosis was made in the
first stages of the disease died, while the other two, which received
no antitoxin, recovered. From this it would appear that the new
antitoxin is not a reliable curative agent in tetanus.

254 GENERAL THERAPEUTICS FOR VETERINARIANS

Curative Vaccination in Hog Cholera.—The serum inoculation
appears to have been proven to be also a curative method (see
p. 248).

Curative Vaccination in Tuberculosis.—Tuberculin, which was
recommended by Koch as a specific curative agent in tuberculosis
in man, did not prove to be effective for this purpose. Further-
more, it is of no value as a curative agent in tuberculosis of cattle.

Curative Vaccination in Septicemia.—Several sera are recom-
mended as curative and protective remedies in the diseases caused
by streptococci and for the complications of contagious pneumonia;
e.g., the anti-streptococcic serum of Marmorek and the sera against
purpura hemorrhagica of Lignieres and Jensen. The reports
concerning the action of these sera are contradictory. The Danish
polyvalent serum against purpura hemorrhagica (Jensen) proved
effective in a case treated by Fréhner,

Organotherapy.—The terms organotherapy, tissue-fluid therapy, and
opotherapy are used to designate the use of animal organs as curative agents.
Testicles, thyroid glands, ovaries, prostates, liver, etc., as such, or in the form
of special preparations (spermin, thyroidin, iodothyrin, etc.), are used in
impotence (spermin), goitre and myxcedema (thyroidin, iodothyrin) and
diseases of the ovaries, prostates, liver, etc., being administered internally.
Only the preparations of the thyroid gland in goitre and myxcedema appear
to have an undisputed action. Experiments in Germany with the other
opotherapeutic preparations have usually resulted negatively.

III. Dracnostic InocuLaTiIon-

Purpose.—The object of diagnostic inoculation is to ascertain
experimentally the identity of the disease in cases in which a
certain demonstration and positive recognition of the infection is
not possible with the usual clinical methods. This is accomplished
by artificially inoculating healthy experimental animals with
infected masses (blood, nasal discharge, vaginal discharge, pus,
milk, feces) in order to produce a typical picture of the disease
(inoculation of other animals), or by inoculating the originally-
diseased animal (self-vaccination, auto-inoculation). In a certain

VACCINATION. IMMUNIZATION. INOCULATION 255

sense, injections of tuberculin and mallein belong to the latter
method of inoculation.

Inoculation of Other Animals.—This method of inoculation is
used for the purpose of diagnosing anthrax, glanders, tuberculosis,
fowl] cholera, swine erysipelas, hog cholera, swine plague, strangles,
contagious pneumonia of horses, hemorrhagic septicemia, black
leg, rabies, malignant cedema and Canadian horse pox.

1. AnrHRrax.—Although the protective vaccination for anthrax
is subcutaneous, the diagnostic inoculation is made cutaneously in
order to avoid mixed infection. The best animals for inoculation
are mice, rabbits and guinea-pigs; the best inoculation materials
are the blood and spleen pulp. Mice are inoculated on the end of
the ear after the tip has been clipped off; rabbits and guinea-pigs
are inoculated in slight scratch-wounds on the ears. If anthrax
is present, the inoculated animal dies in two to three days; on
post-mortem examination numerous characteristic anthrax bacilli
are found in the blood.

2. Buack Lea.—Guinea-pigs are used as inoculation animals.
Rabbits are immune to black leg but are very susceptible to an-
thrax. If guinea-pigs and rabbits are inoculated simultaneously
with the same material and only the guinea-pigs die, then black
leg is probably present. Inoculated guinea-pigs continue to live
if they are treated with black-leg serum. In contrast with anthrax,
the inoculations are made subcutaneously only and not cuta-
neously. The subcutaneous inoculation of guinea-pigs is the most
important diagnostic method in doubtful cases and in question-
able post-mortem findings.

3. GLANDERS.—Several male guinea-pigs are inoculated simul-
taneously with the suspected material (pus). The inoculations
are made subcutaneously in the abdominal region—a fold of skin
is cut with small scissors and a pocket is formed into which the
material is inserted; or, the material is injected intraperitoneally.
Fourteen days after the subcutaneous injection, if glanders is
present, characteristic symptoms appear. The point of inocula-
tion has been transformed into an ulcer, in the proximity of which

256 GENERAL THERAPEUTICS FOR VETERINARIANS

nodular swellings of the lymph glands up to the size of a hazel-
nut may be felt; later, these rupture; on post-mortem examination,
purulent lymph glands and glanders abscesses are found, the latter
especially in the testicles (glandular orchitis); also glandular
nodules in the spleen, liver and lungs. A negative result from the
inoculation does not exclude the presence of glanders. When the
result is positive, a diagnosis of glanders is only justified when the
bacillus mallei is also demonstrated in cultures (pseudo-glanders!).
Other inoculation animals are the horse and the ass, the latter
contracting acute glanders and usually dying in about 8 days;
also cats, which, after subcutaneous (dorsal) inoculation, present
symptoms similar to those exhibited by guinea-pigs. Concerning
injection with mallein, see page 260.

4. TupercuLosis.—The best inoculation animal is the guinea-
pig. After the usual intraperitoneal inoculation (milk), numerous
fresh tubercles of the size of millet seed appear in about three
weeks upon the peritoneum and in the spleen, liver, and lymph
glands. Following subcutaneous injection (mucus from the
lungs), a purulent ulcer develops at the point of injection and the
neighboring lymph glands become swollen; after 3 to 4 weeks
numerous tubercles form in the internal organs. After intra-
muscular inoculation (rapid inoculation), the neighboring lymph
glands are transformed in ten days into firm nodules of the size
of small peas, which may be extirpated and examined microscopic-
ally. Intramammary inoculation and subcutaneous injection with
simultaneous crushing of the lymph glands are followed in five
days by the appearance of nodular swellings in the glands con-
cerned. Test inoculations of guinea-pigs is the most certain method
of clinically diagnosing tuberculosis. Concerning inoculation with
tuberculin, see page 258. '

Fow. CuHoLera.—A pigeon is inoculated subcutaneously with
blood from a dead bird. A drop of blood from the dead bird is
introduced under the skin of the breast of the pigeon by means of
a lancet to the depth of a millimetre. If cholera is present, the
musculature beneath the point of inoculation becomes necrotic

VACCINATION. IMMUNIZATION. INOCULATION 257

and yellow and the pigeon dies in 12 to 48 hours; on post-mortem
examination a characteristic picture of cholera is found (hemor-
rhagic enteritis) and the specific cholera bacilli are recovered from
the blood.

6. Swine ErysiPeLas.—Subcutaneous inoculation of mice
(skin pocket) or pigeons (breast) is followed in 24 hours by char-
acteristic symptoms: dejection, roughened hair, dyspnoea, mucous
discharge from the eyes and agglutination of the eyelids. Mice
die in 2 to 4 days; pigeons in 3 to 4 days; the specific bacilli are
found in the blood.

7. SrraNGLEs.—The most suitable inoculation animals are
white mice, which are immune to glanders. The inoculation is
made subcutaneously in the sacral region with a drop of pus or
nasal discharge. Death usually occurs in 3 to 6 days and on
post-mortem examination a pronounced picture of septicemia is
presented (enlarged spleen, cloudy swelling of the internal organs,
exudate in the body cavities, blood infiltration at the point of
inoculation); in the blood, the specific strangles cocci are found.
More rarely, the animals die in 10 to 20 days with symptoms of
metatastic pyemia. Field mice react only locally to strangles inoc-
ulation, which is contrary to their behavior to glanders inoculation,

8. Raxsius.—The best method is the intra-ocular inoculation
of rabbits with the brain substance of the suspected dog; the
‘ material should be obtained in as fresh condition as possible.
After 12 to 14 days, the inoculated animal dies of dumb rabies.
Intramuscular and subconjunctival injection are also simple
methods, but the subdural (intracranial, lumbar) and intracerebral
inoculation of rabbits is more complicated.

9. Hemorrgacic Septicam1a.—Rabbits and mice die in 6
hours after cutaneous and subcutaneous inoculation, and in 12
to 24 hours after inoculation by feeding; large numbers of the
bacilli of hemorrhagic septicemia are found in the blood; a further
characteristic in rabbits is hemorrhagic tracheitis.

10. Mauienant CipEma.—Only subcutaneous inoculations are
effective with mice and guinea-pigs; cutaneous inoculations are

17

258 GENERAL THERAPEUTICS FOR VETERINARIANS

without effect (contrary to anthrax). The inoculated animals die
in 8 to 14 hours with symptoms of an extensive subcutaneous
cedema, in which the characteristic bacilli are easily demonstrated.
Guinea-pigs are also inoculated subcutaneously for black leg.

Tuberculin Injection.—Tuberculin is obtained by the evapora-
tion of bouillon cultures of tubercle bacilli and is official [in Ger-
many] in two forms: as fluid (old tuberculin) and as dried tuber-
culin (dry tuberculin, tuberculol). [In the United States, the
evaporated tuberculin is diluted with a 14 per cent. solution of
carbolic acid before it is sent out to the practitioner, the extent
of the dilution varying in different laboratories.] Tuberculous
animals are very sensitive to tuberculin and react to it with fever
and local inflammation. This reaction indicates the presence of
tuberculosis; not with certainty, it is true, but yet with great
probability. Therefore, tuberculin is, after all, a very valuable
diagnostic agent. It is employed according to different methods:

1. Subcutaneous (thermal reaction).

2. Conjunctival (ophthalmic reaction, eye test).

3. Cutaneous and intracutaneous (dermal reaction).

1. THE SuspcuTaNnrous TUBERCULIN TzstT (thermal reaction)
is the oldest method. Fluid tuberculin diluted [in Germany]
with ten times the amount of 1% per cent. carbolic acid solution
is injected under the skin. The dose of the tuberculin for cows
is 0.5 gram, for calves 0.1 gram. [The dose of the preparations of
tuberculin used in the United States varies from 1 c.c. to 4 c.c.,
depending upon the extent to which the evaporated tuberculin has
been diluted with the 14 per cent. carbolic acid solution.] The
diagnostic reaction consists of a rise of temperature of at least
2° F., which occurs 12 to 15 hours after the injection. [It is very
generally agreed that a reaction may occur or begin at any
time from the 9th to the 20th hour after injection, and it is
therefore considered necessary to begin the temperature measure-
ments not later than the 9th hour and to continue them in all
cases until at least the 20th hour after the tuberculin is injected.
In any case in which the temperature is rising at the 20th hour,

VACCINATION. IMMUNIZATION. INOCULATION 259

the temperature measurements should be continued until the
temperature begins to fall or until a reaction occurs. American
veterinary sanitary authorities recommend that at least three
temperature measurements be taken before the tuberculin is
injected, at intervals of 2 or 3 hours, and that the tuberculin be
injected preferably between 6 and 9 p.m.] The disadvantages of
the subcutaneous method are that it is misleading in 13 per cent.
of the cases tested (incorrect diagnosis); that it requires a great
amount of time, as at least two temperature measurements must
be taken before and four after the injection; that it cannot be
applied to animals in a febrile condition; that cattle previously
injected with tuberculin will not react to the usual dose but require
five times the quantity; that the general condition and the milk
secretion is influenced unfavorably by the reaction fever, and
that now and then chronic tuberculosis is transformed into the
acute form. [According to American statistics, errors in diag-
nosis are much fewer than are indicated by the German figures
given above. Statistics compiled by the Bureau of Animal
Industry? show that of 24,784 cattle which reacted to tuberculin
from 1893 to 1908, 24,387 were found to be tuberculous on post-
mortem, which is only 1.07 per cent. failures.]

2. THe Oputuatmic Test (ophthalmic reaction, conjunctival
reaction) has been recently given the preference [in Germany]
over the subcutaneous method on account of its greater certainty,
simplicity, cheapness, and harmlessness, and also because it is not
influenced by the presence of fever or by a previous subcutaneous
injection. It is applied in the following manner: four drops of a
5 per cent. solution of dry tuberculin or of a 25 per cent. solution
of tuberculol are introduced into the conjunctival sac, or a quantity
of a 1 to 2 per cent. tuberculin vaseline the size of a pea is placed
in the conjunctival sac with a glass rod. A typical purulent dis-
charge from the eye and a pronounced cedema appear in 12 to
14 hours. Rectal, vaginal, and nasal applications have the same
effect. [In Pennsylvania, an alcoholic precipitate of a glycerin

2 Twenty-fifth Annual Report, Bureau of Animal Industry, p. 99.

260 GENERAL THERAPEUTICS FOR VETERINARIANS

bouillon culture of tubercle bacilli suspended in physiological salt
solution is used. Two suspensions are made, one containing 4 per
cent. of the precipitate and the other 8 per cent. Two drops of the
4 per cent. suspension are placed in the eye to sensitize it, and 4
days later two drops of the 8 per cent. suspension are placed in the
same eye. Thereaction occurs in6tol4hours. As yet, however,
the test has not been substituted for the subcutaneous test.]

3. THe CUTANEOUS AND INTRACUTANEOUS METHOD consists in
the application of a concentrated tuberculin solution to the
shaved or scarified skin, or its injection into the tissue of the cutis.
The dermal reaction is a pronounced cedematous, puffy swelling
at the place of inoculation (lateral surface of the neck, caudal-
anal fold).

In order to insure the greatest possible certainty in diagnosis,
it is recommended that all three tests, the subcutaneous, con-
junctival, and cutaneous, be applied (simultaneous method).

Mallein Injection.—Fluid mallein (raw mallein), obtained by
the evaporation of cultures of glanders bacilli, and dry mallein,
an alcoholic precipitate of the fluid mallein, are introduced into
the animal body in order to utilize for diagnostic purposes the
excessive sensibility of infected animals to mallein, manifested in
the form of local symptoms of inflammation or symptoms of a
general febrile affection. According to the place of application
of the mallein (conjunctiva, subcutis, cutis), three methods of
malleinization are distinguished:

(a) The ophthalmic test or ophthalmic reaction.
(b) The subcutaneous test or thermal reaction.
(c) The cutaneous test or cuti-reaction.

(a) THe Opuraatmic Test (ophthalmic reaction, conjunctival
malleinization) is applied by introducing into the conjunctival
sac with a brush or dropper a few drops of fluid mallein (0.2 c.c.
or 0.2 gram per horse, 0.5 ¢.c. or 0.5 gram for 5 horses), or a few
drops of a 1 per cent. solution of dry mallein [precipitated mallein].
The other eye serves as a control. The specific reaction usually
begins 5 to 6 hours after the instillation and continues 36 to 48

VACCINATION. IMMUNIZATION. INOCULATION 261

hours. It consists of a purulent discharge from the eye, congestion
and swelling of the conjunctiva, and swelling and agglutination of
the eyelids. The result of the test is to be determined at the
twelfth hour after the instillation at the earliest, and at the twenty-
fourth hour at the latest. A positive reaction is a certain indica-
tion of the presence of glanders. On the other hand, the presence
of glanders is not positively excluded by a single negative reaction,
but only when a second test three weeks after the first also gives a
negative reaction. In the early stages of glanders the hypersensi-
tiveness to mallein is absent; it does not appear until toward the
second week after the infection. In doubtful cases (serous or mucous
discharge from the eye), the eye test sometimes gives a positive re-
sult, when repeated on the same day (sensitization). With a positive
reaction, an increase of temperature to over 38.5° C. [101.3° F.] usu-
ally occurs in 24 hours which is also of diagnostic importance. The
presence of fever is not a contraindication to the application of the
eye test. (To be preferred to the subcutaneous method.)

In recent years, the eye test has been found to be the most
trustworthy, the simplest, the most convenient, the cheapest, the
most rapid and, for examining large numbers of horses (remounts,
imported horses), the most suitable method of diagnosing glanders,
especially in Austria, where it has been recognized by the veteri-
nary sanitary laws since 1910 (civil and military laws), in Denmark
and in Germany (Prussia, Wirtemburg). Recently, it has been
officially prescribed in Bavaria.

(b) Tur Suscutangous Meruop or the thermal reaction con-
sists [in Germany] in the subcutaneous injection of 0.02 gram of
dry mallein or 0.5 gram of raw mallein. [In the United States,
the evaporated glycerin bouillon culture of bacillus mallei is
diluted in the laboratory with 14 per cent. carbolic acid solution,
and the quantity injected depends upon the extent of the dilution.]
A rise of temperature of over 2° C. [3.6° F.] during the two days
following the injection, with a typical temperature curve with
two apexes, is to be regarded as a positive indication of glanders,
while horses which do not show any febrile reaction and those with

262 GENERAL THERAPEUTICS FOR VETERINARIANS

a temperature rise of less than 1.2° C. [2.1° F.] are to be considered
free from the disease. The reports from different countries con-
cerning the diagnostic value of subcutaneous malleinization are
contradictory. [In the United States, the Bureau of Animal
Industry and the Pennsylvania Livestock Sanitary Board have
abandoned it for the ophthalmic test.] A disadvantage of the
method is that it cannot be applied to horses in a febrile condition.

[The directions for applying the subcutaneous mallein test, as published
by the U. S. Bureau of Animal Industry in 1910 and 1912, are as follows:

The preferable site for injection is on the side of the neck about the centre,
where any local swelling is plainly visible. The hair should be clipped from
an area about 2 inches in diameter, and the skin thoroughly cleansed with a
disinfecting solution, such as 5 per cent. carbolic acid. Carefully sterilize the
syringe and needle before commencing the injection of each group of animals,
and immerse the needle in a disinfecting solution before injecting each animal.
It is better to use a separate syringe, needle, and thermometer for animals
exhibiting symptoms suspicious of glanders. Carbolized oil, vaseline, or lard
should be used to facilitate the insertion of thermometers and also to disinfect
them. On the day of injection, the temperature of each animal should be
recorded not less than three times at intervals of not less than two hours; for
instance, at 2,5,and 8 p.m. A careful clinical examination of each animal.
should also be made, and to each one some designation should be given by
which the animal will be known throughout the test. Mallein may then be
injected at 8 or 10 p.m., providing the preliminary temperatures are not ab-
normal. After injection the temperatures should again be recorded, starting
at the expiration of not more than 10 hours, and should be repeated at intervals
of approximately 2 hours until the expiration of at least 20 hours from the
time of injection, and should be continued over a longer period in the case
of an animal with a rising temperature at the twentieth hour, if, at the same
time, a local reaction is present. What constitutes a reaction sufficient to
warrant condemnation of the animal has been the subject of many articles
and prolonged discussion. The Bureau of Animal Industry has adopted the
following uniform principles for judging the mallein test:

1. In order that a reaction produced by mallein may be considered posi-
tive it should evince the characteristics of a typical reaction; that is, a combi-
nation of thermal, local, and general reactions.

2. By atypical reaction is to be understood a gradual rise of temperature
of at least 3° F. and to above 104° F., the maximum temperature being sus-
tained in the form of a single or double plateau. It should be accompanied
by a local as well as a general reaction.

VACCINATION. IMMUNIZATION. INOCULATION 263

The local reaction consists of an infiltration at the site of injection, form-
ing a large, abrupt, painful swelling with radiating lymphatics appearing as
raised cords, generally attaining greatest prominence at from 18 to 21 hours
after injection. The general reaction is exhibited by a stiffened gait, depres-
sion, loss of appetite, and accelerated breathing.

3. The presence of a local reaction, especially when associated with a
general reaction, should be regarded as evidence of glanders, even if the
thermal reaction be slight or absent. ;

4, Animals giving an atypical reaction and those reaching a maximum
temperature of 103° F. should be retested after the expiration of not less than
15 days.]

(c) Cutaneous malleinization consists of the injection of mallein
into the scarified skin and the pronounced local swelling which is
produced. The method is complicated, technically difficult and
the reaction varies with the method of application (superficial or
deep scarification).

Directions for Applying the Mallein Eye Test.

J. Nature of the Test.—Horses infected with glanders are hypersensitive
to mallein. They therefore react when mallein is instilled into the conjunc-
tival sac with specific local symptoms of inflammation. The specific reaction
is a pronounced redness and swelling and a purulent inflammation of the
conjunctiva of the eyelids, especially in the inner canthus of the eye (drops
of pus, flakes of pus in the discharge, purulent discharge). A serous, sero-
mucous or mucous discharge is not specific. The specific reaction does not
begin immediately, but at the earliest 5 to 6 hours after the instillation of the
mallein; it usually continues for 36 to 48 hours, sometimes longer. The best
time to observe it is from the twelfth to the twenty-fourth hour. The slight
symptoms of irritation of the conjunctiva (tears, photophobia, slight redness
of the conjunctiva), which occur in many horses very soon after the mallein
is instilled and disappear after a few hours, must not be mistaken for the
specific mallein reaction.

II. Application.—Kither fluid mallein (raw mallein) or dry [precipitated]
mallein is used.

With a brush or dropper (eye pipette), a few drops of fluid, undiluted
mallein or of a freshly-prepared 1 per cent. solution of dry [precipitated] mallein
in distilled water or physiological salt solution are introduced into the right
eye. The left eye serves as a control.

In order that the eye may be examined for the symptoms of the specific
reaction in daylight, it is recommended that the test be begun in the morning

264 GENERAL THERAPEUTICS FOR VETERINARIANS

or in the evening. When the mallein is instilled in the morning, the reaction
will appear at the earliest in the afternoon; when it is made in the evening,
the first observation of the eye can be made the next morning.

Since drops of pus flowing from the eye and sticking to the hair may be
thrown off by movements of the head and thus escape detection, restless horses
should be tied up short during the test.

The presence of fever does not interfere with the application of the test.

The test does not influence the blood test.

III. Judgment.—The test may terminate in three ways: positive, nega-
tive, doubtful.

The reaction is positive if a purulent discharge from the eye occurs in
12 to 24 hours.

The reaction is negative if a discharge from the eye does not appear in
12 to 24 hours.

The reaction is doubtful if after 12 to 24 hours only a serous, seromucous
or mucous discharge occurs from the eye, or if only adrop of purulent secretion
collects in the inner canthus of the eye without any discharge.

The judgment of the test is based upon the following principles:

1. The presence of glanders is assumed as probableif a positive reaction
occurs 12 to 24 hours after the instillation of the mallein.

2. The absence of glanders is assumed as probable if a negative reaction
occurs 12 to 24 hours after the instillation of the mallein and if, in addition,
a negative reaction is again obtained upon a repetition of the test three weeks
later. (In the initial stages of glanders the hypersensitiveness to mallein is
absent; this appears only toward the second week after infection.)

3. If the reaction to the first test is doubtful, a second test is begun on
the same day. If the reaction to the second test is positive, the presence of
glanders is assumed as probable. If the reaction to the second test is negative
or doubtful, then a third test is made after 3 weeks. If the reaction to the
third test is negative, it is assumed as probable that glanders is not present.
If the reaction to the third test is positive, the presence of glanders is assumed
as probable. If the reaction to the third test is doubtful, the horse remains
under suspicion of glanders,

WATER AS A REMEDY. HYDROTHERAPY

Synonyms: Hydrotherapy, hydriatrics, balneotherapy, Priessnitz’s!
cure, water-cure. :

General.—Water has been employed as a healing remedy
since ancient times. In spite of this, it is not possible to present
to-day a clear, scientific analysis of its method of action. Some of
the undoubted successes of hydrotherapy are still based upon pure
empiricism (Priessnitz), and cannot at this time be scientifically
explained at all, or only incompletely. The difficulty of placing
hydrotherapy on a rational foundation is due to the circumstance
that the effect of water upon the body is very complicated. Several
very different factors apparently codperate in the water-cure.
Not only the water itself, but also its temperature and likewise
certain mechanical factors appear to exert a combined action.
The continuance of the application and the change from cold to
warm water are also of importance. Among the different proper-
ties of water, the irritant action of cold water upon the skin is of
the greatest consideration in veterinary therapeutics. The internal
use of water (mineral water), as ordinarily employed in human
medicine, is not practicable in veterinary medicine. As with the
other cutaneous irritants, the effect of water upon the body is
very extensive, which accounts for the frequent use of hydro-
therapy in the most varied disease conditions.

Actions.—1. Upon THE skin water has in the first place a
cleansing effect, and consequently in a certain sense a disinfectant
action. In addition, when its influence is long continued, it brings
about a swelling and loosening (maceration) of the epithelial cells,
with increased desquamation of the same. Since the capacity of
cold water for heat is very great, it takes up heat from the body

1 Vincent Priessnitz, agriculturist in Grafenberg, Austrian Silesia; lived |
from 1799 to 1851, and founded in 1826 the first hydropathic establishment.
265

266 GENERAL THERAPEUTICS FOR VETERINARIANS

when applied locally or generally and therefore operates as an
antipyretic in conditions of abnormally high temperature. Cold
and hot water act as cutaneous irritants, producing at first a con-
traction of the cutaneous vessels and of the smooth muscle of the
skin with a consequent anzmia, followed by a pronounced reactive
relaxation of the vessels of the skin and of the underlying parts
with a decided hyperemia of the same. On this account, cold
water is to be regarded as an epispastic rubefacient which not only
influences and changes the local circulatory relations of the skin
and the tissues beneath it (subcutis, tendons, tendon sheaths,
muscles, articulations, bones) but also, when used extensively,
affects the blood distribution of the entire body, causing the blood
to flow from the centre of the body to the periphery and depleting
the internal organs. While cold water produces a passive hyper-
emia, hot water, and moderately warm water when the application
is long continued (cataplasms), generate an active hyperemia.
These actions upon the skin point to numerous indications for the
treatment of local diseases of the skin, the subcutis, the mus-
culature, tendons, bones and articulations as well as general febrile
and internal diseases. Furthermore, the hyperemia produced
considerably stimulates the secretory activity of the skin (water,
urea and metabolic products), sometimes even to the extent of pro-
ducing perspiration. Since a relation exists between the secretory
functions of the skin and different internal organs, especially the
kidneys and lungs, a therapeutic action may be exerted upon these
organs by the use of water. Depending upon the temperature,
water exerts a stimulant action upon nerves or exerts a sedative
effect in abnormal, painful conditions.

Of great practical importance in all these cases, in addition to
the temperature of the water, is the continuance of its action and a
change from cold to warm. In reference to the temperature, a
distinction must be made between cold (0-15° C.), tepid (15-
30° C.), warm (30-38° C.) and hot (38° C. and above). Only cold
and hot water exert a pronounced action as cutaneous irritants
in the manner described above. Warm water corresponding in

HYDROTHERAPY 267

temperature to that of the body is indifferent, and the action of
tepid water is weak. The colder or the warmer the water in com-
parison to the body temperature of the animal, the more pro-
nounced is its action upon the skin. In regard to the continuance
of action, when cold water is used for the purpose of reducing tem-
perature its application must naturally be continued as long as
possible. But if the water is employed as a cutaneous irritant,
then the therapeutic effect is in direct relation to the shortness and
frequency of the individual applications. When a single applica-
tion of cold water produces a reaction in the skin in the form of a
change in the circulatory relations (hyperemia), the condition dis-
appears after a certain interval, and a renewal of the cutaneous
irritation is naturally required to again bring about the same
reaction with its healing effects upon the organism. One long-
continued application of cold water produces only a single reaction,
which occurs in the beginning. For these reasons frequent applica-
tions are indicated, and on this account Priessnitz dressings, for
example, are changed frequently (on the average every 3 hours).
The effects produced under these circumstances are as follows:
When the dressing which has been dipped in cold water is first
applied, anemia and cooling of the skin occurs; this is gradually
followed by a hyperemia, which is continued several hours and
which is promoted by the warm overlying dressing. After this
period, the circulatory relations are again equalized and in order to
produce a new reaction the cold irritant must be renewed; @.e., a
new cold dressing must be applied.

Failure of a patient to show any reaction in the skin after a
proper application of cold water is evidence of great weakness of the
nervous system and justifies an unfavorable prognosis. For
prophylactic purposes, the frequent use of cold water in healthy
animals is recommended to facilitate the occurrence of the reaction
and to exercise and strengthen the skin (cold rub-down for horses
and cattle, washing).

2. THE CIRCULATORY APPARATUS is influenced in very different
directions by hydrotherapy. As already observed, cold water

268 GENERAL THERAPEUTICS FOR VETERINARIANS

causes at first, in consequence of irritation of the peripheral vaso-
motor centres (Lenaschew, Pliigers Archiv., vol. 26), a contraction
of the cutaneous vessels with anemia of the skin, which drives the
blood to the interior and also increases the blood-pressure, the
activity of the heart and the internal temperature. With the
occurrence of the reaction in the skin, contrary effects are pro-
duced. The blood-vessels dilate, the blood flows from the centre
to the periphery, and blood-pressure, heart activity, pulse fre-
quency and internal temperature decrease. It is therefore pos-
sible to act with hydrotherapy upon every single factor of the circu-
lation: upon the lumen and tension of the blood-vessels, upon the
heart, upon the blood-pressure, upon the blood distribution and
upon the blood heat. Waiter is consequently a valuable remedy
in all conditions of inflammation and congestion and in general
febrile diseases. It is also a derivative remedy, particularly on
account of its regulating influence upon blood distribution. Inter-
esting investigations have been made by Schiiller (Deutsches
Archiv. fiir Klin. Medizin, vol. 14) concerning the derivative effect
of water upon the deeply situated organs, which are of therapeutic
importance, especially in inflammation of the brain. In trephined
rabbits, constriction of the vessels of the pia and contraction of the
brain were observed after the application of warm compresses to the
skin, while the employment of cold dressings on the skin or a cold
bath caused a dilation of the vessels of the pia. The same action
apparently extends to the spinal cord, the lungs and the other vis-
cera. These experimentally established facts justify scientifically
the hydropathic derivation which has been hitherto practised
empirically, especially in inflammation of the brain, pneumonia,
pleuritis and peritonitis. Finally, since cold water also increases
metabolism, as is shown by the increased elimination of carbon
dioxide and the increased absorption of oxygen demonstrated in
animals experimentally by Réhrig and Zuntz, the resorbent effects
of external applications of water in connection with the stimula-
tion of the circulation are readily understood.

3. THE NERVOUS SYSTEM is affected in different ways, accord-

HYDROTHERAPY 269

ing to the temperature of the water. Cold water stimulates the
activity of nerve tissue; warm water, on the contrary, has a seda-
tive effect, soothing and depressing. Depending upon whether
the application of the water is local or general, a local or total
alteration of innervation can be brought about, either of the nature
of a stimulation or depression, which is not possible with other
cutaneousirritants. Upon the nervesof theskin the action is direct,
while the other parts of the nervous system are influenced reflexly
through the skin (counter-irritation). By the application of cold
water, a weakened nervous system is stimulated, entirely inde-
pendent of the change in circulation (derivation), while warm water
applications depress an abnormally stimulated nervous apparatus.
This is true of the brain and spinal cord as well as of the nerves of
the different internal organs, such as the stomach, intestines, kid-
neys, uterus, lungs, heart, etc. Well-known examples of these
actions of water are the stimulant effects of cold and the sedative,
anodyne effects of warm water applications in colic of the horse
and the favorable action of the Priessnitz dressing in abnormal
sensibility of the larynx (cough), pharynx (difficult swallowing),
brain, musculature (rheumatism), articulations and tendons
(inflammation).

4, THE BODY CELLs are nutritively stimulated by moist heat
(cold acts reversely) and their function of forming antitoxins and
their regeneration activity are thereby accelerated. Local leu-
cocytosis is also promoted by heat, but is inhibited by cold (see the
chapter on acrics).

5. Tus cuanps of the body (liver, kidneys, pancreas; gastric,
intestinal and cutaneous glands) are also influenced in different
ways by applications of water, partly through the circulation
(derivation) and partly through the nervous system (counter-irri-
tation). The secretions of the liver and kidneys in particular are
stimulated by cold and decreased by warm water applications.

6. THE MUSCULATURE has, as is well known, special relations
with the skin; the diseases caused by chilling (rheumatism, rheu-
matic hemoglobinemia [azoturia}) demonstrate that the two are

270 GENERAL THERAPEUTICS FOR VETERINARIANS

intimately associated. In these diseases, it may be assumed, the
chilling acts as an abnormal cutaneous irritant, causing a disturb-
ance of the circulation, innervation and especially the metabolism
of the musculature. Similar influences can be exerted upon the
diseased musculature by the employment of hydropathic dressings,
the disturbed circulation and innervation being affected by deriva-
tion and counter-irritation. Warm water is most desirable for this
purpose because it at the same time allayspain. Cold water is more
suitable to the prophylactic hardening against the diseases men-
tioned. Experience has taught that muscular rheumatism as well
as rheumatic hemoglobinemia [azoturia] can be effectively pre-
vented by accustoming the skin to the irritation from cold and
hardening it against the harmful results. Avoiding too warm
stabling and covering, accustoming to cold, and especially frequent
cold rubbing down when rationally employed etord good protec-
tion against these diseases.

7. THE RESPIRATION is stimulated by cold water. Cold appli-
cations are therefore employed as stimulants in weakness and
paralytic conditions of the respiratory centre (syncope, poisoning
by chloroform) and to strengthen expiration in pulmonary and
bronchial diseases. On the other hand, the diseased lungs are
relieved by the derivation of the blood from the lungs to the skin
(cutaneous respiration) by means of moist, warm applications.
In these respects hydrotherapy is of importance in the treatment, of
pneumonia and other respiratory diseases.

8. Locatty, cold at first causes contraction of the arteries and
anemia (checking hemorrhage, antiphlogistic action), later dila-
tion and congestion of the veins with slowing of the circulation and
resorption and decrease of the leucocytes. Moist heat, especially
the Priessnitz dressing and cataplasms, promotes local blood cir-
culation and cell activity and also local leucocytosis and the
formation of antitoxins. Hot applications generate an active
hyperemia, which extends to a considerable depth (musculature,
peritoneum) and continues for 24 hours and longer; in addition,
the circulation of lymph and consequently resorption is stimulated

HYDROTHERAPY 271

(hyperlymphia, cedema formation). See the experimental inves-
tigations of Schiiffer.?

Hyperemia as a Healing Remedy.—Bier® has drawn attention to the
favorable effects of chronic passive hyperemia, produced artificially by elastic
bandages and by hot-air apparatuses, upon surgical suppurative and inflam-
matory processes. Passive hyperemia, like active hyperemia, hasaresorbent,
bactericidal and anodyne action and stimulates the formation of new tissue.
The same effects are produced by the continued employment of high degrees
of heat by means of Ullmann’s‘ hydro-thermo regulator, which was introduced
into veterinary surgery by Bayer® and Eberlein® and found by them to be of
value especially in chronic tendinitis, tendovaginitis, shoulder boils, exostoses,
thickening of the skin, articular and muscular diseases, wounds and ulcers
of the horse (constant, regulated heat treatment in the form of dry or moist
heat). Upon the basis of his experiences in the Vienna clinic, Schmidt? has
formed the following conclusions concerning the value of Bier’s passive hyper-
zemia in veterinary medicine: The aspirator is most useful in diseases of the
paws of small animals (phlegmon, panaritium). The rubber tubing and the
elastic bandage can be used on all of the domestic animals, but the technique
presents numerous difficulties, which are greater in animals than in man.
Purulent inflammations of the articulations and tendon sheaths and phleg-
monous processes in the hoof are best suited to the passive hyperzemic treat-
ment. On account of the technical difficulties and the dangers attending the
treatment, however, it can only be employed in stationary clinics under con-
tinual control; its use in general practice and in polyclinics is precluded.
According to Réder® also, the field for the use of Bier’s passive hyperemia is
limited; he recommends venous stasis by means of bandages in wounds of
the coronet, in contused wounds and after resection of the lateral cartilage,
and the employment of the aspirator in shoulder boils. Kriiger,® as a result

2 Schaffer, Der Einfluss unserer therapeutischen Massnahmen auf die
Entziindung. Stuttgart, 1907, Ferd. Enke.

3 Bier, Die Hyperdmie als Heilmittel. Leipzig, 5. Aufl., 1907.

4 Ullmann, Wirkungen und therapeutische Verwertung konstanter Wirme-
applikationen. Physiklinisch-medizinische Monatshefte, 1904.

5 Bayer, Der Hydrothermoregulator. Zeitschr. f. Tiermed., 1903.

6 Eberlein, Der Hydrothermoregulator. Berl. Archiv., 1905.

7 Schmidt, Die Biersche Stauungshyperdimie in der Tierheilkunde. Mo-
natshefte fir prakt. Tierheilkde., 1907.

8 Réder, Dresdener Naturforscherversammlung, 1907.

® Kriger, Hyperimie als Heilmittel in der Tierheilkunde. Zeitschr. fir
Vet., 1910.

272 GENERAL THERAPEUTICS FOR VETERINARIANS

of his experiences in the Berlin Horse-shoeing School, agrees with Schmidt
and Réder that passive hyperemia, when properly employed in suitable cases,
is to be regarded as a good healing method in veterinary medicine. Eberlein
and Braun? have cured four cases of inflammation of the temporomaxillary
articulation in the horse with Klapp’s aspirator.

Uses.—The external use of water for healing purposes is in
many cases similar to the use of the cutaneous irritants (see p. 148).
The indications for the employment of hydrotherapy are, however,
more numerous than for the use of cutaneous irritants. More-
over, the water is often preferred to these drugs because of the
simplicity of its application and the cheapness of the hydropathic
apparatuses. The most important diseased conditions treated
with water are the following:

1. Local surgical affections of the skin, subcutis, tendons,
tendon sheaths, muscles, joints, bones, and lymph glands. The
application of cold water is indicated only in active hyperemia
and in entirely fresh, acute inflammatory conditions in these parts.
On the other hand, warm, moist applications or cataplasms are
indicated in all subacute and chronic inflammations, in passive
hyperemia and in extravasations in the parts named. This is
true especially of fluid and solid exudates, indurations, old swellings
and thickenings of the skin, subcutis, tendons, articulations, bones
and muscles, and also of purulent inflammations and ripening
abscesses. The moist heat in these cases dilates the vessels, accel-
erates the disturbed and sluggish blood and lymph circulation,
promotes metabolism and resorption, softens hard inflammatory
products, encourages the outwandering of white blood-cells (phago-
cytosis, histolysis), accelerates connective tissue formation and
cicatrization and stimulates the formation of antitoxins.

2. General febrile diseases. The antipyretic action of cold
water in the form of cold poultices, irrigations, douches, baths,
fomentations and rectal infusions depends upon the withdrawal of
heat; the cold must continue to operate for a long time, however,

10 Braun, Die Saugbehandlung nach Klapp bei der Arthritis purulenta des
Kiefergelenks des Pferdes. Monatshefte fiir prakt. Tierheilkunde, 1912.

HYDROTHERAPY 273

because a temporary application causes at first a rise of the internal
temperature. Warm, moist applications also exert an antipyretic
effect, since under their influence blood is drawn from the centre
of the body to the periphery and gives off heat; codperating with
this action is the influence upon the vasomotor and caloric nerve
centres.

3. Inflammation of the lungs, pleura, peritoneum, brain and
spinal cord, stomach and intestines, kidneys, liver, and uterus.
The hydropathic effect of warm, moist applications consists of the
contraction of the dilated vessels in diseased internal organs and of
the derivation of the blood to the skin.

4. Edema of the lungs, brain, and glottis. The action is the
same.

5. Muscular rheumatism. The warm, moist applications exert
a derivative and anodyne action.

6. Colic and cough. The action is the same.

7. Paralytic conditions of the nervous system (cerebral, spinal
and peripheral paralyses, weakness of the loins, parturient paresis,
poisonings, paresis of the gastric and intestinal musculature).
Cold or hot water (cutaneous irritation, counter-irritation) is
indicated in these conditions.

8. Excited conditions of the nervous system (pains, spasms,
hyperzsthesia, increased reflex activity). Warm water (sedative
action) is employed in these conditions.

9. Exudates (fluid and solid) in the internal organs. The
warm, moist applications promote the circulation, leucocytosis,
metabolism, and resorption.

10. Kidney and liver diseases (stimulation of the secretion,
derivation).

11. Catarrhs of the respiratory apparatus (inhalation of steam).

12. Obesity (stimulation of metabolism).

Forms of Application.—1. Priessnitz’s dressing. This is ap-
plied in the following manner: The skin is first covered with a
piece of linen or cotton cloth, or a bandage, which has been dipped

in cold water, and over this cold, wet dressing a dry, woollen cover-
18

274 GENERAL THERAPEUTICS FOR VETERINARIANS

ing or bandage is so applied that the surface of the dressing re-
mains entirely dry (warm, moist poultice). After about 1 to 3
hours, a reactive hyperemia of the skin has taken place under the
bandage in the manner before described, so that the dressing must
be renewed after this period. A renewal of the dressing is also
indicated when the inner layers of the bandage have become dry.
On account of the early occurrence of maceration of the skin,
care must be taken not to continue the use of the dressing too
long; in order to avoid inflammation of the skin, it is recommended
that the dressing be left off over night or every second or third day.

2. Irrigation. By this is understood the irrigation of the body
or parts of it with cold water by means of a rubber hose. This
serves to withdraw heat generally and locally in fever and in
inflammations of peripheral parts (hoofs, tendons, joints, head).

3. Douche. This is the application of a stream of cold water
with the simultaneous action of mechanical force (pressure from a
syringe or from water pipes, irrigation from a higher level); it
acts as a powerful stimulant to the nervous system, especially in
depressed conditions of the brain and spinal cord.

4, Baths. The domestic animals are in general rarely sub-
jected to complete baths for hydrotherapeutic purposes; on the
other hand, cold and warm local baths are employed in different
forms, especially foot baths for horses, cattle and dogs, for the
purpose of reducing temperature, softening and cleansing. Ac-
cording to Wenz (Dissertation, Giessen, 1911), a preliminary
warm bath increases the effect of a succeeding cold bath, while
the reverse of this order is unfavorable. Additional investigations
on the action and use of baths on animals have been published by
Lucas (Berl. Arch., 1910).

5. Cold rectal infusions. These serve to reduce the tempera-
ture in fever and to stimulate intestinal peristalsis and evacuate
the rectum; they are used most frequently on the horse (clysters,
irrigations).

6. Clay poultices. This is the oldest form of hydrotherapy
used in veterinary medicine. The cooling effect is slight, accord-

HYDROTHERAPY 275

ing to Bayer, the temperature being only temporarily depressed
a few degrees.

7. Cataplasms. These are effective especially because of their
heat and moisture.

Other forms of hydrotherapy which may be mentioned are
simple cold and hot poultices, the ice poultice (ice pack), Leiter’s
cooling apparatus, and the different cold and warm washes. In
regard to the use of the thermo-regulator, see the text-books on
operations and instruments. This apparatus makes possible the
uninterrupted (24 hours and more) action of radiating heat of
42 to 44°C,

MASSAGE
Synonym: Mechanotherapy.

Nature and Forms.—Massage is the application of pressure
upon the skin and the parts beneath it. It has been used for a
long time in veterinary medicine, intentionally in the form of
rubbing and unintentionally in the application of ointments. It is
also one of the oldest methods of healing used in the treatment
of man (Chinese, Greeks, Romans, primitive people). After being
forgotten for a long time (during the entire middle ages up to
modern times), the method was to a certain extent rediscovered
in Sweden by Per Hendrick Ling (Swedish medical gymnastics).
Zander displaced the masseur by mechanical apparatus (mechano-
therapy). Mezger, Mosengeil, Zabludowski and others have
recently built up the method practically and scientifically. The
following varieties of massage are distinguished:

1. Stroxine (EFFLEURAGE).—This consists in passing the
finger tips or the flat of the hand superficially and gently over the
skin.

2. Ruspine (MassaGE A Friction).—In this variety of mas-
sage, the skin is rubbed under strong pressure.

3. KNEapING (PETRISSAGE).—The part of the body concerned
is pressed with the finger tips or fist as dough is kneaded.

4. Tappinc (TAPOTEMENT).—The diseased member is tapped
or struck at short intervals (edge of the hand, fist, stick). Tapping
is employed in paralyses of muscles and nerves and as preliminary
massage in the neighborhood of articulations.

In addition, compression (constant pressure), vibration (inter-
mittent pressure by special apparatuses) and active and passive
movement (mechanotherapy in the restricted sense, Swedish
medical gymnastics) may be considered as forms of massage.

Action.—As in the case of cutaneous irritation and hydro-

therapy, the effect of massage upon the body is very extensive.
276

MASSAGE 277

The action appears to be not exclusively mechanical but partly
dynamic. The most important local effects of massage are a
cleansing, stimulant, anodyne and a dynamic action. In addi-
tion, massage produces important general effects. Its influence
upon the individual organs is as follows:

1. The circulation of the blood and lymph is influenced by
massage first of all. The action here is the same as that which
occurs during motion in the vessels of the extremities, where the
venous blood and lymph is forced centripetally toward the heart
by the contraction of the muscles and the tension of the fascia
with the codperation of the valves of the vessels, a process which
may be called a natural or physiological massage. The pressure
exerted upon the body by artificial massage produces at first an
anemia of the parts concerned in consequence of the blood and
lymph being pressed out of the veins and lymph vessels toward
the heart. With the cessation of the pressure, a large amount of
fresh blood flows into the empty spaces and the area becomes
hyperemic (aspiratory and pressure action). The repeated alter-
nate occurrence of anemia and hyperemia stimulates and acceler-
ates the circulation in the massaged parts.

2. The acceleration of the circulation brings about an increase
of metabolism, leucocytosis, histolysis, and local antitoxin forma-
tion, promotes retrogressive changes and regeneration, stimulates
the resorption of the products of fatigue and metabolism, patho-
logical products, exudates and extravasations, and improves the
nutrition of the part massaged (experiments of Mosengeil with
pigments injected into the joints).

3. Solid, fibrinous exudates and blood coagula beneath the
skin, in tendon sheaths and in joint cavities are mechanically
crushed by massage and thus prepared for resorption. In addi-
tion, swellings of the skin and mucous membranes, subcutis,
musculature, tendons and tendon sheaths, joints, etc., are reduced
in volume.

4, Contractions of the musculature are overcome by tapping
the muscle; simple rubbing and stroking brings about hyperemia

278 GENERAL THERAPEUTICS FOR VETERINARIANS

with increased nutrition and blood formation; in addition, the
capacity for work is increased, as by training.

5. The nervous system is stimulated by massage in the same
manner as by cutaneous irritation. The cutaneous nerves are
stimulated by kneading and tapping and the stimulation acts
reflexly upon the central nervous system. Paralyzed peripheral
nerves (motor and sensory) especially are treated by massage.
Light massage (stroking) appears to reduce increased suscepti-
bility of nerves.

6. Other general effects of massage include increase of cardiac
activity, pulse and body temperature, reflex stimulation of gastric
and intestinal peristalsis, diuresis and diaphoresis, change in the
distribution of the blood (depletion of the central organs, deriva-
tive action), improvement of the general state of nutrition and
strengthening of the body constitution.

Uses.— Massage is used principally in surgery; it can, however,
be employed with advantage in internal medicine. But its value
in veterinary medicine must not be overestimated. The alleged
results of massage in practice are in great part to be attributed
to the healing power of nature and to the simultaneous employ-
ment of hydrotherapy and medical treatment. For horses espe-
cially, massage will never attain the same importance as for man,
where suggestion is frequently the principal healing factor; in
addition, the hair of the horse, the resistance of many animals
and the bodily difficulties arising for the masseur hinder the
application of the method. Furthermore, much time is often
lost with massage; blisters and firing are much more valuable
therapeutic measures than massage.

The most important indications for massage are the following:

1. Blood stasis, lymph stasis, cedemas of the skin, mucous
membranes, and subcutis (especially prophylactically against
formation of thrombi and in decubitus).

2. Contusions, hemorrhages and lymphorrhagia on the sur-
face of the body (saddle pressure, hematomas of the thigh).

3. Subacute, aseptic inflammations of the skin, subcutis, ten-

MASSAGE 279

dons, tendon sheaths, joints, bones, glands and udder (milking).
Massage should not be applied too early in fresh distortions of the
joints and in acute periostitis (only after several days’ treatment).

4, Chronic inflammatory thickenings and indurations in the
organs mentioned in paragraph 3, splints, galls, ulcers, badly
granulating wounds, stiffness and weakness of the limbs in old
horses and after hard work.

5. Muscular rheumatism, muscular paralysis, muscular atrophy
and muscular cramp.

6. Paralysis of peripheral, motor and sensory nerves, spinal
and cerebral paralytic conditions.

7. Chronic inflammation of the cornea (leucoma); oedema of
the eyelids.

8. Colic, constipation, tympanites, paresis of the rumen, atony
of the gastric and intestinal musculature.

9. Febrile general diseases, inflammation of internal organs,
obesity, diabetes, anemia (Weir Mitchell’s method), cardiac
failure (Oertel’s method).

10. In healthy animals, massage in the form of training and
rubbing down after exercise is an important factor in maintaining
health, especially in horses.

Contraindications.—Since massage promotes the resorption of
the products of inflammation (fibrin, serum, blood), it can be
employed only in simple, non-septic inflammations. In all cases
in which septic material is present in the area of inflammation,
especially the bacteria of septicemia and pyemia, massage must
be omitted, otherwise a general infection of the body will result
from the resorption of the infectious material. Massage is espe-
cially contraindicated in phlegmona, abscesses, septic mastitis,
metastatic tendovaginitis (contagious pneumonia of horses), ery-
sipelatous swellings (influenza), malignant oedema, black leg, all
purulent, sanious and septic inflammatory conditions in general
and in fresh keratitis.

Massage is to be avoided particularly in phlebitis, lymphan-
gitis and purulent lymphadenitis, because here the danger of a

280 GENERAL THERAPEUTICS FOR VETERINARIANS

blood infection is the greatest. In addition, phlebotomy fistule
and venous thrombi should not be massaged, since lung emboli
may result from the disintegration of the thrombus. Massage of
arterial thrombi cannot be unqualifiedly recommended because
of the danger of peripheral emboli. Finally, massage is forbidden
in animals in many cases by the local sensitiveness.

Technique of Massage.—To massage correctly requires on the one hand
good instruction and practice and on the other hand a certain adaptability
of the fingers and hand. Definite rules concerning the variety and the con-
tinuance of massage can not belaid down. Massaging according to a fixed
system should be especially avoided; each case is to be scientifically individ-
ualized. The principle of massage is that the stroking, rubbing and kneading
movements should be centripetal where possible, 7.e., in the direction from
the periphery toward the heart. On the legs, for example, one massages from
below upward, and on the neck from above downward, following the course
of the venous blood and lymph. The movements may also be circular, from
above downward and the reverse alternately; the chief result is then altera-
tion of the circulation. Usually, massage is begun and ended with stroking.
The “introductory massage” is begun on the healthy, centrally situated parts
in order first of all to clear the paths of diversion. Massage is usually per-
formed with the dry hand (finger tips, surface of the hand, thumbs, fist);
when massage is long-continued the hand is moistened or is anointed with
pure oil, paraffin ointment, lard or with a medicated ointment (camphor
ointment, iodoform ointment). The official paraffin ointment! (white vaseline)
is the best. Massage is continued on the average for 10 to 20 minutes and is
applied once or twice daily. In massaging articulations, flexing, extending
and rotating movements are employed. Very hard indurations, as splints,
etc., can be massaged with the assistance of sticks and plates. Aids of this
kind are unnecessary in other conditions; this is also true of the use of objects
placed upon the skin to receive the pressure or blow. Tapping is used in
paralytic conditions and as a preliminary massage in distortions. The sur-
face of the fingers and the hollow of the hand are well adapted for stroking,
both hands being used alternately; deep-lying parts are massaged with the
tips of the thumbs. Rubbing is performed with the joints of the fingers and
hand held rigidly, the hands movingin straight lines or in a circle over small sur-
faces. In kneading, the soft parts are grasped transversely with the hands and
pressed with the fingers progressively toward the centre of the body. Tap-
ping consists of elastic taps with the loose-jointed hand or slapping with the

[! Petrolatum album of the U. S. Pharmacopeia.]

MASSAGE 281

hollow of the hand; the fist and instruments are also used. Massage of the
rumen and intestines is performed by pressing both fists into the flank region
against the organ concerned; general rubbing of the abdominal wall operates
indirectly. In colic of the horse, the large colon can be massaged from the
rectum. Massage of the cornea is performed by placing some ointment (yellow
mercuric oxide salve, 1 : 25) between the lids, drawing them over the eye and
gently rubbing. The articulations, tendons and muscles are most frequently
massaged. For more details of the technique of massage, see the works of von
Mosengeil, Reibmayr, Zabludowski, Vogel and others. Concerning the
action and uses of massage in veterinary medicine see also Kohlhepp (Disser-
tation, Giessen, 1906), Goldbeck (Zeitachr. f. Vet., 1908) and Leuffen (Mo-
natshefte fir prakt. Tierheilkunde, 1912).

ELECTRICITY AS A REMEDY. ELECTROTHERAPY

Synonyms: Galvanotherapy, Faradotherapy, Franklinotherapy.

General.—Although electricity has been employed for healing
purposes for a long time, it is only within the last seventy years
that its action upon the body has been closely examined scientific-
ally (Remak, Ziemssen, Erb). Furthermore, its physiological
action remains unexplained to-day in many respects. Electro-
therapy is therefore still in part a purely empirical healing method.
In veterinary medicine, electricity is seldom employed for curative
purposes and, indeed, is used mostly only on dogs and horses.
According to the form of electricity employed and the object of the
treatment, the following forms of electrotherapy are differentiated:

1. GALVANOTHERAPY consists in the employment of the con-
tinuous (galvanic) current generated in galvanic batteries.

2. FARADOTHERAPY uses the interrupted (faradic, induced)
current, which is generated by means of an induction apparatus.

3. FRANKLINOTHERAPY is seldom employed; static or friction
electricity is used.

4. Evecrro.ysis (galvanolysis) is the chemical decomposition
of fluids by the galvanic current, the electrodes being placed upon
the skin.

5. ELECTROPUNCTURE (galvanopuncture) serves the same
purposes as the needle-shaped electrodes which are used to
penetrate the tissues.

6. GaLvanocatstic is the use of the galvanic current to heat
firing apparatus.

Action.—The effects of electricity upon the living animal
body are very complicated and have not been completely investi-
gated. The nervous system and the musculature are influenced
first of all by the electric current. But the fluids of the body,

especially the blood, and the glands and other tissues appear also
282

ELECTROTHERAPY 283

to be changed in certain respects by electricity. In general the
following effects are recognized:

1. The stimulant action is produced most strongly by the
induced (faradic) current. It causes burning of the skin (cutaneous
irritation), stimulation of the sensory and motor nerves, muscular
contraction, dilation of the blood-vessels (stimulation of the vaso-
dilators), increase of gland activity and of metabolism. Electricity
therefore operates as a stimulant to most of the organs of the body.

2. The electrotonic action consists in the alteration of the
physiological electrotonus, 7.e., a change in the susceptibility of
the nerves (anelectrotonus, catelectrotonus). To this are probably
due in great part the curative results of electrotherapy in nerve
diseases. The electrotonic action of the continuous current espe-
cially is sedative, reducing the receptivity of the nerves.

3. A chemical action is undoubtedly produced by the electric
current, especially in the region of the poles (anode, cathode). It
acts first of all upon the fluids (serum, blood) and upon the salts
contained in them. As is well known, salts and other compounds
(water) are separated by electrolysis into their positive and nega-
tive elements and the positive (alkaline) elements are attracted
by the negative pole or cathode while the negative elements (acid)
are attracted by the positive pole or anode. The electric current
in muscles and nerves is probably due to a similar combination
of chemical opposites.

4. A cataphoric action is manifested by substances which ordi-
narily are not diffused through the tissues of the body becoming
diffusible under the influence of the electric current. Because of
the results obtained in experiments with potassium iodide and
cocaine, it is assumed that pathological products also become
diffusible.

The so-called catalytic (alterative) action appears to consist
essentially of a stimulation of the vasomotor and trophic nerves
and consequently falls under the first-named action.

Uses.—In veterinary medicine, electrotherapy is indicated in

284 | GENERAL THERAPEUTICS FOR VETERINARIANS

the following diseased conditions in the smaller domestic animals
and in horses:

1: As a stimulant in pareses and paralyses of the posterior
quarters and in paralyses of the peripheral nerves and muscles (pa-
ralysis of the facial and radial nerves, tongue, bladder, quadriceps
and penis, and amblyopia). In these conditions, the interrupted
(faradic, induced) current is used in medium strength, because
every single one of the numerous interruptions stimulates the
nervous system.

2. As a sedative in excitable conditions of the muscles (twitch-
ings after canine distemper). The galvanic or continuous current
is used as mildly as possible.

3. As a diagnostic and prognostic to demonstrate the retention
or loss of sensory and motor excitability in paralytic conditions of
the. nervous system and musculature (testing electric excitability).

The surgical employment of the galvanocaustic and electro-
puncture for the destruction of new formations has not been made
use of in veterinary medicine.

Technique.—The best induction apparatus for veterinary purposes is the
small, handy apparatus of Spamer (price, $7 to $10). If the electric treat-
ment is limited to paralytic conditions, this apparatus will be entirely sufficient.
For other cases, a small galvanic apparatus can be used. The method of using
these apparatuses is described in the directions which accompany them. In
general, it is to be remembered that the hairy skin of animals is a poor con-
ductor of electricity and that the electrodes must therefore be moistened (salt
water is best) before they are applied. It is also to be remembered that the
electric excitability is increased in the region of the negative electrode (cath-
ode), while it is decreased in the region of the anode. Of especial practical
importance are the facts already mentioned, namely: that the nerves are
soothed by a weak galvanic current, while they are stimulated by a strong
faradic current. In the employment of the faradic current, a weak current is
used in the beginning and the strength is slowly increased until a reaction
(twitching, pain) is obtained; the current is permitted to operate in the latter
strength on the paralyzed part for 10 to 15 minutes, one to three times a day.
If a weaker current later produces twitching it is an indication of improvement.
The strength of current used can be exactly regulated with the apparatus. .
The application of the electrodes differs; usually one electrode is placed as

ELECTROTHERAPY 285

close as possible to the paralyzed nerve or muscle, while the other one is applied
in the neighborhood. In spinal paresis of the posterior quarters an electrode
is placed on the moistened sole of each hind foot so that the current will pass
through the entire posterior parts; in paralysis of a single limb, one electrode
is applied to the sole of the foot and the other in the region of the lumbar cord.
The spinal cord is either treated longitudinally, with the anode placed upon the
upper (anterior) and the cathode upon the lower (posterior) part; or trans-
versely, with the electrodes upon the sternum (anode) and spinal column
(cathode); the galvanic current, with the largest electrodes possible, operates
best. The brain is treated with the electrodes applied to the back of the neck
and to the forehead, the weakest galvanic current possible being used.

A more complete discussion of electrotherapy will be found in Grundriss
der Elektrotherapie fiir Tierarzte by Tereg (Berlin, 1902), and in the special
works of Erb, Pierson-Sperling, Rosenthal, Benedikt, Levandowski, Meyer,
Grdupner and others.

Thermopenetration.—This term refers to the generation of heat in the
inner parts of the body with the assistance of the electric current. The un-
limited high-frequency current can be introduced into the body in any strength
desired without producing any effect upon the nervous system. It exerts a
favorable influence on man, especially in neuralgias and rheumatic affections.
An electric warm-current healing apparatus called the “Stangerotherm” has
been recommended for animals,

BLEEDING
Synonyms: Venesection, phlebotomy.

General.—Bleeding, a healing method of the old therapeutics,
has in the last several decades very correctly passed out of fashion.
A critical examination of its indications has shown that in most
cases in which it is employed early it is at least unnecessary, while
in a large number of cases it is even directly harmful. This is
especially true of its former conventional employment in all
febrile and inflammatory diseases. Still, it cannot be entirely
dispensed with even to-day, especially in veterinary medicine.
There are some very well-defined diseases, especially of horses and
cattle, in which bleeding under certain circumstances saves life.

Action.—The most important effect upon the body of the
decrease in the total quantity of blood (5 to 10 liters in horses and
cattle) which results from bleeding is the withdrawal of a large
amount of water. In this respect, the effect of bleeding agrees
entirely with the action of diaphoretic, sialagogue, diuretic, and
laxative drugs, especially arecoline. Following this withdrawal of
water, the blood seeks to regain at least its former volume as
quickly as possible by taking up any fluids in the body at its
disposal (lymph, fluid exudates), creating a temporary hydremia.
Upon this process rests one of the most important effects of bleed-
ing. Another important effect is the derivation of the blood from
the internal organs; the quicker the blood is withdrawn in bleeding
the more rapidly and promptly this action occurs. The other
effects of bleeding upon the body are of no special practical im-
portance. It may be mentioned that bleeding also corrects dis-
turbances of the circulation, removes poisons from the body with
the blood and increases proteid metabolism, while the fat and
carbohydrate metabolism is depressed (increased excretion of
urea, decreased elimination of carbon dioxide and decreased

absorption of oxygen, according to Bauer).
286

BLEEDING 287

Uses.—Bleeding is still indicated to-day in the following
conditions:

1. Laminitis of horses. Experience has taught that a free
bleeding as early as possible in this condition, in connection with
arecoline, is the best treatment for laminitis (founder).

2. In the first stages of inflammation of the brain, so long as
symptoms of cerebral congestion are present (pronounced injec-
tion of the visible mucous membranes of the head, increased
temperature of the cranium, strong pulsation of the arteries of
the head, symptoms of psychic excitement).

3. In congestion of the lungs with threatened cedema of the
lungs.

4. In poisoning of the blood (carbon monoxide, illuminating
gas, hemoglobin, uremia).

Bleeding is also recommended in rheumatic hemoglobinemia
{azoturia] of horses, as a prophylactic against parturient apoplexy
and in different internal circulatory disturbances (heart diseases).
In some sections it is used empirically in the beginning of fattening.
On the other hand, its employment has been proven to be not
without objection in inflammation of the brain and lungs, in
pulmonary hemorrhage and in chlorosis (it is alleged to promote
the formation of blood in chlorosis of man). Bleeding exerts no
prophylactic effect against infectious diseases, as has been estab-
lished experimentally by Zschokke.

Transfusion.—This method is unnecessary in veterinary medi-
cine and its use in human medicine is strongly contested. It con-
sists in introducing into the veins of a diseased individual defibri-
nated blood from an individual of the same species. Transfusion
is recommended in excessive loss of blood and in poisoning of
the blood (carbon monoxide). It has, however, been recently sup-
planted by infusion and injections of sodium chloride in solution.

Infusion.—By this is understood the introduction of solutions
of medicines directly into the circulation through a vein. In
human medicine, infusion of sodium chloride solution especially
is recommended in place of transfusion in poisonings, cholera, etc.

GENERAL THERAPEUTICS OF THE ORGANS OF LOCO-
MOTION (MUSCLES, TENDONS, NERVES,
ARTICULATIONS, BONES)

Therapeutic Methods.—The diseases of the organs of locomo-
tion comprise the principal part of surgery. They include the
consideration of inflammation, atrophy, paralysis and laceration
of the muscles, paralysis of the nerves, inflammation and lacera-
tion of tendons, inflammation and fracture of the bones, and
inflammation and dislocation of the articulations. The thera-
- peutic methods employed in the treatment of these diseases are
naturally very numerous and differ with the character of the
individual case. With regard to them and the excellent natural
healing processes which operate in these conditions, especially in
bone fractures, the reader is referred to the text-books on general
surgery. Nevertheless, there are some observations to be made
from the standpoint of general therapeutics. The surgical methods
of treatment most frequently used are the following:

1. The rest treatment is the most important method of healing
in all painful and acute inflammatory conditions of the muscles,
tendons, bones, and articulations. “Rest the afflicted part.’
Simply permitting horses to “ stand” will alone in many cases
bring about healing (natural healing). The application of a
plaster-of-Paris dressing in fracture of bones and sprained joints
acts in the same manner.

2. The exercise treatment, on the contrary, is indicated in
some chronic inflammatory conditions of the muscles, nerves,
tendons and articulations (muscular rheumatism, atrophy of
muscles, paralyses of muscles and nerves, and contractions). By
exercise, as by massage, the circulation, resorption, innervation
and metabolism are stimulated locally and generally, muscular

activity and the body constitution are strengthened, and under
288

ORGANS OF LOCOMOTION 289

certain circumstances pain is decreased. In addition, exercise
operates as a prophylactic against hemoglobinemia [azoturia],
parturient apoplexy and stable founder.

3. Hydrotherapy (cold, heat, Priessnitz dressing), cutaneous
irritants, firing, massage, and electrotherapy are very important
methods of treatment in numerous acute and chronic surgical
disease conditions. (See the chapters on those methods.)

4. The medical method consists in the use of direct stimulants
of the muscles and nerves: veratrin and strychnine; also in the
subcutaneous and parenchymatous injection of morphine, cocaine,
sodium chloride, and oil of turpentine (shoulder lameness).

5. The operative treatment is either direct or indirect. Exam-
ples of the direct method are: section of contracted tendons or
muscles (tenotomy, myotomy), incision of purulent inflammations
of muscles, bones and tendon sheaths, and resection of necrotic
tendons, while neurotomy is an example of the indirect or symp-
tomatic method.

6. Regulation of the shoeing is very important in numerous
surgical diseases (diseases of the hoof, ring bone, spavin, diseases
of tendons).

49

INDIFFERENT REMEDIES. MECHANICALS

Definition.—The terms indifferent and mechanical are used to
designate a group of therapeutic agents which in general do not |
produce any chemical or pharmacological effect upon the organ-
ism and which are employed only for their mechanical action.
The group includes protective, emollient, cleansing, absorbent,
dilating, and uniting remedies.

L. PROTECTIVES

Synonyms: Obtegents, involvents, obvolents, lubricants; covering, pro-
tecting, soothing remedies, bandages or dressings.

Uses.—The protectives serve to cover the skin and mucous
membranes in inflammatory conditions and when wounds are
present; also to guard and defend these structures against injurious
influences. Wounds upon the skin are most frequently treated
by the use of bandaging materials. In addition, the different
varieties of eczema, erosions and burns and also the specific inflam-
‘mations of the skin require the employment of protective remedies
in the form of salves. The latter are also applied to the skin
prophylactically to protect it from flowing secretions (pus) and
caustic substances (cantharides). The protectives are admin-
istered internally in the different inflammatory conditions of the
‘mucous membrane of the pharynx, cesophagus, stomach and intes-
tines and as mechanical antidotes in intoxications (see p. 216); the
mucous membrane of the bladder and rectum is also accessible to
applications of protectives. Finally, they are used to prevent the
dissipation of heat and moisture from the skin, to promote cu-
taneous resorption in the epidermatic application of medicines
and to lubricate the instruments and hands.

Remedies.—1. Fats and oils: Lard, olive oil, linseed oil, pea-

nut oil, almond oil, rape oil, poppy-seed oil, cod liver oil, cacao oil,
290

INDIFFERENT REMEDIES. MECHANICALS 291

coca oil, mutton suet, spermaceti, ointment of rose water, and
sevum salicylatum.!

2. Mucilaginous remedies: Linseed, acacia, althea, traga-
canth, salep, mallow, dietetic remedies (oat and barley mucilage).

3. Paraffin ointment,? lanolin, simple cerate.

4. Plasters and liniments: Adhesive plaster, Lund’s plaster,?
Carron oil (linamentum calcis).

5. Silver nitrate (silver covering of burns and other cutaneous
affections).

6. Gelatin, collodion, traumaticin [gutta-percha dissolved in
chloroform], water glass. '

7. Starch, lycopodium, zinc oxide, bolus, talcum, pulvis talci
salicylicus (N.F.).

8. Cotton and other dressing material,

2. EMOLLIENTS

Synonyms: Demulcents, solvents; softening, loosening, liquefying, dis-
integrating remedies.

Actions and Uses.—The emollients operate upon the different
pathological indurations of the skin, subcutis, tendons, tendon
sheaths, and muscles by mechanical diffusion and imbibition
(water, oil, glycerin, soap), by preventing the dissipation of heat
and water (poultices) and by chemical solution (lyes, alkalies),
disintegration and liquefaction. The remedies concerned in in-
ternal softening and solution have already been considered in the
chapters on resorbents (p. 76), expectorants (p. 107) and diuretics
(p.113.) The external disease conditions which are most frequently
treated with emollients are thickenings of the skin, calluses, scabs
and crusts upon the skin, squamous eczema, thickenings of the
subcutis, hard swellings in the tendons and tendon sheaths as in

[' Salicylic acid 2 parts, benzoic acid 1, mutton suet 97.]

(? Petrolatum album.]

[? Turpentine and pitch, equal parts; liquefy by heat, mix, and spread on
cloth.]

292 GENERAL THERAPEUTICS FOR VETERINARIANS

tendinitis and tendovaginitis, indurations of glands, udder nodules
and rheumatic indurations of muscles.

Remedies.—1. Water and all remedies containing water (baths,
cataplasms, moist applications).

2. Moist heat, especially in the form of the Priessnitz dressing
and cataplasms.

3. Fats, soaps, glycerin, and lyes (soda lye, potash lye, potas-
sium sulphate).

3. CLEANSING REMEDIES

Action and Uses.—The ordinary cleansing agents, water and
soap, operate mechanically to remove dirt, scabs, pus, and other
disease products, and particularly infectious materials. In the
latter respect, the cleansing agents act at the same time as dis-
infectants. As already stated (p. 182), a thorough cleansing is in
many cases equal in value to a disinfection. Water and soap,
when rationally used, frequently suffice as disinfectants; provided
the water is clean, 7.e., free from infectious materials, that it is
used in sufficient amount and, when possible, warm or hot, and
that a good preparation of soap is used. An entirely neutral soap
is best for cleansing the skin (soft soap irritates the skin, as may
be frequently observed especially in dogs). On the other hand,
for cleansing utensils and other articles a soap with a strong
alkaline reaction is desired, t.e., a soap which contains free lye,
because the free lye exerts a disinfectant as well as a cleansing
effect. Soft soap is therefore preferred for this purpose.

Absorbent Remedies (Imbibents, Rophetics)—These serve

-to absorb blood, serum, pus, and other fluids. Their action is

purely physical. They include dressing materials (cotton, wood
wool, jute, etc.). Wood wool possesses the greatest imbibing
properties. Freshly-burned charcoal absorbs gases (SH:) and
poisons, and starch absorbs iodine.

Dilating Remedies (Dilatants)—A mechanical dilation by
means of dilating pencils (laminaria, tupelo) is used in surgery
and obstetrics.

INDIFFERENT REMEDIES. MECHANICALS 293

' Uniting Remedies (Contentives).—These serve to unite solu-
tions of continuity (wounds, fractures of bones). The so-called
immovable dressings are made of rubber, gelatin, water glass,

| , plaster-of-Paris, starch paste, etc. Medical uniting substances
for wounds are collodion, traumaticin [gutta-percha dissolved in
chloroform], and adhesive plaster.

AIR AS A REMEDY

General.— While the air acts as the excitant or carrier in differ-
ent diseases, it is also an important healing factor in a number of
diseases. As regards the harmful effects of the air, these can be
referred in part to its temperature and in part to the admixture ©
of dust, bacteria, and poisons. Stable air is an especially frequent
source of diseases of all kinds. Its constant, uniform temperature,
which is usually too high, exerts a relaxing effect upon the general
body constitution and produces a consequent predisposition to dis-
ease. The best known of the stable diseases which occur through
the influence of the temperature of the stable air are rheumatism,
rheumatic hemoglobinemia [azoturia], catarrhs, brain and lung
diseases, and also summer wounds in army horses. Secondly,
stable air operates pathologically through its contained bacteria,
gases and mechanical admixtures. These favor especially the
development of tuberculosis, glanders, contagious pneumonia of
horses and other infectious diseases. The carbon dioxide, ammonia
and other gases which may be present act barmfully upon the
respiration. The outside air can also cause disease in different
ways (bot air, dusty air, arsenical fumes, lead vapors). By a
careful prophylaxis all of these disease conditions may be indirectly
avoided.

Furthermore, air is a very important direct curative agent.
Its healing action is in part due to the oxygen it contains (open
suppuration, anaérobes), in part to its temperature and in part to
its purity. To what extent the ozone of the air possesses healing
properties has not been scientifically determined.

Therapeutic Action of Cold Air.—Cold air operates first, like
cold water, as a cutaneous irritant. The anemia produced primar-
ily in the cutaneous vessels is followed by a reactive hyperemia

of the skin. Asa consequence the circulation is stimulated through-
294

AIR AS A REMEDY 295

out the entire body and the blood is driven from the internal
organs, especially the lungs, digestive apparatus and brain, to the
periphery, metabolism is increased and the constitution is strength-
ened. Heat is given off by the body to the surrounding cold air,
provided the action of the latter continues long enough. Cold
air consequently acts as a refrigerant. Upon the basis of these
actions, cold air is employed in the form of ventilation of stables,
and animals are exercised in cold air, bivouacked and placed in
cold compartments and in shady places to make them hardy;
cold air is also employed as a preventive against rheumatism and
other diseases due to chilling, as a curative agent in all febrile
diseases of the internal organs, and in congestion of the lungs
and brain.

Therapeutic Action of Pure Air.—Pure air, rich in oxygen,
poor in carbon dioxide, free from bacteria and other impurities,
is the best natural remedy in all catarrhal affections of the respira-
tory apparatus. It is employed in the form of good ventilation,
the air in the stable being renewed as often as possible, or the
animal is placed in the open air (pasture, bivouac, exercise in the
open). The renewal of the air in the bronchi and alveoli promotes
respiration and removes the injurious air from these structures.
Furthermore, the introduction of fresh air dilutes and removes the
infectious material present, which is also in part destroyed by the
oxygen (disinfectant action of fresh air). Especially good results
have been obtained in this respect in strangles, contagious pneu-
monia, tuberculosis, and other infectious diseases.

Climate.—Climate can only be made use of for healing purposes in veter-
inary medicine in exceptional cases, which is in contrast to the very highly-
developed climato-therapy of human medicine. The importance of climate in
a hygienic sense for the domestic animals has, it is true, been known for a
long time. It is known, for example, that the mountain breeds, because of
the vigorous climate, are more resistant to diseases of all kinds than the breeds
of the lowlands. It is further known that imported animals (monkeys,
parrots) are very susceptible to disease and frequently die of tuberculosis
because of the change of climate. A similar effect is observed on horses,
cattle and sheep when they are taken into a new region with a different climate.

\

296 GENERAL THERAPEUTICS FOR VETERINARIANS

For economical reasons, a change of climate for therapeutic purposes is per-
missible with the domestic animals only in very rare cases (removal to ele-
vated pastures or to distant farms), although frequently such a change ap-
pears to be indicated, especially in convalescence.

Light.—The use of light as a healing remedy was introduced by Finsen
of Copenhagen. He uses the bactericidal (chemical action of the ultraviolet,
violet and blue rays) as well as the inflammation-producing (thermal action
of the red rays) forces of light and has in this manner cured numerous cases
of lupus in man. His method consists in concentrating the rays of a very
strong arc light by means of a rock crystal and directing them through a
layer of distilled water which is continually cooled. Iwanow (Repert. d. pol.
Sanit. vét., 1902) has obtained excellent results with Finsen’s apparatus in the
treatment of eczemas of the horse.

Réntgen’s Rays.—These are used in surgery for the local treatment of
malignant neoplasms (carcinomas, sarcomas). Radium acts in a similar
manner (radiotherapy). In internal medicine, the Réntgen rays have proven
less satisfactory (employed in chronic myelomas and in lymphatic leukemia
and aleukemic splenic tumors).

Abortive method, 8

Abortives, 119

Absorbent materials, 292

Absorbents of gas, 32, 52

Acid-neutralizing stomachics, 32

Acrics, 146

Air as a remedy, 104, 294
harmful effects of, 294

Alactics, 127

Alterants, 76, 159

Amara, 30

Amblotics, 119

Anesthesia, general and local, 101, 102

Anzsthetics, 97
Analeptics, 93
Analgesics, 97
Anaphrodisiacs, 121
Anexosmotics, 48
Angio-asthenics, 72
Angiosthenics, 7}
Anodynes, 97
Antacids, 32
Antagonistics, 216
Antagonists, 216
Antaphrodisiacs, 121
Antatrophics, 134
Antemetics, 32
Antentozoa, 165
Antepizoa, 160
Anterotics, 121
Anthelmintics, 165
Anti-asthmatics, 97
Anticatarrhalics, 159
Anticathartics, 48
Anticonvulsives, 97
Antidepertitorics, 134
Antidiarrheeics, 48
Antidotes, 216
chemical, 217
mechanical, 216
physiological, 219
symptomatic, 220
Antidyscratics, 159
Antidysenterics, 48
Antidyspeptics, 29
Antiepileptics, 97
Antifebrilics, 84
Antifermentatives, 169
Antiferments, 52
Antigalactagogues, 127
Antigalactics, 127

INDEX

Antihidrotics, 132
Antineuralgics, 97
Antiparalytics, 93
Antiparasitics, 109, 160
Antipediculous, 160
Antiperiodics, 84
Antiphlogistics, 159
Antiphthiriacs, 160
Antiplastics, 76, 138
Antipsorics, 160
Antiputrids, 169
Antipyretics, 84, 86
Antiscabious, 160
Antisepsis, 170
Antiseptic stomachics, 31
styptics, 49
Antiseptics, 109, 169, 172
for wounds, 209
internal, 213
Antisialagogues, 132
Antispasmodics, 52, 97
Antitznics, 165
Antitetanics, 97
Antithermics, 84
Antitoxics, 216
Antitypics, 84
Antityposics, 84
Antizymotics, 169
Antodontalgics, 97
Aperients, 40
Aperitives, 40
Aphrodisiacs, 120
Arabian medicine, 14
Aristotle, 12
Aromatic stomachices, 31
Artificial arrest of hemorrhage, 68
Asclepiade, 9
Asepsis, 170
Aseptics, 169
Astringent styptics, 49
Astringents, 48, 157
Attenuation, methods of, 230

Balneotherapy, 265

Bechics, 109

Bitter stomachics, 30

Bleeding, 286

Blisters, 146

Blood diseases, dietetic treatment of,
3

general therapeutics of, 60
297

298

Blood-forming remedies, 63

Blood plastics, 63, 134

Blood-vessels, general therapeutics of
the diseases of, 64

Boerhaave, 10, 17

Bone plastics, 134

Bradysphygmics, 57

Brown,

Calefacients, 159
Cardiac ene general therapeutics
oO ?
sedatives, 58
stimulants, 58
tonics, 58
Cardiacs, 57
Carminatives, 52
Catheretics, 152
Catharsis, results of, 43
theories of, 41
Cathartics, 40, 45
Causal healing method, 6
Causes of immunity, 227
Caustics, 152
Cauterics, 152
Cauterization, 156
Cellular pathology, 21
Cerebralics, 91
Chemical antidotes, 217
Chemotherapy, 23
Cholagogue laxatives, 54
Cholagogues, 54
Cleansing remedies, 292
Climate, 295
Coagulants, 157
Cold, 69
Colyseptics, 169, 172
Composting, 202
Compression, 68, 276
Confortants, 137
Confortatives, 137
Conservants, 169
Conservation of animal products, 214
Conservative healing method, 8
Constipating remedies, 48
Contentives, 293
Corrosives, 152
Curative vaccination, 252
Cutaneous irritants, 146
mallein test, 263
tuberculin test, 260

Demulcent styptics, 48

Demulcents, 291

Derivants, 146

Derivative healing method, 5
medicines, 146

INDEX

Dermerethistics, 146
Diagnostic inoculation, 254
Diaphoretics, 129
Diapnoics, 129
Dietetic method, 7
treatment of blood diseases, 63
intestinal diseases, 40
liver diseases, 55
stomach diseases, 29
Dee organs, general therapeutics
or,
Digestives, 29
Dilatants, 292
Dilating remedies, 292
Direct healing method, 5
Discutients, 76
Disinfectant stomachics, 31
Disinfectants, 169
for infectious diseases, 201
for wounds, 209
mechanical, 208
relative rank of, 173
Disinfection for infectious animal
diseases, 183
of wounds, 178, 209
preliminary, 182
preparation for, 182
Diuretics, 113
Drastics, 40

Ebriantics, 97

Ecbolics, 119

Eccoprotics, 40

Ectrotics, 119
Electropuncture, 282
Electricity as a remedy, 282
Electrolysis, 282

Emesis, effects of, 35
Emetics, 34, 216
Emmenagogues, 119
Emollients, 291

Empirical healing method, 7
Enterostyptics, 48
Epileptifacients, 93
Epispastics, 146
Erasistratus, 12
Erethistics, 146

Erotics, 120

Errhines, 107

Erythrotics, 63
Escharotics, 152
Euphorics, 93

Euplastics, 63, 134
Evacuants, 40

Excitants, 93

Exhilarants, 93

Expectant healing method, 7

INDEX

Expectorants, 107

Exsiccants, 157

External antiparasitics, 160
xudates, general therapeutics of, 73
te a general therapeutics of,

Fallopius, 16

Faradotherapy, 282

Febrifuges, 84

Fever, general therapeutics of, 80
Firing, 156

Foods, 134

Franklinotherapy, 282

Galactagogues, 122

Galactics; 122

Galen, 12

Galvanocaustic, 282

Galvanotherapy, 282

Gas absorbents, 52

Gas-expelling drugs, 52

General healing method, 5

Genital organs, general therapeutics
of the diseases of, 118

Glands, general therapeutics of, 128

Hematics, 63
Hematinics, 63
Hematopoietics, 63
Hemostatics, 69
Hahnemann, 19
Harvey, 16
Healing methods, 4
Heart diseases, general therapeutics
of, 56
remedies, 57
sedatives, 58
stimulants, 57
tonics, 58
Heat, 69 .
Hemorrhage, methods of arresting, 63
Hepatic stimulants, 54
Hepaties, 54
Herophilus, 12
Hidrotics, 129.
Hippocrates, 10 .
History of therapeutics, 9
Hoffmann, 17
Homeopathy, 19
Hufeland, 18
Humoral pathology, 11, 18
Hydragogue cathartics, 43
diuretics, 113
Hydriatrics, 265
Hydrotherapy, 105, 265
Hyperzmia as a remedy, 271

299

Hyperinotics, 63
Hyperkinetics, 93
Hypnotics, 97

Imbibents, 292
Immunity, 225
acquired, 226
active, 226
artificial, 227
causes of, 227
individual, 225
inherited, 226
natural, 225
passive, 226
species, 225
Indifferent remedies, 290
Indirect healing method, 5
Inhalations, 105, 106
Inoculation, diagnostic, 254
methods of, 225
Internal antiseptics, 213
Intestinal diseases, dietetic treat-
ment of, 40
general therapeutics of, 38
mechanical treatment of, 51
operative treatment of, 51
Intracutaneous tuberculin test, 260
Intradermal tuberculin test, 260
Involvents, 290
Trritants, 146

Kneading, 276

Lactics, 122

Lactifuges, 127

Laxatives, 41

Lenitives, 41

Ligation, 68

Light, 208, 296

Litholytics, 113

Lithothryptics, 113

Liver aa dietetic treatment of,

general therapeutics of, 52
mechanical treatment of, 55
remedies, 53
Locomotory organs, general thera-
peutics of, 288
Lubricants, 290

Mallein, 260
test, cutaneous, 263
ophthalmic, 260, 263
subcutaneous, 261
Malpighi, 16
Mange remedies, 160
Massage, 276

300

Masticatives, 131
Masticatorics, 131
Mechanical antidotes, 216
disinfectants, 208
Sveum of intestinal diseases,
5

of liver diseases, 55
of stomach diseases, 33
Mechanicals, 290
Mechanotherapy, 276
Medicinal plastics, 135
Metabolism, general therapeutics of
the diseases of, 133
Metasyncritics, 159
Methods of healing, 4
Mitigation, methods of, 230
Monk’s medicine, 14
Morgagni, 16
Mucous membranes, general thera-
peutics of, 143
Mucus-dissolving remedies, 109
Mydriatics, 141
Myotics, 142

Narcosis, 101

Narcotic stomachics, 32
styptics, 49

Narcotics, °97

Nauseosa, 34

Nauseotics, 34

Nerve sedatives, 97
stimulants, 93

Nervines, 90

Nervous system, general therapeutics

of diseases of, 88
Neurotics, 90
Nutrients, 134, 137

Obstruents, 48
Obtegents, 290
Obvolvents, 290
Odinegogues, 119
Operative treatment of intestinal
diseases, 51
of stomach diseases, 34
Ophthalmic mallein test, 260, 263
tuberculin test, 259
Osmotics, 40

Palliative method, 6
Paracelsus, 9, 14
Paralyzants, 97
Parasitics, external, 160
Paré, 16

Paregorics, 97
Parturefacients, 119
Pasteurization, 207

INDEX

Pellentics, 119
Peptics, 29
Peripherics, 92
Peristaltics, 40
Phlebotomy, 286
Physical antidotes, 216
Physiological antidotes, 219
healing method, 6
stomachics, 29
Plastics, 134
food, 134
medicinal, 134
Pneumatics, 107
Polysphygmics, 57
Preservants, 169
Preservation of animal products, 214
Priessnitz, 19, 265
Priessnitz’s dressing, 273
Prophylactic method, 7
Protective vaccination, 236
Protectives, 48, 290
Ptarmics, 107
Ptyalogogues, 131
Pupil-contracting remedies, 142
Pupil-dilating remedies, 141
Purgatives, 40
Pustulants, 146, 148

Rademacher, 19

Radical healing method, 6

Rational healing method, 6
Reducing remedies, 138
Refrigerants, 159

Heaulauens concerning vaccination,

for disinfection, 184

Resolvents, 76
Resorbents, 76
Respiratory apparatus, general thera-

peutics of the diseases of, 103
Roborants, 137
Réntgen’s rays, 296 :
Rophetics, 292
Rubbing, 276
Rubefacients, 146, 148
Ruminatorics, 32

Saline stomachics, 30
Schonlein, 18
Sedantics, 97
Sedatives, cardiac, 58
nerve, 97
Serum therapy, 22
Sialagogues, 131
Sialics, 131
Skin, general therapeutics of, 143, 144
Solvents, 291

INDEX

Somniferics, 97
Soporifics, 97
Spasmodics, 93
Spinalics, 92
Spinants, 93
Spontaneous arrest of hemorrhage, 66
Stahl, 18
Statistical healing method, 7
Sternutatorics, 107
Stimulant stomachics, 31
Stimulants, cardiac, 58
nerve, 93
Stomach arti dietetic treatment
ol,
general therapeutics of, 25
mechanical treatment of, 33
operative treatment of, 34
Stomachics, 29
Stroking, 276
Styptics, general, 70
intestinal, 48
local or topical, 69
Subcutaneous mallein test, 261
tuberculin test, 258
Sudorifics, 129
Suppletives, 29
Suppurants, 148
Suppuratives, 146
Sydenham, 17
Symptomatic antidotes, 220
healing method, 6

Tapping, 276
Temperantics, 97
Temperants, 159
Tetanics, 93
Thermopenetration, 285
Tonics, 137, 157
cardiac, 58
Torsion, 68
Transfusion of blood, 62
Transudates, general therapeutics of,
73

301

Tuberculin, 258
test, cutaneous and
neous, 260
ophthalmic, 259
subcutaneous, 258

‘6 }
intracuta-

Udder, general therapeutics of the
diseases of, 118

Uniting remedies, 293

Urinary organs, general therapeutics
of the diseases of, 112

Uterines, 119

Uterus, general therapeutics of the
diseases of, 118

Vaccination, 225, 250
curative, 252
emergency, 236
for the different diseases, 237
methods of, 233
prophylactic, 236
protective, 236
purposes of, 235
varieties of, 235

Vaso-astringents, 71

Vaso-constringents, 71

Vasodilants, 72

Vasodilators, 72

Vasomotor stimulants, 71

Venesection, 286

Vermifuges, 165

Vesal, 16

Vesicants, 146, 148

Vibration, 276

Vital healing method, 8

Vomiting, effects of, 35

Vomitives, 34

Vomitorics, 34

Von Haller, 18

Waiting healing method, 7
Water as a remedy, 265
Worm remedies, 165
Wound disinfectants, 209