LY Se ee - \ _ << \ AK AY \ \\ \ RAY \\ SO \ LY Lee CILIA \’ . \ So XQ AN \\ QQ WW AY WAAAY AY WAY \ RAY ‘ AN AWS N NY RN RVs » UY NY ‘ SAN WAY ACR KKRK A \ SY RAN AK AY QQ \ MOK \ \ MOK NAIA ‘ AK AY LE ite: Yue LZ Glass_D Y_/ ees Sobre Gort? COPYRIGHT DEPOSI VETERINARY MEDICINE SERIES f No. 15 EPIZOOTICS AND THEIR CONTROL DURING WAR A Guide for Army, Government and Practicing Veterinarians By DR. HERMAN MIESSNER Professor of Hygiene and Director of the Hygienic Institute of The Royal Veterinary College, Hanover With Thirty-Seven Illustrations Translated by A. A. LEIBOLD, D.V.M. Bacteriologist, Research Department, The Abbott Laboratories, Chicago Published by AMERICAN VETERINARY PUBLISHING CO. CHICAGO CopyricHt 1917 . in AMERIGAN VETERINARY PUBLISHING ia AUTHOR’S PREFACE In this book it is my object to describe in a condensed form all of the diseases of animals that occur and are of most interest in the present world war. It seems unnec- essary to attempt to write a new book on infectious dis- eases, In view of the large number of excellent works already in print, but I learned from our experiences in the field how necessary it is for the practicing veteri- narian to have conveniently at hand a small consulting book that contains every-day matters of importance, for it is next to impossible to carry the larger books. All of the observations that we have made while controlling and combating epizodtics during the years of the war, were most critically considered and are given in this book in their entirety. It is, of course, impossible to discuss in this brief work all the questions in connection with the diseases to be mentioned, and only such questions as relate to the most important diseases can be considered at the present time. This was taken into consideration even in the mere selection of the subjects to be discussed, and especially so in the individual chapters. Glanders assumes such an important role in the war, due to its having spread over such wide areas, that it would nec- essarily have to be given more space for consideration than diseases of less importance. Likewise, one can easily understand that the various diagnostic methods would be given particular attention. In the chapter on contagious pleuropneumonia of horses (influenza pectoralis) (brust- seuche) is considered the advancement made in the treat- ment of this malady with arsenic, while facts that every veterinarian are supposed to know are discussed only 3 4 AUTHOR’S PREFACE in a brief manner. Ina similar way, only the important facts are considered in connection with other diseases. Since the prime object in this book is to discuss the diseases of those animals used for transport purposes, namely, horses, I will devote the greater part to equine diseases. Tlowever, there are two contagious diseases discussed, both of which are almost exclusive cattle mal- adies, because cattle are also used for transport purposes as well as supplying the army with fresh meat; further- more, because our experiences in past wars have shown us that cattle plague (rinderpest) and contagious pleuro- pneumonia (luwngenseuche) always appear at that time. The risk of importing the extremely dangerous and easily transmitted disease, rinderpest, is greater at the present time because it is known that the Russian army, due to the scarcity of their meat supply, procure meat-produc- ing animals from Mongolia and Manchuria, the chief sources of rinderpest. In order to correspond with the first expressed idea to make this book solely a practical and brief work, almost all methods for research that require experts and well equipped laboratories, are in this case only briefly de- scribed and the reader is referred to more detailed text- books for further information on this subject. Keeping in mind the rule that ‘‘preventing epizooties is more im- portant than controlling epizoéties,’’ special attention is given to every known method which would assist in an early diagnosis or which would facilitate the prevention or eradication of infectious diseases. With the same object in mind there is described in the first or general section of the book the equipment of horse hospitals and depots as well as the laboratories for blood examination. Questions concerning disinfection and the most impor- tant disinfecting substances are also discussed in that part of the book. AUTHOR’S PREFACE 5 I am cognizant of the fact that in this work I have not exhausted my subject, for in my attempt to be brief I was forced to limit the explanation in many cases— and, moreover, a subject of this kind never will be ex- hausted. It was also necessary to omit many discussions dealing with the subject at hand because they were of military interest in connection with the defense of the country. But, nevertheless, I hope to have succeeded in writing a book which will be helpful to the army veteri- narian as well as the government and practicing vet- erinarian, because it is their duty to prevent the intro- duction of contagious diseases into the interior through transport and meat-producing animals and to combat existing epizodtics among the animals owned by the civil population. Some of my experiences in past years and during the present war I utilized as guides in writing this book, while other valuable suggestions were given me by colleagues who are at the front. I also wish to thank Assistant Lange and Dr. Berge, both of my institution, who helped me in the proofreading, and Dr. Liitje, who contributed some very illustrative drawings. I am also grateful for the courtesy shown by the publisher of the original Ger- man edition, who showed such unusual ability in repro- ducing illustrations and publishing this work. I believe that in dedicating this little booklet to my honored former teacher, the senior master of veterinary medicine, Professor Dr. Schiitz, I could not dedicate it to a more worthy individual, for we are indebted to him and thank him for the great amount of work he has done in research on the infectious diseases of animals. Hannover, September, 1915. H. MrIessner. WAR HORSES All unoffending, unsuspecting, led, They come—patient, resistless, dumb— To swell the heaps of nameless dead. —Ever Holmes. TRANSLATOR’S NOTE The aim and scope of this book have been described in the author’s preface, so that it is hardly necessary to dwell further on these phases. The very favorable comment that has been passed on Miessner’s Kriegstierseuchen und thre Bekampfung by American veterinarians familiar with the German lan- guage, caused the publisher and translator to come to the conclusion that American veterinarians might profit materially from an English translation of the book. When Dr. Miessner wrote this book the world war had been in progress approximately one year. His connec- tion with a German regiment of artillery during this time gave him ample opportunity to study the war from a veterinarian’s viewpoint and to see the need of a concise treatise on animal plagues and their control. The mag- nitude and seriousness of this war make it absolutely imperative that we protect all of our resources and par- ticularly our food and transport animals. The obvious necessity of this should stimulate all veterinarians to thoroughly familiarize themselves with animal plagues and their prophylaxis so as to be in a position to render all possible assistance to curb any outbreak of disease that might endanger the lives of our animals. While translating this book it was always my object to adhere as closely as possible to the original text, but my aim throughout was to reproduce the ideas expressed rather than the style of the author. Those familiar with translating idiomatic expressions will appreciate the dif- ficulty of this task. 7 8 TRANSLATOR’S NOTE No changes were made in the order of the subject matter from that in the original text. Some references to certain military regulations enforced in Germany were omitted for the obvious reason that they would not be of any essential value to the veterinarian in this country. All illustrations which appear in the original text have been reproduced. The subject matter in the appendix has been included in this volume with the object of presenting in a compact form the experiences of a few American veterinarians who have been connected directly or indirectly with the world war. No originality is claimed for this portion of the book, the contents being made up of excerpts taken from the American Journal of Veterinary Medi- cine, due credit being given in each instance. I wish to acknowledge my particular indebtedness to Dr. C. A. Zell, Assistant Director, Research Department, The Abbott Laboratories, for the valuable assistance ren- dered by him in the preparation of this translation. Acknowledgment is also due to Dr. J. H. Achard, of the Editorial Staff, American Journal of Clinical Medicine, for his kind and helpful suggestions. Acknowledgment is also due to the publishers who proved themselves most courteous and helpful in many ways in the preparation of this book. Chicago, July, 1917. A. A. LEIBOLD. CONTENTS PAGE ist) OID LUT SiRyaONISS 65 6 ne a Seo hoe on comcr Soeon aromas 1a PART ONE Horse Hospitals and Horse Depots.................... 13 Blood ixamination Stations. saqee ese nes. els alee 19 Mics tease Cal ON ere neste Fe sr A Paes eap ee eater RL ts wee de cee sie Seorey PART TWO GiIGHINGIONES) <2 caso: ais oS caS ee aoe oko Be One eee 29 PASTING HDT Aaa Nees cba eee ect eacgcl ct st snaysis, epbhal ote: 81,0 (eves! osat aceite cane 85 TEEI ORES). se, cs erste Sees ica eG oir RC Og EN ee ee 99 FIVE asn on Ceres tae one ets eet ia che eevee wise e aunitcie w(soece are su eleivel's 113 Contagious Pleuropneumonia of Horses................ 127 atorerivalelontlieniZal, 2 nciscxars ae ects eicie ow wietd suse 6 ates sue 143 SUMAN OVC! icone ceeras clhe nctesne we see eisii@ cis eee es Se Bele ars 147 WINE eee te ee eh Nk GRRE cate 155 Contagious Pleuropneumonia of Cattle................ 167 JEG VEN OESIEN oer ckte as SCION eRe ia ac Dae em Pera nae I(T APPENDIX Hints on Handling War Horses in America, by A. A. HOMO eras ease oer ael vee aera ee acl's = hee Maelo chag alee Sede 197 TUN ID IBDEC 55 °5 ee 6 ae orotic Ansley eae RR tee rote See 209 ILLUSTRATIONS PAGE Formalin disinfection apparatus................ 25 Nodules and ulcers on the skin of a glanderous NOISE) 4kin 6/a5 oles o poo So COO UIS. OI ClobiG GN cin omarion 31 3. Ulcers and scars on the‘nasal mucosa of a horse.. 34 4, Glanderous ulcers of the mucosa on the ventral WU GE NG) TENN S GucamucodoasnocceuoooN ead 35 5. Glanders scars on the tracheal mucosa........... 36 6. Section through lung of a horse showing new and oldvelanders!nodulesyy ici cece sci scie cisleieieel ey-ickes 37 7. Calecareous fibrous nodules of embolic nature in HO@ UNS ooocoonacd0n0nadb00dd60000e0000000006 43 8. Male guinea pig infected with glanderous material 45 OMA HSE LIME TTOM para etter cre dar ste ite lequnsietevacalgee tent oe a atleilc tates 49 10. Schematic representation of complement-fixation MOA CLUOMMere sth lcfersicieke sctasste lao State fal sie s Siecd te Gieveynty 54 11.. Complement-fixation experiment ................ 55 12. Schematic representation of conglutination reac- ELIOT Payeicrtench excel spas eyerede > aye istenct eye ars cokeetre ya Uap ates 59 13. Mallein, antimallein and complement............ 61 14 Ophthalmicy reactions. we seismic ce eee eee: 65 15. Ophthalmic reaction; degree of reaction......... 67 16. Agglutination and fixation titre and ophthalmic reaction during the course of a glanders case.. 74 Meme AeMlus ANtHTACIS 6s 21006 slave ats eis «roe ect mets viele ene 85 18. Precipitation experiment in anthrax............. 94 19. Negri bodies in a ganglion cell................. 99 20. Female Sarcoptes communis...................-- 113 2ieebernale Psoroptes CommuUNIsse sae o. oe Seen e : 115 Zee SALCOPbICMmINAMS Os 2.8. Ko1-eeaeO abel cee ekana cer ofeugieso hi erel ss 119 bo po He CO Or ILLUSTRATIONS PAGE Trypanosoma equiperdum 2... 00s s<:s'sidiae see 155 Unpigmented spots on the vulvar lips in dourine.. 157 Swelling of the udder in dourine................ 159 Swelling of the testicle and penis in dourine...... 161 Pustular ‘skin ‘eruption’... ..1.. 0. oo. see 163 Scheme of contagious pleuropneumonia sectioned VUNG oy. Waders lola eie's feiss oie alelere c.eteretieiel aera 169 Diphtheroid lesions on the mucose of the upper and lower jaws in rinderpest..............00. 177 Reddening of the gums with loss of substance and fibrinous.layers in rinderpests +) .':\.c,-rieie ieee 179 Losses of substance with diphtheroid layers on the hard palate of cattle in rinderpest............ 181 Heifer sick with rinderpest:... ./.:1.\s.tarcio estrone 183 Diphtheroid lesions on the mucosa of the tongue ANG PRAY oor L esse aces 5:10 oleie hs Oe 185 Hyperemia of the abomasum in rinderpest....... 187 Striated hyperemia in rinderpest.............:.. 189 Portion of small intestine showing striated and patchy hemorrhages of the mucosa in rinderpest 190 Acute inflammation of the gall bladder in rinder- OSG) aie le eeis aio eon co eiailsilels (otae ele lateuere Pens Toei amma 191 PART ONE HORSE HOSPITALS AND HORSE DEPOTS PROBLEMS OF HORSE HOSPITALS AND DEPOTS It is an obvious necessity that the army be supplied with horse hospitals and horse depots, maintained in the interests of the health of horses and the prevention and combating of infectiou. diseases. Opportunity must be given to the fighting and marching army divisions to ship behind the battle fronts for treatment their sick horses, as well as those horses that are unable to travel. For this horse hospitals must be provided. In order to meet the demand at all times, army divisions must also be - Siven opportunity to replace rapidly any horses that have either died or become sick. With this object in view, horse depots should be placed near the front, which will supply a great number of serviceable, healthy horses, destined for the front. It has been proved ex- pedient to separate entirely the horse hospitals from the horse depots, in order to prevent any infection of horses at the depots through the medium of sick horses which have been returned from the troops, and in that way keep these horses at the depots serviceable and free from disease. Since the very sick horses or horses other- wise made unfit for war purposes are sent back home, suitable hospitals should be made available for these returning animals. Ina lke manner horse depots should be arranged at home and in the army corps in order to receive healthy horses destined for the front. Besides caring for those animals showing external dis- ease, it becomes the duty of the horse hospitals and depots to combat all possible infectious diseases with the best available methods, special attention being directed to glanders. Since many of the hospital horses that are 13 14. EPIZOOTICS: THEIR CONTROL DURING WAR useless for war purposes, are returned to the civil pop- ulation, proper preventive measures are carried out at the hospitals to preclude the spread of a communicable disease to the horses of the civil population; and, on the other hand, it becomes the problem of the depots to prevent the transmission of diseases from horses from home to the army horses of the fighting troops. ARRANGEMENTS OF HORSE HOSPITALS AND DEPOTS In order to prevent the spread of diseases, it is neces- sary that all horse hospitals and depots have three-room stables, each of which is separate from the others. Stable No. 1 serves to receive the incoming horses; stable No. 2 receives such horses as have been shown to be infected, and is comprised of three divisions in which are kept the— (a) Glanders suspects. (b) Strangles cases. (c) Horses infected with other diseases—all being sep- arated from one another. Stable No. 3 is intended for those horses known to be absolutely free from infectious diseases and which are ready for distribution. The stables must provide separate drinking troughs and mangers; in case this is not possible it becomes nec- essary to erect heavy partitions; and even individual nose-bags must be provided, for feeding and watering the horses in some instances. All horses are to be examined for symptoms of glan- ders before they are given quarters. The glanderous horses should be killed immediately and not allowed to be placed in these stables. Every horse is to be given a serial number which is best done by cutting it into the hair, or burning it on the hoof or braiding a numbered card in the mane or tail. Before horses leave the hos- HORSE HOSPITALS AND DEPOTS 15 pitals or depots they are to be subjected to the ophthal- mic mallein test and, as far as possible, to the serodiag- nostic tests. ; Division Horse Hospitals In order to relieve the fighting and marching troops of the severely sick horses and others unfit to travel, a hospital must be arranged in the neighborhood to eare for such animals; 7.¢., a division horse hospital. The division horse hospitals are to be made mobile since they must follow the troops, even though they follow at a slower rater of speed. It is therefore necessary that they send such animals, which require a long time to eure or those not fit to travel or to be used in war, to the corps or army horse hospitals in the rear. Staff Veterinarian Ohm very kindly made some valu- able suggestions to me by letter. According to him, all horses must be carefully marked so that those discharged from the division hospital as cured can be returned to the regiment and officers from which they came. In this way only, will the confidence in this arrangement be kept and strengthened and an early delivery of sick and other horses needing careful handling, be made possible. This is of special interest in order quickly to restore the horses and rapidly to make them serviceable again. It is necessary to inscribe the serial number of the hospital on the left side of the horse’s neck by cut- ting the hair, and to renew the regimental brand on the left side of the cheek; in such cases, where horses belong to officers, a leather tag with the officer’s name on it is braided into the tail. All horses placed in the receiving stable No. 1 are immediately groomed and well cared for; in the evening the ophthalmic mallein test is ap- plied and blood is withdrawn for serodiagnosis. Horses found, by means of the biological tests, to be infected with glanders are immediately killed and buried accord- 16 EPIZOOTICS: THEIR CONTROL DURING WAR ing to instructions. Horses that react doubtfully are subjected to further observation and examination by means of the usual methods in stable No. 2, division for glanderous suspects. In a similar manner the remain- ing horses are distributed to the different divisions of the stable, depending on the conditions from which the horses are suffering. Horses showing fever and suffer- ing from an incurable external malady are killed and buried, whereas those that do not give evidence of having fever are sold to the slaughterer. Horses which can not be used any longer by the troops, but which are still serviceable for farm work, must be immediately sent to the permanent horse hospitals and sold there. Thoroughly experienced practicing veterinarians are selected for the horse hospitals; and, beside the com- manding veterinarian, it is necessary to have one veteri- narian to about every 100 horses. Dietetic forage (bran, linseed oil cake, crushed oats, etc.) must be provided for the horses which are in poor physical condition or very sick. Corps or Army Horse Hospitals The corps or army horse hospitals afford a place to care for the sick horses and combat the infectious dis- eases according to the instructions given. Such animals, that are either difficult to cure or known to be incurable or unfit for war purposes, should be sent to the immobile hospitals at home. The corps or army horse hospitals are to be equipped with a plentiful supply of modern veterinary operating apparatus such as the excellent portable collection ar- ranged in a synoptical manner in a box offered by the Hauptner firm (Berlin). _ These hospitals also have to supply suitable transport HORSE HOSPITALS AND DEPOTS 17 ambulance wagons in order to get those horses which are unfit for travel from the division hospitals, or to take them to the nearest railroad station so they may be sent home. - It would also be useful to have a laboratory connected with the corps or army horse hospitals which would be equipped with microscopes, staining utensils and glass- ware in which ordinary bacteriological. examinations could be carried on. Dissecting instruments are to be kept on hand and dissecting rooms arranged where, as occasion arises, the post-mortem examination of horses suffering with infectious diseases (glanders) ought to be performed in order to insure an orderly examination and disposition of the cadaver. Immobile Horse Hospitals We then finally come to immobile horse hospitals back home, which receive those horses that require prolonged treatment or that need to be especially cared for, and which transfer with the usual caution the unfit horses to the civil authorities. The horses that have been cured and shown to be free from infectious diseases and their usefulness determined, can be given over to the perma- nent horse depots at home. Immobile Horse Depots The duty of the immobile horse depots is to determine whether the horses that are well and serviceable for war purposes, from the immobile horse hospitals, as well as the newly purchased horses from home, are free from glanders; this is done by means of the ophthalmic mallein test and blood examination. These horses are to be trained so that in the event of their being needed at the front, they may be sent as horses accustomed both to the saddle and wagon. 18 EPIZOOTICS: THEIR CONTROL DURING WAR Mobile Horse Depots In case no direct transportation of horses to the troops is desired, they are then sent from the immobile horse depots to the mobile horse depots of the army or army corps, from where the required horses are given over to the individual bodies of troops. GENERAL MEASURES FOR THE PREVENTION OF INFECTIOUS DISEASES Inspections of the horses are to be carried out at least every 14 days. The horse depots, horse hospitals and military formations often come in contact with strange horses and when infectious diseases are actually present in the military formation or in their neighborhood, in- spections should be repeated every seven days. Notice. should be taken that at these times all horses should be examined. Horses recently assigned to troops are held separate until the veterinary examination shows them to be free from infectious disease, after which they are allowed to enter the military formations. Captured horses are not to be placed with the regular army horses until, by the use of the ophthalmic test or serological tests, they have been shown to be free from infectious diseases, especially from glanders. To prevent the nasal discharges and saliva of sick horses from soiling drinking and feeding utensils, such articles should not be allowed to be used in common. In that way the chief sources of spreading infectious dis- eases like glanders and strangles are overcome. Before occupying stables the mangers should be carefully cleaned whenever circumstances permit. The bedding is removed whenever possible; and where a permanent bedding is used the upper layer, at least, should be changed. BLOOD EXAMINATION STATIONS 19 Periodic disinfections of the hospitals and depots should be carried out by using formalin and milk of lime, for which special apparatus must be provided (see chapter on disinfection on page 21). The changing and mixing up of horses during the movement of troops or while they are in their quarters are to be limited as far as possible. The placing together of army horses or bringing them in contact with horses of the civil population is to be especially avoided. Cattle and sheep barns, and sheds and granaries are to be used whenever possible. Stables in which infected horses are stalled or have been stalled are to be marked with distinct and substan- tial inscriptions, stating the name of the disease in ques- tion. Furthermore these inscriptions should designate the branch of the service and the time of departure of such troops. Infected places should not be allowed to be occupied by strange horses. By regular and repeated instructions, the troops are to be taught how to recognize infectious diseases of horses and how to combat them. All horses that are to be given over to a horse hospital or depot or sent back home, must be branded with the insignia of the branch of the service from which they have come, or marked in some other manner, so that in case of inquiry re- garding a glanderous case it can be determined from what body of troops the horse originates. BLOOD EXAMINATION STATIONS IMMOBILE BLOOD EXAMINATION STATIONS Near the front at suitable and conveniently centralized points, blood examination stations are located. It is the function of those in charge of these stations to examine, for glanders-antibodies, with the agglutination and com- plement-fixation methods, the blood of all horses within 20 EPIZOOTICS: THEIR CONTROL DURING WAR their province. The blood examination stations are supplied with trained veterinarians and the necessary helping personnel in order to handle the large amount of work required of them. They provide laboratories which make it possible to examine 1,000 or more horses per day. The equipment of the laboratory consists of water- baths with racks that, at the same time, will receive 100 or more test tubes, which can be regulated; centrifuges, pipettes, test tubes, centrifuge tubes, bottles, small animal cages, etc., as well as the necessary washing apparatus for cleaning the glassware. From these laboratories suitable boxes are also forwarded containing centrifuge tubes necessary for the examinations and _ bleeding needles; also the examination lists are to be placed in these boxes (see chapter on glanders on page 29). MOBILE BLOOD EXAMINATION STATIONS It was found necessary, especially when difficulties in transportation were to be taken into consideration, to have, besides the immobile ones, mobile blood examina- tion stations, which could move forward with the quickly advancing troops, in order not to delay the results of the examinations through the long transportation of the blood samples. These blood examination stations are equipped with wagons, automobiles, ete., with which means the blood can be collected direct from those bodies of troops that must be examined. The equipment of the mobile examination stations is similar to that of the immobile ones except that they are provided with smaller apparatus on account of their smaller range of activity. The arrangement has the advantage that the apparatus necessary for the blood examination can easily be packed and in emergency can be shipped to a more favorably located point, where a new mobile blood ex- amination station is to be fitted out. DISINFECTION By disinfection we mean the freeing of objects from infectious materials, everything living or dead which can cause infectious diseases in man or animals being looked upon as infectious matter. The disinfection con- sists of (1) the mechanical removal of the infectious materials; (2) the killing or preventing the growth of living disease-producing agents. It is necessary that objects to be disinfected undergo a mechanical cleaning process first; without following such a procedure it is questionable whether effect of the disinfection reaches such objects and no proof can be given that all infec- tious matter is destroyed. Disinfection is effected in several different ways. In some cases it may result in the infectious material dis- integrating entirely as by the use of antiformin; in other eases it depends on the osmotic disturbances which may lead to the death of delicate bacteria. Likewise, oxidiz- ing processes may assist in the rapid extinction of bac- teria. However, the destruction is mostly done by coagulating the living protoplasm. The lesser effect of dry heat in contrast to that of moist heat can be easily accounted for by this method; also the greater resist- ance of spores, as a general rule, compared to the vege- tative forms of life. The vegetative forms contain de- cidedly more water (80%) than the spores. As a result of this greater water content, they are more easily coag- ulated and are, therefore, destroyed at lower tempera- tures than the spores, which contain little water. Moist heat has a stronger effect than dry heat because in this way moisture is brought in contact with the spores so that the albumin is caused to coagulate more quickly. Most of the disinfecting agents, including those which form gas, work best in watery solutions; therefore, as an 21 22 EPIZOOTICS: THEIR CONTROL DURING WAR example, concentrated formaldehyd gas or absolute alco- hol is not good for disinfecting purposes, but, the moment these substances are diluted with water, their disinfect- ing powers are very materially increased. Oils are not suitable as vehicles for disinfectants for they prevent water from penetrating the bacteria. Al- bumins hinder the disinfecting power in the same way, since they form insoluble compounds with metals. To demonstrate: bichlorid of mercury will kill anthrax bac- teria in a 1 to 500,000 watery solution, but in an albu- minous solution, not in a weaker solution than 1 to 1,500. The following demands are to be made of dis- infectants: They must— 1—act quickly, 2—hbe readily soluble in water, 3—be cheap and easily kept, 4—not too poisonous, 5—have recognizable odor, 6—be as little injurious as possible to the objects which are to be disinfected. DISINFECTION OF EQUIPMENT Disinfection of metal objects, chains, ete., is best done with fire. Parts of harness should, as far as practicable, be left in a disinfectant for some time (bacillol, creolin, lysol). If this is not possible they should be carefully cleaned and then washed with a disinfectant. DISINFECTION OF STABLES AND RAILROAD CARS Disinfection of these places must necessarily be pre- ceded by a mechanical cleansing. Litter that may be present, is to be removed and stowed away in some out- lying spot, or eventually burned. We may proceed as follows: A layer of noninfected manure, straw or peat is placed on the floor of the stables or cars about 25 em. DISINFECTION 23 deep, 1.5 to 2 m. wide and of desirable length, and on this the manure to be disinfected is piled with slanting sides about 1.25 m. high. On top of this pile is placed a layer of noninfected manure, straw, leaves, peat or other loose material about 10 em. thick; if this is done in the open the pile is then covered with a layer of earth about the same thickness. Further disposition of this material may then be made as suggested above. This is to be followed by a thorough mechanical cleaning of the floor, walls and ceilings of the respective quarters. Steam is best for this purpose, although brushing with stiff brushes and hot soda water must suffice in most instances. After the cleaning the disinfection follows. Any of the various disinfectants may be used for this purpose. The simplest and safest is to disinfect with formaldehyd, milk of lime or milk of chlorinated lime. Attention is called to the fact that in the field one has to deal chiefly with the killing of the nonspore-bearing bacteria. When sporulating bacteria (anthrax) are in question, it is important that the disinfection be more thorough. (a) FORMALDEHYD Formaldehyd (CH,O) is derived by oxidizing methyl alcohol (Ch,OH). CH,0OH + O = CH,O + H,O Methyl alcohol Formaldehyd This is done by passing the methyl alcohol vapors mixed with air over glowing spirals of platinum or copper, and while these vapors are cooling a solution of formaldehyd is yielded. By passing this into water a solution of formaldehyd of about 40 per cent strength —formalin—is obtained; this is better known in the Pharmacopeia as formaldehydrin solution. 24 EPIZOOTICS: THEIR CONTROL DURING WAR Use of Formaldehyd The best disinfecting action from formaldehyd can be gotten when formaldehyd and water are heated, and a sufficient quantity of the mixed vapors developed to saturate a given area (Fliigge). Five per cent solutions of formaldehyd (12.5 per cent formalin) have proved themselves to be most effective. Therefore the dry for- maldehyd preparations which can be obtained on the market are not suited for disinfecting purposes; the formaldehyd must be diluted with water and applied in the form of vapor. In order to vaporize diluted watery formaldehyd solutions, an apparatus which has been recommended by Fliigge’s has proved to be very good. It consists of a kettle for the formaldehyd solu- tion and above is a little spout (Diise) which leads the steam away. Below the kettle an alcohol lamp is placed. Both the kettle and alcohol lamp are encased in a metal covering in order to prevent any loss of heat. For an area of 10 cb. m. which has been tightly closed and where several hours’ disinfection is desired, one liter of formaldehyd solution, 7.e., 50 grams formaldehyd or 125 grams formalin, is necessary. When applying the for- maldehyd process, it is always necessary to tightly close the building so as to prevent the entrance of air or exit of formaldehyd vapors. Formaldehyd remains in the building for quite a while and irritates the mucous membranes. One can overcome this disadvantage in human medicine by the introduction of ammonia into the disinfected room by which means the formaldehyd is changed to neutral hexamethylentetramin. For this purpose about 150 c.cm. commercial, 25 per cent ammonia should be vapor- ized for every 100 c.cm. formol or 40 gm. formaldehyd. The ammonia vaporizers are given to the formaldehyd disinfectors (in human medicine) but can be dispensed DISINFECTION 25 with in veterinary medicine. For the vaporization and distribution of the formalin one can use an apparatus as seen in the accompanying illustration; the segmented sheet lead cans serve as containers for the formalin, aleohol and ammonia. The catalogue of Leitz-Bergmann, FIGURE 1 Formalin disinfection apparatus according to Fligge, model 1914, of the main sanitary depot of Berlin. Berhn, lists this apparatus with all the parts at 127.50 Mk.; without the ammonia developer, 110 Mk. Besides the formaldehyd vapors one can use one to one and one-half per cent formaldehyd solution, which is best apphed by using a fire water-pump or a disin- fecting apparatus as is used for the spraying of milk of lime. Schntirer recommends that disinfection with for- maldehyd solution be repeated after an interval of one to one and one-half hours, since by this method a stronger and more lasting action is obtained. For the disinfec- 26 EPIZOOTICS: THEIR CONTROL DURING WAR tion of a railroad car he uses each time 30 liters of a one per cent formaldehyd solution, 15 liters being sprayed through one door and 15 through the other. When repeating he uses a like amount, which makes a total of 60 liters of a one per cent formaldehyd or 2.25 per cent formaldehyd solution for such an area. In dis- infecting a stable a similar procedure is to be followed. In order that the disinfector may not be too much an- noyed himself by this preparation, he must station him- self in the stable door or some other place which opens on the outside and from there spray all corners and angles of the stable. (b) MILK OF LIME If formaldehyd can not be had, milk of lime or milk of chlorinated lime will give good results. Milk of lime is best applied by the use of a pressure apparatus. Such disinfection apparatuses are provided with a hand pump, pressure hose and long nozzle. They can be carried on the back and hold 25 liters, or are transportable and contain 60 liters. If such appara- tuses are lacking one can use a brush or scouring rag fastened to a long stick. The preparation of milk of lime is done as follows: One slakes the lime (CaO) by sprinkling it evenly with one-half its quantity of water until it is entirely pulverZeO.. CaO and He ea aan ae quick lime slaked lime. By mixing the slaked lime (pulverized hydrate of lime) with different quantities of water, milk of lime can be made to any desired strength. Thick milk of lime is made by adding three liters of water while gently stirring to one liter of freshly slaked lime, DISINFECTION 27 Thin milk of lime (5 per cent milk of lime) is prepared by adding 20 liters of water to one liter of freshly slaked lime. In case freshly slaked lime is not to be had, one can also prepare the milk of lime by mixing to every liter of slaked lime 3 to 20 liters of water. The unslaked lime in the lime quarry remains un- changed approximately four years, since on the surface a thin layer of carbonate of lime is formed which prevents the penetration of air into the depths of the lime. This upper layer in lime quarries is not suitable for disin- - fecting purposes and must first be removed. The milk of lime should be thoroughly stirred before using and in case one wishes to apply it with a spraying apparatus, it should also be passed through a sieve in order to pre- vent any clogging of the apparatus. (c) MILK OF CHLORINATED LIME Milk of chlorinated lime is produced from chlorid of lime. Thick milk of chlorinated lime is made by slowly adding one liter of chlorid of lime to three liters of water, stirring it all the while. Thin milk of chlo- rinated lime is made in the same manner except that 20 liters of water are used instead of but three. It is to be noted that the chlorid of lime must be kept in a closed vessel where it is protected from light and must have a strong chlorin odor. Milk of chlorinated lime should always be freshly prepared before using. (d) CRESOLS Cresol is obtained by first adding lye to coal tar from which a shake extract is then made. This is acidified and distilled at 200° C. (392° F.). The various cresols are soluble in water only to the extent of five per cent; the addition of soap increases the solubility. Such mix- 28 EPIZOOTICS: THEIR CONTROL DURING WAR tures can be used as disinfectants with very little fear of poisoning and are on the market under the following names: liquor eresoli saponatus (carboxal I); carboxal II (substitute for creolin) ; bacillol; diluted cresol-water, e.g., liq. eres. sap. 50, aq. 100. (e) PHENOLS Coal tar, distilled at 200° C. (392° F.) which contains 40 per cent phenol, is shaken with lye and then mixed with hydrochloric acid; the phenols floating on the sur- face are removed and distilled. Pure earbolie acid be- comes red when exposed to air and readily decomposes. When wishing to keep it for some length of time it is better to use carbolic acid liquefied with ten per cent water. Three per cent phenol solution is made: Acid carbol: liquef. .... .e2Ped 3 AiG) TONE. os. ic dacs we nhc 100 (f) BICHLORID OF MERCURY Hydrargyri Chloridum Corrosioum (HgCl,). Tablets of bichlorid of mercury contain equal parts of bichlorid and sodium chlorid (NaCl). Bichlorid of mercury is obtained by dissolving mercury in nitro- hydrochloric acid and then evaporating this to the point of crystallization. Its solubility is increased by the addi- tion of sodium chlorid. A 1 to 1,000 solution destroys vegetative forms and a 1 to 100 solution destroys spores in a short time. PART TWO GLANDERS, MALLEUS ETIOLOGY OF GLANDERS Bacillus mallet, which was discovered by Loeffler and Schtitz in 1882, is recognized as the cause of glanders. The rods are 2 to 5 micra long, 0.2 to 0.5 micron wide, nonmotile, Gram negative and lie individually and some- times in pairs—one behind the other. It stains best with carbol-fuchsin (about 14 minute) with which quite a number of granules can be demon- strated. The honey-like growth obtained on potatoes is typical for the glanders bacillus; this turns a brownish color after a variable length of time. Glycerin-agar cultures appear slimy, transparent, grey to yellowish-white. The resistance of the glanders bacillus is compara- tively weak. Dried nasal discharge which contains the elanders bacillus is not infective after three days. Sun- light or drying kills the bacillus in a few hours, whereas it remains virulent for several months under damp and dark weather conditions. Ten minutes exposure to a temperature of 55° C. (131° F.) destroys pure cultures. Material from the internal organs of a glanderous horse is not infective after a few days. Bichlorid of mercury 1 to 1,000; milk of chlorinated lime 1 to 800; milk of lime 4 to 100; lysol, creolin, car- bolic acid in one to three per cent solutions, destroy the elanders bacillus in a few minutes. THE SPREAD OF GLANDERS Glanders is spread: 1—Indirectly by one horse sniffing at another or by snorting or violently sneezing ; 29 30 EPIZOOTICS: THEIR CONTROL DURING WAR 2—Directly : (a) By using common drinking troughs or mangers which are soiled with nasal discharge, saliva or particles of food from glanderous horses ; (b) Through equipment, e.g., blankets, harness, sad- dles, curryecombs, ete., which have been used on glan- derous horses. SYMPTOMATOLOGY OF GLANDERS The portals of entrance for the glanders bacillus are the skin and mucous membranes. The lesions of glanders are dependent upon the manner in which the bacillus gains entrance to the body. Skin Lesions (Dermatitis Malleosa) In the beginning boils and tubercles appear which vary in size from that of cherries to walnuts. They later rupture to form ulcers with irregular edges about the size of a lentil to that of a twenty-five cent coin. (Der- matitis malleosa ulcerosa.) A pus-like, yellow discharge exudes from the surface of the ulcer which often dries and leaves a scab-like covering on the ulcer. The lesions may heal and become covered with hair again so that later the affected area is more difficult to find. Besides the affections of the skin, we find an inflammation of the regional lymph glands and lymph vessels. These become swollen in a cord-like manner and in their course nodular enlargements are formed. The pearl-like en- largements which develop in the course of the cord may rupture and appear as an ulcer. When the lymph sys- tem of the limbs is involved, we often find combined with it an inflammation of the subcutaneous tissue and phleg- monous processes of the extremities (Dermatitis malleosa diffusa phlegmonosa). GLANDERS ol Glanders lesions are found especially on the head, also in the places where the harness rests, particularly on the withers and in the region where the saddle rests as well as on the limbs. Swellings that occur on the fet- lock are apt to be mistaken for ordinary bruises, except that the phlegmonous inflammation of the subcutaneous FIGURE 2 Nodules and ulcers on the skin of a glanderous horse arranged like a string of pearls. tissue, which usually occurs here, is absent. Further- more, the glanderous processes have the tendency to follow the lymph vessels, which results in new nodules or swellings. By means of the blood circulation we get in addition to the skin lesions, metastatic glanderous processes in the internal organs, especially in the lungs. Lesions of the Mucous Membrane (a) Digestive Tract: It is rare to find visible lesions in the digestive tract, although one must admit that the 32 EPIZOOTICS: THEIR CONTROL DURING WAR glanders bacilli are often taken up with food and espe- cially water. When the stomach is only partly filled, acidity is high, and as a consequence those bacilli that pass into the stomach become very much attenuated or even destroyed. This explains why glanders lesions are seldom found in the intestinal mucous membrane. (b) Respiratory Tract: Infection of the mucous membrane of the respiratory tract occurs either through the inspired air or by soiling it with glanderous nasal discharges and particles of food, and finally by food or water containing glanders bacilli coming from the fauces or pharynx. Consequently, we find on the visible nasal mucous membrane, lentil-sized grey-red nodules at first and later ulcers with irregular edges and a lardaceous base. In case they heal they form scars which are flat and ranged in a star-like manner. Associated with this — is a nasal discharge of a purulent character. Since the lesions of the mucous membrane often occur only on one side of the nasal cavity, the nasal discharge is consequently mostly unilateral. Accompanying these changes is a steady enlargement of the regional sub- maxillary lymph nodes. The nodules, which originally were the size of a lentil to that of a pea and from which ~ the lymph nodes of that region are composed, become the size of a hazelnut; they become confluent and grow one into the other, which results in hard, compact, pain- less knots without increased warmth, and which are the size of a hen’s egg. Finally, although not always, these lymph nodes become attached to the neighboring subcu- taneous tissue. Fluctuation and abscess formations are never observed. The lungs become involved secondarily from the mucous membrane of the oral respiratory tract through the bronchioles or blood. (c) Sexual Organs: Occasionally glanders infection can occur through testicular glanders of a stallion. The GLANDERS 33 first ulcerations localize on the mucous membrane of the vagina, and secondarily the infection occurs on the skin of the inner surface of the hind leg by means of the vaginal secretions which contain glanders bacilli and which flow over these regions. Summary All nodular-forming, ulcerated or cicatrized glanders lesions of the skin or mucous membrane are always asso- ciated with pathological conditions of the regional lymph system; consequently, when making a diagnosis it is nec- essary to take into consideration the condition of the lymph vessels and lymph nodes that become firm, pain- less and enlarged as well as often being grown into one another when glanders is present. When glanders lesions are in the lungs, one will observe in such infected animals a cough and occasionally shortness of breath. Although horses become emaciated in generalized acute glanders of the internal organs and show a continual rising of the temperature above 38.5° C. (101.3° F.), we miss these symptoms when the lesions are very small or partly or entirely healed. Usually the animals are in good con- dition, the coat shines and they do not show any rise in temperature. PATHOLOGICAL ANATOMY OF GLANDERS The typical product of reaction following invasion of the glanders bacilli into tissue is the glanderous nodule. It is produced as a result of proliferative and exudative processes of the tissue, which one can assume occur through irritation by the glanders bacillus and its toxins. First, the fixed cells of the tissue (connective tissue cells, endothelial cells of blood and lymph vessels, epithelial cells of the alveoli and glands) become swollen and then proliferate by means of mitosis (indirect cell division). 34 EPIZOOTICS: THEIR CONTROL DURING WAR The resulting exudating process which follows somewhat later causes a gradual degeneration of the nodule pro- duced by the cellular proliferation. In this degenerative FIGURE 3 Uleers and sears on the nasal mucosa of a horse. process some nuclear granules remain which can be stained (chromatotexis). The central part of the nodule assumes a purulent appearance. | GLANDERS 35 The nodules in the mucous membrane rupture to the outside and ulcers result which may become confluent with neighboring nodules that have undergone degen- FIGURE 4 Glanderous ulcers of the mucosa on the ventral wall of the trachea. ~ eration, producing larger ulceration. These ulcers re- sult in flat, star-like scars. Occasionally the prolifera- tion gains the upper hand and the entire mucous mem- 36 EPIZOOTICS: THEIR CONTROL DURING WAR brane becomes covered with a streaked, slightly elevated sear tissue as is sometimes seen in the trachea. Glander- LLLECRCT TERE. GRRE AER SGRPAIS ON aE es \ | FIGURE 5 Glanders sears on the tracheal mu- cosa arranged in a streaked or striped manner, ous changes of the mucous membranes occur most fre- quently on the nasal septum, on the floor of the inferior meatus, the mucous membrane of the pharyngeal cay- GLANDERS 37 ity, the covering valve of the eustachian tube, the laryn- geal surface of the epiglottis, the arytenoid cartilage, the edges of the arytenoid-epiglottal folds and vocal cords, FIGURE 6 Section through the lung of a horse showing new and old glanders nodules: (a) new focus with grey proliferation center and red periphery; (b) somewhat older focus showing yellow degeneration center; (c) still older focus showing central area degenerated and a translucent periphery. the ventral walls of the trachea and the bifureation of the trachea. According to Schiitz the glanders nodules in the lungs 38 EPIZOOTICS: THEIR CONTROL DURING WAR are first composed of new formed tissue cells and appear grey. As a consequence of the resulting exudation, the peripheral portions of the nodule soon show pneumonic changes and are reddened—red hepatization. In the cen- -tral part polymorphonuclear neutrophilic leukocytes occur coming from the exudate; the degeneration of the centrally lying cells now begins, leaving behind nuclear fragments of the cells. The focal area of degeneration which seems to be irregularly outlined gradually becomes larger, and the acute inflammation in the surrounding pulmonary tissue passes over into a chronic one so that the original red peripheral zone becomes grey, due to the fibrous tissue proliferation which becomes hyaline as it gets older. Calcification of the central area is never observed. The glanderous lesions in the lungs are always of various ages. Adjoining new homogeneous grey no- dules, there occur some with a red periphery in which the central region shows a small, yellow, purulent area; also older nodules having a glassy, hyaline peripheral grey zone and a larger, straw-yellow, somewhat dry, degenerative area of a mortar-like quality. As a result of the confluence of several glanders foci in the lungs, larger nodule formations may arise, in which as a rule, upon cross-section, the original con- fluence of the individual foci can be detected. Further- more, as a result of the toxic irritation of the glanders bacillus, pneumonia and accumulation of exudate in the interstitial pulmonary tissue may occur and cause such a portion of the lung to be in a gelatinous condition (gelatinous pneumonia). A_ gelatinous pneumonia, which is occasionally observed in other diseases, can only be recognized as glanderous when it occurs in con- junction with the nodular changes. In connection with the lung lesions, we always find in the bronchial or mediastinal lymph glands glanderous changes which are GLANDERS 39 often of such small size that they can be found only after a careful examination of the lymph system and by mak- ing many sections. Then, however, one observes in the even and usually swollen marrow-like lymphatic tissue, straw-yellow degeneration-areas about the size of a pin- head or pea, which are filled with purulent or dry mortar-like material—never with calcified degeneration masses. Glanderous nodules which occur under the pleura and even in some cases deeper in the lung tissue, are usually found only by careful scrutiny and palpation. Further- more, considerable skill is necessary in sectioning such nodules, which should only be done with a thin sharp ’ knife, for one can recognize the structure of a glanderous nodule only by sectioning squarely through the center, never by passing through the peripheral portion. The mandibular and retropharyngeal lymph glands are considerably enlarged as soon as glanderous lesions occur on the skin or mucous membranes of the head. Individual nodules attain the size of a hazelnut to that of a walnut. The inflammatory process extends from the interstitial lymph gland tissue to the capsule (peri- adenitis) eventually to the contiguous tissue or the skin (paradenitis) which is followed by adhesions in these parts. In the swollen nodules one can find small yellow foci which later become enlarged and develop into a purulent fluid; usually they contain, besides the glanders bacilli, cocci. In the spleen and the liver, glanderous nodules fre- quently occur of the size of a pea to that of a hazelnut. As a rule they contain a central, purulent degenerative area and a tough, grey-yellow periphery. Lymph nodes which occur at the porta of the liver have undergone changes similar to those in the bronchial lymph nodes. The kidneys are seldom the seat of glanderous proc- 40 EPIZOOTICS: THEIR CONTROL DURING WAR esses. However, glanders occurs here in the form of various sized nodules containing central degenerative areas. The cortex is the part principally affected. Only a few instances have been cited where glanderous changes have occurred in the intestinal mucosa and the regional lymph glands. Ulcers of the intestinal mucosa sometimes described as glanderous, are usually parasitic in nature (Strongylus bidentatus). The sexual apparatus is seldom affected. Occasionally one finds stallions with diseased testicles, in which case the testicle and the surrounding tissue have become a caseous mass. In mares the vaginal and uterine mucous membrane is swollen and infiltrated with nodules, ulcers and sears which resemble those found on the nasal mucosa. Glanderous lesions of muscles and bones do not occur very frequently. In the muscle one finds foci of the size of lentils to that of walnuts which have degenerated in the center. The bones are enlarged (especially to be observed in the ribs) and infiltrated with pea-sized foci which occasionally communicate through openings with the surrounding tissue. DIFFERENTIAL DIAGNOSIS In the Living Horse (a) Chronic Nasal Catarrh: In this condition a mu- cous, watery discharge occurs from both nostrils. The typical glanderous involvement of the mandibular lymph nodes does not occur. (b) Chronic Catarrh of the Accessory Nasal Cavities: Such changes are usually unilateral. A fairly copious discharge that has a foul odor due to carious processes occurs, particularly when the head is lowered. Percus- sion and trephining give results that are worthy of con- sideration in making a diagnosis. GLANDERS 41 {e) Tumors of the Nasal Cavities: Fibroma, chon- droma, carcinoma, sarcoma, rhinoscleroma, amyloid. Usually these changes are associated with a snorting respiratory sound, and the lymph nodes are normal. (d) Tuberculosis: During recent times nodules, swell- ings and scars have been found on the nasal mucosa in tuberculosis. Corresponding with the preponderant pro- liferative character of tuberculosis, we find the ulcer sur- rounded by an elevated rim. In a similar manner the sears become elevated on the surface of the mucous mem- brane and usually in a star-shaped manner. The regional lymph nodes are infiltrated with tough, very small, easeous and calcareous foci. In the ulcers, tubercles and lymph nodes, one can readily find tubercle bacilli. (e) Strangles: Strangles is usually found only among young horses; in them it usually occurs as an acute infectious disease, which is associated with painful and fluctuating inflammatory processes of the submaxillary lymph nodes. Suppurating lymph nodes, which are al- ways present, have the tendency to rupture toward the outside. (£) Morbus maculosis: In morbus maculosis one ocea- sionally finds ulcers or nodular hemorrhagic points on the nasal mucosa, and sometimes resultant scars, which are apt to be misleading. The submaxillary lymph nodes are usually unchanged. The preliminary descriptions are to be taken into consideration. (g) Shortness of breath: The pulmonary changes in elanders which are so often associated with shortness of breath and cough can easily be confused with harmless conditions, and only specific biological methods of exam- ination will give satisfactory results here. (h) Lymphangitis with phlegmon: In connection with infected skin wounds, one sometimes observes phlegmo- nous inflammation of the surrounding tissue; these can 42 EPIZOOTICS: THEIR CONTROL DURING WAR be differentiated from the glanderous condition by their marked tendency to heal; however, such changes should always be examined with great circumspection. (i) Scars: Sears, resulting from traumata, occasionally oecur after injuring the mucous membrane of the nasal septum, with the thumb-nail during the examination of the oral opening of the nostril. Failure to find other changes verifies such a diagnosis. In the Autopsied Horse (a) Entozoic nodules: They are caused by the larva of the Strongylus dentatus, which have escaped from the circulation into the lungs, while migrating from the intestinal region. The parasitic nodules can be differen- tiated from the glanderous nodules in that the central degenerative area is surrounded by a smooth, glassy, grey-white, fibrous capsule. As a rule the central mass quickly undergoes calcification. Furthermore, we find upon microscopical examination collections of eosino-- philic leukocytes which occur in the glanders nodules only in quickly disappearing small numbers. The regional lymph glands are, as a rule, not affected; occasionally there occur small calcified foci in the intact tissue of the lymph nodes. It is necessary to distinguish between the erey transversely-sectioned nodules (Schiitz) which oe- cur in the parenchyma of the lung and which later become ealcified centrally only, and the embolic fibrous nodules (Olt). They are spherical, the size of a pepper- corn to that of a pea, and the round, thin capsule is in close contact with a small obliterated blood vessel. Later they become almost entirely calcified, during which proc- ess the lamellar condition of the capsule is distinguish- able. Corresponding to the embolic nature of these nodules, one occasionally finds the lungs filled with count- less numbers of such calcified nodules, which causes one GLANDERS 43 to imagine that it is infiltrated with grains of sand— eritty lung. The ulcers caused by the Strongylus bidentatus, found especially in the large intestine, are often confused with the glanderous lesions which are rarely found in this FIGURE 7 Calcareous fibrous nodules of embolic nature in the lung. Sandy lung or gravelly lung. location. A further examination of the mesenteric lymph nodes, which are always involved in glanderous condi- tions of the intestinal mucosa, but not in verminous con- ditions, should always be made in such cases. A marked eosinophilia of the ulcers on the mucous membrane is always noted in strongylus invasions. (b) Chronic bronchial catarrh: Bronchitis develops in the form of nodules, which extend from the inflamma- 44 EPIZOOTICS: THEIR CONTROL DURING WAR tory process of the smaller bronchioles to the surround- ing pulmonary parenchyma. When examined with a good light the center of the sectioned bronchus shows such nodular points, from which, as a rule, sausage-lke, calcareous masses can be pressed out. (c) Blood aspiration: This occurs most often in horses after strong aspiration following death. The nodules are of the size of a pea to a hazelnut and are colored an even red; the communicating bronchi like- wise contain blood. (d) Hemorrhagic Infarcts: The hemorrhagic infarcts are wedge shaped and show a homogeneous condition of the cut surface, which, according to their age, may be partly red and partly grey. DIAGNOSIS OF GLANDERS The diagnosis of glanders is especially difficult during the life of the animal when the external parts which are to be examined are either intact or healed, and as a result show changes that are difficult to recognize. All of the former usual methods such as determining the presence of the bacillus, inoculation of guinea pigs, trephining, etc., have been more or less withheld. In animal inocu- lations one must always use at least four to six guinea pigs, because occasionally not all guinea pigs become sick. This should especially be taken into account when one is dealing with chronic glanders. The inoculation follows by using material which has been triturated in a mortar with sterile water and then filtered free from the coarser particles, the injection being made subeu- taneously in the abdominal region between the hind legs. After four to eight days the precrural lymph glands become swollen as does also the scrotum; at the site of injection an abscess develops; the animals die usually in two to six weeks. It cannot be emphasized too strongly GLANDERS 45 that all methods for diagnosing glanders should seriously be taken into consideration. FIGURE 8 Male guinea pig infected with glanderous material. Abscess at the site of infection on the abdominal skin; marked swelling of the scrotum. (Strauss’ reaction.) The clinical symptoms are equally as important as the biological reactions. We do not have to deal with the 46 EPIZOOTICS: THEIR CONTROL DURING WAR solving of mathematical problems but with conditions in the living body. Here the changes are not as constant, so it behooves one to observe all symptoms. It is neces- sary that one have broad training and experience in order to arrive at the correct conclusion in doubtful cases. A decision at times is made not only from objective find- ings in a single case, but also from all circumstances bearing upon it, such as age, the spread of glanders in one group of horses, the equipment of the stables, drinking troughs, the manner of feeding, ete.; in other words, the ease or difficulty of the spread of the glanders bacillus. In a clinical examination one must, above all things, examine the skin for the presence of nodules and ulcers, in which case the points where the harness rests are first to be taken into consideration. Enlargements of the lymph glands and cord-like swellings of the lymph ves- sels, are also to be observed. Following this, a careful examination is to be made of the Schneiderian membrane for nodules, ulcers and scars as well as the presence of a nasal discharge. Coincidentally, we always find painless, firm enlargements of the regional submaxillary lymph glands without elevation of temperature of these glands. Furthermore, one must be on the alert for cough, short- ness of breath and note the general condition of nutri- tion, and finally the temperature must be considered, since in acute glanders the temperature always rises above 38.5° C. (101.8° F.). Aside from the clinical examination, thorough use is to be made of the biological reactions. In this respect what was said above holds good, for they are not infallible, and it is well to use at times this method and at others some other method. For that reason, one should, wherever possible, carry out different tests at the same time. Con- sequently, the following are to be considered: GLANDERS ay The agglutination test. The complement-fixation test. The conglutination test. The ophthalmic test. THE AGGLUTINATION TEST By agglutination we understand the clumping together of microdrganisms, which at the same time lose their mobility. Ageglutination is always observed when one brings together the serum of an artificially infected animal or one that has suffered a natural infection, with the corre- sponding causal bacterium. Those substances which oc- eur in the serum as the result of such infection are spoken of as the agglutinins. As an example, they are found in greater quantities in the serum of a glanderous horse. Such a serum will agglutinate glanders bacilli. Ageglutination of the glanders bacillus is best accom- plished by adding known dilutions of the horse serum to 2 «ec. of a killed B. mallei culture and reading the results after twenty-four to thirty-six hours. When a positive agglutination reaction is finished, the agglu- tinated glanders bacilli have gravitated to the bottom of the tube and formed a broad, irregularly edged, white precipitate,-and the supernatant fluid is perfectly clear. In the event of a negative reaction (no glanders) there are quite a number of bacteria which gravitate to the bottom, but in the deepest portion of the test tube will be found a non-transparent, circular percipitate and the supernatant fluid will be clouded. The agglutinins are specific, 2.e., they will act only upon the causal bacterium with the help of which they were produced in the animal body. In other words, the serum of a glanderous patient will agglutinate only glanders bacilli, and the serum of a typhoid patient will agglutinate only typhoid bacilli, 48 EPIZOOTICS: THEIR CONTROL DURING WAR ete. The agglutinins are not immediately formed in the serum of glanders-affected horses, but it requires about four to five days before we can demonstrate their pres- ence. The quantity of the agglutinins then steadily in- creases, and the development reaches its maximum on the tenth or eleventh day after the infection. This potency remains with but slight variation for two or three weeks and then gradually decreases until after a lapse of about six to nine months, after which the quantity of agglu- tinins will be approximately as great as at the time of infection. It is worthy of note that agglutinating sub- stances are found in the serum of horses free from glanders (normal agglutinins), although they may be present in much smaller quantities. The presence of normal agglutinins forces us, when carrying out the agglutination test, in testing the agglutinability of a suspected serum, not to overlook this fact. It is not only necessary to demonstrate the mere pres- ence of agglutinins, for some are found in every horse, but it is necessary to determine the amount of agglutinins which will act as a criterion whether the serum origi- nated from a glanderous or healthy horse. For that rea- son only a highly diluted serum should be brought together with glanders bacilli because experience in this respect has taught that sera of glanderous horses will still agglutinate in high dilutions but not so with sera from glanders-free horses. The smallest amount of serum that will agglutinate we refer to as agglutination titre and as a rule express this as 1 to 400 or 1 to 2,000, abbreviating this, 400 or 2,000, 2.e., the serum has a max- imum dilution of 400 or 2,000. The higher the agglu- tination titre, just so much greater are the probabilities that the serum originated from a glanderous horse. Healthy horses on the average have an agglutination titre of about 400, 2.e., their serum will agglutinate in GLANDERS 49 dilutions of 1 to 400. However, it 1s not unusual that non-glanderous horses have an agglutination titre of 600, 800 and even 1,000, although this is very uncommon. Gland ers-Seru m. FIGURE 9 Ageglutination. Upper row: agglutination of a glanders serum having an agglutination titre of 1:400 to 1:2000; in all four tubes is a clear super- natant fluid and a broad veil-like, irregularly out- lined precipitate. Lower row: agglutination of a normal serum hay- ing an agglutination titre of 1:400. In a dilution of 1:800 and above no agglutination; fluid cloudy; sharply outlined precipitate. (According to a draw- ing by Dr. Liitje.) 50 EPIZOOTICS: THEIR CONTROL DURING WAR Sera showing an agglutination titre above 1,000 always originated from glanderous horses. Corresponding with the aforementioned increase and decrease of agglutinins during the course of glanders infection, the agglutination titre will naturally become changed, and when the serum of a normal horse shows an agglutination titre of approximately 300, he will, in four to five days after infection, show a rise to 500 and at the tenth to eleventh day a rise of 2,000 to 4,000. In the course of time the agglutination titre gradually decreases and at the end of three or four months will show a maximum of 800; after six to nine months it will have reached the terminal maximum of 300 (Sehiitz and Miessner ). We can conclude from this increase and decrease in the agglutination titre of the serum of a glanderous horse the following: (a) By means of the agglutination reaction it is pos- sible to recognize an infection with glanders in horses on the sixth to ninth day. (b) High agglutination titre bespeaks a recent glan- ders infection. (ce) Horses chronically infected with glanders (those having been sick more than six months) cannot definitely be determined as glanderous by means of the agglutina- tion reaction. THE COMPLEMENT-FIXATION TEST The disadvantage of the agglutination reaction lies in the fact that by its use a case of chronic glanders in a horse cannot, as a rule, be diagnosed. This gave im- petus to inaugurate a second serological test, the so-called complement-fixation reaction. By antigens we mean such proteins (bacterial, eyto- logical, milk, hemotological, ete.) which have the power GLANDERS 51 to cause the production of antibodies in the lving animal. Antibodies have distinctly different character- istics; those which take part in the complement fixation are, according to Erlich’s side-chain theory, two armed— amboceptors, 7.c., they have two distinct affinities. With these they seek to bind on the one hand the antigen and on the other the ever-present complement. Antibodies develop as a result of treating an animal with antigens; they are specific and will unite only with their antigens from which they originated. The antibodies resist heat (thermostabile) ; the complement is destroyed at 56° C. (thermolabile ). This phenomenon can be demonstrated im vitro, which can be made especially lucid by using as antigens blood corpuscles. By injecting sheep blood corpuscles (anti- gen) into a rabbit there are produced the two-armed antibodies (sheep blood anti-serum) which possess affini- ties to join with the blood corpuscles (antigen) on the one hand and the complement on the other. When mix- ing sheep blood corpuscles with sheep blood anti-serum (antibodies) of a rabbit in a test tube, a binding of the antibodies with the blood corpuscles results and this binds with the complement in the serum. This action is indicated by the appearance of a red color which is caused by the red corpuscles going into solution— hemolysis (+). If the sheep blood anti-serum (sensitized rabbit serum) is previously heated to 56°C. (132° F.), «e., inactivated, there will be no hemolysis because at this temperature the complement is destroyed—the comple- ment being the lytic factor. The combination of antigen and heated anti-serum in which the thermostabile anti- body (amboceptor) is contained, but the thermolabile complement missing, we designate the inactive hemolytic system. If one adds to this system normal guinea pig 52 EPIZOOTICS: THEIR CONTROL DURING WAR serum (complement) hemolysis will be produced due to the complement in this serum. It is to be deduced from this that in order to produce hemolysis, the com- plement is always used and bound (a similar action takes place in bacteriolysis as well as in the union of any antigen and antibody). The complement fixation reac- tion and its use as a diagnostic test rest upon these facts. As an example, if we bring the serum of a glanderous horse, which serum has been previously heated to 56° C. in order to destroy the thermolabile complement, to- gether with glanders bacilli, then the one arm of the amboceptors in the serum will show an affinity for the glanders bacilli and the other for the complement. Since the glanderous horse serum was previously heated, the complement was destroyed and consequently one arm will remain free. But if we add some complement arti- ficially ; that is, by the addition of normal guinea pig serum, the one free affinity of the amboceptor will imme- diately unite with the complement in the guinea pig serum. The complement binding process can be recognized either macroscopically or microscopically ; consequently, in order to make this visible, we use an indicator, which has been mentioned previously in the inactivated hemo- lytic system (Schiitz and Schubert). Experiment No. 1. In a test tube mix inactivated serum from a glanderous horse, guinea pig serum (com- plement) and B. mallei extract. In one hour sheep blood corpuscles and the inactivated sheep blood anti- serum (inactivated sensitized rabbit serum) are added. Solution of the red blood corpuscles can result only if the complement (guinea pig serum) which is free in the test tube unites with the sheep blood anti-serum. How- ever, this is not what takes place since the complement was previously bound to the glanders antibodies. Con- GLANDERS 53 sequently, hemolysis of the blood corpucles does not occur owing to the absence of complement in the sheep blood anti-serum. As a result the blood corpuscles after a time precipitate to the bottom and the supernatant fluid becomes water-clear—inhibited hemolysis (— hemolysis). Experiment No. 2. The experiment will result en- tirely different if we should add in the first part macti- vated serum of a non-glanderous horse together with guinea pig serum (complement) and B. mallei extract. The glanders-free serum does not contain a two-armed antibody for glanders bacilli and complement and as a result there will be no union with the glanders bacilli nor with the complement, the complement remaining free, not fixed. If, after the lapse of an hour, we add the inactivated hemolytic system, the blood corpuscle amboceptor (inactivated sensitized rabbit serum), which has become fixed with its one arm to the blood corpuscles (hemolytic antigen), will act with greater energy on the complement contained in the guinea pig serum and a solution of the blood corpuscles (+ hemolysis) will ensue. The hemolysis can be easily recognized by the appear- ance of a cherry red color in the test tube. Both experiments are expressed in the following for- mal manner: 1. B. mallei extr.+inact. glanders serum + comple- ment; after one hour + bld. corp. anti-serum + bld. corp. = negative hemolysis — 2. B. mallei extr. + inact. normal serum + complement ; after one hour+bld. corp. anti-serum+bld. corp. = hemolysis + The lack of hemolysis is a sign that the suspected serum originated from a glanderous horse; the presence of hemolysis indicating that the serum originated from a glanders-free horse. The complement binding substances will first appear 54 EPIZOOTICS: THEIR CONTROL DURING WAR Complement Inactive k _ Hemolytic System Antigen Antibody ——— aa Inhibition of Glanders Hemolysis Complement : Glanders ~ Normal Serum Antigen B Strangles- Antigen Gianders Serum 56? o1@ al Glandets Antigen Strangles Serum Hemolysis 56° D FIGURE 10 Schematic representation of complement-fixation reaction. A. —hemolysis when using glanders bacilli (anti- gen) and glanders serum (antibodies) as in Experi- ment 1. B. + hemolysis when using glanders bacilli and normal serum as in Experiment 2. C. + hemolysis when using strangles cocci (anti- gen) and glanders serum. D. + hemolysis when using glanders bacilli and strangles serum. GLANDERS 5d after some time following a glanders infection in the horse similarly as with the agglutinins; also a consider- able interim elapses as in the agglutination process. As a rule they can first be demonstrated in a serum of glanders infected horses on the twelfth to the fourteenth ee 2 3 4 5 6 > 2NaCl (3NaCl anact “lanact + “anacl, 3 INaClh | ; ‘nach, : ee wees on RDO Figure 11 Complement-fixation experiment. Tubes 1 and 2 contain the suspected serum; 3 and 4, the known glanders serum as control; 5 and 6, the known normal serum as control. The last six tubes serve as controls in order to determine whether the substance employed im the experiment react as they should; extract (E), complement (C), sheep blood anti-serum (A), blood corpuscles (B), and salt solution (NaCl). day. Deducing from this one can conclude that the com- plement fixation method for diagnosing of a recent case of glanders is not so well suited as the agglutination reaction, but on the other hand the complement binding substances (glanders antibodies) remain in the serum of a glanderous horse much longer than the agglutinins; consequently, the complement fixation method can still 56 EPIZOOTICS: THEIR CONTROL DURING WAR be applied for some time in chronic cases of glanders, in which instance the agglutination reaction would not be applicable. In such cases (chronic glanders) the com- plement fixation method is of inestimable value. In the case of the agglutination reaction, it is neces- sary to reckon with very high dilutions of the suspected horse serum, whereas in the complement fixation method this is not the case, and we can express ourselves in a more lucid manner by using actual figures to show the quantity of serum used in every experiment. Experience has shown that all sera originating from glanderous horses, used in the quantity of .2 ¢.c., are able to bind the landers bacilli and complement. We designate the smallest amount of serum that will still bind the com- plement as fixing titre (potency) or binding titre. We can deduce from this that the smaller the binding titre just so much more certainly has the horse glanders. The agglutination and complement-fixation methods supple- ment one another in a very desirable manner since the agglutination method gives us an idea how recently the horse was infected, and frequently the approximate duration of the glanders infection. This is also the reason why Schiitz uses both methods for diagnosing elanders. THE CONGLUTINATION TEST Cattle serum which has been inactivated by heating to 56° C. (132.8° F.) has the ability to agglutinate red blood corpuscles (sheep) if active horse serum (not heated) is added. Neither horse serum nor inactivated cattle serum can produce this agglutination separately. In this action the blood corpuscles become clumped to- gether in a fibrous-like mass, which equals positive con- glutination (+) and the fluid which originally was a cloudy red is now clear and colorless. This reaction is caused by the thermostabile conglutinin which is present GLANDERS 57 in the eattle serum and is also known as colloid. The conglutinin will act only if the red blood corpuscles are bound to the complement (alexin) of normal horse serum by means of the two-armed normal amboceptors (sensibilisin) that occur in cattle serum. If the com- plement is missing, there will be no conglutination. The unaffected (not sensitized and alexinized) red blood cor- puscles gravitate to the bottom of the test tube and the supernatant fluid becomes water clear (negative con- elutination) as in negative hemolysis. The conglutination test accordingly can be used in a similar manner as the complement fixation test for diag- nosing glanders, except that in place of the complement- containing guinea pig serum, one uses the complement- containing serum of a normal horse, and in place of using sheep blood antiserum (sensitized rabbit serum), one uses inactivated cattle serum (conglutinin). The absence or presence of conglutination of the red blood corpuscles serves as an indicator, 1.¢e., whether the complement was bound or not bound, and accordingly whether the suspected horse serum originated from a elanderous or nonglanderous horse (Pfeiler and Weber). Experiment No. 1. In a test tube add to a mixture of inactivated glanders serum and B. mallei extract, normal horse serum (complement). After the lapse of one hour, sheep blood corpuscles and inactivated cattle serum (conglutinin) are added to this. Conglutination of the red blood corpuscles could occur only if the com- plement (normal horse serum) were free (not bound) in the test tube and, with the help of normal amboceptors in the cattle serum, unite with the red blood corpuscles. This does not occur because the complement was pre- viously united with the glanders antibodies. Conse- quently conglutination of the blood corpuscles does not occur, owing to the absence of complement, which indi- 58 EPIZOOTICS: THEIR CONTROL DURING WAR cates that the suspected serum originated from a glan- derous horse. Experiment No. 2. The experiment will result dif- ferently as soon as we bring together the inactivated serum of a glanders-free horse and normal horse serum (complement) and B. mallei extract. The glanders-free serum does not contain a two-armed antibody for bind- ing the glanders bacilli and complement; consequently there will be no union with the glanders bacilli or with the complement—the complement is not bound. If after the lapse of one hour we add red blood corpuscles and inactivated cattle serum (conglutinin), the red blood corpuscles can be so influenced by the use of the available normal amboceptors and the complement of the normal horse serum, that the cattle serum will bring about conglutination of the red blood corpuscles. Both experiments are expressed in the following formal manner: 1. B. mallei extr.+inact. glanders serum + normal horse serum; after one hour + inact. cattle serum + bld. corps. =— conglutination. 2. B. mallei extr. + inact. normal serum + normal horse serum; after one hour + inact. cattle serum + bld. corps. = + conglutination. The absence of conglutination indicates that the sus- pected serum originated from a glanderous horse; the presence of conglutination indicates the serum originated from a glanders-free horse. The conglutination test is carried out analogously to the complement fixation test with which it primarily has great similarity. Consequently what was said in regard to the complement fixation test also applies here. It is frequently used as a control on other serological tests and is at times used to diagnose chronic cases of elanders instead of using complement fixation tests. The GLANDERS Complement Horse ser. Glanders Antigen Antibody % Inact. Cattle Ser. Wel Blood Corp. Glanders Antigen Norm.Serum 56° Soa Strangles- Antigen Glanders Serum Glanders- Antigen 5 (> # erale one Red Blood Figure 12 Schematic representation of conglutination reac- tion. A. —conglutination when using glanders bacilli (antigen) and glanders serum (antibodies) as in Eixperiment 1. B. + conglutination when using glanders bacilli and normal serum as in Experiment 2. C. + conglutimation when using strangles cocci (antigen) and glanders serum. D. + conglutination when using glanders bacilli and strangles serum. 59 60 EPIZOOTICS: THEIR CONTROL DURING WAR conglutination test, due to its more simple character, is often preferred to the complement fixation test; also, the latter requires the tediously produced sheep blood anti- serum (sensitized rabbit serum) and expensive guinea pig serum, whereas with the conglutination test one can use the easily obtained normal sera of cattle and horses. Examining the Sera of Suspected Cases of the Ass and Mule The normal sera of the ass and mule contain sub- stances that bind guinea pig complement of their own accord (without first binding with B. mallei extract). We can quite naturally see that upon adding the inacti- vated hemolytic system, solution of the red blood cor- puscles does not occur due to the lack of complement. Consequently the complement fixation test for these sera is not applicable when endeavoring to make a diagnosis. This also apples for some normal horse sera, although this is very rare. The exact nature of these complement binding substances is not well understood, but in all prob- ability they are normal amboceptors which on account of their peculiar behavior toward guinea pig complement are spoken of as anti-complementary normal amboceptors. The above-mentioned sera possess no anti-comple- mentary characteristics toward the complement in horse serum. Therefore, in the diagnosis of glanders in the ass and mule as well as in a few horses whose sera bind normal guinea pig complement, it is highly desirable, if not necessary, to use the conglutination method in which the complement of horse serum determines the reaction instead of the guinea pig complement. Schiitz and Waldmann introduced the modified com- plement fixation method for these sera. It resembles a conglutination method, but instead of sheep corpuscles being used guinea pig blood corpuscles are used. This method is referred to as the K. H. method. GLANDERS 61 THE OPHTHALMIC TEST Theory of Action It is well known that in the ophthalmic test a prepara- tion containing glanders substance (mallein) is brought in contact with the conjunctiva. In glanderous horses there develops after ten to twenty hours an inflammatory swelling of the conjunctiva accompanied by a purulent discharge. The development of this reaction can be explained according to Ehrlich’s side chain theory; the glanders substances in the mallein (antigens) endeavor FIGURE 13 (a) Mallein; (b) antimallein; (c) complement (serum + leukocytes). to unite with the antibodies which develop in the body of the glanderous animal. It is well known that the anti- bodies are composed of two uniting arms (haptophore eroups), one of which attempts to unite with the antigen (mallein), and the other with the complement. The com- plement, a fermentative substance, occurs in serum and has as its origin, at least in part, in leukocytes. Conse- quently, one can readily see that at the site where the mallein was applied, following the union of glanders antibodies and glanders antigens, a serous fluid and white blood corpuscles will be drawn to that locality ; and as a consequence inflammation and exudation re- sult, leukocytes being mixed with the exudate. According to this theoretical discussion, one can read- ily understand the development of the reaction, the swelling of the eyelids and the purulent discharge. As 62 EPIZOOTICS: THEIR CONTROL DURING WAR the result of the incomplete destructive action of the complement on the mallein, peptones are developed in the body which are poisonous, and they cause a rising temperature. According to this it is self-evident that the mallein must be brought in the closest contaet with the mucous membrane in order to produce a satisfactory reaction, 7.e., it should draw serum and leukocytes to the part. Performing the Test According to my personal experience, I have gotten very good results with that form of mallein known as Malleinum siccum—F oth (dry mallein). I have no expe- rience with other preparations. My observations have proved to me that it is necessary to become well ac- quainted with the strength of the preparation which one uses and always to use mallein coming from the same source (same firm), because there is no doubt whatever that the method of preparation, density and virulence of the bacteria used have a decided influence on the character of the reaction. In some localities a fluid mallein is being used and it is remarkable that quite a few positive reactions are obtained in glanders-free horses. This can only be explained by the presence of preservatives in the mal- lein, which have an irritating action on the mucosa and cause the animals to rub themselves on halter chains and eribs, which readily leads to a resulting inflammatory process. It is also possible that fluid mallein after some time may spoil and the resulting products act as irri- tants to the mucous membrane. Considering these facts I cannot recommend too strongly the exclusive use of dry mallein which will not cause any of the aforementioned false reactions. Malleinum siccum—Foth (dry mallein) is prepared from a 4.5 per cent glycerin bouillon culture of B. mallei. a ae GLANDERS 63 In order to maintain the virulence of the glanders bacilli, only such strains are to be used that have been passed through field mice, guinea pigs or cats. Cultures are erown on a large seale in flasks of 100 to 250 ce. for three weeks at 37.7° C. (99.8° F.), and then after testing for purity, it is concentrated to one-tenth of its original vol- ume by heating at a constant temperature of 76° C. (168.8° F.). Following this it is filtered through Swed- ish filter paper. This fluid mallein is then slowly poured into twenty-five to thirty times its volume of absolute aleohol. Almost immediately a dense, fine white precipi- tate results. This precipitate is then, after twenty- four hours, collected on absorbent filter paper, freed from alcohol and finally dried in a vacuum in the pres- ence of freshly dehydrated calcium chlorid, without — heating. The final product is a very light voluminous, vellowish white, not entirely hygroscopic powder which should form an absolutely clear solution in water. This ean be had on the market in tubes containing .03 of a eram. The powder is placed into any small available dish and in order to prepare a one per cent solution 3 «.c. of physiological salt solution or sterile water are added to it. Complete solution takes place very quickly. With an ordinary small camel’s hair brush, a little of this mallein solution is painted on the inner surface of the eyelid. It is not difficult to execute this simple process even upon the most nervous horses. It is much to be preferred to other methods such as the introduction of the mallein with a pipette or a glass rod; also when applying the mal- lein to a large number of horses at one time, as it often happens in practice, one does not always have satisfac- tory control so that the drop of mallein may not go into the conjunctival sack. This would also prove to be the ease under poor stabling conditions or where there was 64 EPIZOOTICS: THEIR CONTROL DURING WAR poor light. Considerable material is also wasted by this method. Furthermore, it is necessary to remember that as soon as the drop of mallein is placed in the eye, the horse immediately closes the eye and most of the fluid is forced out by this sudden movement, which prevents the most important feature in malleinization, 7.e., the intimate union between the mallein and the conjunctiva, which alone can produce a reaction. Judging the Reaction After about twelve hours following the malleinization, the horses are to be examined in order to see what reac- tion has occurred. In the healthy horse the eyes will be unchanged. Occasionally one may observe a _ slight mucous discharge, which, however, cannot be looked upon as a true reaction, but nevertheless it should be noted on the examination list with a plus sign (+). Glanders-sick horses show variations in their reaction. The weak reaction (++) is indicated in that the eyelashes are moist and that eventually a small drop of pus is formed. In such cases as well as in those where a serous discharge occurs in a healthy horse, one is forced to closely examine the conjunctival sack itself; this is done by forcing the eyeball back with the index finger of the left hand, which readily exposes the conjunctival sack for examination. In the glanders-sick animal we will find small drops of pus on the surface of the conjunctiva even though the reaction is very slight; in the healthy animal we will find only a mucous exudate. In the medium reaction (+++) the conjunctiva is reddened and at the same time a purulent discharge is noted; also the lower eyelid is swollen and lght is painful to the eye. The strong reaction (++++) is indicated in that besides the purulent conjunctivitis, a swelling of both eyelids and photophobia are present. The very strong GLANDERS 65 Introducing the mallein. Sero-mucous discharge +. Purulent discharge + ++. Ophthalmic reaction. Negative reaction —. Pus drops in conjunctival sac+-. Discharge with pasting together of eyelids ++-++4. FIguRE 14 (After a drawing by Dr. Liitje.) 66 EPIZOOTICS: THEIR CONTROL DURING WAR reaction (+++++) is recognized in that the eyelashes are pasted together by the purulent material and the eye is kept closed; also the animal shows a weakened condi- tion and refuses to eat. Still stronger reactions are shown by a unilateral nasal discharge and swelling of the submaxillary lymph nodes. Reactions such as are indicated by three plus signs (+++), four plus signs (++++) and five plus signs (+++4-+) can never cause a doubt in one’s mind as to their positiveness. The beginner may have trouble in recognizing the weaker reaction, as indicated by one plus and two plus signs and where we find a mucous discharge in the non-glanderous horse. However, if one is always on the alert for a purulent exudate and in- flamed condition of the conjunctiva, one should with a little practice always make a correct diagnosis. In order to draw comparisons one should examine the untreated eye, for in that way the inexperienced individual will be able in a short time to make a correct diagnosis on large numbers of horses even though he is doing so by just casually glancing at them in walking by. He must, of course, be very careful in the doubtful cases in which the skin at the inner canthus of the eye is covered with a serous exudate, to examine the conjunctival sack for the possible presence of purulent fluid. In the event that a doubt still exists, one can apply mallein to the other eye and after twenty-four hours one will usually find that such doubtful cases will give a strong reaction after the second malleinization. As a last resort one ean still use in individual cases the serological tests. Measuring Temperatures Schniirer first demonstrated that every reaction is ac- companied by a rising temperature above 38.5° © (101.3° F.). Through personal experience I could barely con- GLANDERS 67 firm such findings, for I found under certain conditions that the temperature rise was very small at times, some- times not more than 0.2 to 0.3 degrees [Centigrade] and furthermore this only remained for a short length of FIGURE 15 Ophthalmic reaction; degree of reaction ++-+-+. time. Consequently, if one desires to make use of the temperature readings these should be taken every two hours by a responsible person from the tenth to the twentieth hour after malleinization. This is the only way in which one may diagnose doubtful cases and such eases where there is a slight rise of temperature that lasts but a short time. This is not at all practicable in 68 EPIZOOTICS: THEIR CONTROL DURING WAR examining large numbers of horses as is done in the army and should be excluded. Considering the small temperature rises that often occur and can only be determined by the most careful readings, they can be omitted if it is desirable to simplify the method of measuring the temperature. Misleading Results Previously Existing Conjunctivitis Misleading results can be avoided in horses that are already suffering from a conjunctivitis by not submit- ting them to the test. Therefore, it is necessary before carrying out the ophthalmic test to determine the exist- ing character of the mucous membrane, especially where there already exists a conjunctivitis. In cases where there is a very slight watery discharge which occasionally occurs from both eyes in horses, one can nevertheless carry out the test, since one can come to a correct deci- sion by first drawing a comparison between the treated and untreated eye. In ease there is a unilateral conjunctivitis one should apply the mallein to the mucosa of the healthy eye. In cases where both eyes are affected with a purulent con- junctivitis, one must perforce omit the ophthalmic test entirely. Foreign Bodies Schniirer called attention to the fact that occasionally the small hairs of the brush or small pieces of glass which chip off in opening the mallein tube might give rise to a misleading reaction. In a like manner small particles of hay or straw or lime from the wall may produce a purulent discharge. In all such cases one should care- fully examine the conjunctival sack for the presence of possible foreign bodies. GLANDERS 69 Previous Removal of the Discharge It is possible, especially in the army, that the secretion might be wiped away, because here the attending soldier always endeavors to present his animal in as clean a condition as possible. Consequently, the stable attend- ants should be previously instructed not to attempt to do anything to the eyes of the animals and, during the time under which the horses are under observation, not to clean them. Pervwodic Ophthalmia Occasionally periodic ophthalmia may lead to an incor- rect diagnosis. According to my views, this can only occur where the ophthalmic test is made coincidentally with an acute attack of moon blindness, associated with conjunctivitis. Personally I have had no experience in this respect. However, a critical examination of the eyes should prevent such mistakes in most cases. Strangles and Diseases Simulating Influenza In determining the character of a reaction in a case of strangles, which frequently has associated with it a purulent conjunctivitis, it is necessary to use consider- able careful judgment. No doubt a better plan would be to postpone the time of carrying out the ophthalmic test until after convalescence. In a like manner it is necessary to take into consideration the conjunctivitis . which always occurs in equine influenza. Fly Troubles in the Open In midsummer, when large numbers of flies are always present, the possibility exists that these flies will take up the secretion (especially if slight) resulting from the test and cause one to make a false report on the ex- amination. It is, therefore, necessary to exercise great care when carrying out the ophthalmic test in the open 70 EPIZOOTICS: THEIR CONTROL DURING WAR on very warm days when large swarms of flies are pres- ent (personal communication from Foth). Previous Malleinization According to Schniirer, about .01 per cent of healthy horses that have been repeatedly subjected to subecuta- neous and local mallein injections show a positive re- action to the ophthalmic test. I have had no oppor- tunity to observe such instances; surely the number must be very small, for it is only occasionally that one has to do with horses that have been repeatedly treated with mallein. Applying the Ophthalmic Test Since the good results obtained in the combating of glanders in Germany are doubtless due to the proved sero-diagnostic tests, one would not deviate under normal conditions from these methods, the more so, as constant and uniform results are guaranteed when the blood sam- ples are submitted to a central office which will insure cooperative work with outlying points, an advantage which cannot be underestimated. However, in such cases where large numbers of horses are under consid- eration, and which, furthermore, are widely separated and not in close proximity to laboratories and when there are insufficient working forces or transport diffi- culties, etc., ete., and when one is forced to make a quick diagnosis, then it becomes necessary to use the ophthal- mic test in order to combat glanders. The amount of antibodies in the serum is not changed by locally apply- ing mallein in glanders-free horses, so that later when one applies blood examination methods one is not influ- enced because of such malleinization. In antithesis to this, upon the subcutaneous application of mallein, the agglutination and complement fixation titres are in- creased, so that healthy horses will appear glanderous. GLANDERS 71 The ophthalmic test should be given preference to the serological methods in diagnosing suspected cases of glanders because of the simplicity of its application and the rapidity with which it enables one to establish a diagnosis. The confusion of blood samples which oceurs at times is also excluded when applying the oph- thalmic test. As in all other tests, in order to judge the reactions correctly, a certain amount of experience is necessary, especially when dealing with doubtful cases. Consequently, the beginner will do well to apply the ophthalmic test a second time in doubtful cases and to separate such horses from others and await the results from a serological test. Directions for Applying the Ophthalmic Test 1. Enough malleinum siccum (dry mallein) and camel’s hair brushes for the treatment of twenty horses. 2. A dose of mallein is prepared by mixing it with 3 ec. of sterile water or physiological salt solution and then well shaken to bring about its solution. 3. The camel’s hair brush is dipped into the mallein solution and the lower conjunctival sack of one eye painted with it. 4, About 12 to 20 hours later the degree of reaction in the eye is observed and a note made accordingly with the following marks: —=Conjunctiva unchanged, no discharge. += limited sero-mucous discharge. ++ = Discharge mixed with drops of pus. +++ = Purulent discharge, lower lid swollen, photopho- bia. ++ = Purulent discharge, lower and upper lids swollen, photophobia. H+++=Strong purulent discharge, both eyelids swollen and pasted together; photophobia; weakness. 12 EPIZOOTICS: THEIR CONTROL DURING WAR 5. After noting the degree of reaction, the same eye in all weakly reacting horses is again treated with the mallein solution (see No. 2). 6. About 12 to 20 hours later the degree of reaction is noted in this second examination. 7. All typically reacting horses are to be isolated im- mediately. 8. Horses that are to be looked upon as reacting typic- ally have in the conjunctival sack or in the inner angle of the eye, a distinctly fresh drop of pus or a purulent discharge has formed. This is to be noted in the record with, at least, a two-plus mark (++). COMBATING GLANDERS Biological Methods of Examination (a) Blood Examination First Blood Examination: The examination of the sera of all suspected animals, by means of the aggluti- nation and complement-fixation tests, has proved emi- nently satisfactory in Prussia, and extensive use of them is made in time of war. More recently the conglutina- tion test is also being used. For these purposes, blood examination stations have been arranged near the front, to which are brought the blood of the suspected army horses for examination. All horses of the army are to be examined by means of serological tests. The withdrawal of the blood is done wherever pos- sible by the veterinarians of the hospitals, horse depots and divisions of the reserve troops. The necessary blood tubes and needles are obtained from the blood examina- tion stations or institutions from that district and for- warded by special messenger in order to avoid any pos- sible delay. The results of the blood examinations are GLANDERS 713 to be communicated to the horse hospitals, divisions of reserve troops, etc. In withdrawing the blood, one should first observe that the needle is free from any particles of blood, which might, as the result of a previous withdrawal of blood, still be clogging it. This is accomplished by thoroughly rinsing it in clear water; secondly, the tube should be ‘ so marked as to define its source in order to avoid any possible confusion with other blood samples. After recording this special mark, the horses are to be numbered consecutively, which is best done by cut- ting the hair, branding or braiding a numbered tag in the mane or tail. In this way only is it possible to avoid losing the identification of an animal. The filled and marked test tubes are sent to the blood examination station and there examined according to the usual methods. The blood examination may require about three days and, considering the time required to arrange laboratory apparatus, the sending of the blood specimen and sending of the report to the troop, it will require under the most favorable transport conditions at least a lapse of eight days. Horses that are reported as suspected of being glan- derous, according to the findings of the blood examina- tion, should be destroyed. Repeating the Blood Examination If there are clinical cases of glanders among a group of horses at the time of the first withdrawal of blood ‘or which were proved glanderous by means of sero- diagnostic tests, a further blood examination is to be earried out after two to three weeks. This is done for the purpose of detecting any horses that might have been in the incubative stage at the time of the first examination and separation of glanderous horses. From 74 EPIZOOTICS: THEIR CONTROL DURING WAR foregoing remarks, it is seen that definite results are obtained with the agglutination test on the sixth to the ninth day after infection and with the complement fixa- tion test on the fourteenth day. Consequently, horses which were in the incubative stage at the time of the first withdrawal of blood, were not proved to be infected }Dausb boda Tle lct Ta Ol slaloleb blo i. aaenen gel -|\Comp1|0ph HH 2000}0,01 oo | ad ad 1s "| 1s a) bd | le} Lal je] le : VU GSA SERA DSe ee awe iver 10.) 1 OO a6 A HA vey TT FIGURE 16 Graphic representation of the agglutination and fixation titre as well as the ophthalmic reaction during the course of a glanders case. by such sero-diagnostic tests and are only recognized upon performing the second test. As a result of this it is often necessary to perform a third and even a fourth blood examination, when the possibility exists that glanders has again made its appearance in a locality. The changes in the agglutination and complement fixation titre, as well as those occurring in the conjune- tival reaction, should be shown in the record in the form of a curve (see illustration 16). GLANDERS 75 Ophthalmic Test In such cases, where difficulties are met in the trans- portation of blood tubes or other necessary apparatus, as in the case where troops are miles away from a rail- road station, or in cases where troop advancements are executed during the examination, serological tests can- not be carried out. In such instances free use should be made of the ophthalmic test. 3 All horses that show a positive ophthalmic reaction are to be killed. For the purpose of bringing about the necessary con- trol in detecting the presence of glanders, I consider it expedient, at least in the case of the eastern army, to apply the ophthalmic test to all troop horses that are either on the firing line or on the march. Its application is always possible and assures an immediate finding of the largest number of existing cases of glanders. Sero- logical tests should be postponed until some later time, when the troops have the assurance of being given a fairly long rest by being placed_in the reserve or per- manent quarters, where such tests are more applicable. A quickly completed examination of all horses is made possible, also the work in combating glanders is con- siderably lessened, by systematically applying the oph- thalmie test and the blood examinations. Individual blood examinations, without considering the duties and location of troop horses at a given time, are not to be recommended; they burden the blood examination sta- tions entirely too much without giving the desired advantage. The following is the type of record cards forwarded to the blood examination stations to be filled out by the veterinarians who withdraw the blood samples and apply the ophthalmic test. 76 HEPIZOOTICS: THEIR CONTROL DURING WAR PeAsresqo oq 0} 91 SME] [E90] 94} SUOSIed Axeyiur Aq pauMmo sasi1oy JO sased uy $991}0U SUIMO][OJ 94} SAIVSGO Poo[q 94} SUIMEeAPYIIM J10joq pue Spied 9y} yNO Surypy uy ua sequin B12 Joaquin B}O Joqunn 4oquinn s}|nsoy ah Toby oo eto as [8149S peyoL Zuoijeurwexy Syeuloy jo psovoy poujwexy sty} jo suoljeulwmexy [eAluy 8g Peon saqunn jo JOqUINN jo 9}eq sesioy yo! snosapurly a Bulog jo pa}oedsns soqunn Anode pw] O 4sq Win (sUUIN[OS ZUIMOT[OF UI BJep [][B psode1 Pynoys salojesoqeT) “UOTJBUTIUIBX)T JO S}[NsoYy ((93@ ‘uoipenbs ‘jueunseay ‘ucrze}7G JUNOUIDY) COs et ia MC Ye a OS ec Tat TT Te ee ea ar ei ae ar Cs ee Tt ee ee a a ee ee Me er er ee Tn) : fo t GLANDERS v ys0] O1Wjey}ydQ pue Asdoyny JO S}Jnsoy {Asdojny ‘swo}dwAs oseosiq TSyeWOY aS sasuoH jo Joquny Jo owey ‘C ‘T (sa1qeys 4891 poojg JO uolzeUsOsU, pollejoq) jo Joqunn 4J9UMQ JO doouy yo uolsiAig @Al}No9su0g EPIZOOTICS: THEIR CONTROL DURING WAR 78 qZ 7 5 49 ce) a I ea "yexig-"wajdwog| uoljeunnsby |*yexi4-"wajdwog|] UoleuNBGy |*yexiy-"wajdwog}] uoleunn bby PouyeW PouyoW PpouyeW ajdwes poojg “Il! sjdwes poojg “II ajdwes pool “| GLANDERS 79 Instructions for Withdrawing Blood and Filling Out Record Cards For withdrawing blood a needle is introduced into the jugular vein, and the blood allowed to flow into a sterile glass tube which is filled about three-quarters. Every tube should be immediately stoppered and given the correct serial number. The label should be placed as near the opening of the glass as possible (top of tube) in order to avoid defacing the label or losing it entirely when placing it in and out of the rack, ete. The blood specimens are well packed and sent to the nearby blood examination stations; one should also make certain that they will be kept as cool as possible. The blood specimens should be numbered consecutively under all conditions and be recorded in column one in this manner, as well as. when being placed in the test tube racks. In recording the results of the blood ex- aminations only such numbers are to be used. Blood ~ samples which do not conform to these demands cannot be examined. In column three, the names or numbers of the horses are to be recorded. The remaining columns are to be filled out properly, the fourth column being especially important. It is very important to mention the suspected cases as well as the probable time of their infection or the exact time when infection could no longer have occurred. In a like manner it is very important to record the day when the blood was withdrawn. In order to prevent the blood of one horse be- coming mixed with that of another, the hands should be washed thoroughly after each bleeding; a new needle is to be used for every horse or in case that they are not available, those having been used may again be used after removing all signs of remaining blood. 80 EPIZOOTICS: THEIR CONTROL DURING WAR A short notation should be made in column eight as to the dates of applying the ophthalmic test and the results of the same (positive ++, doubtful +, negative —). Under remarks, in column four, one should note whether dealing with glanders-suspects, glanders-car- riers, or glanders-free horses. Care of the Needle The needles are obtained from the laboratory in a clean sterile condition. They should never be sterilized in the flame or with dry heat. After blood has been withdrawn, the needle is to be washed in cold water by using the wire stylet; however, they should not remain in the water any longer than necessary. Following this they should be rinsed in aleco- hol, dried with moderate heat, and vaselin applied inside and outside. The needles are always to be returned with the blood specimens and record ecards. Immunization Passive Immunization Passive immunization of horses has as yet not proved satisfactory, chiefly because no serum has been obtained that was high enough in potency. Active Immunization with Virulent Glanders Bacilla Active immunization has not given practical results, because on the one hand it is dangerous to produce a glanders vaccine, and on the other no satisfactory immu- nization can be obtained. Furthermore, there is too much danger connected with the handling of virulent elanders bacilli. Active Immunization with Attenuated or Killed Glanders Bacteria or Glanders Extract The attenuation of the bacteria was performed by ani- mal passage, prolonged cultivation of the bacteria on GLANDERS 81 artificial media, preservation of cultures at low tempera- ture, previously handhng with cattle bile or serum, with- out showing that such vaccine materials had any prac- tical value. Recently Levi, Blumenthal and Marxer be- heve they have gotten better results by using bacteria attenuated in a solution of urea. There are no corrob- orative tests up to date that have proved the value of such immunization. Recently, however, Marxer and Pfeiler produced an immunity with large quantities of bacterial substances and their extracts, but since no experiments have been carried out up to date, no opin- ion can be expressed on the efficiency of this method. Notation: The simultaneous method, 2.¢., the simul- taneous application of a serum and bacteria or bacterial extracts precludes itself because we have no efficacious serum at our disposal. ATTEMPTS AT CURING The author has carried out numerous experiments for the purpose of curing by using salvarsan on animals that were artificially infected with glanders, but always had negative results. Recently similar experiments were carried out on naturally glanderous horses with neosal- varsan. According to the publications of a number of Russian authors no healing influence whatever was ob- tained from the use of this preparation on glanderous lesions nor did it check the spread of glanders. Even after using five grams of neosalvarsan several times, the new formation of glanderous nodules in the lungs of horses was not prevented. VETERINARY POLICE REGULATIONS In the first place, glanders is introduced by means of glanderous horses; it was proved in ‘this war that the 82 EPIZOOTICS: THEIR CONTROL DURING WAR spread of glanders in our army was due to captured and requisitioned horses from occupied territories. There- fore, these horses should not be brought in contact with service horses until they have been proved free from glanders by means of the ophthalmic test. Horses looked upon as glanderous in liew of clinical lesions or from the results obtained by means of biological tests, are to be killed immediately and the non-mutilated cadavers removed. In every outbreak of glanders it is necessary to determine how it was introduced. Imme- diate notification is to be sent to military divisions that receive these glanderous horses and also to those to whom horses were forwarded within six months previous to the outbreak of the disease. Stock that is considered to be capable of infecting other animals with glanders are all to be given the ophthalmic test and examined with other serological tests with the object of actually determining whether they are glanderous or not. All such horses are to be kept isolated until the conclusion of the examina- tions. ’ v = ae ' ‘ " > i Sop rs 3 ¢, 2 & MP nt DOURINE ETIOLOGY OF DOURINE Dourine is caused by the Trypanosoma equiperdum. Trypanosomae belong to the unicellular forms of animal FIGURE 23 Trypanosoma equiperdum: (a) flagellum with undulating mem- brane; (b) principal nucleus; (c) blepharoplast; (d) vacuoles; (e) chromatin bodies; (f) erythrocyte; (g) polymorphonuclear leukocyte. (After a drawing by Dr. Liitje.) life (protozoa) and live in the serum, in which they move between the red corpuscles in a lively wave-like, tortuous manner. Their bodies are about 10 to 15 micra 155 156 EPIZOOTICS: THEIR CONTROL DURING WAR long and tapered at each end. The blunter end is pro- vided with a long flagellum. In the inner parts of the parasite, a principal nucleus is found in the approximate center and a secondary nucleus or blepharoplast in the posterior end. The flagellum originates from the ble- pharoplast and follows next to the body as an undulating membrane and then projects as a long thread from the anterior end of the protozodn. It is frequently very dif- ficult to demonstrate parasites; at times one succeeds in doing this in smears of the prepucial secretion (smegma) or of the urethral secretion, and in the fluid which escapes upon incising a raised area (plaque). It can be more certainly demonstrated by experimentally inoculating mice, rabbits or dogs. In the consideration of the small number of trypanosomes, it was found desir- able to use at least 20 to 30 mice or other experimental animals and to infect these with prepucial secretion, fluid from the plaques or with defibrinated blood. This ex- periment does not always result in a positive manner, but nevertheless a few animals become sick, and in the course of a week one then comparatively easily finds the trypanosomes in the blood. Preparation and Staining of Blood Specimens A fresh drop of blood from a puncture wound is caught on the narrower edge of a clean glass slide. The narrow edge of a piece of filter paper having the same form as the glass slide is dipped into this drop and drawn with the free end to the opposite narrow edge of the glass side. In this manner the drop of blood between the filter paper and the glass slide is spread out over the slide into a very thin film. (a) Simple staining. After fixation (with flame or alcohol) of the preparation, stain with carbol-fuchsin one-fourth minute and rinse in water. DOURINE 157 (b) Rapid staining according to Giemsa. The prep- arations are first fixed by placing them in a mixture of aleohol and ether for one-half hour. After completely FIGURE 24 Dourine. Unpigmented spots on the vulvar lips. drying, they are placed in a freshly prepared solution of ten drops of Giemsa’s stain (Dr. Griibler, Leipzig) with 10 ce. of distilled water for twenty to thirty minutes. Rinse in distilled water and dry. 158 EPIZOOTICS: THEIR CONTROL DURING WAR SPREAD OF DOURINE Dourine is the only protozoan disease known at the present time which is not transmitted by means of inter- mediary carriers but is transmitted by direct contact from animal to animal. Infection always occurs during coition, and the disease is transmitted entirely by means of coition through mares and stallions infected with dourine. Dourine can be termed only conditionally a war plague, since among army horses themselves it will play but a subordinate part, because being spread only through the sexual act, it is not given an opportunity to become generalized. The reason why dourine has, in spite of this, been mentioned in this book, lies in the fact that the captured horses, especially those originating from Russia and which are used in the interior for breeding, have spread the disease to our home-bred stal- lions and in that way also to our mares. - Therefore, when delivering horses captured from Russia, particular attention must be directed toward this disease and only horses whose non-suspicious character is ensured after being kept under observation for a prolonged period should be used for breeding purposes. Due to the fact that dourine runs a chronic course and is very difficult to diagnose, which is often the case, it is most expedient not to use for breeding purposes horses captured from Russia. This regulation appears all the more justified since, according to the experiences so far with dourine among horses that originate in localities where the dis- ease is indigenous, the disease runs such a mild course that its diagnosis is clinically impossible. Not until our native stallions have covered Russian mares and after that again have served a large number of native mares, does dourine become evident among our animals. Our DOURINE 159 horse husbandry seems just at this time to be in great danger through the introduction of horses captured from Russia, which are afflicted with latent dourine; therefore, we must attempt by all possible means to pre- serve the good health of our expensive breeding mares. This circumstance should lead to a general prohibition of the use for breeding purposes of horses captured from Russia. FIGURE 25 Dourine. Swelling of the udder. SYMPTOMATOLOGY OF DOURINE The period of incubation varies from one week to several months. First Stage Stallions: In the male animal one will observe swell- ing of the testicle, sheath and penis. The urethral mucous membrane is loosened and slightly reddened. 160 EPIZOOTICS: THEIR CONTROL DURING WAR Very often a mild, slightly clouded discharge exists. Fre- quently there is difficulty in micturation. Mares: In the female animal we find there always exists first of all a loosening of the vaginal mucous mem- brane associated with the formation of a slightly mucous and clouded exudate. The lips of the vulva become swollen, but above all one observes on the otherwise pigmented skin of the vulva and the region of the anus, non-pigmented spots (toad spots) which surround the edge of the vagina and the opening of the anus. With this is associated a swelling of the udder and the neigh- boring subcutaneous tissue, in which manner the sub- cutis from the udder to the external angle of the hip may become changed into an edematous mass. The swell- ing may incidentally disappear only to suddenly reappear. Second Stage During the course of weeks or months, rounded or elon- gated swellings of the skin occur on different parts of the body in mares and stallions. The hair at these locations is staring and the swelling feels soft and slightly ede- matous. The form and size of these patches (plaques) vary considerably. Frequently they attain the size of the hand but are not always regularly outlined. As a rule these patches remain only for a few days, then dis- appear entirely or reappear on other parts of the body. They do not leave a residuum. Third Stage Symptoms of paralysis appear coincidentally with atrophy of the musculature. The hind feet are moved forward in a scraping, dragging manner. The symptoms of paralysis may become so severe that the animal falls, ‘‘ooes down,’’ and is no longer in a condition to rise. DOURINE 161 At times the paralysis extends to the facial muscles and causes the upper and lower lips to be drawn in a slanting manner. Likewise, paralysis of the penis may FIGURE 26 Dourine. Swelling of the testicle and penis. Paralysis of the penis and beginning gangrene. (After Lorenz and Miessner. ) ensue. It hangs in a limp manner and as a result in- juries occur that develop into gangrenous processes, which may cause the death of the animal. 162 EPIZOOTICS: THEIR CONTROL DURING WAR Fourth Stage During this last stage cachexia rapidly develops so that when death ensues the animal is reduced to a mere skeleton. PATHOLOGICAL ANATOMY OF DOURINE The mucosa of the vagina and vulva is thickened and has undergone cellular infiltration. The tissue surround- ing the udder has undergone a gelatinous metamorphosis. The scrotum and tissue of the penis have undergone a similar edematous swelling. The lymph nodes near the genital organs are enlarged and upon section appear moist. The musculature is fairly dry. Just the opposite to this, however, we find that the intermuscular fibrous tissue, especially where the nerves pass through (hind limbs), has undergone a pappy, gelatinous metamor- phosis. The lumbar portion of the spinal cord has at times become entirely softened and the bone marrow has a red color. DIFFERENTIAL DIAGNOSIS OF DOURINE Glanders Dourine can be confused with glanders in eases in which glanders affects the genital organs, as occurs some- times when stallions with affected testicles are used for service. The appearance of ulcers on the vaginal mu- cous membrane and on the inner surface of the thigh, which never occur in dourine, as well as the absence of unpigmented spots and plaques, guards against error. Coital Exanthema Coital exanthema consists of an exudative inflamma- tion of the vulva and vagina of the mare, or the prepuce and penis of the stallion. The exanthema is character- ized by vesicles, which soon rupture after their forma- DCURINE 163 tion, leaving superficial erosions. This may lead to swell- ing of the mucous membrane of the vagina, on the pre- puce and on the lower end of the penis. The course is FIGURE 27 Pustular skin eruption. Unpigmented spots on the skin fold between the vulvar lips and muscles of the thigh. (After Miessner and Evers.) mild and complete recovery occurs in two to three weeks. The typical lesions, which occur on the udder and skin in dourine as well as the paralytic symptoms, are absent. Contagious Pustular Cutaneous Eruptions of the Genitals Not until recently did I have opportunity to see, in company with Veterinarian Evers, in a number of mares 164 EPIZOOTICS: THEIR CONTROL DURING WAR that had been covered by an imported Belgian stallion, unpigmented spots (toad spots) on the skin which were very suspicious of dourine. These spots occurred in the fold of the skin between the muscles of the thigh and vulvar lips. These unpigmented spots represented the remains of previous pustular nodules and ulcers the site of which had been in the previously mentioned fold. of the skin. Furthermore, the Belgian stallion, as well as the home-bred stallion of the farm that had again coy- ered some of the mares after they had been covered by the former, showed on the skin of the penis in each case two or three sharply defined unpigmented spots about the size of a lentil. The course of the disease in all animals was mild. Swelling of the testicles or udder, plaques and paralytic symptoms were absent. Further- more, the unpigmented spots of dourine always occur on the skin of the vulvar lips (see Fig. 27). COMBATING DOURINE Serotherapy and Chemotherapy Up to the present time no success has been attained in producing either an active immunity by using atten- uated trypanosomes, or a passive immunity with the serum of animals which had withstood an attack of dourine. Consequently, one must confine the treatment to chemotherapy. According to the experiments of the author, arsenophenylglycin, which was used intrave- nously in doses of 20 grams, has proved itself very suc- cessful. Since more efficient arsenical preparations are being used at the present time, it would doubtless be well to recommend a trial with neosalvarsan in cases where it is indicated; it should be applied similarly as in pectoral influenza, in doses of four and one-half grams dissolved in about 100 c¢.c. of sterile water and injected intravenously. Also, in the second place, trypan-blue DOURINE 165 could be injected intravenously in quantities of 50 c.c. of a one to five per cent solution. VETERINARY POLICE REGULATIONS Since the disease is always transmitted by means of copulation, it is therefore necessary to prevent all sick stallions and mares from copulating for a period of three years. It is, furthermore, necessary to carefully examine at intervals of fourteen days all other stallions in the endangered district that are still healthy and capable of being used for service. Suspected horses should not be allowed to have sexual intercourse until they have been freed from suspicion and should be examined every two weeks by an official veterinarian. Stallions and mares that have had coitus with diseased horses should not be allowed to copulate for one year from the date of the last copulation and may not be changed to another station without the con- sent of the veterinary police. They should be examined every four weeks by an official veterinarian. Lifting the Quarantine The quarantine regulations may be discontinued : (a) In the case of diseased horses, three years after the official veterinarian announces the disappearance of visible disease symptoms ; (b) In the case of suspected animals, just as soon as they can be looked upon as nonsuspicious, according to the official veterinarian’s judgment; (c) In the case of exposed animals, just as soon as they do not show any suspicious symptoms after being held under observation one year, or as soon as it is proved that the animals with which they came in coital contact need no longer be suspected ; (d) After all sick and suspected stallions have been castrated. CONTAGIOUS PLEUROPNEUMONIA OF CATTLE Pleuropneumoma contagiosa bovum (Lungenseuche,) ETIOLOGY OF CONTAGIOUS PLEUROPNEUMONIA The etiological agent of contagious pleuropneu- monia (Asterococcus mycoides) was first cultivated by Nocard and Roux in collodion sacks in the abdominal eavity of rabbits. The virus is so small that it passes through porcelain filters and consequently cannot be demonstrated microscopically. Therefore, one must al- ways rely, in making a diagnosis, on the symtoms in the living animal and the pathological lesions in the dead animal. Only cattle are susceptible to this disease; not even small experimental animals. SYMPTOMATOLOGY OF CONTAGIOUS PLEUROPNEU- MONTA The symptoms of the disease are easily recognized in the living animal by the aid of the following described anatomical lesions. Usually one will observe after an incubation period of three to six weeks, but which may prolong or shorten itself, cough, slight fever and reduced appetite. Somewhat later during the course of the dis- ease larger portions of the lungs may become affected which manifest themselves clinically in increased res- piratory rate. These symptoms may continue more or less for a long time, according to when the process ex- tends to the pleura, which will occur sooner or later. Coincidentally with the appearance of the pleuritis, fluid collects in the pleural sacks, recognized upon percussion by dullness which is limited by a horizontal line. At the same time further rising in the temperature and increased respirations will be observed. The appetite as well as the secretion of milk stops almost entirely. 167 168 EPIZOOTICS: THEIR CONTROL DURING WAR If contagious pleuropneumonia is found to be present in a large cattle station which manifests itself in the herd by a great deal of coughing, then one ean, as a rule, assume that a number of cattle were sick at the time of the arrival of the veterinarian. Animals that are acutely sick stand back from the manger, do not eat, show in- creased body temperature, and auscultation and percus- sion, furthermore, conclusively show that the thoracic organs are involved. Due to the fact that these mani- festations appear not only in this disease, but in others also, a positive diagnosis during the life of the animal is frequently difficult. Therefore, one must always take the post-mortem lesions into consideration and in ease a dead animal is not available for autopsy, a sick animal should be killed. These precautions are especially to be observed since contagious pleuropneumonia has not ap- peared in Germany for many years, and therefore much depends upon a correct diagnosis. PATHOLOGICAL ANATOMY OF CONTAGIOUS PLEURO- PNEUMONIA Contagious pleuropneumonia manifests itself as a fine interstitial process which oceurs in the interlobular pul- monary tissue; therefore, one justly designates conta- gious pleuropneumonia as pneumonia interstitialis or as peripneumonia. The virus, which is probably taken up with the inspired air, finds lodgment in the interstitial tissue where, as a result of irritating the blood and lymph vessels, it produces a marked exudation into the sur- rounding tissue. As a result of this the interstitium expands and acquires a gelatinous nature. Coincident- ally proliferation of the connective tissue takes place; the tissue in between becomes firm and of a whitish-grey color. Gradually the process creeps farther into the interstitial tissue so that soon larger portions of the PLEUROPNEUMONIA OF CATTLE 169 interlobular lung tissue become involved and take on a firmer consistence. At the same time the walls of the larger blood and lymph vessels in the interlobular tis- sue become affected, which then often form thrombi. The vessels upon cross section of these parts of the lung FIGURE 28 Scheme of contagious pleuropneumonia sectioned lung: (a) dis- tended interlobular tissue showing lymph spaces; (b) thrombus; (¢) normal lung tissue; (d) beginning pneumonia in the periphery of the lobule; (e) totally changed lobule—grey hepatization ; (f) totally changed lobule—red hepatization; (g) sphacelus; (h) pleuritis. (After a drawing by Dr. Liitje.) appear as more or less thick plugs or cords, according to whether they are cut tranversely or longitudinally. The changes that have just been described greatly resemble erysipelas in their manner of development as well as in their anatomical appearance. In the inter- lobular tissue, which is composed of many lymph spaces and lymph vessels analogous to the skin, the process 170 EPIZOOTICS: THEIR CONTROL DURING WAR advances rapidly as in erysipelas and can spread over large areas in a short time. Schiitz, whose descriptions are used as a base in the following deductions, therefore refers to contagious pleuropneumonia as erysipelas pul- monum. When the disease continues for some time, the changes do not confine themselves to the interstitial tissue, but extend to the alveolar pulmonary parenchyma. With this, exudation and engorgement of the alveoli with fibrin occur. What is to be looked upon as especially characteristic is that as a result of the gradual advanc- ing of the hepatization from the periphery toward the center, one will find upon cross section lobules in which the inflammation has always confined itself to the peri- pheral zone, whereas those alveoli lying centrally still contain air and are pink. The cut surface of the hep- atized areas is granular. This is caused by fibrin plugs, which protrude from the alveoli upon making the sec- tion, whereas the closing elastic, alveolar walls retract. As a result of the process gradually continuing to creep on and extending from the interstitium to the paren- chyma, not all portions of the lung are attacked simul- taneously. Consequently, one encounters hepatized areas of various ages. Alternating with air-containing, pink lobules we find such as are of a firm consistence and partly dark or yellow-red and partly grey. As a result of the varied colored lobules of the lung which are sep- arated by the distended, grey-white interlobular tissue bands, the cut surface assumes a veined, somewhat coarsely reticulated, mottled appearance resembling mar- ble (marbled cut surface). The filling up of the interlobular tissue with fluid and cellular matter is conditional upon a pressure on the pulmonary veins. This results in a compression of the vessels in question and an arterial passive hyperemia PLEUROPNEUMONIA OF CATTLE 171 in the lobules which they supply. Associated with this we usually have an obstruction-edema and as a result of the vessel walls continually becoming more seriously affected the blood passes through. The hemorrhagic infarct which finds its origin in this manner, finally undergoes necrosis. By means of peripheral suppuration the dead area becomes separated and we find within the lung tissue more or less large necrosed foci (sphacelus or sequester). As has been proved, the virus of contagious pleuropneumonia can remain viable in these sphaceli longer than one year. Consequently, such animals are able to infect healthy cattle for a long time. For this reason they represent a greater danger for the further spread of the disease. Conditions are different when a thick capsule has been formed around the sphacelus as a result of reactive inflammation. Such foci are to be looked upon as not dangerous. The process finally extends from the capsular tissue to the mucosa of the bronchioles; this leads to a catarrh and thickening of the mucosa (catarrhal bronchitis). As long as the catarrhal process remains within the lung, the pleura does not become involved. But the moment that part of the perilobular tissue, which lies closely under the pleura, becomes affected, there is dan- ger of extension of pathological changes to the pleura. The delicate endothelium of the pleura cannot resist the pressure of the fluid in the perilobular tissue and conse- quently ruptures. The virus now escapes into the pleural sacks and in that way inflammatory changes, with col- lection of the fluid in the pleural sacks as well as fibri- nous adhesions between the visceral and thoracic pleura, follow. Later, after the continuation of this develop- ment, thick, skin-like layers form on the two layers of the pleura, in which ease the pericardium is usually involved. The bronchial and mediastinal lymph nodes also be- 172 EPIZOOTICS: THEIR CONTROL DURING WAR come involved in this process; they become swollen three to five times their normal size and are very moist upon their cut surface. At times one meets within the en- larged lymph nodes more or less large dead foci. The moment the exudative inflammation attacks the pleura, the originally chronic disease assumes an acute . character; the temperature rises and the appetite be- comes lessened. Dullness, limited by a horizontal line, is found to be present upon percussion. The period at which the chronic form of the disease passes over to the acute varies according to whether the primary foci were distant or near the pleura and whether the process from such a focus toward the pleura extends slowly or rapidly. DIFFERENTIAL DIAGNOSIS Hemorrhagic Septicemia Occasionally the interstitial tissue may also be affected and distended in hemorrhagic septicemia, which causes one to suspect contagious pleuropneumonia. Distinction can be made, however, in that hemorrhagic septicemia hepatization has a hemorrhagic character and the process proceeds from the center to the periphery. Further- more, the alveolar tissue is always affected first and the perilobular tissue secondarily. Also when such changes are of the same age and of recent development, it fur- thermore indicates that hemorrhagic septicemia is pres- ent. As a rule, we also fail to find in this condition thrombotic changes, never observe sphacelus-formation and also the rind-like layers on the pleural membranes are absent. As a final test one could inoculate a rabbit which would always give a negative result in case the disease is contagious pleuropneumonia. If, however, hemorrhagic septicemia is present, then |the rabbits, which may be infected with bits of lung, usually die in PLEUROPNEUMONIA OF CATTLE 173 one to two days and many bipolar bacteria can be dem- onstrated in their blood. Catarrhal Bronchopneumonia Such a disease particularly occurs in young cattle during transport. Such animals cough a good deal. Upon autopsy one finds the interlobular tissue distended and the lobules at different points in the stage of grey hepatization. As a rule sphacelus formations and pleu- ritic lesions are absent. Verminous Bronchopneumonia It is possible that the marked coughing of cattle af- fliicted with verminous bronchopneumonia can, from a clinical standpoint, arouse one’s suspicions of contagious pleuropneumonia. The fact that only young cattle, after running on pasture are affected, ought to exclude the possibility of contagious pleuropneumonia. The lung worms are demonstrated comparatively easily in the finer branches of the bronchioles. Traumatic Pericarditis In this disease adhesions are found to occur between the pericardium, visceral and thoracic pleura; further- more, in case the process which produced the rind-like layers should further involve the lungs and be accom- panied by a distension of the interlobular tissue, one’s suspicions of contagious pleuropneumonia may be aroused. Usually the foreign body which produced the traumatic pericarditis can easily be found. Gangrenous Bronchopneumonia As a result of medicines intended for the alimentary tract being inspired by cattle, or due to other causes, 174 EPIZOOTICS: THEIR CONTROL DURING WAR serious pneumonic changes associated with mortification of the tissue may result which may also lead to a dis- tension of the interstitial tissue. The formation of ne- crotic foci can arouse one’s suspicion of sphacelus forma- tions as we are accustomed to see in contagious pleuro- pneumonia. But in such cases, we always notice the serious affection of the bronchial mucous membrane, fill- ing of the bronchioles with a smeary, fetid fluid and the strong, putrid odor of the necrotic areas, which guards us in making a mistake. The affected areas in contagious pleuropneumonia never give off a putrid odor. COMBATING CONTAGIOUS PLEUROPNEUMONIA Vaccination In combating contagious pleuropneumonia the healthy animals are vaccinated at the base of the tail with the lymph obtained from diseased portions of lung. They then pass through a light form of the disease and develop an active immunity. In this way, however, virus carriers are produced which may help in the further spread of contagious pleuropneumonia. Consequently, this method of immunization has been entirely given up in Germany. (H. Raebiger. ) VETERINARY POLICE REGULATIONS As in rinderpest, the veterinary police regulations have given the best results when all sick animals as well as those suspected of having contagious pleuropneumonia and those which had been exposed were immediately killed. The lungs from the sick animals must be entirely destroyed; the meat can be distributed only after being cooled; the hides are to be exported only after they have been dried in case they are not immediately taken to a tannery. PLEUROPNEUMONIA OF CATTLE 175 Lifting the Quarantine The disease can be considered eradicated and the pre- seribed quarantine regulations dispensed with when the entire herd has died, been killed or been removed. The Same may be done when the sick and suspected animals have been killed and if no new eases of the disease have appeared among the exposed animals for a period of at least six months after the killing of the last case of the disease. In both instances the disinfection is to be car- ried out by the official veterinarian according to instruc- tions. Compensation Whenever the owner has reported the disease at the proper time he will receive as compensation four-fifths of the actual value of the dead animals [in Germany]. No compensation is given in such cases where the animals became sick 180 days after their importation [in Ger- many |]. RINDERPEST PESTIS BOVINA (Cattle plague) ETIOLOGY OF RINDERPEST We must look upon the cause of rinderpest as a very small, non-filtrable microdrganism, but which up to the present time has not been demonstrated. It has FIGURE 29 Rinderpest. Diphtheroid lesions on the mucose of the upper and lower jaws. (Hnglish commission of 1866.) very little resistance; it is easily destroyed by sunlight, drying and highly diluted solutions of disinfectants. The virus can be found in the blood and the secretions and af 178 EPIZOOTICS: THEIR CONTROL DURING WAR excretions of sick animals. Even virus-containing blood, which has been protected at low temperature and from the light, remains viable only for a few days. Conse- quently, the contagium soon dies in the outside world. The spread of rinderpest results principally by means of direct contact with sick or apparently healthy cattle which are already infected or which have withstood an at- tack of the disease (virus carriers, 2.¢e., virus spreaders) ; it may also result from hides, scraps of meat from ani- mals infected with rinderpest, or from urine or feces or the manure on which diseased animals have stood. Finally, goats and sheep, which are susceptible to the disease, may cause a further spread, as well as men and animals that have come either in direct or indirect con- tact with such animals. The contagium is not spread with unusual ease, and in this respect, rinderpest differs in a favorable manner from foot-and-mouth disease. SYMPTOMATOLOGY OF RINDERPEST The period of incubation is three to seven days, and at the most, nine days. The disease begins with a contin- uous but high temperature, which is usually 41° C. to 42° C. (105.8° F. to 107.6° F.) ; vacillations in tempera- ture up to one degree daily are observed. The fever con- tinues two to three days before other disease symptoms appear ; this is to be considered especially typical. After this the temperature falls again, but remains above nor- mal except, of course, in rapidly fatal cases, where an unexpected sudden drop in the temperature occurs. Two or three days after the appearance of the fever, the appetite and milk secretion become less; the animals become noticeably weaker and weaker. At first the feces are dry, but on the third day they become thin and fluid, slimy and mixed with traces of blood. Bloody diarrhea is seldom observed (Gerlach). Toward the end, invol- RINDERPEST 179 untary defecation sets in; the anus is held open and allows the dark red, hemorrhagic and infiltrated rectal mucosa to protrude. Nervous cases which are at times observed, manifest themselves in a shaking of the head, swaying gait, shiv- FIcurE 30 Rinderpest. Reddening of the gums around the neck of the incisors, associated with loss of substance and fibrinous layers; in front of and below these an elongated diphtheroid layer showing a deep central area; on a number of papille the superficial layer of epidermis is detached in a circular manner and the underlying tissue becomes visible. (After Hutyra and Marek.) ering and twitching, symptoms that resemble malignant eatarrhal fever, although one fails to find corneal opac- ity, which is so typical of the latter disease. An exanthema develops on the finer unpigmented areas of the skin on the udder and scrotum as well as on the inner surfaces of the thighs; desquamation and scurf- like formations occur, and at times emphysema is ob- 180 EPIZOOTICS: THEIR CONTROL DURING WAR served in the subeutis. Frequently, however, these changes are lacking. The oral mucosa is loosened and reddened in patches; erey points develop about the size of a pinhead to that of a hempseed, due to the drying of the superficial epi- thelial layer. The cheesy dead material may either remain at these sites or it is cast off, leaving behind more or less large erosions having a red base and an irregular border. The mucosa is chiefly affected in the neighbor- hood of the incisor teeth, inner surface of the lips, com- missures of the mouth, edges of the tongue and inner surface of the cheeks. Hutyra and Marek, as well as Zwick, describe as par- ticularly striking, the inflammatory process resulting in necrosis on the papillae of the mucosa-of the lps and cheeks, to which C. Miller also alluded in 1877. The papillae are often partially or totally denuded, leaving them reddened at these points; at times the apex of the papillae is entirely missing. Excoriations on the hard palate are constantly observed (Goring). Robert Koch did not find the exanthematous and diph- theroid changes of the mucosa of the mouth and hard palate very marked, whereas most authors allude to them as having differential significance and seldom, if ever, failed to find them present (Theiler). In the grey race of cattle, the disease process frequently confines itself to the gums around the incisors (Hutyra and Marek). The internal portions of the conjunctivae are reddened and lacrimation exists. The lacrimal secretion, which is at first cloudy and mucous in character, later becomes purulent. The nasal mucosa is at first reddened in patches and later diffusely reddened. Near the openings of the nos- trils one will observe larger and smaller grey spots and eventually loose layers of the dead epithelium. In such RINDERPEST 181 cases, the expired air has a noticeably fetid odor (Hutyra and Marek). FIGURE 31 Rinderpest. Large losses of substance with occasional diphtheroid layers on the hard palate of cattle. (Hnglish commission of 1866.) Usually a cough exists, and the respirations at times are increased to thirty to forty per minute, especially when death is about to occur. A mucopurulent nasal 182 EPIZOOTICS: THEIR CONTROL DURING WAR discharge of variable quantity, which later becomes a dirty grey and has an offensive odor, is usually associ- ated with these changes. Abnormal sounds are not, as a rule, detected upon percussion and auscultation. When rinderpest made its appearance in Germany in 1877, C. Miiller records that the respiratory organs appeared espe- cially affected in the first stage of the disease. Coughing and dyspnea were always present, so that it was not impossible to confuse the symptoms with those of con- tagious pleuropneumonia or ordinary pneumonia. But at the same time the changes in the epithelium of the oral mucosa, especially the buccal papillae, were seldom lack- ing. These experiences coincide to a marked degree with the observations of the Austro-Hungarian commission in 1914. The vaginal mucosa is reddened in patches or streaks; in the later stage of the disease small areas of the super- ficial surface of the mucosa die and leave ulcers behind. Eggebrecht always observed polyuria. COURSE OF RINDERPEST Due to the peculiar course of rinderpest, only the simultaneous appearance of several typical symptoms in different animals of the same herd can be taken into consideration in establishing a diagnosis. Never are all of the described symptoms observed in one and the same animal, but only in a few of them. The difficulty in making a diagnosis is also increased in that the disease occurs much more mildly in animals coming from rinder- pest-infected districts than in our native-bred eattle. This is doubtless due to the fact that cattle in such localities where rinderpest prevails possess a certain im- munity; also partly that they have withstood an attack of the disease. Consequently, in such animals rinder- pest will usually run an abortive course, and some cattle RINDERPEST 183 will not sicken at all. In contrast to this, the disease may run a much more serious course in our native-bred animals, and in that way exhibit deviations from the normal. FIGURE 32 Heifer sick with rinderpest. The animal is very weak and somnolent; lachrimation is increased and a mucopurulent nasal discharge exists. (After Zwick.) Animals in which the disease runs an abortive course are weak only a few days, as a rule; eat little; go lame and show a little fever. Now and then a mild ecatarrh of the mucous membranes develops which may be accom- 184 EPIZOOTICS: THEIR CONTROL DURING WAR panied by diarrhea. Often such animals entirely recover within eight days. In spite of this, however, they harbor the virus and excrete it during their illness and also most likely for a longer or shorter period after recovery. Virus excreting animals therefore are a source of infec- tion to all neighboring animals, and in case the disease is not recognized early enough, they can very quickly spread the infection further. . In the milder course, fever first develops, followed by streaked and patchy reddening of the mucosae, which may result in defects of the superficial layers. Diarrhea appears on the third to fourth day. On the fourth to fifth day the symptoms usually subside, and in eight to fourteen days the animals usually recover in ease the disease does not become more serious and lead to death. The mortality is ordinarily about fifty per cent. The serious course is immediately ushered in with a high fever. After the third day this is followed by serious disturbances, especially of the digestive appa- ratus. Diarrhea develops, characterized by fluid, ill- smelling feces, which are mixed with traces of blood. Coéxisting with this is involuntary defecation, due to paralysis of the sphincter muscle of the anus. The ani- mals do not eat; give no milk; are strikingly weak; lie down a good deal, and die in ninety per cent of the cases on the fourth to fifth day. At times nervous symptoms can also be present, such as muscular tremors, spasms or disturbances of the respiratory apparatus, which mani- fest themselves by dyspnea, loud groaning or purulent nasal discharge. PATHOLOGICAL ANATOMY CF RINDERPEST The most marked anatomical changes occur in the mucosa of the digestive tract, and secondarily in the mucosa of the respiratory tract. Occasionally one finds a ae RINDERPEST 185 the previously described scab formations and nodules in the skin. . Besides the loosened necrotic layers and ulcers on the lips, gums, hard palate and tongue, which have already FIGURE 33 Serious diphtheroid lesions on the mu- cose of the tongue and pharynx. (English commission of 1866.) been alluded to, further pathognomonic changes are to be met in the abomasum and small intestines. The mucosa of the fore-stomachs can be stripped off very easily and the underlying surface is hyperemic. The omasum is always filled with dry contents. The mucosa of the abomasum and pylorus is loosened, reddened in 186 EPIZOOTICS: THEIR CONTROL DURING WAR patches and streaks and covered with a slimy mass. In the majority of cases variously sized necrotic layers are found on the summits of the folds of mucosa, which, after they are removed, leave ulcers of the size of lentils to that of a penny, with irregular edges and a red base. Hutyra and Marek found in some of the cases scabs of the size of hemp to lentil seeds, which were grey, flat and somewhat centrally raised, and upon removing them, smooth-edged depressions were left. They also observed in some apparently healthy animals, round, cicatrized ulcers on the edges and sides of the folds of the mucosa, which probably answer for the ‘‘residues of rinderpest’’ described by Mrowka. The intestinal mucosa exhibits all the gradations of the metamorphosis, beginning with an ordinary catarrh and passing over to more or less marked loosening and black-red discoloring of the mucosa, and finally to super- ficial death, which results in diphtheroid layers being formed. However, extensive croupous layers and crust formations are seldom met. Koch found in three cases out of ten autopsies, fibrinous bloody exudates in the intestinal walls. These formed themselves into casts on the intestinal wall, sometimes three feet long, and con- sisted of cast-off intestinal epithelium, firm fibrinous masses and blood. The single and grouped lymph nodules (Peyer’s patches) are almost always affected. At first they are swollen and manifest themselves as protuber- ances. They then undergo purulent degeneration. Re- mains of the follicle are still to be seen on the basie¢ struc- ture. Finally, all the lymph nodules transform to puru- lent granular masses, which supplant the sites of the Peyer’s patches in the form of bed-like elevations. The mucosa of the glottis, trachea and bronchi is swollen and reddened; at times small ulcers are found in it. Associated with the more marked changes in the RINDERPEST 187 bronchial mucosa there is always an interlobular pul- monary emphysema. The liver, heart and kidneys show parenchymatous degeneration. The gall bladder is stretched and filled with greenish bile. Its mucosa is reddened, at first with FIGURE 34 Rinderpest. Hyperemia of the abomasum; round ulcers, which are partly covered with scabs. (After Hutyra and Marek.) petechiae and later with small wart-shaped nodules. The latter may undergo degeneration and leave ulcers which later become confluent. The spleen is usually normal. DIFFERENTIAL DIAGNOSIS OF RINDERPEST According to the judgment of experienced practition- ers, the diagnosis 1s often more easily made during the life of the animal than by basing conclusions on the pathologic anatomical lesions. In cases of doubt, it was found best to stand sick animals with healthy ones or to 188 EPIZOOTICS: THEIR CONTROL DURING WAR artificially infect healthy cattle, goats or sheep with material taken from sick animals (slime, blood, ete.), in which case one should, of course, absolutely separate all animals. Foot-and-Mouth Disease In this disease not only are the oral mucosae involved, but also the feet. The spread of the disease occurs faster among all animals of a stable than does rinderpest. The saliva on the mouth forms long, sticky threads. Contagious Pleuro-Pneumonia Here exclusive affection of the respiratory organs prevails, which manifests itself by cough, dyspnea and dullness which is limited horizontally. The lack of changes in the mucosae of the head may be used for dif- ferential diagnosis. Finally, when making a post mortem examination in cases of contagious pleuro-pneumonia, we find distension of the interlobular tissue, which is filled with a lymphatic fluid; various aged pneumonie areas, which always begin at the perilobular tissue; and thrombi. Malignant Catarrhal Fever The changes of the mucous membrane limit themselves chiefly to those of the respiratory tract; they are diph- theroid in nature. Deeper losses in substance are lack- ing. Marked difficulty in breathing exists. The cornea of the eyes is always dim. Rabies Only the nervous forms of rinderpest, which have as- sociated with them paralysis of the limbs, can be con- fused with rabies. In rabies no changes oceur on the mucous membranes in either the living or dead animal. Serious Diarrhea (Gastro-Enteritis) Gastro-enteritis can be caused by spoiled or improper food or water containing Hyphomycetes (mold-fungi), RINDERPEST 189 irritating substances (saltpetre, ete.), as well as various bacteria, especially the paratyphoid group. The rapid course of rinderpest has without a doubt much similarity to gastro-enteritis, particularly when the course is asso- ciated with a discharge of bloody feces as in gastro- FIGURE 35 Rinderpest. Striated hyperemia, especially on the summits of the folds of the mucosa. (After Hutyra and Marek.) enteritis. The diagnosis of gastro-enteritis is made cer- tain by the fact that excoriations on the oral mucosa are lacking in this disease; also careful observation of the accompanying circumstances and especially the eating of harmful feed. Coccidiosis This is a noncontagious intestinal disease due to Coc- cidium Zirni, in which during the advanced stage bloody 190 EPIZOOTICS: THEIR CONTROL DURING WAR diarrhea may develop. The disease is almost exclusively confined to young animals or such that have grazed on pastures. FIGURE 36 Rinderpest. Portion of small intestine showing striated and patchy hemorrhages in the mucosa, especially on the summits of the longitudinal folds; at one point is seen a grey-yellow, dry seab-like layer on a Peyer’s patch. (After Zwick.) Paratuberculosis This disease (Johne’s disease) is caused by an acid- fast rod (B. paratuberculosis) which resembles the tu- bercle bacillus. It leads to a thickening of the intestinal mucosa and profuse diarrhea. The diagnosis is made certain by considering the chronic character of this dis- ease and the failure to find diphtheroid lesions of the mucous membranes. Poisoning Lead poisoning is at times apt to produce similar le- sions, for here we also see excoriations on the oral mucosa RINDERPEST | 191 and nervous symptoms, muscular tremors and attacks of mania. The animals are always constipated in lead poisoning, and the history of the case will prevent error FIGURE 37 Rinderpest. Acute inflammation of the gall bladder; swelling and necrosis of the mucous fol- licles. (After Hutyra and Marek.) in diagnosis. The animal may obtain the lead from feed in the neighborhood of mines or from water that has been conducted through lead pipes. Finally, we must also consider that cattle may lick freshly painted 192 EPIZOOTICS: THEIR CONTROL DURING WAR structures to which lead paint (red lead) has been ap- plied, and in that way become affected with lead poisoning. COMBATING RINDERPEST Immunization Active Immunization (Bile and Blood Vaccination) : Active immunization was carried out by using bile in some cases and blood in others, which were obtained from animals sick with rinderpest. Animals vaccinated with these materials remained immune for one year. The vaccinations have as a general rule proved successful, but should be used only in rinderpest regions, 7.e., where the disease occurs more frequently, for we produce in this way virus carriers or virus disseminators, through which the disease becomes more widely spread. In re- gions where the disease occurs only sporadically, the vaccinations will give disadvantageous results. Passive Immunization: In regions free from rinder- pest, good results can be obtained through passive immu- nization, especially in such instances where it is desirable to produce a broad belt of immune farms around a dis- ease-infected locality and in that way prevent the fur- ther spread of the disease. The sera of animals that have withstood an attack of rinderpest are used for immunizing purposes. Due to the low protective power of such a serum, the process of Kolle and Turner has been used more recently, in which cattle are highly immunized by systematically treating with virulent rinderpest blood, which produces an effi- cient serum and produces satisfactory immunity in doses of 50 to 100 cc. Simultaneous Method (Serum-blood Vaccination): In order to increase the passive immunity produced with RINDERPEST 193 serum, which affords protection only for one to two weeks, 10 to 30 c.c. of the specific serum are injected on one side and simultaneously 0.5 to 1 ¢.c. of virulent rinderpest blood is injected on the opposite side of the animal. VETERINARY POLICE REGULATIONS FOR RINDERPEST As a result of the German rinderpest law of April 7, 1869, rinderpest has not made its appearance in Ger- many within the last twenty-five years. The most im- portant means of combating the disease is by killing not only the sick but also such cattle as have come in direct or indirect contact with sick cattle, as well as carrying out isolation and compensation. If necessary, the iso- lation of an infected farm or village may be accomplished by a military cordon. The use of hides and meat of animals found to be healthy on the ante- and post- mortem examinations, is allowed after the meat has been cooled and the hides dried or placed in milk of lime (1 to 60) for three days. Animals which have died or been killed should be buried or otherwise destroyed so as to render them innocuous. Skinning of cadavers is prohibited. In order to prevent the further spread of the disease, it was found desirable to appoint inspectors whose duty it was to closely observe all stock on the farms adjacent to the disease-infected area. Furthermore, all larger slaughter houses are to be quarantined, because it is easiest to spread the disease from animals that are suf- fering from a latent form of the disease. All rinderpest-sick or suspected animals are to be re- ported within eight days from the time the disease made its appearance. When suspicion is based on very good ground, temporary quarantine is to be declared. 194 EPIZOOTICS: THEIR CONTROL DURING WAR Lifting the Quarantine The disease can be considered as eradicated when all stock has either died or been killed, or when three weeks have elapsed since the last sick animal or death occurred, and when the prescribed disinfection has been carried out. Compensation Compensation is given up to the actual value of ani- mals, equipment, etc., destroyed by government order, the amount of compensation being determined by tax commissioners. No compensation is allowed for stock that die ten days after their importation. [In Germany. | ; HINTS ON HANDLING WAR HORSES IN AMERICA By A. A. Lersotp, D. V. M.* Before horses and mules reach their respective desti- nations for service during war time, veterinarians must necessarily give them much thought and attention. From the time that animals pass inspection for purchase until they are safely landed in a fit condition for the service they are to perform, they are subjected to many and various conditions that tend to diminish greatly their numbers. A moment’s reflection on the altered condi- tions that mobilization and transportation occasion, will convince anyone who is familiar with the handling and transportation of large numbers of ‘‘green’’ horses, that, at best, it is bad for the horse and far from ideal for those whose duty it is to give him needful care. ' Dismissing without discussion the recommendations that could be made in connection with physical examina- tion of horses for soundness, and considering the prob- lems relative to their care after they have been pur- chased, one may consider the handling of horses for use in war under two general classifications, viz.: 1m concen- tration camps or at remount depots and during transpor- tation to the scenes of action. Handling Horses in Concentration Camps It should be stated at the outset that every horse that is purchased for military purposes by the various coun- tries that have well organized logistic branches of their armies, is identified by branding. This makes possible the most careful investigations in connection with each individual animal, including its purchase price, from whom purchased, its origin, the officers who make the * Abstracted from The American Journal of Veterinary Medicine. 197 198 APPENDIX inspection at the time of purchase, and any data in con- nection with its treatment at hospitals in case of sick- ness; and if lost, a report of the cause of death is re- turned to those to whom such is due. In a discussion of certain phases of the subject of caring for horses at concentration camps, Dr. T. C. Teidebold* of Chicago states: They (the horses or mules) are shipped from the original point of purchase to some concentration camp, such as I have run for two different contractors since the war has started. They are shipped usually to the limit on time; that is to say, they are allowed to be in the cars right up to thirty-six hours, as it is an offense to leave them longer, and I want to state that they receive very little food or nourishment while they are in transit. Immediately a trainload of horses comes into the Union Stock Yards or a concentration camp, the horses are put in pens which are thirty feet square and are bedded deeply with straw, the mangers being full of hay. They are allowed to eat as much as they desire for some two or three hours before being watered, and this is an all important point from a veterinary viewpoint, for if there is anything discouraging to the veterinarian, it is to have a trainload of horses come in and through some mis- understanding allowed to be watered immediately upon arrival. In such an event the veterinarian’s services are in great de- mand, for he has then to treat colic, chills, and what not. One can readily understand the amount of water a horse will drink after having had none for thirty-six hours. I have even had horses come in during the summer time so fatigued and thirsty that to allow them to take a quart or two of water would mean death. Great care has to be exercised at this time, as I have stated, after their arrival. After the horses have stood for some two or three hours, the water is given to them gradually until their thirst is satisfied. They have hay at liberty. After the horses are kept on this diet for twenty-four hours, they are placed the first day for fifteen minutes on a ration of grain, consisting of two-thirds oats and one-third corn, with a little bran in it. We allow them, after the first day, twenty minutes to this grain ration, and we figure that in this time a horse will consume six to eight pounds. ~ * American Journal of Veterinary Medicine, Vol. XII, page 391. APPENDIX 199 The horses are sorted under a veterinarian’s direction every day. We employ a system of feeding here which is different from any place that I have seen in the United States. The grain ration which these horses are fed is given in a separate pen. We do this, feeling that we have accomplished three very im- portant parts which go to make up the proper handling of army horses, namely: we feed the grain, we exercise the horses, and every horse comes before the caretaker’s eye each day. One of the important points for a veterinarian who is handling many army horses is the segregation of all sick animals immediately when they are found ailing, and this is a large task when one has from a few hundred to five or six thousand horses on hand at a time. Each concentration camp is equipped with a hospital and good facilities for caring for horses. We practice here in the yards the following methods in our hospital, and I wish to state that we have found them to work out quite well under most conditions: A horse is brought from the concentration camp to the hos- pital. The veterinarian in charge immediately gives the horse an examination, prescribes for him and numbers him, and he is recorded on a chart. This chart states the date this horse came to the hospital, the medicine that was given, his temperatures night and morning, and the medicine he is given as an adjunct to the initial dosing. In this way, it matters not how many are treated or in the hospital, as each horse is treated, one might say, aS an individual case. We have carried in our concentra- tion camp here in the hospital department up to 1,388 head of horses. The hospital attendants are allotted a certain number of horses to care for. The doctors in charge are likewise allotted a number. All horses reaching our concentration camp are vac- cinated with the United States Standard Serum Company’s vac- cine twelve hours after landing, if it is possible to give them this length of time. The question will arise as to loss, and the percentage which are sick from the totals. With the experiences I have had it is hard to state just what percentage of the horses get sick, as there are a great many things that cause the differences in the percentage I might enumerate. I will simply state that for one man I have handled and kept in the concentration camp some 75,000 head of horses, with a total loss of 1.52 per cent. These horses average on feed about fifteen days at this concentration 200 APPENDIX camp, from which they are shipped directly to the boats. The losses as a whole, talking with the different contractors, amount to between 8 per cent and 10 per cent. One bunch of horses may pass and land with a percentage of 2 or 3 per cent, while another one may run as high as 20 per cent, but on an average about 8 per cent would about meet the conditions. Following a careful inspection of a British concen- tration camp, Dr. J. V. Lacroix* has written as follows: To handle such large numbers of animals, necessarily there is required large fields that adjoin stables and corrals and hos- pitals. ‘‘Pasture riders’? keep watch of the horses and bring - to the hospital any animal that manifests evidence of being sick. Those who ride about inspecting horses must, of course, be able to recognize unwell animals on sight, and as they are handled in such large numbers that individual attention is impossible, often the first evidence of an animal’s being in an abnormal condition is its gauntness. : Where about thirty thousand horses and mules are kept under the general supervision of one veterinarian, and this without the existence of elaborate facilities for handling the multitudinous ailing subjects, they are perforce handled in groups and classi- fied according to the general character of ailment or acuteness of affection. As soon as convalescence has progressed sufficiently to justify such measures, subjects are turned out in lots where they may exercise at will and feed from common troughs. In such lots it is noticed that immediately an animal regains suf- ficient vigor and desire to become playful, it is then an annoy- ance to others and must be placed with stronger animals where none will suffer because of its gamboling tendencies. On the other hand, when subjects suffer a relapse or fail to progress satisfactorily when placed with a given group of convalescent animals, they are returned to quarters where exertion is unneces- sary and where individual attention is possible. Infectious pneumonia and pleuritic affections are of common occurrence in the particular camp visited by the writer. There pneumonia is generally treated by providing for the patient’s comfort in every way possible. Fresh air is allowed in abundance and subjects are not frequently molested for any reason. Medica- * American Journal of Veterinary Medicine, Vol. XII, page 440. APPENDIX 201 tion is infrequent. Needless to say, probably every form of pneumonia occurs at this place, and consequently complications of all sorts are numerous. Among the more common complications that attend the various respiratory diseases are pleurisy, cardial and pericardial affections, laryngeal hemiplegia, purpura hemorrhagica, cerebral, spinal and meningeal inflammations. Influenza also is to be observed, and intestinal manifestations of this affection are usually signalized by serious diarrheic disturbances. Amaurosis is to be noted in some animals and is probably, in most instances, a sequel to influenza contracted in camp rather than of long standing. Acute digestive disorders are said to be of rare occur- rence. This, according to the popular conception regarding the feeding of horses, is remarkable. These animals are necessarily fed grain in common from large troughs where many horses eat together. Such methods of handling horses should, it would seem, result in considerable trouble from colic. Animals that are not hopelessly affected but unfit for army service are sold at ‘‘cash sale’’ as soon as they may be put in marketable condition. The percentage of losses, all things taken into consideration, is not great. Surgical cases are not so numerous as are non-surgical affec- tions, excepting for fistula of the withers and poll. Approx- imately 12 to 15 per cent of these cases are of poll evil; the balance are fistule of the withers, and in about 3 per cent of cases the two conditions coéxist. Brand abscesses—crural in- fections that result from branding—are of rather frequent occur- rence and somewhat troublesome to treat. This is due chiefly to the fact that the true condition is not recognized, as a rule, until considerable suppuration has taken place, and then it becomes necessary to drain the parts surgically. And as these cases require more or less after-attention, restraint of subjects so affected in a suitable manner to give them proper attention, is time-consuming. Contused wounds and lacerations of considerable extent occur during stampedes. Horses occasionally run into fences or other obstacles when stampeded at night, and various wounds of the forearms or prepectoral region are inflicted. Such cases are treated along usual surgical lines and results therefrom are quite satisfactory. Lameness is-to be observed as the result of various causes, chief among which are foot affections such as thrush, ‘‘nail 202 APPENDIX quick’’ injuries, subcoronary abscesses and quitters. Tendinitis and sprains occur and occasionally a chronic affection is to be observed. The one thing that was most interesting to the writer was the one hundred and eighty-nine cases of fistula and poll evil that were under the care of one of the veterinarians. To this particular veterinarian is entrusted the care of all of these cases, and results in so far as final outcome is concerned are unusually good. The method of treatment is decidedly not in keeping with surgical teachings, and at first thought is seem- ingly not really humane. However, upon careful consideration of the situation as it presents itself, one is compelled to ac- knowledge that no evidence of suffering greater than would be oceasioned by average surgical intervention is to be observed. Moreover, in view of the fact that the numbers of such eases treated preclude their being handled in the manner that is recommended and practiced by those who are most successful in this work in private practice, it is quite necessary that other means be employed. The method: of treatment consists in confining the subjects and, after making an incision into the abscess cavity at a point near the median line, pus is evacuated and Lewis’ lye (a prepa- ration whose active principle consists of sodium hydrate) is introduced into the cavity. The amount employed varies some- what with the size of the cavity and the condition of the af- fected parts. As soon as the caustic comes in contact with the tissues, chemical changes that occur from the combination of moisture abstracted from the wound and the caustic, result in immediate evacuation of the contents of the cavity. This pre- vents further introduction of caustic even if it should be desira- ble or necessary. Five or six dessert spoonsful2 are probably the greatest quantity employed at a time, and it is very seldom that this amount can be introduced. Subsequent to the intro- duction of this agent, reactionary inflammation occurs, but not more than attends the use of the milder caustic agents and not so much as results from those commonly employed. This is probably due to the fact that the caustic is not confined in the depths of the wound in any way, and because of a free opening 1 Credit is due Dr. J. H. Snider for this method of handling fistule. Dr. Snider began using this treatment in private practice and later employed it in hundreds of cases in his work at a remount station. 2One or two dessert spoonsful are all that is required in the ay- erage instance. APPENDIX 203 at the top, spontaneous evacuation resultant from chemical activity prevents extensive destruction of tissue. It is of utmost importance to thoroughly anoint the skin of both shoulders and fore legs to prevent injury that would result from discharge issuing from the wound. This is accomplished by carefully rubbing into the skin a heavy petrolatum and sub- sequently applying an additional amount upon the surface of the skin. This precaution is taken before the caustic is introduced or immediately following its use. After-care consists in cleansing the wound area and removing any eschars or necrotic tissue that may be contained within the wound. This is done in from one to two weeks after the ani- mals are first handled. A second application of petrolatum to the skin surrounding the wound is now made and no further treatment is ordinarily necessary. The animals that are under- going treatment are kept in a large corral, where they may exercise at will. No rubbing or molesting of wounds is ob- served, and recoveries succeed this form of treatment in from one and one-half to three months’ time. Comparatively little disfigurement follows, and the percentage of recoveries is much higher than would be believed by anyone who has had extensive experience in handling such cases, unless he were to make critical observations of these animals. In a discussion of the treatment of pneumonia as it occurs at the British Remount Depot at Newport News, Va., Capt. James Gregg, M. R. C. V. S., and his assist- ants* call attention to extraordinary results that they have gotten with the use of soluble iodin injected intra- venously. Dr. G. S. Glover, one of the aforementioned writers of the articles on pneumonia, describes their method of intravenous medication with a preparation of iodin that is dissolved in a normal saline solution. He describes his technic thus: The jugular vein is raised by compression with cord and a small area is clipped and painted with iodin. The animal is bled, about one gallon of blood being removed by the use of a * American Journal of Veterinary Medicine, Vol. XII, page 505. 204 APPENDIX large caliber slip hypodermic needle, one and one-half inches long. Immediately after bleeding and through the same needle, normal salt, one quart, with soluble iodin, one dram, is injected by use of Fowler’s salt solution apparatus. The adapter fitting the slip of the needle makes only one puncture necessary for the bleeding and administration of medicine. (I have yet to see my first jugular infection from this method.) Daily or every two or three days the injection is repeated according to results. Bleeding is also repeated in a few days if a full pulse is noticed. This treatment has been found bene- ficial even in cases where the pulse contraindicated bleeding. The results in many cases were nothing short of wonderful. In our work, animals have to be hastened to the convalescent stage in order to make room for new arrivals, but full time is given in the convalescent pen for a complete recovery before they are moved to the shipping pen. Strychnin (one grain t. i. d.) is given as a tonic to all animals off feed. Tapping is resorted to when indicated. Biological preparations have their place in the treat- ment of various ailments affecting ‘‘green’’ animals that are being handled for purposes of war. The method of employing bacterins, serums and antitoxins is so well known that more than mere mention of their use is un- necessary. Handling Horses During Their Transportation When the transportation of horses to the scenes of action necessitates a long journey, and particularly when the journey is to another country and by boat, greater hazard attends such transportation. A good descrip- tion of the veterinarian’s duties is here quoted from an article, ‘‘The Veterinarian’s Duties as Conducting Offi- cer in Trans-Oceanic Shipment of Horses,’’ by Charles Banks, D. V. M.* Dr. Banks describes his experiences as a veterinarian on transport duty between America and Great Britain, while in the service of the latter country. * American Journal of Veterinary Medicine, Vol. XII, page 370. APPENDIX 205 The first duties generally will be to inspect all grain, hay and feed in general. This is no small job on the New Orleans docks on a hot day. Quantity as well as quality of feed has to be considered with reference to the length of trip, weather condi- tions, etc., ete. All stalls, troughs, pharmacy outfit, list of medi- cines and instruments are also inspected. At the time of loading, mules are to pass inspection in single file from a chute one-quarter of a mile long. Horses are brought before the veterinarian four at a time, and a physical examina- tion is necessary. Membranes are examined, pulse noted, respira- tion counted, mouth examined, ete. The ship is waiting and the examination must be fast but thorough, because once an animal gets past and on the ship, it is in the veterinarian’s charge and eounts against him if not delivered in good condition on the shores of the United Kingdom. Various forms of influenza, stomatitis, pneumonia, fever, lameness, wounds, stocked legs and general physical mal-condi- tion must be dealt with. These horses and mules have already passed by the British remount veterinary officer at the pens, but I have rejected as many as twenty-one in a shipment of 900 head and as many as eighteen in a shipment of 500. As soon as the last animal is on board, carpenters tear down the loading chutes, board up the entrances, which are used as stalls; good- byes are said with best wishes, and with a handshake the pilot gives the order to ‘‘ cast off’’ and the steamer slowly moves away on her perilous trip across the Atlantic. Besides the animals, the cargo generally is mixed, always one-third food products or munitions, always weight sufficient to put her deep enough in the water to retard her speed and make it very dangerous in rough weather on account of the open hatches. One is provided with a head foreman, four or more assistant foremen, one horseman to every twenty head, and sometimes a dispenser and two night watchmen. They are gen- erally easy to handle, good natured and jolly but rough, and on shore in the United Kingdom are generally closely watched. The first two or three days out hay only is fed, about 15 pounds with salt and plenty of water. The third day, one part oats is fed with two parts bran morning and night, 7 a. m. and 4:30 p. m.; hay three times daily and salt every other day. Mucking out must begin at once and continue throughout the voyage. One cannot enter any port without inspection, and if filth has accumulated the ship may be refused entrance into 206 APPENDIX the dock. Disinfection continues throughout the voyage and is very important. Crude creolin and chlorid of lime are used mostly. The conducting officer must be energetic. There must be unremitting attention to and supervision of watering, feeding, mucking out, ete. In other words, one must look after every man and every animal personally day and night. Sick animals are removed to the upper decks as far as possi- ble, which is not very easy when the runway is removed to allow the hatches to be put on in case of rough weather. The treatment of hopeless cases is not attempted. It is contrary to hygienic principles and leads to the infection of neighbor- ing animals. Unnecessary drugging is avoided. Preventive hygiene and active individual attention are far more important than drugs on board ship. The thermometer is very valuable on shipboard, but many times in using it one needs to be an athlete on account of the forward-backward motion of the animals, the limited space and crowding neighbors, ete. The successful conducting officer must be a hygienist and dis- ciplinarian rather than a therapeutist, a good horse master rather than a skilled prescriber. The trip from New Orleans, La., to Avonmouth, England, a port of Bristol on the Avon river, takes twenty-two days from the start to the unloading time. It takes eight days going through the Gulf of Mexico and the straits of Florida. The temperature of the water there was never less than 80° and in parts of the steamer the thermometer registered 107°. The nights were as hot as the days down below. There was no breeze, or else the breeze would follow us, which is worse than none. The steamer being all steel, the sun and the water (86°) keep it from cooling until it passes Bermuda and starts across the Atlantic. On one trip I had 100 mules with high fever, not eating any- thing except a little hay. They had pus in the inferior, anterior chambers of their eyes so they couldn’t see the feed trough. There were cases of regular sea sickness, heat exhaustion, fever, collapse, influenza and complications. Every case of septic pneumonia must be destroyed as soon as a definite diagnosis can be made. Any animal landed with the symptoms counts against one’s bonus. About this time there may be a strike among the horsemen or a shirking of work, failure to carry APPENDIX 207 out orders, etc., which leads to heroic measures, especially with a negro crew. Ship life and food do not agree with the average American hobo, and he rebels about the second week. When due to the carelessness of some horseman, the veterinarian in charge sees a mule going over the side, costing him from $50 to $100, according to the per cent it makes, it causes him to sit up and take notice. INDEX PAGE A Abscesses in lymph vessels and skin of the head.... 150 ANICTING) | Sas gra MRR Ses Pare 122 Ageglutination test........ 47 Alopecia areata ......... 122 America, handling war HORSES 20sec oh eae: 197 PNT CUD a Na eras Bie ear ie 85 Anthrax bacillus, cultivat- TIN? TEN Se wiall seo aaa Do 86 Anthrax bacillus, resistance Die CN a el ene 88 Anthrax bacillus, staining (CLOVES ose anes eile elcoenen se 87 Anthrax, combating ...... 96 Anthrax, diagnosis of..... 92 Anthrax, etiology of..... 85 Anthrax, pathological anat- OWI, Ol S Bingoay A geese 5 90 Anthrax, precipitation test II) 92s Sateen area ee ee 93 Anthrax, spread of....... 88 Anthrax, symptomatology of 89 Anthrax, veterinary police regulations in ......... 97 JNPSTIMOSOINAUI 65 Soguebso oe 141 B Bichlorid of mereury..... 28 Bid MUGS oe aisle eis oe sae 122 Blood aspiration ......... 44 Blood examination in gland- CUS ete negates, nl sieoaietere 2 Blood examination stations 19 PAGE Blood examination stations, MIMO, Se n6coseqoace 19 Blood examination station, LAaOL ODO Tastes agile CISA CRO ar 20 Blood examinations, record cards oles ee 76, 77, 78 Blood, instructions for with- GIR WANINS? | ons wale a cls oo 6 a 79 Blood specimens in dourine, preparation and staining Oubaa enact yer sone tey tepara lar 156 Breath, shortness of...... 41 Bronchopneumonia, catar- TMA Le Peele eto ea slens 173 Bronchopneumonia, gan- OMEMOUS ase ek ee ciate wens 173 Bronchopneumonia, vermin- QUST Goines syene S he ie iekea ts 173 Cc Cat, rabies in the......... 103 Catarrhal bronchopneu- MMODIUAN hus Sons ss ss eee a 173 Catarrh, chronic bronchial 43 Catarrh, chronic nasal.... 40 Catarrh of accessory nasal GAVAGIES Se) aie steystaa clave 40 Catarrhal fever, malignant 188 Catarrhal influenza ....... 143 Catarrhal influenza, com- batinioy vase eur Hea tais cians 145 Catarrhal influenza, etiol- OS yi OL ees Ve ieee): 143 Catarrhal influenza, patlio- logical anatomy of,..,. 145 209 210 INDEX PAGE PAGE Catarrhal influenza, spread Contagious pleuropneumonia GE) ot eee 143 of horses... 2 gee 127 Catarrhal influenza, symp- Contagious pleuropneumonia, tomatology of.......... 143 pathological anatomy of. 168 Cattle, contagious pleuro- Contagious pleuropneumonia, pneumonia of ......... 167 symptomatology of..... 167 Catile plague %4.3s.40c0 5s 177 Contagious pleuropneumonia, Cattle; rabies ins ae en = 103 veterinary police regula- Chemo-therapy of influenza 132 Chlorinated lime, milk of.. 27 Chortoptes °. iuced% seis. 8 115 COCCIGIOBIS). =.,5h- omen 189 Coital exanthema ........ 162 Combating anthrax ...... 96 Combating catarrhal influ- SUPEW Ganon acach soon Oe 145 Combating contagious pleu- ropneumonia .......... 174 Combating dourine ...... 164 Combating glanders ...... 72 Combating horse mange.. 123 Combating influenza...... Combating rabies ........ Combating rinderpest .... 192 Combating strangles Complement-fixation test.. 50 Complications of strangles 150 Concentration camps, horses TB ss seep age ee 197 Conglutinatien test ...... 56 Contagious pleuropneumonia combating 2...) .25 er): 174 Contagious pleuropneumonia, differential diagnosis of 172 Contagious pleuropneumonia differentiated from rin- GOEPOSE: fess cors aicucteotevers 188 Contagious pleuropneumonia, etiology VOL. A: vereetl ee 167 Contagious pleuropneumonia Of. cattlesi2 00. See. see tions for:. -/.2 ee seeeee Contagious pustular erup- tions of the genitals.... 163 Cresols ). 2.5...) 3 eee 27 Corps or army horse hos- pitals;.).!s2). 22a 16 Coryza contagiosa equorum 147 Course of rinderpest...... 182 D Depots and hospitals..... 13 Depots, immobile ........ 17 Depots, mobile |... aes 18 Dermanyssus gallinae .... 122 Diagnosis of anthrax...... 92 Diagnosis of glanders..... 44 Diagnosis of rabies....... 105 Differential diagnosis of contagious pleuropneu- Monia) ©. bs ae ee ee 172 Differential diagnosis of dourine ....+\sjaceeemeee 162 Differential diagnosis of glanders. .). ... sche 40 Differential diagnosis of MANGE ~. \,. cs eee 121 Differential diagnosis of rinderpest ©: 5 s\s\-\etnee 187 Disinfection . ..-e- eee 21 Disinfection of equipment. 22 Disinfection of stables and railroad cars. 2qesuter 22 INDEX 211 PAGE PAGE Division horse hospitals... 15 G Dog, rabies in the........ 102 Gangrenous bronchopneu- ID GWA Fae oseecs cece oee 155 NONI: coz teetaysioslchsiey-re 151, 173 Dourine, combating ...... GAS) Gastro-enteritisy. seer 188 Dourine, differential diag- Genitals, contagious pustu- MOMS OE ‘Godeceooscevave 162 lar eruptions of........ 163 Dourine differentiated from (GHANNGIETHES! 5 cg 5c 000000006 29 mllenNiENS) Socéaonusoso0r 162 Glanders, attempts at cur- Dourine, etiology of....... 155 ALIN Oa Uerrent) auorctavencusispetcaeveye ee 81 Dourine, pathological anat- Glanders, blood examina- @Wihy OF Soouwocbooobo 40 162 IGM. TN, Sedcseaccucoo te 72 Dourine, preparation and Glanders, combating ..... 72 staining of blood speci- Glanders, diagnosis of.... 44 TAG WN ssossbcnoeeds 156 Glanders, differential diag- Dourine, spread of........ 158 MOSIS Os weyegehsruee si steely ater 40 Dourine, symptomatology of 159 Glanders, dourine differen- Dourine, veterinary police tiate diet om ieee 162 regulations for ........ 165 Glanders, etiology of..... 29 Glanders, immunization in 80 & Glanders, patholog- Entozoic nodules ........ 42 ical anatomy of........ 33 Equipment, disinfection of 22 Glanders, spread of....... 29 Etiology of anthrax....... g5 Glanders, symptomatology Htiology of catarrhal in- Ode spent Mistrial Gre ai ses’ 30 nay 23 ee pea eee 143 Glanders, veterinary police Etiology of contagious Te culat1onsyaneyr tape 81 pleuropneumonia ....... 1i¢7 Goats, rabies im-- 3.2.5 .- 104 Etiology of dourine...... 155 H BOR) Os BUDS Sal ae 49 Haematopinus macrocepha- Etiology of influenza..... 127 Teme ea ce cae 19] TOOEy, of We oe 13 Hemorrhagic infarcts..... 44 Etiology of rabies........ 9 4 ans onan 172 : ; emorrhagiec septicemia. .. Etiology of rinderpest. . Ue Saisnayee 492 : Terpes tonsurans ....... Etiology of strangles..... eee ee hospitals and depots 13 = Horses during transporta- tion, handling ......... 204 Fistula, treatment of..... 202 Horses in concentration Foot-and-mouth disease... 188 CANNU) Cosco ssocsoasue 197 Formaldehyd ............ 23 Horses, psoroptic mange of 120 Formaldehyd, use of...... 24 Horse, rabies in the...... 104 212 INDEX PAGE PAGE Horses, sarcoptic mange of 118 Lice ........ Jj... emo 121 Horses, symbiotic mange of 121 Lime, milk of............ 26 Hospitals and depots..... 13 Lymphangitis with phleg- Hospitals and depots, ar- MOD 6... seo/ cede 41 rangementS of ......... 14. byssa) ......J.63330 eee 99 Hospitals, corps or army.. 16 Hospitals, division ....... 15 M Bopha a e Malleus |.) /2 23 29 Bhi sat de i Man, rabies: 0.2.22 1. uae 104 I Mange: \.(s:s sien che eeeenrenee 113 TImmobile blood examina- eae coma sah ae ee : t Mange, differential diag- t1ON. StALIONS Siete tes <