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TUFTS UNIVERSITY LIBRARIES
3 9090 013 413 865
Webster Family Librai^ of Veterinary Medicine Cummings School of Veterinary Medicine at Ms Ltniv&rsity 200 vVestboro Road North Grafton. MA 01536
U.S. DEPARTMENT OF AGRICULTURE.
BUREAU OF ANIMAIv INDUSTRY.
SPECIAL REPORT
DISEASES OF THE HORSE.
VREPARED UNDER THE DIRECTION OF
Dr. D. K. S^LIMON,
CHIEF OF THE BUREAU OF ANIMAL INDUSTRY.
Drs. Michener, Law, Harbaugh, Trumbower, Liautard, holcombe, huidekoper, and dickson.
REI^RINTED BY ORDER OK CONGRESS.
WASHINGTON:
GOVERNMENT PRINTING OFFICE. 1896.
si
5
TABLE OF CONTENTS,
Lcftcv of trajismittul.
By Dr. D. E. Salmon, Chief of Biireau ~
Methods of administering medicines,
ByCH. B. MiCHENER, V. S --- 9
Diseases of the digestive organs.
By Ch. B. MiCHENER, V. S 15
Diseases of the urinary organs.
By James Law, F. R. C. V. S . --- «1
Diseases of the respirator}] organs.
By W. H. Harbaugh, V. S. - -- 89
Diseases of the generative organs,
By James Law, F. R. C. V. S 139
Diseases of the nervous systent,
ByM. R. Trumbower, V. S --- 187
Diseases of the lieart and. blood vessels,
ByM. R. Trumbower, V. S 225
Diseases of the eye.
By James Law, F. R. C. V. S - - . - 255
Lameness,
By A. Liautard, M. D.. V. S _.-.. 279
Diseases of the fetlock-, anlde, and foot,
By A. A. HoLCOMBE, D. V. S 369
Diseases of the skin,
By James Law, F. R. C. V. S 433
Wounds and their trecdment ,
By Ch. B. Michener, V. S 4G1
General diseases.
By Rush Shippen Huidekoper, M. D. , Vet. 475
Shoeing,
By William Dickson, V. S , . . 545
3
LIST OP ILLUSTRATIONS.
Page.
Plate I. Digestive apparatus . 59
II. Bots 59
III. Intestinal worms 59
IV. Longitudinal section through kidney 88
V. Microscopic anatomy of kidney _ . . 88
VI. Microscopic anatomy of kidney 88
VII. Calculi and instrument for removal 88
VIII. Instruments used in difficult labor. 18o
IX. Normal presentations 185
X. Abnormal presentations 185
XI. Abnormal presentations 185
XII. Abnormal presentations 185
XIII. Abnormal presentations 185
XIV. Anterior presentations 185
XV. Position of the left lung 138
XVI. The nervous system 223
XVII. Interior of chest, showing jiosition of heart and diaphragm 253
XVIII. Circulatory apparatus 253
XIX. Theoretical section of the horse's ej-e 277
XX. Skeleton of the horse 368
XXI. Superficial layer of muscles 368
XXII. Splint 368
XXIII. Ring-bone 368
XXIV. Various types of spavin 368
XXV. Bone-spavin 368
XXVI. Bone-spavin 368
XXVII. Dislocation of shoulder and elbow, Bourgelafs apparatus 368
XXVIII. The sling in use . 368
XXIX. Anatomy of foot 432
XXX. Anatomy of foot 432
XXXI. Foundered feet 432
XXXII. Ring-bone and navicular disease 432
XXXIII. Quarter crack and remedies 432
XXXIV. Sound and contracted feet 432
XXXV. Diseases of the skin 459
XXXVI. Mites that infest the horse 459
XXXVII. General diseases. Inflamnuxtion 544
XXXVIII. General diseases. Inflammation 544
XXXIX. Glanders, nasal septum of horse, right side, showing acute lesions, 544
XXXX. Glanders, middle region of nasal septum, left side, showing ulcers. 544 XXXXI. Glanders, j^osterior half of nasal septum, right side, showing
cicatrices 544
XXXXII. Shoeing 557
XXXXIII. Shoeing 557
XXXXIV. Shoeing : 557
LETTER OE TRANSMITTAL
Sir: I have the honor to siil)mit herewith a report upon diseases of the horse, whicli has been prepared with great care by a nnniber of the most eminent members of the veterinary profession in the United States. The production of a Avork of this character is a task of such mag:nitude that it could not be undertaken by any one man with a prospect of its early completion. It was deemed best, therefore, to divide the subject into sections and to place the preparation of each section in the hands of a veterinarian whose practical experience and reputation Avould insure a valuable contribution. Bj^ adoj)ting this plan the contents of the volume have been made ready for the printer within a year from the time the work was begun, While, on account of this method of preparation, there may not be quite the same uni- formitj' of style and treatment which would be expected in a volume written by a single author, it is hoped that this will not be found objectionable, and the speedy completion and the co-operation of authors Avho have given special attention to their subjects will prove of great advantage.
The need of a work on the diseases of the horse, which could be dis- tributed to farmers as a safe and scientific guide in the treatment of this species of our domesticated animals, either when affected with slight disorders or serious illness, has long been felt. This obvious want has led to the preparation of the present volume, which is designed as the first of a series to cover the diseases of all varieties of farm ani- mals. The writer would not advise the farmer in ordinary circum- stances to dispense with his veterinarian, any more than he would advise him to treat the diseases of his own family, to manufacture his own furniture, or to be his own blacksmith. There are, however, only too many cases in which the veterinarian can not be i^rocured in time f<n' success, if at all; and, consequently, the farmer who knows or has the means of learning the nature of the disease and the proper treatment will be able to save an animal when otherwise he would lose one. It is common for intelligent people to laugh at the idea of attempting to make every man his own doctor, his own veterinarian, or his own carpenter, and in an ideal condition of society no doubt this would be absurd. But under the conditions which actually obtain on our farms, the farmer Avho can use tools, if but awkwardly, often finds it extremely convenient to temx)orarily usurp the functions of
8 LETTEE OF TRANSMITTAL.
the carpenter; and he also finds that in many cases he must treat liis ailing animals or allow them to suffer without treatment. Knowing this to be the case, is it not far better for the stock-owner to have at his command the advice of veterinarians eminent in their profession than for him to follow the absurd, often barbarous methods of treat- ment which have been handed down by tradition from the empiricism and ignorance of long-past ages?
It is an extremely difficult matter to divest medical literature of technical terms and expressions more or less incomprehensible to the general reader. This has made scientific medicine a sealed book to the masses of our people, and there is no subject of which they are more ignorant. An attempt has been made in this work to present the matter in as simple language as possible, and while some of the authors have been more happy than others in this respect, it is be- lieved that no great difficulty will be met with in any of the articles.
AVhile the subject has been treated in language of a more or less popular style and the book is intended as a guide to the farmer, its intrinsic scientific value should not be entirely lost sight of. In many respects it is a notable contribution to existing knowledge, and it will be prized by the veterinarian not less than by the farmer. No doubt there are some defects in this first edition which the experience of the future will enable us to remedy, but as a whole the book is one which can not fail to be of immense service in educating horse-owners and in hastening the adoption of humane and scientific treatment in the disorders which afflict man's most patient and faithful servant.
The illustrations have been very carefully drawn by Mr. Haines, the greater part of the subjects being selected by Dr. Cooper Curtice. In cases where they have been copied due credit has been given on the plates, but it should be stated here that Ave are indebted to Dr. John S. Billings, of the Army Medical Museum, for the use of the Auzoux models and a number of specimens of diseased feet from which drawings were made.
Very respectfully, D. E. Salmon,
Chief of Bureau of An imal Induslrij.
Hon. J. M. Rusk,
Secretary of Agriculture.
SPECIAL REPORT
ox
DISEASES OF THE HORSE
METHODS OF ADMINISTERING MEDICINES.
By CH. B. MICHENER, V. S.,
Professor of Cattle Pathology and Obstetrics at the New York College of Veterinary Surgeons, Inspector of the Bureau of Animal Industry, etc.
Medicine may enter tlie body through any of the following designated channels: First, by the mouth; second, by the lungs and upper air- passages; third, by the skin; fourth, under the skin (hypodermic methods) ; fifth, by the rectum; and, sixth, by intra-venous injections.
(1) By the mouth. — Medicines can be given by the mouth in the form of powders, balls, drenches, and electuaries.
Powders. — These should be as finely iDulverized as possible, in order to secure a rapid solution and absorption. Their action is in this way facilitated and intensified. Powders must be free from any irritant or caustic action ux^on the mouth. Those that are without any disagree- able taste or smell are readily eaten on the feed or taken in the drink- ing water. When placed on the feed they should first be dissolved or suspended in water and thus sjjrinkled on the feed. If mixed dry the horse will often leave the medicine in the bottom of his manger.
Balls. — When jjroperly made these are cylindrical in shape, 2 inches in length and about three-fourths of an inch in diameter. They should be fresh, but, if necessary to keep them some time, they should be made up with glycerin, or some such agent, to prevent them from becoming too hard. Very old, hard balls are sometimes passed whole with the manure, without being acted upon at all. Paper is to be wraj^ped around balls when given ; it should be thin but firm ; toilet paper is the best. Balls are preferred to drenches when the medicine is extremely disagreeable or nauseating; when the dose is not too large; when the horse is ugly to drench; when the medicine is intended to act slowly. 5961— HOR 1* 9
10
Certain medicines can not, or sliould not, be made into balls — medicines reqnii'ing to be given in large doses, oils, caustic substances, unless diluted and tlioroughh' mixed with the vehicle, deliquescent or efflores- cent salts. Substances suitable for balls can be made up b}^ the addition of honey, sirup, soap, etc., when required for immediate use. Gelatin capsules of different sizes are now obtainalilo and are a con- venient means of giving medicines in ball form.
Drenches are to be given when the medicine is liquid, when the dose is large, and when we desire speedy action.
Electuaries are medicines mixed mostly with licorice-root powder, molasses, or sirup to the consistency of honey, or a "soft-solid." They are intended, chiefl}^ to act locally upon the mouth and throat. They are given with a wooden paddle or strong long-handled spoon.
When balls are to be given we should observe the following direc- tions : In shape they should be cylindrical, of the size above mentioned, and soft enough to be easily compressed by the fingers. If made round or egg-shaped, if too long or too hard, thej^ are liable to become fixed in the gullet and cause choking. Balls may be given with the "ball- ing gun " (obtainable at any veterinarj'- instrument maker's) or by the hand. If given b}" the hand a mouth speculum or gag should l)e used to prevent the animal from biting the hand or crushing the ball. Always loosen the horse before attempting to give a ball ; if tied he ma}^ break his halter and injure himself or the one giving the ball. With a little ijractice it is much easier to give a ball without the mouth-gag, as the liorse always fights more or less against having his mouth forced o[)en. The tongue must be firmly grasped with the left liand and gentl;)' luilled forward; the ball, slightly moistened, is then to be placed with the tips of the fingers of the right hand as far back into the mouth as i)ossi])le; as the tongue is loosened it is drawn back into the mouth and carries the ball backward with it. The mouth should be kept closed for a minute or two. We should always have a l)ail of water at hand to offer the horse after balling. This precaution will often prevent him from coughing out the ball or its becoming lodged in the gullet.
It is very often impossible to get balls properly made or to induce owners or attendants to attempt to give them, and for these reasons medicines by the mouth are mostly given in the form of drenches. When medicine is to be given as a drench Ave must be careful to use enough water or oil to thoroughly dissolve or dilute it ; more than this makes the drench bulky and is unnecessary. Insoluble medicines, if not irritant or corrosive, maybe given simply suspended in water; the bottle to T)e well shaken immediately before giving the drench. The bottle used for drenching purposes should be clean, strong, and smooth about its neck; it should be without shoulders, tapering, and of a size to suit the amount to be given. A horn or tin bottle maybe better, in that they arc not so easily broken by the teeth. If the dose is a small
11
one the liorse\s Lead luay be lield up by the left huiul ^vhile the medi- cine is poured into the mouth by the right. The left thumb is to be placed in the angle of the lower jaw, and the fingers spread out in such a manner as to suj)port the lower lip. Sliould the dose be large, the horse ugly, or the attendant unable to support the head as directed above, the head is then to be held u]) by running the tines of a long- handled wooden fork under the nose-band of the halter; the halter- strap or a roi^e may be fastened to the nose-band and thrown over a limb, beam, or through a pulley suspended from the ceiling. Another way of supporting the head is to jilace a loop in the end of a roj^e, and introduce this loop into the mouth just behind the upx)er front teeth or tusli;s, the free end to be run through a pulley, as before described, and lield by an assistant. It is never to be fastened, as the horse might do himself serious injury if made fast. The head is to be ele- vated just enough to prevent the horse from throwing the liquid out of his mouth. The line of the face should be horizontal, or only the least particle higher. If the head is drawn too high tlie animal can not swallow with ease, or even with safetj". (If this is doubtful, just fill your mouth with w'ater, throw back the head as far as possible, and then trj^ to swallow.) The person giving the drench should stand on some object in order to reach the horse's mouth, on a level, or a little above it. The bottle or horn is then to be introduced at the side of the mouth, in front of the molar teeth, in an upward direction. This will cause the horse to open his mouth, when the base of the bot- tle is to be suddenly elevated, and about 4 ounces of the liquid allowed to escape on the tongue as far back as possible, care being used not to get tlic neck of the bottle between the back teetli. The bottle is to be immediately removed, and if the horse does not swallow this can be encouraged by rubbing the fingers or neck of the bottle against the roof of the mouth, occasionally removing them. As soon as this is swallowed repeat the operation until he has taken all tlie drench. If coughing occurs, or if, by any mishap, the bottle should be crushed in the mouth, lower the head immediately.
Do not rub, pincli, or X)ound the throat, nor draw out the tongue when giving a drench. These in no wa}^ aid the horse to swallow and oftener do harm.
Drenches must never he (jlcen through the )wse: they are liable to strangle the animal, or, if the medicine is irritating, it sets np an inflam- mation of the nose, fauces, windpipe, and sometimes the lungs. Cattle are easily drenched by simply holding them by the nose with the left hand, while the medicine is j)oured into the niouth with the right. Balls are not to be given to cattle; they often become imbedded in the great mass of food in the stomach and act tardily or not at all.
(2) Medicines are administered to the lungs and upjjer air passages by insuiflation, inlialation, and nasal douche. Insufflation, consists of blowing an impalpable powder directly into the nose. It is but rarely
12
resorted to. Gaseous and volatile medicines are given by inhalation, as is also medicated steam or vapor. Of the gases used we may men- tion, as the chief ones, sulphurous acid gas, and occasionally chlorine. The animal or animals are to be placed in a tight building, where these gases are generated, until the atmosphere is sufficiently impregnated with them. Volatile medicines, as the anaesthetics (ether, chloro- form, etc.), are only to be given by the attending surgeon. Medicated vapors are to be inhaled by placing a bucket containing hot water, vinegar and water, scalded hay or bran, to which carbolic acid, iodine, or other medicines have been added, in the bottom of a long grain bag. The horse's nose is to be inserted into the top of the bag, and he thus inhales the " medicated steam." Care must be taken not to have this hot enough to scald the animal. Scalding bran or hay is often thus inhaled to favor discharges in sore throat or "distemper."
The nasal douclie is employed by the veterinarian in treating some local diseases of the nasal chambers. Special appliances and profes- sional knowledge are necessary Avhen using liquid medicines by this method. It is not often resorted to, even by veterinary surgeons, since the horse, as a rule, objects very strongly to this mode of medication.
(3) By the Skin. — Medicines are often administered to our hair- covered animals by the skin, yet care must be taken in applying some medicines, as tobacco- water, carbolic acid solutions, etc. , over the entire body, as poisoning and death follow in some instances from absorption through the skin. AVe must also exercise care, and not apply poisonous medicines over very large raw or abraded surfaces, for the same rea- sons. For domestic animals medicines are only to be applied by the skin for local i)i^rposes or diseases, as laudanum, chloroform liniment, etc. , for neuralgia.
(4) Under the Skin — Hypodermic Method. — Medicines are fre- quently given by the hj^podermic sjainge, under the skin. It will not be safe for any but medical or veterinary practitioners to use this form of medication, since the medicines thus given are powerful poisons. There are many jH'ecautions to be observed ; a knowledge of anatomy is indisi^ensable.
(5) By the Rectum. — Medicines may be given by the rectum when we can not give or retain them by the mouth ; when we want a local action on the last gut; to destroy the small worms infesting the large bowels; to stimulate the peristaltic motion of the intestines and cause evacuation ; and to nourish the bodj^ Medicines are here given in the form of suppositories, or as liquid injections — enemas.
Suppositories are conical bodies made up of oil of theobroma and opium (or whatever medicine is indicated in special cases), and are introduced into the rectum or vagina to allay irritation and pain of these X)arts. Thej are not mucli used in A'eterinary practice.
Enemas, when given for absorption, should be small in quantity, neutral or slightly acid in reaction, and of a temperature of from 90°
13
to 100° F. These, like foods given by the rectum, should only be introduced after the last bowel has been emptied by the hand, or by copious enemas of tepid water. Enemas or clj'sters are mostly given to aid the action of physics, and should then be in quantities sufficient to distend the bowel and cause the animal to eject them. Simple water, salt and water, or soap and water, in quantities of a gallon or more, may be given every half hour. It is best that the horse retain them for some little time, as the liquid serves to moisten the dung and favor a passage. Stimxilcding enemas (turpentine 2 ounces, in linseed oil 6 ounces) should be administered after those already mentioned have emptied the last bowel, with the purpose of still further increas- ing the natural worm-like movement of the intestines and aiding the purging medicine.
Liquids may be thrown into the rectum by the means of a large syr- inge, or diiferent kinds of complicated pumjis. A very good "injec- tion pipe " can be made \)y any tinsmith at a trifling cost, and should be constantly on hand at every stock-farm. It consists of a funnel, about G inches deej) and 7 inches in diameter, which is to be furnished with a pipe-like prolongation, placed at right angles to it, from 14 to 16 inches in length, and carefully rounded and soldered at the ends. This pipe must hQ perfectly smooth, in order to x)reventinjurj^ to the rectum. Introduce this pipe to its full extent, after thoroughly oiling it, and pour the liquid into the funnel rapidly. The pressure of the atmosphere will force the liquid into the bowels. For all ordinary purposes this instrument is quite as good as the more complicated and expensive ones.
Ordinary cold water, or even ice-cold water, is highly recommended by many as a rectal injection for horses overcome by the excessive heat of summer, and may be given by this simple pipe.
(6) Intra- Venous Injections. — Injections directly into veins are to be practiced by medical or veterinary i)ractitioners only, as are Ijrobably some other means of giving medicines — intra-trachael injec- tions, etc.
DISEASES OF THE. I)I(;ESTIVE ORGANS.
By CH. B. MICHENER, V. S.,
Professor of Cattle Pathology and Obstetrics at the Neir York College of Veferinarjj Suyyeons, Inspector Bureau of Animal Industry, etc.
It will not. prove an easy task to write "a jjlaiu account of tlie com- mon diseases, with directions for preventive measures, hygienic care, and the simpler forms of medical treatment" of the digestive organs of the liorse. This study includes a careful consideration of the food and drink of our animals, their quality, quantity, analyses, etc. This, of itself, is material for a book. Being limited as to simce, one must endeavor to give simply an outline; to state the mostimijortant facts, leaving many gaps, and continually checking the disposition to write anything like a full description as to cause, prevention, and modes of treatment of disease.
These article are addressed entirely' to farmers and stock-owners, and I must ask my professional brethren to bear this in mind, when disposed to complain of a want of scientific treatment of the subjects.
Water. — It is generally held, at least in practice, that any water that stock can be induced to drink is sufficiently pure for their use. This practice occasions losses that would startle us if statistics were at hand. Water that is impure from the presence of decomposing organic matter, such as is found in wells and ponds in close proximity to manure heaps and cess-j)ools, is frequently the cause of diarrhea, dys- enter}-, and many other diseases of stock, while water that is impreg- nated with different poisons, and contaminated with specific media of contagion, j^roduces death in very many instances.
Considering first the quant it}' of water required by the horse, it may be stated that when our animals have access to water continually they never drink to excess. Were the horse subjected to ship-voyages, or ain^ other circumstances where he must depend upon his attendant for the supply of water, it maybe roughly stated that each horse requires a daily average of about 8 gallons of water. This will vary soraeAvhat upon the character of his food; if upon green food, less water will be needed than when fed upon dry hay and grain.
15
16
The time of giving water sliould be carefully studied. At rest, the horse should receive water at least three times a day; wiien at work, more frequently. The rule here should be to give in small quantities and often. There is a popular fallacy that if a horse is w^arm he should not be allowed to drink, many claiming that the first swalloAv of water ' ' founders " the animal, or j^roduces colic. This is erroneous. No matter how warm ahorse maybe, it is always entirely safe to allow him from six to ten swallows of water. If this is given on going into the stable, he should be given at once a pound or tAvo of haj' and allowed to rest about an hour before feeding. If water be now offered him it will in many cases be refused, or at least he will drink but spar- ingly. The danger, then, is not in the "first swallow" of water, but is due to the excessive quantity that the animal will take when warm if not restrained.
"Water should never be given to horses when it is ice-cold. It may not be necessary to add hot water, but we should be careful in placing water-troughs about our barns to have them in such position that the sun may shine ujion the water during the winter mornings. 'VV'ater, even though it be thus cold, seldom i^roduces serious trouble if the horse has not been deprived for a too great length of time.
In reference to the purify of water Smith, in his "Veterinary Hy- giene," classes spring, deep-well water, and uj^land surface-water as wliolesomie; stored rain-water and surface-water from cultivated land as suspicious; river water to which sewage gains access and shallow- well water as dangerous. The water that is used for drinking jjurposes for stock so largel}^ throughout some States can not but be impure. I refer to those sections where there is an impervious clay subsoil. It is the custom to scoop or hollow out a large basin in the different pas- tures. During rains these basins become filled with water. The clay subsoil being almost impervious acts as a jug, and there is no escape for the water except by evaporation. Such water is stagnant, but would be kept comparatively fresh by subsequent rains were it not for the fact that much organic matter is carried into these ponds by sur- face drainage during each succeeding storm. This organic matter soon undergoes decomposition, and as the result we find diseases of different kinds much more prevalent where this water is drunk than where the water-supply is wholesome. Again, it must not be lost sight of that stagnant surface-water is much more certainly contaminated than is running water by one diseased animal of the herd, thus endangering the remainder.
The chief impurities of water may be classed as organic and ijior- ganic. The organic imi)urities are either animal or vegetable sub- stances. The salts of the metals are the inorganic impurities. Lime causes hardness of water, and occasion will be taken to speak of this when describing intestinal concretions. Salts of lead, iron, and copper are also frequently found in water, and will be referred to hereafter.
17
About the only examination of water that can be made by the aver- age stock-raiser is to observe its taste, color, smell, and clearness. Pure water is clear and is without taste or smell. It should jjossess a slight bluish tint.
Chemical and microscopic examination will frequently be necessary in order to detect the presence of certain i)oisons, bacteria, etc., and can of course only be conducted by experts.
Foods and feeding. — In this place one can jiot attempt anything like a comjirehensive discussion of the subject, and I must content myself with merely giving a few facts as to the different kinds of food, preparation, digestibility, proper time of feeding, quality, and quan- tity. Improi^er feeding and watering will doubtless account for over one-half of the digestive disorders met with in the horse, and hence the reader can not fail to see how very important it is to have some proper ideas concerning these subjects.
Kinds of food. — In this country horses are fed chiefly upon hay, grass, roots, oats, corn, wheat, and rye. Many think that they could be fed on nothing else. Stewart, in "The Stable Book," gives the following extract from Loudon's Encj^clopedia of Agriculture, which is of interest at this point:
In some sterile countries they (liorses) are forced to subsist on dried fish, and even on vegetable mold; in Arabia, on milk, flesh-balls, eggs, broth. In India horses are variously fed. The native grasses are judged very nutritious. Few, perhaps no oats are grown; barley is rare, and not commonly given to horses. In Bengal a vetch, something like the tare, is used. On the western side of India a sort of pigeon-i^ea, called gram {Cicer arietinum) forms the ordinary food, with grass while in season, and hay all the year round. Indian corn or rice is seldom given. In the West Indies maize, gtiinea corn, sugar corn tops, and sometimes molasses, are given. In the Mahratta country salt, i^epper, and other spices are made into balls, with flour and butter, and these are supposed to produce anima- tion and to fine the coat. Broth made from sheep's head is sometimes given. In France. Spain, and Italy, besides the grasses, the leaves of limes, vines, the tops of acacia, and the seeds of the carob-tree are given to horses.
For information as to the nutritive value, chemistry, and classifica- tion of the different kinds of food, I will refer the reader again to Smith's Veterinary Hygiene.
We can not, however, leave aside entirely here a consideration of the digestibility of foods; and by this we mean the readiness with which foods undergo those changes in the digestive canal that fit them for absorption and deposition as integral parts of the animal economy.
The age and health of the animal will, of course, modify tlie diges- tibility of foods, as will also the manner and time of harvesting, pre- serving, and preparing the foods.
In the horse digestion takes place principally in the intestines, and here, as in all other animals and with all foods, we find that a certain part only of the provender is digested; another portion is indigested. This proportion of digested and indigested food must claim passing
18
notice at least, for if tlie horse receives too much food a hirge i^ortion of digestible food must pass out unacted ui^on, entailing not only the loss of this unused food, but also calling for an unnecessarj'^ expendi- ture of Adtal force on the i)art of the digestive organs of the horse. It is thus that, in fact, too much food may make an animal poor.
In selecting food for the horse we should remember the anatomical arrangement of the digestive organs, as well as the physiological func- tions performed by each organ. Foods must be wholesome, clean, and sweet; the hours of feeding regular; the mode of preparation found by practical experience to be the best must be adhered to, and clean- liness in preparation and administration must be observed.
The length of time occupied by stomach digestion in the horse varies with the different foods. Hay and straw jjass out of the stomach more rapidly than oats. It would seem to follow, then, that oats should be given after hay, for if reversed the hay would cause the oats to be sent onward into the intestines before being full}- acted u^jon by the stom- ach, and as a result produce indigestion. Experience confirms this. There is another good reason why hay should be given first, particu- larly if the horse is very hungry or if exhausted from overwork, namely, it requires more time in mastication (insuring proper admix- ture of saliva) and can not be bolted as are the grains. In either instance Avater must not be given soon after feeding, as it waslies or sluices the food from the stomach before it is fitted for intestinal digestion.
The stomach begins to enii:>ty itself very soon after the commence- ment of feeding, and continues rapidly while eating. Afterwards the passage is slower, and several hours are required before the stomach is entirely emjjty. The natui-e of the work required of the horse must guide us in the selection of his food. Rapid or severe labor can not be performed on a full stomach. For such horses food must be given in small quantitj- and fed to them about two hours before going to their work. Even liorses intended for slow work must never l)e engorged with bulky, innutritions food immediately before going to labor. The small stomach of the horse would seem to lead us to the conclusion that this animal should be fed in small quantities and often, which, in reality, should be done. The disproportion between the size of the stomach and the amount of water drank tells us plainly that the liorse should always be watered before feeding. One of the common errors of feeding, and the one that x^i'oduces more digestive disorders than any other, is to feed too soon after a hard daifs worlc. This must never be done. If a liorse is completely jaded it will be found beneficial to give him an alcoholic stimulant on going into the stable. A small quantity of hay may then be given, but his grain should be withheld for one or two hours. These same remarks will apply with equal force to the horse that for any reason has been fasting for a long time. After a fast feed less than the horse would eat; for if allowed too much the
stomach becomes engorged, its walls paralyzed, and ''colic" is almost sure to follow. The horse should be fed three or four times a day ; nor will it answer to feed liim entirely ui)on concentrated food. Bulky food must be given to detain the grains in their passage through the intestinal tract; bulk also favors distention, and thus mechanically aids absorption. To horses that do slow work for the greater part of the time, chopped or cut hay fed with crushed oats, ground corn, etc., is the best manner of feeding, as it gives the required bulk, saves time, and half the labor of feeding.
Sudden changes of diet are always dangerous. — "When desirous of changing the food, do so ver}'^ gradually. If a horse is accustomed to oats a sudden change to a full meal of corn will almost always sicken him. If we merel}' intend to increase the cjuantity of the usual feed, this again must be done gradually. The quantity of food given must always be in proportion to the amount of labor to be performed. If a horse is to do less work, or rest entirely from work for a few days, see that he receives less feed. If this was observed even on Saturday night and Sunday there would be fewer cases of " Monday morning sickness," such as colics and lymphangitis. Foods should also be of a more laxa- tive nature w' hen the horse is to stand for some days. Above all things we should avoid feeding musty or moldy foods. These are very fre- quent causes of disease of different kinds. Lung trouble, as bron- chitis and "heaves," often follows the use of such food. The digest- ive organs always suffer from moldy or musty foods. Musty hay is generally considered to i)roduce disorder of the kidneys; and all know of the danger to pregnant animals from feeding upon ergotized grasses or grains.
Leaving these somewhat general considerations, I will refer briefly to the different kinds of foods :
Haij. — The best hay for horses is timothy. It should be about one year old, of a greenish color, crisp, clean, fresh, andpo-ssessinga sweet, pleasant aroma. Even this good hay, if kept for too great a length of time, loses part of its nourishment, and while it VL\B,y not be positively injurious, it is hard, dry, and indigestible. New hay is difficult to digest, i^roduces much salivation (slobbering) and occasionally purg- ing and irritation of the skin. If fed at all it should be mixed with old hay.
Second crop or afiennalh. — This is not considered good hay for horses, but it is prized by some farmers as a good food for milch cows, they claiming that it increases the flow of milk. The value of hay depends upon the time of cutting, as well as care in curing. Hay should be cut when in full flower, but before the seeds fall; if left longer, it becomes dry and woody and lacks in nutrition. An essential point in making hay is that when the crop is cut it should remain as short a time as iwssible in the field. If left too long in the sun it loses color, flavor, and dries or wastes. Smith asserts that one hour more
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than is necessary in the sun causes a hjss of 15 to 20 per cent in the feeding value of hay. It is impossible to state any fixed time that hay must have to cure, this depending, of course, upon tlie weather, thick- ness of the crop, and many other circumstances ; but it is well known that in order to preserve the color and aroma of hay it should be turned or tedded frequent!}" and cured as quiclx'hj os possible. On the other hand, hay spoils in the mow if harvested too green or when not suffi- ciently dried. Mow-burnt hay produces disorders of the kidneys and bowels and causes the horse to fall off in condition. Musty or moldy hay has often been said to produce that peculiar disease known variously as cerebro-spinal meningitis, putrid sore throat, or choking distemper.
The average horse, getting grain, should be allowed from 10 to 12 pounds of good hay a day. It is a mistake of manj^ to think that horses at light work can be kept entirely on hay. Such horses soon become pot-bellied, fall off in flesh, and do not thrive. The same is true of colts; unless the latter are fed with some grain they grow up to be long, lean, gawky creatures, and never make as good horses as those accustomed to grain, with or in addition to their hay.
Sfraiv. — The straws are not extensively fed in this country, and when used at all they should be cut and mixed with hay and ground or crushed grain. Wheat, rye, and oats straw are the ones most used, and of these oats straw is most easily digested and contains the most nourishment. Pea and bean straw are occasionally fed to horses, the pea being preferable according to most writers.
Chaff. — Wheat and rye chaff should never be used as a food for horses. The beards frequently become lodged in the mouth or throat and are productive of more or less serious trouble. In the stomach and intestines they often serve as the nucleus of the "soft concre- tions " which are to be described when treating of obstructions of the digestive tract.
Oat chaff, if fed in small quantities and mixed with cut hay or corn- fodder, is very much relished by horses. It is not to be given in large quantities, as I have repeatedlj^ witnessed a troublesome and some- times fatal diarrhea to follow the practice of ^dlowing horses or cattle free access to a pile of oat chaff.
Grains. — Oats take precedence of all grains as a food for horses, as the ingredients necessary for the complete nutrition of the body exist in them in the best i)roportions. Oats are besides more easily digested and a larger proportion absorbed and converted into the various tis- sues of the body. Care must be taken in selecting oats. According to Stewart the best oats are one year old, x^li^mp, short, hard, clean, bright, and sweet. New oats are indigestible. Kiln-dried oats are to be refused as a rule, for even though originallj^ good this drjdng i^roc- ess injures them. Oats that have si^routed or fermented are injurious and should never be fed. Oats are to be given either whole or crushed ; whole in the majority of instances, crushed to old horses
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and those having defective teeth. Horses, also, that "bolt their feed are best fed upon crushed oats and out of a manger large enough to permit of s^jreading the grain in a thin layer.
The average horse requires, in addition to the allowance of hay above spoken of, about 12 quarts of good oats daily. The best oats are those cut about one week before being fully rijie. Not only is the grain richer at this time in nutritive materials, but there is also less waste from ' ' scattering " than if left to become dead ripe. Moldy oats, like hay and straw, not only xn'oduce serious digestive disorders, but have been the undoubted cause of outbreaks of that dread disease in horses, already referred to, characterized by inability to eat or drink, sudden paralysis, and death.
Wheat and rye. — These grains are not to be used as food for horses except in small quantities, bruised or crushed, and fed mixed with other grains or haj'. If fed alone, in any considerable quantities, they are almost certain to produce digestive disorders, laminitis (founder), and similar troubles. They should never constitute more than one- fourth of the grain allowance, and should always be ground or crushed.
Bran. — The bran of wheat is the one most used, and its value as a feeding stuff is A'ariouslj^ estimated. It is not to be dei^ended upon if given alone, but may be fed with other grains. It serves to keep the bowels ox)en. Sour bran is not to be given. It disorders the stomach and intestines and may even produce serious results.
Maize — Corn. — This grain is not suitable as an exclusive food for young horses, as it is deficient in salts. It is fed whole or ground. Corn on the cob is commonly used as the food for horses affected with " lami^as." If the corn is old and is to be fed in this manner it should be soaked in pure, clean water for ten or twelve hours. Corn is better given ground, and fed in quantities of from 1 to 2 quarts at a meal mixed with crushed oats or wheat bran. We must be very particular in giving corn to a horse that is not accustomed to its use. It must be commenced in small quantities and verj^ gradually increased. I know of no grain more likely to produce what is called acute indiges- tion than corn if these directions are not observed.
Linseed. — Ground linseed is occasionally fed with other foods to keep the bowels open and to improve the condition of the skin. It is of i3articular service during convalescence, when the bowels are slug- gish in their action. Linseed tea is very often given in irritable or inflamed conditions of the digestive organs.
Boots — Botatoes. — These are used as an article of food for the horse in many sections. If fed raw and in large quantities they often pro- duce indigestion. Their digestibility is favored by steaming or boiling. They possess, in common with other roots, slight laxative properties.
Beets. — These are not much used as food for horses.
Carrots. — These make a most excellent food, particularly during sickness. They improve the appetite and slightly increase the action
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of tlie bowels and kidneys. They i)ossess also certain alterative properties. The coat becomes smooth and glossy Avhen carrots are fed. Some veterinary writers claim that chronic congh is cured by giving carrots for some time. The roots may be considered then as an adjunct to the ]'egular regime, and if fed in small (iuan titles are highly beneficial.
Grasses. — Grass is the natural food of horses. It is composed of a great variety of plants, differing widely as to the amount of nourish- ment contained, some being almost entirely without value as foods and only eaten when there is nothing elseo btainable; others are posi- tively injurious or even poisonous. None of the grasses are sufficient to keep the horse in condition for work. Horses thus fed are "soft," sweat easily, purge, and soon tire on the road or when at hard work. To growing stock grass is indispensable, and there is little or no doubt but that it acts as an alterative when given to horses accustomed to grain and hay. It must be given to such subjects in small quantities at first. The stomach and intestines undergo rest and recuperate if the horse is turned to grass for a time each year. It is also certain that during febrile diseases grass acts almost as a medicine, lessening the fever and favoring recovery; wounds heal more rapidly than when the horse is on grain, and some chronic disorders (chronic cough for instance) disappear entirely when at grass. In my experience grass does more good when the horse crops it himself. This may be due to the sense of freedom he enjoys at pasture, to the rest to his feet and limbs, and for many similar reasons. When cut for him it should be fed fresh or when but slightly wilted.
PREPARATION OF FOODS.
Foods are prepared for feeding for any of the following reasons: To render the food more easily eaten; to make it more digestible; to economize in amount; to give it some new property, and to preserve it. We have already spoken of the preparation of dr^ang, and need not revert to this again, as it only serves to preserve the different foods. Drying does, however, change some of the properties of food, i. e., removes the laxative tendency of most of them.
The different grains are more easily eaten when ground, crushed, or even boiled. Rye or wheat should never be given whole, and even of corn it is found that there is less waste when ground, and, in common with all grains, it is more easily digested than when fed whole.
Hay and fodder are economized when cut in short pieces. Not only will the horse eat the necessary amount in a shorter time, but it will be found that tiicre is less waste, and the mastication of the grains (whole or crushed) fed with them is insured.
Reference has already been made to those horses that bolt their food, and we need only remark here that the consequences of such ravenous eating may be prevented if the grains ai-e fed with cut hay,
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straw, or fodder. Long or uncut haj should also be fed, even though a certain amount of hay or straw is cut and fed mixed with grain.
One objection to feeding cut ha}^ mixed with ground or crushed grains, and wetted, must not be overlooked during the hot months. Such food is apt to undergo fermentation if not fed directly after it is mixed, and the mixing-trough even, vinless frequently scalded and cleaned, becomes sour and enough of its scrapings are given with the food to produce flatulent (wind) colic. A small amount of salt should always be mixed with such food.
Bad hay should never be cut simply because it insures a greater con- sumption of it; bad foods are dear at any price and should never be fed. We have before spoken of the advantage of boiling roots. Not only does this render them less liable to produce digestive disorders, but it also makes them clean. Boiling or steaming grains is to be recommended when the teeth are poor, or when the digestive organs are weak. Of ensilage as a food for horses I have no experience, but am inclined to think that (and tliis opinion is based upon the imper- fect manner in which the crop is often stored) disordered digestion would be more frequent were it extensively fed.
DISEASES OF THE TEETH.
Dentition. — This covers the period during which the J'oung horse is cutting his teeth, from birth to the age of five years. With the horse more difliculty is experienced in cutting the second or permanent teeth than with the first or milk teeth. There is a tendency among farmers and many veterinarians to pay too little attention to the teeth of young horses. Percivall relates an instance illustrative of this, that is best told in his own words:
I was requested to give my opinion concerning a horse, then in his fifth year, who had fed so sparingly for the last fortnight, and so rapidlj- declined in condi- tion in consequence, that his owner, a veterinary surgeon, was under no light apprehensions about his life. He had himself examined his mouth, \A-ithout hav- ing discovered any defect or disease; thougli another veterinary surgeon was of opinion that the difficulty or inability manifested in mastication, and the conse- quent cudding, arose from preternatural bluntness of the surfaces of the molar teeth, which were, in consequence filed, but without beneficial result. It was after this that I saw the horse; and I confess I was, at mj first examination, qiTite as much at a loss to offer any satisfactory interpretation as others had been. While meditating, however, after my insi)ection, on the apparently extraordinarj- nature of the case, it struck me that I had not seen the tusks. I went back into the stable and discovered two little tumors, red and hard, in the situation of the inferior tusks, which, when pressed, gave the animal insufferable pain. I instantly took out my pocket-knife and made crucial incisions through them both, down to the coming teeth, from which moment the horse recovered his appetite and by degrees his wonted condition.
The mouths of young horses should also bo frequently examined to see if one or more of the milk teeth are not remaining too long,
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causing the second teeth to grow in crooked, in which case the first teeth should be removed by the forceps.
Irregidarities of teeth. — There is quite a fashion of late years, espe- cially in large cities, to have horses' teeth regularly "floated" or "rasped" by "veterinary dentists." In some instances this is very beneficial, while in most cases it is entirel}^ unnecessar3\ From the character of the food, the rubbing or grinding surface of the horse's teeth should be rough. Still we must remember that the upper jaw is somewhat wider than the lower, and that from the fact of the teeth not being i^erf ectly apposed, a sharp ridge is left unworn on the inside of the lower molars and on the outside of the upper, which may exco- riate the tongue or lips to a considerable extent. This condition can readil}^ be felt by the hand, and these sharp ridges when found should be rasped down by a guarded rasp. Anyone can do this without the aid of the veterinarian. In some instances the first or last molar tooth is unnaturally long, owing to the absence of its fellow on the opposite jaw. Should it be the last molar that is thus elongated it will require the aid of the veterinary surgeon, who has the necessary forceps or chisel for cutting it. The front molar maj" be rasped down, if much patience is taken. In decay of the teeth it is quite common to find the tooth corresponding to the decayed one on the opposite jaw very much elongated, sometimes to that extent that the mouth can not be perfectly closed. Such teeth must also be shortened by the bone for- ceps, chisel, bone-saw, or rasp. In all instances where horses "quid" their food, where they are slobbering, or where they evince pain in mastication, shown by holding their head to one side while chewing, the teeth should be carefully examined. If, as is mostly the case, all these symptoms are referable to sharp corners or projections of the teeth, these must be removed by the rasp. If decayed teeth are found, or other serious difficulty detected, an expert should be called.
Toothache. — This is rare in the horse, and is mostly witnessed where there is decay of a tooth. I have observed it only in the molar teeth. Toothache is to be discovered in the horse by the i^ain expressed by him while feeding or drinking cold water. I have seen horses affected with toothache that would suddenly stop chewing, throw the head to one side, and slightly open the mouth. They behave as though some sharp body had punctured the mouth. If upon examination there is no foreign body found we must then carefully examine each tooth. If this can not be done with the hand in the mouth we can, in most instances, discover the aching tooth bj^ pressing each tooth from with- out. The horse will flinch when the sore tooth is pressed upon. In most cases there is nothing to be done but the extraction of the decayed tooth, and this, of course, is only to be attempted by the veterinarian.
There is a (leforinitij, known as parrot-mouth, that interferes with prehension, mastication, and, indirectly, with digestion. The upper
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incisors project in front of and beyond the lower ones. Tlie teeth of both jaws become nnusually long, as they are not worn down by fric- tion. Such horses exi^erience much difficulty in grazing. Little can be done exceiDt to occasionally examine the teeth, and if those of the lower jaw become so long that they bruise the "bars" of the upper jaw, they must be shortened by the rasj) or saw. Horses with this deformity should never bo left entirel}' at pasture.
DISEASES OF THE MOUTH.
Ldinpas is the name given to a swelling of the mucous membrane covering the hard palate and projecting in a more or less XDrominent ridge immediately behind the upper incisors. There is no doubt but that in some rare instances, and i^articularly while teething, there is a congestion and swelling of this part of the roof of the mouth which may interfere with feeding. In one instance in my practice I found the swelling so extensive that the mucous membrane was caught between the front teeth when the horse attempted to eat. Should this exist the swollen parts are to scarified, being careful not to cut deeply into the structures. An astringent wash of alum water may also be beneficial. Burning of the lampas is cruel and unnecessary, and should never be permitted, as it often causes serious results to follow.
It is quite a common ojiinion among owners of horses and stablemen that lampas is a disease that very frequentlj' exists. In fact whenever a horse fails to eat, and if he does not exhibit very marked symptoms of a severe illness, they say at once "he has the lampas." It is almost impossible to convince them to the contrary, yet in a practice extend- ing over fifteen j^ears I have never seen but two or three cases of what is called lampas that gave rise to the least trouble or that called for any treatment whatever. It may be put down, then, as more a disease of the stableman's imagination than of the horse's mouth.
Sfomatitis. — This is an inflammation of the mucous membrane lining the mouth and is produced by irritating medicines, foods, or other sub- stances. In cities it frequently follows from eating out of ash-barrels. The symptoms are swelling of the mouth, which is also hot and pain- ful to the touch; there is a coj)ious discharge of saliva; the mucous membrane is reddened, and in some cases there are observed vesicles or ulcers in the mouth. Tlie treatment is simple, soft feed alone often being all that is necessary. In some instances it may be advisable to use a wash of chlorate of potash, borax, or alum, about one-half ounce to a pint of water. Ilaj', sti-aw, or oats should not be fed unless steamed or boiled.
Glossitis, or inflammation of the tongue, is very similar to the above, and mostly exists Avith it and is due to the same causes. Injuries to the tongue may produce this simple inflammation of its covering mem- brane, or, if severe, may produce lesions much more extensive, such as lacerations, abscesses, etc. These latter would require surgical
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treatment, btit for the simpler forms ol inflammation of the tongue the ti'eatmeut recommended for stomatitis should be followed.
PtyaUsiii or salivation consists in an abnormal and excessive secre- tion of saliva. This is often seen as a sj'-mptom of irregular teeth, in- flammation of the mouth or tongue, or of the use of such medicines as lobelia, mercu ry , and many others. Some foods produce this, as clover, and particularly second crop ; foreign bodies, as nails, Avheat-chaff , and corn-cobs becoming lodged in the mouth. If the cause is removed, as a rule no further attention is necessary. Astringent washes may be applied to the mouth as a gargle or by means of a sponge.
Pharyngitis is an inflammation of the mucous membrane lining of the pharynx (back part of the mouth). It rarely exists unless accom- panied by stomatitis, glossitis, or laryngitis. In those instances where the inflammation is mostlj^ confined to the pharynx we notice febrile S3'mptoms — difficulty of swallowing either liquids or solids; there is but little cough except when trying to swallow; there is no soreness on i^ressure over larynx (large ring of the windpipe). Increased flow of saliva, difficulty of swallowing liquids in particular, and cough only when attempting to swallow, are the symptoms best marked in pharjmgitis. For treatment, chlorate of potash in half-ounce doses three or four times a day is the best. This may be given suspended in warm water as a gargle, or may be mixed with licorice-root jjowder and honey and given with a strong spoon or w^ooden paddle. Borax or alum water maybe substituted for chlorate of potash in the same-sized doses. Soft food should be given, but I have seen some cases where the animal would eat corn from the cob better than anj'thing else.
Paralysis of the ^^liarijnx, or, as it is commonly called, "x^aralj'sis of the throat," is one of the most stubborn diseases of the horse that we are ever called to treat. A horse is suddenly noticed to be unable to eat, and his manger is found to contain much saliva and frothy food that has been returned through his nose. The sympfoms which enable us to tell that paralysis of the pharynx exists are as follows: The owner says he has a horse that "can't eat." That is all he knows. We find the animal with a somewhat anxious countenance; manger, as above described; pulse, respiration, and temperature, at first, about the same as in health ; tlie horse will constantly try to eat or drink, but is unable to do so ; if water be offered him from a pail he will apparently drink with avidity, but, if we notice, the quantity of water in the pail remains about the same; he will continue trying to drink by the hour; if he can succeed in getting ixny fluid into the back part of the mouth it comes out at once through the nose. Foods also return through the nose, or are dropped from the mouth, quidded. An examination of the mouth by inserting the hand fails to find any obstruction or any abnormal condition, except, perhaps, that the parts are too flabby to the touch. These cases go on from bad to worse; the horse constantly and rapidlj^ loses in condition, becomes
27
very much emaciated, the eyes are llollo^^' and lustreless, and death soon occurs from inanition.
Treatment is very unsatisfactory. Severe blisters should he applied behind and under the jaw; the mouth is to be frequently swabbed out with alum or chlorate of potash, 1 ounce to a pint of water, by means of a sponge fastened to the end of a stick. Strychnia is the best agent to be used to overcome this paralysis, and should be given in 1-grain doses three or four times a day. If the services of a veter- inarian can be obtained he should give this medicine by means of a h3'i)odermic s\ringe, injecting it deeply into the pharynx. In my experience the blister externally, the freciuent swabbing of the mouth, as above described, and the use of a nerve stimulant are all that can be done. This disease may be mistaken at times for foreign bodies in the mouth or for the so-called cerebro-spinal meningitis. It is to be distinguished from the former by a careful examination of the mouth, the absence of any offending body, and by the flabby feel of the mouth ; from the latter by the animal appearing in perfect health in every i)articular except this inability to eat or drink.
Abscesses sometimes form in the pharynx and give rise to symptoms resembling those of laryngitis or distemper. Interference with breath- ing, that is of recent origin, and i^rogression, without any observable swelling or soreness about the throat, will make us suspect the for- mation of an abscess in this location. But little can be done in the waj^ of treatment, save to hurry the ripening of the abscess and its discharge, by steaming with hops, hay, or similar substances. If the abscess can be felt through the mouth it must be opened by the attending veterinary surgeon.
DISEASES OF THE CESOPHAGUS OR GULLET.
It is rare to lind disease of this organ, except as a result of the in- troduction of foreign bodies too large to pass, or the exhibition of irritating medicines. Great care should be taken in the administra- tion of irritant or caustic medicines that they be thoroughly diluted. If this is not done erosions and ulcerations of the tljroat ensue, and this again is prone to be followed 'by constriction — narrowing — of the gullet. The mechanical trouble of choking is quite common. It fre- quently occurs when the animal is suddenly startled while eating apples or roots, and we should be careful never to suddenly approach or put a dog after horses or cows that are feeding upon such sub- stances. If left alone they \Qvy rarely attempt to swallow the object until it is sufficiently masticated.
Choking also arises from feeding oats in a deep, narrow manger to such horses as eat very greedily, or bolt their food. Wheat chaff is also a frequent source of choke. This accident may result from the attempts to force eggs down without breaking or from gi-vdng balls that are too large or not of the proper shape.
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Whatever object causes the choking, it may lodge in the upper part of the oesophagus, at its middle portion, or close to the stomach, giviiTg rise to the designations of pliaryngeal, cervicaJ, and ihoracic choke. In some cases where the original obstruction is low we find all that part of the gullet abov^ it to be distended with food.
The symptoms will vary according to the position of the body caus- ing choke. In 2'>^^<^^^'yngeal cliolxe the object is lodged in the upper p)oriion of oesophagus. The horse will present symptoms of great distress, hurried breathing, frequent cough, excessive flow of saliva, sweating, trembling, or stamping with the fore feet. The abdomen rapidly distends with gas. The diagnosis is completed by manipulat- ing t*Iie upper part of the throat from without and by the introduction of the hand into the back part of the mouth, finding the body lodged here. In cervical choke (where the obstruction is situated at any point between the throat-latch and the shoulder) the object can both be seen and felt. The symptons here are not so severe; the horse will be seen to occasionally draw himself up, arch his neck, and some- times utter a loud shriek; the expression becomes anxious, and attempts at vomiting are made. The abdomen is mostly full and tynii^anitic. Should there be any question as to the trouble a decided conclusion may mostly be reached by pouring water into the throat from a bottle. If the obstruction is complete you can see the gullet become distended with each bottle of water by standing on the left side of the horse and watching the course of the oesophagus, just above the windi:)ipe. This is not always a sure test, as the obstruction may be an angular body, in which case liquids would pass it. Solids taken would show in these cases; but solids should not, however, be given, as they serve to increase the trouble by rendering the removal of the body more difficult. In cervical choke one can always, with a little care, feel the imprisoned object.
In thoracic choke the symptoms are still less severe. Our attention will be directed to this part of the oesophagus by food or water being ejected through the nose or mouth after the animal has taken a few swallows. There Avill be some symptoms of distress, fullness of the abdomen, cough, and occasionally the crying or shrieking as heard in cervical choke. The diagnosis is complete if, upon passing the probang (a hollow, flexible tube made for this j^urpose), an obstruction is encountered.
Treaiment. — If the choke is at the beginning of the gullet {pharyn- geal) we must endeavor to remove the obstacle through the mouth. A mouth-gag or si)eculum is to be introduced into the mouth to pro- tect the hand and arm of the operator. Then while an assistant, Avith his hands grasped tightly 'behind the object, presses it upward and forward with all his force, the operator must pass his hand into the mouth until he can seize the obstruction and draw it outward. This mode of procedure must not be abandoned Avith the first failure, as Ave
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may get the obstacle farther toward the moiitli by continued efforts. If we fail with the hand, forceps may be introduced through the mouth and the object seized when it is just beyond the reach of the fingers. Should our efforts entirely fail we must then endeavor to force the obstruction downward by means of the probang. This instrument, which is of such signal service in removing choke in cattle, is decidedly more dangerous to use for the horse, and I can not pass this point without a word of caution to those who have been known to introduce into the horse's throat such objects as whip-stalks, shovel-handles, etc. These are always dangerous, and I have seen more than one horse die from this barbarous treatment.
Cervical clioT^e. — In this, as well as in thoracic choke, we must first of all endeavor to soften or lubricate the obstruction by pouring oil or mucilaginous drinks down the gullet. After this has been done we are to endeavor to move the object by gentle manipulations with the hands. If choked with oats or chaff (and these are the objects that most fre- quently produce choke in the horse), we should begin by gently squeez- ing the lower portion of the impacted mass, and endeavoring to work it loose a little at a time. This is greatly favored at times if we apply hot fomentations immediately about the obstructions. We should persist in these efforts for at least an hour before deciding to resort to other and more dangerous modes of treatment. Should we fail, hoAvever, the probang may be used. In the absence of the regular instrument, which must always be flexible and finished with a smooth cup-shaped extremity, we may use a long piece of inch hose. The mouth is to be kept open by a gag of wood or iron and the head slightly raised and extended. The iDrobang is then to be carefully guided by the hand into the upjier part of the gullet and gently forced doMTiward until the obstruction is reached. Pressure must then be gradual and firm. Do not, at first, attemj^t too much force, or the oesophagus will be ruptured. Simply keep up this firm, gentle pres- sure until you feel the object moving, after which you are to rapidly follow it to the stomach. If, again, this mode of treatment is unsuc- cessful, a veterinarian or medical doctor is to be called in, who can remove the object by cutting down upon the gullet, opening it, and removing the offending body. This should scarcely be attempted by a noAace, as a knowledge of the anatomj^ of the parts is essential to avoid cutting the large arter}-, vein, and nerve that are closely related to the oesophagus in its cervical j^ortion.
Thoracic clioke can only be treated by means of the introduction of oils and mucilaginous drinks and the careful use of the probang. Some practitioners speak very highly of the value of thick soap-suds, generously horned down the animal's throat.
Stricture of the oesopJiagus is mostly due to corrosive medicines, pre- vious choking (accompanied by lacerations, which, in healing, narrow the passage), and pressure on the gullet by tumors. In the majority
30
of cases of stricture wo soou have dilatation of the gullet iu front of the constricted portion. This dilatation is due to the frequent accumula- tion of solid food above the constriction. Little can be done in either of these instances except to feed on sloppy or liquid food.
Sacular dilatcdion of tJie cesophagus. — ^This niostl}^ foUoAvs chokinp:, and is due to rupture of the muscular coat of the gullet, allowing the internal or mucous coat to hernia or pouch through the lacerated muscular walls. This sac or pouch gi-adually enlarges, from the fre- quent imprisonment of food, until it presses upon the gullet and pre- vents swallowing. When liquids are taken the solid materials are partially washed out of the pouch. The symptoms presenting them- seh'os ai"e as follows: The horse is able to swallow a few mouthfuls of food without apparent distress; then he will suddenly stoj) feeding, paw, contract the muscles of his neck, and eject a portion of the food through his nose or mouth. As the dilatation thus emjjties itself the symptoms gradually subside, only to reappear when he has again taken solid food. Liquids pass without any, or but little, inconven- ience. Should this dilatation exist in the cervical region, surgical interference may sometimes prove eifectual; if in tlio thoracic portion, nothing can be don^, and the jDatient rapidly i)asses from hand to hand by " swapping, " until, at no distant date, the contents of the sac become too firm to be dislodged as heretofore, and the animal succumbs.
DISEASES OF THE STOMACH.
Imj^cictioii — Stoniach staggers, or gorged stomach. — These are terms given to the stomach when it is so enormously distended with food that it loses all power of contracting upon its contents. It occurs most frequently in those horses that after a long fast are given a large feed, or in those that have gained access to the grain-bin and eaten ravenously. The jiroportionally small stomach of the horse, as well as his inability to vomit, will account for the frequency of stomach staggers. I have witnessed this trouble most frequently in t^eamstei's' horses and those that are not fed as often as they should be. After a long fast it is the custom to feed abundantly. The horse bolts his food, and the stomach not having time to empty itself becomes dis- tended and paralyzed. To prevent this condition it is sufficient to feed at shorter intervals, to give small quantities at a time, and to seciire the feed-bins so that if a horse gets loose he can not "stuff himself to bursting. "
Symptoms. — Percivall says that "a stomach simplj^ surcharged with food, without any accompanying tympanitic distention, does not appear to occasion local pain, but to operate rather that kind of influence upon the brain which gives rise to symptoms, not stomachic, but cerebral. Hence the analogy between this disease and staggers, and hence the appellation for it of ' stomach staggers.' " The horse soon after eating becomes dull and heavy, or drowsy; slight colicky
31
symptoms are obsei'ved, and are eoutinnoiis; lie rareiy lies down, Ijut carries his liead extemled and low, nearly toucliing tlie ground. Dullness rai)idly increases, tlie eyes are partially closed, vision is imi)aired, he presses or thusts his head against the manger or sides of the stall, and paws or even climbs with his fore feet. Respirations are less frequent than in health, tlie pulse slow and sluggish. All these symptoms rajjidly increase in severity; he becomes delirious; cold sweats bedew the bod}'; he trembles violently, slobbers or vomits a sour, fermenting mass, staggers from side to side, or plunges madly about until he drops dead. Usually the bowels are constipated, although (and especially if the engorgement is due to eating wheat or rye) diarrhea has been observed. These symptoms resemble in some particulars those of "blind " or " mad " staggers, but if Ave are careful to get the history of the case, /. e., ravenous eating after a long fast, or gaining access to grain-bins, wc shoidd not l)e in much danger of confounding them. Posi-mortein examinations sometimes reveal rup- ture of the stomach, owing to its enormous distension, and to the vio- len,ce with Avhich he throws himself in his delirium. If not ruptured the stomach will be distended to its utmost.
Trecdment for these cases is verj- unsatisfactory. A purgative of Barbadoes aloes, 1 ounce, should be given at once. We should then try to stimulate the walls of the stomach to contraction by giving cay- enne pepper, one-half ounce, or half-ounce doses of Jamaica ginger. Injections into the rectum, last gut, of turpentine 2 ounces, in 8 ounces of linseed oil, may stimulate the bowels to act, and thus, in a meas- ure, relieve the stomach. Cold applications applied to the head may in some cases relieve the cerebral symptoms already referred to, and some recommend bleeding for the same purpose.
Tympanik's of the stomach. — This is of somewhat frequent occur- rence, according to my observation, but is not, I believe, as a rule, separatel}' treated of by works on veterinary medicine. It is similar in cause and symiitoms to the above, yet distinct enough to enable the careful observer to readily differentiate between them. In tym- panites of the stomach we find this organ to be greath' distended as before, but in this case its contents are gaseous, or probably a mix- ture of food and gases, like fermenting yeast. This disease of the horse corresponds exactly with "hoven" or "blown" in cattle, and may be due to overloading the stomach with young, succulent, grow- ing herbage, clover in particular, from whose subsequent fermenta- tion gas is liberated in quantities sufficient to enormously distend the stomach. Growing wheat or lye are also fertile causes of this disten- tion if eaten in any considerable amounts. Another very frequent cause of stomach-bloat is overfeeding, particularly if given immedi- ately before hard work. Many people, if the}^ expect to make a long journey, think to fit their horses for the fatigue consequent tliereto by giving an extra allowance of oats or other food just before starting.
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This is most injudicious. The horse starts to his work feeling full and oppressed; he soon grows dull and listless, and fails to respond to the whip; sweats profusely; attempts to lie down; his head is car- ried forward and doAvnward, and if checked up is heavy on the reins, stumbles or blunders forward, and often falls. If looked at carefully you can not fail to observe that he is unusuallj^ full over the posterior ribs. The flanks may also be distended with gas, and sound like a drum on being struck, though I have seen cases where the gases were entii'ely confined to the stomach. With this condition the pain and distress are constant; the swelling referred to plainly appreciable; head extended and low, retching or even vomiting of fermented food. On placing the ear to tlie horse's windpipe a distinct metallic sound can be heard, as of air rushing through the windpipe. Such cases are rapid in their course and often fatal.
Treaiment must be prompt and energetic. An antacid should be given, and, as these cases mostly occur on the road awaj^, i^robably, from all drug-stores, you should hasten to the first house. Get com- mon baking soda, and administer 2 to 4 ounces of it as quickly as pos- sible. One-half ounce of cayenne pepper may be added to this with advantage, as it serves to aid the stomach to contract upon its con- tents, and expel the gas. Charcoal, in any amount; chloride of lime, one-half ounce; carbonate of ammonia, one-half ounce; or any -medi- cine that will check or stop fermentation, or absorb the gases, may be given. A jDhj^sic of 1 ounce of aloes, or 1 pint of linseed oil, should be given to unload the stomach and bowels. Cold water, dashed with force over the stomach, is thought hy some to favor condensation of the gas. This lesson should be learned from one of these attacks — and doubtless will be if, as is often the case, the horse dies — that when a horse or any other animal is expected to do an unusual amount of work in a short time he will best do it upon a spare feed. Curb j^our gen- erosity and humanity (?) for the brute until the journey's end, and even then wait until the horse is thoroughly rested before giving the usual feed.
Rupture of the stomach. — This mostly occurs as a result of engorged or tympanitic stomach, and from the horse violently throwing himself when so affected. It may result from disease of the coats of the stom- ach, gastritis, stones or calculi, tumors, or anything that closes the opening of the stomach ijito the intestines, and very violent pulling or jumping immediately after the animal has eaten heartily of bulky food. These or similar causes may lead to this accident.
The symptoms of rupture of the stomach are not constant, nor always reliable. We should always make inquiry as to what and how much the horse has been fed at the last meal. Vomiting has, pretty generally, been declared to be a symptom of ru^jture of this organ. I wish to preface what I may say concerning this with the statement that I have observed vomiting when the post-mortem examination revealed
33
rupture; that I have found mixture of the stomacli where vomiting had not occurred ; that I have Avitnessed vomiting where the horse soon after made a rapid recover}', /. e. , when the stomach was not ruptured. In spite of this contradictory evidence, I am of the opinion that, taken in connection with other symptoms, this sign is of value as pointing toward rupture of tlie stomach. This accident has occurred in my practice mostly in lieavy draught horses. A lu'ominent symp- tom observed (though I have also seen it in diaphragmatic hernia) is where the horse, if possible, gets the front feet on higher ground tlian the hind ones, or sits on his haunches, like a dog. This position affords relief to some extent, and it will be maintained for some min- utes; it is also quickly regained when the horse has changed it for some other. Colicky symptoms, of course, are present, and these will vary much, and present no diagnostic value. As the case progresses " tlie horse will often stretch forward the fore legs, lean backwards and downwards until the belly nearly touches the ground, and then rise up again with a groan, after which the fluid from his nostrils is issued in increased quantity." The pulse is fast and weak, breathing hurried, body bathed in a clammy sweat, limbs tremble violently, the horse reels or staggers from side to side, and death quickly ends the scene.
In the absence of any pathognomonic symptom Percivall says we must take into account the history of the case; the subject of it; the circumstances attending it ; the swollen condition of the abdomen ; tlie symi^toms of colic that cease suddenly and are succeeded by cold sweats and tremors; the pulse from being quick and small and thready, growing Aveak and more frequent, and at length running down and becoming altogether imperceptible; the countenance donating gloom and despondency of the heaviest character, looking back at the flank and groaning, sometimes crouching with the hind quarters, with or without eructation, and vomiting.
There is no freatmeni that can be of any use whatever. Could we be sure of our diagnosis it would be better to destroy the animal a-t once. Since, however, there is alwaj's the possibility of a mistake in diagnosis, we may give powdered opium in 1-drachm doses every two or three hours, with the object of keeping the stomach as quiet as j)0ssible.
Gasffifis is an inflammation of the mucous membrane lining the stomach. As an idiopathic disease it very rarely exists; but is mostly seen to be due to mechanical irritation, or to giving irritant and corro- sive i)oisons in too large doses or without sufficient dilution. Tlie sijtiqyfoins are not well marked; there is a febrile condition, colicky pains, and, mostly, intense thirst. When poisons have produced gas- tritis there will be other symptoms referable to the action of the par- ticular poison swallowed. If, for instance, the gastritis is due to a salt of lead, we must exiDect to find difficult or labored breathing, 5901 — HOR 2
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abdominal i^ains, partial iiaralysis of extensor mnscles primarily, tot- tering gait, convulsions, and death. Where the poisoning by lead is gradual the symptoms differ somewhat. There is a general appear- ance of unthriftiness, loss of appetite, staring coat, constii^ation, watery swellings under the jaws, a gray or blue line along the margin of the gums, and a progressive i^aralysis, noted often at first in the anterior extremities. Colicky symptoms are also observed. Abortion is often noticed during chronic lead-poisoning. In all cases of lead- l^oisoning the stomach, and often intestines, show erosions of its lin- ing membrane, which in other parts is darker in color, and the mucous membrane is easily stripped off. Chronic poisoning by lead is to be expected near paint works, about newly-painted buildings, where paint kegs are left in the fields, where horses take small particles of lead with their food, where soft water runs through new lead l^ipes, and where the drinking Avater is draAvn from wells or cisterns containing lead. Lead can be detected in almost all parts of the body at the post-mortem examination of chronic poisoning.
Treatment. — In acute gastritis, due to the careless or accidental administration of large quantities of this poison, we must give sul- phuric acid, oO to GO drops well diluted with water, milk, white of eggs, oils, and demulcent drinks, as linseed gruel or tea. If the gas- tritis is chronic, due to the long ingestion of small j)articles of lead, we must administer from one-half to 1 pound of Epsom salts. Iodide of potassium in 1-drachm doses, twice or thrice daily, are here of mucli service. If much pain exists it ma30)e relieved by giving mor- l)hia in 3 to 5 grain doses, repeated two or three times a daj'.
Where arsenic is the poison producing gastritis or gastro-euteritis (inflammation of the stomach and bowels), we have symptoms of abdominal pain, nausea, or vomiting, purging that is accompanied by an offensive odor, staggering gait, quickened breathing, jiaralysis of the hind extremities, and death. On opening a horse that has died of arsenical j^oison we are struck l)y the escape of large quantities of offensive gas. There are patches of inflammation and extravasation of blood in the stomach, and often hi the intestines. Chemical tests should be resorted to before giving a decided opinion that death is due to arsenic. Poisoning from this agent is most common where sheep have been dipped in arsenical preparations for the "scab" and then allowed to run on pasture without first drying their wool. Arsenic is thus deposited upon the grass and is eaten by horses graz- ing thereon, producing the sjnnptoms of gastritis and death. Gas- tritis may also occur from poisoning by copper, the mercurials, and some vegetable drugs. Gastritis produced l)y anj'- of the irritant poi- sons is to be treated with oils and demulcent diinks. Opium may l)e given to allay pain and inflammation. Care should bo observed in feeding for a time, being careful to give only soft and easily digested foods.
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BOTS — LARV.^. OF THE GAD-FIA'.
There are such erronooiis opinious extant concerning the Ijot and the depredations it is supposed to commit upon the horse that a some- what careful study should be made of it.
Of the many insect parasites and tormentors of solipeds the gad- flies (G^stridae) are of the most importance. Cobbold, who is the best autlioritj^ on the subject, says:
The common gad-fly (Gastrojih Has equi) attacks the anim^al while grazing late in the summer, its object being, not to derive sustenance, but to deposit its eggs. This is accomplished by means of a glutinous excretion, causing the ova (eggs) to adhere to the hairs. Tlie parts selected are chiefly those of the shoulder, base of the neck, and inner part of the fore legs, especially about the knees, for in these situations the horse will have no difficulty in reaching the ova with its tongue. When the animal licks those parts of the coat where the eggs have been placed the moisture of the tongue, aided by warmth, hatches the ova, and in something less than three weeks from the time of the deposition of the eggs the larvae have made their escape. As maggots they are next transferred to the mouth and ultiuiatel}- to the stomach along with food and drink. A great many larvae i^erish during this passive mode of immigration, some being dropped from the mouth and others being crushed in the fodder during mastication. It has been calcu- lated that out of the many hundreds of eggs deposited on a single horse scarcely one out of fifty of the larvse arrives within the stomach. Notwithstanding this waste the interior of the stomach may become completely covered (cuticular portion) with bots. Whether there be few or many they are anchored in this situation chiefly by means of two large cephalic hooks. After the bots have attained perfect growth they vohmtarily loosen their hold and allow themselves to be carried along the alimentary canal until they escape with the feces. In all cases they sooner or later fall to the ground and when transferred to the soil they bury themselves beneath the surface in order to undergo transformation into the pupa condition. Having remained in the earth for a period of six or seven weeks they finally emerge from their pupal-cocoons as perfect dipterous (winged) insects — the gad-fly. It thus appears that bots ordinarily pass about eight months of their lifetime in the digestive organs of the horse.
The si^ecies just described infest chiefl}' the stomach and duode- num— small gut leading from the stomach.
Another species of oestrus affecting the horse is the O'strus hcemor- rhoidalis. These are found fastened to the mucous membrane of the rectum (last gut), or even outside upon the anus, and occasion mucli irritation and annoyance, and, at times, require to be removed by the fingers or forcejjs.
The opinion, almost universally entertained, that bots frequentlj" cause colicky- i)ains, is erroneous. It is very common to liear bystand- ers declare that almost every horse with abdominal pains "has the bots," and their suggested treatment is always varied and heroic.
Almost all horses in the country, as well as horses in the cities dur- ing their first jear there, have " the bots." It is in exceptionally rare instances that they produce any appreciable symptoms or disturb- ances. In my own practice I have never known bots to be tlie cause
36
of any serious ailment of tlie hoi-se; and only once lias my father, in a practice extending over fifty years, known bots to be the cause of death. In this instance the bots seemed to have simultaneously loosened their hold xv^on the mucous lining of the stomach, and were forced as an impermeable wedge into the pjdoric orifice, or outlet, of the stomach, and thus, preventing the i)assage of food or medicine, produced death. Were the bots to attempt to fasten themselves to the sensitive lining of the bowels in their outward passage they might cause irritation and expressions of pain in the foi*m of colicky symp- toms, but this they seldom or never do. The opinion frequently expressed at post-mortem examinations, when the stomach is found to be ruptured, that "the bots have eaten through the stomach," is again a mistake. Bots never do this; the rupture is due to overdis- tention of the viscus with food or gases. Some writers on veterinary medicine have even urged that bots, by their presence, stimulated the stomach secretions, and were thus actually an aid to digestion. This opinion is as far from the truth as the more general one referred to above, concerning the harm they do.
Bots may, and probably do, when in large enough numbers to be fastened to the true digestive jjortion of the stomach, slightly inter- fere with digestion; the animal may not thrive, the coat stares, and emaciation may follow; but beyond this, with the exception already noted, tliey are harmless. Even were they the cause of trouble, there are no medicines that affect them ; neither acids, nor alkalies, anthel- mintics (worm medicines), nor anodynes cause them to become loose and to pass out of the body. To i^revent them it is necessary to watch for their eggs on the legs and different parts of the body in the late summer and autumn. These eggs are to be carefully scraped off and burned. Horses should not be watered from stagnant ponds, as they frequently swallow the ripening eggs with such water. It is entirely useless to attempt any treatment to rid the horse of bots; they go at their appointed time, and can not be dislodged before this. We should remember that in following their natural course or stages of existence the bots loosen their hold during May and June mostly. They are then expelled in great numbers, and horse-owners, noticing them in the manure, hasten to us saying "my horse has the bots." If we are honest we tell him tliat, in the natural course of events, nature is doing for him that which we can not do. We may say in conclusion, then, that bots seldom produce miy evil effects whatever; that not more than once in ten thousand times are they the cause of colicky symptoms, and that thej'' require no medicine to eject them.
INDIGESTION.
Indigestion is a term api3lied to all those conditions where, from any cause, digestion is imperfectly performed. It is not at all uncommon to witness in the horse symptoms similar to those of dyspepsia in man.
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The disturbances of digestion included under this head are not so ])yo- nounced as to jiroduee colic, yet our consideration of diseases of the digestive organs would bo incomplete if we failed to mention this, the most frequent of all digestive disorders. The seat and causes of indi- gestion are found to vary in different horses, or even in the same horse at different times. Apart from tlie indigestibility of the food itself there are many causes productive of indigestion. The teeth are often at fault. Where these are sharp, irregular, or decayed the food is imperfectly masticated and swallowed before there is a proper admix- ture with the saliva. Bolting of the food; the bile — secretion of the liver — may be defective in quality or quantity; there may be lack of secretion of the i^ancreatic juice, or there may be simjily want of per- istaltic movement of the stomach and intestines, thereby causing an interrui)tion of the passage of the ingesta. The lorincipal seat of indi- gestion, however, is in the stomach or small intestines. Whenever, from any cause, the secretions from these i^arts arc excessive or defi- cient, dyspepsia or indigestion must invariably follow. Indigestion is often due to keex^ing horses on low, marshy j)astures, and i^articu- larly during cold weather; wintering an hard, dry hay or corn-stalks, and other bulky and innutritive food; irregular feeding or overfeed- ing (though this latter is more likely to produce engorged stomach, or tympanites of the stomach, which have been described by some as "acute indigestion").
Sy)nptoins. — Indigestion is characterized by irregular appetite; re- fusing all food at times, and at others eating ravenously; the appetite is not only irregular, but is often depraved; there is a disposition on the part of the horse to eat unusual substances, as wood, soiled bed- ding, or even his own feces; the bowels are irregular, to-day loose and bad smelling, to-morrow bound; grain often passed whole in the feces, and the hayi^assed in balls or imi^acted masses undergoing but little change; the horse frequently passes considerable quantities of wind that has a sour odor. The animal loses flesh, the skin presents a hard, dry appearance, and seems verj^ tight (hide-bound). If these symi)toms occur in a single horse in a stable where others are kept we must look not to the feed, but to the animal himself, for the cause of his trouble.
Treatment. — It is evident, from the many causes of indigestion and from its protean forms, that we must be exceedingly careful in our examinations of the subject of this disorder. We must commence with the food, i^s quality, quantit}^ and time of feeding; examine the water supply, and see, besides, that it is given before feeding; then we must carefully observe the condition of the mouth and teeth; and, continuing our observations as best we may, endeavor to locate the seat of trouble — whether it is in the stomach, intestines, or annexed organs of digestion, as the liver and pancreas. If the teeth are sharp or irregular they must be rasped down; if any are decayed they must
38
be extracted; if indigestion is due to ravenous eating or bolting the food, "Nve must tben feed from a large manager where the grain can be si)read and the horse compelled to eat slowlj'.
In the great majority- of cases I have found a cathartic, aloes 1 ounce, or linseed oil 1 pint, to be of much serAdce if given at the out- set. Any irritation, such as worms, undigested food, etc., that are operating as "causes," are thus remoA'ed, and in many instances no further treatment is required. There is mostly a tendency to disten- sion of the stomach and bowels with gas during indigestion, and I have never found any treatment so effective as the following alkaline tonic: Baking soda, powdered ginger, and powdered gentian, equal parts. These are to be thoroughly mixed and given in heaping table- spoonful doses, twice a day, Ijefore feeding. This powder is best given by dissolving the above quantity in a half pint of water, and given as a drench.
INTESTINAL WORMS.
Although there are several species of worms found in the intestines of horses, it will be sufficient, in an article like this, to refer only to three or four of the most common ones. Worms are most frequently seen in young horses, and in those that are weak and debilitated. They commonly exist in horses that are on low, wet, or marshy pas- tures and in those that drink stagnant water.
The intestinal worm most commonly seen is known as the Lnin- hrk-oid worm. In form it is much like the common earth-worm. It is white or I'eddish in color, and measures from 4 to 12 inches in length, thougli some have been seen that were nearly 30 inclies long. In thickness they vary from the size of a rj-e straw to that of a lady's little finger, being thickest at the middle, and tapering at both ends. They are found singly or in groups or masses, and infest chiefly the small intestines.
Another common variety of intestinal worm is called i\\.Q pi}\-irorm, and is found mosth* in the large intestines. These are semi-trans- parent, thread-like worms, measuring in length from 1 to 2 inches.
The tape-worm, once seen, is easily recognized. It is white, flat, thin, broad, and jointed. The head is found at the smaller end of the worm. Tape-worms of the horse sonjetimes jneasure from 20 to 30 feet in length.
Symptoms of intestinal ivorms. — Slight colicky pains arc noticed at times, or there may only be switching of the tail, frequent passages of manure, and some slight straining, itching of the anus, and rub- bing of the tail or rump against the stall or fences; the horse is in poor condition; does not shed his coat; is hide-bound and pot-bellied; the appetite is depraved, licdcing the walls, biting the wooden work of the stalls, licking parts of his body, eating earth, and being particu- larlv fond of salt; the bowels are irregular, constipation or diarrhea
39
being noticed. Some place much dependence upon llic symptom of itching of the upper lip, as sho^vn by the horse frequently turning it up and rubbing it upon the wall or stalls. Others again declare that whenever Ave see the adherence of a dried whitish .substance about the anus worms are i)resent. The one sympton, however, that we should always look for, and certainty the only one that may not deceive us, is seeing the horse pass the worms in his dung.
Treatment. — Remedies to destroy intestinal worms are much more efficient if given after a long fast, and then the worm medicine must be supplemented hy a physic to carry out the Avorms. Among the best worm medicines may be mentioned santonine, turpentine, tartar emetic, infusion of tobacco, and bitter tonics. To destroy tape-Avorms, areca nut, male-fern, and i)umpkin seeds are the best. If a horse is passing the long round worms, for instance, the plan of treatment is to give tAvice daily for three or four days a drench composed of tur- pentine, 1 ounce, and linseed oil 2 or 3 ounces, to be foUoAAed on the fourth day by a physic of Barbadoes aloes, 1 ounce. If the pin- worms are present (the ones that infest the large boAvels), injections into the rectum of infusions of tobacco, infusions of quassia chips, one-half pound to a gallon of Avater, once or twice daily for a few days, and followed by a physic, are most beneficial. It should be borne in mind that intestinal Avorms are mostly seen in horses that are in poor condition; and an essential part of our treatment then is to improA^e the appetite and j^oAvers of digestion. This is best done by giA^ing the A'cgetable tonics. One-half ounce of PeruA'ian bark, gentian, ginger, quassia, etc., is to be giA'en twice a day in the feed or as a drench. Unless some such medicine.s and good food and pure water are given to tone up the digestiA'^e organs the worms will rapidly acciTmulato again, even though they may haAc all been expelled by the worm medicines proper.
DISEASES OF THE IXTESTINES.
Spasmodic or cramp colic. — This is the name giA'en to that form of colic produced by contraction, or spasm, of a jjortion of the small intestines. It is i:>roduced by indigestible food; foreign bodies, as nails and stones in the boAvels; large drinks of cold Avater Avhen the animal isAvarm; diiA'iug a heapted horse through deep streams, cold rains, draughts of cold air, etc. Unequal distribution of or interfer- ence Avith the nerA'ous supply here i)roduces cramj) of the boAvels, the same as external cramps are produced. Spasmodic colic is much more frequently met Avith in high-l)red, round-l)arreled, nervous horses than in coarse, lymphatic ones.
Symj^ton}.^. — These should be carefully studied in order to diagnose this from other forms of colic requiring q-uite different treatment. Spasmodic colic abvays begins suddenly. If feeding, the horse is seen to stop aln-uptly, stamp impatiently, and prol^ably look backwards.
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He soon evinces more acute pain, and this is shown bj^ pawing, sud- denly lying down, rolling, and getting up. There is then an interval of ease; he will resume feeding, and api^ear to be entirely well. In a little while, however, the pains return and are increased in severity, only to again i^ass off for a time. As the attack i)rogresses these intervals of ease become shorter and shorter, and pain may be con- tinuous, though even now there are exacerbations of pain. Animals suffering from this form of colic evince the most intense j^ain; they throw themselves down, roll over and over, jumj) up, whirl about, drop down again, paw, or strike, rather, with the front feet, steam and sweat, make frequent attempts to pass their urine, and the penis is partially erected. Only a small amount of water is passed at a time, and this is due to the bladder being so frequently emptied, i. e., fliere is hut little water to pass. These attemi)ts to urinate are almost alwaj^s regarded as sure symptoms of trouble of the kidneys or bladder. In reality they are only one of the many ways in which the horse expresses the presence of pain. Allow me to digress slightly, and to assure the reader that diseases of the bladder or kidneys of the horse ar^e exceed- ing! ij rare. The stomach and bowels are affected in a thousand instances where the kidneys or bladder are once. Attempts to pass water and failure to do so are not enough to warrant us in joronounc- ing the case one of "trouble with his water," nor should we, if a horse jields or sinks when pinched over the loins, declare that kidney disease exists. Try this pressure on any horse, and the great majority will be seen to thus yield; in fact, this is rather a sign or sj'mptom of health than of disease.
To recapitulate the symptoms of spasmodic colic: Keep in mind the history of the case, the type of horse, the suddenness of the attack, the intervals of ease (which become of shorter duration as the case pro- gresses), the violent pain, the normal temperature and pulse during the intervals of ease, the frequent attempts to urinate, the erection of the penis, etc., and there is but little danger of confounding this with other forms of colic.
Treatment. — Since the pain is due to spasm or cramj) of the bowels, medicines that overcome spasms — anti-spasmodics — are the ones indi- cated. Probably there is no medicine better than chloral hj^drate. This is to be given in a dose of 1 ouiK?e in a half pint of water as a drench. A very common and good remedy is sulphuric ether and lau- danum; of each 2 ounces in half pint of linseed oil. Another drench may be composed of 2 ounces each of sulphuric ether and alcohol in 8 ounces of water. If nothing else is at hand we may give whisky; one- half pint in hot water. If relief is not obtained in one hour from any of the above doses, they may then be repeated. The bodj^ should be warmly clothed and persi^iration induced. Blankets dipped in very hot water to which a small quantity of turpentine has been added should be placed around the belly and covered with dry blankets, or
41
the abdomen may be rubbed with stimulating liniments or mustard- Avater. The diificulty, however, of api^ljing hot blankets and keeping them in place forces us in most instances to dispense with them. If the crami:> is due to irritants in the bowels a cure is not complete until we have given a cathartic of 1 ounce of aloes or 1 pint of linseed-oil. Injections into the rectum of warm, soapy water, or salt and water, aid the cure.
One word here about injections, or enemas, as they are called. These, as a rule, should be lukewarm and from 3 to G quarts are to be given at a time. They may be repeated every half hour if necessary. Great care is to be taken not to injure the rectum in giving rectal injections. A large syringe is the best means by which to give them. If tins is not to be had, take a large elder, from which the pith has been removed, or a piece of hose. A large hog's bladder is to be filled with the fluid to be injected and tied about one end of the elder or hose. The point to be introduced into the rectum must be blunt, rounded, and smooth. It is to be thoroughly oiled and then carefully pushed through the anus in a slightly ui)ward direction. Pressure upon the bladder will force its contents into the bowel. Much force must be avoided, for the rectum may be lacerated and serious complications or even death result. Exercise will aid the action of the bowels in this and similar colicky troubles, but severe galloping or trotting is to be condemned. If the horse can have a loose box or paddock it is the best, as he will then take what exercise he wants. If the patient be extremely violent it is often wise to restrain him, since rupture of the stomach or displacement of the bowels may result and complicate the troubles.
Flatulent colic — Tympanites — Wind colic — Bloat. — Among the most frequent causes of this form of colic are to be mentioned sudden changes of food, too long fasting and food then given while the animal is exhausted, new hay or grain, large quantities of green food, food that has lain in the manger for some time and become sour, indigesti- ble food, irregular teeth, crib-biting, and in fact anything that produces indigestion may produce flatulent colic.
The symptoms of wind colic are not so suddenly developed, nor so severe as those of cramp colic. At first the horse is noticed to be dull, paws slightly, may or may not lie down. The pains from the start are continuous. The belly enlarges, and by striking it in front of the haunches a drum-like sound is elicited. If not soon relieved the above symptoms are aggravated, and in addition we notice difficult breath- ing, profuse perspiration, trembling of anterior limbs, sighing respira- tion, staggering from side to side, and, finally, jilunging forward dead. The diagnostic symptom of flatulent colic is the distention of the bow- els with gas, detected by the bloated appearance and resonance on per- cussion.
5961— HOR 2*
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The treatment for "wind colic differs very materially from that of cramp colic. Alkaliues neutralize the gases formed, and must be promptly given. Probablj' as good a domestic remedy as can be had is baking-soda, in doses of from 2 to 4 ounces. If this fails, give chlo- ride of lime in half-ounce doses, or the same quantity of carbonate of ammonia everj- half hour until relieved. Absorbents are also of serv- ice, and we may give charcoal in any quantity. Relaxants and anti- S23asmodics are also beneficial in this form of colic. Chloral hydrate not only possesses these qualities, but it also is an anti-ferment and a pain-reliever. It is then i)articularly well adapted in the treatment of wind colic, and should be given in the same sized doses and in the manner directed for spasmodic colic.
A physic should always be given in flatulent colic as early as possi- ble, the best being Barbadoes aloes in the dose alreadj' mentioned. Injections, per rectum, of turpentine 1 to 2 ounces, linseed-oil 8 ounces, may be given frequently to stimulate the peristaltic motion of the bow- els and favor the escape of wind. Blankets Avrung out of hot water do much to afford relief; they should be renewed every 5 or 10 min- utes and covered with a dry woolen blanket. This form of colic is much more fatal than cramp colic, and requires prompt and persistent treatment. It is entirely unsafe to i)redict the result, some apparenth' mild attacks going on to speedy death, while others that appear at tlxe onset to be very severe yielding rapidly to treatment. Do not cease your efforts until you are sure the animal is dead. I v>-as called, in one instance, and on reaching mj' patient the owner informed me that *' the horse had just died." The heart, however, was still beating, and bj- energetic measures (tapping, etc. ) I " brought him back to lif e, " as the onlookers asserted. In these severe eases puncturing of the bowels in the most prominent (distended) part by means of a small trocar and canula, or with the needle of a hypodemic syringe, thus allowing the escape of gas, has often saved life, and such jiunctures are not followed by any bad results in the majority of instances.
Impaction of the large intestines. — This is a very common bowel trouble and one which, if not promptly recognized and proper!}^ treated, results in death. It is caused mostly by overfeeding, espe- cially of grain, and I have noticed that it is much more common where lye is fed alone, or with other grains; old, dry, hard hay, or stalks when largely fed; deficiency of secretions of the intestinal tract, lack of water, want of exercise, paralysis of nerve endings, medicines, etc.
Symptoms. — Impaction of the large boAvels is to be diagnosed by a slight abdominal pain, which may disappear for a day or two to reap- pear with more violence. The feces is passed somewhat more fre- quently, but in smaller quantities and more dry; the abdomen is full, but not distended with gas; the horse at first is noticed to paw and soon begins to look back at his sides. Probably one of the most char- acteristic symptoms is the position assumed when down. He lies flat
43
on his side, bead and legs extended, oceasionalh' raising liis head to look toward his flank; he remains on his side for from five to fifteen minutes at a time. Evidently this position is the one giving the most freedom from pain. He rises at times, walks about the stall, paws, looks at his sides, backs up against the stall, which he presses Avithhis tail, and soon lies do\\ii again, assuming his favored position. The bowels have ceased entirely to move. The pulse is but little changed at first, being full and sluggish; later, if this condition is not over- come, it becomes rapid and feeble. I have known horses to suffer from impaction of the boAvels for a week, jet eventually recover, and others have reported cases extending two or even three weeks which ended favorably. As a rule, however, they seldom last over four or five days, many, in fact, dying sooner than this.
The irecdment consists of efforts to produce movement of the bowels, and to prevent inflammation of the same from arising. A large cathar- tic is to be given as early as possible; either of the following are recommended : Powdered Barbadoes aloes 1 ounce, calomel 2 drams, and powdered nux vomica 1 dram; or linseed oil 1 pint, and croton oil 15 droxDS. Some favor the administration of Epsom salts, 1 pound, with one-quarter pound of common salt, claiming that this causes the horse to drink largely of water, and thus mechanically softening the impacted mass and favoring its expulsion. Whichever physic is selected it is Cvssential that you give a full dose. This is much better than small and relocated doses. It must be borne in mind that horses require about twenty-four hours in which to respond to a phj'sic, and under no circumstances are physics to be repeated sooner than this. If aloes has been given and has failed to operate at the projier time, oil or some different cathartic should then be administered. Allow the hoi-se all the water he will drink. The action of the physic may be aided by giving, every three or four hours, one-half ounce of tinc- ture of belladonna, or one-half dram of powdered nux vomica. Copious enemas are to be given every hour, and should be varied; giving first soapy water, then salt and water, or the emulsions of turpentine already alluded to in describing other diseases of the bowels. Enemas of glycerine, 2 to 4 ounces, are often l)eneficial. Rubbing or knead- ing of the abdominal walls, the application of stimulating liniments or strong mustard water will also, at times, favor the expulsion of this mass. Walking exei-cise must occasionally be given. If this treat- ment is faithfully carried out from the start the majority of cases will terminate favorably. Where relief is not obtained inflammation of the bowels may ensue, and death follow from this cause.
Constipation or costiveness is often witnessed in the horse, and par- ticularly in the foal. Many colts die every year from failure on the part of the attendant to note the condition of the bowels soon after birth. Whenever the foal fails to pass anj^ feces, and in i^articular if it presents any signs of colicky pains — straining, etc. — hnmediate
44
attention must be given it. As a rule, it will only be necessary to give a few injections of soapy water in the rectum and to introduce the finger through the anus to break down any hardened mass of dung found there. If this is not effective, a purgative must be given. Oils are the best for these 3'oung animals, and I mostly select castor oil, giving from 2 to 4 ounces. The foal should always get the first of the mother's milk, as this milk, for a few days, j)ossesses decided laxative properties. If a mare, while suckling, is taking laudanum or similar medicines, the foal should be fed during this time by hand and the mare milked upon the ground. Constipation in adult horses is mostly the result of long feeding on dry, innutritions food, deficiency of intes- tinal secretions, scanty water supply, or lack of exercise. If the case is not complicated with colicky symptoms, a change to light, sloppy diet, linseed gruel or tea, with x^lenty of exercise, is all that is required. If colic exists a cathartic is needed. In very many instances the con- stipated condition of the bowels is due to lack of intestinal secretions, and when so due, must be treated by giving fluid extract of belladonna three times a day in 2-dram doses, and handful doses daily of Epsom salts in the feed.
ALIMENTARY CONCRETIONS — GASTRIC AND INTESTINAL.
Gastric concretions, calculi {stones) i)i the stomach. — There are jjrob- ably but few symptoms exhibited by the horse that will lead us to sus- pect the presence of gastric calculi, and possibly none by which we can unmistakably assert their presence. Stones in the stomach have been most frequently found in millers' horses. A small i)iece of the mill-stone or other foreign body may serve as a nucleus around which is deposited in layers the calcareous substances which abound in their feed (the sweepings of the mill floor, mixed with good food). I have noticed, and it is generall}^ recorded by veterinary writers, that a depraved and capricious aj^petite is common in horses that have a stone forming in their stomach. There is a disposition to eat the Avood-work of the sta- ble, earth, and, in fact, almost any substance within their reach. This symptom must not, however, be considered as pathognomonic, since it is observed when calculi are not present. Occasional colics may result from these "stomach stones," and when these lodge at the outlet of the stomach they maj' give rise to symi^toms of engorged stomach, already described. I remember one instance in which I found a stone that weighed nearly 4 iiounds in the stomach of a horse.
The position that seems to afford the most relief to the afflicted ani- mal is sitting upon the haunches. Constipation may or may not be l^resent. From all this we may conclude that there is reason to sus- pect the i^resence of stone in the stomach, if there is a history of depraved appetite; repeated attacks of colic (and particularly if these have recovered ahruptly) ; and the position sought by the horse while suffering — sitting on the haunches, or standing with the front feet
45
upon some elevation. Dnrini^ the fatal attack the symptoms are sim- ply those of obstruction, followed by those of inflammation and gan- grene, and are not diagnostic. There is, of course, no freatment that will prove effective. AVe can simpl j' give remedies to move the bowels, to relieve pain, and to combat inflammation.
Intestinal concretions, calculi {stones) in tlie intestines. — These con- cretions are found mostly in the large bowels, though they are occa- sionally met with in the small intestines. They are of various sizes, weighing from 1 ounce to 25 pounds; they may be single or multiple, and differ in composition and appearance, some being soft (composed mostly of animal or vegetable matter), while others are porous or honey-combed (consisting of animal and mineral matter), and others again that are entirely hard and stone-like. The hair-balls, so com- mon to the stomach and intestines of cattle, are very rare in the horse. Intestinal calculi form around some foreign body as a rule, mostly a nail, piece of wood, or something of this description, whose shape they assume to a certain extent. Layers are arranged concentrically around such nucleus until the sizes above spoken of are formed. These stones are also often found in millers' horses, as Avell also as horses in lime- stone districts where the water is hard. When the calculi attain a sufficient size and become lodged or blocked in some part of the intes- tines, they cause obstruction, inflammation of the bowels, colicky symi)toms, and death. Some veterinarians pretend to diagnose the presence of these bodies during life, but I know of no certain signs or symptoms that reveal tiiem. Recurring colics and character of food and water may enable us to make a good guess at times, but nothing more.
The symptoms will be those of obstruction of the bowels. Upon lyost-mortem examinations we will discover these stones, mostly in the large bowels; the intestines will be inflamed or gangrenous about the point of obstruction. Sometimes calculi have been expelled by the action of a physic, or they may be removed by tlie hand when found to occux^y the last gut.
Treatment. — As in concretions of the stomach, thei-e can be but little done more than to overcome spasm (if any exists), and to give physics with the hope of dislodging the stone or stones and carrying them on and outward.
Intussusception or Invagination is the slipping of a portion of the intestine into another portion immediately adjoining, like a jjartially turned glove finger. This may occur at anj' i)art of the bowels, but is most frequent in the small guts. The invaginated portion may be slight — 2 or 3 inches only — or extensive, measuring as many feet. Treves, who has written a most valuable work on intestinal obstruc- tion in man, maybe quoted in substance, to some extent. He cautions us not to confound what he classes as ' ' obstructive intussusception " with intussusception of the djdng. This latter is often seen upon
46
post-moriem examination of cliildren, or with us in young eolts. These invaginations occur shortly before death, and are due to irreguhir con- tractions of the bowels that take place during the act of dying. Mus- cular actions are, at this time, iri-egular and tumultuous, and it is not surprising that intussusception is i^roduced. "Intussusceptions of the dying" are characterized by the following peculiarities: They are small, fi'co from any trace of congestion, inflammation, or adhesion, and can very easily be reduced by slight traction; the}' are ax)t to l>e miiltiple, and are most frequently directed forward. In obstructive intussusception, on the other hand, the inturned bowel is in the direc- tion of the anus. There are adhesions of the intestines at this point, congestion, inflammation, or even gangrene.
Causes of invagination. — This accident is most likely to occur in horses that are suffering from spasm of the bowel or in those where a small portion of the gut is paralyzed. The natural worm or ring-like contraction of the gut favors the passage of the contracted or par- alyzed portion into that immediately behind it. It may occur during the existence of almost Rnj abdominal trouble, as diarrhea, inflamma- tion of the bowels, or from injuries, exposure to cold, etc.
Symptoms. — Unless the invaginated portion of the gut becomes strangulated, prol)abl3'' no sj^mptoms will be appreciable, except con- stipation. Strangulation of the bowel may take place suddenly, and the horse die within twenty- four hours, or it may occur after several days, a week even, and death follow at this time. There are no symptoms. positivel.y diagnostic. Colicky i^ains, more or less severe, are observed, and there are no, or but few, passages of dung. I have observed severe straining in some instances of intussusception, and this should l>e given due credit when it occurs. As death approaches the horse sweats profusely, sighs, presents an anxious countenance, the legs and ears become cold, and there is often freedom from pain immediately before death. In some rare instances the horse recovers, even though the invaginated portion of the gut has become strangu- lated. The imprisoned portion here sloughs away so gradually that a union has taken place between the intestines at the ix)int where one portion has slipped into that behind it. The piece sloughing off is found passed Avith the manure. Such cases are exceedingly rai-e, but their possibility should guide us in our treatment. Cathartic medi- cines are more calculated to do harm than good. AVe should treat with anodj'nes and anti-si)asmodics, chloral hydrate, laudanum, and sulphuric ether, and medicines to prevent inflammation. Some prac- titioners favor the administration of powdered opium, 1 to 2 drams, every three or four hours. Injections of salt and water or emulsions of turpentine are given with the somewhat fanciful idea of producing l^eristalsis of the intestines in a direction opposite to the normal one, ■i. e., contraction from the anus forward. If this can be j) rod need l)y these or any other means, it will prove a A'aluable adjunct to other
47
treatment. Soft feed and mucilaginous and nourishing di-inks are to l)e gi^•en during these attacks.
li^olvuhis, Gut-tie or Twisting of the Boirels. — These are the terms applied to tlie boAvels when twisted or knotted. This accident is I'ather a conimon one, and frequently results from the violent manner in which A horse throws himself about when attacked by spasmodic colic. The symptoms are the same as those of intussusception and obstruc- tions of the bow'els; the same directions as to treatment are therefore to be observed.
Diarrltea is due to eating moldy or musty food, drinking stagnant water, diseased condition of the teeth, eating irritating suljstances, to being kejit on low, marshy pastures, and exposure during cold nights, low, darnj) stables, or to some morbid or inflammatory condition of the intestinal canal or some of its annexed organs. It is more frequently a synijjtom of functional disorder than an organic disease. >Some horses are predisposed t<i scour and are called ''washy " by horsemen; they are those of long bodies, long legs, and nari-ow, flat sides. Horses of this build are almost sure to scour if fed or v,atered immediately before being put to work. Fast or road work, of course, aggravates this trouble. Diarrhea may exist as a complication of other diseases, as pneumonia and influenza for instance, and again during the dis- eases of the liver.
The synqjtoms are the frequent evacuations of liquid stools, with or without pronounced abdominal pain, loss of appetite, emaciation, etc.
Treatment is at times very simple, but requires the utmost care and judgment. If due to faulty food or water it is sufficient to change these. If it results from some irritant in the intestines, this is best gotten rid of by the administration of an oleaginous purge, the diarrhea mostly disapipearing with the cessation of the o]3eration of the medicine. If, however, jjurging continues, it may be checked by gi^nng wheat flour in water, starch water, white-oak bark tea, chalk, opium, or half -dram doses of sulphuric acid in one-half i^int of water twice or thrice daily. I have good results from i)OM'dered opium, '1 drams, and subnitrate of bismuth, 1 ounce, repeated three times a day. One-quarter pound doses of the "Thompsonian composition,'' to which maybe added 1 ounce of baking soda, given two or three times a day, are frequently effective. It should be remembered in all cases to look to the water and feed the horse is receiving. If either of these is at fault they are at once to be discontinued. We should feed sparingly of good, easily digested foods. In tliat peculiar build of nervous horses that scour on the road but little can be done, as a rule. They should be watered and fed as long as possible before going on a drive. If there is much flatulencj' accompanying diarrhea, baking soda or other alkaline med- icines often produce a cui-e, while if the discharges have a very dis- agreeable odor, this can be corrected by 1 ounce of sulphite of soda or half-dram doses of carljolic acid in water, repeated twice a day. Be
48
slow to resort to either the vegetable or mineral astringents, sinoe the majorit}^ of cases will yield to change of food and water, or the admin- istration of oils. Afterwards feed upon wheat-flour gruel or other light foods. The body should he warmly clothed.
Superpurgcdlon. — This is the designation of that diarrhea or flux from the bowels that at times is induced by and follows the action of a physic. It is accompanied by much irritation or even inflammation of the bowels, and is always of a serious character. Although in rare instances it follows from a usual dose of physic and where every pre- caution has been taken, it is most likelj^ to result under the following circumstances : Too large a dose of physic ; to giving physics to horses suffering from pneumonia, influenza, or other debilitating diseases; to riding or driving a horse when purging; to exposure or draughts of cold air, or giving large quantities of cold water while the physic is operating. There is always danger of superpurgation if a physic is given to a horse suffering from diseases of the respiratory organs. Small and often-repeated physics are also to be avoided, as they pro- duce debility and great depression of the sj'stem and j^redispose to this disorder. When a jjli^'sic is to be given we should give the horse sloppy food until the medicine begins to operate; we must clothe the body with a warm blanket; keej) out of draughts; give only chilled water in small quantities. After a horse has iDurged from twelve to twenty-four hours it can mostly be stopped or " set," as horsemen say, by feeding on dry oats and liaj'. Should the purging continue, how- ever, it is best treated by giving demulcent drinks — linseed tea, oat- meal or wheat-flour gruel. After this the astringents spoken of for diarrhea may be given. Besides this the horse is to receive brandy in doses of from 2 to 4 ounces, with milk and eggs, four or five times a da3^
Laminitis "founder" is a frequent sequelae of superpurgation and is to be guarded against by removing the shoes and standing the horse on moist sawdust or some similar bedding.
Dysentery. — Williams defines dysentery, or blood}' flux, as an intes- tinal inflammatory action of a peculiar or specific character, attended with fever, occasional abdominal iiain, and fluid alvine discharges, mingled witli blood or albuminous materials ; the tissue changes, which are usually regarded as special, being situated chiefly in the minute gland structures and inter-connective tissue of the large intestine, and of an ulcerative or gangrenous character. To be plainer, dysentery is characterized by coffee-colored or bloody discharges, liquid, and very offensive in odor, and passed with much tenesmus (straining). It is very rare in tlie horse.
Causes. — Probably tlie most common cause is keeping j^oung horses in particular for a long time on low, wet, marshj^ pastures, without other feed (a diarrhea of long standing sometimes terminates in dysen- tery); exposure during cold, wet weather; decomposed foods; stag- nant water that contains large quantities of decomposing vegetable
49
matter; low, damp, and dark stables, particularly if crowded; the existence of some disease, as tuberculosis of the abdominal form.
Symptoms. — The initial symptom is a chill, which probably escapes notice in the majority of instances. The discharges are offensive and for the most part liquid, although it is common to find lumps of solid fecal matter floating in this liquid portion ; shreds of mucous mem- brane and blood are passed, or the evacuations may be muco-purulent; there is much straining, and, rarely, sjTuptoms of abdominal pain; the horse lies down a great deal ; the pulse is quickened and the tempera- ture elevated. The appetite may remain fair, but in spite of this the horse rai)idly loses flesh and becomes a sorry-looking object. Death rarely follows under two to three weeks. Thirst is a prominent symptom.
Treatment. — This is most unsatisfactory, and I am inclined to place more dependence ujjon the care and feed than any medication that may be adopted. First of all the horse must be placed in a dry, warm, yet well- ventilated stable ; the skin is to receive attention by frequent rubbings of the surface of the body, with lilankets, and bandages to the legs. The water must be pure and given in small quantities; the food, that which is light and easily digested. Medicinally, we must give at first a light dose of castor oil, about one-half pint, to which has been added 2 ounces of laudanum. The vegetable or mineral astrin- gents are also to be given. Starch injections containing laudanum often afford great relief. The strength must be kept uji by milk punches, eggs, beef tea, oat-meal gruel, etc. In spite of the best care and treatment, however, dysentery mostly proves fatal.
Hcemorrlioids — PiJes. — These are rare in horses, although more fre- quently met with than most people suppose. Thej^ are diagnosed by the appearance of bright-red irregular tumors after defecation, which may remain visible at all times or be seen only when the horse is doAvn or after passing his manure. They are mostly due to constipation, to irritation or injuries, o'r follow from the severe straining during dysentery. I have observed them to follow from severe labor pains in the mare.
Treatment. — Attention must be i^aid to tlie condition of the bowels; they should be soft, but inirging is to be avoided. The tumors should be washed in warm water and thoroughly cleansed, after which we must scarify them and gently but firmly squeeze out the liquid that will be seen to follow the shallow incisions. While this treatment maybe considered as heroic, to say the least, by medical practitioners, yet it has invariably proven successful in my experience, no bad results following. After thus squeezing these tumors and before replacing through the anus, bathe the parts with some anodyne wash. I prefer for this purpose the glycerite of tannin and laudanum in equal parts. Mucilaginous injections into the rectum may be of service for a few davs.
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Enteritis is an inflammation of the mneous membrane lining the bowels. This inflammation may extend and involve the mnsculai- or even serous coats. From my observations enteritis is exceedingly rare in the horse imless caused by irritants or corrosive i>oisons, or following from inAagination, twisting of the bowels, etc. In fact, I can not remember ever to have seen but one case of enteritis apart from these or similar causes. It is claimed, however, by some that enteritis may be x)roduced bj' drinking when warm large quantities of cold water, driving through deep streams when the animal is heated, washing the entire surface of the lx)d3" at such a time, and bj' feeding moldy or musty foods, or keej)iug the horse in damp cellar stables.
Symptoms. — Febrile symptoms, from the onset, mark all attacks of idiopathic enteritis. The membranes of the nose, mouth, and eyes are congested and reddened, the mouth is hot and dry, respirations are increased, the pulse is hard and rapid, temperature is elevated to 103° or 105° Fall. Colicky pains are continuous. The horse walks about the stall, paws, lies down carefully, and most frequentlj- tui-ns himself uj)on his back by the side of the stall and remains in this posi- tion for some time. Thii*st is present. As a rule, the bowels are sluggish oj" even entirely inactive, but "when this disease is due to irritant foods or medicines i^urging and tymxianites may be present. The inflammatory pulse, high temperature, continuous pain, which is increased upon pressure, position of the horse when down, coldness of ears and legs, etc., will enable us to dignose a case of enteritis. Where enteritis follows as a complication of diseases before described, the symptoms will depend upon the character of the original intestinal disorder.
Treatment. — We must rely almost wholly upon opium iuternally. Give 1 or 2 drams of powdered opium every three or four hours. One dram of extract of belladonna should be added to the above doses of opium. Calomel in 1-dram doses twice a day is also recommended. As a rule, purgatives and enemas are not to be given; our object is to keep the bowels as quiet as possible. Hot blankets applied to the l)elly, or counter-irritants to abdominal walls, are ad\isable. Give mucilaginous drinks, as linseed tea, oatmeal gruel, and starch water. Avoid all solid foods that are in the least hard, dry, and indigestible. If, when the sj'mjitoms of inflammation subside, tlie bowels do not act, try to encourage this l)y means of walking exercise and iujections per rectum. Should tliese fail a mild cathartic is indicated.
Another form of disease, described by some as enteritis, by others us nnico-enteritis and '''■ (ipopJexij <^>f the large h on-' els," in much uiorc common. It is perhaps the most raj)idly fatal of all l)owel diseases, and is seen most frequentlj' in heavy draught horses. Its causes are hard to determine, but it may follow exposure to cold storms, immers- ing llie body in cold water, and in fact about the same causes that j)ro- duce true enteritis. In this disease we And in the large bowels mostly
51
au extensive effusion or extravasation of blood between tlie mucous and muscular coats, giving a bluish or black color. The intestinal ■walls are thickened by this effusion and sometimes measure from 2 to 3 inches in thickness.
The s>jiiipfo)}i.s are severe and i^ersistent x)ain, lalx>red resi)ii*ation, rapid and ireali: pulse, profuse pei"spiration, and paleness of the visi- ble mucous membranes. A peculiar, anxious exi^ression exists that, once seen, is almost diagnostic. Toward the last the horse sighs, breathes stertoroush', staggers and pitches about, and dies in a state of delirium. The}' rarely live more than ten or twelve hours, and often die inside of six hours.
Treatment. — This is of but little avail, since the case has mostly made great progress before being seen. Probably the best domestic remedy is white-oak bark tea given in large and frequently repeated doses. Tannic acid, 1 dram, or fluid extract of ergot, 1 ounce, are preferable, if at hand, and can be given everj* half hour until four or five doses have been taken. Hot applicatious to the body — blankets wrung out of hot water and sprinkled with turpentine — are to be ap- plied frequently. Mustard water should be applied with smart fric- tion to the legs. Could we see these cases at their inception general blood-letting might j)rove of service.
Her)! la. — There are several different kinds of hernia? that require notice at this j)oint, not all of which, however, produce any serious symptoms or results. Abdominal hernije or ruptures are divided into reducihie, irreducible, and strangidated, according to condition; and into inguincd, scrotal, rentral, umhilicalySind diapliragmatic, according to their situation. A hernia is reducU)Je when it can be easily returned into the aMomen. It consists of a soft swelling, without heat, pain, or any uneasiness, generally larger after a full meal, and decreases in size as the bowels become empty. An irreducible hernia is one that can not be returned into the abdomen, and j'et does not cause any pain or uneasiness. Strangidated hernia is one where the contents of the sac are greatly distended, or whej-e from pressure upon the blood-vessels of the imprisoned portion the venous circulation is checked or stopped, thereby causing extensiA'e congestion, swelling, inflammation, and, if not relieved, gangrene of the part and death of the animal. Hernia may be congenital and accidental or acquired.
Congenital scrotal hernia. — Not a few foals are noticed from birth to have an enliirged scrotum, which gradually increases in size up to about the sixth month, sometimes longer. In some instances I have noticed the scrotum of a six-months old colt to be as large as that of an adult stallion, and have been repeatedly asked to prescribe treat- ment for it. This is entirely unnecessary in ninety-nine out of every hundred cases, as this enlargement entirel}' disappears by the time the colt has reached his second year. Any interference, medicinal or surgical, is worse than useless. If the intestine contained within the
52
scrotum slioiild at any time become strangulated., it must then be treated the same as in an adult horse.
Scrotal hernia is caused by dilatation of the sheath of the testicle, combined with relaxation of the fibrous tissue surrounding the ingui- nal ring, thus allowing the intestine to descend to the scrotum. At first this is intermittent, appearing during work and returning when the horse is at rest. For a long time this form of hernia may not cause the least uneasiness or distress. In course of time, however, the imprisoned gut becomes filled with feces, its return into the abdominal cavity is i)revented, and it soon becomes strangulated. While the gut is thus filling the horse often appears dull, is disinclined to move, appetite is impaired, and there is rumbling and obstruction of the bowels. Colicky symptoms now suiiervene. I do not wish to imply that strangulation and its consequent train of symptoms always fol- low in scrotal hernia, as I know of an old horse where the scrotum, by weight of the contained gut, forms a pendulous tumor reaching half way to the hock, and yet he has never experienced any serious inconvenience.
Inguinal hernia is but an incomplete scrotal hernia, and, like the latter, may exist and cause no signs of distress, or again it may become strangulated and cause the death of the animal. Inguinal hernia is seen mostly in stallions, next in geldings, and very rarely in the mare. Bearing in mind that scrotal hernia is seen onlj^ in horses, we can pro- ceed to detail the synq^torns of both strangulated, inguinal, and scrotal hernia at the same time. When, during the existence of colicky symptoms, we find a horse kicking with his hind feet Avliile standing, or lying upon his back, we should look to the inguinal region and scrotum. If scrotal hernia exists the scrotum will be enlarged and lobulated ; by pressure we may force a portion of the contents of the gut back into the abdomen, eliciting a gurgling sound. If we take a gentle but firm hold upon the enlarged scrotum and then have an assistant cause the horse to cough, the swelling will be felt to expand and as quickly contract again.
The history of these cases will materially aid us, as the owner can often assure us of preceding attacks of "colic," more or less severe, that have been instantaneously relieved in some (to him) unaccount- able manner. The colicky symptoms of these herni?e are "not diag- nostic, but, x)robably, more closelj' resemble those of enteritis than any other bowel diseases. Cold sweats, particularly of the scrotum and thighs, are held by some writers to be liathognomonic.
The diagnosis can, in many cases, onl}' be made by a veterinarian, when he has recourse to a rectal examination ; the bowels can here be felt entering the internal al^dominal ring. If the reader can be sure of the existence of these hernipp, he should secure the horse ujpon its back, and, with a hand in the rectum, endeavor to catch hold of tlie wandering bowel and pull it gently back into the cavity of the
53
abdomen. Pressure should be made upon the scrotum during this time. I once succeeded in reducing a strangulated scrotal hernia, after having cast the animal, l)y keeping a bag of cracked ice ui3on the scrotum, thus condensing the imprisoned gases and causing con- traction of the swelling. If these means fail a veterinarian must be called to reduce the hernia by means of incising the inguinal ring, replacing the intestines, and castrate, using clamps and performing the "covered operation."
Ventral hernia. — In this form of hernia the protrusion is through some accidental ox)ening or rujiture of some of the abdominal coats or coverings. It may occur at any part of the belly except at the umbili- cus, and is caused by kicks, blows, hooks, severe jumping or pulling, etc. Ventral hernia is most common in i^regnant mares, and is here due to the weight of the foetus or some degenerative changes taking place in the abdominal coats. It is recognized by the appearance of a swelling, at the base of which can be felt the opening or rent in the abdominal tunics, and from the fact that the swelling containing the intestines can be made to disappear when the animal is placed in a favorable position.
Treatment. — In many instances there is no occasion for treatment, and again, where the hernial sac is extensive, treatment is of no avail. If the hernia is small we may attempt a cure by the methods to be described in treating of umliilical hernia. If we are fortunate enough to be jiresent when the hernia occurs, and particularly if it is not too large, we may, by the j)roper application of a i)ad and broad bandage, effect a perfect cure.
Umjjilical hernia is the passing of any portion of the bowel or omen- tum through the navel, forming a "tumor" at this jioint. This is often congenital in our animals, and is due to the imperfect closure of the umbilicus and to the ijosition of the body. Many cases of umbilical hernia, like inguinal and scrotal of the congenital kind, dis- appear entirely by the time the animal reaches its second or third year. Advancing age favors cure in these cases from the fact that the omentum (swinging suj)port of tlie bowels) is proportionally shorter in adults than in foals, thus lifting the intestines out of the hernial sac and allowing the opening in the walls to close. Probably one of the most fre(|uent causes of umbilical hernia in foals is the practice of keeping tliem too long from their dams, causing them to fret and worry, and to neigh or cry by the hour. The contraction of the abdom- inat muscles and pressure of the intestines during neighing seem to open the umbilicus and induce hernia. Accidents may cause umbil- ical hernia in adults in the same manner as ventral hernia is produced, though this is very rare.
Treatment. — The treatment of umbilical hernia varies much with different practitioners. We should remember the fact that congenital hernise are often removed with age, but probabh^ congenital umbilical
54
hernia? less frequently tliau others. Among tlie many jjlans of treat- ment are to be mentioned the application of a pad over the tumoi-, the pad being held in place by a l)road, tiglit bandage placed around tlie animal's bodj'. Tlie chief objection to this is the difficulty in keeping the pad in its place. Blisters are often applied over the swelling, and as the skin hardens and contracts by tlie formation of scabs an artifi- cial bandage or i^ressure is produced that at times is successful. Another treatment that has gained considerable repute of late years consists in first clipping off the hair over the swelling. Nitric acid is tlien applied by a small brush, using only enough to moisten the skin. This sets up a deep-seated adhesive inflammation, which, in veiy many cases, closes the oj)ening in the navel. Still another plan is to inject a solution of common salt by means of the hypodermic syringe at three or four i)oints about the base of the swelling. This acts in the same manner as the preceding, but in my experience is not as effectual.
Others again, after keeping the animal fasting for a few hours, cast and secure it upon its back; the bowel is then carefullj^ returned into the abdomen. The skin over the opening is to be pinched up and one or two skewers are to be run tlirough the skin from side to side as close as j)ossible to the umbilical opening. The skewers are kept in place by j)assing a cord around the skin between them and the abdo- men and securely tied. Great care must be taken not to draw these cords ioo fiylii, as this would cause a speedy slough of the skin, the intestines would extrude, and death result. If properly applied an adhesion is established between the skin and the umbilicus which effectually closes the orifice.
Diaphragmatic hernia. — This consists of the passage of any of the abdominal viscera through a rent in the diaphragm (midriff) into the cavity of the tliorax. It is rather a rare accident and one often impos- sible to diagnose during life. Colicky symjitoms, accompanied by great difficulty in breathing, and the peculiar position so often assumed (that of sitting upon the haunches), are somewhat character- istic of this trouble, though those symptoms, as we have already seen, may be i^resent during diseases of the stomach or anterior j)orti()n of the bowels. Even could we pronounce, with certainty, this form of hernia, there is little or nothing that can Ix^ done. Leading the horse uj) a very steep gangway or causing liim to I'oar up may possibly cause the hernial i)ortion to return to its natural position. Tliis is not enough, however; it must be kept there.
Peritonitis is an inflammation of the serous membrane lining the cavity of and covering the viscera contained within the abdomen. It is very rare to see a case of idiopathic peritonitis. It is, however, somewhat common from extension of the inflammatory action involv- ing organs covei-ed by the peritoneum. I*eritonitis is often caused by injuries, as iiunctured wounds of tlie abdomen, severe blows or kicks,
55
or, as is still more common, foUoAving the operation of castration. It follows frequently from strangulated hernise, invagination, rupture of the stomach, intestines, liver, or womb.
Sijnipto)ns. — Peritonitis is mostly preceded bj' a chill; the horse is not disposed to move, and if comj)elled to do so moves with a stiff or sore gait ; he paws with the front feet, and probablj' strikes at hisbelh* with the hind ones; lies down very carefully, and as the pain is increased while down he maintains during most of the time the stand- ing position; he walks uneasily- about the stall. Constipation is usu- ally present. Pressure on the belly causes acute pain, and the horse will bite, strike, or kick at you if so disturbed; the abdomen is tucked up; the extremities tine and cold. The temperature is higher than normal, reaching from 102° to KM"" Fall. The pulse in peritonitis is almost, of itself, diagnostic; it is quickened, beating from seventy to ninety beats jyev minute, and is Jiard and icinj. This peculiarity of the puise is characteristic of inflammation of the serous membrane, and if occurring with colicky sjnnptoms, and, in particular, if follow- ing any injuries, accidental or surgical, of the jperitoneum, we may rest assured that peritonitis is present. Peritonitis in the horse is mostly fatal when it is at all extensive. If death does not occur in a short time, the inflammation assumes a chronic form, in which there is an extensive effusion of water in the cavity of the belly, consti- tuting what is known as ascites, and which, as a rule, results in death.
The iveatment of peritonitis is to be somewhat like that of enteritis. Opium in powder, 1 to 2 drams, with calomel, one-half dram, is to be given ever}- two, three, or four hours, and constitutes our main depend- ence in this disease. Extensive counter-irritants over the belly, con- sisting of mustard-plasters, turpentine stupes, or even mild blisters, are highly recommended. Purgatives must never be given during this complaint. Should we desire to move the bowels it can be done by gentle enemas, though it is seldom necessary to resort even to this.
Ascites, or droi)sy of the abdomen, is mostly seen as a result of sul)- acute or chronic peritonitis, but may be due to diseases of the liver, kidneys, heart, or lungs. There will be found, on opening the cavity of the belly, a large collection of yelloAvish or reddish licxuid; from a few quarts to several gallons may be present. It may be clear in color, though generally it is yellowish or of a red tint, and contains numer- ous hjose flakes of coagulable h'mph.
Symptoms. — There is a slight tenderness on pressure; awkward gait of the hind legs; the horse is dull, and may have occasional xevy slight colicky j)ains, shown by looking back and striking at the belly with the hind feet, Oftener, however, these colicky symptoms are absent. Diarrhea often j)recedes death, but during the progress of the disease the bowels are alternately constipated and loose. On percussing the abdominal walls we find that dullness exists /o the same lieighf on both sides of the belly; bj'" suddenly pushing or striking the abdomen Ave
56
can hear the rushing or flooding of water. If the case is an advanced one the horse is pot-bellied to the extreme, and dropsical swellings are seen under the belly and upon the legs.
Treatment is, as a rule, unsatisfactory. Saline cathartics, as Epsom or Glauber salts, and diuretics, ounce doses of saltpeter, are to be given. If a veterinarian is at hand he should withdraw the accumu- lation of water by tapping and should then endeavor to i)revent its recurrence (though this is almost sure to follow) l)y giving three times a day saltpeter, 1 ounce, and iodide of i^otash, 1 dram, and by the application of mustard or blisters over the abdominal walls. Tonics, mineral and vegetable, are also indicated. Probably the best tonic is one consisting of powdered sulphate of iron, gentian, and ginger in equal parts. A heaping tablespoonful of the mixture is to be given as a drench or mixed with the feed, twice a day. Good nutritious foods and gentle exercise complete the treatment.
DISEASES OF THE LIVER.
This organ in the horse is but rarely the seat of disease, and when we consider how frequently the liver of man is affected, this can not , but appear strange to all. There is a difference of the anatomical arrangement of the liver of the horse from that of man that may to some extent account for this rarity of disease in the former. It is very common to hear the would-be veterinarian assert that a horse "has disease of his gall-bladder." He thus displays his ignorance, as the horse has no such biliary reservoir. This absence of the gall- bladder may account to a certain extent for his freedom from liver diseases; as over-distension of this and the presence in it of calculi (stones) in man is a frequent source of trouble. In domestic animals, as in man, hot climates tend to produce diseases of the liver, just as in cold climates lung diseases prevail. Not only are diseases of the liver rare in horses, but they are also A'ery obscure, and in many cases i^ass totally unobserved until after death. There are some symptoms, however, which, when jDresent, should make us examine the liver as carefully as jiossible. These are jaundice (yellowness of the mucous membranes of the mouth, nose, and ej^es) and the condi- tion of the dung, it being light in color and j)asty in appearance.
Hepatitis, inflammation of the liver, maybe general or local and may assume an acute or chronic form. The symptoms of acute hepatitis are: Dulless; the horse is sufi'ering from some internal pain, but not of a severe type; constipated and clay-colored dung balls, scanty and high-colored urine, and general febrile symptoms. If lying down he is mostly found on the left side; looks occasionally toward the right side, which, upon close inspection, may be found to be slightly enlarged over the posterior ribs, where pain upon pressure is also evinced. Obscure lameness in front, of the right leg mostly, is said by some of the best veterinary writers to be a symptom of hepatitis.
57
The horse, toward tlie last, reels or staggers in his gait and falls backward in a fainting fit, dnring one of which he finally succninbs. Death is sometimes due to rupture of the enveloping coat of the liver or of some of its blood-vessels.
Among the causes that lead to this disease we must mention first the stimulating effect of overfeeding, particularly during hot Aveather. Those horses that are well fed and receive but little exercise — old favorites that are being liberally fed and have passed the time of service, pensioned heroes of years of faithful toil — these are the best subjects for diseases of this organ. We must add to these causes the more mechanical ones, as injuries on the right side over the liver, worms in the liver, gall-stones in the biliary ducts, foreign bodies, as needles or nails that have been swallowed and in their wanderings have entered the liver, and, lastly, in some instances, the extension of inflammation from neighboring i^arts, thus involving this organ. Acute hepatitis may terminate in chronic inflammation, abscesses, rupture of the liver, or may disappear, leaving behind no trace of disease whatever.
Treatment. — This should consist, at first, of the administration of 1 ounce of Barbadoes aloes or other i^hysic. A large blister is to be applied to the right side, letting it extend from a little behind the girth backward to the last rib and in width about 12 to 14 inches mid- way between the si^ine above and the middle of the belly below. General blood-letting, if had recourse to early, must prove of much benefit in acute inflammation of the liver. The vein in the neck — jugular — must be opened, and from 4 to G quarts of blood may be drawn. Saline medicines, to act on the kidneys, should follow this treatment ; 1-ounce doses of saltpeter or muriate of ammonia, repeated three or four times a day, are jirobably as good as any. The horse is to be fed sx)aringly on soft food, bran-mashes chiefly. If we prove successful and recovery takes place, see to it that the horse afterwards gets regular exercise and that his food is not of a highly nutritious character, or excessive.
It will, I think, be useless to attempt much of a description of chronic Jiepatitis, the sj-mptoms of this trouble being so obscure that the veterinary surgeon, in most cases, can scarcely hope to do more than diagnose it by exclusion. True, if a horse has had acute hepati- tis and remains dull for too great a length of time, with occasional slight colicky symptoms, yellow membranes, etc., we may not fear of being far wrong in saying that this disease has passed to the chronic form ; but to diagnose this form of hepatitis, without any such pre- vious knowledge of the case, is, to tell the truth, very often " guess- work " with us.
Jaundice — Icterus — llie Yellou-s. — This is a condition caused by the retention and absorption of bile into the blood. It was formerly considered to be a disease of itself, but can not, I think, be accepted
58
as more thau a symptom, or at most as expressing the existence of functional disorder of the liver. "The Yellows" is observed by look- ing at the eyes, nose, and month, wlien it will be seen that these parts are yellowish instead of the pale-pink color of health. In white or light-colored horses the skin even may show this yellow tint. The nrine is saffron-colored, the dung is of a dirty gray color, and consti- pation is mostly present. Jaundice may be present as a sjnnptom of almost any inflammatorj- disease. AVe know that when an animal is "fevered" the secretions are checked, the bile is retained and absorbed throughout the system, and yellowness of the mucous mem- branes follows. Jaundice may also exist during the presence of sim- ple constiiiation, liepatitis, biliary calculi, abscesses, hardening of the liver, etc.
Treafmerif. — When jaundice exists we must endeavor to rid the system of the excess of bile, and this is best accomplished by giving purgatives that act \x])o\\ the liver. Calomel, 2 drams, with aloes, 7 drams, should be given. Glauber salts in handful doses once or tAvice a day for a week is also effective. May-apple, rhubarb, castor oil, and other cathartics that act upon the first or small bowels, may be selected. We must be careful to see that the l)owels are kept open by avoiding hard, dry, bulky foods.
Eupiure of the liver. — This is known to occur at times in the horse, most frequently in old, fat horses and those that get but little exer- cise. Horses that have suffered from chronic liver disease for years eventually present symptoms of colic and die quite suddenly. Upon posf-morfem examination Ave discover that the liver had ruptured. The cicatrices or scars that are often found upon the liver lead me to think that that organ may suffer smdJl rui)ture and yet the horse recover from it. This result can not obtain, however, if the rent or tear is extensive, since in sucli cases death must quickly follow from hemorrhage, or, later, from peritonitis. Enlarged liver is particularly liable to rupture, and it is not surprising that, when we read of this organ weighing 55 to GO pounds, this accident occurs. The immediate causes of ruj)ture appear to be excessive muscular exertion, sudden distention of the abdomen with gas, or some accident, as falling or being kicked by another horse.
The synipioms of rupture Avill dei)end upon the extent of the lacer- ation. If slight there will be simplj' the symptoms of abdominal i^ain, looking back to tlie sides, lying down, etc. ; if extensive the horse is dull and dejected, has no appetite, l)reathing becomes short and catching; he sighs or sobs, visible mucous membranes are pale, extrem- ities cold, pulse fast, small, and Aveak or running down. Countenance noAv shoAvs much distress, he SAveats i)rofusely, totters in his gait, props liis legs Avide apart, reels, staggers, and falls. He may get up again, but soon falls dead. The rapid running-doAvn pulse, paleness of the eyes, nose, and mouth, sighing, stertorous breathing, tottering
< .-V .->: St- •': ^ K ^ >> i; ^ V, Ni iT v; :§ t^
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59
gait, etc., are the symi)toms by Avhich we kiioAv that the animal is dying from internal hemorrhage.
Treaimeui. — But little can be done. Opium in povrder, in doses of 2 drams every two or three hours, maj' be given, with the idea of pre- venting as much as possible all movements of internal organs. If we have reason to suspect internal bleeding we should give large and frequent doses of white-oak bark tea, dram doses of tannic or gallic acid, or the same quantity of sugar of lead, everj' half hour or hour. Fluid extract of ergot or tincture of the chloride of iron, in ounce doses, maj' be selected. Cold water dashed upon the right side or injected into the rectum is highly spoken of as a means of checking the hemorrhage.
Biliary calculi — Gall-stone.^. — These are rarely found in the horse, but may occupy the hei^atic ducts, giving rise to jaundice and to colicky pains. There are no absolutely diagnostic symptoms, but should we find a horse that suffers from repeated attacks of colic, accompanied by symptoms of violent pain, and that during or follow- ing these attacks the animal is jaundiced, we may liazard the conjec- ture that gall-stones are present. There is little or nothing to be done excex)t to give medicines to overcome pain, trusting that these concre- tions may pass on to the bowels, where, from their small size, they will not occasion any inconvenience.
Diseases of the pancreas and spleen are so rare, or their symi^toms so little understood, that it is impossible to write anj-thing concerning either of these organs and their simple diseases that will convey to the reader information from a worthy stand-point, i. e. , that of experi- ence and observation. It is sometimes well, even for the veterinarian, to know that he does not know. This knowledge has saved my readers an infliction.
DISEASES OF THE URINARY ORGANS.
By JAMES LAW, F. R. C. V. S., Professor of Veterinary Science, etc., in Cornell University.
The iirinaiy organs constitute the main channel through which are excreted the nitrogenous or albuminoid iDrinciples, whether derived directly from the food or from the muscular and other nitrogenized tissues of the body. They constitute, besides, the channel through which are thrown out most of the poisons, whether taken in by the moutli or skin or develoxDcd in connection with faulty or natural digestion, blood-forming, nutrition, or tissue destruction; or, finally, poisons that are developed within the bod}" as the result of normal cell-life or of the life of bacteria or other germs that have entered the body from Vv-ithout. To a large extent, therefore, these organs are the sanitary scavengers and purifiers of the system, and when their functions are impaired or arrested the retained poisons quickly show their presence in resulting disorders of the skin and connective tissue beneath it, of the nervous system, or other organs. Nor is this influ- ence one-sided. Scarcely an important organ of the body can suffer derangement without entailing a corresponding disorder of the urinary system. Nothing can be more striking than the mutual balance maintained between the liquid secretions of the skin and kidneys dur- ing hot and cold weather. In summer, when so much liquid exhales through the skin as sweat, comparatively' little urine is passed, whereas in winter, when the skin is inactive, the urine is correspond- ingly increased. This vicarious action of skin and kidneys is usually kept within the limits of health, but at times the draining ofC of the water by the skin leaves too little to keej) the solids of the urine safely in solution, and these are liable to crj'stallize out and form stone and gravel. Similarly the passage in the sweat of some of the solids that normally leave the bod}', dissolved in the urine, serves to irritate the skin and produce troublesome eruptions. A disordered liver contrib- utes to the i)roduction, under different circumstances, of an excess of biliary coloring-matter, which stains the urine; of an excess of hip- puric acid and allied products, which, being less soluble than urea
61
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(tlie uorinal protluct of tissue cliango), favor the formation of stone, of taurocliolic acid, and otlier bodies that tend, when in excess, to destroy the blood globules and to cause irritation of the kidneys by the resulting- haemoglobin excreted in the urine, and of glycogen too abundant to be burned up in the system, which induces saccharine urine (diabetes). Any disorder leading to impaired functional activ- ity of the lungs is causative of an excess of hippurie acid and allied bodies, of oxalic acid, of sugar, etc. , in the urine, which irritate the kidneys even if they do not produce solid deposits in the urinary pas- sages. Diseases of the nervous system, and notably of the base of the brain and of the spinal cord, induce various urinary disorders, prominent among which are diabetes, chylous urine, and albuminuria. Certain affections, with imperfect nutrition or destructive waste of the bony tissues, tend to charge the urine with iihosphates of lime and magnesia, and endanger the formation of stone and gravel. In all extensive inflammations and acute fevers the liquids of the urine are diminished, while the solids (waste products), which should form the urinary secretion, are increased, and the surcharged urine proves irritant to the urinary organs or the retained waste products poison the system at large.
Diseases of the heart and lungs, by interfering with the free onward flow of the blood from the right side of the heart, tend to throw that liquid back on the veins, and this backward pressure of venous blood strongh- tends to disorders of the kidneys. Certain poisons taken with the food and water, notably that found in magnesian limestone and those found in irritant diuretic plants, are especially injurious to the kidneys, as are also various cryptogams, vrhether i^resent in musty hay or oats. The kidney's may be irritated by feeding green vegetables covered with hoar-frost or by furnishing an excess of food rich in phos- phates (wheat bran, beans, pease, vetches, lentils, rape-cake, cotton- seed cake) or bj^ a privation of water which entails a concentrated condition and high density of the urine. Exposure in cold rain or snow storms, cold draughts of air, and damp beds are liable to fur- ther disorder an already overworked or irrital)lo kidney. Finally, sprains of the back and loins may cause bleeding from the kidneys or inflammation.
The right kidnej^, weighing 23^ ounces, is shaped like a French bean, and extends from the loins forward to beneath the heads of the last two ribs. The left kidnej- (Plate lY) resembles a heart of cards, and extends from the loins forward beneath the head of the last rib only. Each consists of three distinct i^arts, («)the external (cortical) or vas- cular part, in which the blood-vessels form elaborate capillar}^ networks within the dilated globular sacs which form the beginnings of the secret- ing (uriniferous) tubes and on the surface of the sinuous secreting tubes leading from the sacs inward toward the second or medullary l^art of the organ; (?>) the internal (medullary) part, made up in the
main of blood- vessels, lympluilu-s, aud nerves extending Ix'tween tlie notch on the inner border of the kidney to and from the oviter vascular portion, in which the secretion of urine is almost exclusively carried on; and ((/) a large saccular reservoir in the center of the kidney, into which all uriniferous tubes pour their secretions and from which the urine is carried away through a tube y (ureter), which passes out of thenotcli at the inner 1)order of the kidney and which opens by a valve- closed orifice into the roof of the bladder just in front of its neck. The bladder is a dilatable reservoir for the retention of the urine until the discomfort of its presence causes its voluntary discharge. It is kept closed by circular muscular fibers surrounding its neck or orifice, and is emptied by looped muscular fibers extending in all directions for- ward from the neck around the blind anterior end of the sac. From the bladder the urine escapes through a dilatable tube (urethra) which extends from the neck of the bladder backward on the floor of the pel- vis, and in the male through the penis to its free end, where it oi)ens through a pink conical papilla. In the mare the urethra is not more than an inch in length, and is surrounded by the circular muscular fibers closing the neck of the bladder. Its opening may be found directly in the median line of the fl(X)r of the vulva, about 4i inches from its external opening.
General symptoms. — These apjjly especially to acute inflammations and the irritation caused l>y stone. The animal moves stiifly on the hind limbs, straddles, and makes frequent attempts to -pass urine, which may be in excess, deficient in amount, liable to sudden arrest in spite of the straining, passed in driblets, or entirely suppressed. Again, it may be modified in density or constituents. Difficulty in making a sharp turn, or in lying down and rising with or without groaning, dropping the back when mounted or when pinched on the loins is suggestive of kidney disease, and so to a less extent are swelled legs, dropsy, and diseases of the skin and nervous system. The oiled hand introduced through the rectum may feel the bladder beneath and detect any over-distension, swelling, tenderness, or stone. In ponies the kidneys even may be reached.
Examinaiion of the urine. — In some cases the changes in the urine are the sole sign of disease. In health the horse's urine is of a deep amber color and has a strong odor. On a feed of grain and hay it may show a uniform transparency, while on a green ration there is an abundant white deposit of carbonate of lime. Of its morbid changes the following are to be looked for: (1) CoJor: White from deposited salts of lime ; bro-rni or red from blood clots or coloring matter; yellow or orange from bile or blood-pigment; pale from excess of water, or variously colored from vegetable ingredients (santonin makes it red, rhubarb or senna, brown; tar or carbolic acid, green). (2) Density: The horse's urine maybe 1.030 to 1.050, but it may greatly exceed this in diabetes and may sink to 1.007 in diuresis. (3) Chemical re-action,
64
as ascertained by blue litmus or red test papers. The horse on vege- table diet has alkaline urine turning red test papers blue, while in the sucking-colt and the horse fed on flesh or on his own tissues (in star- vation or abstinence during disease) it is acid, turning blue litmus red. (4) Organic constituents, as when glairy from albumen coagulableby strong nitric acid and boiling, when charged with microscopic casts of the uriniferous tubes, with the eggs or bodies of worms, with sugar, blood, or bile. (5) In its salts, which may crystallize out spontaneously, or on boiling, or on the addition of chemical re-agents.
Albuminous urine in the horse is usually glairy, so that it may be drawn out in threads, but its presence can always be tested as fol- lows: If the liquid is opaque, it may be first passed through filter paper; if very dense and already precipitating its salts, it may be diluted with distilled water; add to the suspected liquid acetic acid drop by drop until it reddens the blue litmus paper; then boil gently in a test tube; if a precipitate is thrown down, set the tube aside to cool and then add strong nitric acid. If the j^recipitate is not dis- solved it is albumen; if dissolved it was probably urate or hii)i)urate of ammonia. Albumen is normally present in advanced gestation; abnormally it is seen in diseases in which there occurs destruction of blood globules (anthrax, low fevers, watery states of the blood, drop- sies), in diseases of the heart and liver which prevent the free escape of blood from the veins and throw back venous pressure on the kid- neys, in inflammation of the lungs and jjleurpe, and even tympany (bloating), doubtless from the same cause, and in all congestive or inflammatory diseases of the kidneys, acute or chronic.
Casts of the uriniferous tubes can only be seen by placing the sus- pected urine under the microscope. They are usually very elastic and mobile, waving about in the liquid when the cover-glass is touched, and showing a uniform clear transparency (waxy) or entan- gled circular epithelial cells or opaque granules or flattened red blood globules or clear refrangent oil globules. They may be even densely opaque from crystals of earthy salts.
Pus cells may be found in the urine associated with albumen, and are recognized by clearing ui), when treated with acetic acid, so that each cell shows two or three nuclei.
DIURESIS — POLYURIA — DIABETES INSIPIDUS — EXCESSIVE SECRETION
OF URINE.
This consists in an excessive secretion of a clear, watery urine of a low speciflc gravity (1.007) with a correspondingly ardent thirst, a rapidly advancing emaciation, and great loss of strength and spirit.
Its causes may be any agent, medicinal, alimentary, or j)oisonous, which unduly stimulates the kidneys; the reckless administration of diuretics, which form such a common constituent of quack horse- powders; acrid diuretic plants in grass or hay; new oats still imper- fectly cured; an excess of roots or other very waterj^ food; a full
65
allowance of salt to animals that have become inordinately fond of it; but, above all, feeding on hay, grain, or bran which has not been properly dried and has become musty and permeated by fungi. Thus hay, straw, or oats secured in wet seasons and heating in the rick or stack is esi^ecially injurious. Hence this malady, like coma somno- lentum (sleepy staggers), is widespread in wet seasons, and especially in rainy districts.
Sijmpfoms. — The horse drinks deep at every oj)portunity and passes urine on every occasion when stopped, the discharge being x^ale, watery, of a low density, and inodorous; in short, it contains a great excess of water and a deficiency of the solid excretions. So great is the quantity passed, however, that the small amount of solids in any given specimen amounts in twenty-four hours to far more than the normal, a fact in keeping with the rapid wasting of the tissues and extreme emaciation. The flanks become tucked up, the fat disap- pears, the bones and muscles stand out prominently, the skin becomes tense and hidebound, and the hair erect, scurfy, and deficient in luster. The eye becomes dull and sunken, the sj^irits are depressed, the animal is weak and sluggish, sweats on the slightest exertion, and can endure little. The subject may survive for months, or he may die early of exhaustion. In the slighter cases, or when the cause ceases to operate, he may make a somewhat tardy recovery.
Treatment. — This consists in stopping the ingestion of the faulty drugs, poisons, or food, and supplying sound hay and grain free from all taint of heating or mustiness. A liberal supply of boiled flaxseed in the drinking water at once serves to eliminate the poison and to sheath and protect the irritated kidneys. Tonics like sulphate or phosphate of iron (2 drams morning and evening) and powdered gen- tian or Peruvian bark (4 drams) help greatly by bracing the sj^stem and hastening repair. To these may be added agents calculated to destro}^ the fungus and eliminate its poisonous products. In that form w^hich depends on musty food nothing acts better than large doses of iodide of potassium (2 drams), while in other cases ci-eosote, carbolic acid (1 dram), or oil of turpentine (4 drams) i^roperly diluted, may be resorted to.
SACCHARINE DIABETES — DIABETES MELLITUS — GLYCOSURIA —
INOSURIA.
This is primarily a disease of the nervous system or liver rather than of the kidneys, j^et, as the most prominent symptom is the sweet urine, it may be treated here. Its causes are varied, but resolve themselves largely into disorder of the liver or disorder of the brain. Ono of the most prominent functions of the liver is the formation of glycogen, a principle allied to grape-sugar, and passing into it by further oxidation in the blood. This is a constant function of the 5961— HOR 3
6G
liver, but in liealtli the resulting sugar is burneu up m the circula- tion and does not apx3ear in the urine. On the contrary, when the sui^ply of oxygen is defective, as in certain diseases of the lungs, the whole of the sugar does not undergo combustion and the excess is excreted by the kidneys. Also in certain forms of enlarged liver the amount of sugar x^roduced is more than can l>e disj^osed of in the natural way, and it appears in tlie urine. A temporary sweetness of the urine often occurs after a hearty meal on starchy food, but this is due altogether to the su]oerabundant sux)ply of the sugar-forming food, lasts for a few hours only, and has no ^pathological significance. In many cases of fatal glycosuria the liver is found to be enlarged, or at least congested, and it is found that the disorder can be produced experimentally by agencies which j)roduce an increased circulation through the liver. Thus Bernard produced glycosuria by pricking the oblong medulla at the base of the brain close to the roots of the pneumogastric nerve, which happens to be also the nerve center (vaso-motor) which presides over the contractions of the minute blood- vessels. The x)ricking and irritation of this center leads to congestion of the liver and the excessive production of sugar. Irritation carried to this point through the pneumogastric nerve causes saccharine urine, and, in keeping with this, disease of the pancreas has been found in this malady, the irritation being conveyed thence to the brain through the i)neumogastric nerve and reflected to the liver through the vaso-motor nerves. The same result follows the reflection of irri- tation from other sources, as from different ganglia (corpora striata, optic tlialami, x>ons, cerebellum, cerebrum) of the brain. Similarly it is induced by interruption of the nervous control along the A'aso- motor tracts, as in destruction of the upper or lower cervical sym- pathetic ganglion, by cutting the nervous branch connecting these two, in injury to the spinal marrow in the interval between the brain and the second or fourth dorsal vertebra, or in disease of the coeliac plexus, which direclt}^ iDresides over the liver. Certain chemical poi- sons also cause saccharine urine, notably woorara, strychnia, morphia, phosphoric acid, alcohol, ether, chloroform, quinia, ammonia, and arsenic.
The sympfoms are ardent thirst and profuse secretion of a pale urine of a high density (LOGO and upward), rapid loss of condition, scurfy, unthrifty skin, costiveness or irregularity of the bowels, indigestion, and the presence in the urine of a sweet principle, grape-sugar or ino- site, or both. This maj^ be most i^romptly detected by touching the tip of the tongue with a drop. Sugar may be detected simply by adding a teaspoonf ul of liquid yeast to 4 ounces of the urine and keep- ing it lightly stopped at a temperature of 70° to 80° F., for twelve hours, whe)i the sugar will be found to have been changed into alco- hol and carbon dioxide. The loss of density will give indication of the amount of sugar transformed; thus a density of 1,035 in a urine
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wliicli was fonuerly LOGO would indicate about 15 grains of sugar to the fluid ounce.
Inosite or muscle-sugar, frequently present in the horse's urine, and even replacing the glucose, is not fermentable. Its i)resence may be indicated by its sweetness and the absence of fermentation, or by Gal- lois' test. Evaporate the suspected urine at a gentle heat almost to drj'uess, then add a droj) of a solution of mercuric nitrate and evapo- rate carefully to dryness, when a 3'ellowish residue is left that is changed on further cautious heating to a deep rose-color, which dis- appears on cooling and reapi^ears on heating.
In advanced diabetes, dropsies in the limbs and under the chest and bell}^, puffy, swollen eyelids, cataracts, catarrhal inflammation of the lungs, weak, uncertain gait, and drowsiness may be noted.
Treatment is most satisfactory in cases dependent on some curable disease of liver, pancreas, lungs, or brain. Thus, in liver diseases, a run at j)asture in Avarm weather, or in winter a warm, sunn}^ well- aired stable, with sufficient clothing and laxatives (sulxDhate of soda, 1 ounce daily) and alkalies (carbonate of potassium, one-fourth ounce) may benefit. To this may be added mild blistering, cupping, or even leeching over the last ribs. Diseases of the brain or pancreas may be treated according to their indications. The diet should be mainly albuminous, such as wheat-bran or middlings, pease, beans, vetches, and milk. Indeed, an exclusive milk diet is one of the very best remedial agencies. It may be given as skim milk or butter-milk, and in the last case combines an anti-diabetic remedy in the lactic acid. Under such an exclusive diet recent and mild cases are often entirely restored, though at the exi)ense of an attack of rheumatism. Codeia, one of the alkaloids of opium, is stronglj^-ecommended by Dr. Tj^son. The dose for the horse would be 3 grains thrice daily. In cases in wiiich there is manifest irritation of the brain bromide of potassium, 4 drams, or ergot, one-half ounce, may be resorted to. Salicylic acid and salicylate of sodium have proved useful in certain cases; also l)hosphate of sodium. Bitter tonics (especially nux vomica, one-half dram) are useful in imj)roving the disgestion and general health.
BLOODY URINE — HEMATURIA.
As seen in the horse bloody urine is usually the direct result of mechanical injuries, as sprains and fractures of tne loins, lacerations of the sub-lumbar muscles (psoas), irritation caused by stone in the kidney, ureter, bladder, or urethra. It may, however, occur with acute congestion of the kidney, with tumors in its substance, or with papilloma or other diseased growth in the bladder. Acrid diuretic plants i)resent in the food may also lead to the escape of blood from the kidney. The predisposition to this affection is, however, incom- parably less than in the case of the ox or sheep, the difference being
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attributed to tlie greater plasticity of the horse's blood in connection ■with the larger quantity of fibrine.
The blood may be present in small clots or in more or less intimate admixture with the urine. Its condition may furnish some indication as to its source ; thus, if from the kidnej^s it is more likely to be uni- formly diffused through the urine, while as furnished b}^ the bladder or passages clots are more likely to be present. Again, in bleeding from the kidney, minute cylindrical clots inclosing blood globules and formed in the uriniferous tubes can be detected under the micro- scope. Precision also may be approximated by observing whether there is coexisting fracture, sprain of the loins, stone or tumor in the bladder or urethra.
The disease being mainlj^ due to direct injury, freatmentvrUl consist first in removing such cause whenever possible, and then in applying general and local styptics. Irritants in food must be avoided, sprains appropriately treated, and stone in bladder or urethra removed. Then give mucilaginous drinks (slippery elm, linseed tea) freely, and styp- tics (tincture of chloride of iron, 3 drams; acetate of lead, one-half dram; tannic acid, one-half dram; or oil of turpentine, 1 ounce). If the discharge is abundant apply cold water to the loins and keep the animal perfectly still.
HEMOGLOBINURIA — AZOTURIA — AZOTAEMIA — POISONING BY
ALBUMINOIDS.
Like diabetes, this is rather a disease of the liver and blood-forming functions than of the kidney, but as prominent symptoms are loss of control over the hind limbs and the passage of ropy and dark-colored urine, the vulgar idea is that it is a disorder of the urinary organs. It in a complex adeetion directly connected with a plethora in the blood of nitrogenized constituents, Avith extreme nervous and muscular dis- order and the excretion of a dense reddish or brownish urine. It is directly connected with high feeding, especially on highly nitrogenized food (oats, beans, pease, vetches, cotton-seed meal), and with a period of idleness in the stall under full rations. The disease is never seen at pasture, rarely under constant daily work, even though the feeding be high, and the attack is usually precipitated by taking the horse from the stable and subjecting it to exercise or work. The poisoning is not present when taken from the stable, as the horse is likely to be noticeably lively and spirited, but he will usually succumb under the first hundred yards or half mile of exercise. It seems as if the aspira- tory power of the chest under the sudden exertion and accelerated breathing speedily drew from the gorged liver and abdominal veins (portal) the accumulated store of nitrogenous matter in an imperfectly oxidized or elaborated condition, and as if the blood, surcharged with these materials, was unable to maintain the healthy functions of
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the nerve centers and muscles. A peculiar anatomical feature of the horse's liver doubtless contributes to this, namely, the persistence, throughout life, of several considerable veins leading directly from the veins of the stomach and intestines (portal veins) into the posterior vena cava and heart.
This condition, common to foetal mammals, persists through life in the solipeds only, among our domestic animals. In all others the portal vein has no communication with the vena cava except through the capillaries of the liver. With the direct channel the rich, crude blood coming from the intestines is drawn at once into the general cir- culation unchanged bj' the secretion in the liver and the chemical changes therein effected. Hence this disease is peculiar to solipeds. It has been noticed rather more frequently in mares than horses, attributable, perhaps, to the nervous excitement attendant on heat, and to the fact that the unmutilated mare is naturally more excitable than the docile gelding.
Syviptoms. — ^In the milder forms this affection may appear as a lame- ness in one limb, from indefinite cause, succeeding to some sudden exertion and attended by a dusky-brown color of the membranes of the eye and nose and some wincing when the last ribs are struck. The severe forms come on after one or two days of rest on a full ration, when the animal has been taken out and driven one hundred jjaces or more. The fire and life with which he had left the stable suddenly give place to dullness and oppression, as shown in hea^ang flanks, dilated nostrils, pinched face, perspiring skin, and trembling body. The muscles of the loins or haunch become swelled and rigid, the subject moves stififl}' or unsteadily, crouches behind, the limbs being carried semi-flexed, and he soon drops, unable to support himself. A\Tien down, the body and limbs are moved convulsively, but there is no power of co-ordination of move- ment in the muscles. The pulse and breathing are accelerated, the eyes red with a tinge of brown, and the urine, if passed, is seen to be highly colored, dark bi'own, red, or black, but it contains neither blood clots nor globules. The color is mainly due to haemoglobin and other imperfectly elaborated constituents of the blood.
It may end fatally in a few hours or days, or a recovery may ensue, which is usually more sj^eedy and perfect if it has set in at an early stage. In the late and tardy recoveries a partial paralysis of the hind limbs may last for months. A frequent sequel of these tardy cases is an extensive wasting of the muscles leading up from the front of the stifle (those supplied by the crural nerve), and a complete inability to stand.
The prevention of this serious affection lies in restricting the diet and giving daily exercise when the animal is not at work. A horse that has had one attack should never be left idle for a single day in the stall or barn -yard. When a horse has been condemned to absolute repose on good feeding he may have a laxative (one-half to 1 pound Glauber
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salts), and liave graduated exercise, beginning witli a short walk and increasing day by da3\
The treatment of the mild cases may consist in a laxative, graduated dailj" exercise, and a daily dose of saltpeter (1 ounce). Sudden attacks will sometimes promj)tly subside if taken on the instant and the sub- ject kept still and calmed by a dose of bromide of potassium (4 drams) and sweet spirits of niter (1 ounce). The latter has the advan- tage of increasing the secretion of the kidneys. In severe cases, as a rule, it is desirable to begin treatment by a full dose of aloes (4 to 6 drams) with the above-named dose of bromide of potassium, and this latter may be continued at intervals of four or six hours, as may be requisite to calm the nervous excitement. Fomentations with warm water over the loins are always useful in calming the excitable condi- tion of the spinal cord, muscles, liver, and kidneys, and also in favor- ing secretion from the two latter. On the second day diuretics ma}" be resorted to, such as saltpeter, one-half ounce, and]3owdered eolchicum, one-half dram, to be repeated twice daily. A laxative may be repeated in three or four days should the bowels seem to demand it, and as the nervous excitement disappears any remaining muscular weakness or paralj'sis may be treated by one-half dram doses of n»ux vomica twice a day and a stimulating liniment (aqua ammonia and sweet-oil in equal proportions) rubbed on the torj)id muscles.
During the course of the disease friction to the limbs is useful, and in the advanced xDaralytic stage the application of electricity along the line of the affected muscles. When the i^atient can not stand he must have a thick, soft bed, and should be turned from side to side at least everj' twelve hours. As soon as he can be made to stand he may be helloed ux) and even supported in a sling.
ACUTE INFLAMMATIOX OF THE KIDNEYS — ACUTE NEPHRITIS.
Inflammations of the kidneys have been differentiated widel}', accord- ing as they were acute or chronic, parenchymatous or tubal, sui^pura- tive or not, with increased or shrunken kidney, etc., but in a work like the present, utility will be consulted by classing all under acute or chronic inflamiiiaUon.
The causes of inflammation of the kidnej'S are extremely varied. Congestion occurs from the altered and irritant products passed through these organs during recovery from inflammations of other organs and during fevers. This may last only during the existence of its cause, or may jjcrsist and become aggravated. Heart disease, throw- ing tlie blood pressure back on the veins and kidneys, is another cause. Disease of the ureter or bladder, jjreventing the escape of urine from the kidney and causing increased fullness and tension in its ]3elvis and tubes, will determine inflammation. Decomposition of the detained urine in such cases, and the ijroduction of ammonia and other irri- tants, must also be named. The advance of bacteria upward from the
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bladder to the kidneys is anotlier cause. The consumption in hay or other fodder of acrid or irritant plants, including- fungi, the absorj)tion of cantharidine from a surface blistered by Spanish flies, the reckless administration of diuretics, the presence of stones in the kidnej^ exposure of the surface to cold and "svet, and the infliction of blows or sprains on the loins, may contribute to its production. Liver disor- ders which throw on the kidneys the work of excreting irritant prod- ucts, diseases of the lungs and heart from which clots are carried, to be arrested in the small blood-vessels of the kidnej', and injuries and paralysis of the spinal cord, are additional causes.
The symptoms are more or less fever, manifest stiffness of the back and straddling gait with the hind limbs, difiiculty in Ij'ing down and rising, or in walking in a circle, the animal sometimes groaning under the effort, arching of the loins and tucking up of the flank, looking back at the abdomen as if from colicky i^ain, and tenderness of the loins to pinching, especially just beneath the bony j)rocesses G inches to one side of the median line. Urine is passed frequently, a small quantity at a time, of a high color, and sometimes mixed with blood or even x)us. Under the microscope it shows the microscopic casts referred to under general symptoms. If treated by acetic acid, boil- ing, and subsequent addition of strong nitric acid, the resulting and persistent precixjitate indicates the amount of albumen. The legs tend to swell from the foot up, also the dependent iDarts beneath the belly and chest, and effusions of liquid ma}^ occur within the chest or abdo- men. In the male animal the alternate drawing up and relaxation of the testicles in the scrotum are suggestive, and in small horses the oiled hand introduced into the rectum may reach the kidney and ascertain its sensitiveness.
Treatment demands, first, the removal of any recognized cause. Then, if the suffering and fever are high, 2 to 4 quarts of blood may be abstracted from the jugular vein; in weak subjects or unless in high fever this should be omitted. Next relieve the kidneys as far as i^ossible by throwing their work on the bowels and skin. A pint of castor oil is less likely than either aloes or salts to act on the kid- neys. To affect the skin a warm stall and heavy clothing may be sui)plemented by dram doses of Dover's powder. Boiled flaxseed may be added to the drinking water, and also thrown into the rectum as an injection, and blankets saturated with hot water should be per- sistently applied to the loins. This may be followed by a very thin X:)ulp of the best ground mustard made with tepid Avater, rubbed in against the direction of the hair, and covered up with paper and a blanket. This may be kept on for an hour, or until the skin thickens and the hair stands erect. It maj then be rubbed or sponged off and the blanket reaisplied. When the action of the bowels has been started it may be kept up by a daily dose of 2 or 3 ounces of Glauber salts.
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During recovery a course of bitter tonics (nux vomica 1 scruple, ground gentian root 4 drams) should be given. The patient should also be guarded against cold, wet, and any active exertion for some time after all active symptoms have subsided.
CHRONIC INFLAMMATION OF THE KIDNEYS.
Chronic inflammation of the kidneys is more commonl}^ associated with albumen and casts in the urine than the acute form, and in some instances these conditions of the urine may be the only jjrominent symptoms of the disease. Though it may supervene on blows, injuries, and exposures, it is much more commonly connected with faulty con- ditions of the sj'Stem — as indigestion, heart disease, lung or liver dis- ease, imperfect blood formation or assimilation. In short, it is rather the attendant on a constitutional infirmity than on a simple local injury.
It may be associated with various forms of diseased kidney, as shrinkage (atrophy), increase (hypertrophy), softening, red congestion, white enlargement, etc., so that it forms a group of diseases rather than a disease by itself.
The symptoms may include stiffness, weakness, and increased sensi- bility of the loins, and modified secretion of urine (increase or sup- pression), or the flow may be natural. Usually it contains albumen, the amount furnishing a fair criterion of the gravity of the affection, and microscopic casts, also most abundant in bad cases. Droj)sy, manifested in swelled legs, is a significant symptom, and if the effusion takes place along the lower line of the body, or in chest or abdomen, the significance is increased. A scurfy, unthrifty skin, lack-luster hair, inability to sustain severe or coutinued exertion, i)oor or irregular appetite, loss of fat and flesh, softness of the muscles, and pallor of the eyes and nose are equally suggestive. So are skin eruptions of various kinds. Anyone or more of these symptoms would warrant an examination of the urine for albumen and casts, the finding of Avhicli signifies renal inflammation.
TreatTnent of these cases is not always satisfactory^, as the cause is liable to be maintained in the disorders of important organs elsewhere. If any such coincident disease of another organ or function can be detected, that should be treated first or simultaneously with this affec- tion of the kidneys. In all cases the building up of the general health is important. Hence a course of tonics may be given (phosphate of iron, 2 drams; nux vomica, 20 grains; powdered gentian root, 4 drams, daily), or 60 drops of sulphuric acid or nitro-muriatic acid may be given daily in the drinking water. If there is any elevated tempera- ture of the body and tenderness of the loins, fomentations may be applied, followed by a mustard pulp, as for acute inflammation, and even in the absence of these indications the mustard may be resorted to with advantage at intervals of a few days. In suppression of urine,
73
fomentations with warm water or witli infusion of digitalis leaves is a safer resort than diuretics, and cupping over the loins may also benefit. To apply a cup shave the skin and oil it; then take a narrow-mouthed glass, rarefy the air within it by introducing a taper in full flame for a second, withdraw the taper and instantly apply the mouth of the glass to the skin and hold it closely applied till the cooling tends to form a A^acuum in the glass and to draw up the skin, like a sucker.
As in the acute inflammation, every attention must be given to secure warm clothing, a warm stall, and pure air.
TUMORS OF THE KIDNEYS — PARASITES.
Tumors, whether malignant or simple, would give rise to sjnnptoms resembling some form of inflammation, and are not likely to be recog- nized during life. To parasites of the kidney belong the eehinococcus, the larval or bladder- worm stage of the small eehinococcus tape-woimi of the dog; also the Cysticercus fistularis, another bladder- Avorm of an unknown tape- worm ; but in these there is the possibility of the pas- sage with the urine of a detached head of the bladder-worm or of'some of its microscopic booklets, which might be found in the sediment of the urine. So with Strongylus gigas (giant strongle), the largest of round worms, which has been found in the kidney of the horse, and the presence of which could only be certified by the i^assage of its microscopic eggs or of the entire worm.
SPASM OF THE NECK OF THE BLADDER.
This affection consists in spasmodic closure of the outlet from the bladder by tonic contraction of the circular muscular fibers. It may be accompanied by a painful contraction of the muscles on the body of the bladder, or if the organ is already undulj^ distended these will be affected with temi^orary j)aral3' sis. It is most frequent in the horse, but by no means unknown in the mare.
The causes are usually hard and continuous driving without opi)or- tunity for passing urine, cold rain-storms, draughts of cold air when perspiring and fatigued, the administration of Spanish fly or the appli- cation of extensive blisters of the same, abuse of diuretics, the pres- ence of acrid diuretic plants in the fodder, and the presence of stone in the bladder. As most mares refuse to urinate wliile in harness, they should be unhitched at sui talkie times for urination. Spasms of the bowels are always attended by spasm of the bladder, hence the free passage of water is usually a symptom of relief.
The symptoms are frequent stretching and straining to urinate, with no result or a slight dribbling only. These vain efforts are attended by pain and groaning. On resuming his natural position the animal is not freed from the pain, but moves uneasily, paws, shakes the tail, kicks at the abdomen with his hind feet, looks back to the 5961— HOR 3*
74
flank, lies down and rises, arclies the back, and attempts to urinate as before. If the oiled hand is introduced into the rectum the greatly distended bladder may be felt beneath, and the patient ^Yill often shrink when it is handled.
It is important to notice that irritation of the urinar}' organs is often present in impaction of the colon with solid matters, because the impacted intestine under the straining of the patient is forced backAvard into the pelvis and presses upon and irritates the bladder. In such case*s the horse stands with his fore limbs advanced and the hind ones stretched back beyond the natural posture, and makes fre- quent eiforts to urinate with varying success. Unpracticed observers naturally conclude that the secondary urinary trouble is the main and only one, and the intestinal impaction and obstruction is too often neglected until it is irremediable. In cases w^here the irritation has caused spasm of the neck of the bladder and overdistention of that organ, the mistake is still more easily made, hence it is imj)ortant in all cases to examine for the impacted bowel, forming a bend or looj) at the entrance of the pebds and usuall}^ toward the left side. The impacted intestine feels soft and doughj-, and is easily indented with the knuckles, forming a marked contrast with the tense, elastic, resil- ient ovcrdistended bladder.
It remains to be noted that similar symptoms may be determined by a stone, or sebaceous mass, or stricture obstructing the urethra, or in the new-born by thickened mucus in that duct and the pressure of hardened impacted feces in the rectum. In obstruction, the hard ini pacted body can usually be felt hj tracing the urethra along the lower and posterior surface of the penis and forward to the median line of the floor of the i^elvis to the neck of the bladder. That part of tlie urethra between the seat of obstruction and the bladder is usually distended with urine, and feels enlarged, elastic, and fluctuating.
Treatment may be begun by taking the animal out of harness. This failing, spread clean litter beneath the belty or turn the patient out on the dung-heai). Some seek to establish sj'mpathetic action by l^ouring water from one vessel into another with dribbling noise. Others soothe and distract the attention by slow whistling. Friction of the abdomen with wisps of straw may succeed, or it may be rubbed with ammonia and oil. These failing, an injection of 2 ounces of laudanum or of an infusion of 1 ounce of tobacco in water may be tried. -In the mare the neck of the bladder is easily dilated by insert- ing two oiled fingers and slightl}^ parting them. In the horse the oiled hand introduced into the rectum maj^ press from before backward on the anterior or blind end of the bladder. Finally a well-oiled gum- elastic catheter may be entered into the urethra through the papilla at the end of the i)enis and i)ushed on carefully until it has entered the bladder. To effect this the penis must first be withdrawn from its sheath, and when the advancing end of the catheter has reached
75
the bend of the urethra beueatli the anus ii must be guided forward hy pressure with the hand, which guidance must be continued onward into the bhidder, the oiled hand being introduced into the rectum for this iDurxDOse. The horse catlieter, 3|- feet long and one-third inch in diameter, may be bought of a surgical-instrument maker.
PARALYSIS OF THE BLADDER.
Parah^sis of the body of the bladder with spasm of the neck has been described under the last heading, and may occur in the same waj^ from overdistension in tetanus, acute rheumatism, paraplegia, and hemiplegia, in which the animal can not stretch himself to stale, and in cystitis, affecting the body of the bladder but not the neck. In all these cases the urine is suppressed. It also occurs as a result of disease of the posterior end of the spinal marrow and with broken back, and is then associated mth palsy of the tail, and it may be of the hind limbs.
The symjjtoms are a constant dribbling of urine when the neck is involved, the liciuid running down the inside of the thighs and irritat- ing the skin. When the neck is unaffected the urine is retained until the bladder is greatly overdistended, when it may be exjjelled in a gush by the active contraction of the muscular walls of the abdo- men; but this never empties the bladder, and the oiled hand intro- duced through the rectum ma}' feel the soft, flabby organ still half full of urine. This retained urine is liable to decompose and give off ammonia, which dissolves the epithelial cells, exposing the raw mucous membrane, and causing the worst type of cystitis. Suppres- sion and incontinence of urine are common also to obstruction of the urethra by stone or otherwise ; hence this source of fallacy should be excluded by manual examination along the whole course of that duct.
Treatment is only applicable in cases in which the determining cause can be abated. In remedial si^rains of the back or disease of the spinal cord these must have appropriate treatment, and the urine must be drawn off frequently with a catheter to prevent overdistension and injury to the bladder. If the paralysis i^ersists after recovery of the sjnnal cord, or if it continues after relief of spasm of the neck of the bladder, apply a pulp of mustard and water over the back part of the bellj' in front of the udder, and cover with a rug until the hair stands erect. In the male the mustard may be applied between the thighs from near the anus downward. Daily doses of 2 drams extract of belladonna, or of 2 grains powdered Sijanish fly, may serve to rouse the lost tone. These failing, a mild current of electricity^ daily may succeed.
INFLAMMATION OF THE BLADDER — CYSTITIS — UROCYSTITIS.
Cystitis may be slight or severe, acute or chronic, i)artial or general. It may be caused by abuse of diuretics, especially such as are irritat- ing (cantharides, turpentine, copaiba, resin, etc.), by the presence of
76
a stone or gravel in the bladder, tlie irritation of a catheter or other foreign body introduced from without, the septic ferment (bacterium) introduced on a filthy catheter, the overdistension of the bladder by retained urine, the extrication of ammonia from retained decomj^osing urine, resulting in destruction of the epithelial cells and irritation of the raw surface, and a too-concentrated and irritating urine. Tlie application of Spanish flies or turpentine over a too-extensive surface, sudden exposure of a perspiring and tired horse to cold or wet, and the presence of acrid plants in the fodder may cause cj'stitis, as they inp^y nephritis. Finally, inflammation may extend from a diseased vagina or urethra to the bladder.
The symptoms are slight or severe colicky pains ; the animal moves his hind feet imeasily or even kicks at the abdomen, looks around at his flank, and may even lie down and rise frequently". More char- acteristic are frequently repeated efforts to urinate, resulting in the discharge of a little clear, or red, or more commonly flocculent urine, always in jets, and accompanied by signs of pain, which persist after the discharge, as shown in continued straining, groaning, and perhaps in movements of the feet and tail. The penis hangs from the sheath, or in the mare the vulva is frequently opened and closed, as after uri- nation. The animal winces when the abdomen is pressed in the region of the sheath or udder, and the bladder is found to be sensitive and tender when pressed with the oiled hand introduced through the rec- tum or vagina. In the mare the thickening of the walls of the blad- der may be felt by introducing one finger through the urethra. The discharged urine, which may be turbid or even oily, contains an excess of mucus, with flat shreds of membrane, with scaly epithelial cells, and pus corpuscles, each showing two or more nuclei when treated with acetic acid, but there are no microscopic tubular casts, as in nephritis. If due to stone in the bladder, that will be found on examination through rectum or vagina.
Treatment implies, first, the removal of the cause, whether poisons in food or as medicine, the removal of Spanish flies or other blistering agents from the skin, or the extraction of stone or gravel. If the urine "has been retained and decomposed it must be completely evac- uated through a clean catheter, and the bladder thoroughly washed out with a solution of 1 dram of borax in a quart of water. Tliis must be repeated twice daily until the urine no longer decomposes, because as long as ammonia is developed in the bladder the protecting layer of epithelial cells will be dissolved and the surface kept raw and irritable. The diet must be light (bran mashes, roots, fresh grass), and the drink impregnated with linseed tea, or solution of slippery-elm or marsli-mallow. The same agents may be used to inject into the rectum, or they may even be used along with borax and opium to inject into bladder (gum arable, 1 dram; opium, 1 dram; tepid water, 1 pint). Fomentations over the loins are often
77
of great advantage, and these may be followed or alternated with the ai)plication of mustard, as in paralj'sis. Or the mustard maj^ be ai)i)lied on the back j)art of the abdomen below, or between the thighs from the anus downward. Finally, when the acute symptoms have subsided, a daily dose of buchu 1 dram, and nux vomica one- half dram, will serve to restore lost tone.
IRRITABLE BLADDER.
Some horses, and especially juares, show an irritability of the blad- der and nerve centers presiding over it b}^ frequent urination in small quantities, though the urine is not manifestly changed in char- acter and no more than the natural amount is i)asscd in the twenty- four hours. The disorder appears to have its source quite as fre- quently in the generative or nervous system as in the urinary. A troublesome and dangerous form is seen in mares, which dash off and refuse all control bj' the rein if driven with a full bladder, but usually 13rove docile if the bladder has been emptied before hitching. In other cases the excitement connected with getting the tail over the reins is a powerful determining cause. The condition is marked in many mares during the period of heat.
An oleaginous laxative (castor oil, 1 pint) will serve to remove any cause of irritation in the digestive organs, and a careful dieting will avoid continued irritation by acrid vegetable agents. The bladder should be examined to see that there is no stone or other cause of irri- tation, and the sheath and penis shovild be washed with soap-suds, any sebaceous matter removed from the bilocular cavity at the end of the penis, and the whole lubricated with sweet oil. Irritable mares should be induced to urinate before they are harnessed, and those that clutch the lines under the tail may have the tail set high by cutting the cords on its lower surface, or it may be prevented getting over the reins \)y having a strap carried from its free end to the breeching. Those prov- ing troublesome when in heat may have 4-dram doses of bromide of potassium, or they may be served by the male or castrated. Some- times irritability may be lessened by daily doses of belladonna extract (1 dram), or a better tone may be given to the parts by balsam copaiba (1 dram).
DISEASED GROWTHS IN THE BLADDER.
These may be of various kinds, malignant or simi)le. In the horse I have found villous growths from the mucous membrane especially troublesome. They maj' be attached to the mucous membrane by a narrow neck or by a broad base covering a great part of the organ. The syinijtoms are frequent straining, i^assing of urine and blood Avith occasionally gravel. An examination of the bladder with the hand in the rectum will detect the new growth, Avhicli may be distinguished from a hard resistant stone. In mares, in which the finger can be
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inserted into tli3 bladder, the recognition is still more satisfactory. The polypi attached by narrow necks may be removed by surgical operation, but for those Avith broad attachments treatment is emi- nently unsatisfactory.
DISCHARGE OF URINE BY THE NAVEL — PERSISTENT URACHUS.
This occurs onl}- in the new-born, and consists in the non-closure of the natural channel (urachus), through which the urine is discharged into the outer water-bag (allantois) in foetal life. At that early stage of the animal existence the bladder resembles a long tube, which is prolonged through the navel string and opens into the outermost of the two water-bags in which the foetus floats. In this way the urine is prevented from entering the inner water-bag (amnios), where it v/ould mingle with the liquids, bathing the skin of the foetus and cause irritation. At birth this channel closes up, and the urine takes the course normal to extra-uterijie life. Imperfect closure is more fre- quent in males than in females, because of the great length and small caliber of the male urethra and its consequent tendencj' to obstruc- tion. In the female there may be a discharge of a few drops only at a time, while in the male the urine will be expelled in strong jets coin- cidently with the contractions of the bladder and walls of the abdomen.
The first care is to ascertain if the urethra is pervious by passing a human catheter. This determined, the open urachus may be firmly closed by a stout waxed thread, carried witli a needle through the tis- sues back of the opening and tied in front of it so as to inclose as little skin as i^ossible. If a ]3ortion of the navel string remains, the tying of tliat may be all suf&cient. It is important to tie as early as possible so as to avoid inflammation of the navel from contact with the urine. In summer a little carbolic acid water or tar water may be applied to keep off the flies.
EVERSION OF THE BLADDER.
Tliis can only occur in the female. It consists in the turning of the organ outside in through the channel of tlie urethra, so that it appears as a red, pear-shap)ed mass hanging from the floor of the vulva and l^rotruding externally between its lips. It may be a mass like the fist, or it may swell up to the size of an infant's head. On examining its upper surface the orifices of the urethra may be seen, one on each side, a short distance behind the neck, with the urine oozing from them drop by drop.
This displacement usually supervenes on a flaccid condition of the bladder, the result of paralysis, over distention, or severe compression during a difficult parturition.
The protruding organ may be washed with a solution of 1 ounce of laudanum and a teaspoonful of carbolic acid in a quart of water, and returned by i^ressing a smooth, rounded object into the fundus and
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directiug it into the uretlirti, while careful X)ressure is made on the sur- rounding liarts with the other hand. If too large and resistant it may be wound tightly in a strip of bandage about two inches broad so as to express the great mass of blood, and exudate and diminish the bulk of the protruded organ so that it can be easily pushed back. This method has the additional advantage of protecting the organ against bruises and lacerations in the eifort made to return it. After the return straining may be kept in check by giving laudanum (1 to 3 ounces), and by applying a truss to press upon the lips of the vulva (see eversion of the womb). The patient should be kept in a stall a few inches lower in front than behind, so that the action of gravity will favor retention.
IXFLAMMATIOX OF THE URETHRA — URETHRITIS — GLEET.
This affection belongs quite as much to the generative organs, yet it can not be entirely overlooked in a treatise on urinarj- disorders. It maj' be induced by the same causes as cystitis (which see), bj" the passage and temiDorarj- arrest of small sfo7ies, or gravel, by the irrita- tion caused by foreign bodies introduced from without, b}^ blows on the penis by sticks, stones, or by the feet of a mare which kicks while being served, by an infecting inflammation contracted from a mare served in the first few days after parturition, or one suffering from leucorrhoea, by infecting matter introduced on a dirtj^ catheter, or by the extension of inflammation from an irritated bilocular cavity filled with hardened sebaceous matter, or from an uncleansed sheath.
The symptoms are SArelling, heat, and tenderness of the sheath and penis, difficulty, pain, and groaning in passing urine, which is liable to sudden temx3orary arrests in the course of a micturition, and later a wliitish muco-i^urulent oozing from the papilla on the end of the penis. There is a tendencj^ to erection of the penis, and in cases con- tracted from a mare the outer surface of that organ will show more or less extensive sores and idcers. Stallions suffering in this way will refuse to mount, or having mounted will fail to complete the act of coition. If an entrance is effected infection of the mare is liable to follow.
Treatment in the early stages consists in a dose of i^hysic (aloes, 6 drams), and fomentations of warm water to the sheath and x^enis. If there is reason to susiaect the presence of infection, inject the urethra twice daily with borax 1 draui, water 1 quart, using it tepid. Where the muco-purulent discharge indicates the supervention of the second stage, a more astringent injection may be employed (nitrate of silver 20 grains, water 1 quart), and the same may be applied to the sur- face of the penis and inside the sheath. Balsam of copaiba (1 dram daih^) may also be given with advantage after the purulent discharge has appeared.
Every stallion suffering from urethritis should be withheld from service, as should mares with leucorrhoea.
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STRICTURE OF THE URETHRA.
This is a permanent narrowing of the urethra at a given point, the result of i^revious inflammation, caused by the passage or arrest of a stone or gravel, by strong astringent injections in the early non-secret- ing stages of urethritis, or by contraction of the lining membrane occurring during the healing of ulcers in neglected inflammations of that canal. The trouble is shown by the passage of urine in a fine stream with straining, pain, and groahing, and by frequent painful erections. It must be remedied bj^ mechanical dilatation, with cathe- ters just large enough to pass with gentle force, to be inserted once a day, and to be used of larger size as the passage will admit them. The catheter should be kept perfectly clean, and washed in a borax solution and well oiled before it is introduced.
URINARY CALCULI — STONE — GRAVEL.
These consist in some of the solids of the urine that have been pre- cipitated from the urine in the form of crystals, which remain apart as a fine powdery mass or magma, or aggregate into calculi or stones of varying size. Their composition is therefore determined in differ- ent animals by the salts and other constituents found dissolved in the healthy urine, and by the additional constituents which may be thrown off in solution in the urine in disease. In this connection it is impor- tant to observe the following analysis of the horse's urine in health :
Water 918.5
Urea - 13.4
Uric acid and urates - _ _ 0. 1
Hippuric acid 26. 4
Lactic acid and lactates 1.0
Mucus and organic matter 23. 0
Siilpbates (alkaline) r 1.2
Phosphates (lime and soda) 0.2
Chlorides (sodium) 1.0
Carbonates (potash, magnesia, lime) 16. 0
1000. 0
The carbonate of lime, which is present in large amount in the urine of horses fed on green fodder, is practically insoluble, and therefore forms in the j)assages after secretion, and its microscopic rounded crystals give the urine of such horses a milky whiteness. It is this material which constitutes the soft, white, pultaccous mass that some- times fills the bladder to repletion and requires to be washed out. In liay-fed horses carbonates are still abundant, while in those mainlj'- grain-fed they are replaced by hippurates and phosphates — the prod- ucts of the wear of tissues — the carbonates being the result of oxida- tion of the vegetable acids in the food. Carbonate of lime, therefore, is a very common constituent of urinary calculi in lierbivora, and in many cases is the most abundant constituent.
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Oxalate of lime, like carbonate of lime, is derived from the burning nj) of the carbonaceous matter of the food in the system, one impor- tant factor being the less perfect oxidation of the carbon. Indeed, Fiirstenberg and Schmidt have demonstrated on man, horse, ox, and rabbit, that under the full play of the breathing (oxidizing) forces, oxalic, like other organic acids, is resolved into carbonic acid. In keei)ing with this is the observation of Lehmann that in all cases in which man suffered from interference with the breathing, oxalate of lime appeared in the urine. An excess of oxalate of lime in the urine may, however, claim a different origin. Uric and hippuric acids are found in the urine of carnivora and herbivora, respectivel}^ as the result of the healthy wear (disassimilation) of nitrogenous tissues. But if these products are fully oxidized they are thrown out in the form of the more soluble urea rather than as these acids. When uric acid out of the body is treated with peroxide of lead it is resolved into urea, allantoine, and oxalic acid, and AYoehler and Frerrichs found that the administration of uric acid not onlj^ increased the excretion of urea, but also of oxalic acid. It may therefore be inferred that oxalic acid is not produced from the carbonaceous food alone, but also from the disintegration of the nitrogenous tissues of the body. An important element of its j)roduction is, however, the imi^erfect pev- formance of the breathing functions, and hence it is liable to result from diseases of the chest (heaves, chronic bronchitis, etc.). This is above all likely to prove the case if the subject is fed to excess on highly carbonaceous foods (grass and green food generally, pota- toes, etc.).
Carbonate of magnesia, another almost constant ingredient of the urinary calculi of the horse, is formed in the same way as the car- bonate of lime, from the excess of carbonaceous food (organic acids) becoming oxidized into carbon dioxide, which unites with the mag- nesia derived from the food.
The phosphates of lime and magnesia are not abundant in urinary calculi of the horse, the phosphates being onlj^ present to excess in the urine in two conditions: (a) when the ration is excessive and specially rich in phosphorus (wheat bran, beans, pease, vetches, rape cake, oil cake, cotton-seed cake); and (b) when through the morbid destructive changes in the living tissues, and especially of the bones, a great amount of phosphorus is given off as a waste product. Under these conditions, hoAvever, the phosphates may contribute to the for- mation of calculi, and this is, above all, likely if the urine is retained in the bladder until it has undergone decomposition and given off ammonia. The ammonia at once unites with the phosphate of mag- nesia to form a double salt, j)hosphate of ammonia and magnesia, which, being insoluble, is at once precipitated. The precipitation of this salt is, however, rare in the urine of the horse, though much more frequent in that of man and sheep.
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These are the chief mineral constitvients of the urine which form ingredients in tlio liorse's calculi, for though iron and manganese are usually present it is only in minute quantities.
The excess of mineral matters in a specimen of urine unquestion- ably contributes to tlie formation of calculi, just as a solution of such matters out of the body is increasingly disposed to throw them down in the form of crj'stals as it becomes more concentrated and approaches nearer to the condition of saturation. Hence, in considering tlie causes of calculi we can not ignore the factor of an excessive ration, rich in mineral matters and in carbonaceous matters (the source of carbonates and much of the oxalates), nor can we overlook the con- centration of the urine that comes from dry food and privation of v>^ater, or from the existence of fever which causes suspension of the secretion of water. In these cases, at least the usual amount of solids arc thrown off by the kidneys, and as the water is diminished there is danger of its approaching the point of supersaturation, when the dissolved solids must necessarily be thrown down. Hence, calculi are more common in stabled horses fed on dry grain and hay, in those denied a sufficiency of water or that have water supplied irregularly, in those subjected to profuse iDerspiration (as in summer), and in those suffering from a watery diarrhea. On the whole, calculi are most commonly found in winter, because the horses are then on dry feeding, but such dr}^ feeding is even more conducive to them in summer v,dien the condition is aggravated by the abundant loss of water by the skin.
In the same way the extreme hardness of the vv^ater in certain dis- tricts must be looked upon as contributing to the concentration of the urine and correspondingly to the production of stone. The carbonates, sulphates, etc., of lime and magnesia taken in the Avater must be again thrown out, and just in proportion as these add to the solids of the urine they disiiose it to precipitate its least soluble constituents. Thus the horse is very obnoxious to calculi on certain limestone soils, as over the calcareous formations of central and western New York, Pennsylvania, and Ohio, in America; of Norfolk, Suffolk, Derbyshire, Shropshire, and Gloucestershire, in England; of Poitou and Landes, in France; and Munich, in Bavaria.
But the saturation of the urine from any or all of these conditions can only be looked on as an auxiliary cause, and not as in itself an efficient one, except on the rarest occasions. For a more direct and immediate cause we must look to the organic matter which forms a large proportion of all urinary calculi. This consists of mucus, albu- men, pus, hyaline casts of the urTniferous tubes, epithelial cells, blood, etc., mainly agents that belong to the class of colloid or noncrystalline bodies. A horse may live for months and years with the urine habit- ually of a high density, and having tlie mineral constituents in excess, without the formation of stone or gi-avel; and again one with dilute urine of low specific gravity will have a calculus.
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Rainey, Orel, and others furnish the exphmation. They not only show that a colloid bodj*, like nmcus, albumen, pus, or blood, deter- mined the i^recipitation or the ciystalline salts in tlie solution, but they determined the precij)itation in the form of globules or spheres, capable of developing by further deposits into calculi. Heat intensi- fies this action of the colloids, and a colloid in a state of decomposition is speciallj^ active. The presence, therefore, of developing fungi and bacteria must be looked upon as active factors in causing calculi.
In looking, therefore, for the immediate causes of calculi we must consider esx)ecially all those conditions which determine the i^resence of albumen, blood, and excess of mucus, pus, etc., in the urine. Thus diseases of distant organs leading to albuminuria, diseases of the kid- neys and urinary passages causing the escape of blood or the forma- tion of mucus or pus, become direct causes of calculi. Foreign bodies of all kinds in the bladder or kidney have long been known as deter- mining causes of calculi, and as forming the central nucleus. This is now explained b}' the fact that these bodies are liable to carry bacte- ria into the passages and thus determine decomj)ositiou, and they are further liable to irritate the mucous membrane and become enveloped in ji coating of mucus, x)us, and perhaps blood.
The fact that horses appear to suffer from calculi, especially on tlie nmgnesian limestones, the same districts in which they suffer from goiter, may be similarly explained. The unknown poison whicli jiro- duces goiter iDresumabl}^ leads to such changes in the blood and urine as will furnish the colloid necessary for precipitation of the urinary salts in the form of calculi.
Classification of Urinary Calculi. — These have been named accord- ing to the place where they are found, renal (kidney), uretral (ureter), vesical (bladder), urethral (urethra), n^xid preputial (sheath or prepuce). They have been otherwise named according to their most abundant chemical constituent, carhonate of lime, oxalate of lime, and phosp)hate of lime calculi. The stones formed of carbonates or phosphates are usually smooth on the surface, though they may be molded into the shape of the cavity in which they have been formed ; thus those in the pelvis of the kidne}^ may have two or three sliort branch-like pro- longations, while those in the bladder are round, oval, or slightly flat- tened upon each other. Calculi containing oxalate of lime, on the other hand, have a rough, open, cr3'stalline surface, which has gained for them the name of mulberry calculi, from a supposed resemblance to that fruit. These are usually covered with more or less mucus or blood, produced by the irritation of the mucous membrane b}' their rough surfaces. The color of calculi varies from white to yellow and deep brown, the shades depending mainlj^ on the amount of the color- ing matter of blood, bile, or urine Avhich they may contain.
Bcnal Calculi. — These may consist of minute, almost microscoijic, deposits in the urinifei-ous tubes in the substance of tlie kidney, but
84
more commonly thoy are large masses and lodged in the pelvis. The larger calculi, sometimes weighing 12 to 24 ounces, are molded in the pelvis of the kidney into a oylindroid mass, with irregular rounded swellings at intervals. Some have a deep brown, rough, crystalline surface of oxalate of lime, while others have a smooth, pearly white asiDect from carbonate of lime. A smaller calculus, which has been called coralline, is also cylindroid, with a number of brown, rough, crj^stalline oxalate of lime branches and whitish depressions of carbo- nate. These vary in size from 15 grains to nearly 2 ounces. Less frequently are found masses of very hard, brownish white, rounded, pea-like calculi. These are smoother, but on the surface crystals of oxalate of lime may be detected with a lens. Some renal calculi are formed of more distinct layers, more loosely adherent to each other, and contain an excess of "mucus but no oxalate of lime. Finally a loose aggregation of small masses, forming a very friable calculus, is found of all sizes within i\ie limits of the pelvis of the kidne}'. These, too, are in the main carbonate of lime (84 to 88 per cent), and without oxalate.
Symptoms of renal calculi are violent colicky pains appearing sud- denly, very often in connection with exhausting work or the drawing of speciall}^ heavy loads, and in certain cases disappearing with equal suddenness. The nature of the colic becomes more manifest if it is associated with stiffness of the back and hind limbs, frequent passage of urine, and above all the passage of gravel Avith the urine, especially at the time of the access of relief. The passage of blood and i)us in the urine is equally significant. If the irritation of the kidney goes on to active inflammation then the symptoms of nei^hritis are added.
Uretral Calculi. — These are so called because they are found in the passage leading from the kidney to the bladder. They are simply small renal calculi which have escaped from the i^elvis of the kidney and have become arrested in the ureter. They give rise to symptoms almost identical with those of renal calculi, with this difference, that the colicky pains, caused by the obstruction of the ureter by the impacted calculus, are more violent, and if the calculus passes on into the bladder the relief is instantaneous and complet-e. If the ureter is completely blocked for a length of time the retained urine may give rise to destructive inflammation in the kidney, which may end in the entire absorption of that organ, leaving only a fibrous cap- sule containing an urinous fluid. If both the ureters are similarly blocked the animal will die of ura^mic poisoning.
Treatment of Renal and Uretral Calculi. — This is unsatisfactory, as it is only the small calculi that can pass through the ureters and escape into the bladder. This may be favored by agents which will relax the walls of the ureters by counteracting their spasm and even lessening their tone, and by a liberal use of water and waterj^ fluids to increase the urine and the pressure upon the calculus from behind.
85
One or two ounces of laudanum, or two drams of extract of bella- donna, may be given and repeated as it may be necessary, the relief of the pain being a fair criterion of the abating of the spasm. To the same end use warm fomentations across the loins, and these should be kept up persistently until relief is obtained. These act not alone by soothing and relieving the spasm and inflammation, but they also favor the freer secretion of a more Avatery urine, and thus tend to cany off the smaller calculi. To further secure this object give cool water freelj', and let the food be only such as contains a large proportion of liquid, gruels, mashes, turnips, beets, apples, pumpkins, ensilage, succulent grasses, etc. If the acute stage has passed and the presence of the calculus is manifested only by the frequent passage of urine with gritty particles, by stiffness of. the loins and hind limbs and by tenderness to pressure, the most prom- ising resort is a long run at pasture where the grasses are fresh and succulent. The long-continued secretion of a watery urine will some- times cause the breaking down of a calculus, as the imbibition of the less dense fluid by the organic sponge-like framework of the calculus causes it to swell and thus lessens its cohesion. The same end is sought by the long-continued use of alkalies (carbonate of i^otas- sium), and of acids (muriatic), each acting in a different way to alter the density and cohesion of the stone. But it is only exceptionallj^ that any of these methods is entirely satisfactoiy. If inflammation of the kidneys develops, treat as advised under that head.
Stone in the bladder. — Vesical calculus. — Cystic ccdculus. — These may be of any size up to over a pound weight. One variety is rough and crystalline and has a yellowish white or deep brown color. These contain about 87 per cent carbonate of lime, the remainder being carbonate of magnesia, oxalate of lime, and organic matter. The phosphatic calculi are smooth and white and formed of thin concen- tric layers of great hardness extending from the nucleus outward. Besides the phosphate of lime these contain the carbonates of lime and magnesia and organic matter. In some cases the bladder contains and may be even distended by a soft pultaceous mass made up of minute round granules of carbonates of lime and magnesia. This, when removed and dried, makes a firm, white, and stony mass. Sometimes this magma is condensed into a solid mass in the bladder by reason of the binding action of the mucus and other organic mat- ter, and then forms a conglomerate stone of nearly uniform consist- ency and without stratification.
The symptoms of stone in the bladder are more obvious than those of renal calculus. The rough mulberry calculi especially lead to irri- tation of the mucous membrane and frequent passing of urine in small quantities and often mingled with mucus or blood, or contain- ing minute gritty particles. At times the flow is suddenly arrested, though the animal continues to strain and the bladder is not quite
8G
emi)tied. In tlie smootli phosi^liatic variety tlie irritation is mueli less marked, and may even be altogether absent. With the pulla- ceous deposit in the bladder there is incontinence of nrine, Avhich dribbles away continually and keeps the hair on the inner side of the thighs matted with soft magma. In all cases alike the calculus may be felt by the examination of the bladder with the oiled hand in the rectum. The i^ear-shaped outline of the bladder can be felt beneatli, and within it the solid oval body. It is most easily recognized if the organ is half full of liquid, as then it is not grasped b}' the contract- ing walls of the bladder, l)ut majO^e made to move from j)lace to place in the liquid. If a pultaceous mass is present it has a soft, doughy feeling, and when pressed an indentation is left.
In the mare the hard stone may be touched by the finger intro- duced through the short urethra.
Tlie treatment of stone in the bladder consists in the removal of the offending body. In the mare this is easily affected with the lithot- omy forceps. These are slightlj^ warmed and oiled, and carried forward along the floor of the passage of the vulva for 4 inches, when the orifice of the urethra will be felt exactly in the median line. Through this the forcejjs are gradually pushed with gentle oscillating movement until they enter the l)ladder and strike against the hard surface of the stone. Tlie stone is now grasped between the blades, care being taken to include no loose fold of the mucous membrane, and it is gradualh' withdrawn with the same careful oscillating motions as before. Facility and safety in seizing the stone will be greatly favored by having the bladder half full of liquid, and if nec- essarj^ one oiled hand may be introduced into the rectum or vagina to assist. The resulting irritation may be treated by an injection of laudanum, 1 ounce, in a x^int of tepid water.
The removal of the stone in the horse is a inucli more difficult i^ro- ceeding. It consists in cutting into the uretlira, just beneath the anus and introducing the lithotomy forceps from this forward into the blad- der, as in the mare. It is needful to distend the ui^ethra with tepid water or to insert a sound or catheter to furnish a guide upon which the incision maybe made, and in case of a large stone it maybe need- ful to enlarge the x)assage by cutting in a direction upward and out- ward with a probe-pointed knife, the back of which is slid along in the groove of a director until it enters the bladder.
The horse may be operated upon in the standing position, being simi)ly i)ressed against a wall by a pole passed from before backward along the other side of the body. The tepid Avater is injected into the end of the penis uniil it is felt to fluctuate under the j^ressure of the flnger, in the median line over the bone just beneath the anus. The incision is then made into the center of the fluctuating canal, and from above downward. AVhen a sound or catheter is used as a guide it is inserted througli tlie penis until it can be felt through the skin at the
87
point wliere the incision is to be made beneatli the anus. The skin is then rendered tense by the thumb and fingers of the left hand i)ress- ing on the two sides of the sound, while the right hand, armed with a scalpel, cuts downward on to the catheter. This vertical incision into tlie canal should escape w^ounding any important blood-vessel. It is in making the obliquely lateral incision in the subsequent dilatation of the urethra and neck of the bladder that sucli danger is to be apprehended.
If the stone is too large to be extracted through the urethra it may be broken down with the lithotrite and extracted x^iecemeal with the forceps. The lithotrite is an instrument composed of a straight stem bent for an inch or more to one side at its free end so as to form an obtuse angle, and having on the same side a sliding bar moving in a groove in the stem and oijerated by a scrcAV so that the stone may be seized between the two blades at its free extremity and crushed again and again into pieces small enough to extract. Extra care is required to avoid injury to the urethra in the extraction of the angular frag- ments, and the gravel or jjowder that can not be removed in this way must be washed out as advised below.
When a j)ultaceous magma of carbonate of lime accumulates in the bladder it must be washed out by injecting water tlirough a catheter by means of a force T)ump or a funnel, shaking it uf) with the hand introduced through the rectum and allowing the mudd}^ liquid to flow out through the tube. This is to be rex^eated until the bladder is empty and the water comes away clear. A catheter with a double tube is sometimes used, the injection passing in through the one tube and escaiDing through the other. But the advantage is more apparent than real, as the retention of the water until the magma has been shaken up and mixed with it hastens greatly its complete evacuation. To prevent the formation of a new deposit any fault in feeding {dvj grain and hay with privation of water, excess of beans, peas, wheat bran, etc.) and disorders of stomach, liver, and lungs must be cor- rected. Give abundance of soft drinking water, encouraging the aninml to drink by a handful of salt dailj^; let the food be laxative, consisting largelj^ of roots, apples, pumiDkins, ensilage, and give daily in the drinking water a dram of carbonate of potash or soda. Pow- dered gentian root (3 drams daily) will also serve to restore the tone of the stomach and sj^stem at large.
Urethral calculus. — Stone in the urethra. — This is less frequent than in cattle and sheep, owing to the larger size of the urethra in the horse and the absence of the S -shaped curve and vermiform appendix. Tlie calculi arrested in the urethra are never formed there, but consist of cystic calculi Avhich have been small enough to pass through the neck of the bladder, but too large to pass through the whole length of tlie urethra and escape. Such calculi therefore are primarilj'- formed eitlier in the bladder or kidney, and have the chemical composition of the
other calculi found in those organs. They may be arrested at any jioint of the urethra, from the neck of the bladder back to the bend of the tul>e beneath the anus, and from that point down to the extrem- ity of the penis. I have found them most frequently in the i^apilla on the extreme end of the penis, and immediately behind this.
The symptoms are violent straining to urinate, but without any dis- charge, or with the escape of water in drops only. Examination of the end of the penis will detect the swelling of the papilla or the urethra behind it, and the presence of a hard mass in the center. A probe inserted into the urethra will strike against the gritty calculus. If the stone has been arrested higher up its position maj'^ be detected as a small, hard, sensitive knot on the line of the urethra, in the median line of the lower surface of the penis, or on the floor of the pelvis in the median line from the neck of the bladder back t-o the bend of the urethra beneath the anus. In any case the urethra between the neck of the bladder and the point of obstruction is likely to be filled with fluid, and to feel like a distended tube fluctuating on pressure.
Treatment may be begun by an attempt to extract the calculi by manipulation of the papilla on the end of the penis. This failing, the calculus may be seized with a pair of fine-pointed forceps and with- drawn from the urethra; or, if necessary, a probe-pointed knife may be inserted and the urethra slightly dilated, or even laid open, and the stone removed. If the stone has been arrested higher up it must be extracted by a direct incision through the walls of the urethra and down upon the nodule. If in the free (protractile) portion of the penis, that organ is to be withdrawn from its sheath until the nodule is exposed and can be incised. If behind the scrotum, the incision must be made in the median line between the thighs and directly over the nodule, the skin having been rendered tense by the fingers and thumb of the left hand. If the stone has been arrested in the intra-pelvic portion of the urethra, the incision must be made beneath the anus and the calculus extracted with forceps, as in stone in the bladder. The wound in the urethra may be stitched up, and usually heals slowly but satisfactorily. Healing will be favored by washing two or three times daily with a solution of a teaspoonf ul of carbolic acid in a pint of water.
Preputial calculus. — Calculus in the sheath or hilocular cavity. — These are concretions in the sheath, though the term has been also applied to the nodule of sebaceous matter which accumulates in the blind pouches (bilocular cavity) by the sides of the papilla on the end of the penis. Within the sheath the concretion may be a soft, cheesy- like sebaceous matter, or a genuine calculus of carbonate, oxalate, phosphate and sulphate of lime, carbonate of magnesia and organic matter. These are easily removed with the fingers, after which the sheath should be washed out with castile soap and warm water, and smeared Avith sweet-oil.
^' \
"" m.
IT.ATK IV
^^ ^ '>^^ \^^\ ^
,t'"^
a Jbrfifyi/ for I'ri.fCJiJn/l por-h/)ri ; h,. Ifrflnlhuy /r>r- hihitltif ) ))or-tioii f.l'pjiphi'/nJ porfimi ofthr latter- rl , /ntf/ior- of tfie pflii.s ; if',(J', Ar-nifi offfif ppt7'i\s\ p , Bm-fteT offhp rrf.tf ■ f'fn/iinflifjiilnfn : t/f^vtpr-.
Geo Marx .ipl afler 0 Aiboval. p.669.
A Haen &Co Lithi.Baltimore
LOXOITiniNAI, SPUmoX THKOrCH KIDXKY,
PLATE V
Structure of the IGdney. Diagrammatir . a ..Mf^dji Urny fat/er,- hBoundrn-i' xo/tf; r,C'ortical kwer, J,Kiy7ffo7i/ fi7hf:^'.f)f)ai i/igontiie mi/nmit ofTennl papilla ;.'i,Fir.'it hrrmrh othifiur-friian . ~'t.Sem7iff 7nxnir7i ofhif7ij'r(ifimt;.xTfiUff hrnjirji ofh7/}irratioTi.;f>.SPrtiyhtc-oUjerfing tnhp: 7,r/nrir finnal hihvJf ; (H^sre/ifliru/ /}orfif>ri of /fpnip's loop; fj. De-sfe/ifJi'Ti// porfinii of /fen If 's loof)/ JO.Lnop offff-n/e; U/'oni 'olutrt/ tahiilf , Ji",. MiilpifflikiJi rm-pn.sr/f, /.'iHf/u/l ar fPT-ir;14,Br-a7tr7> .siipplpiti/; t/ir fj/onif/y)/i ; J,5ylff'f'rf7ii rcs.seJ nfthf (/lo77i4Tiih ; J^> , R/7i/tr/i (joi7i(/ r//rerfli ' It} f?if rap///firif's, //^Sirrfif/ht arfenjo/es cxjrning f/ii-p/tly irinii thf rr/itiJ firtfri,-; /''i.strajf/hi a/ft>/-ioie ctnniTu/ frorrt the afferent > 'psspJ /ff' ihe gh>/iipniTi(s^- J.9, Sfra/i/ht a7tf'7in7(' ro/ni/itj fiymi tfw fiif/i/lar-i' p7e.v//s; '^0,]?7sc//lnr loop of ff If jjp/rinn'rls s'/Ti'ffrr-fnt rrssf-/ of'thf f//imif7-i//iis //o/'/ig fn t/7f r/i/>iff7i/-p ple.T/7s,<''-^/'af)i/t/iTi' plf.m.s of'ffif (j7/>/itf>/-i//aj pa7t of the (•i)7-f7rnf sirhstn/ue ; 23,Cn/rina/i/ p/p.r/is oftfie ptjrfuin'dM nfFfrrein ,- ^4/,fyyr-fitYt/ jtlf. v//s oftttf A-iflriPf: ?S,Vf77/if f^tcU/tfnp, ?0'Jp/7i r/j7/imr/ fioni thornpff/n/'ifsoftfip portf.v; 'J7;Jfitfj- /ohu/ari'piri,- ?i'i,Tp7/i T-pffifuiff t7ip I'Pmif rffffir ,- '.'!l\'e7i(ip 7fr/np.
. 1 ofp : 77if s/ta/i/-(/ pi Iff n/ 'fhp iu-i/i/i7-i/ tliirM- rpf/TPsPut tfip pfirf iff H'/u'r/t ffif ppif/ir//iifn is fod/lpfl a7ir/ ofn g/-7i7}iihi7- itppp7i7-ti/ifjp .
Tieo Maj-x, after DArbovai p.37Z.
A Hoen&Co Lith. Baltimore
MICR OSCOPIC AXATOivIY OF KIDNE^^
PI. ATP. VI
^^ \
R.enai Glomerulus. a,Arteri,' ofthe glorneruliMS; b.Brafic?t siipplx/iru/ thf uJfe/-e/if i/esseL ofthe^ glom^rtdus, QAfferent i 'essel oftfie gloTnervCLp , (Z,^/ttery going dfrectli/ to the ccipilZar^iJ plecajs of the cortJ/'ril svLbstftrtce.; e.CapiUary pleazi-s,- f Glomprabis .
Renal Glomerulus Avifhits afferent vessels and efferents . a^-anx-h of'T-nuU ai-tK/vj^ b.Affi'jvTif I'essp/ ofthr gJameruhi^, c. GUfrrtf/vjIvs, d^fferejit / 'cssp/ go utg ircto a corpuscle; e, of'.l^/xifjigTu .
lieo Marx del. after D Arboval. p 373
A Moen&Co Lith BaHimore
MICROSCOPIC ANATOMY' OF KIDN'E^'
PLATE Vn.
PhospTijotic calculus, uric add nurZeiJS.
X 215
(mIcuIos of oocaltzte of Urn p .
©
5-\ m
'•£'/ Q
HeTvod, casts. Some deprived of epttheUum, lU'o are d^efja^ cxjlored, -frorrv the presence of urate, of soda, .
Straight forceps used trvTemoving calculi,..
Haiaes del after Hurtrel D'Arboval.
A Hoen&Co bth.Bahimore
CAI.CULI AND IXST11UME^;T FOR. REMOV.VJ. ,
DISEASES OF THE RESPIRATORY ORGANS.
By W. H. HARBAUGH, V. S., Richmond, Virginia.
Tlie organs pertaining to the respiratory function may be popularly classed as follows: The nasal openings, or nostrils; the nasal cham- bers, through which the air passes in the head; the sinuses in the head, communicating with the nasal chambers; the i^harynx, common to the functions of respiration and alimentation ; the lar^-nx, a com- plicated structure situated at the top of the wind-pipe; the trachea, or wind-pipe; the bronchi (into which the wind-pipe divides), two tubes leading from the wind-pipe to the right and left lung, respec- tively; the bronchial tubes, which penetrate and convey air to all parts of the lungs; the lungs.
The pleurals a thin membrane that envelops the lung and is reflected against the walls of the thoracic cavitj^ The diaphragm is a mus- cular structure, completely separating the contents of the thoracic cavity from those of the abdominal cavity. It is essentially a muscle of inspiration, and the principal one. Other muscles aid in the mechanism of respiration, but the diseases or injuries of them have nothing to do with the class under consideration.
Just within the nasal openings the skin becomes gradually but per- ceptibly finer, until it is succeeded by the mucous membrane; the lino of demarkation is not always well defined. Near about the junc- tion of the skin and membrane is a small hole, presenting the appear- ance of having been made with a punch; this is the opening of the nasal duct, a canal that conveys the tears from the eyes. Within and above the nasal openings are the cavities or fissures called the false nostrils; if the finger is inserted up into them it will be demon- strated that the superior extremity is blind; just in this situation there is often found a little tumor, to be described hereafter. The nasal chambers are completely separated, the right from the left, by a cartilaginous partition. Each nasal chamber is divided into three continuous compartments by the two turbinated bones.
The mucous membrane lining the nasal chambers, and in fact the entire respiratory tract, is much more delicate and more frequently diseased than the mucous membrane of any other part of the body.
89
90
Tlie sinuses of the head are compartments which communicate with tlie nasal chambers and are lined with a continuation of the same membrane that lines the nasal chambers; their presence increases the volume and modifies the form of tlie head without increasing its weight.
The horse, in a normal condition, breathes exclusively through tlie nostrils; no air passes through the mouth in respiration. This is one reason why horses probably are affected oftener with colds than other animals. The organs of respiration are more liable to dis- ease than the organs connected with anj' other function of the animal, and, as many of the causes can be prevented, it is both important and I)rofitable to know and study the causes. The respiratory surface in the lungs of the horse is estimated to be from 200 to 500 square feet.
The cause of many of the diseases of these organs may be given under a common head, because even a simple cold, if neglected or badl}^ treated, may run into the most complicated lung disease and terminate fatally. In the spring and fall, when the animals are changing their coats, there is a marked predisposition to contract disease, and consequently care should be taken at those periods to prevent other exciting causes.
Badly ventilated stables are a frequent source of disease. It is a great mistake to think that country stables necessarily have purer air than city stables. Stables on some farms are so faultily constructed that it is almost impossible for the foul air to gain an exit. All stables should have an unlimited supply of pure air, and be so arranged that strong draughts can not blow directly on the animals. Hot stables are almost always illy ventilated, and the hot stable is a cause of disease on account of the extreme change of temperature a horse is liable to when taken out, and extreme changes of temperature are to be avoided as certain causes of disease. A horse taken from i)as- ture and kept in a hot stable is almost sure to contract a cold; the stable should be thrown open and the temperature gradually increased in such cases, when practicable, to avoid the sudden change.
A cold, close stable is invariably damp, and is to be avoided as much as the hot, close, and foul stable. Horses changed from a cold to a Avarm stable are more liable to contract cold than when changed from a warm to a cold stable. Pure air is more essential than warmth, and this fact should be especially remembered when the stable is made close and foul to gain the warmth. It is more economical to keep the horse warm with blankets than to prevent the ingress of pure air in order to make the stable warm.
Stables should be well drained and kept clean. Some farmers allow dung to accumulate in the stalls until tliere is hardlj' sufficient room for the liorses. This is a pernicious i)ractice, as the decomposing organic matter evolves poisonous gases that are predisposing or excit- ing causes of disease. When a horse is overheated it is not safe to
91
allow him to dry bj' evaijoration ; rubbing liiin dry and gradually cooling him out is the wisest treatment. When a horse is hot — cov- ered with sweat — it is dangerous to allow him to stand in a draught; it is the best i)lan to walk him until his temperature moderates. In such cases a light blanket thrown over the animal may prevent a cold. Overwork or overexertion often causes the most fatal cases of conges- tion of the lungs. Avoid j)rolonged or fast work when the horse is out of condition or unaccustomed to it. Animals that have been working out in cold rains should be dried and cooled out, and not left to dry by evaporation. "When the temperature of the weather is at the extreme, either of heat or cold, diseases of the organs of respira- tion are most frequent.
It is not to be suj)posed tliat farmers can give their horses the par- ticular attention given to valuable racing and pleasure horses, but they can most assuredly give them common-sense care, and this will often save the life of a valuable or useful animal. Xegiect on the j)art of the owner is as often (x^erhai^s oftener) the cause of disease in the horse as neglect on the part of the servant. If the owner properly considers his interests he will study the welfare of his horses so that he may be able to instruct the servant in details of stable manage- ment, as it often hapi^ens that the fault on the i)art of the servant is due to want of knowledge more than to willful neglect.
WOUNDS ABOUT THE NOSTRILS.
Wounds in this neighborhood are common, and are generally caused by getting snagged on a nail or splinter, or by the bite of another horse; or by getting "run. into," or b}^ running against something. Occasionally the nostril is so badly torn and lacerated that it is impos- sible to effect a cure without leaving the animal blemished for life, but in the majority of instances the blemish or scar is due to the want of conservative treatment on the x)art of the owner or attendant. As soon as possible after the accident the parts should be brought together and held there by stitches. If too much time is allowed to elapse the swelling of the parts will cousiderabl}^ interfere. The skin in this neighborhood is thin and delicate, and therefore it is easy to insert sutures. Never cut awa}' an}" skin that may be loose and hang- ing, or else a scar will certainly remain. Bring the parts in direct aijposition and x)lace the stitches from a quarter to a half inch apart, as circumstances may demand. It is not necessary- to have special surgeons' silk and needles for this operation; good linen thread or ordinary silk thread will answer. The wound afterwards only re- quires to be kept clean. For this purpose it should be cleansed and discharges washed away daily witli a solution made of carbolic acid 1 part, in water 40 parts. If the horse is inclined to rub the w'ound against some object on account of the irritabilit^^.his head should be
92
tied by moans of two halter ropes to prevent him rubbing the wound open. The head should be so tied about ten days, except when at work or eating.
TUMORS WITHIN THE NOSTRILS.
As before mentioned, a small globular tumor is sometimes found within the false nostril, under that part of the skin that is seen to puff or rise and fall when a horse is exerted and breathing hard. These tumors contain matter of a cheesy consistency, and are simple. If the tumor is well opened and the matter squeezed out nature will do the rest to perform a perfect cure. If the opening is made from the out- side through the skin it should be at the most dependent part, but much the best way to open the tumor is from the inside. Quiet the animal, gently insert your finger uj) in the direction of the tumor, and you will soon discover that it is much larger inside than it appears to be on the outside. If necessary put a twitch on the ear of the horse to quiet him; run the index finger of your lef thand against the tumor; now, with the right hand, carefully insert the knife by run- ning the back of the blade along the index finger of the left hand until the tumor is reached; with the left index finger guide the point of the blade quickly and surely into the tumor ; make the opening large ; there is no danger; a little blood may flow out for awhile, but it is of no consequence. Squeeze out the matter and keep the part clean.
COLD IN THE HEAD — CATARRH.
Catarrh means a discharge of fluid from the mucous membrane. The form of catarrh under present consideration is at first a congestion, followed by inflammation of the mucous membrane of the nasal chambers — the Schneiderian or pituitary membrane, as it is specifically termed. The inflammation usually extends to, the membrane of the sinuses of the head and often to the membrane of the larjmx and l)harynx, causing the complication of sore throat. Quite frequently the membrane of the eyes is also affected, as evidenced by its congested condition and the flow of tears down over the cheeks; the nasal duct (spoken of before) is lined with a continuation of the same membrane^ and hence the inflammation of the membrane of the eyes is only an extension of the disease over a continuous tract, and not a specific disease as often supposed. The membrane of the nasal duct being swollen, the effect of the congestion or inflammation, tlie tears can not flow freely through it, therefore they escape from the eyes and flow over the cheeks.
Symptoms. — The membrane at the beginning of the attack is dry, congested and irritable; it is of a much deeper hue than natural, pink- ish-red or red. Soon a watery discharge from the nostrils makes its appearance; the eyes may also be more or less affected, and tears flow
93
over the cheeks. The animal has some fever, which may be easily detected by placing the finger in the mouth, as the feeling of heat con- veyed to the finger will be greater than natural.
To become somewhat expert in ascertaining the changes of temiDera- ture in the horse, it is only necessary to place the finger often in the mouths of horses known to be healthy. After you have become accus- tomed to the warmth of the mouth of the healthy animal you will have no difficulty in detecting a marked increase of the temi^erature. Some veterinarians become so expert in this method of examination that they trust to it in preference to the use of thermometers.
The animal may be dull ; he frequently emits a sort of sneezing snort, but does not cough unless the throat is affected; he expels the air forcibly through his nostrils very often in a manner that may be aptly called "blowing his nose." A few days after the attack begins the discharge from the nostrils changes from a watery to that of a thick mvicilaginous state, of a yellowish-white color, and may be more or less profuse. Often the appetite is lost, and the animal becomes debilitated.
Treatment. — This disease is not serious, but inasmuch as neglect or bad treatment may cause it to run into a dangerous complication, it should receive proper attention. The animal should not be worked for a few days. A few days of quiet rest, with pure air and good food, will be of greater benefit than medication administered while the horse is excited and exposed to draughts and changes of temperature. The benefit derived from the inhalation of steam can not be overestimated. This is effected by holding the horse's head over a bucketful of boil- ing water so that the animal will be compelled to inhale steam with every inhalation of air. Stirring the hot water with a wisp of hay causes the steam to arise in greater abundance. By no means adopt the pernicious method of steaming — advised by some authors and prac- ticed by many people — by putting the head in a bag with hot water or scalded bran. Common sense would be sufficient to condemn the method, if those who practice it would only think. With the head so closely confined in the bag the horse is compelled to inhale over and over the foul air expelled from the lungs. This is malpractice on a healthy horse, and much worse when the animal is ill, for then it has a greater necessity for pure air.
The horse should be made to inhale steam four or five times a day, about fifteen or tAventy minutes each time.
Particular attention should be paid to the diet. Give bran mashes, scalded oats, linseed gruel, and grass if in season. If the horse evinces no desii'e for this soft diet, it is well to allow any kind of food he will eat, such as hay, oats, corn, etc.
If the animal is constipated, relieve this symptom by injections (enemas) of warm water into the rectum (last gut) three or four times a day, but under no circumstances administer purgative medicines.
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For simple cases tlie foregoing is all that is required, but if the appe- tite is lost, aud the animal appears debilitated and dull, give 3 ounces of the solution of acetate of ammonia and 2 drams of powdered chlo- rate of potassium diluted with a pint of water three times a day as a drench. Be careful when giving the drench; do not pound the horse on the gullet to make him swallow; be x)atient, and take time, and do it right.
If the weather be cold, blanket the animal and keep him in a com- fortable stall. If the throat is sore, treat as advised for that ailment, to be described hereafter.
When the inflammatory symptoms subside and the appetite is not regained, give 2 ounces each of the tincture of gentian and spirits of nitrous ether in a pint of water, as a drench, every night and morning for several days. If, after ten days or two weeks, the discharge from the nostrils continues, give 1 dram of i)owdered sulphate of iron three times a day. This may be mixed with bran and oats, if the horse will eat it, but if he will not eat the food with the iron in it, give the iron as a drench, dissolved in a pint of water.
It may be objected that rather more space than necessary is devoted to this simple affection ; but when it is known that there is a ten- dency to the extension of the trouble, and that serious complications may ensue, the fact should be appreciated that there is every reason why the common cold should be thoroughly understood and intelli- gently treated in order to i^revent the more dangerous diseases.
CHRONIC CATARRH — XASAL GLEET.
This is a subacute or chronic inflammation of some part of the membrane affected in common cold, the disease just described. It is manifested by a persistent discharge of a thick, white, or yellowish- white matter from one or both nostrils. The sinuses of the head are the usual seat of the disease. The commonest cause is a neglected or badly treated cold, and it usually follows those cases where the horse has suffered exposure, been overworked, or has not received proper food, and, as a consequence, has become debilitated.
Other but less frequent causes for this affection are : Fractures of the bones that involve the membrane of the sinuses; and even blows on the head over the sinuses, of sufficient force to rujiture blood- vessels within. The blood thus escaping into the sinus acts as an irritant, and sets up an inflamination. Diseased teeth often involve a sinus, and cause a fetid discharge from the nostril. Violent cough- ing is said to have forced particles of food into the sinus, which acted as a cause of the disease. Tumors growing in the sinuses are known to have caused it. It is also attributed to matter from disease of the turbinated bones. Absorption of the bones forming the walls of the sinuses has been caused by the pressure of pus collecting in them, and by tumors filling up the cavity.
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Symptoms. — The long-continued discharge, which varies in quantity according to the attendant circumstances — the cause of the trouble and the part affected — will invariably indicate the disease. Great caution must be exercised when examining these cases, as horses have been condemned as glandered when really there was nothing more ailing them than nasal gleet. This affection is not contagious, nor is it dangerous, although difficult to cure in some instances. In most cases the discharge is from one nostril onl}'^, which signifies that the sinuses on that side of the head are affected. The discharge may be intermittent, that is, quantities may be discharged at times, and again little or none for a day or so. The glands under and between the bones of the lower jaw may be enlarged. The peculiar ragged-edged ulcer of glanders is not to be found on the membrane within the nos- trils, but occasionally sores are to be seen there. If there is any doubt about it, you should study well the sj'mptoms of glanders to enable you to be at least competent to form a safe opinion.
The eye on the side of the discharging nostril may have a peculiar appearance and look smaller than its fellow. There may be an enlarge- ment, having the appearance of a bulging out of the bone over the part affected, between or below the eyes. The breath may be offensive, which indicates decomi)Osition of the matter or bones, or, especially, disease of the teeth. A diseased tooth is further indicated by the horse holding its head to one side when eating, or dropping the food from the mouth after partly chewing it. When you tap on the bones between the eyes, below the ej'es and above the back teeth of the upper jaw, a hollow drum-like sound is emitted, but if the sinus is filled with pus or contains a large tumor the sound emitted will be the same as if a solid substance were struck; by this means the sinus affected may be located in some instances. The hair may be rough over the affected i)art, or even the bone may be soft to the touch and the i)art give somewhat to pressure, or leave an impression where it is l^ressed uj)on with the finger.
Treatment. — The cause of the trouble must be' ascertained before treatment is commenced. In the many cases where the animal is in poor condition (in fact, in all cases), he should have the most nutritive food and regular exercise. The food, or box containing it, should be l)laced on the ground, as the dependent position of the head favors the discharge.
The cases that do not require a surgical ox^eration must, as a rule, have x^ersistent medical treatment. Mineral tonics are of the most value. For eight days give the following mixture : Sulphate of iron, 3 ounces ; i)owdered nux vomica, 1 ounce ; mix and make into sixteen powders. Give one powder mixed with the food twice a day. When all of the foregoing has been administered the following may be tried for eight days: Sulphate of copper, 4 ounces; powdered gentian, 6 ounces; mix and di\ide into sixteen powders. Give one on the food
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twice a day. If the animal will not eat tlie powder on the food, put the medicine in a pint of water in a bottle, shake well and give as a drench. After this substitute the following: One dram of iodide of iwtassium, dissolved in a bucketful of drinking water, one hour before each meal. Much benefit is often derived from the effect of a blister over the face. The ordinary fly blister plaster of the drug store mixed with one-third its weight of lard is efi&cient. Sulphur burnt in the stable while the animal is there to inhale its fumes is also a valuable adjunct. Care should be taken that the fumes of the burning sulphur are sufficiently diluted with air, so as not to suffocate the horse. Chloride of lime sprinkled around the stall is good. Also keep a quantity of the chloride under the hay in the manger so that the gases will be inhaled as the horse holds his head over the hay while eating. Keep the nostrils washed; the discharges may be washed away for appearance sake, but squirting solutions up the nose is worse than useless, as they do not come in contact with the diseased part.
If the nasal gleet is the result of a diseased tooth the tooth must be removed, and the subsequent treatment will be according to indica- tions. The operation of trephining is the best possible way to remove the tooth in such cases, as it immediately oiDens the cavitj^ Avhich can be attended to direct.
In all those cases of nasal gleet where sinuses contain either collec- tions of pus or tumors, the only relief is by the trephine; and it is a fact that, no matter how thoroughly described, this is an operation that will be very seldom attempted by the non-professional, although the operation is simple and attended in the majority of instances with success. It would therefore be a useless waste of time to give the modus operandi.
An abscess involving the turbinated bones is similar to the collec- tion of pus in the sinuses, and must be relieved by trephining.
THICKENING OP THE MEMBRANE.
This is sometimes denoted by a chronic discharge, a snuffling in the breathing and a contraction of the nostril. It is a result of common cold and requires the same treatment as prescribed for nasal gleet, viz., the sulphate of iron, sulphate of copper, iodide of potassium, etc. The membranes of both sides may be affected, but one side only is the rule; and the affected side may be easily detected by holding the hand tightly over one nostril at a time. When the healthy side is closed in this manner, the breathing through the affected side will demonstrate a decreased caliber or an obstruction.
NASAL POLYPUS.
Tumors with narrow bases (somewhat pear-shaped) are occasion- ally found attached to the membrane of the nasal chambers, and are
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obstructions to breathing through the side in which they are located. They vary much in size ; some are so small that their presence is not manifested, while others almost completely fill up the chamber, thereby causing a serious obstruction to the passage of air. The pedicel of the tumor is generally attached high up in the chamber, and usually the tumor can not be seen, but occasionally it increases in size until it pan be observed within the nostril. Sometimes, instead of hanging down towards the nasal opening, it falls back into the pharynx. It causes a discharge from the nostril, a more or less noisy snuffling sound in breathing, according to its size, a discharge of blood (if it is injured), and sneezing.
The side that it occupies can be detected in the same way as de- scribed for the detection of the affected side when the breathing is obstructed by a thickened membrane.
The only relief is the removal of the polypus, which, like all other operations, should be done by an expert when it is i^ossible to secure one. The operation is jjerformed by grasping the base of the tumor with suitable forceps and t^visting it round and round until it is torn from its attachment. The resulting hemorrhage is checked by the use of an astringent lotion, such as a solution of the tincture of iron, etc.
PHARYNGEAL POLYPUS.
This is exactly the same kind of tumor described as nasal polypus, the only difference being in the situation. Indeed, the pedicel of the tumor may be attached to the membrane of the nasal chamber as before explained, or it may be attached in the fauces (opening of the back part of the mouth), which is often the case, and by the body of the tumor falling into the pharnyx it gets the name of pharj^ngeal polypus. In this situation it may seriously interfere with breathing. Sometimes it drops into the larnyx, causing the most alarming symp- toms. The animal coughs or tries to cough, saliva flows from the mouth, the breathing is performed with the greatest difficulty and accompanied b}^ a loud noise ; the animal appears as if strangled and often falls exhausted. When the tumor is coughed out of the larnyx the animal regains quickly and soon appears as if nothing was ailing. These sudden attacks and quick recoveries should lead to the detec- tion of the trouble. The examination must be made by holding the animal's mouth open with a balling iron or speculum and running the hand back into the mouth. If the tumor is within reach it must be removed with forceps by torsion, and the hemorrhage controlled as before advised.
BLEEDING FROM THE NOSE.
Tliis often occurs during the course of certain diseases, viz., influenza, bronchitis, purpura hemorrhagica, glanders, etc. But it 5961— HOR 4
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also occurs independent of other affections; and, as before mentioned, is a symptom of polypus or tumor in the nose.
Injuries to the head, exertion, violent sneezing — causing a rupture of a small blood-vessel — also induce it. Tlie bleeding is almost inva- riably from one nostril only, and is never very serious. The blood escapes in drops (very seldom in a stream), and is never frothy as when the hemorrhage is from the lungs. (See "Bleeding from Lungs.") In most cases, bathing the head and wasliing out the nostrils with cold water are all that is necessary. If the cause is known you will be guided according to circumstances. If the bleeding continues, pour ice-cold water over the face, between the eyes and down over the nasal chambers. A bag containing ice in small pieces applied to the head is often efficient. If in spite of these measures the hemorrhage con- tinues, try plugging the nostrils with cotton, tow, or oakum. Tie a string around the plug before it is pushed up into the nostril, so that it can be safely withdrawn after four or five hours. If both nostrils are bleeding plug only one nostril at a time. If the hemorrhage is pro- fuse and persistent give a drench composed of 1 dram of acetate of lead dissolved in a pint of water; or 1 dram gallic acid dissolved in a pint of water may be tried.
INFLAMMATION OP THE PHAKYNX.
As alread}^ stated, the pharynx is common to the functions of both respiration and alimentation. From this organ the air passes into the larynx and thence onward to the lungs. In the posterior part of the pharynx is the superior extremitj^ of the gullet, the canal through which the food and water pass to the stomach. Inflammation of the pharynx is a complication of other diseases, viz. , influenza, strangles, etc., and is probably always, more or less, complicated with inflamma- tion of the larynx. That it may exist as an independent affection there is no reason to doubt, but so closely do the symptoms resemble those of laryngitis, and as the treatment is the same as for the latter disease, it is unnecessary to give it further consideration in a separate article.
SORE THROAT — LARYNGITIS.
The larynx is situated in the space between the lower jaw bones just back of the root of the tongue, and is retained in this position by the windpipe, muscles, and bones to which it is attached. It may be con- sidered as a box (somewhat depressed on each side), composed princi- pally of cartilages and small muscles, and lined on the inside with a continuation of the respiratory mucous membrane. Posteriorly it opens into and is continuous with the windpipe. It is the organ of the voice, the vocal cords being situated within it; but in the horse this function is of little or no consequence. It dilates and contracts to a certain extent like the nostrils, thus regulating the volume of air pass- ing through it. The mucous membrane lining it internally is so highly
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sensitive that if the smallest particle of food happens to drop into it from the ijharynx the muscles instantly contract and violent coughing ensues, which is continued until the source of irritation is ejected. This is a wise provision of nature to prevent foreign substances gain- ing access to the lungs. That iirojection called Adam's apple in the neck of man is the prominent part of one of the cartilages forming the larynx.
Inflammation of the larynx is a serious and sometimes a fatal dis- ease, and, as before stated, is usually complicated with inflammation of the pharynx, constituting what is i)oi)ularly known as ''sore throat."
Symptoms. — About the first symptom noticed is the cough, followed by a difficulty in swallowing, which ma}'^ be due to the soreness of the membrane of the pharynx, over which the food or water must pass, or to the pain caused by the contraction of the muscles necessary to impel the food or water onward to the gullet ; or this same contraction of the muscles may cause a pressure on the larynx and produce the pain. In manj^ instances the difficulty in swallowing is so great that the water, and in some cases the food, is returned through the nose. The mouth is hot, and saliva dribbles from it. The glands between the lower jaw bones and below the ears may be swollen. Pressure on the larynx induces a violent fit of coughing. The cough is very characteristic ; it is easilj^ seen that the animal is ' ' coughing at his throat." The head is more or less "poked out," and has the apx)sar- ance of being stiffly carried. The membrane in the nose becomes red. A discharge from the nostrils soon appears. As the disease advances, the breathing may assume a more or less noisy character; sometimes a harsh rasping snore is emitted with every respiration, the breathing becomes hurried, and occasionally' the animal seems threatened with suffocation.
Treatment. — In all cases steam the nostrils as advised for cold in the head. In bad cases cause the steam to be inhaled continuously for hours, until relief is afforded. Have a fresh bucketful of boiling water every fifteen or twenty minutes. In each bucketful of water put a tablespoonful of oil of turpentine, which will be carried along -svith the steam to the affected parts and have a beneficial effect. In mild cases steaming the nostrils five, six, or seven times a day will suffice.
The animal should be placed in a comfortable, dry stall (a box-stall preferred), but should have a pure atmosphere to breathe. The body should be blanketed, and bandages applied to the legs. The diet should consist of soft food — bran mashes, scalded oats, linseed gruel, and, best of all, grass, if in season, which should be carried to him as soon as cut, and a fresh supply offered often. The manger or trough should not be too higli nor too low, but a temporary one should be constructed at about the height ho carries his head. Having to reach too high or too low may cause so much pain that the animal
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would rather forego satisfying what little appetite he might have than inflict pain by craning his head for food or water. A supply of fresh water should be before him all the time ; he will not drink too much, nor will the cold water hurt him. Constipation (if present) must be relieved by enemas of warm water, administered three or four times during the twenty-four hours.
A liniment composed of 2 ounces of olive oil and 1 ounce each of solution of ammonia and tincture of cantharides, well shaken together, should be thoroughly rubbed in about the throat from ear to ear, and about 6 inches down over the windpipe and in the space between the lower jaws. This liniment should be applied once a day for two or three da,js.
When the animal can swallow without much difficulty, give the fol- lowing preparation: Fluid extract hyoscyamus 1 dram, jjowdered chlorate potassium 2 drams, simple sirup or molasses 2 ounces. Mix all together and drench very carefully. Repeat the dose every six hours.
If the animal is breathing with great difficulty do not attempt to drench him, but persevere in steaming the nostrils, and dissolve 2 drams of chlorate of jDotassium in every gallon of water he will drink; even if he can not swallow much of it (and even if it is returned through the nostrils), it will be of some benefit as a gargle to the pharynx.
When the breathing begins to be loud great relief is afforded in some cases by giving a drench composed of 2 drams of fluid extract of jaborandi in half a pint of water. If benefit is derived, this drench may be repeated four or five hours after the first dose is given. It will cause a free flow of saliva from the mouth within thirtj^ minutes.
In urgent cases, when sufi'ocation seems inevitable, the operation of tracheotomy must be ijerformed. It must be admitted that this oper- ation appears to be (to the non-professional) a very formidable one, but as it is certainly a means of saving life where all other measures have failed, it is the duty of the writer to describe it. To describe this operation in words that would make it comprehensible to the general reader is a much more difficult task than performing the oper- ation, Avhich in the hands of the expert is one of the simplest, and attended with less danger (from the operation itself) than any of the special operations on organs.
The operator should be provided with a tracheotomy tube (to be purchased from any veterinary instrument maker) and a sharp knife, a sponge, and a bucket of clean cold water. The place to be selected for opening the windpipe is that i^art which is found, uj^ou examina- tion, to be least covered with muscles. Run your hand down the front part of the windi)ipe and you maj^ easily detect the rings of cartilage of which it is composed ; about 5 or 6 inches below the tliroat it will be the most plainly felt. Right here, then, is the place to cut through.
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Have an assistant liold tne animal's head still ; no necessity of putting a twitch on the nose. Grasp your knife firmlj'^in the right hand, select the spot to cut, and cut. Make the cut from above to below dii'cctly on the median line on the anterior surface of the mndpipe. Do not attempt to dissect your way in, that is too slow, it annoys the horse and makes him restless, besides it gives a novice time to become nervous. Make the cut about 2 inches long in the windpipe; this necessitates cutting three or four rings. One bold, nervy stroke is usually sufficient, but if it is necessarj^ to make several other cuts to finish the oj)eration do not hesitate. Your intention must be to make a hole in the windpipe sufficiently large to admit the tracheotomy' tube, and you have not accomplished your purpose until you have done so. It is quickly manifested when the windpiiDc is severed, the hot air rushes out, and when air is taken in it is sucked in with a noise. A slight hemorrhage may result (it never amounts to much), which is easily conti*olled by washing the wound with a sponge and cold v.ater; do not get any of the water in the windpii^e. Do not neglect to instruct your assistant to hold the head down immediately after the Oi^era- tion, so that the neck will be in a horizontal line. This will prevent the blood getting into the windpipe and allow it to drop directly on the ground. If you have the self-adjustable tube, it retains its i^lace in the wound without further trouble after it is inserted. The other kind requires to be secured in position hy means of two tapes or strings tied around the neck. After the hemorrhage is somewhat abated sponge the blood away and see that the tube is thoroughly clean, then insert it, directing the tube downwards towards the lungs. To insure the tube being clean, it is best to keep it immersed in a solution of 1 ounce of carbolic acid in 20 ounces of water for about thirty minutes previous to inserting it in the windpipe.
The immediate relief this operation affords is wonderful to behold. The animal, a few minutes before on the verge of death from suffoca- tion, emitting a loud wheezing sound with every breath; with haggard countenance, body swaying, i)awing, gasping, fighting for breath, is now breathing tranquilly, and ten to one is nosing about the stall in search of something to eat.
The tube should be removed once a day and cleaned with the carbonc acid solution (1 to 20), and the discharge washed away from the wound with a solution of carbolic acid, 1 part to 40 j)arts water. Several times a day the hand should be held over the opening in the tube to test the animal's ability to breathe through the nostrils, and as soon as it is demonstrated that breathing can be performed in the natural way the tube should be removed, the wound thoroughlj^ cleansed with the carbolic acid solution (1 to 40), and closed by inserting four or five stitches through the skin and muscle. Do not include the cartilages of the windpipe in the stitches. Apply the carbolic acid solution to the wound three or four times a day until healed. When the tube
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is removed to clean it tlie lips of tlie wound may be pressed together to ascertain whetlier or not the horse can breath through the larynx. The use of the tube should be discontinued as soon as possible.
It is true that tracheotomy tubes are seldom to be found on farms, and especiallj^ when most urgently required. In such instances there is nothing left to be done but, with a strong needle, pass a wax end or other strong string through each side of the wound, including the cartilage of the wind-pipe, and keep the wound open by tying the strings over the neck. The operation of tracheotomy is not always successful in saving the animal's life, and the principal reason of this is that it is deferred too long and the animal is beyond recovery before it is attempted.
During the time the tube is used the other treatment advised must not be neglected. After a few days the discharge from the nostrils becomes thicker and more profuse. This is a good symptom and sig- nifies that the acute stage has x)assed. At any time during the attack, if the hoi'se becomes weak, give the following drench every four or five hours : Spirits of nitrous ether, 2 ounces ; rectified spirits, 2 ounces ; water, 1 pint. When the i)Ower of swallowing is regained and the i)ro- fuse discharge of thick, yellowish-white matter from the nostrils announces the fact of the convalescing stage, administer the follow- ing: Tincture of the iDerchloride of iron, 1 ounce; tincture of gentian, 2 ounces; water, 1 pint. This should be given every morning and evening for about a week or ten days. Good nutritive food must now be given — hay, oats, and corn. Do not be in a hurry to put the ani- mal back to work, but give plenty of time for a complete recovery. Gentle and gradually increasing exercise may be given as soon as the horse is able to stand it.
If abscesses form in connection with the disease they must be opened to allow the escape of pus, but do not rashl}- plunge a knife into swollen glands; wait until j^ou are certain the swelling contains pus. The formation of pus may be encouraged by the constant application of poultices for hours at a time. The best iwultice for the purpose is made of linseed meal, with sufficient hot water to make a thick paste. If the glands remain swollen for some time after the attack, rub well over them an application of the following: Biniodido of mercurj^, 1 dram; lard, 1 ounce; mix well. This may be applied once every day until the part is blistered.
Sore throat is also a symptom of other diseases, such as influenza, strangles, purpura hemorrhagica, etc., which diseases may be consulted under their proper headings.
After a severe attack of inflammation of the larynx the mucous membrane may be left in a thickened condition, or an ulceration of the part may ensue, either of which are liable to produce a chronic cough. For the ulceration it is useless to prescribe, because it can neither be diagnosed nor topically treated by the non-professional.
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If a chronic cougli reniam.s after all tlie other symptoms have disap- peared, it is advisable to give 1 dram of iodide of potassium dissolved in a bucketful of drinking water one hour before feeding, three times a day, for a month if necessary. Also rub in well the preparation of iodide of mercury (as advised for the swollen glands) about the throat, from ear to ear, and in the space betvreen the lower jaw bones. The application may be repeated every third day until the part is blistered.
SPASM OF THE LARYNX.
This has been described by some authorities. The symptoms given are : Sudden seizure by a violent fit of coughing ; the horse may reel and fall, and after a few minutes recover, and be as well as ever. The treatment recommended is: Give a pint of linseed oil and after it has operated administer 3 drams of bromide of potassium three times a day, dissolved in the drinking water, or give as a drench in about a half pint of water, for a week. Then give a dram of powdered nux vomica (either on the food or shaken with water as a drench) once a day for a few weeks.
CROUP AND DIPHTHERIA.
Both of these diseases, it is claimed, afEect the horse. But such cases must be rare, as veterinarians of extended exi)erience have failed to recognize a single ease in their i)ractice. The sjnnptoms are so much like those of inflammation of the larynx that it would be impos- sible for the general reader to discriminate between them.
ROARING.
Horses that are affected with a chronic disease that causes a loud unnatural noise in breathing are called "roarers." This class does not include those affected with severe sore throat, as in these cases the breathing is noisj^ only during the attack of the acute disease.
Roaring is caused by an obstruction to the free passage of the air in some part of the respiratorj"^ tract. Nasal polypi, thickening of the membrane, pharyngeal polypi, deformed bones, paralysis of the wing of the nostril, etc., are occasional causes. The noisy breathing of horses after having been idle and put to sudden exertion is not due to any disease, and is onlj^ temporary. Very often a nervous, excitable horse will make a noise for a short time when started off, generally caused bj-^the cramped position in which the head and neck are forced, in order to hold him back.
Many other causes may occasion temporary, intermitting, or per- manent noisy respiration, but after all other causes are enumerated it will be found that more than nine out of ten cases of chronic roar- ing are caused by paralysis of the muscles of the larynx; and almost invariably it is the muscles of the left side of the larynx that are affected.
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In chronic roaring the noise is made wneu the air is drawn .nto the lungs; and only when the disease is far advanced is a sound produced when the air is expelled, and even then it is not near so loud as during inspiration.
In a normal condition the muscles dilate the aperture of the larynx by moving outward the cartilage and vocal cord, allowing a sufficient volume of air to rush through. But when the muscles are paralyzed the cartilage and vocal cord that are nominally controlled by the affected muscles remain stationary; therefore when the air rushes in it meets this obstruction, and the noise is produced. When the air is expelled from the lungs its very force pushes the cartilage and vocal cords out, and consequently noise is not always produced in the expi- ratory act.
The paralysis of the muscles is due to derangement of the nerve that supplies them with energy. The muscles of both sides are not sup- plied by the same nerve; there is a right and a left nerve, each supply- ing its respective side. The reason why the muscles on the left side are the ones usually paralyzed is owing to the difference in the ana- tomical arrangement of the nerves. The left nerve is much longer and more exposed to interference than the right nerve. This pair of nerves is given off from its parent trunks (the pneumogastrics) after the latter enter the chest, and consequently they are called the recur- rent larjmgeal nerves, on account of having to recur to the larynx.
In chronic roaring there is no evidence of any disease of the larynx, other than the wasted condition of the muscles in question. The disease of the nerve is generally located far from the larynx. Disease of parts contiguous to the nerve along any part of its course vasiy interfere with its proper function. It is not really necessary for the nerve itself to be the seat of disease; pressure upon it is sufficient; the pressure of a tumor on the nerve is a common cause. Disease of lymphatic glands within the chest through which the nerve passes on its way back to the larynx is the most frequent interruption of nerv- ous supply, and consequently roaring. When roaring becomes con- firmed medical treatment is entirely useless, as it is impossible to restore the wasted muscle and at the same time remove the cause of the interruption of the nervous supply. Before the disease becomes permanent it may be benefited by a course of iodide of potassium, when it is caused by disease of the lymphatic glands. Electricity has been used with indifferent success. Blistering or firing over the larynx is of course not worthy of trial if the disease is due to inter- ference with the nerve supply. The administration of strychnia (nux vomica) on the ground that it is a nerve tonic, with the view of stimu- lating the affected muscles, is treating only the result of the disease without considering the cause, and is therefore useless. The opera- tion of extirpating the collapsed cartilage and vocal cord is believed to be the only relief, and as this operation is critical and can only be performed by the skillful veterinarian, it will not be described here.
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From the foregoing description of the disease it A\dll be seen tliat the name "roaring," by which the disease is generally known, is only a symptom and not the disease. Chronic roaring is also in many cases accomj)anied by a cough. The best way to test Avhether a horse is a " roarer " is to either make him pull a load rapidly up a hill or over a sandy road or soft ground; or if he is a saddle horse gallop him up a hill. The object is to make him exert himself. Some horses require a great deal more exertion than others before the characteris- tic sound is emitted. The greater the distance he is forced the more he will appear exhausted if he is a roarer; in bad cases the animal becomes utterly exhausted, the breathing is rapid and difficult, the nostrils dilate to the fullest extent, and the animal ajjpears as if suffocation is imminent.
An animal that is a roarer should not be used for breeding purposes, no matter how valuable the stock. The taint is transmissible in many instances, and there is not the least doubt in the minds of those Avho know best that the offsj^ring whose sire or dam is a roarer is born with an hereditary predisposition to the affection.
Grunting. — A common test used by veterinarians when examining "the wind" of a horse is to see if he is a "grunter." This is a sound emitted during expiration when the animal is suddenly moved, or startled, or struck at. If he grunts he is further tested for roaring. Grunter s are not always roarers, but as it is a common thing for a roarer to grunt such an animal must be looked upon with suspicion until he is thoroughly tried by pulling a load or galloped up a hill. The test should be a severe one. Horses suffering with pleurisy, i)leu- rodynia, or rheumatism, and other affections accompanied vnXh much pain, will grunt when moved, or when the pain is aggravated, but grunting under these circumstances does not justifj^ the term of "grunter" being applied to the horse, as the grunting ceases when the animal recovers from the disease that causes the i)ain.
I-Ii(jli hlowing. — This term is applied to a noisy breathing made by some horses. It is distinctlj^ a nasal sound, and must not be con- founded Avith ' ' roaring. " The sound is produced by the action of the nostrils. It is a habit and not an unsoundness. Contrary to roaring, when tlie animal is put to severe exertion the sound ceases. An ani- mal that emits this sound is called a "high-blower." Some horses have, naturally, very narrow nasal openings, and they may emit sounds louder than usual in their breathing when exercised.
TlliisUifig is only one of the variations of the sound emitted by a horse called a ' ' roarer, " and therefore needs no further notice, except to remind the reader that a whistling sound may be produced during an attack of severe sore throat or inflammation of the larynx, which passes away with the disease that causes it.
Thick tuind. — This is another superfluous term applied to a symp- tom. The great majority of horses called " thick- winded " belong 5961— HOR 4*
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eitlier in tlie class called "roarers," or are affected with "lieaves," and therefore no separate classification is needed. Mares heavy with foal, horses excessively fat, and those that have not been exercised for so long that the muscular system has become unfit for work ; horses with large bellies, and, especially, when the stomach is loaded with coarse, fibrous, or bulky food, emit a louder sound than natural in their breathing, and are called "thick-winded." The treatment in such cases is obvious: "Remove the cause and the effect will cease." AVhile it must be admitted that "thickening of the mucous mem- brane of the finer bronchial tubes and air cells may cause the breath- ing called "thick- winded," it must at the same time be admitted that there is no symptom by which the condition can be distinguished from what will hereafter be described as "heaves," by the general reader, at least.
THE WINDPIPE.
The windpipe, or trachea, as it is technically called, is the flexible tube that extends from the larynx, which it succeeds at the throat, to above the base of the heart in the chest, where it terminates by dividing into the right and left bronchi, the tubes going to the right and left lung respectively. The windpipe is composed of about fifty incomplete rings of cartilage united by ligaments. A muscular layer is situated on the superior surface of the rings. Internally the tube is lined with a continuation of the mucous membrane that lines the entire respiratory tract, which here has ver}^ little sensibility in contrast to that lining the larjnix, which is endowed with exc^uisite sensitiveness.
The windpipe is not subject to any si^ecial disease, but is more or less affected during laryngitis (sore throat), influenza, bronchitis, etc., and requires no special treatment. The membrane may be left in a thickened condition after these attacks. One or more of the rings may be accidentallj^ fractured, or the tube maj^ be distorted or mal- formed, the result of violent injury. After the operation of trache- otomj'" it is not uncommon to find a tumor or malformation as a result or sequel of the operation. In i^assing over this section attention is merely called to those defects, as they require no particular attention in the way of treatment. However, it may be stated that any one of the before-mentioned conditions may constitute one of the causes of noisy respiration described as "roai'ing."
GUTTURAL POUCHES.
These two sacs are not included in the organs of respiration, but sometimes pus collects in them to an extent that considerably inter- feres AA'ith resi^iration. They are in close x^roximity to the pharynx and larynx, and when filled with matter the functions of the last- named organs can not be prox)erly performed. They are situated above the throat, and communicate with the jiharynx, as well as with
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the cavity of the tympanum of the ear. They are peculiar to solii^eds. Tliey contain air, except when filled Avitli pus. Their function is unknown.
One or both guttural pouches may contain pus. The symptoms are : Swelling on the side below the ear and an intermittent discharge of matter from one or both nostrils, especially when the head is depressed.
The swelling is soft, and, if i:)ressed upon, matter will escape from the nose if the head is dei^ressed. As before mentioned, these pouches communicate with the i3harynx, and through this small ojjen- ing matter may escape. A recovery is probable if the animal is turned out to graze, or if he is fed from the ground, as the dependent i^osition of the head favors the escape of matter from the i)Ouches. In addi- tion to this, give the tonics recommended for nasal gleet. If this treatment fails an operation must be i^erformed, which should not be attemi)ted by anj'oue unacquainted with the anatomy of the part.
METHODS OF EXAMINATION FOR DISEASES HAVING THEIR SEAT WITHIN THE CHEST.
To lay down a set of rules for the guidance of the general reader in discriminating between the diiferent affections of the organs of res- piration situated in the thoracic cavity, is a task hard to accomi)lish. In the first place, it is presumed that the reader has no knowledge whatever of the anatomical arrangement, and i^robably but a meager idea of the jjhysiology of the organs, therefore the use of technical language, which would make the task a simple one, is out of the ques- tion. And, to one who scarcely understands the signs and laws of health, it is difScult to convey in comprehensive language, in an arti- cle like this, an adequate idea of the great importance attached to signs or symptoms of disease. Then, again, the methods used for the detection of symptoms not visible are such as require special culti- vation of the particular senses brought into play. It will be the endeavor of the winter, when describing the symptoms of each partic- ular disease, to do so in such manner that a serious mistake should not be made; but for the benefit of those who may desire a more thorough understanding of the subject a brief review of the various methods employed and an explanation of certain symptoms "vWll be given here.
Pulse. — By the pulse is meant the beating of the arteries, which fol- lows each contraction of the heart. Tlie artery usually selected in the horse for "taking the ijulse" is the submaxillary where it winds around the lower jaw-bone. On the inner side of the jaw-bone the artery may be readily felt and pressed against the bone, hence its adaptability for the purpose of detecting each peculiarity. The num- ber of beats in a minute, the regularity, the irregularity, the strength or feebleness, and other peculiarities are principally due to the action of the heart.
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In the healthy horse the average number of beats in a minute is about forty; but in different horses the number may vary from thirt}- five to forty-five and still be consistent with health. The breed and temperament of an animal have mvich to do with the number of pulsa- tions. In a thoroughbred the number of beats in a given time is gen- erally greater than in a coarse-bred horse. The pulse is less frequent in a dull plethoric animal than in an excitable one. The state of the pulse should be taken when the animal is quiet and at rest. Work, exercise, and excitement increase the number of pulsations. If the pulse of a horse be taken while standing quietly in the stable it will be found less frequent than when he is at pasture.
It is not within the scope of a work of this kind to give all the j)ecul- iarities of the pulse; only a few of the most important will be noticed. It should, however, be stated that if the reader would learn something of the i)ulse in disease he must first become acquainted with the pulse in health ; he must know the natural peculiarities before he can detect the deviations caused by disease.
By a frequent pulse is meant an increased number of beats in a given time. An infrequent pulse means the reverse. A quich pulse refers to the time occupied by the indi^adual pulsation. The beat may strike the finger either quicMy or slowly. Hence the pulse may beat forty quick pulsations or forty slow pulsations in a minute.
The i)ulse is called intermitting when the beat now and then is omitted. The omission of the beat vnsij be at the end of a given num- ber of i)ulsations, when it is termed regularly intermittent, or it may be irregularly intermittent.
A large pulse means that the volume is larger than usual, and a small pulse means the opi^osite. When the artery is easily com- pressed and conveys the feeling of emptiness it is called & feeble pulse. When a feeling of hardness and resistance is conveyed to the finger it is termed a hard pulse. A double pulse is when the beat seems to give two rapid beats at once. Besides other peculiarities the pulse may include the character of two or more of the foregoing classes.
In fever the pulse is modified, both as regards frequency and other deviations from the normal standard. When a horse is quietly stand- ing at rest, if the i)ulse beats fifty-five or more in a minute, fever is present.
Temperature. — The temperature of the healthy horse ranges from about 99i° to 101i° F. The average may be placed at about 100° F. The temperature is subject to slight alterations by certain influences. A high surrounding temj)erature increases the animal temperature, and cold tlie reverse. Exercise increases it. Mares have a higher temperature than males. Drinking cold water lowers the animal temi^erature. It is higher in the young than in the old. The process of digestion increases the temperature.
The most accurate method of taking the temperature is by intro- ducing a registered clinical thermometer into the rectum. This
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instrument can be piircliased from any dealer in surgical instruments. Even the best made may vary somewhat from being exact, but one sufficiently true for the i3urpose is easily obtained. It should be self- registering. The thermometer should remain in the gut for about three or four minutes. Before inserting it you should be sure the mercurj^ is below the minimum temperature. The end containing the mercury should be pushed in gently, leaving only sufficient out- side to take hold of when you desire to withdraw it.
In describing the symptoms of "cold in the head" the method of ascertaining an increase of temperature by placing the finger in the mouth is referred to. The method requires considerable practice and a delicac}^ of touch to become expert, but, when a thermometer is not at hand, a little practice will enable a person of ordinary intelligence to detect the existence or absence of fever.
Respiration. — In health, standing still, the horse breathes from twelve to fifteen times a minute; work or excitement increases the number of respirations.
The character of the breathing is changed by disease. Quick breath- ing refers to an increased number of resi)irations, which may be due to disease or to simple exercise. Difficult hreathing is always asso- ciated with something abnormal, and is often a perfect guide to the trouble. Stertorous hreatliing must not be confounded with the diffi- cult breathing or noisy respiration of sore throat, roaring, etc. By stertorous breathing is meant what, in the human being, is called snoring, which is due to a relaxation of the palate and not to disease of the part. In the horse it is generally associated with brain disease, Avhen the consequent derangement of the nervous functions causes the relaxation of the soft palate. Abdominal breathing is when the ribs are kept as nearlj^ stationary as possible, and the abdominal muscles assist to a much greater extent than natural in respiration; the abdomen is seen to work like a bellows. In pleurisy, owing to the pain caused by moving the ribs, this kind of breathing is always present. Thoracic breathing is the opposite of abdominal breath- ing— that is, the ribs rise and fall more than usual, while the abdom- inal muscles remain fixed; this is due to abdominal pain, such as peritonitis, etc. Irregular breathing is exemplified in "heaves," and often during the critical stages of acute diseases.
Secretions. — In the first stages of inflammatory disease these func- tions are noticed with benefit. For instance, in the common cold at the beginning of the attack the membrane mthin the nostrils is dry and congested, which state gradually gives way to a watery discharge, soon followed by a thick mucus. In pleurisy the surfaces are at first dry, which can be easily ascertained by ijlacing the ear against the chest over the affected part, when the dry surfaces of the pleural will be heard rubbing against each other, producing a sound likened to that of rubbing two pieces of paper one against the other. In dis- eases of the respiratory organs the bowels are usually constipated,
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and tlie urine becomes less in ciuautity and of a liigiier color. Tke skin is usually hot and drj'^, buttliere are instances when perspiration is X) refuse. At the beginning- of the attack there is generally a chill (in most instances unnoticed by the attendant), caused by the con- traction of the blood-vessels in the skin driving the blood internally.
Cough. — This is usually a violent effort to remove some source of irritation in the respirator}^ tract. The dry co?/(/7i is heard during the first stages of disease of the respiratory^ organs. In x>leurisy the cougli is a dry one. The cough in x^leurisy is noticeable on account of the apparent effort of the animal to supj)ress it. The moist cough is heard when the secretions (following a dry stage) are re-established. Cough is but a sjnnptom — the effect of a disease. Roaring, heaves, XDleurisy, iDueumonia, etc., have a cough x^eculiar to each affection.
AuscuUaiion. — This term is applied to the method of detecting dis- eases of the organs within the chest by listening to the sounds. Gen- erally the ear is placed directly against tlie part, but occasionally an instrument called the stethoscox)e is emxjloyed. The former is the best mode for horses. In order to gain any satisfaction or knowledge by the practice of this method the reader must first become familiar with the sounds in a healthy horse, wliich can only be learned by prac- tice. Much more x)ractice and knowledge are then required to discrim- inate i^roperly between abnormal sounds and their significance.
Percussion. — As api)lied to the x)racticeof medicine this term refers to the act of striking on some x)art of the bod}^ to determine the condi- tion of the internal organs by the sound elicited. If a wall of a cavity is struck the sound is easily distinguished from that emitted when a solid substance is knocked on. When x)ercussing the chest, the ribs are struck with the tips of the fingers and thumb held together, or with the knuckles. An instrument called the pleximeter is sometimes laid against the part, to strike on. If the surface is soft over the part to be percussed, the left hand is pressed against it firml}-, and the middle finger of it struck with tlie ends of the fingers of the right hand to bring out the sound. This method of examination also requires much practice on the healthy as well as the unhealthy animal.
BRONCHITIS.
As previousl}^ described, the windpipe terminates by dividing into the right and left bronchi, running to the right and left lung, respec- tively. After reaching the lungs these tubes divide into innumerable branches, gradually decreasing in size, which xienetrate all parts of the lungs, ultimately terminating in the air-cells. The bronchial tubes are formed much the same as the windpixjc, consisting of a base of car- tilaginous rings Avith a lajev of fibrous and muscular tissue, and lined internally with a continuation of the resxjiralory mucous membrane.
Bronchitis is an inflammation of the bronchial tubes. The mucous membrane alone maybe affected, or the inflammation may involve the
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Avliole tube. Broucliitis affecting tlie larger tubes is less serious tliau when the smaller are involved. The disease may be either acute or chronic. The causes are generally much the same as for other dis- eases of the respirator}^ organs, noticed in the beginning of this article. The special causes are: The inhalation of iiTitating gases and smoke, and fluids or solids gaining access to the parts. Bronchitis is occa- sionally associated with influenza and other specific fevers. It also supervenes on common cold or sore throat.
Symptoms. — The animal appears dull; the apiDctite is partiall}^ or wholly lost; the head hangs; the breathing is ver}' much CLuickened; the cough, at first dry, and having somewhat the character of a "bark- ing cough," is succeeded in a few daj's by a moist rattling cough; the mouth is hot; the visible membranes in the nose are red; the i)ulseis frecLuent, and during the first stage is hard and quick, but as the dis- ease advances becomes smaller and more frequent. iVf ter a few days a whitish discharge from the nostrils ensues ; sometimes this discharge is tinged with blood, and occasionally it may be of a brownisli or rusty color. By auscultation or placing the ear to the sides of the chest unnatural sounds can now be lieai*d. The air j)assing over the inflamed surface causes a hissing or wheezing sound v>-hen the small tubes are affected, and a hoarse, cooing, or snoring sound when the larger tubes are involved. After one or two days the dry stage of the disease is succeeded by a moist stage of the membrane. The ear now detects a different sound, caused by the bursting of the bubbles as the air passes through the fluid, which is the exudate of inflamma- tion and the augmented mucous secretions of the membrane. The mucus may be secreted in great abundance, which, by blocking up the tubes, may cause a collapse of a large extent of breathing surface. Usually the mucus is expectorated, that is, discharged through the nose. The matter is coughed up, and when it reaches the larynx much of it may be swallowetl, or, as the case may be, discharged from the nostrils. The horse can not spit like the human being, nor does the matter coughed uj) gain access to the mouth. In serious cases all the symi)toms become aggravated. The breathing is labored, short, quick, \)\\t not painful. It is both thoracic and abdominal. Tlie ribs rise and fall much more than natural. This fact alone is enough to exclude the idea that the animal may be affected with j)leurisy, because, in x)leuris3% the ribs are as nearly fixed as in the power of the animal to do so, and the breathing accomplished to a great extent by aid of the abdominal muscles. The horse persists in standing throughout the attack. He prefers to stand witli head to a door or window to gain all the fresh air possible, but may occasionally wan- der listlessly about the stall if not tied. The bowels most likely are constipated; the dung is covered with slimy inucus. This apjjear- ance of the dung is usually defined by stablemen to be "cold on the bowels," or "dung covered with cold." The urine is decreased in
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qnautity and darker in color than usual. The animal shows more or less thirst; in some cases the mouth is full of saliva. The discharge from the nose increases in quantitj^ as the disease advances and inflammation subsides. This is rather a good symptom, as it shows one stage has passed. The discharge then gradually decreases, the cougli becomes less rasping but of more frequent occurrence until it gradually disappears with the return of health.
Bronchitis, affecting the smaller tubes, is one of the most fatal dis- eases, while that of the larger tubes is never very serious. It must be stated, however, that it is an exceedingly difficult matter for a non-expert to discriminate between the two forms, and further, it may as well be said here that the non-exjiert will have difficulty in discriminating between bronchitis and pneumonia. Therefore the writer will endeavor to point out a course of treatment in each dis- ease that will positively benefit either affection if the reader happens to be mistaken in his diagnosis. The critic may say that this plan is not a truly scientific method of treating disease. The only reply necessary to be made is that this series of articles is intended to be of practical value to the horse-o^^^^ing public, and is in no manner intended as a text-book for experts and those already acquainted with the technical literature on the subject. Scientific terms which would make the work easy for the author would only tend to make it valueless to the general reader. Likewise a different prescription for each form and stage of the affection would only confuse a person who is unable to appreciate the various phases of the disease.
Treatment. — Of first importance is to insure a pure atmosphere to breathe, and next to make the patient's quarters as comfortable as possible. A well-ventilated box-stall serves best for all purposes. Cover the body with a blanket, light or heavy as the season of the year demands. Hand rub the legs until they are Avarm, then apply flannel or Derby bandages from the hoofs to the knees and hocks. If the legs can not be made warm with hand rubbing alone, apply the liniment recommended in the treatment of sore throat. Rub in thoroughly and .then put on the bandages. Also, rub the same lini- ment well over the side of the chest, behind the elbow and shoulder- blade, covering the space beginning immediately behind the elbow and shoulder-blade and running back about 18 inches, and from the elbow below to within 5 or 6 inches of the ridge of the backbone above. Repeat the application to the side of the chest about five days after the first one is applied.
Compel the animal to inhale steam as advised for cold in the liead. In each bucketful of boiling water put a tablespoonful of oil of tur- X^entinc. This medicated vapor coming in direct contact with the inflamed bronchial tubes is of much greater benefit than can be imagined by one who has not experienced its good effect. In serious cases the steam should be inhaled every hour, and in any case the
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oftener it is done the greater will be the beneficial results. Three times a ddy admii ister the following drench: Solution of tlie acetate of ammonia, 3 oun..'es; spirits of nitrous ether, 2 ounces; bicarbonate of potassium, one-half ounce; water, 1 pint. Care must be used in drenching. If it greatly excites the horse it is best not to push it. If you see that it does harm do not persist in making the animal worse. Be satisfied with dissolving one-half ounce of bicarbonate of potassium in everj" bucketful of water the animal will drink. It is well to keep a bucketful of cold water before the animal all the time. If the horse is prostrated and has no appetite give the following drench: Spirits of nitrous ether, 2 ounces; rectified spirits, 3 ounces; water, 1 i)int. Repeat the dose every four or five hours if it appears to benefit. When the horse is hard to drench, and if you have some one about who is expert in administering balls, give the following: Pulverized carbonate of ammonia, 3 drams; linseed meal and molasses sufiicient to make the whole into a stiff mass; wrap it with a small piece of tissue paper and it is ready to administer. This ball may be repeated every four or five hours. When giving the ball care should be taken to prevent its breaking in the mouth, as in case of such accident it will make the mouth sore, which may prevent the animal from eating. If the bowels are constipated give enemas of warm water. Do not give purgative medicines. Do not bleed the animal. Depressing treatment onlj" helps to bring on a fatal termination.
If the animal retains an appetite a soft diet is preferable, such as scalded oats, bran mashes, and grass if in season. If he refuses cooked food allow in small quantities anything he will eat. Hay, corn, oats, bread, apples, carrots may all be tried in turn. Some horses will drink sweet milk when they refuse all other kinds of food, and especiall}^ is this the case if the drinking water is withheld for awhile. One or two gallons at a time, four or five times a day, will suj)port life. Bear in mind that when the disease is established it will run its course, which may be from two to three weeks, or even longer. Good nursing and iiatience are required.
When the sj^mptoms have abated and nothing remains of the disease except the cough and a white discharge from the nostrils, all other medicines should be discontinued and a course of tonic treatment pur- sued. Give the following mixture: Pulverized sulphate of iron, 3 ounces; powdered gentian, 8 ounces; mix w-ell together and divide into sixteen powders. GiA^e a powder every night and morning mixed with bran and oats, if the animal will eat it, or shaken with about a pint of water and administered as a drench.
If the cough remains for a length of time that leads you to think it will become chronic, saj^ three or four weeks after the horse is appar- ently well, apply the liniment to the throat and down over the mnd- pipe and over the breast. Rub it in thoroughly once a day until three or four applications are made. Also give 1 dram of iodide of
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23otassium dissolved in a bucketful of drinking water, one nour before eaeli meal for two or tliree weeks if necessary. Do not put tlie animal at work too soon after recovery. Allow ample time to regain strength. This disease is prone to become chronic and maj' run into an incurable case of thick wind.
It has been stated that it will be a difficult matter for the non-i3ro- fessional to discriminate between bronchitis and pneumonia. In fact the two diseases are often associated, constituting broncho-pneumonia; therefore, the reader should carefully studj^ the symi)toms and treat- ment of x^ueumonia.
CHRONIC BRONCHITIS.
This maj' be due to the same causes as acute bronchitis, or it may follow the latter disease. An attack of the chronic form is liable to be converted into acute bronchitis by a very slight cause. This chronic affection in most instances is associated with thickening of the walls of the tubes. Its course is slower, it is less severe, and is not accompanied with as much fever as the acute form. If the animal is exerted the breathing becomes quickened and he soon shows signs of exhaustion. In many instances the animal keeps up strength and appearances moderately well, but in other cases the appetite is lost, flesh gradually disappears, and the horse becomes emaciated and debilitated. It is accompanied by a cough, which in some cases is a husky, smothered, or muffled excuse for a cough, while in other cases the cough is hard and clear. A whitish matter is discharged from the nose, which may be curdled in some instances. If the ear is placed against the chest behind the shoulder-blade, the rattle of the air passing through the mucus can be heard within. It is stated that the right side of the heart may become enlarged to such an extent that it is easily felt beating by placing the hand against the chest behind the right elbow.
Treatment. — Generally the horse is kept at work when he is affected with this form of bronchial trouble, as the owner says "he has only a deep cold." It is true that some authorities express the ox3inion that work does no harm, but they arc mistaken. Rest is necessary, if a cure is desired, as even under the most favorable circumstances, a cure is difficult to effect. The animal can not stand exertion, and should not be compelled to undergo it. Besides, there is a great x)i*obability of acute bronchitis supervening at any time.
The animal should have much the same general care and medical treatment prescribed for the acute form; if material benefit has not been derived give the following: Powdered nux vomica, 3 ounces; powdered arsenic, 70 grains; iiowdered sulphate of copper, 3 ounces; mix together and divide into thirty-four powders. Give a i)owder mixed Avith l)ran and oats every night and morning. An application of mustard ai^plied to the breast is a beneficial adjunct. If all other
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treatment fails, try the following combination, recommended by a good authority: Hydrocyanic acid (Sclieele's strength), 20 minims; nitrate of x)otassium, 3 drams; bicarbonate of soda, 1 ounce; water, 1 pint. This dose should be given every morning and evening for one or two weeks, if necessary.
The diet should be the most nourishing. Bad food is harmfid at any time, but especially in this disease. Avoid bulky food. Linseed mashes, scalded oats, grass and green-blade fodder, if in season, is the best diet.
THE LUNGS.
The lungs are the essential organs of respiration. They consist of two (right and left) spongy masses, commonly called the "lights," situated entirely within the thoracic cavity. On account of the space taken uj) by the heart, the left lung is the smaller. Externally, they are completely covered by the pleura. The structure of the lung con- sists of a light, soft, but very strong and remarkably elastic tissue, which can only be torn with difficulty. The lung of the fostus v,iiich has never respired will sink if placed in water, but after the lung has been inflated with air it will float on water so long as healthy. This fact is made useful in deciding whether or not an animal was born dead or died after its birth. Each lung is divided into a certain num- ber of lobes, which are subdivided into numberless lobules (little lobes). A little bronchial tube terminates in every one of these small lobules. The little tube then divides into minute branches which open into the air-cells (pulmonarj'^ vesicles) of the lungs. The air- cells are little sacs having a diameter varj^ing from one-seventieth to one-two-hundredth of an inch; they have but one Oliening, the com- munication with the branches of the little bronchial tubes. Small blood-vessels ramify in the walls of the air-ceUs. The walls of the air- cells are extremely thin and consist of two layers; the blood-vessels, being between the laj'ers, thus expose a surface to the air in two different cells. The air-cells are the consummation of the intricate structures forming the respiratory apparatus. They are of prime imjiortance, all the rest being complementary. It is within these cells that is accomplished all that constitutes the ultimate result of the function of respiration. It is here the exchange of gases takes place. As before stated, the walls of the cells are very thin; so, also, are the walls of the blood-vessels. Through these walls escapes from the blood the carbonic-acid gas that has been absorbed by the blood in its circulation through the different parts of the body; and through these walls is absorbed by the blood, from the air in the air-cells, the oxj'^gen gas, which is the life-giving element of the atmosphere.
Throughout the substance of the lungs the bronchial tubes terminate in the air-cells. Blood-vessels are in every part; likewise lymphatic vessels and nerves, which require no more than mention in this pax)er.
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To give a rude idea of the arrangement of the respiratory apparatus as a whole, we may profitably compare it to a tree, for the want of a better illustration. Say that all the respiratory tract from the nasal openings back to the pharynx are the roots in the ground; the larynx may be compared to the large part of the trunk just above the earth; the windpipe will represent the body or the bole of the tree; the right and left bronchi may be considered the first two or largest limbs ; the bronchial tubes are then comparable to all the rest of the limbs, branches and twigs, gradually becoming smaller and. branching out more frequently, until the smallest twigs terminate by having a leaf appended; and to complete the comparison we may as well say the leaf will do to represent the air-cells. Now, imagine all parts in and around the limbs, branches, twigs, and leaves filled in with some mate- rial (say cotton or tow) and the whole covered over with silk or satin to about the beginning of the branches on each of the first two large limbs. The cotton or tow represents the lung-tissue and the silk or satin covering will represent the pleura. It must be admitted that this is rather a rough Avay to handle such delicate structures, but if the reader is possessed of a good imagination he may gain, at least, a comprehension of the subject that will suffice for the purpose of being better able to locate the various diseases and appreciate the mechan- ism of the resiairatory organs in their relations to each other.
CONGESTION OF THE LUNGS.
Inflammation of the lungs is always preceded by congestion, or, to make it plainer, congestion may be considered as the first stage of inflammation. Congestion is essentially an excess of blood in the A'essels of the parts affected. Congestion of the lungs in the horse, v.iien it exists as an independent affection, is generall}^ caused by overexertion when the animal is not in a fit condition to undergo more than moderate exercise.
The methods practiced by the trainers of running and trotting horses will give an idea of what is termed " putting a horse in condi- tion" to stand severe exertion. The animal at first gets walking exercises, then after some time he is made to go faster and farther each day; the amount of work is daily increased until the horse is said to be "in condition." An animal so prei)ared runs no risk of being affected Avith congestion of the lungs if he is otherwise healthy. On the other hand, if the horse is kept in the stable for the i)urpose of laying on fat or for want of something to do, the muscular system becomes soft, and the horse is not in condition to stand the severe exertion of going fast or far, no matter hoAv healthy he may be in other respects. If such a horse be given a hard ride or drive, he may start off in high spirits, but soon becomes exhausted, and if he is pushed he will slacken his pace, show a desire to stop, and may stag- ger or even fall. Examination will show the nostrils dilated, the
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flanks heiving, the countenance haggard, and ever}' other appear- ance of suffocation. IIow was this brought about? The heart and muscles were not accustomed to the sudden and severe strain put upon them; the heart became unable to perform its work; the blood accumulated in the vessels of the lungs, which eventually became engorged with the stagnated blood, constituting congestion of the lungs.
The animal, after having undergone severe exertion, maj'^ not exhibit SLTiy alarming symptoms until returned to the stable ; then he will be noticed standing with his head down, legs spread out, the ej'es wildly staring or dull and sunken. The breathing is very rapid and almost gasping, the body is covered with perspiration in most cases, which, however, may soon evaporate, leaving the surface of the body and the legs and ears cold; the breathing is both abdominal and thoracic; the chest rises and falls and the flanks are powerful!}' brought into action. If the pulse can be felt at all it will be found beating verj' frequently, one hundred or more to a minute. The heart may be felt tumultuously thumping if the hand is placed against the chest behind the left elbow, or it may be scarcely perceptible. The animal may tremble all over the bod}'. If the ear is placed against the side of the chest a loud murmur will be heard, and perhaps a fine crackling sound.
ISTo intelligent person should fail to recognize a case of congestion of the lungs when brought on by overexertion, as the history of the case is sufficient to point out the ailment. The disease may also arise from want of sufficient pure air in stables that are badly ventilated. In all cases of suffocation the lungs are congested. It is also seen in connection with other diseases.
Treatment. — If the animal is attacked by the disease while on the road stop him immediately. Do not attempt to return to the stables. If he is in the stable make arrangements at once to insure an unlim- ited supply of pure air. If the weather is warm, out in the open air is the best place, but if too cold let him stand with, head to the door. By no means have him walked, as is sometimes done. Let him stand still; he has all he can do if he obtains sufficient pure air to sustain life. If he is encumbered with harness or saddle remove it at once and begin rubbing the body with cloths or wisps of hay or straw. This stimulates the circulation in the skin, and thus aids in relie\'ing the lungs of the extra quantity of blood that is stagnated there. If you have three or four assistants let them go to work with enthusiasm, rub the body and legs well, until the skin feels natural; rub the legs until they are warm, if possible; rub in over the cold part of the legs an application of the liniment recommended for the same purpose in the treatment of bronchitis, but do not apply it to the chest. When the circulation is reestablished, i)ut bandages on the legs from the hoofs up as far as possible. Throw a blanket over the body and let the rubbiner be done under the blanket. Diffusible stimulants are the
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medicines indicated. Brandy, whisky (or even ale or beer if nothing else is at hand), ether, and tincture of arnica are "all useful. Two ounces each of spirits of nitrous ether and alcohol, given as a drench, diluted with a pint of water, every hour until relief is afforded, is among the best of remedies. But if it takes too long to obtain this mixture, give a quarter of a i)int of whisky in a pint of water every hour, or the same quantity of brandy as often, or a quart of ale every hour, or an ounce of tincture of arnica in a pint of water every liour until five or six doses have been given. K none of these remedies are at hand, 2 ounces of oil of turj^entine, shaken with a half pint of milk, may be given. This will have a beneficial effect until more applicable remedies are obtained. A tablespoonful of aqua ammonia (harts- horn), diluted with a pint of water and given as a drench every hour, has undoubtedly^ been of great service in saving life when nothing else could be obtained in time to be used with benefit. If the foregoing treatment fails to be followed by a marked improvement after seven or eight hours' perseverance, the p*nimal may be bled from the jugu- lar vein. Do not take more than 5 or 6, quarts from the vein, and do not repeat the bleeding. The blood thus drawn will have a tarry appearance.
When the alarming symptoms have subsided active measures may be stopped, but care must be used in the general treatment of the ani- mal for several days, for it must be remembered that congestion may be followed by pneumonia. The animal should have a comfortable stall, where he will not be subjected to draughts or sudden changes of temj)erature ; he should be blanketed and the legs kept bandaged. The air should be i)ure, a plentiful supply of fresh cold water always before him, and a diet composed i)rincipally of bran mashes, scalded oats, and grass, if in season. When ready for use again he should at first receive moderate exercise only, which may be daily increased until he may safely be put at regular work.
APOPLEXY OF THE LUNGS.
This is but another term for congestion of the lungs, and for prac- tical liurposes needs no special description, except to remark that when a hemorrhage occurs during the congested state of the lungs the blood escai)es from the ruptui-ed vessels and extravasates into the lung tis- sue. Such cases are called pulmonary apoi^lexy, and usuallj' occui' during the course of some specific disease.
PNEUMONIA — LUNG FEVEE.
Pneumonia may attack both lungs, but as a general rule one lung only is affected, and in the great majority of cases it is the right lung. The air-cells are the i^arts affected jprincipally, but the minute branches of the bronchial tubes always, to a greater or less extent, are iuA'^olved in the inflammation. Inflammation of the lungs occurs
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in three principal varieties, but in a Avork of this kind there is no necessity to discriminate, and therefore the disease will be described under a common head. It already lias been mentioned that pneumonia may be complicated with bronchitis, and it will hereafter be pointed out that it is very commonly complicated with i3lem'is3\ In this arti- cle the disease will be considered mainlj^ as an independent affection, and its complications will be more fully described under separate heads.
The inflammation usually begins in the lower part of the lung and extends upwards. The first stage of the disease consists of congestion or engorgement of the blood- vessels, and if tliis condition continues the blood exudes from the vessels into the adjacent lung tissue; if rupture of small blood-vessels occurs there will be extravasations of blood in the contiguous j)arts. The fluids thus escaping collect in the air-cells and in the minute branches of the little bronchial tubes, and, becoming coagulated there, completely block up the cells and exclude the air.
In this condition the lung is increased in volume and is much heavier, and will sink in water. The pleura covering the affected x^arts is alwaj^s more or less inflamed. A continuance of the foregoing phenomena Ls marked by a further escape of the constituents of the blood, and a change in the membrane of the cells, which become swollen. The exudate that fills the air-cells and minute bronchial branches under- goes disintegration, and is converted into a fatty material. The Avails of the cells almost invariablj^ remain unaltered.
It must not be imagined, that the foregoing changes take place in a uniform manner. While one portion is onlj^ congested another part maj' be undergoing disintegration, while still another part may be involved in the exudative stage.
The usual termination of x)iieumonia is in resolution, that is, a res- toration to health. This is gradually brought about by the exuded material contained in the air-cells and lung tissues becoming degen- erated into fatty and a mucus-like substance Avhich are removed by absorption. The blood-vessels return to their natural state and the blood circulates in them as before. Much material, the result of the inflammatory process, is also gotten rid of by expectoration, or rather (in the horse) by discharge from the nostrils. In the cases that do not terminate so happily the lung may become gangrenous (or mortified), or an abscess may form, or the disease may be merged into the chronic variety.
Pneumonia may be directly induced by any of the influences named as general causes for diseases of the organs of respiration, but in many instances it is due to eitlier Avillful neglect or ignorance. A common cold or sore throat may run into a fatal case of pneumonia if neglected or improi^erly treated. An animal may be debilitated by a cold, and when in this weakened state ma}'- be compelled to undergo exertion beyond his strength; or he may be kept in bad
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quarters, such as a badly ventilated stable, where the foul gases are shut in and the pure air is shut out; or the stable may be so open that i)arts of the body are exposed to draughts of cold air. Either of the foregoing causes may induce congestion of the lungs in an ani- mal predisposed to it on account of having already a disease of the respiratory organs. The congestion is soon followed by the other stages of inflammation, and a case of i^neumonia is established with a tendency to a fatal termination, as it is altogether likelj'^ the animal will be so much reduced in constitution as to be unable to fight off a collapse. An animal is predisposed to pneumonia when debilitated by any constitutional disease, and especially during convalescence if exj)osed to any of the exciting causes. Foreign bodies, such as food, accidentally getting in the lungs by way of the mndpipe, as well as the inhalation of irritating gases and smoke, ofttimes produce fatal attacks of inflammation of the lung and bronchial tubes. Pneumo- nia is frequently seen in connection with other diseases, such as influ- enza, purjDura hemorrhagica, strangles, glanders, etc. An abnormal state of the blood j)redisposes to it. Pneumonia and pleurisy are most common during cold, damp weather, and especiallj^ during the prevalence of the cold north and northeasterly winds. Wounds punc- turing the thoracic cavity may induce it.
Symptoms. — Pneumonia, when a primary disease, is ushered in by a chill, more or less prolonged, which in most cases is seen neither by the owner nor the attendant, but is overlooked. The breathing becomes accelerated, and the animal hangs its head and has a very dull appearance. The mouth is hot and has a sticky feeling to the touch ; the heat conveyed to the finger in the mouth demonstrates a fever; if the thermometer is placed in the rectum the temperature will be found to have risen to 103° F., or higher. The pulse is verj^ frequent, beating from seventy or eighty to one hundred or more a minute; the character of the pulse varies very much; it may be hard or feeble, large or small, intermitting, etc. There is usually a dry cough from the beginning, which, however, changes in character as the disease advances; for instance, it may become moist, or if pleu- risy sets in the cough will be peculiar to the latter affection, that is, cut short in the endeavor to suppress it. In some cases the discharge from the nostrils is tinged with blood, while in other cases it has the appearance of matter. The appetite is lost to a greater or less extent, but the desire for water is increased, particularly during the onset of the fever. The membrane within the nostrils is red and at first dry, but sooner or later becomes moist. The legs are cold. The bowels are more or less constipated, and what dung is passed is usually cov- ered Avith a slimy mucus. The urine is passed in smaller quantities than usual and is of a darker color.
The animal prefers to have the head where the freshest air can be obtained. When affected with pneumonia a horse does not lie down.
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but persists in standing from the beginning of the attack. How e\ er, if pneiinic nia is complicated with pleurisy the horse may appear rest- less and lie down for a few moments to gain relief from the ijleuritic pains, but he soon rises. In pneumonia the breathing is verj^ rapid, and sometimes even the most negligent observer will notice that it is difficult, but wlien the i^neumonia is complicated with pleurisy the ribs are kept as still as possible and the breathing is abdominal, that is, the abdominal muscles are now made to do as much of the work as they can perform. Remember if pleurisy is not present thei*e is no pain. To the ordinary observer the animal may not appear danger- ously ill, as he does not show the seriousness of the ailment by vio- lence, as in colic, but a careful observer will discover at a glance that the trouble is something more serious than a cold.
If the reader has practiced auscultation and percussion sufficiently to discriminate the sounds, or absence of sounds, of the diseased lung from the sounds of the normal lung, he may still further satisfy him- self in diagnosing the ailment. When the lung is healthy, if the chest is knocked on, a more or less resonant sound is emitted, accord- ing to the part struck ; but when the air cells are filled with the exu- date of inflammation, and the surrounding lung tissue contains the exudate and extravasated blood, the air is excluded, and the part of the lung thus affected is solidified; now, if the chest is struck over this solidified part, a dull sound is obtained. Therefore, percussion not onlj' shows that the lung is affected with pneumonia, but it points to the spot affected. Moreover, if pleurisj^ exists in conjunction with pneumonia, and the walls of the chest are knocked on with a view of gaining information from the sounds elicited, when that part imme- diately over the affected pleura is struck, the animal flinches, as the blows, even if thej'^ are but moderate, cause severe pain.
By auscultation, listening to the sounds within the chest, we gain much information. When the ear is placed against the chest of a healthy horse the respiratory murmur is heard more or less distinctlj", according to the part of the chest that is beneath the ear. In the very first stage of pneumonia this murmur is louder and hoarser; and, also, there is heard a fine crackling sound something similar to that produced when salt is thrown in a fire. After the affected part becomes solid there is an absence of sound over that particular part. After absorption begins, you mil again hear sounds, which gradually change until the natural sound is heard announ.cing the return of health.
When a fatal termination is approaching all the symptoms become intensified. The breathing becomes still more rapid and difficult; the flanks heave; the j)oor animal stares wildly about as if imiDloring aid to drive off the terrible feeling of suffocation ; the body is bathed with the sweat of death ; he staggers, but quickly recovers his balance ; he may now, for the first time during the attack, lie down; he does so,
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however, in the hope of relief, which he fails to find, and with difQ- culty struggles to his feet; he pants; he heaves; the nostrils flap; he staggers and sways from side to side and backwards and forwards, but still tries to retain the standing position, even by propping himself against the stall. It is no use, as after a fearful and agonizing fight for breath, he goes down ; still instinct with the desire to live he makes a few ineffectual efforts to breathe, which only result in a horrible wheezing, gasping noise ; the limbs stretch out and become rigid, and — he rises no more. A bystander breaks the silence with the remark, "He died hard. " Such is the usual death scene when caused by pneu- monia. It amounts to a veritable struggle against suffocation. Death ensues usually in from ten to twenty days after the beginning of the attack. On the other hand when the disease is terminating favorably the signs are obvious. When the fever abates the animal gradually improves in appetite ; he takes more notice of things around him ; his spirits improve; he has a general appearance of returning health, and he lies down and rests easy. In the great majority of cases pneu- monia, if properlj^ treated, is by no means a fatal disease.
Treatment. — The general outline of the treatment is much the same as advised for bronchitis. The comfort and siTrroundings of the patient must be attended to first. The cxuarters should be the best that can be provided. Pure air is essential. Avoid placing the ani- mal in a stall where he ma}' be exposed to draughts of cold air and sudden changes of temperature. Some authorities state that such exposure is not harmful after pneumonia has set in, but nevertheless the reader is advised to pursue the conservative course and not to experiment. When making the stable comfortably^ warm do not pre- vent the access of pure air. It is much better for the animal if the air is cold and pure than if it is warm and foul. It is better to make the animal comfortable with warm clothing than to make the stable warm by shutting off the ventilatioji. The animal should have an unlimited supply of fresh cold drinking water from the start. Blanket the body. Rub the legs until they are warm and then i^ut bandages on them from the hoofs up as far as thej^ are cold. If warmth can not be re-established in the legs by hand-rubbing alone, apply the lini- ment as recommended in the treatment of bronchitis.
The bandages should be removed once or twice every day, the legs well rubbed, and the bandages reapplied. Rub well over the affected side an application of the liniment mentioned in the treatment of sore throat. The application may be repeated in four or five days. Do not use mustard; no doubt about its acting, and acting quicklj', too, but experience teaches that it is not so good as something less irritat- ing and more prolonged in its beneficial effects. Much harm is often done by clipping off hair and rubbing in powerful escharotic blister- ing compounds. They do positive injury and retard recovery, and should not be allowed. Much benefit }nay be derived from hot appli- cations to the sides of the chest if the facilities are at hand to apply
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them. If the weather be not too cold, and if the animal is in a com- fortable stable, the following method may be tried: Have a tub of hot water handy to the stable door; soak a woolen blanket in the water, then quickly wring as much water as possible out of it and wrap it around the chest. See that it fits closely to the skin; do not allow it to sag down so that air maj' get between it and the skin. Now wraj) a dry blanket over the wet hot one. The hot blanket should be renewed evevy half hour, and while it is off being wetted and wrung, the dry one should remain over the wet part of the chest to prevent reaction. The hot applications should be kept up for three or four hours, and when stopped, the skin should be quickly rubbed as dry as possible, an application of liniment rubbed over the wet j)art, and a dr}' blanket snuglj' fitted over the animal; and especial care should be taken to cover with it the wet i^art of the skin. If the hot appli- cations appear to benefit, they may be tried on three or four consecu- tive days. Unless every facility and circumstance favors the applica- tion of heat in the foregoing manner do not attemiit it. If the weather is very cold, or any of the details are omitted, more harm than good may result. In the majority of cases, warm clothing to the body, bandages to the legs, and the liniment applied to legs and chest Avill suffice.
It is xjossible that cases occur that may be slightly benefited by bleeding, but the non-exj)ert is certainly unable to discriminate in such instances, and therefore blood-letting should never be practiced. Indeed, many veterinary i)ractitioners of great experience wholly con- demn the practice of bleeding in pneumonia as positively hurtful. "When pneumonia follows another disease the system is always more or less debilitated, and requires the careful use of stimulants from the beginning; to still further weaken the animal by tapping him (if the expression may be used), and letting escape in a stream the very source of remaining strength, is one of the most effectual methods of retarding recovery, even if it does not hasten a fatal termination.
Another and oftentimes a fatal mistake made by the non-j)rofes- sional is the indiscriminate and reckless use of aconite. This drug is one of the most active poisons, and should not be handled b}' anyone who does not thoroughly understand its action and uses. It is only less active than prussic acid in its i)oisonous effects. It is a common opinion, often expressed hy non-jDrofessionals, that aconite is a stimu- lant; nothing could be more erroneous. In fact, it is just the reverse; it is one of the most powerful sedatives used in the iDractice of medi- cine. In fatal doses it kills bj^ paralyzing the A'crj- muscles used in breathing; it weakens the action of the heart, and should not be used in anj'- but strong or sthenic tj'pes of inflammation, and then only by the expert. After an extensive experience in the treatment of pneu- monia in various sections, from the cold northern regions of Canadca to the temperate climate of Virginia and North Carolina, the writer
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has discarded aconite entirely from the list of medicines he uses m the treatment of this affection. Do not give purgative medicines. If con- stijiation exists, overcome it by an allowance of laxative diet, such as scalded oats, bran and linseed mashes, and grass if in season.
A careful observer will notice that the dung jjassed by the animal is coated with mucus; this is an indication that the bowels are in an irri- table condition; in fact they are affected to a small extent by the dis- ease. Now, if a purgative dose is administered the irritable state is aggravated; they become inordinately active and a diarrhea or super- purgation is established that proves a most difficult matter to check. It must be remembered that the animal is already weakened b}^ an exhaustive disease, and the "running off at the bowels" not only still further weakens the animal, but may caiise the bowels to become inflamed, and thus insure a fatal termination. It is a common practice among non-prcTfessionals to give aloes and oil to a horse with pneu- monia, and, considering this fact, it is no wonder that it proves such a fatal disease in their hands. If the costiveness is not relieved by the laxative diet, give an enema of about a quart of warm water three or four times a day.
A diet consisting principally of bran mashes, scalded oats, grass or blade fodder, when in season, is preferable if the animal retains an api)ctite; but if no desire is evinced for food of this particular descrip- tion, then the animal must be allowed to eat anj^thing that will be taken spontaneously. Hay tea, made b}^ pouring boiling water over good hay in a large bucket, and allowing it to stand until cool, then straining off the liquid, Avill sometimes create a desire for food. The animal may be allowed to drink as much of it as he desires. Corn on the cob is often eaten when everything else is refused. Bread vAny be tried, also apples or carrots. If the animal can be persuaded to drink milk it may be sujjported by it for days. Three or four gallons of sweet milk may be given during the day, in which may be stirred three or four fresh eggs to each gallon of milk. Some horses will drink milk, while others will refuse to touch it. It should be borne in mind that all food must be taken by the horse as he desires it. No food should be forced down him. If the animal will not eat, you will only have to wait until a desire is shown for food. All kinds may be offered, first one thing and then another, but food should not be allowed to remain long in trough or manger; the very fact of it con- stantly being before him will cause him to loathe it. When the animal has no appetite for anything, the stomach is not in a proper state to digest food, and if it is poured or drenched into him it will onl}^ cause indigestion and aggravate the case. It is a good practice to do nothing when there is nothing to be done that will benefit. This refers to medicine as well as food. Nothing is well done that is over done. The following drench should be administered every six hours: Solution of the acetate of ammonia, 3 ounces; spirits of nitrous ether, i ounce;
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bicarbonate of potassium, 3 drams; water, 1 pint. Care should be used in drenching; no reclclessness such as filling the mouth with medicines, then holding the hand tightly over the nostrils and pound- ing on the throat and windiiipe, kicking the horse in the belly or ribs, or other like conduct, should be practiced. If the animal coughs or attempts to cough Avhile the head is up, let the head down immediately. Better to lose the medicine than to cause it to get into the lungs.
There are many valuable medicines used for tlie different stages and different tj^pes of pneumonia, but in the opinion of the writer it is useless to refer to them here, as this work is intended for the use of those who are not sufficiently acquainted with the disease to recognize its various tyx^es and stages; therefore they would only confuse. If you can administer a ball or capsule, or have any one at hand who is capable of doing it, a dram of sulphate of quinine in a capsule, or made into a ball, with sufficient linseed meal and molasses, given every three hours during the height of the fever, will do good in many cases. The ball of carbonate of ammonia, as advised in the treatment of bronchitis, may be tried if the animal is hard to drench.
If the horse becomes very much debilitated, stimulants of a more pronounced character are required. The following drench is useful: Rectified spirits, 3 ounces; spirits of nitrous ether, 2 ounces; water, 1 pint. This maj^ be reijeated every four or five hours if it seems to benefit. Or 6 ounces of good whisky, diluted with a pint of water, may be given as often, instead of the foregoing.
There are cases where sedatives are undoubtedly beneficial, but a knowledge both of disease and medicine is required to discriminate in such cases; therefore the only rational course to pursue in a work of this kind is to map out a line of treatment that will do good in all cases and harm in none, and at the same time be within the under- standing of those who have not made a special study of disease.
During the period of convalescence good nutritive food should be allowed in a moderate qviantity. Tonic medicines should be substi- tuted for those used during the fever. The same medicines advised for the c<yaivalescing period of bronchitis are equally efficient in this case. Likewise, the same general instructions apph'' here.
Death Tnay occur during the first stage of the disease, owing to the severity of the fever, or it may occur during the period when the lungs are solidified bj^ the exudate of the inflammation filling up the air cells and broncliial tubes, or it may take place later, when the exudate fails to liquefy and undergo absorption, and is then due to suppura- tion, the formation of an abscess, or gangrene or mortification. As a matter of course pneumonia is most often fatal when both lungs are involved in the inflammation.
In concluding, it ma}^ be well to remind you that if pneumonia is properly treated the great majority of cases will terminate in a com- plete restoration to health. In all cases much will depend on the good
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judgment of the i3ersoii directing tlio treatment of the case. If it is seen that any one thing is doing harm, then that particular thing shonkl be omitted. For instance, if drenching the animal is attended with harm, that is, if it nnnecessarily excites him, or if he obstinately refuses to swallow the medicine, then do not further annoy him by persistently trying to do what you are able to see only makes matters worse. Omit the drenching, and dissolve 3 drams of bicarbonate of potassium in every bucketful of water he will drink of his own free will. Give the quinine in capsules or balls, and also the carbonate of ammonia balls. A balling iron (or mouth speculum) may be obtained from any veterinar}^ instrument dealer. A little practice with it will enable joxi to become somewhat expert in giving medi- cines in the latter form. Do not give quinine and ammonia together; let at least an hour intervene between the administration of the two different medicines.
PLEURISY.
The thoracic cavity is divided into two lateral compartments, each containing one lung, besides other organs. Each lung has its sepa- rate pleural membrane or covering. The anatomical arrangement of the i^leura is simple to the anatomist, but a detailed description of it would be bej' ond the comprehension of the average reader. Suffice it to say that the i)lenra is the thin, glistening membrane that covers the lung, and also completely covers the internal walls of the chest. It is very thin, and to tlie ordinar}^ observer appears to be x^art of the lung, which, in fact, it is for all practical purposes. The smooth, shiny surface of the lung, as well as the smooth, shin}^ surface so familiar on tlie rib, is the pleura. In health this surface is always moist. A fluid (called serum) is thrown off (secreted) by the pleura, which causes the surface to be constantl}' moist. This is to prevent the effects of friction between the lungs and the walls of the chest and other contiguous i^arts which come in contact. It must be remem- bered the lungs are constant!}' dilating each time a breath is taken in, and contracting each time a breatli of air is expelled. It maj^ be readily seen that if it were not for the moistened state of the surface of the pleura the continual dilation and contraction and the conse- quent rubbing of the iDarts against each other would cause a serious friction. This, then, is the office of the pleura — to secrete or moisten its surface with a fluid to prevent the ill effects of friction.
Inflammation of this membrane is called pleui'isy. Being so closely united Avith the lung, it can not always escape participation in the disease when the latter is inflamed. Pleurisy may be due to the same predisposing and exciting causes as mentioned in the beginning of this work as general causes for diseases of the organs of respiration, such as exposure to sudden changes of temperature, confinement in damp stables, etc. It may be caused by wounds that penetrate the chest, for
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it must be remembered that such wounds must necessarily pierce the pleura. A fractured rib may involve the pleura. The inflammation following such wounds may be circumscribed, that is, confined to a small area surrounding the wound, or it may spread from the wound and involve a large portion of the iDleura. The i^leura may be involved secondarily when the heart or its membrane is the x>rim.ary seat of the disease. It may occur in conjunction with bronchitis, influenza, and other diseases. It is commonly seen in connection with rheumatism. Diseased growths that interfere with the i^leura may induce j)leurisy, but it is most frecjuently met with in connection with pneumonia, for the reason given heretofore. Pleurisy will be described here as an independent afCection, although it should be remembered that it is very often associated with the foregoing diseases.
When the animal is affected with pleurisy an ordinary observer should have no diflBculty in detecting the disease, i)rovided the diag- nostic sj-mptoms are studied beforehand. The very first stage is a congested state of the blood vessels in the parts affected ; the surface of the membrane becomes dry and roughened (this fact will be again referred to when the sj'mi^toms are described). This dry condition is followed, after a certain period, by an effusion of fluid, that is, more fluid than usual is thrown off by the membrane when in a diseased condition. This fluid accumulates in the space between the lungs and the walls of the chest, constituting hj'dro-thorax, or dropsy of the chest. This fluid may undergo certain changes ; in it float coagulated masses called- fibrin. The surface of the lung may adhere to the internal surface of the ribs. The quantity of exuded fluid varies to a great extent. In some cases the chest contains an enormous amount, and when it is not absorbed pus may be generated to a greater or less extent.
Symptoms. — When the disease exists as an independent affection it is ushered in by a chill, but this is usually overlooked. About the first thing noticed is the disinclination of the animal to move or turn round. "When made to d6 so he grunts or groans with pain. He stands stiff, the ribs are fixed, that is, the ribs move very little in the act of breathing, but the abdomen works more than natural; both the fore feet and elbows may be turned out; during the onset of the attack the animal may be restless, and acts as if he had a slight colic ; he may even lie down, but does not remain long down, for when he finds no relief he soon gets up. After effusion begins these signs of restless- ness disappear. If the observer looks for it, a furrow will be found running along the lower part of the chest fi'om behind the elbow back to the flank; this is due to the endeavor of the animal to keep the ribs fixed in as near as possible an immovable j)osition. Every movement of the chest causes excruciating x^ain, therefore the cough is peculiar; it is short and suppressed, and comes as near being no cough as the animal can make it in his desire to suppress it. The breathing is
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hurried, the mouth is hot, the temperature being elevated from 102^ or 103° to 105° F. The usual symi^toms that accompany fever are present, such as costiveness, scanty, dark-colored urine, etc. The pulse is frequent, perhaps seventy or more a minute, and is hard and wiry. The legs and eai s are cold.
Percussion is of valuable service in this affection. The ribs may be struck with the knuckles. By striking different parts you will come to a spot of greater or less extent where the blows cause much pain to be evinced. The animal ma}^ grunt or groan every time it is struck. Another method of detecting the affected part is to press the fingers between the ribs, each space in succession, beginning behind the elbow, until you arrive at a place where the pressure causes more flinching than at any other part. Auscultation is also useful. In the first stage, when the surfaces are dry and rough, if the ear is placed against different parts of the chest you will eventually come to the affected part, which will be readily manifested by a friction sound very much like that produced by rubbing two pieces of coarse paper together. The sound appears immediately under the ear, and is dis- tinct. No such friction sound occurs when the membrane is healthy, as the natural moisture, heretofore mentioned, prevents the friction. In many cases this friction is so pronounced that it may be felt by placing the hand over the affected jDart. When the dry stage is suc- ceeded by the exudation of fluid, this friction sound disappears. After the effusion into the cavity takes place there sometimes is heard a tinkling or metallic sound, due to dropping of the exudate from above into the collected fluid in the bottom of the cavity, as the collected fluid more or less separates the lung from the chest walls.
Within two or three days the urgent symptoms are abated, owing to the exudation of the fluid and the subsidence of the pain. The fluid may now undergo absorption, and the case terminate favorably within a week on ten days.
If tlie quantity of the effusion is large, its own volume retards the process of absorption to a great extent, and consequently^ convales- cence is delayed. In some cases the symptoms manifest a serious state. The pulse becomes more frequent, the breathing more hurried and labored, the flanks work like bellows, the nostrils flap, the eyes stare wildly, the countenance expresses much anxiety, and general signs of dissolution are plain. After a time swellings appear under the chest and abdomen and down the legs. These swellings are due to transfusion of the fluid from within the chest into the surround- ing tissues. The accumulation in the chest is called hj'dro-thorax or dropsy of the chest. When this fluid contains pus the case usu- ally proves fatal. The condition of pus within the ca\dty is called empysema.
Pleurisy may affect only a small area of one side, or it may affect both sides. It is oftener confined to the right side.
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Treatme7it.— This varies very little from the treatment of bron- chitis and pneumonia, but as frequently stated lieretofore, pleurisy is so liable to be complicated with either of the diseases named, the variation in the treatment may be considered as merely adjunct treatment of the pleuritic complication.
The instructions in regard to the general management of bronchitis and pneumonia must be adhered to in the treatment of pleurisy. Comfortable quarters, pure air, warm clothing to the body and band- ages to the legs, a plentiful supply of pure cold water, the laxative food, etc., in this case are equally necessary and efficacious. The hot applications applied to the chest as directed in the treatment of pneumonia are very beneficial in pleurisy, and should be kept up while the symptoms show the animal to be in pain.
During the first few days, when pain is manifested by restlessness, do not apply the liniment to the sides of the chest, as it ^^n\l not only irritate the animal and increase the restlessness but will heighten the fever as well. After four or five days, when the symptoms show that the acute stage has somewhat subsided, the liniment may be well rubbed over the affected part with benefit, as it will greatly promote the absorption of the effusion. The application may be repeated on alternate days until several applications have been made. From the beginning the following drench should be given every six hours: Solution of the acetate of ammonia, 3 ounces; spirits of nitrous ether,' 1 ounce; bicarbonate of potassium, 3 drains; water, 1 pint.
If the patient becomes debilitated the stimulants as prescribed for pneumonia should be used according to the same directions. The same attention should be given to the diet. If the animal will par- take of the bran mashes, scalded oats, and grass, it is the best, but ]f he refuses the laxative diet then he should be tried with different kinds of food, and allowed whichever kind he desires.
In the beginning of the attack, if the pain is severe, causing the animal to lie down or paw, the following drench should be given: Tincture of opium, 2 ounces; raw linseed oil, 13 ounces. If the pain continues, the tincture of opium may be repeated within four or five hours.
If the case is not progressing favorably in ten or twelve days after the beginning of the attack, convalescence is delayed by the fluid in the chest failing to be absorbed. The animal becomes dull and weak and evinces little or no desire for food. The breathing becomes still more rapid and difficult. An effort must now be made to excite the absorption of the effusion. An application of the liniment should be rubbed over the lower part of both sides and the bottom of the chest. The following drench should be given three times a day, for seven or eight days if it is necessary and appears to benefit: Tincture of the perchloride of iron, 1 ounce; tincture of gentian, 2 ounces; water, 1 5961 — HOR 0
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pint. Also give 1 dram of iodide of potassium dissolved in the drink- ing-water an lio\ir before feeding, every night and morning for a week or two.
Hydro-thorax is sometimes difficult to overcome by means of the use of medicines alone, when an operation called paracentesis thoracis is performed. In i)lain language this means tapping the chest to allow an escape for the accumulated fluid. The operation is per- formed with a combined instrument called tlie trocar and canula. The puncture is made in the lower part of the chest, in the space between the eighth and ninth ribs. Wounding of the intercostal arteiy is avoided by inserting the instrument as near as possible to the anterior edge of the rib. If the operation is of benefit it is only so when performed before the strength is lowered beyond recovery. The operation merely receives a passing notice here, as it is not pre- sumed that the non-professional will attempt it, although it is attended with little danger or difficulty in the hands of the exj)ert.
We have described bronchitis, pneumonia, and x^leuris}' mainly as thej' occur as independent diseases, and have treated them in a way that an intelligent i:)erson can not possibly do harm. While it is true much more might have been said in regard to the different stages and tyi^es of the affections, and also in regard to the treatment of each stage and each particular type, the jilan adopted is considered the wisest on account of simplifying as much as possible a subject of which the reader is supi^osed to know very little, if anjiihing.
A few words will now be devoted to these affections as thej' occur, when two or more exist at the same time and in the same animal.
PLEURO-PNEUMONIA.
The disease is so called when the animal is affected with pleurisy and pneumonia combined, which is most frequently the case. At the beginning of the attack only one of the affections maj^ be present, but the other soon follows. It has already been stated that the pleura is closely adherent to the lung. The pleura on this account is fre- quently more or less affected by the spreading of the inflammation from the lung tissue. There is a combination of the symptoms of both diseases, but to the ordinary- observer the symptoms of pleurisy are the most obvious. The course of treatment to be pursued differs in no manner from that given for the affections when they occur inde- X)endently. The symj^toms will be your guide as to the advisability of giving oil and laudanum for the pain if the pleurisy is very severe. Do not resort to it unless it is necessary to allay the pain.
BROXCHO-PLEURO-PNEUMONIA.
This Is the term or terms applied when bronchitis, pleurisy, and pneumonia all exist at once. This is bj' no means a common occur- rence. However, it is impossible for one who is not an expert to diag- nose the state with certainty. The apparent symptoms are the same as when the animal is affected with pleuro-imeumonia.
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BRONCHO-PNEUMONIA.
This is also a common comx^lication. Either one or the other may be first in oi)eration. When bronchitis affects the smaller bronchial tubes the inflammation readily extends to the air-cells and thence to the lung- tissue, constituting pneumonia. Or the bronchial lube may be secondarih" involved by the extension of the inflammation from the air-cells. Nothing in regard to the treatment of this condition requires to be said here, as it has been fullj" described when speaking of bron- chitis and ijneumonia as separate diseases. A brief review of some of the unfavorable results of i^leurisy and pneumonia will not be out of place here:
SUPPURATION AND ABSCESS IN THE LUNG.
There are instances, and especially when the surroundings of the patient have been bad, when the inflammation terminates in an abscess in the lung. Sometimes, when the inflammation has been extreme, sui)i3uration in a large portion of the lung takes j)lace. Impure air, the result of improper ventilation, is the most frecxuent cause of this termination. The sjnnptoms of suppuration in the lung are an exceed- ingly offensive smell of the breath, and the discharge of the matter from the nostrils.
MORTIFICATION.
Gangrene or mortiflcation means a death of the i:)art affected. Occa- sionally, owing to the intensity of the inflammation or bad treatment, pneumonia and pleuro-pneumonia terminate in mortification, which is soon followed by the death of the animal.
ABSCESS IN THE SPACES BETWEEN THE RIBS,
Abscess of the intercostal sj)aces has been recorded as a result of pleurisy. Following the attack of lileurisj^ an enlargement appears on some part of the chest, which may burst of its own accord. When it makes its appearance it is advisable to apph^ poultices of linseed meal and hot water, or bathe it continuously for hours at a time with water as hot as can be comfortably borne. This treatment will hasten the formation of matter. When it is soft in the center it should be lanced and the matter allowed to escape. The course of tonic treat- ment and nutritive food advised in the treatment of pleurisy should be kept up.
HEMOPTYSIS — BLEEDING FROM THE LUNGS.
Bleeding from the lungs maj' occur during the course of congestion of the lungs, bronchitis, pneumonia, influenza, purpura hemorrhagica, or glanders. An accident or exertion may cause a rupture of a vessel. Plethora predisposes to it. Following the rupture of a vessel the
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blood may escape into the lung tissue and cause a serious attack of pneumonia, or it may fill uj) the bronchial tubes and prove fatal by suffocating the animal. When the hemorrhage is from the lungs it is accompanied by coughing; the blood is frothy and comes from both nostrils. "Whereas when the bleeding is merely from a rupture of a vessel in some part of the head (heretofore described as bleeding from the nose) the blood is most likely to issue from one nostril only, and the discharge is not accompanied by coughing. The ear may be placed against the windpipe along its course, and if the blood is from the lungs a gurgling or rattling sound will be heard. When it occurs in connection with another disease it seldom requires special treatment. When caused by accident or overexertion the animal should be kept quiet. If the cough is frequent or paroxysmal a dose composed of 2 ounces of tincture of opium in 8 ounces of raw linseed oil may be given to allay the irritability, which may stop the hemorrhage by checking the cough. If the hemorrhage is profuse and continues for several hours 1 dram of the acetate of lead dissolved in a pint of water may be given as a drench, or 1 ounce of the tincture of the perchloride of iron, diluted with a pint of water, may be given instead of the lead. It is rare that the hemorrhage is so profuse as to require internal reme- dies. But hemorrhage into the lung may occur and cause death by suffocation without the least manifestation of it by the discharge of blood from the nose.
CONSUMPTION.
Pulmonary consumi^tion, "the same as phthisis or consumption in man," has been described by European authors as affecting the horse. It is mentioned here merely to give the writer an opportunity to say that he never saw a case of it, and never conversed with a veterinarian on the subject who has met with a case in the horse. This fact does not prove that the horse is exempt from the disease, but it at least ]3roves that it must be rare indeed.
DROPSY OP THE LUNG.
This condition has been noticed as a result of heart disease, and as it is said almost invariably to terminate fatally, no further notice of it is necessary here.
HEAVES — BROKEN WIND — ASTHMA.
Much confusion exists in the popular mind in regard to the nature of broken wind. Many horsemen apply tlie term to all ailments where the breathing is difficult or noisy. Scientific veterinarians are well acquainted with the phenomena and locality of the affection, but there is a great diversity of oi)inion as regards the exact cause. Asthma is generally thought to be due to spasm of the small circular muscles that surround the bronchial tubes. The continued existence of this
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affection of the muscles leads to a paralysis of them, ana is considered one of the primary stages of broken wind.
Some eminent veterinarians maintain that the exciting cause of broken ^rind is due to a lesion of the i^neumogastric nerve. That there is good foundation for this opinion there can be no doubt. The pneu- mogastric nerves send branches to the bronchial tubes, lungs, heart, stomach, etc. All the organs just mentioned may sooner or later be- come involved in connection with broken wind. It may be said that broken wind is always associated with disorder of the function of digestion. It is claimed that coarse or indigestible food irritates the branches of the pneumogastric nerves which supply the walls of the stomach, and this irritation is reflected or extended to the branches of the same nerve which sujjply the lungs, when the lesions consti- tuting broken wind follow.
In itself broken wind is not a fatal disease, but death is generally caused by an affection closely connected with it. After death, if the organs are examined, the lesions found depend much upon the length of time broken wind has affected the animal. In recent cases very few changes are noticeable, but in animals that have been broken- winded for a long time the changes are well marked. The lungs are paler than natural, and of much less weight in x^roportion to the vol- ume, as evidenced by floating them in water. The walls of the small bronchial tubes and the membrane of the larger tubes are thickened. The right side of the heart is enlarged and its cavities dilated. The stomach is enlarged and its walls stretched. And in many old cases the intestinal walls undergo the same changes. The important change found in the lungs is a condition technically called pulmonary emphy- sema. This is of two varieties: First, what is termed vesicular emphysema, which consists of an enlargement of the capacity of the air-cells (air vesicles) by dilation of their walls ; the Avails after a time degenerate, and finally give way, and thus form a communication with other air-cells. The second form is called interlobular emphy- sema, and follows the first. In this variety the air finds its way into the lung tissue between the air-cells, or, as its name indicates, in the tissue between the small lobules.
Symptoms. — Almost every experienced horseman is able to detect "heaves." The peculiar movement of the flanks and abdomen point out the ailment at once. But in recent cases the affected animal does not always exhibit the characteristic breathing unless exerted to a certain extent. The cough which accompanies this disease is peculiar to it. It is difficult to describe, but the sound is short, and something like a grunt.
When air is inspired, that is, taken in, it ai)i)ears to be done in the same manner as in health; it maj" possibly be done a little quicker than natural, but not enough to attract anj' notice. It is when the act of expiration (or expelling the air from the lungs) is perfoi'med
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tnat tne great change in the breathing is i^erceptible. It must now be remembered that the lungs have lost much of their power of con- tracting on account of the degeneration of the Avails of the air-cells, and also on account of the paralysis of muscular t issue before men- tioned. The air j)asses into them freely, but the power to expel it is lost to a great extent by the lungs; therefore the abdominal muscles are brought into play. These muscles, especially in the region of the flank, are seen to contract, then pause for a moment, then comjjlete the act of contracting, thus making a double bellows-like movement at each expiration, a sort of jerkj" motion with every breath. When the animal is exerted a wheezing noise accompanies the breathing. This noise may be heard to a less extent when the animal is at rest if the ear be applied to the chest.
As before remarked, indigestion is always present in these cases. The animal has a depraved appetite, as shown by a desire to eat dirt and soiled bedding, which he often devours in preference to the clean food in the trough or manger. The stomach is liable to be overloaded with indigestible food. The abdomen may assume that form called "pot-bellied." The animal f requentlj' i)asses wind, Avhich is of fi A'ery offensive odor. Attacks of colic may occur, which in some cases are fatal. When first put to work dung is j)assed freciuently; the bowels are often loose. The animal can not stand much work, as the mus- cular system is soft. Round-chested horses are said to be predis- posed to the disease, and it is certain that in cases of long standing the chest usually becomes rounder than natural.
Certain "smart" individuals become very expert in managing a horse affected with "heaves" in suppressing the sjnni^toms for a short time. Thej" take advantage of the fact that the breathing is much easier when the stomach and intestines are empty. They also resort to the use of medicines that have a depressing eft'ect. When the veterinarian is examining a horse for soundness, and he suspects that the animal has been " fixed," he usually gives tlie horse as much water as he will drink and then lias him ridden or driven rapidly up a hill or on a heavy road. This will bring out the characteristic breathing of "heaves." All broken-winded horses have the cough peculiar to the affection, but it is not regular. A considerable time may elax)se before it is heard and then it may come on in paroxysms, especially when first brought out of the stable into the cold air, or when excited by work, or after a drink of cold water. The cough is usually the first symptom of the disease.
Treatment. — When tlie di.sease is established there is no cure for it. Proi^er attention j^aid to the diet will relieve the distressing symptoms to a certain extent, but they will undoubtedly reapjiear in their inten- sitj^ the first time the animal overloads the stomach or is allowed food of bad quality. Putting aside all theories in regard to the primary cause of tlie affection, it is generally admitted that it is closely allied
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to derangement of the digestive organs, most particularly the stoi.i,.c'ii. This l)eing the fact, it is but reasonable to infer that if the animal is allo^ved nothing but food of the best quality the predisposition lo " heaves " is lessened. Clover hay and bulky food generally, which, as a rule, contains biit little nutriment, have much to do with the cause of the disease, and therefore should be entirely omitted when the animal is affected, as well as before. A high authority asserts that the disease is unknown where clover hay is never used. The diet should be confined to food of the best quality and in the smallest qnantit}-. The bad effect of moldy or dusty hay, fodder, or food of anj" kind can not be overestimated. A small quantity of the best hay once ii day is sufficient. The animal should invariably be watered before feeding; never directly after a meal. It is a good plan to slightly dampen the. food to allaj^ the dust. The animal should nat be worked immediately after a meal. Exertion, Avhen the stomach is full, invariablj' aggravates the sjnnptoms. Turning on pasture gives relief. Carrots, iDotatoes, or turnips chopped and mixed with oats or corn are a good diet.
Many different medicines have been tried, but not one has yet been discovered that gives even partial satisfaction in the treatment of broken wind. Arsenic, however, is about the only remedy that retains any reputation of being efficacious in palliating the symptoms. It is best administered in the form of the solution of arsenic in hydrochloric acid (Liq. Acidi. Ars. ), which should be obtained from the drug store, as it is then of a standard preparation. Each ounce of the solution contains a little over 4+ grains of arsenic. A tablesi)oonful mixed with bran and oats three times a da}" for about two weeks, then about twice a daj' for about two vreeks longer, then once a day for several weeks, is a good way to give this remedy. If the bowels do not act regularly, a i)int of raw linseed oil may be given once or twice a month. It must, however, be borne in mind that all medical treat- ment is of secondary consideration ; careful attention i^aid to the diet is of greatest importance. Broken-winded animals should not be used for breeding purposes. A iDredisposition to the disease is likely to be inherited.
CHRONIC COUGH.
A chronic cough may succeed the acute diseases of the respiratory organs, such as pneumonia, bronchitis, larj^ngitis, etc. It accompa- nies chronic roaring, chronic bronchitis, broken wind. It may suc- ceed influenza. As previouslj" stated, cough is but a symptom and not a disease in itself. Chronic cough is occasionallj' associated with diseases other than those of the organs of respiration. It may be a symptom of chronic indigestion or of worms. In such cases it is caused by a reflex nervous irritation. The i^roper treatment in all cases of chronic coug-h is to ascertain the nature of the disease of
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wliicli it is a symptom, and then cure tlie disease if possible, and the cough will cease.
The treatment of the affections will be found under their appro- priate heads, to which the reader is referred.
PLEURODYNIA.
This is a form of rheumatism that affects the intercostal muscles, that is, the muscles between the ribs. The apparent symptoms are very similar to those of pleurisy. The animal is stiff and not inclined to turn around; the ribs are kept in a fixed state as much as possible. If the head is pulled round suddenly, or the affected side struck with the hand, or if the spaces between the ribs are pressed with the fingers the animal will flinch and perhaps emit a grunt or groan expressive of much pain. It is distinguished from pleurisy by the absence of fever, cough, the friction-sound, the effusion into the chest, and by the existence of rheumatism in other parts. The treatment for this affection is the same as for rheumatism affecting other parts.
WOUNDS PENETRATING THE AVALLS OF THE CHEST.
According to the theory of some teachers of phj'-siology, Avhen an opening is made in the wall of the chest sufficient for the admission of air a collapse of the lung should occur. But in practice this is not always found to be the case. The writer has attended several such cases, and one in particular was not seen until about twelve hours after the wound was inflicted. It is true the breathing was consider- ably altered, but no bad effect followed the admission of air into the thoracic cavity. The wound was closed and treated according to the method of treating wounds generally, and a speedy and perfect recov- ery was made. The Avound may not penetrate the pleura; in such cases no great harm is done, but if the pleura is penetrated pleurisy may follow, and even pneumonia if the wound involves the lung.
The condition called pneumo-thorax means air in the chest. This may be due to a wound in the wall of the chest, or it may be due to a broken rib, the sharp edge of which wounds the lung sufficiently to allow air to escape into the space between the lung and ribs, which is naturally a vacuum. Air gaining access to the thoracic cavity through a wound may have a peculiar effect. The wound may be so made that when the walls of the chest are dilating a little air is sucked in, but during the contraction of the wall the contained air presses against the torn part in such a manner as to entirely close the wound ; thus a small quantity of air gains access with each inspiration, while none is allowed to escape until the lung is pressed into a very small compass and forced into the anterior part of the chest. The same thing may occur from a broken rib inflicting a wound in the lung. In this form the air gains access from the lung, and there may not even be an open- ing in the walls of the chest. Decomposition of the fluid in hydro- thorax, with consequent generation of gases, is said to have caused
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the same condition. In such cases the air is generally absorbed, and a spontaneous cure is the result. But when the symptoms are urgent it is recommended that the air be removed by a trocar and canula or by an asj)irator.
The treatment of wounds that penetrate the thoracic cavity should, for the foregoing reason, be prompt. It should be quickly ascertained whether or not a foreign body remains in the wound, then it should be thoroughly cleaned with a solution of carbolic acid one part in water forty parts. The Avound should then be closed immediately. If it is an incised wound it should be closed with sutures; if torn or lacerated, a bandage around the chest over the dressing is the best plan. At all events, air must be prevented from getting into the chest, as soon and as effectually as possible. The after treatment of the wound should principalh^ consivSt in keeijing the parts clean with the solution of car- bolic acid, and applying fresh dressing as often as required to keep the wound in a healthy condition. Care should be taken that the dis- charges from the vround have an outlet in the most dependent part. (See Wounds.) If the wound causes much pain it should be allayed with a dose of tincture of opium in raw linseed oil, as advised in the treatment of pleurisy. If pleurisy supervenes, it should be treated as advised under that head.
THUMPS — SPASM OF THE DIAPHRAGM.
"Thumps" is generally thought to be, b}^ the inexperienced, a pal- pitation of the heart. While it is true that palpitation of the heart is sometimes called "thumps," it must not be confounded with the affection under consideration.
In the beginning of this article on the diseases of the organs of res- piration the diaphragm was briefly referred to as the principal and essential muscle of respiration. Spasmodic or irregular contractions of it in man are manifested by what is familiarly known as hiccoughs. Thumps in the horse is identical with hiccoughs in man, although the peculiar noise is not made in the throat of the horse in all cases.
There should be no difficult}' in distinguishing this affection from palpitation of the heart. The jerky motion affects the Avhole body, and is not confined to the region of the heart. If one hand is placed on the body at about the middle of the last rib, while the other hand is placed over the heart behind the left elbow, it will be easily demon- strated that there is no connection between the thumping or jerking of the diaiihragm and the beating of the heart. If the ear is placed against the body it will be discovered that the sound is made posterior to the region of the heart. In fact, when the animal is affected with spasms of the diaphragm the beating of the heart is usually much weaker and less perceptible than natural. Thumps is produced by the same causes which produce congestion of the lungs, and is often oDGl— HOP 5*
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seen in connection witli the latter disease. If not relieved, death usually results from congestion of the lungs, as the breathing is inter- fered with by the inordinate action of this the princii)al muscle of inspiration so much that proper aeration of the blood can not take place. The treatment should be precisely the same as prescribed for congestion of the lungs.
RUPTURE OF THE DIAPHRAGM,
Post mortem examinations reveal a great many instances of rupture of the diaphragm. It is the general opinion among veterinarians that this takes place after death, and is due to the generation of gases in the decomposing carcass, which distend the intestines so that the dia- pliragm is ruptured by the great pressure against it. Of course it is X)ossible for it to haiipen before death and by strangulating the kriuckle of intestine that may be in the rupture cause death; but there are no symptoms b}^ which it may be diagnosed.
DISEASES OF THE GENERATIVE ORCxANS.
By Dr. JAMES LAW, F. R. C. V. S.,
Professor of Veterinary Science, etc., in Cornell University.
COXGESTIOX AND INFLAMMATION OF THE TESTICLES — ORCHITIS.
• lu the prime of life, in vigorous liealtli, and on stimulating food stallions are subject to congestion of the testicles, which become swollen, hot, and tender, but without any active inflammation. A reduction of the grain in the feed, the administration of 1 or 2 ounces of Glauber salts daily in the food, and the bathing of the affected organs daily with tepid water or alum water will usually restore them to a healthy condition.
When the factors producing congestion are extraordinarily potent, when there has been frequent copulation and heavy grain feeding, when the weather is warm and the animal has had little exercise, and when the proximity of other horses or mares excite the generative instinct without gratification, this congestion may grow to actual inflammation. Among the other causes of orchitis are blows and pen- etrating wounds implicating the testicles, abrasions of the scrotum by a chain or rope passing inside the thigh, contusions and frictions on the gland under rapid paces or heavy draught, compression of the blood- vessels of the spermatic cord by the inguinal ring under the same cir- cumstances, and finally, sympathetic disturbance in cases of disease of the kidneys, bladder, or urethra. Stimulants of the generative functions, like rue, savin, tansy, cantharides, and daniiana may also be accessory causes of congestion and inflammation. Finally, certain specific diseases like vial du coU, glanders, and tuberculosis, localized in the testicles, will cause inflammation. Apart from actual wounds of the parts the symptoms of orchitis are swelling, heat, and tender- ness of the testicles, straddling with the hind legs alike in standing and walking, stiffness and dragging of the hind limbs or of the limb on the affected side, arching of the loins, abdominal pain, mani- fested by glancing back at the flank, with more or less fever, ele- vated body temperature, accelerated pulse and breathing, inappetence,
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and dullness. In bad cases tlie scanty urine may be reddish and the swelling may extend to the skin and envelopes of the testicle, which may become thickened and doughy, pitting on pressure. The swelling may be so much greater in the convoluted excretory duct along the upper border of the testicle as to suggest the presence of a second stone. Even in the more violent attacks the intense suffering abates some- what on the second or third day. If it lasts longer it is likely to give rise to the formation of matter (abscess). In exceptional cases the tes- ticle is struck with gangrene or death. Improvement may go on slowly to complete recovery, or the malady may subside into a subacute and chronic form with induration. Matter (abscess) may be recognized by the i^resence of a soft spot, where pressure with two fingers will detect fluctuation from one to the other. When there is liquid exu- dation into the scrotum, or sack, fluctuation may also be felt, but the liquid can be made out to be around the testicle and can be pressed up into the abdomen through the inguinal canal. When abscess occurs in the cord the matter may escape into the scrotal sack and cavity of the abdomen and pyaemia may follow.
Treatment consists in perfect rest and quietude, the administration of a purgative (1 pound to 1^ pounds Glauber's salts), and the local application of an astringent lotion (acetate of lead 2 drams, extract of belladonna 2 drams, and water 1 quart) upon soft rags or cotton wool, kept in contact with the j^art by a suspensory bandage. This bandage, of great value for support, may be made nearly triangular and tied to a girth around the loins and to the upper i^art of the same surcingle by two bands carried backwai'd and upward between the thighs. In severe cases scarifications one-fourth inch deej) serve to relieve vascu- lar tension. When abscess is threatened its formation may be favored by warm fomentations or poultices, and on the occurrence of fluctua- tion the knife may be employed to give free escape to the pus. The resulting cavity may be injected daily with a weak carbolic acid lotion, or salol may be introduced. The same agents may be used on a gland threatened with gangrene, but its promj)t removal by castration is to be preferred, antiseptics being applied freely to the resulting cavity.
SARCOCELE.
This is an enlarged and indurated condition of the gland resulting from chronic inflammation, though it is often associated with a specific deposit like glanders. In this condition the natural structure of the gland has given place to embryonal tissue (small, round cells, with a few fibrous bundles), and its restoration to health is very improbable. Apart from active inflammation, it may increase very slowly. The diseased testicle is enlarged, firm, non-elastic, and comparatively in- sensible. The skin of the scrotum is tense, and it may be cedematous (pitting on pressure), as are the deeper envelopes and spermatic cord. If liquid is present in the sack the symjitoms are masked somewhat.
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As it incre^ises it causes awkward, straddling, dragging movement of the hind limbs, or lameness on the affected side. The spermatic cord often increases at the same time with the testicle, and the inguinal ring being thereby stretched and enlarged, a portion of intestine may escape into the sack, complicating the disease with hernia.
The only rational and effective treatment is castration, and even this may not succeed when the disease is specific (glanders, tuberculosis).
HYDROCELE — DROPSY OF THE SCROTUM.
This may be merely an accompaniment of dropsy of the abdomen, the cavity of which is continuous with that of the scrotum in horses. It ma}^ be the result, however, of local disease in the testicle, spermatic cord, or walls of the sack.
The symptoms are enlargement of the scrotum, and fluctuation under the fingers, the testicle being recognized as floating in water. Jiy jjressure the liquid is forced, in a slow stream, and with a percep- tible thrill, into the abdomen. Sometimes the cord, or the scrotum, is thickened and i)its on pressure.
Treatment may be the same as for ascites, yet when the effusion has resulted from inflammation of the testicle or cord, astringent applications (chalk and vinegar) may be applied to these. Then if the liquid is not reabsorbed under diuretics and tonics, it may be drawn off through the nozzle of a hypodermic syringe, which has been first passed through carbolic acid. In geldings it is best to dissect out the sacks.
VARICOCELE.
This is an enlargement of the venous network of the spermatic cord, and gives rise to general thickening of the cord from the testicle up to the ring. The same astringent dressings may be tried as in hydrocele, and this failing castration may be resorted to.
ABNORMAL NUMBER OF TESTICLES.
Sometimes one or both testicles are wanting; in most such cases, however, they are merely partially developed, and retained in the inguinal canal, or abdomen (cryptorchid). In rare cases there may be a third testicle, the animal becoming to this extent a double mon- ster. Teeth, hair, and other indications of a second foetus have like- wise been found in the testicle, or scrotum.
DEGENERATION OF THE TESTICLES.
The testicles may become the seat of fibrous, calcareous, fatty, carti- laginous, or cystic degeneration, for all of which the appropriate treat- ment is castration. They also become the seat of cancer, glanders, or tuberculosis, and castration is requisite, though with less hope of arresting the disease. Finally they may become infested with cystic tape-worms, or the armed round worm {sclerostomum equinum).
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WARTS ON THE PENIS.
These are best removed bj^ seizing them between the thumb and forefinger and tAvisting them off. Or they may be cnt off with scis- sors and the roots cauterized with nitrate of silver.
DEGENERATION OF PENIS — PAPILLOMA, EPITHELIOMA.
Tlie penis of tlie horse is subject to great cauliflower-like growths on its free end, which extend back into the substance of the organ, obstruct the passage of urine, and cause very fetid discharges. The only resort is to cut them off, together with whatever portion of the l)enis has become diseased and indurated. The operation, which should be i)erformed by a veterinary surgeon, consists in cutting through the organ from its upper to its lower aspect, twisting or tjing the two dorsal arteries and leaving the urethra longer b}^ half an inch to 1 inch than the adjacent structures.
EXTRAVASATION OF BLOOD IN THE PENIS.
As the result of kicks, blows, or of forcible striking of the yard on the thighs of the mare which it has failed to enter, the penis may become the seat of effusion of blood from one or more ruptured blood- vessels. This gives rise to a more or less extensive swelling on one or more sides, followed by some heat and inflammation, and on recov- er}^ a serious curving of the organ. The treatment in the early stages may be the api)lication of lotions, of alum, or other astringents, to limit the amount of effusion and favor absorption. The penis should be suspended in a sling.
PARALYSIS OF THE PENIS.
This results from l)lows and other injuries, and also in some cases fi'om too frequent and exhausting service. The yard hangs from the sheath, flaccid, pendulous, and often cold. The passage of urine occurs with lessened force, and especially without the final jets. In cases of local injurj^ the inflammation should first be subdued by astringent and emollient lotions, and in all cases the system should be invigorated bj^ nourishing diet, while 30-grain doses of nux vomica are given twice a day. Finallj^, a weak current of electricity sent through the penis from just beneath the anus to the'free portion of the yard, continued for ten or fifteen minutes and repeated daily, may prove successful.
SELF- ABUSE — MASTURBATION,
Some stallions acquire this vicious habit, stimulating the sexual instinct to the discharge of semen, by rubbing the penis against the helly or between the fore limbs. Tlie only remedy is a mechanical
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one, the fixing of a net under the penis in such fashion as will pre- vent the extension of the penis, or so prick the organ as to compel the animal to desist through pain.
MAL DU COIT-^DOUEINE.
Til is is i)ropagated, like sj^philis, b}' the act of copulation and affects stallions and mares. It has heen long known in Xorthern Africa, Arabia, and Continental Europe. It was imported into Illi- nois in 1882 in a Percheron horse.
From one to ten days after copulation, or in stallions it maj' be after some weeks, there is irritation, swelling and a livid redness of the external organs of generation, sometimes followed by the eruption of small blisters one-fifth of an inch across, on the i^enis, the vulva, clitoris, and vagina, and the consequent rupture of these vesicles and the formation of ulcers or small open sores. Vesicles have not been noticed in this disease in the dry climate of Illinois. In the mare there is frequent contraction of the vulva, urination, and the dis- charge of a watery and later a thick viscid liquid of a whitish, yel- lovvdsh, or reddish color, which collects on and soils the tail. The swelling of the vulva increases and decreases alternately, affecting one part more than another and giving a distorted appearance to the opening. The affection of the skin leads to the appearance of circu- lar white spots, which may remain distinct or coalesce into extensive patches which persist for months. This with the soiled tail, red, swollen, puckered, and distorted vulva, and an increasing weakness and paralysis of the hind limbs, serve to characterize the affection. The mare rarely breeds, but ■^^^.ll take the male and thus pro^^agate the disease. The disease winds up with great emaciation and stu- pidit}', and death in four months to two years. In horses which serve few mares there ma}^ be only swelling of the sheath for a j'ear, but with frequent copulation the progress is more rapid. The penis may be enlarged, shrunken, or distorted; the testicles are unusualh^ pen- dent and may be enlarged or wasted and flabby; the skin, as in the mare, shows white spots and patches. Later the i^enis becomes par- tially paralyzed and hangs out of the sheath; swelling of the adjacent Ij-mphatic glands (in the groin) and even of distant ones, and of the skin, appear, and the hind limbs become weak and unsteady. In some instances the glands under the jaw swell, and a discharge flows from the nose as in glanders. In other cases the itcliing of the skin leads to gnawing and extensive sores. Weakness, emaciation, and stupidity increase until death, in fatal cases, yet the sexual desire does not seem to fail. A stallion without sense to eat except when food was put in his mouth, would still neigh and seek to follow mares. In mild cases an apparent recovery may ensue, and through such animals the disease is propagated to new localities to be roused into activity and extension under the stimulus of service.
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The diseased nerve centers are the seat of eryptogamic growths. (Thannhoffer. )
Treatment of the maladj^ has i? roved eminently unsatisfactory. It belongs to the purely contagious diseases, and should be stamped out by the remorseless slaughter or castration of every horse or mare that has had sexual congress with a diseased animal. A provision for Government indemnity for the animals so destroyed or castrated, and a severe penalty for putting any such animal to breeding, would serve as effectual accessory resorts.
CASTRATION OF STALLIONS.
This is usually done at one year old, but may be accomplished at a few weeks old, at the expense of an imperfect development of the fore parts. The simplicity and safety of the operation are greatest in the young. The delaj^ till two, three, or four years old Avill secure a better development and carriage of the fore parts. The essential part of castration is the safe removal or destruction of the testicle and the arrest or prevention of bleeding from the spermatic artery found in the anterior part of the cord. Into the many methods of accomplishing this, limited space forbids us to enter here, so that the method most commonly adopted, castration by clamps, will alone be noticed. The animal having been thrown on his left side, and the right hind foot drawn up on the shoulder, the exposed scrotum, penis, and sheath are washed with soap and water, any concretion of sebum being carefully removed from the biloeular cavity in the end of the penis. The left spermatic cord, just above the testicle, is now seized in the left hand, so as to render the skin tense over the stone, and the right hand, armed with the knife, makes an incision from before backward, about three-fourths of an inch from and parallel to the median line between the thighs, deep enough to expose the testicle and long enough to allow that organ to start out through the skin. At the moment of making this incision the left hand must grasp the cord very firmly, otherwise the sudden retraction of the testicle by the cremaster muscle may draw it out of the hand and upwards through the canal and even into the abdomen. In a few- seconds, when the struggle and retraction have ceased, the knife is inserted through the cord, between its anterior and jjosterior portions and the latter, the one which the muscle retracts, is cut completely through. The testicle will now hang limp and there is no longer any tendency to retraction. It should be pulled down until it will no longer hang loose below the wound and the clamps applied around the still attached portion of the cord, close up to the skin. The clamps, Avhich may be made of any tough wood, are grooved along the center of the surfaces opposed to each other, thereby fulfilling two important indications, (a) enabling the clamps to hold more securely and {h) providing for the application of an antiseptic to the cord. For this purpose a dram
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of sulphate of copper may be mixed with an ounce of lard and pressed into the groove in the face of each clamp. In applying the clamp over the cord it should be drawn so close with jjincers as to press out all blood from the compressed cord and destroy its vitality-, and the cord applied upon the comijressing clamps should be so hard- twined that it will not stretch later and slacken the hold. When the clamp has been fixed the testicle is cut off one-half to 1 inch below it, and the clamp may be left thus for twenty-four hours; then, by cutting the cord around one end of the clamp, the latter may be opened and the stump liberated, without any danger of bleeding. Should the stump hang out of the wound it should be pushed inside with the finger and left there. The wound should begin to discharge white matter on the second day in hot weather, or the third in cold, and from that time a good recovery may be expected.
CONDITIOXS FAVORABLE TO SUCCESSFUL CASTRATION.
The young horse suffers less from castration than the old, and very rarely perishes. Good health in the subject is all important. Castra- tion should never be attemjited during the prevalence of strangles, influenza, catarrhal fever, contagious pleurisy, bronchitis, pneumonia, purpura hsemorrhagica, or other specific disease, nor on subjects that have been kept in close, illy ventilated, filthy buildings, where the system is liable to have been charged with putrid bacteria or other products. Warm weather is to be preferred to cold, but the fly time should be avoided or the flies kept at a distance by the apjilication of a watery solution of tar, carbolic acid, or camphor to the wound.
CASTRATION OF CRYPTORCHIDS (RIDGLINGS).
This is the removal of a testicle or testicles that have failed to descend into the scrotum, but have been detained in the inguinal canal or inside the abdomen. The manipulation requires an accurate anatomical knowledge of the parts, and special skill, experience, and manual dexterity, and can not be made clear to the unprofessional mind in a short notice. It consists, however, in the discovery and removal of the missing gland by exploring through the natural chan- nel (the inguinal canal), or, in case it is absent, through the inguinal ring or through an artificial opening made in front and above that channel between the abdominal muscles and the strong fascia on the inner side of the thigh (Poupart's ligament). Whatever method is used, the skin, hands, and instruments should be rendered aseptic with a solution of mercuric chloride 1 part; Avater 2,000 parts (a car- bolic acid lotion for the instruments), and the spermatic cord is best torn through by the ecraseur. In many such cases, too, it is desirable to sew uj) the external wound and keep the animal still, to favor healing of the wound by adhesion.
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PAIX AFTER CASTRATION.
Some horses are pained and very restless for some hours after cas- tration, and this may extend to cramjis of tlie howels and violent colic. This is best kept in check by carefully rubbing the patient dry when he rises from the operation, and then leading him in hand for some time. If the pain still persists a dose of laudanum (1 ounce for an adult) may be given.
BLEEDING AFTER CASTRATION.
Bleeding from the wound in the scrotum and from the little artery in the posterior portion of the spermatic cord always occurs, and in warm weather may appear to be quite free. It scarcely ever lasts, however, over fifteen minutes, and is easilj" checked by dashing cold water against the part.
Bleeding from the spermatic artery in the anterior part of the cord may be dangerous when due precaution has not been taken to prevent it. In such case the stump of the cord should be sought for and the artery twisted with artery forceps or tied Avith a silk thread. If the stump can not be found, pledgets of tow wet with tincture of muriate of iron may be stuffed into the canal to favor the formation of clot and the closure of the artery.
STRANGULATED SPERMATIC CORD.
If in castration the cord is left too long, so as to hang out of the wound, the skin wound in contracting grasps and strangles it, pre- venting the free return of blood and causing a steadily advancing swelling. In addition the cord becomes adherent to the lips of the wound in the skin, whence it derives an increased supply of blood, and is thereby stimulated to more rapid swelling. The subject walks stiffly, with straddling gait, loses appetite, and has a rapid pulse and high fever. Examination of the wound discloses the partial closure of the skin wound, and the protrusion from its lips of the end of the cord, red, tense, and varying in size from a hazel-nut upward. If there is no material swelling and little protrusion the wound may be enlarged with the knife and the end of the cord broken loose from any connection with the skin, and pushed up inside. If the swelling is larger the mass constitutes a tumor, and must be removed. (See below. )
SWELLING OF THE SHEATH, PENIS, AND ABDOMEN.
This occurs in certain unhealthy states of the system, in unhealthy seasons, as the result of operating without cleansing the sheath and penis, or of keeping the subject in a filthy, impure building, as the result of infecting the wound by hands or instruments bearing septic bacteria, or as the-result of i^remature closure of the wound, and im- prisonment of matter.
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Pure air and cleanliness of groin and wound are to be secured. Antiseptics, like the mercuric chloride lotion (li)art to 2,000) are to be applied to the parts; the wound, if closed, is to be opened anew, any accumulated matter or blood washed out, and the antiseptic liquid freely applied. The most tense or dependent parts of the swelling in sheath or penis, or beneath the belly, should be pricked at intervals of 3 or 4 inches, and to a depth of half an inch, and antiseptics freely used to the surface. Fomentations with warm water may also be used to favor oozing from the incisions and to encourage the formation of white matter in the original wounds, which must not be allowed to close again at once. A free, cream-like discharge imi:)lies a healthy action in the sore, and is the precursor of recovery.
PHYMOSIS AND PARAPHYMOSIS.
In cases of swelling, as above, the j)enis may be imprisoned within the sheath (phjanosis) or protruded and swollen so that it can not be retracted into it (paraphj-mosis). In these cases the treatment indi- cated above, and especially tlie scarifications, will prove a useful j)re- liminaiy resort. The use of astringent lotions is always desirable, and in case of the protruded x)enis the application of an elastic or simple linen bandage, so as to press out the blood and accumulated fluid, vrill enable the operator to return it.
TUMORS ox THE SPERMATIC CORD.
These are due to rough handling or dragging upon the cord in cas- tration, to strangulation of unduly long cords in the external wound, to adhesion of the end of the cord to the skin, to inflammation of the cord succeeding exjDosure to cold or wet, or to the presence of septic or irritant matters. These tumors give rise to a stiff, straddling gait, and may be felt as hard masses in the groin connected above with the cord. They may continue to grow slowly for manj^ j'ears until they reach a weight of 15 or 20 pounds, and contract adhesions to all sur- rounding parts. If disconnected from the skin and inguinal canal they may be removed in the same manner as the testicle, while if larger and firmh' adherent to the skin and surrounding parts generally they must be carefully dissected from the parts, the arteries being tied as they are reached and the cord finally torn through with an ecraseur. When the cord has become swollen and indurated uj) into the abdomen such removal is impossible, though a partial destruction of the mass may still be attempted by passing white hot pointed irons upward toward the inguinal ring in the center of the thickened and indurated cord.
CASTRATION BY THE COVERED OPERATION.
This is only required in case of hernia or protrusion of bowels or omentum into the sack of the scrotum, and consists in the return of
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the hernia and tlie application of the caustic clamps over the cord and inner walls of the inguinal canal, so that the walls of the latter become adherent above the clamps, the canal is obliterated, and further pro- trusion is hindered. For the full description of this and of the oi^era- tion for hernia in geldings, see article on hernia.
CASTRATION OF THE MARE.
Castration is a much more dangerous operation in the mare than in the females of other domesticated quadrupeds, and should never be resorted to except in animals that become unmanageable on the recur- rence of heat, and that will not breed or that are utterly unsuited to breeding. Formerly the operation was extensively practiced in Europe, the incision being made through the flank, and a large pro- portion of the subjects perishing. By operating through the vagina the risk can be largely obviated, as the danger of unhealthy inflam- mation in the wound is greatly lessened. The animal should be fixed in a trevis, with each foot fixed to a post and a sling placed under the body, or, better, it may be thrown and put under chloroform. The manual operation demands special professional knowledge and skill, but it consists essentially in making an opening through the roof of the vagina just above the neck of the womb, then following with the hand each horn of the womb' until the ovary on that side is reached and grasped between the lips of forceps and twisted ofl". It might be torn off by an ecraseur especially constructed for the purj)ose. The straining that follows the operation may be checked by ounce doses of laudanum, and any risk of j)rotrusion of the bowels may be obvi- ated by appljang the truss advised to prevent e version of the womb. To further prevent the pressure of the abdominal contents against the vaginal wound the mare should be tied short and high for twenty-four or forty-eight hours, after which I have found it best to remove the truss and allow the privilege of lying down. Another important point is to give bran mashes and other laxative diet only, and in moderate quantity, for a fortnight, and to unload the rectum by copious injec- tions of warm water in case it should threaten to become impacted,
STERILITY.
Sterility may be in the male or in the female. If due to the stallion, then all the mares put to him remain barren; if due to the mare, she alone fails to conceive.
In the stallion sterility may be due to the following causes: (a) Imperfect development of the testicles, as in cases in which they are retained within the abdomen ; (b) inflammation of the testicles, result- ing in induration ; (c) fatty degeneration of the testicles, in stallions liberally fed on starchy food and not sufficiently exercised; (d) fatty degeneration of the excretory ducts of the testicles {vasa deferentia) ; (e) inflammation or ulceration of these ducts; (/) inflammation or
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ulceration of the mucous membrane covering the penis; {y) injuries to the penis from blows (often causing paralysis) ; (h) warty growths, on the end of the penis; (i) tumors of other kinds (largely pigmentary) affecting the testicles or penis; (j) nervous diseases Avhich abolish the sexual appetite, or that control over the muscles which is essential to the act of coition ; (k) azoturia with resulting weakness or paralysis of the muscles of the loins or the front of the thigh (above the stifle) ; (/) ossification (anchylosis) of the joints of the back or loins, which renders the animal unable to rear or mount; {m) spavins, ringbones, or other i^ainf ul affections of the hind limbs, the pain of which in mounting causes the animal to suddenly stop short in the act. In the first three of these only (a, h, and c) is there real sterility in the sense of the non-development or imperfect development of the male vivify- ing element (spermatozoa). In the other examijles the secretion may be i)erfect in kind and amount, but as copulation is prevented it can not reach and imi)regnate the ovum.
In the mare barrenness is equally due to a variety of causes. In a number of breeding studs the proportion of sterile mares has varied from 20 to 40 per cent. It may be due to : (a) Imperfect development of the ovary and non-maturation of ova; (&) cystic or other tumors of the ovary; (c) fatty degeneration of the ovary in very obese, pam- pered mares; (d) fatty degeneration of the excretory tubes of the ovaries (fallopian tubes); (e) catarrh of the womb, Avith muco- purulent discharge; (/) irritable condition of the womb, with profuse secretion, straining, and ejection of the semen; {g) nervous irritabil- ity, leading to the same expulsion of the male element; (h) high con- dition (plethora) with profuse secretion and excitement; {i) low condition with imperfect maturation of the ova and lack of sexual desire ; (j) poor feeding, overwork, and chronic debilitating diseases, as leading to the condition just named; (k) closure of the neck of the womb, temporarily by spasm, or permanently by inflammation and induration; (Z) closure of the entrance to the vagina through imjierf orate hymen, a rare though not unknown condition in the mare; (?//) acquired indisposition to breed, seen in old, hard-worked mares, which are first put to the stallion when aged; {n) change of climate has repeatedly been followed by barrenness; (o) hybridity, which in male and female alike usually entails sterility.
The treatment of the majority of these conditions will be found dealt with in other parts of this work, so that it is only necessary here to name them as causes. Some, however, must be siDcciallj^ referred to in this place. Stallions with undescended testicles are beyond the reach of medicine, and should be castrated and devoted to other uses. Indurated testicles may sometimes be remedied in the early stages by smearing with a weak iodine ointment daily for a length of time, and at the same time invigorating the system by liberal feeding and judicious work. Fatty degeneration is best met by an albuminoid
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diet (wheal bran, cotton-seed meal, rape cake) and constant well-regu- lated work. Saccharine, starchy, and fatty food (potatoes, wheat, corn, etc.) are to be specially avoided. In the mare one diseased and irritable ovarj^ should be removed, to do away with the resulting excitabilit}^ of the remainder of the generative organs. An irritable womb, with frequent straining and the ejection of a profuse secretion, may sometimes be corrected by a restricted diet and full but well- regulated work. Even fatigue will act beneficially in some such cases, hence the practice of the Arab riding his mare to exhaustion just before service. The perspiration in such a case, like the action of a purgative or the abstraction of blood just before service, benefits, by rendering the blood-vessels less full, by lessening secretion in the womb and elsewhere, and thus counteracting the tendency to the ejection and loss of semen. If these means are ineffectual a full dose of camphor (2 drams) or of salacin may at times assist. Low condi- tion and anremia demand just the opT)osite kind of treatment — rich, nourishing, albuminoid food, bitter tonics (gentian), sunshine, gentle exercise, liberal grooming, and supj)orting treatment generally are here in order. Spasmodic closure of the neck of the womb is com- mon and is easih' remedied in the mare by dilatation with the fingers. The hand, smeared ■s\ith belladonna ointment and with the fingers drawn into the form of a cone, is introduced through the vagina until the projecting, rounded neck of the womb is felt at its anterior end. This is opened by the careful insertion of one finger at a time until the fingers have been passed through the constricted neck into the oj)en cavity of the womb. The introduction is made with a gentle, rotary motion, and all precipitate violence is avoided, as abrasion, laceration, or other cause of irritation is likely to interfere with the re- tention of the semen and with impregnation. If the neck of the womb is rigid and unyielding from the induration which follows inflamma- tion— a rare condition in the mare, though common in the cow — more force will be requisite, aiid it maj' even be needful to incise the neck to the depth of one-sixth of an inch in four or more opposite direc- tions, prior to forcible dilatation. The incision may be made with a probe-pointed knife, and should be done hy a professional man if possible. The subsequent dilatation may be best effected by the slow expansion of si)onge or seaweed tents inserted into the narrow canal. In such cases it is best to let the wounds of the neck heal before put- ting to horse. An imperforate hymen may be freely incised in a crucial manner until the passage will admit the human hand. An ordinary knife may be used for this puri^ose, and after the operation the stallion may be admitted at once or onlj^ after the wounds have healed.
INDICATIOXS OF PREGNANCY.
As the mere fact of service by the stallion does not insure preg- nancy, it is important that the result should be determined, to save
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the mare from unnecessary and dangerous work or medication Avhen actually in foal and to obviate wasteful and needless precautions when she is not.
The cessation and non-recun-ence of the sj'mptomsof heat (horsing) is a most signiticant though not infallible sign of conception. If the sexual e?ccitement speedih' subsides and the mare persistently refuses the stallion for a month, she is probabl}' pregnant. In verj- excep- tional cases a mare will accept a second or third service after weeks or months, though pregnant, and some mares will refuse tlie horse persistenth", though conception has not taken place, and this in spite of v.arm weather, good condition of the mare, and liberal feeding. The recurrence of heat in the pregnant mare is most likely to take place in hot weather. If heat merely persists an undue length of time after service, or if it reappears shortly after, in warm weather and in a comparatively idle mare, on good feeding, it is less signifi- cant, while the persistent absence of heat under such conditions may be usually accepted as proof of conception.
An unwonted gentleness and docilit}" on the part of a i)reviously irritable or vicious mare, and supervening on service, is an excellent indication of pregnancy, the generative instinct which caused the excitement having been satisfied.
An increase of fat, with softness and flabbiness of muscle, a loss of energy, indisposition for active work, a manifestation of laziness, indeed, and of fatigue early and easilj^ induced, when preceded by service", will usuallj^ imply conception.
Enlargement of the abdomen, especiall}' in its lower third, with sliglit falling in beneath the loins and hollowness of the back are significant symptoms, though they may be entirely absent. Swelling and firmness of the udder, with the smoothing out of its wrinkles, is a suggestive sign, even though it aT)pears only at intervals during gestation.
A steady increase in weight (14 i)ounds daily) about the fourth or fifth month is a useful indication of i^regnancy. So is a swollen and red or bluish-red appearance of the vaginal mucous membrane.
From the seventh or eighth mouth onward the foal may be felt bj^ the hand (palm or knuckles) pressed into the abdomen in front of the left stifle. The sudden push displaces the foal toAvard the opposite side of the womb, and as it floats back its hard body is felt to strike against the hand. If the pressure is maintained the movements of the live foal are felt, and especially in the morning and after a drink of cold water, or during feeding. A drink of cold water will often stimulate the foetus to movements that may be seen by the eye, but an excess of iced water may pi-ove injurious, even to the causing of abortion. Cold water da.shed on the belh^ has a similar effect on the foetus and equally endangers abortion.
Examination of the uterus with the oiled hand introduced into tlie rectum is still more satisfactory, and if cautiously conducted no more
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dangerous. The rectum must be first emptied and then the hand car- ried forward until it reaches the front edge of the pelvic bones below, and pressed downward to ascertain the size and outline of the womb. In the unimpregnated state the vagina and womb can be felt as a sin- gle rounded tube, dividing in front to two smaller tubes (the horns of the womb). In the pregnant mare not only the bodj^ of the womb is enlarged, but still more so one of the horns (right or left), and on com- pression the latter is found to contain a hard, nodular body, floating in a licjuid, which in the latter half of gestation may be stimulated by gentle pressure to manifest spontaneous movements. By this method the presence of the foetus may be determined as early as the third month. If the complete natural outline of the virgin womb can not be made out, careful examination should always be made on the right and left side for the enlarged horn and its living contents. Should there still be difficulty the mare should be placed on an inclined plane, with her hind j)arts lowest, and two assistants, standing on opposite sides of the body, should raise the lower part of the abdomen by a sheet j^assed beneath it. Finally the ear or stethoscope applied on the wall of the abdomen in front of the stifle may detect the beat- ing of the foetal heart (one hundred and twenty-five per minute) and a blowing sound (the uterine sough), much less rapid and correspond- ing to the number of the j)ulse of the dam. It is heard most satis- factorily after the sixth or eighth month and in the absence of active rumbling of the bow^els of the dam.
DURATION OF PREGNANCY.
Mares usually go about eleven months with young, though first preg- nancies often last a year. Foals have lived when born at the three hundredth day, so with others carried till the four hundredth day. With the longer pregnancies there is a greater probability of male offspring.
HYGIENE OF THE PREGNANT MARE.
The pregnant mare should not be exposed to teasing by a young and ardent stallion, nor should she be overworked or fatigued, particu- larly under the saddle or on uneven ground. Yet exercise is benefi- cial to both mother and offsjiring, and in the absence of moderate work the breeding mare should be kept in a lot where she can take exercise at vnll.
The food should be liberal, but not fattening, oats, bran, sound hay, and other foods rich in the principles which form flesh and bone being especially indicated. All ailments that tend to indigestion are to be especially avoided. Thus rank, aqueous, rapidly groA\ai grass and other green food, parti allj^ ripe rye grass, millet, Hungarian grass, vetches, pease, beans, or maize are objectionable, as is over-ripe fibrous, innutritions hay, or that which has been injured and ren- dered musty by wet, or that ^diicli is infested with smut or ergot.
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Food that tends to eostiveness should be avoided. "Water g-iven often, and at a temperature considerably above freezing, Avill avoid the dan- gers of indigestion and abortion which result from taking too much ice-cold water at one time. Very cold or frozen food is objectionable in the same sense. Severe surgical operations and medicines that act violentlj^ on the womb, bowels, or kidneys are to be avoided as being liable to cause abortion. Constipation should be corrected, if possi- ble, by bran mashes, carrots, or beets, seconded by exercise, and if a medicinal laxative is required it should be olive oil or other equally bland agent.
The stall of the pregnant mare should not be too narrow so as to cramp her Avhen lying doAvn, or to entail violent efforts in getting up, and it should not slope too much from the front backward, as this throws the weight of the uterus back on the pelvis and endangers pro- trusions and even abortion. Violent mental impressions are to be avoided, for though the majority of mares are not affected thereby, yet a certain number are so profoundly impressed, that peculiarities and distortions are entailed on the offspring. Hence, there is wisdom shown in banishing i)arti-colored or objectionably tinted animals, and those that show deformities or faulty conformation. Hence, too, the importance of preventing prolonged acute suffering by the pregnant mare, as certain troubles of the eyes, feet, and joints in the foals have been clearly traced to the concentration of the mother's mind on cor- responding injured organs in herself. Sire and dam alike tend to reproduce their personal defects which predispose to disease, but the dam is far more likely to jjerpetuate the evil in her progeny wdiich w'as carried while she was personally enduring severe suffering caused by such defects. Hence, an active bone spavin or ring-bone, causing lameness, is more objectionable than that in which the inflammation and lameness have both passed, and an active oj)hthalmia is more to be feared than even an old cataract. For this reason all active dis- eases in the breeding mare should be soothed and abated at as early a moment as possible.
EXTRA-UTERINE GESTATION.
It is rare in the domestic animals to find the fcetus developed else- wiiere than in the womb. The exceptional forms are those in which the sperm of the male, making its Avay through the womb and Fallo- pian tubes, impregnates the ovum prior to its escape, and in which the now vitalized and growing ovum, by reason of its gradually increas- ing size, becomes imprisoned and fails to escape into the womb. The arrest of the ovum maybe in the substance of the ovary itself (ovarian pregnancy), in the Fallopian tube (tubal pregnancy), or when by its continuous enlargement it has ruptured its envelopes so that it escapes into the cavity of the abdomen, it may become attached to any part of the serious membrane and draw its nourishment directlv from that
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(abdominal preg'iianey). In all siioh cases there is an increase and enlargement of the capillar}^ blood-vessels at the i)oint to Avhich the cmbrj^o has attached itself so as to furnish the needful nutriment for the grov/ing offspring.
All appreciable symptoms are absent, imless from tlie death of the fcEtus, or its interference with normal functions, general disorder and indications of parturition supervene. If these occur later than the natui'al time for i^arturition the}' are the more significant. There may be general malaise, loss of appetite, elevated temperature, accelerated 15ulse, "with or without distinct lal)or pains. Examination with the oiled hand in the rectum will reveal the womb of the natural unim- pregnated size and shape and with both horns of one size. Further exploration may detect an elastic mass apart from the womb and in the interior of wiiich may be felt the characteristic solid body of the foetus. If the latter is still alive and can be stimulated to move the evidence is even more perfect. The foetus may die and be carried for j^ears, its soft structures becoming absorbed so as to leave only the bones, or by pressure it maj^ form a fistulous ox^ening through the ab- dominal walls, or less frequently through the vagina or rectum. In the latter cases the best course is to favor the expulsion of the foal and to wash out the resulting cavity with a solution of carbolic acid 1 part to water 50 ]3arts. This may be repeated dail}^ Where there is no spontaneous opening it is injudicious to interfere, as tlie danger from the retention of the foetus is less than that from septic fermenta- tions in the enormous foetal sack when tliat has been opened to the air.
MOLES — ANIDIAX MONSTERS.
These are evidently i^roduets of conception, in Avhich the impreg- nated ovum has failed to develop naturally, and presents only a cha- otic mass of skin, hair, bones, muscles, etc. , attached to the inner surface of the womb by an umbilical cord, which is itself often shriv- eled and wasted. They are usually accompanied hyn, well-developed foetus, so that the mole may be looked upon as a twin which has under- gone arrest and vitiation of development. They are expelled by the ordinar}' iirocess of parturition, and usually, at the same time, with the normally developed offspring.
CYSTIC DISEASE OF THE WALLS OF THE AVOMB — VESICULAR MOLE.
This condition apiiears to be due to hypertrophy (enlargement) of the villi on tlie inner surface of the womb, which become greatly increased in number and hollowed out internally into a series of cysts or x^ouches containing liquid. Unlike the true mole, therefore, they appear to be disease of the maternal structure of the womb rather than of the product of conception. Rodet, in a case of this kind, which luid x)roduced active labor x^ains, quieted the disorder witli ano- dynes and secured a recovery. Where this is not available attempts
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may be made to remove the mass with tlie ecraseur or ollierwise, fol- lowing this up with antiseiitic injections, as advised under tlie last heading.
DROPSY OF THE WOMB.
This appears as a result of some disease of the walls of tlie Avomb, but has been frequently observed after sexual congress, and lias, there- fore, been confounded with pregnane}*. The symptoms are tlioso of l^regnancy, but Avithout any movements of the foetus and without the detection of any solid body in the womb when examined with the oiled hand in the rectum. At the end of four or eight months there are signs of parturition or of frequent straining to pass urine, and after a time the liquid is discharged clear and watery, or mudd^', thick, and fetid. The hand introduced into the womb can detect neither foetus nor foetal membrane. If the neck of the womb closes the liquid may accumulate a second time, or even a third, if no means are taken to correct the tendency. The best resort is to remove any diseased prod- uct that may be found attached to the walls of the womb, and to inject it daily with a, warm solution of carbolic acid 2 drams, chloride of zinc one-half dram, water 1 quart. A course of bitter tonics, gentian 2 drams, sulphate of iron 2 drams, daily, should be given, and a nutri- tious, easily digested and slightly laxative diet allowed.
DROPSY OF THE AMNIOS.
Tliis differs from simple dropsy of the womb iu that the lluid col- lects in the inner of the two water bags (that in which the foal floats) and not in the otherwise void cavity of the womb. This affection can occur only in the pregnant animal, while drojDS}^ of the womb occurs in the unimpregnated. The blood of the pregnant mare con- tains an excess of water and a smaller proportion of albumen and red globules, and vdien this is still further aggravated 1)}* ])ooy feeding, and other unhj-gienic conditions, there is developed the tendency to liquid transudation from the vessels and dropsy. As the watery con- dition of the blood increases A\ith advancing pregnancy, so dropsy of the amnios is a disease of the last four or five months of gestation. The abdomen is large and pendulous, and the swelling fluctuates under pressure, though the solid bodj^ of the foetus can still be felt to strike against the hand j)ressed into the swelling. If the hand is introduced into the vagina the womb is found to be tense and round, with the projecting rounded ueck effaced, while the hand in the rec- tum will detect the rounded SAVollen mass of the womb so firm and tense that the body of the foetus can not be felt within it, Tlie mare moves weakly and unsteadily on her limbs, having difficulty in sup- porting the great weight, and in bad cases there may be loss of appe- tite, stocking (dropsy) of the hind limbs, difficult breathing, and colicky pains. The tension may lead to abortion, or a slow, laborious parturition may occur at the usual time.
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Treatment consists in relieving tlie tension and accumulation by puncturing- the foetal membrane with a canula and trochar intro- duced through the neck of the womb and the withdrawal of the tro- char so as to leave the canula in situ. Or the membranes may be punctured with the finger and the excess of liquid allowed to escape. This may bring on abortion, or the Avound may close and gestation continue to the full term. A course of tonics (gentian root 2 drams, sulphate of iron 2 drams, daily) will do much to fortify the system and counteract further excessive effusion.
DROPSY OF THE LIMBS, PERINEUM, AND ABDOMEN,
The disposition to dropsy often shows itself in the hind and even in the fore limbs, around and beneath the vulva (perinseum) and beneath the abdomen and chest. The affected parts are swollen and pit on pressure, but are not especially tender, and subside more or less perfectly under exercise, hand rubbing, and bandages. In obsti- nate cases rubbing with the following liniment maj^ be resorted to : Compound tincture of iodine, 2 ounces; tannic acid, one-half dram; water, 10 ounces. It does not last over a day or two after i^arturition.
CRAMPS OF THE HIND LIMBS.
The pressure of the distended Avomb on the nerves and blood-vessels of the pelvis, besides conducing to dropsy, occasionally causes cramps of the hind limbs. The limb is raised Avithout flexing the joints, the front of the hoof being directed toAvard the ground, or the spasms occurring intermittently the foot is kicked Aiolentlj^ against the ground seA^eral times in rapid succession. The muscles are felt to be firm and rigid. The cramps may be i^romptly relieved by active rub- bing, or by Avalking the animal about, and it does not reappear after parturition.
CONSTIPATION.
This may result from compression by the graAdd AV'omb, and is best corrected by a graduated alloAA^ance of boiled flaxseed.
PARALYSIS.
The pressure on the nerves of the pelvis is liable to cause paralysis of the hind limbs, or in the mare of the nerve of sight. These are obstinate until after parturition, A\^hen they recover spontaneously, or under a course of nux A^omica and (locally) stimulating liniments.
PROLONGED RETENTION OF THE FGETUS (FOAL).
In the mare, though far less frequently than in the cow, parturition ma}^ not be completed at term, and tlie foal may continue to be car- ried in the Avomb for a number of months, to the serious, or even fatal, injury of the niare. Hamon records one case in AA'^hich the mare died
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after carrying the foetus for seventeen months, and Caillier a similar result after it had been carried twenty-two months. In these cases the fcjetus retained its natural form, but in one rei)orted by Gohier, the bones only were left in the womb amid a mass of apparently purulent matter.
Tlie cause may be any effective obstruction to the act of parturition, such as lack of contractile i30wer in the womb, unduly strong (inflam- matory) adhesions between the womb and the foetal membranes, Avrong presentation of the foetus, contracted pelvis (from fracture, or disease of the bones), or disease and induration of the neck of the womb.
The mere prolongation of gestation does not necessarily entail the death of the foal; hence the latter has been born alive at the four hundredth day. Even when the foal has perished, putrefaction does not set in unless the membranes (water bags) have been riTptured, and septic bacteria have been admitted to the interior of the womb. In the latter case a fetid decomposition advances rai^idly, and the mare usually j)erishes from jDoisoning with the putrid matters absorbed.
At the natural period of parturition i3reparations are apparently made for that act. The vulva swells and discharges much mucus, the udder enlarges, the belly becomes more pendent, and the animal strains more or less. No progress is made, however; there is not even opening of the neck of the womb, and after a time the symptoms subside. The mare usually refuses the male, j^et there are exceptions to this rule. If the neck of the womb has been opened and putref jdng changes have set in in its contents, the mare loses appetite and condi- tion, i)ines, discharges an offensive matter from the generative pas- sages, and dies of inflammation of the womb and putrid infection. In other cases there is a slow wearing out of the strength and the mare iinall}' dies of exhaustion.
The treatment is such as will facilitate the expulsion of the foetus and its membranes, and the subsequent washing out of the womb with disinfectants. So long as the mouth of the womb is closed, time should be allowed for its natural dilatation, but if this does not come about after a day or two of straining the opening maj" be smeared with extract of belladonna, and the oiled hand, with the fingers and thumb drawn into the form of a cone, may be inserted by slow oscillating movements into the interior of the womb. The water bags may now be ruptured, any malpresentation rectified (see "Difficult Parturi- tion"), and delivery effected. After removal of the membranes wash out the womb first with tepid water, and then with a solution of 2 ounces of borax in half a gallon of water.
This injection may have to be repeated if a discharge sets in. The same course may be pursued even after j^rolonged retention. If the soft parts of the foetus have been absorbed and the bones only left these must be carefully sought for and removed, and subsequent
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djiily injections will be required for some time. In such cases, too, a course of iron tonics (sulphate of iron, 2 drams, dailj^) will be liigiily beneficial in restoring liealtli and vigor.
ABORTION.
Abortion is, strictly speaking, the expulsion of the impregnated ovum at any i)eriod from the date of impregnation until the foal can survive out of the Avomb. If the foal is advanced enough to live it is premature 'parturition, and in the mare this may occur as earlj' as the tenth month (three hundredth day).
The mare may abort by reason of almost any cause that \evy pro- foundly disturbs the system. Hence very violent inflammations of important internal organs (bowels, kidneys, bladder, lungs) may induce abortion. Profuse diarrhea, whether occurring from the reek- less use of purgatives, the consumption of irritants In the food, or a simple indigestion, is an effective cause. No less so is acute indiges- tion with evolution of gas in the intestines (bloating). The presence of stone in the kidnej^s, ureters, bladder, or urethra may induce so much sympathetic disorder in the womb as to induce abortion. In exceptional cases wherein mares come in heat during gestation service by the stallion may cause abortion. ]>lows or pressure on the al^do- men, rapid driving or riding of the pregnant mare, especially if she is soft and out of condition from idleness; the brutal use of the spur or Avhip, and the jolting and straining of travel by rail or boat are pro- lific causes. Bleeding the pregnant mare, a painful surgical opera- tion, and the throvfing and constraint resorted to for an operation are other causes. Traveling on heavy, muddy roads, slips and falls on ice, and jumping must be added. The stimulation of the abdominal organs by a full drink of iced water may precipitate a miscarriage, as ma}' exposure to a cold rain-storm or a very cold night after a Avarm day. Irritant poisons that act on the urinary or generative organs, such as Spanish flies, rue, savin, tansy, cotton-root bark, ergot of rye or other grasses, the smut of maize and other grain, and various fungi in musty fodder are additional causes. Frosted food, indigestible food, and above all green succulent vegetables in a frozen state have proved effective factors, and fiUhy, stagnant water is dangerous. Low condition in the dam and plethora have in opposite ways caused abortion, and hot relaxing stables and lack of exercise strongly con- duce to it. The exhaustion of the sire by too frequent service, entail- ing debility of the ofl'spring and disease of the foetus or of its envelopes, must be recognized as a further cause.
The symptoms vary mainly according as the abortion is early or late in pregnancy. In the first jnonth or two of pregnancy the mare may miscarry without observable symptoms, and the fact only appears by her coming in heat. If more closely observed a small clot of blood may be found behind lier, in which a careful search reveals tha
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rudiiuenlsof the foal. II" tlio oceiirreuee is soiucAvliat later in g-estalion there will be some general disturbance, inappetence, neighing, and straining, and tlie small bod}^ of the foetus is expelled, enveloped in its membranes. Abortions during the later stages of pregnancy are attended with greater constitutional disturbance, and the process resembles normal i)arturition, with the aggravation that more effort and straining is requisite to force the foetus through the comparatively undilatable mouth of the womb. There is the swelling of the vulva, witli mucus or even bloody discharge; the abdomen droops, the flanks fall in, the udder fills, the mare looks at her flanks, jjaws with the fore feet and kicks with the hind, switches the tail, moves around uneasily, lies down and rises, strains, and, as in natural foaling, expels fii*st mucus and blood, then the waters, and finally the foetus. This may occupy an hour or two, or it may be j)rolonged for a day or more, the symptoms subsiding for a time, only to reappear with renewed energy. If there is lualiiresentation of the foetus it will hinder progress until rectified, as in difficult parturition. Abortion may also be followed by the same accidents, as flooding, retention of the placenta, and leucorrhoea.
The most important object in an impending abortion is to recognize it at as early a stage as possible, so that it may, if possible, be cut siiort and i)revented. Any general indefinable illness in a pregnant mare should lead to a close examination of the vulva as regards swell- ing, vascularity^ of its mucous membrane, and profuse mucous secre- tion, and above all anj^ streak or staining of blood; also the condition of the udder, if that is congested and swollen. Any such indication, with colicky pains, straining, hoAvever little, and active movement of the foetus or entire absence of movement, are suggesti^'e symptoms and should be duly counteracted.
The changes in the vulva and udder, with a soiled and bloodj' con- dition of the tail, may suggest an abortion alread}^ accomplished, and the examination v.-ith the hand in the vagina may detect the mouth of the womb soft and dilatable, and the interior of the organ slightly filled with a bloody liquid.
Treaiment should be preventive if possible, and would embrace the avoidance of all causes mentioned, and particularly of such as may seem to be i^articularh" operative in the particular case. Where abor- tions have ali'eady occurred in a stud, the especial cause, in the mat- ter of food, water, exposure to injuries, overwork, lack of exei-ciss, etc., may often be identified and removed. A most important point is to avoid all causes of constipation, diarrhea, indigestion, bloating, violent purgatives, diuretics or other potent medicines, painful opei'a- tions, and slippery roads, unless well frosted.
AVhen abortion is imminent the mare should be i)laced alone in a roomy, dark, quiet stall, and have the straining checked \yy some seda- tive. Laudanum is usually at hand and may be given in doses of 1
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or 2 ounces, according to size, and repeated after tAvo or three hours, and even dail}^ if necessary. Chloroform or chloral hydrate, 3 drams, may be substituted if more convenient. These should be given in a pint or quart of water, to avoid burning the mouth and throat. Or viburnum prunifolium, 1 ounce, may be given and repeated if neces- sary to prevent straining.
When all measures fail and miscarriage proceeds, all that can be done is to assist in the removal of the foetus and its membranes, as in ordinary j)arturition. As in the case of retention of the foetus, it may be necessary after delivery to employ antispeptic injections into the womb to counteract putrid fermentation. This, however, is less requi- site in the mare than in the cow, in which the jDrevalent contagious abortion must be counteracted by the peristent local use of antiseptics. After abortion a careful hygiene is demanded, especially in the matter of i3ure air and easily digestible food. The mai-e should not be served again for a month or longer, and in no case until after all discharge from the vulva has ceased.
SYMPTOMS OF PARTURITIOX.
As the period of parturition approaches the swelling of the udder bespeaks the coming event, the engorgement in exceptional cases extending forward on the lower surface of the abdomen and even into the hind limbs. For about a week a serous fluid oozes from the teat and concretes as a yellow, wax-like mass around its orifice. About twenty-four hours before the birth this gives place to a whitish, milky liquid, Avhieh falls upon and mats the hairs on the inner sides of the legs. Another symi^tom is enlargement of the vulva, with redness of its lining membrane, and the escape of glairy mucus. The belly droops, the flanks fall in, and the loins ma}^ even become depressed. Finally the mare becomes uneasy, stops feeding, looks anxious, whisks her tail, and may lie down and rise again. In many mares this is not repeated, but the mare remains down; violent contractions of the abdominal muscles ensue; after two or three pains the AA^ater-bags api^ear and burst, folloAA'ed by the fore feet of the foal, with the nose betAveen the knees, and by a few more throes the foetus is expelled. In other cases the act is accomplished standing. The Avliole act may not occupy more than fiA^e or ten minutes. This, together Avith the disposition of the mare to aA^oid obserA^ation, renders the act one that is rarely seen by the attendants.
The naA^el-string, AA^hich connects the foal to the membranes, is rui^tured AAdien the foetus falls to the ground, or Avlien the mare rises, if she has been down, and the membranes are expelled a few minutes later.
NATURAL PRESENTATION,
When there is a single foal the common and desirable presenta- tion is Avitli the fore feet first, the nose betAveen the knees, and AA'ith
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the front of the hoofs and knees and the forehead directed upward toward the anus, tail, and croup (Plate IX, Fig. 1). In this way the natural curvature of the body of the foetus corresponds to the curve of the womb and genital passages, and particularly of the bony i>el- vis, and the foal passes with much greater ease than if it were placed with its back downward toward the udder. When there is a twin birth the second foal usually comes with its hind feet first, and the backs of the legs, the points of the hocks, and the tail and croup are tui-ned upward toward the anus and tail of the mare (Plate IX, Fig. 2). In this way, even with a jjosterior presentation, the curvature of the l)od3' of the foal still corresponds to that of the passages, and its expulsion may be quite as easy as in anterior presentation. Any presentation aside from these two maj^ be said to be abnormal and will be considered under "Difficult Parturition."
DIFFICULT PARTURITION.
With natural iDresentation this is a rare occurrence. The great length of the fore limbs and face entail, in the anterior presentation, the formation of a long cone, which dilates aiid glides through the ])assages with comparative ease. Even with the hind feet first a simi- lar conical form is presented, and the process is rendered easy and quick. Difficulty and danger arise mainly from the act being brought on prematurel}'' before the passages are sufficiently dilated, from nar- rowing of the pelvic bones or other mechanical obstruction in the pas- sages, from monstrous distortions, or duplications in the foetus, or from the turning back of one of the members so that the elongated conical or wedge-shaped outline is done away with. But i)romptas is tlie normal parturition in the mare, difficult and delayed parturitions are surrounded by special dangers and require unusual i^recautions and skill. From the proclivity of the mare to unhealthy inflamma- tions of the peritoneum and other abdominal organs, i^enetrating wounds of the womb or vagina are liable to prove fatal. The contrac- tions of the womb and abdominal walls are so powerful as to exhaust and ])enumb the arm of the assivStant, and to endanger penetrating wounds of the genital organs. By reason of the looser connection of the foetal membranes with the womb, as compared with those of rumi- nants, the violent throes early detach these membranes throughout their whole extent, and the foal, being thus separated from the mother and thrown on its own resources, dies at an early stage of any jjro- tracted parturition. The foal rarely survives four hours after the onset of parturient throes. From the great length of the limbs and neck of the foal it is extremely difficult to secure and bring up limb or head which has been turned back when it should have been presented. When assistance must be rendered the operator should don a thick woolen undershirt with the sleeves cut out at the shoulders. This 51JG1 — HOR (J
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protects the body and leaves tiie whoie arm free for manipulation. Before inserting the arm it should be smeared with lard. This i)ro- tects the skin against septic infection, and favors the introduction of the hand and arm. The hand should be inserted with the thumb and fingers draAvn together like a cone. "Whether standing or lying the mare sliould be turned with head down liill and hind parts raised as much as possible. The contents of the abdomen gravitating forward leave much more room for manipulation. Whatever part of the foal is presented (head, foot) should be secured with a cord and running noose before it is pushed back to search for the other missing i)arts. Even if a missing part is reached no attempt should be made to bring it up during a labor pain. Pinching the back will sometimes check the pains and allow the operator to secure and bring up the missing member. In intractable cases a large dose of chloral hydrate (1 ounce in a quart of water) or the inhalation of chloroform and air (equal proportions) to insensibility may secure a respite, during which the missing members may be replaced. If the waters have been discharged and the mucus dried up, the genital jiassages and body of the foetus should be lubricated with lard or oil before any attempt at extraction is made. When the missing member has been brought up into ]30si- tion, and presentation has been rendered natural, traction on the foetus must be made only during a labor j)ain. If a mare is inclined to kick, it may be necessary to apply hobbles to protect the operator.
PREMATURE LABOR PAIXS.
These may be brought on by any violent exertion, use under the saddle, or in hea^n*' draught, or in rapid paces, or in travel by rail or sea, blows, kicks, crushing by other animals in a doorway or gate. Excessive action of purgative or diuretic ageuts, or of agents that irritate the bowels or kidnej's, like arsenic, Paris green, all caustic salts and acids, and acrid and narcotico-acrid vegetables, is equally injurious. Finally, the ingestion of agents that stimulate the action of the gravid womb {ergot of rye or of other grasses, smut, various fungi of fodders, rue, savin, cotton-root, etc.) may bring on labor j^ains l^rematurely.
Besides the knowledge that parturition is not j'et due, there will be less enlargement, redness and swelling of the vulva, less mucous dis- charge, less filling of the udder, and less appearances of wax and prob- ably none of milk from the ends of the teats. The oiled hand intro- duced into the vulva will not enter with the ease usual at full term, and the neck of the womb will be felt not on\j closed, but with its pro- jecting papilla?, thi'ough which it is perforated, not yet flattened down and etfaced, as at full term. The symptoms are indeed those of threatened abortion, but at such an advanced stage of gestation as is co]ni)atible with the survival of the oifspring.
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The ireafment consists in llic septirntioii of tlie mare from all oilier animals in a quiet, dark, secluded place, and the free use of anti- spasmodics and anodynes. Opium in dram doses every two hours, or laudanum in ounce doses at similar intervals, "will often suffice. When the more urgent symptoms have subsided these doses may be repeated thrice a day till all excitement passes off or until the passages have become relaxed and prepared for parturition. Viburnum prunifolium, in ounce doses, may be added if necessary. Should parturition become inevitable, it may be favored and any necessary assistance furnished.
DIFFICULT PARTUEITIOX FROM XARROW PELVIS.
A disprojjortion between the foetus got by a large stallion and tlie jjelvis of a small dam is a serious obstacle to parturition, sometimes seen in the mare. This is not the rule, however, as the foal up to birth usually accommodates itself to the size of the dam, as illusti'ated in the successful crossing of Percheron stallions on mustang mares. If the disproportion is too great the only resort is < n^hryoiouiy.
FRACTURED HIP-BOXES.
More commonly the obstruction comes from distortion and narrow- ing of the pelvis as the result of fractures. (Plates XIV, Fig. 2.) Fractures at any point of the lateral wall or floor of the pelvis are repaired v.ith the formation of an extensive bony deposit bulging into the passage of the i)elvis. The displacement of the ends of the broken bone is another cause of constriction and between the two conditions the passage of the foetus may be rendered impossible without embry- otomy. Fracture of the sacrum (the continuation of the back-bone forming the croup) leads to the depression of the x)osterior part of that bone in the roof of the pelvis and the narrowing of the pas.sage from above downward liy a bony ridge presenting its sharj) edge forward.
In all cases in which there has l>een injury to the bones of the j)elvis the obvious iirecaution is to withliold the marc from breeding and to use her for work only.
If a mare with a pelvis thus narrovred has got in foal inach'ertently, abortion may be induced in the early months of gestation by slowly introducing the oiled finger through the neck of the v>'omb and follow- ing this by the other fingers until the whole hand has been introduced. Then the water-bags may be broken, and with the escape of the liquid the womb will contract on the solid foetus and labor pains will ensue. The fcetus being small it will pass easily.
TUMORS IX THE VAGIXA AXD PELVIS.
Tumors of various kinds may form in the vagina or elsewhere within the pelvis, and when large enough will obstruct or prevent the passage of the ftetus. Gray mares, which are so subject to black pig- ment tumors {melanosis) on the tail, anus, and vulva, are the juost
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likely to suffer from this. Still more rarely the wall of the vagina becomes relaxed, aud being- pressed hf a mass of intestines will pro- trude through the lips of the vulva as a hernial sac, containing a part of the bowels. AVhere a tumor is small it ma}^ only retard and not absolutel}^ prevent i)arturition. A hernial protrusion of the wall of the vagina may be pressed back and emptied so that the body of the ftjetus engaging in the passage may find no further obstacle. "When a tumor is too large to allow delivery the onl}^ resort is to remove it, but before proceeding it must be clearly made out that the obstruc- tion is a mass of diseased tissue, and not a sac containing intestines. If tlie tumor hangs bj^ a neck it can usually be most safel}^ removed by the ecraseur, the chain being passed around tlie pedicel and gradually tightened until that is torn through.
HERNIA OF THE WOMB.
The rupture of the musculo-fibrous floor of the bell}' and the escape of the gravid womb into a sac formed by the peritoneum and skin hanging towards the ground, is described by all veterinary obstetri- cians, yet it is verj^ rarely seen in tlie mare. The form of the foetus can be felt through the walls of the sac, so that it is easy to recognize the condition. Its cause is usually external violence, though it may start from an umbilical hernia. When the period of parturition arrives, the first effort should be to return the foetus within the proper abdominal cavity, and this can sometimes be accomplished with the aid of a stout blanket gradually tightened around the bellj^ This failing, the mare may be placed on her side or back and gravitation brought to the aid of manipulation in securing the return. Even after the hernia has been reduced the relaxed state of the womb and abdominal walls may serve to hinder parturition, in Avhich case the oiled hand must be introduced through the vagina, tlie foetus brought into position, and traction coincident with the labor pains employed to secure delivery.
TWISTING OF THE NECK OF THE WOMB.
This condition is veiy uncommon in the mare, though occasionally seen in the cow, owing to the greater laxity of the broad ligaments of the womb in that animal. It consists in a revolution of the Avonib on its own axis, so that its right or left side will be turned upward (quarter revolution), or the lower surface may be turned upward and the upper surface downward (half revolution). The effect is to thi-ow the narrow neck of the womb into a series of spiral folds, turning in the direction in which the womb has revolved, closing the neck and rendering distention and dilatation impossible.
The i^eriod and pains of parturition arrive, but in spite of con- tinued efforts no progress is made, neither water-bags nor liquids appearing. The oiled hand inti'oduced into the closed neclc of the
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■\voml3 will readily delect the spiral dii'eotion of the folds on its inner surface.
The method of relief -whicli I have successfully adopted in the cow may be equall)^ happj'^ in the mare. The dam is placed (witli her head uphill) on her rij?ht side if the upper folds of the spiral turn toward the right, and on her left side if they turn toward the left, and the oiled hand is introduced through the neck of the womb and a limb or other part of the body of the foetus is seized and pressed against the wall of the womb, while two or three assistants turn the animal over her back toward the other side. The object is to keep the womb stationary while the animal is rolling. If success attends the effort, the constriction around the arm is suddenly relaxed, the spiral folds ai'e effaced, and the water-bags and f(ptus press forward into the passage. If the first attempt does not succeed it may be repeated again and again until success crowns the effort. Among my occasional causes of failure have been the prior death and decouiix)- sition of the foetus, with the extrication of gas and overdistention of the womb, and the supervention of inflammation and inflammatory exudation around the neck of the womb, which hinders untwisting. The first of these conditions occurs early in the horse from the detach- ment of the fcfital membranes from the wall of the womb, and as the mare is more subject to- fatal peritonitis than the cow, it may be con- cluded that both these sources of failure are more probable in the equine subject.
When the case is intractable, though the hand may l)e easih- intro- duced, the instrument shown in Plate YIII, Fig. 7, may be used. Each hole at the small end of the instrument has i^assed through it a stout cord with a running noose, to be passed around two feet or other portion of the foetus which it may be possible to reach. The cords are then drawn tight and fixed around the handle of the instru- ment, then by using the cross-handle as a lever the foetus and womb may be rotated in a direction opposite to that causing the obstruction. During this process the hand must be introduced to feel when the twist has been undone. This method ma}^ be supplemented, if neces- sarj% b}^ rolling the mare as described above.
EFFUSION OF BLOOD IX THE VAGINAL WALLS.
This is common as a result of diflficult parturition, but it may occur from local injury before that act, and may seriously interfere with it. This condition is easily recognized by the soft, doughy swelling so characteristic of blood clots, and b}' the dark red color of the mucous membrane. I have laid open such swellings witli the knife as late as ten days before parturition, evacuated the clots, and di-essed the wound daily with an astringent lotion (sulphate of zinc 1 dram, carbolic acid 1 dram, water 1 quart). A similar resort might be had, if necessary, during parturition.
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CALCULUS (stone) AND TUMOR IX THE BLADDER.
Tlic x)ressurc upon the bladder containing a stone or a tumor may prove so painful that the mare will voluntarily suppress tlie labor pains. Examination of the bladder with the finger introduced through the urethra will detect the offending agent. A stone should be extracted with forceps (see "Lithotomy"). The large papillary tumors which I have met with in the mare's bladder have been inva- riably delicate in texture and could be removed xjiecemeal by forcejis. Fortunately, mares affected in this waj'" rarely breed.
IMPACTIOX OF THE RECTUM WITH F^CES.
In some animals, with more or less paralysis or weakness of the tail and rectum, the i*ectum ma}' become so impacted with solid faeces that the mare is unable to discharge them, and the accumulation both by reason of the mechanical obstruction and the x)ain caused by pressure uioon it will impel the animal to cut short all labor jjains. The rounded swelling surrounding the anus will at once suggest the con- dition, when the obstruction may be removed by the well-oiled or soaped hand.
SPASM OF THE XECK OF THE WOMB.
This occurs in the mare of specially excitable temperament, or under I)articular causes of irritation, local or general. Labor pains, though continuing for some time, produce no dilatation of the neck of the womb, which will be found firmlj'^ closed so as to admit but one or two fingers, and this, althovigh the i^rojection at the mouth of the womb may have been entirely effaced, so that a simple round opening is left with rigid margins.
The simplest 'treaiinod consists in smearing this part with solid extract of belladonna, and after an interval inserting the hand with fingers and thumb drawn into the form of a cone, rupturing the membranes and bringing the foetus into position for extraction, as advised under '"Prolonged Retention of the Foetus." Another mode is to insert through the neck of the womb an ovoid caoutchouc bag, emi^t}-, and furnished with an elastic tube 12 feet long. Carry the free end of this tube upward to a height of 8, 10, or 12 feet, insert a filler into it, and proceed to distend the bag vt'ith tepid or warm water.
FIBROUS BAX'DS COXSTRICTIX(4 OR CROSSING THE XECK OF THE \VOMB.
These occurring as the result of disease have been several times observed in the mare. They may exist in tlie cavit}' of the abdomen and compress and obstruct the neck of the womb, or they may extend from side to side of the vagina across and just behind the neck of the womb. In the latter position the)' may be felt and quickly remedied by cutting them across. In the abdomen they can only be reached
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by incision, and two alternatives are presented: (1) To perform embryotomy and extract tlie fo?tns piecemeal; and (2) to make an incision into the abdomen and extract by the Csesarian operation, or simply to cnt the constricting- band and attempt deliveryby the usual channel.
FIBROUS CONSTRICTION OF VAGINA OR VULVA.
This is i^robably always the result of direct mechanical injury and the formation of rigid cicatrices which fail to dilate with the remainder of the passages at the approach of parturition. The presentation of the foetus in the natural Avay and the occurrence of successive and active labor pains without any favorable result will direct attention to the rigid and unyielding cicatrices Avhich may be incised at one, two, or more points to a depth of half an inch or more, after which the natural expulsive efforts will usuallj' prove effective. The result- ing wounds may be washed frequently with a solution of 1 i)art of carbolic acid to 50 parts of water, or of 1 part of mercuric chloride to 500 parts water.
FCETUS ADHERENT TO THE WALLS OF THE WOMB.
In inflammation of the mucous membrane lining the cavity of the womb and implicating the foetal membranes, the resulting embryonic tissue sometimes establishes a medium of direct continuity between the womb and fcetal membranes; the blood vessels of the one com- municate freely Avith those of the other and the fibers of the one are l)rolonged into the other. This causes retention of the membranes after birth, and a special risk of bleeding from the womb, and of sep- tic poisojiing. In exceptional cases the adhesion is more extensive and binds a portion of the body of the foal firmly to the womb. In such cases it has repeatedly been found impossible to extract the foal until such adhesions were broken dawn. If they can be reached with the hand and recognized they may be torn through Avith the fingers or with a blunt hook, after which delivery may l)e attempted with hoi)f of success.
EXCESSIVE SIZE OF THE FCETUS.
It would seem that a small inare may usually be safely bred to a large stallion, 3-et this is not always the case, and when the small size is an individual rather than a racial characteristic or the result of extreme youth, the rule can not be expected to hold. There is always great danger in breeding the young, small, and undeveloped female, and the dwarfed representative of a larger breed, as the offspring- tend to partake of the large race characteristics and to show them even prior to birth. AVhen impregnation has occurred in the very young or in the dwarfed female, tliere are two alternatives — to induce abortion, or to wait until there are attempts at parturition and to extract by embryotomy if impracticable otherwise.
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CONSTRICTION OF A MEMBER BY THE NAVEL STRING.
Ill man and animals alike the winding of the umbilical cord round a member of the fa?tiis sometimes leads to the amputation of the lat- ter. It is also known to get wound around the neck or a limb at birth, but in the mare this does not seriously impede jiarturition, as the loosely attached membranes are easily separated from the womb and no strangulation or retarding occurs. The foal may, however, die from the cessation of the placental circulation unless it is speedily delivered.
WATER IN THE HEAD (HYDROCEPHALUS) OF THE FOAL.
This consists in the excessive accumulation of liquid in the ven- tricles of the brain so that the cranial cavit}^ is enlarged and con- stitutes a great projecting rounded mass occupying the space from the eyes upward. (See Plate XIV, Fig. 3.) With an anterior pres- entation (fore feet and nose) this presents an insuperable obstacle to progress, as the diseased cranium is too large to enter the pelvis at the same time with the fore-arms. With a posterior presentation (hind feet) all goes well until the body and shoulders have passed out, Avhen i^rogress is suddenly arrested by the great bulk of the head. In the first case, the oiled hand introduced along the face detects the enormous size of the head, which may be diminished by puncturing it with a knife or trochar and cannula in the median line, evacuating the water and pressing in the thin bony walls. With a jjosterior presentation, the same course must be followed; the liand jsassed along the neck will detect the cranial swelling, which nvdy be i^unc- tured with a knife or trochar. Oftentimes with an anterior presen- tation the great size of the head leads to its displacement backward and thus the fore-limbs alone engage in the passages. Here the lirst object is to seek and bring up the missing head, and then puncture it as above suggested.
DROPSY OF THE ABDOMEN IN THE FOAL — ASCITES.
The accumulation of liquid in the abdominal cavity of the foetus is less frequent, but when present it may arrest i^arturition as com- pletelj' as will hydrocephalus. With an anterior presentation the foal maj" pass as far as the shoulders, but behind this all efforts fail to secure a further advance. With a posterior presentation the hind legs as far as the thighs may be expelled, but at this point all progress ceases. In either case the oiled hand passed inward by the side of the foal will detect the enormous distention of the abdomen and its soft, fluctuating contents. The only course is to puncture the cavity and evacuate the li<iuid. With the anterior presentation this may be done Avith a long trochar and cannula, introduced through the chest and diaphragm; or with a knife an incision may be made
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"between the first two ribs, and the lungs and hearr cut or lorn out, when the diaphragm will be felt j)ro,jecting strongly foi'ward and may be easily punctured. Should there not be room to introduce tlie hand through the chest, the oiled hand may be passed along beneath the breast bone and the abdomen punctured. With a posterior presenta- tion the abdomen must be punctured in the same way, the hand, armed with a knife protected in its palm, being passed along the side of the flank or between the hind limbs. It should be added that mod- erate drops}' of the abdomen is not incompatible Avitli natural deliv- er}-, the liquid being at first crowded back into the portion of the belly still engaged in the womb, and passing slowly from that into the advanced portion as soon as that has cleared the narrow passage of the pelvis, and passed out where it can expand.
GENERAL DROPSY OF THE FCETUS.
In this 6ase the tissues generally are distended with liquid, and the skin is found at all points tense and rounded, and pitting on pressure with the fingers. In some such cases delivery may be effected after the skin has been punctured at narrow intervals to allow the escape of the fluid and then liberally smeared with fresh lard. More com- monly, however, it can not be reached at all points to be so punc- tured, nor sufficiently reduced to be extracted whole, and resort must be had to einbryotovnj.
SWELLING OF THE FCETUS WITH GAS — EMPHYSEMA.
This has been described as occurring in a living foetus, but I have only met with it in the dead and decomposing foal, after futile efforts have been made for several days to effect delivery. These cases are very difficult ones, as the foal is inflated to such an extent that it is impossible to advance it into the passages, and the skin of the foetus and the walls of the womb and vagina have become so dry that it is impracticable to cause the one to glide on the other. The hair comes off any part that may be seized, and the case is rendered the more offensive and dangerous by the very fetid liquids and gases. The only resort is embrijofoniy, by which I have succeeded in saving a valuable mare that had carried a colt in this condition for four days.
CONTRACTIONS OF MUSCLES.
The foal is not always developed symmetrically, but certain groups of muscles are liable to remain short or to shorten because of jjersist- ent spasmodic contraction, so that.even the bones become distorted and twisted. This is most common in the neck. The bones of this part and even of the face are drawn to one side and shortened, the head being held firmly to the fiank and the jaws being twisted to the right 5961— HOR 6*
or left. Ill other'cases the flexor muscles of the fore-limbs are con- tracted so that these members are strongly bent at the knee. In neither of these cases can the distorted part be extended and straight- ened, so that body or limbs must necessarily^ present double, and natural deliver}- is rendered impossible. The bent neck may some- times be straightened after the muscles have been cut on the side to which it is turned, and the bent limbs after the tendons on the back of the shank bone have been cut across. Failing to accomplisli this, the next resort is to emhryoiov}]].
TUMORS OF THE FCETUS — INCLOSED OVUM.
Tumors or diseased growths may form on any part of the foal, in- ternal or external, and by their size impede or hinder parturition. In some cases what appears as a tumor is an imprisoned and undevel- oped ovurn^ which has grafted itself on the foetus. These are usually sacculated and may contain skin, hair, muscle, bone, and other natural tissues. The only course to be pursued in such cases is to excise the tumor, or, if this is not feasible, to perform emhryotoniy.
MONSTROSITIES.
Monstrositj- in the foal is an occasional cause of difficult joarturition, especially such monsters as show excessive development of some part of tlie body, a displacement or distortion of jDarts, or a redundancy of parts, as in double monsters. Monsters may be divided into —
(1) Monsters with absence of parts — alisence of head, limb, or other organ.
(2) Monsters with some part abnormally small — dwarfed iiead, limb, trunk, etc.
(.3) Monsters through unnatural division of parts — cleft head, trunk, limbs, etc.
(4) Monsters through absence of natural divisions — absence of mouth, nose, eyes, anus, confluent digits, etc.
(5) IVfonsters through fusion of jjarts — one central eye, one nasal opening, etc.
(0) Monsters through abnormal position or form of xiarts — curved spine, face, limb, etc:
(7) Monsters through excess of formation — enormous head, super- numerarj" digits, etc.
(8) Monsters tlirougli imperfect differentiation of sexual organs — hermaphrodites.
(r») Double monsters — double-lieaded, double-bodied, extra limbs, etc.
The Cannes of monstrosities appear to be very varied. Some mon- strosities, like extra digits, absence of horns or tails, etc., run in fami- lies and are produced almost as certaiuly as color or form. Others are associated with too close breeding, the powers of symmetrical
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development being interfered with, just as in other cases a sexnal incompatibility is developed, near relatives failing to T)i'eed with each other. Mere arrest of development of a part may arise from acci- dental disease of the embryo ; lienee vital organs are left out, or por- tions of organs, like the dividing walls of the heart, are omitted. Sometimes an older foetus is inclosed in the body of another, each hav- ing started independently from a separate ovum, but the one having become embedded in the semi-fluid mass of the other and having developed there simultaneously with it, but not so largely nor x^er- fectly. In many cases of redundance of jparts, the extra i^art or mem- ber has manifestly develojped from the same ovum and nutrient cen- ter with the normal member to which it remains adherent, just as a nev\' tail will grow out in a newt when the former has been cut off. In the early embryo, v/ith its great powers of develoxjment, this factor can operate to far greater x^urpose than in the adult animal. Its influence is seen in the fact x^ointed out bj' St. Hilaire that such redundant x^arts are nearly always connected vrith the corresx^onding portions in the normal f cetus. Thus sux^erfluous legs or digits are attached to the normal ones, double heads or tails are connected to a common neck or rumxD, and double bodies are attached to each other by corresponding points, navel to navel, breast to breast, back to back. All this suggests the develox)mont of extra x>arts from the same x^i'imary layer of the impregnated and develox^ing ovum. The effect of disturbing conditions in giving such wrong directions to the develoxomental forces is v/ell shown in the experiments of St. Hilaire and Valentine in varnishing, shaking, and otherwise breaking up the natural connections in eggs, and thereb}" determining the formation of monstrosities at will. So, in the mammal, blows and other inju- ries that -detach the foetal membranes from the walls of the womb or that modify their circulation Iw inducing inflammation are at times followed by the develox)ment of a monster. The excitement, mental and x>hysical, attendant on fright occasion all}' acts in a similar way, acting x^robably through the same channels.
The monstrous forms likely to interfere with x^ai'turition are such as from contracted or twisted limbs or sx)ine, must be presented double; where supernumerary limbs, head, or body must apx:)roach the x^assages v\'ith tlie iiatural ones; where a head or other member lias attained to an unnatural size ; Avhere the body of one foetus has become inclosed in or attached to another, etc.
Extraction is sometimes possible by straightening the members and securing such a x^resentation as will reduce the xJi'esenting mass to its smallest and most wedge-like dimensions. To effect this it may be needful to cut the flexor tendons of bent limbs or the muscles on the side of a twisted neck or body; and one or more of the manipulations necessary to secure and bring u]) a missing member may be requii-ed. In most cases of monstrosity by excess, however, it is needful to
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remove the superfluous parts, in Avhich case the general pi-incii3les employed for einhryotoniy must be followed. The C?esarian section, by which the f(etus is extracted through an incision in the walls of the abdomen and womb, is inadmissible, as it practically entails the sacrifice of the mare, Avhich should never be done for the sake of a monster. See "Embryotomy."
ENTRANCE OF TWINS INTO THE PASSAGE AT ONCE.
Twins are rare in the mare, and still more rare is the impaction of both at once into the pelvis. The condition would be easily recog- nized by the fact that two fore limbs and two hind would occupy the passage at once, the front of the hoofs of the fore feet being turned upward and those of the hind feet downward. If both belonged to one foal they would be turned in the same direction. Once recog- nized, the condition is easily remedied by passing a rope with a run- ning noose round each foot of the foal that is farthest advanced or that promises to be most easily extracted, and to push the members of the other foetus back into the depth of the womb. As soon as the one foetus is fully engaged in the j)assage it will hold its place and its delivery will i)roceed in the natural way.
TABLE OF WRONG PRESENTATIONS.
?^ cb S
Incompletely extended. Flexor tendons short- ened.
Crossed over the neck.
Bent back at the knee.
Bent back from the shoulder.
Bent downward on the neck.
Head and neck turned back beneath the breast.
Turned to one side.
Turned upward and backward on the back.
Hind-limbs Hind feet engaged in the pelvis.
Transverse Back of foal to side of pelvis.
Inverted Back of foal to floor of pelvis.
TT- IT 1, ( Bent on itself at the hock.
Hmd-hmbs -j gg^^ .^^ ^i^g i^^jj
Transverse Back of foal to side of pelvis.
Inverted Back of foal to floor of pelvis.
\ With back and loins presented.
'/ With breast and belly presented.
Fore-limbs.
Head
Transverse presentation of body.
FORE-LIMBS INCOMPLETELY EXTENDED.
Incases of this kind, not only are the back tendons behind the knee and shank-bone unduly short, but the sinew extending from the front of the slioulder-blade over the front of the elbow and down to the head of the shank-bone is also shortened. The result is that the fore-limb is bent at the knee and the elbow is also rigidly bent. The condition obstructs parturition by the feet becoming pressed against the floor of the pelvis or by the elbow pressing on its anterior brinu Relief is to be obtained by forcible extension. A rope with a running noose is passed around each fetlock and a repeller (see Plate VIII), planted in
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the breast is pressed in a direction uj)ward and backward while active traction is made on the ropes. If the feet are not thereby raised from the floor of the pelvis the palm of the hand may l)e placed beneath them to protect the mucous membrane until they have advanced suf- ficiently to obviate this danger. In the absence of a repeller, a smooth rounded fork-handle maybe employed. If the shortening is too great to allow of the extension of the limbs in this waj', the tense tendons ma)^ be cut across behind the shank bone and in front of the elbow, and the limb will be easily straightened out. This is most easily done with an embryotomy' knife furnished with a ring for the middle fin- ger, so that the blade maybe protected in the palm of the hand. (See Plate XIV, Fig. 4.)
ONE PORE-LIMB CROSSED OVER THE BACK OF THE NECK.
With the long fore-limbs of the foal this readily occurs and the result- ing increase in thickness, both at the head and shoulder, offers a seri- ous obstacle to progress. (See Plate X, Fig. 2. ) The hand introduced into the passage detects the head and one fore foot, and further back on the same side of the head the second foot, from which the limb may be traced obliquely across the back of the neck.
If parturition continues to make progress the displaced foot may bruise and lacerate the vagina. By seizing the limb above the fetlock it may be easily pushed over the head to the proper side, when parturition will proceed normally.
FORE-LIMB BENT AT THE KNEE.
The nose and one fore foot x)resent, and on examination the knee of the missing fore-limb is found farther back. (Plate X, Fig. 1.) First place a noose each on the presenting pastern and lower jaw, and push back the body of the foetus with a repeller, while the operator seizing the shank of the bent limb extends it so as to press back the knee and bring forward the fetlock and foot. As progress is made little by lit- tle the hand is slid down from the region of the knee to the fetlock, and finally that is secured and brought \\p into the passage, when parturition will proceed without hindrance. If both fore-limbs are bent back the head must be noosed and the limbs brought up as above, one after the other. It is usually best to employ the left hand for the right fore-limb, and the right hand for the left fore-limb.
FORE- LIMB TURNED BACK FROM THE SHOULDER.
In this case, on exploration by the side of the head and jiresenting limb, the shoulder only can be reached at first. (Plate X, Fig. 4.) By noosing the head and presenting fore-limb these may be drawn for- ward into the pelvis, and the oiled hand being carried along the shoul- dei' in the direction of the missing limb is enabled to reach and seize the fore-arm just below the elbow. The bodj^ is now pushed back by
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the assistants pressing on the liead and x^i'esenting limb or on a repel- ler planted in the breast until the knee can be brought up into the I)elvis, after -syhich the procedure is the same as described in the last I)aragrai)h.
HEAD BENT DOWN BETWEEN THE FORE-LIMBS.
This ma}' be so that the poll or naj)o of the neck with the ears can be felt far back between the fore-limbs, or so that only the upper border of the neck can be reached, head and neck being bent back beneath the body. AVith the head only bent on the neck, noose the two j)resenting limbs, then introduce the hand between them until the nose can be seized in the palm of the hand. Next have the assist- ants push back the presenting limbs, while the nose is strongly lifted upward over the lirim of the pelvis. This accomplished it assumes the natural position and parturition is eas}'.
When both head and neck are bent downward it maj* be impossible to reach the nose. If, however, the labor has only commenced, the limbs may be drawn upon until the operator can reach the ear, l^y dragging on which the head may be so far advanced that the fingers may reach the orbit; traction upon this while the limbs are being- pushed back may bring the head uj) so that it bends on the neck only, and the further iDrocedure will be as described in the last paragraph.
If the labor has been long in progress and the foetus is jammed into the pelvis, the womb emptied of the waters and firmly contracted on its solid contents, the case is incomparably more difficult. The mare may be chloroformed and turned on her back with hind parts elevated, and the womb may bo injected with sweet-oil. Then, if the ear can be reached, the correction of the mal-i^resentation may be attempted as above described. Should this fail one or more sharp hooks may be inserted in the neck as near the head as can be reached, and ropes attached to these may be dragged on, while the body of the foal is pushed back by the fore-limbs or hy a repeller. Such repulsion should be made in a direction obliquely upward toward the loins of the mother so as to rotate the fa^tus in such a waj' as to bring the head up. As this is accomplished a hold should be secured nearer and nearer to the nose, with hand or hook, until the head can be straightened out on the neck.
All means failing, it becomes necessary- to remove the fore-limbs {emhryoioinij) so as to make more space for bringing uj) the head. If, even then, this can not be accomplished, it may be i)ossible to push the body backward and ujaward with the repeller until the hind-limbs are brought to the passage, when they may be noosed and delivery effected with the jjosterior presentation.
HEAD TURNED BACK ON THE SHOULDER.
In this case, the fore-feet present, and the oiled hand passed along the fore-arms in search of the missing head finds the side af the neck
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turned to one side, the liead being perhaps entirely out of reach. (Plate XIII, Fig. 1.) To bring forward the head it may be desirable to lay the mare on the opposite side to that to which the head is turned, and even to give chloroform or ether. Then the feet being noosed, the body of the foetus is pushed by the hand or repeller for- ward and to the side opposite to that occupied by the head until the head comes within reaeh, near the entrance of the pehis. If such displucement of the foetus is diflficnlt, it may be facilitated by a free use of oil or lard. When the nose can be seized it can be brought into the passage as when the head is turned down. If it can not be reached the orbit may be availed of to draw the head forward unt^ the nose can be seized or the lower jaw noosed. In very diificult cases a rope maj- be passed around the neck by the hand, or with the aid of a curved carrier (Plate VIII), and traction may be made upon this while the body is being rotated to the other side. In the same way, in bad cases, a hooli may be fixed in the orbit or even between the bones of the lower jaw to assist in bringing the head up into i^osition. Should all fail, the amputation of the fore-limbs may be resorted to as advised under the last heading.
HEAD TURXED UPWAED OX THE BACK.
This differs from the last mal-presentation only in the direction of the head, which has to be sought above rather than at one side, and is to be secured and brought forward in a similar manner. (Plate XIII, Fig. 2.) If a rope can be passed around the neck it will prove most effectual, as it naturally slides nearer to the head as the neck is straightened, and ends by bringing the head vrithin easy reach.
HIND FEET ENGAGED IN THE PELVIS.
In this case fore-limbs and head present naturally, but the hind- limbs bent forward from the hip and the loins arched allow the hind feet also to enter the x)assages, and the farther labor advances the more firmly does the body of the foal become wedged into the pelvis. (Plate XII, Fig. 2. ) The condition is to be recognized by introducing the oiled hand along the bellj' of the foetus, when the hind feet will be felt advancing. An attempt should at once be made to push them back, one after the other, over the brim of the j)elvis. Failing in this, the mare may be turned on her back, head down hill, and the attempt renewed. If it is possible to introduce a straight rope carrier, a noose passed through this may be jjut on the fetlock and the repulsion therebj^ made more effective. In case of continued failure the ante- rior presenting part of the body may be skinned and cut off as far back toward the pelvis as possible (see "Embryotomy"); then nooses are placed on the hind fetlocks and traction is made upon these while the quarters are pushed back into the womb. Then the remaining portion is brought away by the posterior pi-esentation.
176
ANTERIOR PRESENTATION WITH BACK TURNED TO ONE SIDE.
The greatest diameter of the axis of tlie foal, like that of the ijelvic passages, is from above downward, and when the fcetns enters the pelvis with this greatest diameter engaged transversely or in the nar- row diameter of the pelvis, parturition is rendered difficult or impossi- ble. In such a case the pasterns and head may be noosed, and the passages and engaged portion of the foal freely lubricated with lard, the limbs may be crossed over each other and the head, and a move- ment of rotation effected in the foetus until its face and back are turned up .toward the croup of the mother; then parturition becomes natural.
BACK OP THE FOAL TURNED TO THE FLOOR OF THE PELVIS.
In a roomy mare this is not an insuperable obstacle to parturition, yet it may seriously impede it, by reason of the curvature of the body of the foal being opposite to that of the passages, and the head and withers being liable to arrest against the border of the pelvis. Lubri- cation of the passage with lard and traction of the limbs and head will usually suffice with or without the turning of the mare on her ])ack. In obstinate cases two other resorts are open: (1) to turn the foal, pushing back the fore-parts and bringing up the hind so as to make a posterior presentation, and (2) the amputation of the fore- limbs, after which extraction will usually l)e easy.
HIND PRESENTATION WITH LEG BENT AT HOCK.
In this form the quarters of the foal with the hind-legs bent up ])eneath them present, but can not advance through the pelvis by rea son of their bulk. (Plate X, Fig. 3.) The oiled hand introduced can recognize the outline of the buttocks, with the tail and anus in the center and the sharp points of the hocks beneath. First pass a rope around each limb at the hock, then with hand or repeller, push the buttocks backward and upward, until the feet can be brought up into the passages. The great length of the shank and pastern in the foal is a serious obstacle to this, and in all cases the foot should be pro- tected in the palm of the hand while being brought up over the brim of the pelvis. Otherwise the womb may be torn. When the pains are too violent and constant to allow effective manipulation, some respite may be obtained by the use of chloroform or morphia, and l)y turning the mare on her back, but too often the operator fails and the foal must be sacrificed. Two courses are still open : first, to cut through the cords behind and above the hock and extend the upper part of the limb, leaving the hock bent, and extract in this way, and, second, to amputate the hind-limbs at the hip joint and remove them separately, after whicli tlie bodv mav l)e extracted.
177
HIND PRESENTATION WITH LEGS BENT FORWARD FROM THE HIP.
This is merely an aggravated form of the presentation last de- scribed. (Plate XII, Fig. 1.) If the mare is roomy a rope maybe passed around each thigh and the bod}- pushed up"\Yard and forward, so as to bring the hocks and heels upward. If this can be accom- plished, nooses are placed on the limb farther and farther down until the fetlock is reached and brought into position. If failure is met with, then amputation at the hips is the dernier ressort.
HIND PRESENTATIONS WITH THE BACK TURNED SIDEW^AYS OR
DOWNWARD.
These are the counterparts of similar anterior presentations and are to be managed in the same way.
PRESENTATION OF THE BACK.
This is rare, yet not unknown, the foal being bent upon itself with the back, recognizable by its sharp row of spines, presented at the en- trance of the pelvis, and the head and all four feet turned back into the womb. (Plate XI, Fig. 1.) The bodj- of the foetus may be extended across the opening transversely so that the head corresponds to one side (right or left), or it may be vertical with the head above or below.
In any such position the object should be to push the body of the foetus forward and uj)ward or to one side, as may best promise to bring up the fore or hind extremities, and bring the latter into the passage so as to constitute a normal anterior or posterior presentation. This turning of the foetus may be favored by a given position of the mother, by the free use of oil or lard on the surface of the foetus, and by the use of a propeller.
PRESENTATION OF BREAST AND ABDOMEN.
This is the reverse of the back presentation, the foal being extended across in front of the pelvic opening, but with the l)elh^ turned toward the passages and with all four feet engaged in the passage. (Plate XI, Fig. 2. ) The most j^romising course is to secure the hind feet with nooses and then j)ush the fore feet forward into the womb. As soon as the fore feet are pushed forward clear of the brim of the pelvis, trac- tion is made on the hind feet so as to bring the thighs into the pas- sage and prevent the re-eutrance of the fore-limbs. If it prove diffi- cult to push back the fore-limbs a noose may be passed around the fetlock of eacli and the cord drawn through the eye of a rope carrier, by means of which the members may be easily jjushed back.
EMBRYOTOMY.
This consists in the dissection of the fcetus so as to reduce its bulk and allow of its exit through the pelvis. The indications for its
. 178
adoption have been f urnislied in tlie foregoing jpages. The o]3eration will vary in different cases according to the necessity for the removal of one or more i3arts in order to secnre the requisite reduction in size. Thus it may he needful to remove head and neck, one fore-limh or both, one hind-limb or both, to remove different parts of the trunk, or to remove superfluous (monstrous) parts. Some of the simplest operations of embryotomy (incision of the head in hydrocephalus, incision of the belly in dropsy) have already been described. It remains to notice the more difficult procedures which can be best undertaken b}^ the skilled anatomist.
Ampidaiionojihefore-Jimhs. — This may usually bo begun on the fetlock of the limb iDrojecting from the vulva. An embryotomy knife is desirable. This knife consists of a blade with a sharp, slightly hooked point, and one or two rings in the back of the blade large enough to fit on the middle finger, while the blade is j^rotected in the palm of the hand. (See Plato XIV, Fig. 4.) Another form has the blade inserted in a mortise in the handle from which it is pushed out by a movable button when wanted. First place a noose around the fetlock of the limb to be anij)utated, cut the skin circularl}^ entirely around the fetlock, then make an incision on the inner side of the limb from the fetlock uj) to the breast bone. Next dissect the skin from the limb, from the fetlock up to the breast bone on the inner side, and as far uj) on the shoulder blade as possible on the outer side. Finally, cut through the muscles attaching the limb to the breast bone, and employ strong traction on the limb so as to drag out the whole limb, shoulder blade included. The muscles around the upper part of the shoulder blade are easily torn through and need not be cut, even if that were possible. In no ease should the fore-limb be removed unless the shoulder blade is taken with it, as that furnishes the greatest obstruction to delivery, above all when it is no longer advanced by the extension of the fore-limb, but is pressed back so as to increase the already thickest posterior portion of the chest. The preservation of the skin from the whole limb is advantageous in various ways; it is easier to cut it circularly at the fetlock than at the shoulder; it covers the hand and knife in making the needful incisions, thus acting as a protection to the womb; and it affords a means of traction on the body after the limb has been removed. In dissecting the skin from the limb the knife is not needful at all j)oints; much of it may be stripped off with the fingers or knuckles, or by a blunt iron spud pushed up inside the hide, which is meanwhile held tense to render the spud effective.
Amjmtation of the head. — This is easy Avlien both fore-limbs are turned l)ack and the head alone has made its exit in part. It is more difficult when the head is still retained in the passages or Avomb, as in double-headed monsters. The head is secured by a hook in the lower jaw, or in the orbit, or by a halter, and the skin is divided
179
circularly around the lower jjart of the face or at the front of the ears, according to the amount of head protriiding. Then an incision is made backward along the line of the throat, and tlie skin dissected from the neck as far back as possible. Then the muscles and other soft parts of the neck are cut across, and the bodies of two vertebrse (neck bones) are severed by cutting completely across the cartilage of the joint. The bulging of the ends of the bones will serve to indi- cate the seat of the joint. The head and detached portion of the neck may now be removed by steady pulling. If there is still an obstacle the knife may be again used to sever any obstinate connec- tions. In the ease of a double-headed monster, the whole of the second neck must be removed with the head. When the head has been detached a rope should be passed through the eye-holes, or through an artificial opening in the skin, and tied firmly around the skin, to be employed as a means of traction when the missing limbs or the second head have been brought up into position.
Amputation of the hind-Jinih. — This maybe required when there are extra hind-limbs, or when the hind-limbs are bent forward at hock or hip joint. In the former condition the procedure resembles that for removal of a fore-limb, but recxuires more anatomical knowledge. Having noosed the i)astern, a circular incision is made through the skin around the fetlock, and a longitudinal one from that uj) to the groin, and the skin is dissected from the limb as high up as can be reached, over the croup if possible. Then cut through the muscles around the hip joint, and, if possible, the two interarticular ligaments of the joint (pubio-femoral and round), and extract the limb by strong dragging.
"In case the limb is bent forwarel at the hock, a rope is passed round that and pulled so as to bring the point of the hock between the lii)S of the vulva. The hamstring and the lateral ligaments of the liock are now cut through, and the limbs extended by a rope tied round the lower end of the long bone above (tibia). In case it is still needful to remove the upper part of the limb, the further procedure is the same as described in the last paragraph.
In case the limb is turned forward from the hip, and the foetus so wedged into the passage that turning is impossible, the case is very difficult, I have repeatedlj'^ succeeded by cutting in on the hip joint and disarticulating it, then dissecting the muscles back from the upper end of the thigh bone. A noose was placed around the neck of the bone and j)ulled on forcibly, while any unduly resisting struc- tures were cut with the knife.
Cartwright recommends to make free incisions round the hip joints and tear through the muscles when they can not be cut; then Avith cords round the pelvic bones, and hooks inserted in the openings in the floor of the pelvis to drag out the pelvic bones; then put cords around the heads of the thiuh bones and extract them: then remove
180
tho intestines; and finally, by means of the loose, detached skin, draw out the body Avith the remainder of the hind-limbs bent forward beneath it.
Renff cuts his way into the pelvis of the foal, and with a knife separates the pelvic bones from the loins, then skinning the quarter draws out these pelvic bones by means of ropes and hooks, and along with them the hind-limbs.
The hind-limbs having been removed by one or the other of these procedures, the loose skin detached from the pelvis is used as a means of traction and delivery is effected. If it has been a monstrosity with extra hind-limbs, it may be possible to bring these up into the passage and utilize them for traction.
Beinoval of the ahdominal viscera. — In case where the belly is unduly large, from decomposition, tumors, or otherwise, it may be needful to lay it oj^en with the knife and cut or tear out the contents.
Removal of the thoracic viscera. — To diminish the bulk of the chest it has been found advisable to cut out the breast-bone, remove the heart and lungs, and allow the ribs to collapse with the lower free ends overlaj)i)ing each other.
Dissection of the triinlc. — In ease it becomes necessa^-y to remove other portions of the trunk, the general rule should be followed of preserving the skin so that all manipulations can be made inside this as a i^rotector, that it may remain available as a means of exercising traction on the remaining parts of the body, and as a covering to protect the vaginal walls against injuries from bones while such part is passing.
FLOODING — BLEEDING FROM THE WOMB.
This is rare in the mare, but not unknown, in connection with a failure of the womb to contract on itself after parturition, or with eversion of the womb (casting the withers), and congestion or lacera- tion. If the blood accumulates in the flaccid womb the condition may only be suspected by reason of the rapidly advancing weakness, swaying, unsteady gait, hanging head, paleness of the eyes and other mucous membranes, and weak, small, failing pulse. The hand intro- duced into the w^omb detects the presence of the blood partly clotted. If the blood escapes 'by the vulva the condition is evident.
Treatment consists in evacuating the womb of its blood clots, giving a large dose of powdei-ed ergot of rye, and in the application of cold water or ice to tlie loins and external generative organs. Besides this a sponge impregnated with a strong solution of alum, or, still better, with tincture of muriate of iron, may be introduced into the womb and squeezed so as to bring the liquid in contact with the w^alls generally.
EVERSION OF THE WOMB.
IL" llie womb fails to contract after difficult parturition, the after- pains Avill sometimes lead to the fundus passing into the body of the
181
organ and jiassing through that and tlie ^'ag■ina until the wlioh> inverted organ aj^pears externally and hangs down on tlie thighs. The result is rapid engorgement and swelling of the organ, impaction of the rec- tum with fteces, and distension of the bladder with urine, all of which conditions seriously interfere with the return of the mass. In i-eturn- ing the Avomb the standing is preferable to the recumbent position, as the abdomen is more pendent and there is less obstruction to the return. It may, hoAvever, be necessary to put hobbles on the hind limbs to prevent the mare from kicking. A clean sheet should be held beneath the Avomband all filth, straw, and foreign bodies washed fi'om its surface. Then with a broad, elastic (india-rubber) band, or in default of that a long strip of calico 4 or 5 inches Avide, Avind the womb as tightly as possible, beginning at its most dependent i^art (the extremity of the horn). This serves two good ends. It squeezes out into the general circulation the enormous mass of blood Avhich engorged and enlarged the organ, and it furnishes a strong j)rotectiA'e covering for the now delicate friable organ, through which it may be safely manipulated Avithout danger of laceration. The next step may be the pressure on the general mass while those j^ortions next the A'ulva are gradually pushed in Avith the hands; or the extreme loAvest point (the end of the horn) may be turned Avithin itself and pu.shed forward into the vagina by tlie closed fist, the return being assisted by manipulations by the other hand, and CA^en by those of assistants. By either mode the manipulations may be made Avitli almost perfect safety so long as the organ is closely wrapped in the bandage. Once a portion has been introduced into the Aagina the rest Avill usually folloAV Avith increasing ease, and the operation should be comi^leted Avitli the hand and arm extended the full length Avithin the Avomb and moved from point to point so as to straighten out all parts of the organ and insure that no i^ortion still remains iuA^erted Avithin another por- tion. Should any such iDartial in Aversion he left it will giA^e rise to straining, under the force of AAhich it Avill gradually increase until tlie Avhole mass Avill be iirotruded as before. The next step is to apply a truss as an effectual mechanical barrier to further escape of the Avomb through the A^uh'a. The simplest is made with tAvo inch ropes, each about 18 feet long. These are each doubled and interAvoA^en at the bend, as seen in Plate VIIT, Fig. 4. The ring formed by the inter- lacing of the two ropes is adjusted around the Aaih'a, the tAvo ends of the one rope are carried up on the right and left of the tail and along the spine, being Avound round each otlier in their course, and are finally tied to the upiier part of the collar encircling the neck. The remaining tAvo ends, belonging to the other roj)e, are carried doAvn- ward and forAvard between the thighs and thence forAvard and upward on the sides of the belly and chest to lie attached to tlie right and left sides of the collar. These ropes are drawn tightly enough to keep closely applied to the opening Avithout chafing, and ^viM fit still more
182
secureh^ when tiie mare raises lier back to strain. It is desirable to tie the mare short so tliat she may be unable to lie down for a day or two, and she should be kept in a stall with the hind parts higher than the fore. Violent straining may be checked by full doses of opium (one-half dram), and any costiveness or diarrhea should be obviated by a suitable laxative or binding diet.
In some mares the contractions are too violent to allow of the return of the womb, and full doses of opium (one-half dram), laudanum {2 ounces), or chloral hydrate (1 ounce) may be demanded, or the mare must be rendered insensible \>y ether or chloroform.
RUPTURE OR LACERATIOX OF THE WOMB.
This may occur from the feet of the foal during parturition, or from ill-directed efforts to assist, but it is especially liable to take place in the everted, congested, and friable organ. The resultant dangers are bleeding from the wound, escape of the bowels through the opening and their fatal injury b}' the mare's feet or otherwise, and j)eritonitis from the extension of inflammation from the vround and from the poisonous action of the sei^tic liciuids of the womb escaping into the abdominal cavity. The first object is to close the wound, but unless in eversion of the womb this is practically impossible. In the last- named condition the wound must be carefully and accurately sewed up before the womb is returned. After its return, the womb must be injected daily with an antiseiJtic solution (borax one-half ounce or carbolic acid 3 drams to a fj[uart of tepid water). If inflammation threatens, the abdomen may be bathed continuously with hot water by means of a heavy woolen rag, and large doses of opium (one-half dram) may be given twice or thrice daily.
RUPTURES OF THE VAGIXA.
These are attended ]iy dangers similar to those belonging to rupture of the womb, and in addition by the risk of x3rotrusion of the bladder, which appears through the lips of the vulva as a red pyriform mass. Sometimes such lacerations extend downward into the bladder, and in others ui3ward into the terminal gut (rectum). In still other cases the anus is torn so that it forms one common orifice with the vulva.
Too often such cases prove fatal, or at least a recovery -is not attained, and urine or fjeces or both escape freely into the vagina. The simple laceration of the anus is easily sewed up, but the ends of the muscular fibers do not reunite and the control over the lower bowel is never fully reacquired. The successful stitching up of the wound communicating v.ith the bladder or the rectum requires unusual skill and care, and though I have succeeded in a case of the latter kind, I can not advise the attempt by unprofessional persons.
183
BLOOD CLOTS IN" THE AVALLS OF THE VAGINA.
See "()l)structions to Parturition."
IXFLAMMATIOX OF THE AVOIIB AND PERITONEUM.
These may result from injuries sustained by tlie Avomb during or after j)arturitLon, from exx^osure to cold or Avet, or from the irritant action of putrid products within the Avomb. Under the inflammation the Avomb remains dilated and flaccid, and decomposition of its secre- tions almost alAvaj's occurs, so that the inflammation tends to assume a putrid character and general septic infection is likely to occur.
Tlie symptoms are ushered in by shivering, staring coat, small rapid j)ulse, eleA'ated temperature, accelerated breathing, inapx^etence, AAitli arched back, stifi: moA'ement of the bodj^, looking back at the flanks, and uneasy motions of the hiud limbs, discharge from the Auh^a of a liquid at first AAatery, reddish, or yelloAvish, and later it maybe A^llitish or glairy, and fetid or not in different cases. Tenderness of the abdo- men shown on x^i'essure is especially characteristic of cases affecting the x^eritoneum or liuingof thebelh', and is more marked lower down. If the animal surviA^es, the inflammation tends to become chronic and attended by a AAiiitish muco-x)urulent discharge. If, on the contrary, it x^roA^es fatal, death is preceded by extreme prostration and Aveakness from the general sex^tic x>oisoning.
In ireatment the first thing to be sought is the removal of all offen- sive and irritant matters from the womb through a caoutchouc tube introduced into the Avomb, and into AA^hieh a funnel is fitted. AVarm Avater should be x^assed until it comes awaA^ clear. To insure that all of the Avomb has been Avashed out, the oiled hand ma}- be introduced to carry the end of the tube into the tAvo horns successiA^ely. When the offensive contents liaA'e been thus remoA^ed, the Avomb should be injected Avith a. quart of water holding in solution one-half ounce per- manganate of x^otash, or, in the absence of the latter, tAvo teasx^oonfuls of carbolic acid. Repeat twice da.ily. Fomentation of the abdomen, or the apx)lication of a Avarm flax-seed x^oultice, may greatly relicA'e. Acetanilid, in doses of half an ounce, repeated tAvice or thrice a day, or sulx)hate of quinia in doses of one-third ounce, may be emx)loyed to reduce the fcA^er. If the great x^ostration indicates sex^tic poisoning- large doses (one-half ounce) bisulphite of soda, or salicylate of soda may be resorted to.
LEUCORRHCEA.
This is a white, glutinous, chronic discharge, the result of a con- tinued sub-acute inflammation of the mucous membrane of the Avomb. Like the discharge of acute inflammation it contains many forms of bacteria, by some of Avhieh it is manifestly inoculable on the penis of the stallion, x^i'oducing ulcers and a specific gonorrhoeal discharge.
184
Treatment may consist in the internal use of tonics (sulphate of iron 3 drams, daily) and the washing out of the womb, as described under the last heading, followed by an astringent antiseptic injection (car- bolic acid 2 teaspoonfuls, tannic acid one-half dram, water 1 quart). This may be repeated two or three times a day.
LAMINITIS OR FOUNDER FOLLOWING PARTURITION.
This sometimes follows on inflammation of the womb, as it fre- quently does on disorder of the stomach. Its symptoms agree with those of the common form of founder, and treatment need not differ.
DISEASES OP THE UDDER AND TEATS — CONGESTION AND INFLAMMA- TION OF THE UDDER.
This is comparatively rare in the mare, though in some cases the udder becomes painfully engorged before j)ai'turition, and a doughy swelling, pitting on pressure, extends forward on the lower surface of the abdomen. When this goes on to active inflammation one or both of the glands become enlarged, hot, tense, and painful; the milk is dried up or replaced by a watery or reddish serous fluid, which at times becomes fetid; the animal walks lame, loses appetite, and shows general disorder and fever. The condition may end in recovery, in abscess, induration, or gangrene, and in some cases may lay the foun- dation for a tumor of the gland.
The treatment is sim^^le so long as there is only congestion. Active rubbing with lard or oil, or better, camphorated oil, and the frequent drawing off of the milk, by the foal or with the hand, will usually bring about a rapid improvement. When active inflammation is present fomentation Avith warm water may be kept up for an hour and followed by the application of the camphorated oil, to which has been added some carbonate of soda and extract of belladonna. A dose of laxative medicine (4 drams Barbadoes aloes) will be of service in reducing fever, and one-half ounce saltpeter daily will serve a similar end. In case the milk coagulates in the udder and can not be withdrawn, or Avhen the liquid becomes fetid, a solution of 20 grains carbonate of soda and 10 droits carbolic acid dissolved in an ounce of water shouldibe injected into the teat. In doing this it must be noted that the mare has three separate ducts opening on the summit of each teat and each must be carefully injected. To draw off the fetid product it may be needful to use a small milking tube, or spring teat- dilator designed by the writer (Plate VIII, Figs. 2 and 3). When pus forms and i^oints externally, and can not find a free escape by the teat, the spot where it fluctuates must be opened freely with the knife and the cavity injected daily with the carbolic acid lotion. When the gland becomes hard and indolent it may be rubbed daily with iodine ointment 1 part, vaseline 6 jiarts.
PLATE VTR
Haines.del.aftet Fleming. AHoen&Co Lith.Bahrmore
INSTRT^MENTS TL'SED IN DIFFICin.T LABOR.
PI.ATE IX.
attor rierain^
VertehTf) Sfirral pn'seidnljnn,.
Z.u/iiIjo-Sfirjyi7 pn'srjtiti/i/rn- .
Haines, del.
A.Hoen jCo Lith.BaltM'iore
NOr^^IAI. PRKSET^r TATIOiSrS.
PI.ATE XI
'/} ri/isi 'e/sc /)i ■fs('nt(r;tu)n - 1 'pper i ■ten ■
.Str/riii-ti/x/onii/ud pn:seriiiifit>ri Hrru/ tuu/ Fee/ rricfagetl .
Haines, aftm l-"li"iniiia
A Hoen &Co Lithocaustic Bahimor
AJ'. X( )HM.\1. 1 >l'vK.SKX'l\ATIC:»NS
PLATE Xn.
Thir//t art/7 rj-oup pT-e.scntrilion,
^ t/i/f'/-/ar//ft:'if///ff//f>/f . Hinf/ /I'nih drrifif-ifni
after Fleming.
A Hoen iCo Lith. Baltimore.
v\B NOR^IAL T'riK SEN 1V\ TIOXS .
PLATE Xm
^Tii&rior presejrtatijOJi^.Jfecut tiirnecL on side .
ylnfervxn- prest'niatwn. IJca/l Uu-tuicL on bcick
AHoen &Co Lith .Baltimore,
^B IKT C)r?^I^I^ F'PIK S K N '1VS.TI ON S
li:
i\,l0/(^
/
5 i^
"-J_
185
TUMORS OF THE UDDER.
As the result of inflammation of the udder it may become the seat of an indurated diseased growth, which may go on growing and seriously interfere with the movement of the hind limbs. If such swellings will not give way in their early stages to treatment by iodine the only resort is to cut them out with a knife. As the gland is often impli- cated and has to be removed, such mares can not in the future suckle their colts, and therefore should not be bred.
SORE TEATS, SCABS, CRACKS, WARTS.
By the act of sucking, especially in cold weather, the teats are sub- ject to abrasions, cracks, and scabs, and as the result of such irrita- tion, or independently, warts sometimes grow and jjrove troublesome. The warts should be clipped off with sharp scissors and their roots burned with a solid 2:)encil of lunar caustic. This is best done before parturition to secure healing before suckling begins. For sore teats use an ointment of vaseline 1 ounce, balsam of tolu o grains, and sulphate of zinc 5 grains.
DISEASES OE THE. N1:R\T)US SYSTEM.
By M. R. TRUMBOWER, V. S.
THE AXATOilY AND PHYSIOLOGY OF THE BRAIX AXD NERVOUS
SYSTEM.
The nervotis sj'stem may be regarded as consisting of two sets of organs, peripheral and central, the function of one being to establish a eomniunication between the centers and the different parts of the body, and that of the other to generate nervous force. The whole may be arranged under two divisions: First. The cerehi'G-spinal or nervous sj^stem of animal life. Second. The sympathetic, ganglionic, or nervous system of organic life. Each is possessed of its own cen- tral and peripheral organs.
In the first, the center is made uj) of tv\'o portions, one large and expanded — the brain — i)laced in the cranial cavity; the other elon- gated— spinal cord — continuous with the brain, and lodged in the canal of the vertebral column. The perij)heral portion of this sj'stem consists of the cerebro-spinal nerves, which leave the axis in symmet- rical pairs, and are distributed to the skin, the voluntary muscles, and the organs of common and spinal sensation.
In the second, the central organ consists of a chain of ganglia con- nected by nerve cords, which extends from the head to the rump of each side of the spine. The nerves of this sj'stem are distributed to the in voluntar}'- muscles, mucons membrane, viscera, and blood-vessels.
The two systems have free intercommunication, ganglia being at tiic junctions.
Two substances, distinguishable by their color, enter into the for- mation of nervous matter, viz. , the w^hite or medullary, and tlie gray or cortical substance. Both are soft, fragile, and easil}' injured, in consequence of wliich the principal nervous centers are always well protected bj" bony coverings. The nervous substances present two distinct forms — nerve fibers and nerve cells. An aggregation of nerve
cells constitutes a nerve ganglion.
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The nerve fibers represent a conducting apparatus, and serve to place the central nervous organs in connection with peripheral end organs. The nerve cells, however, l)esides transmitting impulses, act as physiological centers for automatic or reflex movements, and also for the sensory, perceptive, trophic, and secretory functions. A nerve consists of a Inindle of tuljular fillers, held together by a dense areolar tissue, and inclosed in a membranous sheath— the neurilemma. Nerve fibers possess no elasticit}^, but are very strong. Divided nerves do not retract.
Nerves are thrown into a state of excitement when stimulated, and are, therefore, said to possess excitable or irritahJe propertiefi. The stimuli may be applied to, or may act upon any part of the nerve. Nerves may be paralyzed by continuous pressure being applied. When the nerves divide into branches, there is never any splitting up of their ultimate fibers, nor yet is there ever any coalescing of them; they retain their individuality from their source to their termination.
Nerves which convey imi^ressionsto the centers are termed sonsory or centripetal, and those which transmit stimulus from the centers to organs of motion are termed motor or centrifugal.
The function of the nervous system may, therefore, be defined in the simj)lest terms, as follows: It is intended to associate the different parts of the hody insiadi a manner that sfinndus applied to one organ may excite or depress the activity of another.
The brain is that portion of the cerebro-spinal axis within the cra- nium, which may be divided into four parts — the medulla oblongata, the cerebellum, the j)07?.s Varolii, and the cerebrum, and it is cov- ered by three membranes called the meninges. The first of these membranes, the dura mater, is a tMc'k, white, fibrous membrane which lines tlie cavity of the cranium, forming the internal i3eriosteum of the bones; it is continuous with the spinal cord to the extremity of the canal. The second, the arachnoid, is a delicate serous membrane, and loosel}^ envelops the l)rain and spinal cord; it forms two layers, leav- ing between them the arachnoid space which contains tlife cerebro- spinal fluid, the use of which is to protect the spinal cord and brain from pressure. The third, the jji'a mcder, is closely adherent to the entire surface of the brain, but is much thinner and more vascular than when it reaches the spinal cord which it also envelops, and is continued to form the sheaths of the spinal nerves.
The medulla oblongata is the prolongation of the spinal cord, ex- tending to the pons Varolii. This portion of the brain is very large in the horse; it is pyramidal in shape, the narrowest part joining the cord.
The pons Varolii is the transverse projection on the base of the brain, between the medulla oblongata and the peduncles of the cere- brum.
The cerebellum is lodged in the posterior part of the cranial cavity, immediately above the medulla oblongata; it is globular or elliptical
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in shape, the transverse diameter being greatest. The body of the cerebellum is composed of gray matter externally and white in the center.
The cerebrum, or brain projier, occupies the anterior jiortion of the cranial cavit^^ It is ovoid in shape, Avith an irregular flattened base, and consists of lateral halves or hemispheres. The greater part of the cerebrum is composed of white matter. The hemisjiheres of the cerebrum are usually said to be the seat of all psj'^chical activities. Only when they are intact are the ijrocesses of feeling, thinking, and A\alling possible. After they are destroyed, the organism comes to be like a complicated machine, and its activity is only the expression of the internal and external stimuli which act upon it. The cerebellum is the great and important central organ for the finer co-ordination and integration of movements. Injuries to the cerebellum cause dis- turbance of the equililjrium of the body, but do not interfere with the l)S3'chical activities or the will or consciousness, neither does an injury to these parts give rise to pain.
The spinal cord or spinal marrow is that j)art of the cerebro-spinal system which is contained in the spinal canal of the backbone, and extends from the medulla oblongata to a short distance behind the loins. It is an irregularly cylindrical structure, divided into two lat- eral symmetrical halves by fissures. The spinal cord terminates pos- teriorly in a i)ointed extremit}^, which is continued hy a mass of nervous trunks — ccmda equince. A transverse section of the cord reveals that it is composed of white matter externally and of graj'^ internally. The spinal cord does not fill up the whole spinal canal. The latter contains, besides, a large venous sinus, fatty matter, the membranes of the cord, and the cerebro-spinal fluid.
The sijinal nerves, forty-two or forty-three in number, arise each by tAvo roots, a suj)erior or sensorj^ and an inferior or motor. The nerves originating from the brain are twenty-four in number, and arranged in j)airs, which are named first, second, third, etc., counting from before backward. They also receive special names, according to their functions, or the parts to which they are distributed, viz :
1. Olfactory. 7. Facial.
2. Optic. 8. Auditory.
3. Oculo-motor. 9. Glosso-Pharyngeal. •1. Pathetic. 10. Pneiimogastric.
5. Trifacial. 11. Spinal- Accessory.
C. Abducens. 12. Hjq^jogiossal.
INFLAMMATION OF THE BRAIN AND ITS MEMBRANES.
Inflammation may attack these membranes singly, or any of the anatomical divisions of the nerve matter, or it may invade the whole at once. Practical experience, however, teaches us that primar}" in- flammation of the dura mater is of rare occurrence, except in direct mechanical injuries to the head or diseases of the bones of the
190
cranium. Neither is the arachnoid often affected with acute inflam- mation except as a secondary result. The pia mater is most com- monly the seat of inflammation, acute and subacute, but from its intimate relation with the surface of tlie bi-ain the latter very soon becomes involved in the morbid changes. Practicallj', we can not separate inflammation of the pia mater from that of the brain proper. Inflammation may, however, exist in the center of the great nerve masses, the cerebrum, cerebellum, pons A^arolii, or medulla at the base of the brain, without involving the surface. AYhen, therefore, inflammation invades the brain and its enveloping membranes it is properlj^ called enceplialUisj when the membranes alone are affected it is called meningitis; or the brain substance alone, cerebritis.
ENCEPHALITIS — INPLAMMATIOX OF THE BRAIN AND ITS MEMBRANES.
Causes. — Exposure to extreme heat and cold, excessive continued cerebral excitement, direct injuries to the brain, such as concussion, or from fracture of the cranium, sometimes as a sequela to influ- enza, pj^seniia, poisons having a direct influence ni^on the encephalic mass, etc.
Sijinptoms. — Acute encephalitis may be ushered in by an increased sensibility to noises, with more or less nervous excitability, contrac- tion of the pupils of the eyes, and a quick, hard pulse. In very acute attacks these symptoms, however, are not always noted. This condition will soon be followed by muscular twitchings, convulsive or spasmodic movements, eyes wide open v,'itli shortness of sight. The animal becomes afraid to have his head handled. Convulsions and delirium may develop, with inability of muscular control, or stupor and coma may supervene. Where the membranes are greatly implicated convulsions and delirium with violence may be expected, but where the brain substances are principally affected stupor and coma will be the prominent symptoms. In the former condition the pulse Avill be quick and hard, in the latter soft or depressed with often a dilatation of the pupils, and deep, slow, stertorous breathing. The symptoms may follow one another in rapid succession, and the disease approach a fatal termination in less than twelve hours. In subacute attacks the sj^mptoms are better defined, and the animal seldom dies before the third daj^ Within three or four days gnulual imjirovement may become manifest, or cerebral softening Avith par- tial paralysis may occur. In all cases of encephalitis there is a marked rise in temperature from the very onset of the disease, with a tendency to increase until the most alarming symptoms develop, succeeded by a decrease when coma becomes manifested. The vio- lence and character of the symptoms greatly depend upon the extent and location of the structures involved. Thus, in some cases we may find marked paralysis of certain muscles, while in others we nmy have spasmodic rigidity of muscles in a certain region. Very rarely the
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animal becomes extremely violent early in tlie attack, and by rear- ing up, striking witli the fore feet, or falling over, may do lumsalf great injur}-. Usuallj', however, the animal maintains the stand- ing i)osition, propping himself against the manger or wall until he falls from inability of muscular control or unconsciousness. Occa- sionally he may go through a series of automatic movements in his delirium, such as trotting or walking, and if loose in a stall will move around in a circle persistently. Early and persistent consti- pation of the bowels is a marked symptom in nearly all acute affec- tions of the brain; retention of the urine, also, is frequently observed. Chronic encephalitis. — This may succeed the acute stage, or maybe due to stable miasma, blood-poison, narcotism, lead-poisoning, etc. Contrary to acute encephalitis, this form is not characterized in its initial stages by excitability, quick and hard pulse, and high fever. The animal appears at first stupid; eats slowly; the pupil of the e3"e does not resi3ond to light quickh'; the animal often throws u^) his head or shakes it as if suffering sudden twinges or pain. He is slow and sluggish in his movements, or there may be partial paralysis of one limb, one side of the face, neck, or body. These symptoms, with some variations, mny be present for several days and then subside, or ihe disease may pass into the acute stage and terminate fatall}'. Chronic encephalitis maj- affect an animal for ten days or two weeks without much variation in the symptoms before the crisis is reached. If improvement commences the sj^m^jtoms usually disappear in the reverse order in which they developed with the exception of the para- l3'tic effects, which remain intractable or permaneu-t. Parah'sis of certain sets of muscles is a very common result of chronic, subacute, and acute encephalitis, and is due to softening of the brain, or to exudation into the cavities of the brain or arachnoid space.
MENINGITIS — THE MAD STAGGERS OF THE OLD V\'RITER8 — INFLAMMA- TION OF THE CEREBRAL ENVELOPES.
Causes. — Excess of heat or cold, wounds of the cranium and mem- branes, rheumatism, influenza, rupture of meningeal blood-vessels, etc.
Symptoms. — In an attack of acute meningitis the symptoms appear very suddenly- and are often extremeh* violent. The violent pain in the head is indicated by the animal flj'ing back in the lialter, plung- ing forward or running ahead, regardless of obstacles or obstructions in the Avay. The pulse is very rapid, the breathing accelerated or panting, the pupils of the eyes contracted, and the muscles of the bod}'- quivering. All these sj'mptoms may develop Avithin a fcAV minutes or in a few hours. If the animal does not obtain' relief , spasms or rigidity of the muscles along one or both sides of the neck or back Avill become manifest, the head Avill be held elevated, the eyeballs Avill retract into their sockets, the eye-lids twitch, convulsions and furious delirium Avill soon appear, folloAved by coma and death. Acute meningitis may
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result fatally in a very few hours. During the whole course of the disease the more violent symptoms occur in paroxysms, and the least noise or disturbance serves to induce them. In the quiescent jjeriods the animal appears dull and drowsy. The urine is frequently ejected in spurts and strong efforts are made to pass manure. In subacide meningitis the symptoms will develop more slowly and be less marked by violence. The sensor}' functions may not be much interfered with until the near approach of death. In such attacks the animal may suffer for a week or longer and ultimately recover. In meningitis the temperature varies from IDS'" to 107° F., according to the severity of the attack.
The violent symptoms of this disease must not be confounded with those of rabies. In the latter the violence is directed at some object or ui)on the animal himself; in the former no malice is shown toward the attendant or surrounding objecl^s, but is simply the manifestation of excruciating jDain in the head. Meningitis may be distinguished from encephalitis and cerebritis bj^ the absence of marked localized paralytic sjnnptoms, or of coma, until the near aj^proach of death. It is characterized by violence, increased sensibility, and delirium.
CEREBRITIS — INFLAMMATION OF THE BRAIN SUBSTANCE.
Causes. — The causes giving rise to this disease are very numerous. Among them may be mentioned all those named heretofore as causing encephalitis and meningitis, cystic and calcareous tumors, thrombi, urpemic poisoning, metastatic abscesses, septic infection, etc.
Symptoms. — Cerebritis, when unaccompanied by other disease, is seldom recognized as such during life. It is alwaj^s localized in extent, and the symptoms manifested depend upon the location of the organic change for their character. The symptoms, therefore, are as varied as the causes; they are usually of slow development and persistent. A'ertigo or giddiness ma}^ be regarded as a constant symptom. The animal may stop on the road, shake his head, or stagger, api^arently undecided in what direction to go. There may be contraction of the pupils, cramp of the muscles on the side of the neck or face, ftulse small and hard and variable in frequency, often, however, slower than normal. The temperature is slightly increased, the respira- tions may be slow and deep, the appetite capricious, bowels consti- pated; rapid emaciation is a common symptom. Such conditions may be apparent for a week or two Aveeks; then the horse may become comatose. The pu^iils dilate, the jjulse becomes intermitting, swal- lowing difficult, the muscles which were previousl}^ rigid become i-elaxed and paralyzed, and the urine may either be retained or be dis- charged involuntarily. In this way the animal may survive another week and then die in a jjaralyzed and unconscious state. Not infre- quently, however, few of those symptoms are manifested, for in some cases the paralysis is sudden from extensive lesions of the brain, and the animal may die within twenty-four hours. '
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SOFTENING AND ABSCESS OF THE BRAIN.
This is one of the terminations of cerebritis. It may also be dne to an insiiflicient supply of blood as a result of diseased cerebral arteries and of apoplexy.
Sympioms. — Drowsiness, vertigo, or attacks of giddiness, increased timidity, or fear of familiar objects, paralysis of one limb, hemiplegia, imperfect control of the limbs, and usually a weak, intermittent pulse. In some cases the symptoms are analogous to those of apoplexy. The character of the symptoms depends upon the seat of the softening or abscess within the brain.
CEREBRAL SCLEROSIS.
This is a result of an inflammation in the structure of the brain affecting the connective tissues, which eventually become hypertro- phied and press upon nerve cells and fibers, causing their ultimate disappearance, leaving the parts hard and indurated.
Sijmpfoms. — This condition gives rise to a progressive paralysis, and may extend along a certain bundle of fibers into the spinal cord. Complete paralysis almost invariably supervenes and causes death.
PATHOLOGY OF ACUTE BRAIN AFFECTIONS.
On making post mortem examinations of horses which have died in the first stages of either of those diseases, we will find an excessive engorgement of the capillaries and small blood-vessels, with corre- spondingly increased redn^ess and molecular changes in both contents and the walls of the vessels. If the death has occurred at a later period of the disease, in addition to the redness and engorgement we will find that an exudation of the contents of the blood-vessels into the tissues and upon the surfaces of the inflamed parts has super- vened. If the case has been one of encephalitis we will usually find more or less watery fluid in the ventricles (natural cavities in the brain), in the sub-arachnoid space, and a serous exudation between the convolutions and interstitial si^aces of the graj^ matter under the membranes of the brain. The amount of fluid varies in difl'erent cases. In some where the animal's l)lood was very plastic, exudations of a membranous character may be present and are found attached to the surface of the pia mater.
In meningitis, especially in chronic cases, iii addition to the serous effusion, we find changes which may be regarded as characteristic in the formation of a delicate and highly vascular laj'er or layers of membrane or organized structure on the surface of the dura mater, and also indications of hemorrhages in connection with tlio mem- branous formations. Haematoma or blood tumors may be found embedded in this membrane. In some cases the hemorrhages are copious, causing paralysis or apoplexy, followed by sjjeedy death. 5961— HOR 7
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In cerebritis, or inflammation of the interior of tlie brain, there is a tendency to softening and suppuration and the formation of abscesses. In some cases the abscesses are small and numerous, surrounded with a softened condition of the brain matter, and sometimes we may And one large abscess. In cases of recent development the walls of the abscesses are fringed and ragged and have no lining membrane. In older or chronic cases, the walls of the abscesses are generally lined with a strong membrane, often having the appearance of a sac or cyst, and the contents have a very ofl!ensive odor.
Treatment. — In all acute attacks of inflammation involving the mem- branes or cerebral masses, it is the pressure from the distended and engorged blood-vessels, and the rapid accumulation of inflammatory products, that endanger the life of the animal in even the very early stage of the disease. The earlier the treatment is commenced to lessen the danger of fatal j^ressure from the engorged blood-vessels, the less amount of inflammatory j)roducts and efl'usion we have to contend with later on. The leading object then to be accomi)lished in the treatment of the first stages of encephalitis, meningitis, or cerebritis is to relieve the engorgement of the blood-vessels before a dangerous degree of effu- sion or exudation has taken i)lace, and thereby lessen the irritation or excitability of the affected structures. If we fully succeed in this stage in the accomplishment of this object, we certainly j^revent a second stage of the disease, and it will only be required to continue a treatment which will tend to lessen irritability to prevent a second engorgement from taking place. But if the attemiDt to relieve the engoi'gement in the first stage has been only partially successful, and the second stage with its inflammatory products and exudations, whether serous or iDlastic, has set in, then the main objects in further treatment are to keep up the strength of the animal and hasten tlie absorption of the exudative products as much as possible. To obtain these results, when the animal is found in the initial stage of the dis- ease, vrhere there is unnatural excitability or stupor Avith increase of temperature and quickened x^^ikse, Ave must rely upon the safest and quickest acting remedj" at hand, AA^hich is coitions bleeding from the jugular A'ein. Especially in acute meningitis, bleeding is imperatiA'cly demanded. The finger should l)e kept on the pulse, and the blood alloAA'ed to flow until there is a marked fluttering or softening of the pulse. As soon as the animal recoA^ers somewhat fi-om the shock of the bleeding, the folloAA'ing medicine shoidd be made into a ball or dissoh'ed in a pint of AA'arm Avater, and be given at one dose: Barba- does aloes, 7 drams; calomel, 2 drams; poAAclered ginger, 1 dram; tincture of aconite, 20 drops.
The animal should be placed in a cool, dark place, as free from noise as possible, and cloths Avrung out of hot AA'ater jilaced upon his head. These should be reneAved frequently for at least twelve hours. "When the animal becomes thirsty half an ounce of saltxieter may be dissoh'ed
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in his drinking water every six hours. Injections of warm water into the rectum may facilitate the action of tlie purgative. Norwood's tincture of veratrum viride, in 20-drop doses, should he given every hour, and 1 dram of solid extract of belladonna every four hours, until the symptoms become modified and the pulse regular and full.
If this treatment fails to give relief tlie disease will pass into the advanced stages, or if the animal has heen neglected in the earh* stages the treatment must be supi)lanted with the hypodermic injection of ergotin, in 5-grain doses, dissolved in a dram of water, every six hours. The limbs may be i^oulticed above the fetlocks with mustard. Cold water or ice-bags should now take the place of the hot-water cloths on the head. Warm blanketing, to promote perspiration, is to be observed in all cases in which there is no excessive perspiration.
If the disease becomes chronic — encephalitis or meningitis — we must place our reliance upon alteratives and tonics, with such incidental treatment as special symptoms may demand. Iodide of i)Otassium in 2-drani doses should be given twice a day, and 1 dram of calomel once a day, to induce absorption of effusions or thickened membranes. Tonics, in the form of iodide of iron in dram doses, to which is added 2 drams of powdered hydrastis, may also be given every six or eight hours, as soon as the active fever has abated. In all cases, after the disappearance of tlie acute symi)toms, blisters (cantharides ointment) should be applied behind the poll. . When paralytic effects remain after the disappearance of all other symptoms, sulphate of strychnia in 2-grain doses, in combination Avith the other tonics, may be given twice a day, and be continued until it produces muscular twitching. In some cases of paralysis, as of the lips or throat, benefit may be derived from the moderate use of the electric batter}-. Many of the recoveries will, however, under the most active and early treatment, be but partial, and in all cases the animals become predisposed to sub- sequent attacks. A long period of time should be allowed to pass before the animal is exposed to severe work or great heat. When the disease depends ui3on mechanical injuries the}" have to be treated and all causes of irritation to the brain removed. If it is due to stable miasma, unemic poisoning, pyaemia, influenza, rheumatism, toxic agents, etc., they should receive promjot attention for their removal or mitigation.
Cerebral softening, abscess, or sclerosis, are practically inaccessible to treatment, otherwise than such relief as may be afforded by the administration of opiates and general tonics, and, in fact, the diag- nosis is largely presumptive.
COXGESTIOX OF THE BRAIN — MEGRIMS.
Congestion of the brain consists in an accumulation of blood in the vessels, also called hj^i^erpemia, or engorgement. It may be active or passiN'e — active when there is an undue determination of blood or
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diminished arterial resistance, and passive when it accumulates in the vessels of the brain, owing to some obstacle to its return by the veins.
Causes. — Active cerebral congestion may be due to hypertrophy of the left ventricle of the heart, excessive exertion, the influence of extreme heat, sudden and great excitement, artificial stimulants, etc. Passive congestion may be produced by any mechanical obstruction which prevents the proper return of blood through the veins to the heart, such as small or ill-fitting collar, which often impedes the blood current, tumors or absceSses pressing on the vein in its course, and organic lesions of the heart with regurgitation.
Extremely fat animals with short thick necks are peculiarly subject to attacks of cerebral congestion. Simple congestion, however, is merely a functional affection, and in a slight or moderate degree involves no immediate danger. Extreme engorgement, on the con- trarj^ may be followed by rux)ture of previously weakened arteries and capillaries and cause immediate death, designated then as a stroke of apoplexy.
Symptoms. — Congestion of the brain is usually sudden in its mani- festation and of short duration. The animal may stop very suddenly and shake his head or stand quietly braced on his legs, then stagger, make a plunge, and fall. The eyes *are staring, breathing hurried and stertorous, and the nostrils widely dilated. This may be followed by coma, violent convulsive movements, and death. Generally, how- ever, the animal gains relief in a short time, but he may remain weak and giddy for several days. If it is due to organic change of the heart or to disease of the blood-vessels in the brain, then the s^'mp- toms may be of slow development manifested by drowsiness, dimness or imperfect vision, dif&culty in voluntary movements, diminished sensibilitj'^ of the skin, loss of consciousness, delirium, and death. In milder cases effusion may take j^lace in the arachnoid spaces and ventricles of the brain followed by paralysis and other complications.
Pathology. — In congestion of the brain the cerebral vessels are loaded with blood, and the venous sinuses distended to an extreme degree, and the pressure exerted upon the brain constitutes actual compression, giving rise to the symptoms just mentioned. On pos/- rnortein examinations this engorgement is found universal through- out the brain and its membranes, which serves to distinguisli it from inflammations of these structures, in Avhich tlie engorgements are confined more or less to circumscribed portions. A prolonged conges- tion may, however, lead to active inflammation, and in that case we will find serous and plastic exudations in the cavities of the brain. In addition to the intensely engorged condition of the vessels we find the gray matter of the brain redder in color than natural. In cases where several attacks have occurred the blood-vessels are often found permanently dilated.
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Treaimenf. — Prompt removal of all meclianieal obstructions to the circulation. If it is due to venous obstruction by too tight a collar, the loosening of the collar will give immediate relief. If due to tumors or abscesses, a surgical operation becomes necessary to afford relief. To revive the animal if he become j)artially or totally uueon- cious cold water should be dashed on the head, and if this does not afford read}' relief recourse must be had to bleeding to lessen arterial tension. Tincture of veratrum viride or of aconite root may be given in twenty-droj) doses every hour until consciousness returns. If the limbs are-cold tincture of capsicum or strong mustard water should be applied to them. If symptoms of paralysis remain after two or three days, an active cathartic and iodide of potassa will be indicated, to be given as prescribed for inflammation of the brain.
Preveniion. — "Well adjusted collar, with strap running from the collar to the girth, to hold down the collar when pulling \\\) grade; regular feed and exercise, without allowing the animal to become excessively' plethoric; moderate checking, allowing a free and easy movement of the head; well ventilated stabling, proper cleanliness, pure water, etc.
SUNSTROKE — HEAT EXHAUSTIOX.
The term sunstroke is applied to affections occasioned not exclu- sively by exiDOSure to the sun's rays, as the word signifies, but by the action of great heat combined generally Avith other causes, such as dryness and rarefaction of the air and an unusual accumulation of electricity. Exhaustion produced by a long continued heat is often the essential factor, and is called heat exhaustion. Horses on the race track undergoing protracted and severe work in hot weather often succumb to heat exhaustion. Draught horses exposed to the direct rays of the sun for many hours, which do not receive proper care in watering, feeding, rest in shady places, suffer very frequently from sunstroke.
Symptons. — Sunstroke is manifested suddenly. The animal stops, drojDS his head, begins to stagger, and soon falls to the ground uncon- scious. The breathing is marked with great stertor, the pulse is very slow and irregular, cold sweats break out in patches on the surface of the body, and the animal often dies without recovering consciousness.
In heat exhaustion the animal usually requires urging for some time previous to the appearance of any other sj'mptoms, generally per- spiration is checked, and then he becomes weak in his gait, the breath- ing hurried or i^anting, ej'es watery and bloodshot, nostrils dilated and highly reddened, assuming a dark, purple color; the pulse is rapid and weak, the heart bounding, followed by unconsciousness and death. If recovery takes place convalescence extends over a long period of time, during which incoordination of movement may persist.
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Paihologij. — Sunstroke, virtually active congestion of the brain, often accompanied by effusion and blood extravasation, characterizes this condition, -with often rapid and fatal lowering of all the vital functions. The death vtviiy be due in many instances to the complete stagnation in the circulation of the brain, inducing ansemia or want of nourishment of that organ. In otber cases it may be directly due to the excessive compression of the nerve matter controlling the heart's action, and cause paralysis of that organ.
Trecdmenf. — Under no circumstances is blood-letting permissible in sunstroke. Ice or ver}^ cold water should be ai)plied to the head and along the spine and half an ounce of carbonate of ammonia or G ounces of whisky should be given in a pint of water. Injections, per rectum, of moderately strong ginger tea or weak ammonia water may be used with benefit. Brisk friction of the limbs and the application of spirits of camphor often yield good results. The administration of the stimulants should be repeated in one hour if the pulse has not become stronger and slower. If the animal is suffering from heat exhaustion similar treatment may l.)e used, with the exception of cold to the head and spine, for in this case clothes wrung out in hot water s'lould be applied. In either case, when reaction has occurred prepara- tions of iron and general tonics may l)e given during convalescence: Sulphate of iron 1 dram, gentian 3 drams, red cinchona bark 2 drams; mix and giA'e in the feed morning and evening.
Prevention . — In very hot weather horses sliould have wet sponges or light sun-shades on the head when at work, or the head may be si)onged Avith cold water as many times a daj' as j^ossible. Proper attention should be given to feeding and watering, never in excess. During the warm months all stables should be cool and well A'enti- lated, and if an animal is debilitated from exhaustive work or disease he should receive such treatment as will tend to build up the system.
An animal which has been affected Avith sunstroke is \Qvy liable to have subsequent attacks when exj^osed to tlie necessary exciting causes.
APOPLEXY — CEREBRAL HEMORRHAGE.
Apoplexy is often confounded with cerebral congestion, but true apoplex}- always consists in rupture of cerebral blood-vessels, with blood extravasation and formation of blood clot.
Causes. — Two causes are involved in the production of apoplexy, the 2n-e(lispos in (J -And \\\q exciting cause. The predisposing cause is degeneration or disease which weakens the blood-vessel, the exciting c;uise is any one which tends to induce cerebral congestion.
Symptoms. — Apoplexy is characterized by a sudden loss of sensa- tion and motion, profound coma, and stertorous and difficult breath- ing. The action of the heart is little disturbed at first, but soon becomes sloAver, then quicker and feebler, and after a little time
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ceases. If tlie rupture is one of a small artery and the extravasation limited, sudden paralysis of some part of the bod}^ is the result. The extent and location of the paralysis depend upon the location within the l)rain vdiich is functionally deranged hy the j)ressure of the extra vasated blood; hence these conditions are very variable.
In the absence of any premonitory symptoms or an increase of tem- perature in the early stage of the attack we may be reasonably certain in making the distinction between this disease and congestion of the brain or sunstroke.
Pailiology. — In apoi^lexy we are generally able to find an atherom- atous condition of the cerebral vessels with weakening and degener- ation of their walls. When a large artery has been ruptured it is usually followed by immediate death, and large rents may be found in the cerebrum, with great destruction of brain tissue, induced by the forcible j)ressure of the liberated blood. In small extravasations i^ro- ducing local paralysis without marked general disturbance, the animal may recover after a time; in such cases gradual absorption of the clot takes X)lace. In large clots atroijhj' of the brain substance may follow, or softening and abscess from want of nutrition may result, and render the animal worthless, ultimately resulting in death.
Treatment. — Place the animal in a quiet, cool place, avoid all stimu- lating food. Administer, in his drinking water or feed, 2 drams of the iodide of potassa twice a day for several weeks if necessary. Medical interference Avith sedatives or stimulants is more apt to be harmful than of benefit, and blood-letting in an aj)oplectic fit is extremelj^ haz- ardous. From the fact that cerebral apoplexj'- is due to diseased or weakened blood-vessels, the animal remains subject to si:bsequent attacks.
COMPRESSION OF THE BRAIX.
Causes. — In injuries from direct violence a piece of broken bone may press uj)on the brain, and according to its size the brain is robbed of its normal space within the cranium. It may also be due to an extravasation of blood or to exudation in the subdural or arachnoid spaces. Death from active cerebral congestion results through com- pression. The occurrence may sometimes be traced to the direct cause, which will give assurance for the correct diagnosis.
Symptoms. — Impairment of all the special senses and localized paralysis. All the sj'mptoms of lessened functional activity of the brain are manifested to some degree. The paral3^sis remains to be our guide for the location of the cause, for it will be found that the paralysis occurs on the opposite side of the bod}' from the location of the injurj^^ and the parts suffering paralysis will denote, to an expert veterinarian or physician, the part of the brain which is suffering compression.
Treatment. — Trephining, hy a skillful operator, for the removal of the cause when due to depressed bone or the presence of foreign bodies.
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When the symptoms of compression follow other acute diseases of the brain, apoplectic fits, etc., the treatment must be such as the exigen- cies of the case demands.
CONCUSSION OP THE BRAIN.
Causes. — This is generally caused ])y an animal falling over back- ward and striking his poll, or perhaps falling forward on his nose; by a blow on the head, etc.
Symptoms. — Concussion of the brain is characterized b}' giddiness, stupor, insensibility, or loss of muscular power, succeeding immedi- ately upon a blow or severe injury involving the cranium. The ani- mal may r&Wj quickly, or not for hours; death may occur on the spot or after a few days. When there is onh^ slight concussion or stun- ning the animal soon recovers from the shock. When more severe, insensibility may be complete and continue for a considerable time; the animal lies as if in a deep sleep; the pupils are insensible to light; the pulse fluttering or feeble ; the surface of the body cold, muscles relaxed, and the breathing scarcely x>erceptible. After a variable interval partial recovery may take place, which is marked by paraly- sis of some parts of the body, often of a limb, the lips, ear, etc. Con- valescence is usually tedious, and frecxuently permanent impairment of some organs remains.
Pathologi/. — Concussion produces laceration of the brain, or at least a jarring of the nervous elements, which if not sufficiently severe to produce sudden death may lead to softening or inflammation, with their respective symptoms of functional derangement.
Treatment. — The first object in treatment will be to establish reac- tion or to arouse the feeble and weakening heart. This can often be accomplished by dashing cold water on the head and body of the ani- mal; frequent injections of weak ammonia water, ginger tea, or oil and turpentine should be given per rectum. In the majority of cases this will soon bring the horse to a state of consciousness. In more severe cases mustard i)oultices should be applied along the si^ine and above the fetlocks. As soon as the animal gains partial consciousness stimulants, in the form of whisky or capsicum tea, should be given. Owing to severity of the structural injury to the brain or the possible rupture of blood-vessels and blood extravasation, the reaction may often be followed by encephalitis or cerebritis, and will then have to be treated accordingly. For this reason the stimulants should not be administered too freely, and they must be abandoned as soon as reac- tion is established. There is no need for further treatment unless com- plications develop as a secondary result. Bleeding, which is so often practiced, proves almost invariably fatal in this form of brain affec- tion. We should also remember that it is never safe to drench a horse with large quantities of medicine when he is unconscious, for he is very liable to draw the medicine into the lungs in inspiration.
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Prevention. — Young horses, wlien harnessed or bitted, for the first few times, should not have their heads checked up high, for it fre- quently causes them to rear up, and, being unable to control their balance, they are liable to fall over sideways or backwards, thus causing brain concussion when thej^ strike the ground.
ANEMIA OF THE BRAIN.
This is a physiological condition in sleep.
Causes. — It is considered a disease or may give rise to disease when the circulation and blood supijly of the brain are interfered with. In some diseases of the heart the brain becomes ansemic, and fainting fits occur, with temjjorary loss of consciousness. Tumors growing within the cranium may i^ress upon one or more arteries and stop the supply of blood to certain i)arts of the brain, thus inducing anaemia, ultimately atrojihy, softening, or sujDpuration. Probably the most frequent cause is found in plugging or occlusion of the arteries by a blood-clot.
Symptoms. — Imperfect vision, constantly dilated pupils, frequently a feeble and staggering gait, and occasionally cramps, convulsions, or epileptic fits occur. «
Patliology. — The exact opposite of cerebral hyperaemia. The blood- vessels are found emj)ty, the membranes blanched, and the brain substance softened.
Treatment. — Removal of the remote cause when i^ossible. General tonics, nutritious food, rest, and removal from all causes of nervous excitement.
ATROPHY OF THE BRAIX.
This condition is i)roduced by a fault in nutrition, embracing the causes which induce anaemia. Gradual absorj^tion and shrinking of brain substance maj^ arise from the constant and increasing pressure arising from the growth of tumors, degeneration in the arterial walls^ hydrocephalus, etc. Atrophy of the brain may be general or local- ized. The cerebrum may waste away in a remarkable degree before any indication of disease becomes manifest.
Symptoms. — It maj^ give rise to viciousness, paralysis, disorders of special sensation, coma, etc. Treatment is of no avail.
HYDROCEPHALUS — BRAIN DROPSY.
This disease is most often seen in young foals and is manifested by an unnaturall}^ large forehead. The forehead bulges out, and the cranial bones may be separated from their connections, and a part of the brain be covered by the skin only. Foals seldom survive this affection, and treatment is useless. In horses hj-drocephalus is a result of chronic meningitis, when an efi'usion of serum is i)oured out 59G1 — HOR 7*
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into the ventricles and arachnoid spaces of the brain. The disease is sometimes indicated by a difficulty in controlling voluntary move- ments, coma, etc. When effusion as a result of meningitis is sus- pected, iodide of potassa in 2-dram doses may be given twice a day and a strong blister applied l>ehind the ears.
TUMORS WITHIN THE CRANIUM.
Tumors within the cranial cavity and the brain occur not infre- quently, and give rise to a variety of symjitoms, imperfect control of voluntary movement, local paralysis, epilepsj', etc.
Osseous tumors, growing from the walls of the cranium, are not ver3" uncommon.
DenUgerous cysts, containing a formation identical to that of a tooth, growing from the temjioral bone, sometimes are found lying loose within the cranium.
Tumors of the clioro'nl plexus, known as hruin sand, are frequentl}^ met with on post-mortem examinations, but seldom give rise to any appreciable symptoms during life. They are found in horses at all ages, and are of slow development. They are found in one or both of the lateral ventricles, enveloped in the folds of the choroid plexus.
Melanotic tumors have been found in the brain and meninges in the form of small, black nodules, in gray horses, and in one instance arc believed to have induced the condition known as string-halt.
Fibrous tumors may develop within or from the meningeal struc- tures of the brain.
Oliomatous tumor is a variety of sarcoma very rarelj' found in the structure of the cerebellum.
Treatment for tumors of the brain is beyond our ambition in the present age.
SPASMS — CRAMPS.
Causes. — Spasm is a marked symptom in many diseases of the brain and of the spinal cord. S^Dasms may result from irritation of the motor nerves as conductors, or maj^ result from irritation of any part of the sympathetic nervous system, and ih&y usually indicate an excessive action of the reflex-motor centers. Spasms maj' be induced by various medicinal agents given in iDoisonous doses, or by effete materials in the circulation, such as nux vomica or its alkaloid strychnia, lead preiaarations, or an excess of the urea products in the circulation, etc. Spasms ma}' be divided into two classes: tonic spasm, when tlie cramj) is continuous or results in persistent rigidity, as in tetanus; clonic spasm, wlicn the cramping is of short duration, or is alternated with relaxations. Cramps may be distinguished from choleraic movements by the extreme pain or suffering which they induce. Spasms may affect involuntary as well as the voluntary muscles, the muscles of the glottis, intestines, and even the heart. They are always sudden in their development.
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SPASM OF THE GLOTTIS.
This is manifested by a strangling respiration; a wheezing noise is produced in the act of inspiration; extreme anxiety and suffering for want of air. The head is extended, the body profusely perspir- ing; pulse verj' rapid; soon great exhaustion becomes manifest; the mucous membranes become turgid and very dark-colored, and the animal thus may suffocate in a short time.
SPASM OF THE INTESTINES.
(See "Cramp-colic")
SPASM OF THE NECK OF THE BLADDER.
This may be due to spinal irritation, or a reflex from intestinal irritation, and is manifested by frequent but ineffectual attempts to urinate.
SPASM OF THE DIAPHRAGM — THUMPS.
Spasmodic contraction of the diaphragm, the principal muscle used in respiration, is generally occasioned by extreme and jirolonged speed- ing on the race-track or road. The severe strain tlnis put upon this muscle finally induces irritation of the nerves controlling it, and the contractions become very forcible and violent, giving the jerking character known among horsemen as thumps. This condition may be distinguished from violent beating of the heart bj^ feeling the pulse beat at the angle of the jaw, and at the same time watching the jerking movement of the body, when it Avill be discovered that the two bear no relation to each other. (See " Palpitation of the Heart.")
SPASM OP THE THIGH, OR CRAMP OF A HIND LIMB.
This is frequently witnessed in horses that stand on sloping plank floors — generally in cold weather — or it may come on soon after severe exercise. It is probably due to an irritation of the nerves of the thigh. In cramps of the hind leg the limb becomes perfectly rigid, and attempts to flex the leg are unsuccessful ; the animal stands on the affected limb, but is unable to move it; it is unnaturally cold; it does not, however, appear to cause much suffering unless attempts are made to change position. This cramp may be of short duration — a few minutes — or it may persist for several days. This condition is often taken for a dislocation of tlie stifle-joint. In the latter the foot is extended backward, and the horse is unable to advance it, but drags the limb after him. An examination of the joint also reveals a change in form. Sjiasms may affect the eye-lids, by closure or by retraction. Spasm of the sterno-maxillaris muscle has been Avitnessed, and the animal was unable to close the jaws until the muscle became relaxed.
Treatment. — An anodyne liniment, composed of chloroform 1 part and soap liniment 4 parts, api^lied to cramped muscles will usually cause relaxation. This may be used where single external muscles
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are affected. In spasm of the glottis inhalation of suliDliuric ether will give cxuick relief. In spasm of the diaphragm, rest and the adminis- tration of half an ounce of chloroform in 3 ounces of whisky, with a pint of water added, will generally sufiice to bring relief, or if tliis fails give 5 grains of sulphate of morphia by hypodermic injection. If spasms result from organic disease of the nervous system, the latter should receive such treatment as its character demands. In cramp of the leg comi)ulsor3Mnovement usually causes relaxation very quickly; therefore, tlie animal should be led out of the stable and be forced to run or trot. Sudden nervous excitement, caused by a crack of the whip or smart blow, will often bring about immediate relief. Should this fail, the anodyne liniment may be used along the inside of the thigh, and chloroform, ether, or laudanum given internally. An ounce of the chloral hydrate will certainly relieve the spasm when given inter- nally, but the cranii) may return soon after the effect has passed off, which in many cases it does very quickly.
ConvuIsio)}s. — Although there is no disease of the nervous system which can be pro^jerly termed convulsive, or justify the use of the word convulsion to indicate any particular disease, yet it is often such a prominent symiitom that a few words may not be out of place. Gen- eral, irregular muscular contractions of various parts of the body, with unconsciousness, characterize what we regard as convulsions, and like ordinary spasms are dependent upon some disease or irrita- tion of the nervous structures, chiefly of the brain. No treatment is required; in fact, a general convulsion must necessaril}^ be self-limited in its duration. Suspending, as it does, respiratory movements, check- ing the oxj'genation and decarbonization of the blood, the rapid accu- mulation of carbonic acid gas in the blood and the exclusion of oxygen quickly puts the blood in a condition to produce the most reliable and speedy sedative effect upon the nerve excitability that could be found, and consequently furnishes its own remedy, so far as the continuance of the convulsive paroxysm is concerned. Whatever treatment is instituted must be directed towards a removal of the cause of the con- vulsive paroxysm.
CHOREA.
Chorea is characterized by involuntary contractions of voluntary muscles. This disease is an obscure disorder, which may be due to pressure upon a nerve, cerebral sclerosis, small aneurisms in the brain, etc. Choreic symptoms have been produced by injecting granules of starch into the arteries entering the brain. Epilejisj^ and other forms of convulsions simulate chorea in appearance.
Sfringhalt is by some termed chorea. This is manifested by a sud- den jerking-up of one or both hind legs when the animal is walking. This symi^ton may be very slight in some horses, but has a tendency to increase witli tlie age of the animal. In some the catching-up of the
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affected leg is very violent, and when it is lowered to the ground the motion is equally sudden and forcible, striking the foot to the ground like a pile-driver. Very rarely chorea may be found to affect one of the fore legs, or the muscles of one side of the neck or the upper j)art of the neck. Involuntary jerking of the muscles of the hip or thigh is seen occasionallj^, and is termed shivering by horsemen.
Chorea is often associated with a nervous disposition, and is not so frequent in animals with a sluggish temperament. The involuntary muscular contractions cause no pain, and do not appear to produce much exhaustion of the affected muscles, although the jerking may be regular and persistent whenever the animal is in motion.
Treatment. — In a few cases, early in the appearance of this affection, general nerve tonics may be of benefit, viz., iodide of iron, 1 dram; pulverized nux vomica, 1 dram; pulverized Scutellaria, 1 ounce. Mix, and give in the feed once a day for two weeks. If the cause is con- nected with organic brain lesions treatment is usually unsuccessful,
EPILEPSY — FALLING FITS.
The cause of epilepsy is seldom traceable to any special brain lesions. In a few cases it accompanies disease of the pituitary bodj', which is located in the under surface of the brain. Softening of the brain may give rise to this affection. Attacks may occur only once or twice a year, or they may be of frequent recurrence.
Synqjtoms. — No premonitory symptoms precede an epileptic fit. The animal suddenly staggers; the muscles become cramped; the jaws may be spasmodically oi^ened and closed, and the tongue become lacerated between the teeth; he foams at the mouth and falls down in a spasm. The urine flows away involuntarily, and the breath- ing may be temporarily arrested. The paroxysm soon passes off, and the animal gets on his feet in a few minutes after the return of con- sciousness.
Treatment. — Dashing cold water on the head during the paroxysm. After the recovery 1 dram of oxide of zinc may be given in his feed twice a day for several weeks, or benefit may be derived from the tonic prescribed for chorea.
COMA — SLEEPY STAGGERS.
This condition, like that of spasm and convulsion, is generally not a disease, but merely a symptom manifested as a result of a variety of brain affections, such as atrophj-, chronic meningitis, with effusion, tumors in the lateral ventricles, etc. Another form of coma is that which accompanies acute diseases of the brain, wherein the animal may be unconscious, with sterterous breathing, difficult respiration, etc. We meet, however, with a type of coma in horses whicli can not easily be attributed to any special disease of the brain, unless it be a modified form of congestion, which is sometimes ameimble to treat-
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ment. This condition is termed immobiUte by the French, and sleepy staggers \>j our stablemen. It is usually attributed to habitual over- loading of the stomach with bulky food and want of exercise.
Sijinptoms. — Sleepy staggers is characterized by drowsiness, partial insensibilit3% sluggish and often staggering gait. The animal is inclined to drop his head in the manger and to go to sleep with a wad of hay in his mouth, which he is apt to drop when he awakens. He will stand for a long time Avith his legs placed in an}^ awkward j)osi- tion in Avhich the owner may choose to put them. The bowels are constipated, the pulse slow and soft, with no fever or pain, Tho ani- mal may remain in this condition for many months without much variation of S3'mi:)toms, or he may become entirely comotose, with delirium or convulsions, and die. Chronic cases are always much better in cold weather than in the summer.
Treatment. — Moderate bleeding from the jugular vein, 1 gallon from a medium-sized horse, and 1^ or 2 gallons from a very large, heavy horse. This should be immediately followed by a cathartic, com^josed of aloes G drams, croton oil G drops, and 1 dram of capsicum, to be made into a ball with hard soap, molasses, or Ijread soaked in water, and given on an empty stomach. After tho cathartic has ceased to oi^erate give one large tablespoonful or half an ounce of the following mixture tAvice a day: Pulverized hydrastis, pulverized ginger, sodium bicarbonate, of each 4 ounces; mix.
In some cases iodide of j)otassa in dram doses twice a day, alter- nated each week with 1 dram of calomel twice a day, Avill prove suc- cessful. In cases where there is a deeji coma or almost continuous unconsciousness, ice bags or cold-water cloths vshould be applied to the head — between the ears, dropping well down over the forehead and extending backward from the ears for 4 or 5 inches.
PARALYSIS — PALSY.
Paral3"sis is a weakness or cessation of the muscular contraction, \>y diminution of loss of the conducting j)ower or stimulation of the motor nerves. Paralytic affections are of two kinds, the perfect and the imi)erfect. The former includes those in Avhich both motion and sen- sibility are affected; the latter those in Avhicli only one or the other is lost or diminished. Paralysis may be general or partial. The latter is diA'ided into hemiplegia and paraplegia. When only a small por- tion of the body is affected, as the face, a limb, the tail, it is desig- nated 'by the term local paralysis. When the irritation extends from the periphery to the center it is termed reflex paralysis.
Causes. — They are very A^aried. Most of tlie acute affections of the brain and spinal cord vasky lead to paralysis. Injuries, tumors, disease of the blood-vessels of tho brain, etc., all haA^e a tendency to produce suspension of the conducting motive power to the muscular structures. Pressure upon, or the severing of, a nerA^e causes a paralysis of the
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parts to AvhicTi such a nerve is distril)iited. Apoplexj' may be termed a general i)aralysis, and in non-fatal attacks is a frequent cause of the various forms of palsy.
GENERAT. PARALYSIS,
This can not take place without i)roduciug immediate death. The term is, however, usuallj' applied to paralysis of the four extremities, whether any other portions of the body are involved or not. This form of palsy is due to comT)ression of the brain bj- congestion of its vessels, large clot formation in apoplexj-, concussion or shock, or any disease in which the whole brain structure is involved in functional disturbance.
HEMIPLEGIA — PARALYSIS OF ONE SIDE OR HALF OF THE BODY.
Hemiplegia is frequently the result of a tumor in the lateral ventri- cles of the brain, softening of one hemisiDhere of the cerebrum, pres- sure from extravasated blood, fracture of the cranium, or it may be due to jjoisons in the blood, or to reflex origin. When hemiplegia is due to or the result of a prior disease of the brain, especially of an inflammatory character, it is seldom complete; it may only affect one limb and one side of the head, neck, or muscles along the back, and may pass off in a few days after the disappearance of all the other evidences of the i^rimarj^ affection. In the majority of cases, how- ever, hemii^legia arises from emboli obstructing one or more blood- vessels of the brain, or the rupture of some vessel the wall of Avhich had become weakened by degeneration and the extravasation of blood. Sensibility in most cases is not impaired, but in some there is a loss of sensibility as well as of motion. In some cases the bladder and rectum are involved in the paralysis.
Sijinptoins. — In hemiplegia the attack ma}* be verj' sudden, and the animal fall down powerless to move one side of the body; one side of the lips will be relaxed; the tongue may hang out on one side of the moutlv; the tail curved around sidewaj's; an inability to swallow food or water may be present, and often the urine dribbles away as fast as it collects in the bladder. Sensibility of the affected side may ])e entirely lost or only partial; the limbs may be cold, and sometimes unnaturally warm. In cases wherein the attack is not so severe the animal may be able to maintain the standing position, but will have great difiiculty in moving tlie affected side. In such cases the animal may recover from the disability. In the more severe, where there is complete loss of the power of movement, recoveries are rare.
PARAPLEGIA — TRANSVERSE PARALYSIS OP THE HIXD EXTREMITIES.
Paralysis of the hind extremities is usually due to some injury, or inflammation affecting the spinal cord. (See "Spinal Meningitis" and " 313-elitis. "') It nuiy also be due to a reflex irritation from disease
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of peripheral nerves, to spinal irritation or congestion caused b}^ blood poisons, etc.
Sijmptoins. — When due to mechanical injury of the spinal cord, from a broken back or spinal hemorrhage, it is generally progressive in its character, although it may be sudden. When it is caused by agents in the blood it may be intermittent or recurrent.
Paraplegia is not difficult to recognize, for it is characterized by a weakness and imperfect control of the hind legs, and jjowerless tail. The urine usually dribbles away as it is formed and the manure is pushed out, ball l)y ball, witliout any voluntary effort, or the passages may cease entirely. When paraplegia is complete, large and ill-con- ditioned sores soon form on the hips and thighs from chafing and bruising, Avhicli have a tendency to quickly weaken the animal and necessitate his destruction.
LOCOMOTOR ATAXIA — INCOORDINATION OF MOVEMENT.
This is characterized by an inability to properly control the move- ment of the limbs. The animal a^ipears usually perfectly health^'', l)ut when he is led out of his stall his legs have a wabbly movement, and he will stumble or stagger, especially in turning. When this is confined to the hind parts it maj^ be termed a modified form of i)ara- plegia, but often it may be seen to affect nearly all the voluntary muscles Avhen they are called into play, and must be attributed to some pressure exerted on the base of the brain.
LOCAL PARALYSIS.
This is frequently met with in horses. It may affect many parts of the body, even vital organs, and it is very frequently overlooked in diagnosis.
FACIA.L PARALYSIS.
^'his is a frequent type of local paralj-sis, and is due to impairment of function of the motor nerve of the facial muscles, the x>ortio dura. The cause may exist at the base of the brain, compression along its course after it leaves the medulla oblongata, or to a bruise after it spreads out on the great masseter muscle.
Symptoms. — A flaccid condition of the cheek muscles, pendulous lips, inability to gi'asp the food, often a sIoav and weak movement in chewing, and difficulty and slowness in drinking.
LARYNGISMUS PARALYTICUS — ROARING.
This condition is characterized by roaring, and is usually caused bj an inflamed or hypertrophied bronchial gland i)ressing against the left recurrent laryngeal nerve, which interferes Avith its conducting power. A similar condition is occasionally induced in acute pleurisy, where the recurrent nerve becomes involved in the diseased process or compressed by plastic exudation.
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PARALYSIS OF THE RECTUM AND TAIL.
This is generally the result of a blow or fall on the rump, which causes a fracture of the sacrum bone and injury to the nerves supply- ing the tail and part of the rectum and muscles belonging thereto. This fracture would not be suspected, were it not for the loss of motion of the tail.
INTESTINAL PARALYSIS.
Characterized by persistent constipation; frequently the strongest purgatives have no effect whatever on the movement of the boAvels. In tlie absence of symptoms of indigestion, or special diseases impli- cating the intestinal canal, torpor of the bowels must be attributed to deficient innervation. This condition may depend upon brain affec- tions, or be due to reflex ijaralysis. Sudden checks of i)erspiration may induce excessive action of the bowels or paralysis.
PARALYSIS OF THE BLADDER.
This usually affects the neck of the bladder, and is characterized by incontinence of urine — the urine dribbles away as fast as it is secreted.
The cause may be of reflex origin, disease of the rectum, tumors growing within the pelvic cavity, injury to the spinal cord, etc.
PARALY'SIS OF THE OPTIC NERVE^AMAUROSIS.
A paralysis of eyesight may occur very suddenlj- from rupture of a blood vessel in the brain, acute local congestion of the brain, the admin- istration of excessive doses of belladonna or its alkaloid atropia, etc.
Sijyn2:)toms. — In amaurosis the jDupil is dilated to its full extent, the eye looks clear, but does not respond to light.
Paralysis of hearing, of the external ear, of the eyelid, partial paral- ysis of the heart and organs of respiration, of the blood vessels from injury to the vaso motor nerves of the oesophagus, or loss of degluti- tion, palsy of the stomach, all may be manifested when the supply of nervous influence is impaired or suspended.
Treatment. — In all paralytic affections there maj' be anesthesia or impairment of sensibility in addition to the loss of motion, or there may be liyperc£stliesia or increased sensibility in connection with the loss of motion. These conditions may call for sj^ecial treatment in addition to that for loss of motion. Where hypera^sthesia is well marked local anodynes may be needed to relieve suffering. Chloro- form liniment or hypodermic injections of from 3 to 5 grains of sul- phate of morphia will allay local pain. If there is marked anaesthesia or loss of sensibility it may become necessary to secure the animal in such a way that he can not suffer serious injury from accidents which he can not avoid or feel. In the treatment of any form of paralysis
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■\ve iiinst always refer to the cause, and attempt its removal if it can be discovered. In eases where the cause can not be determined we have to rely solely upon a general external and internal treatment Externally, fly-blisters or strong irritant liniments may be applied to the paralyzed parts. In hemiplegia they should be applied along the bony part of the side of the neck; in paraplegia, across the loins. In some cases hot- water cloths will be benellcial. Internally, it is well to administer 1 dram of j^owdered nux vomica or 2 grains of sulphate of strychnia tv, ice a day until twitching of some of the voluntary muscles occur; then discontinue it for several daj'S, and then com- mence again with a smaller dose, gradually increasing it until twitch- ing recurs. In some cases Fowler's solution of arsenic in teaspoonful doses twice a day, in the drinking water, proves beneficial. Occasion- ally benefit may be derived from the application of the electric cur- rent, especially in eases of roaring, facial paralysis, paralysis of the eyelid, etc. Nutritious but not too bulky food, good ventilation, clean stabling, moderate exercise if the animal is capable of taking it, good grooming, etc., should be observed in all cases.
SPINAL MENINGITIS — INFLAMMATION OF THE MEMBRANES ENVELOPING
THE SPINAL CORD.
Causes. — This may be induced by the irritant properties of blood- poisons, exhaustion, and exposure, spinal concussion, all forms of injui'}' to the spine, tumors, caries of the vertebrae, rheumatism, etc.
Sijnqytoms. — A chill may be the i^recursor, a rise in temperature, or a general weakness and shifting of the legs. Soon a painful, convul- sive twitching of the muscles sets in, followed by muscular rigidity along the spine, in which condition the animal will move very stiffly and evince great pain in turning. Evidences of paralj'sis or paraplegia develop, retention or incontinence of urine, and oftentimes sexual excitement is present. The i)resence of marked fever at the begin- ning of the attack, associated with spinal sjinptoms, should lead us to suspect spinal meningitis or mj^elitis. These two conditions usually appear together, or myelitis follows inflammation of the meninges so closely that it is almost imi)ossible to separate the two; practically it does not matter much, for the treatment will be about the same in both cases. Spinal meningitis generalh' becomes chronic, and is then marked principallyby paralysis of that portion, or parts of it, posterior to the seat of the disease.
Pathology. — In spinal meningitis we will find essentially the same condition as in cerebral meningitis; there will be an effusion of serum between the membranes, and often a plastic exudation firmly adherent to the 2^ict mater serves to maintain a state of paralysis for a long time after the acute symptoms have disappeared bj^ compressing the cord. Finally, atrophy, softening, and even abscess may develop Avithinthe cord. Unlike in man, it is usually found localized in horses.
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■1 Trecdmeni. — Bags filled Avitli ice slioiild be api)lied aloiiu' the spine, to be followed later ou by strong blisters. The fever should be con- trolled as early as possible by giving 20 drops of Norwood's tincture of veratrum viride every hour, iiutil the desired result is obtained. One dram of the fluid extract of belladonna, to control pain and Avascular excitement of the spinal cord, may be given everj^ five or six hours imtil the puiDils of the eyes become pretty well dilated. If the pain is very intense 5 grains of sulphate of morphia should be injected hyijodermically. The animal must be kept as free from excitement as x)ossible. If the urine is retained in the bladder it must be drawn off every four or six hours. In very acute attacks the disease gener- ally proves fatal in a few daj's. If, however, the animal grows better some form of paralysis is ax)t to remain for a long time and the treat- ment will have to be directed then toward a removal of the exudative products and a strengthening of the system and stimulation of the nervous functions. To induce absorption iodide of potassa in 2 dram doses may be given dissolved in the drinking water twice a day. To strengthen the system, iodide of iron 1 dram twice a day and 1 dram of nux vomica once a day \r\ixj be given in the feed. Electricity to the j)aral3'zed and weakened muscles is advisable; the current should be Aveak, but be continued for half an hour two or three times daily. If the disease is due to a broken back, caries of the vertebrse, or some other irremediable cause, the anim;il should ])e destroyed at once.
MYELITIS — INFLAMMATION OF THE SUBSTANCE OF THE SPINAL COED.
This is a rare disease, except as a secondary result of spinal menin- gitis or injuries to the spine. Poisoning, by lead, arsenic, mercury, phosphorus, carbonic-acid gas, etc., has been known to produce it. Myelitis may be confined to a small sj^ot in the cord or may involve the whole for a variable distance. It may lead to softening, abscess, or degeneration.
Symptoms. — The attack may begin with a chill ov convulsions; the muscles twitch or become cramped very early in the disease, and the bladder usually is affected in the outset, in which there may be either retention or incontinence of urine. These conditions are followed by complete or partial paralysis of the muscles posterior to the locality of the inflamed cord, and the muscles begin to waste away rapidly. The paralyzed limb becomes cold and dry, due to the suspension of proper circulation; the joints may swell and become (edematous; A'esic- ular eruptions appear on the skin, and frequently gangrenous sloughs form on the paralyzed i^arts. It is exceedingly seldom that recovery takes i)lace. In a few instances it may assume a chronic type, when all the symptoms become mitigated, and thus continue foi- some time nntil septicaemia, pj^semia, or exhaustion causes death.
Pathology. — The inflammation maj^ involve nearly the whole length of the cord, but generally it is more intense in some places tlian others;
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when due to mechanical injury the inflammation may remain con- fined to a small section. The cord is swollen and congested, reddened, often softened and infiltrated with pus cells, and the nerve elements are degenerated.
Treatment. — Similar to that of spinal meningitis.
SPINAL SCLEROSIS.
This is the sequence of myelitis, when some mild form of the disease has been existing. Thickening and hardening of the interstitial tis- sues of the cord, the result of inflammatory products, constitute scle- rosis. The affected section has a gray appearance, is firmer than the surrounding tissue, sometimes j)resents a depressed surface and at other times may be elevated above the general level of the cord.
Symptoms. — Paralysis of sensation or motion in local muscles, and when located in the region of the neck may present the symptoms of locomotor ataxia or inco-ordination of movement. Spinal sclerosis may be suspected when these symptoms succeed an attack of myelitis.
Treatment. — The iodide of iron may be given in dram doses twice a day for a week, alternating with two-grain doses of sulphate of strychnia twice a day for a Aveek.
SPINAL CONGESTION AND SPINAL HYPERJEMIA.
The distinction between congestion and hyperjemia is one of degree rather than kind. In both we find an excess of blood. In hypersemia the current is unusually rapid, in congestion it is unusually slow. The distinction between hypersemia and inflammation is also difficult to make; one is only the forerunner of the other. As the blood ves- sels of the pia mater are the x)rincipal source of supply to the spinal cord, hyperemia of the cord and of the meninges usually go together. The symptoms are, therefore, closely allied to those of spinal menin- gitis and mj^elitis. When the pia mater is diseased the spinal cord is almost invariably affected also.
Cause. — Sudden checking of the perspiration, violent exercise, blows, and falls.
Symptoms. — The symptoms may vary somewhat with each case, and closely resemble the first symptoms of spinal meningitis, spinal tumors, and myelitis. First, some disturbance in movement, lower- ing of the temperature, and partial loss of sensibility i:)Osterior to the seat of the congestion. If in the cervical region it may cause inter- ference in breathing and the action of the heart. When in the region of the loins there may be loss of control of the bladder. When the congestion is sufficient to produce compression of the cord, paraplegia may be complete. Usually fever, spasms, muscular twitching, or muscular rigidity arc absent, which will serve to distinguish spinal congestion from spinal meningitis.
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Treatment. — Hot-water applications to tlie spine, one-dram doses' fluid extract of belladonna repeated every four hours, and tincture of aconite root 20 drops every hour until the symptoms become amelio- rated. If no inflammatory products occur the animal is likely to recover.
SPINAL ANEMIA.
This may be caused by extreme cold, exhausting diseases, spinal embolism or plugging of a spinal blood-vessel, an interference with the circulation through the abdominal aorta, from compression, throm- bosis, or aneurism of that vessel; tlie spinal vessels may be caused to contract through vaso-motor influence, a result of ijeripheral irritation of some nerve.
Symptoms. — Spinal anaemia causes paralysis of the muscles iised in extending the limbs. When the bladder is affected it precedes the weakness of motion, while in spinal congestion it follows, and increased sensibility, in place of diminished sensibility, as in si)inal congestion, is observed. Pressure along the spine causes excessive pain.
Trecdrnent. — If the exciting cause can be removed the animal recovers; if this fails, the spinal cord may undergo softening.
SPINAL COMPRESSION.
When caused by tumors or otherwise when pressure is slight, it produces a paral3'Sis of the muscles used in extending a limb and con- traction of those which flex it. When compression is great it causes comiDlete loss of sensibility and motion posterior to the compressed part of the cord.
Compression of a lateral half of the cord produces motor paralysis, disturbance in the circulation, and difficulty of movement, an increased sensibility on the side corres]3onding to the compressed section, and a diminished sensibility and some paralysis on the opposite side.
Treatment. — When it occurs as a sequence of a j) receding inflam- matory disease, iodide of potassa and general tonics are indicated. When due to tumors growing Avithin the spinal canal, or to pressure from displaced bone, no form of treatment will result in any benefit.
SPINAL HEMORRHAGE.
This may occur from changes in the wall of the blood-vessels, in connection with tumors, acute myelitis, traumatic injuries, etc. The blood may escape througli the pia mater into the sub-arachnoid cav- ity, and large clots be formed.
Symptoms. — The s^nnptoms are largely dependent upon the seat and extent of the hemorrhage, as they are principally due to the compression of the cord. A large clot may j)rqduce sudden ijarajilegia accompanied by severe pain along the spine; usually, however, the paralysis of both motion and sensation is not very marked at first;
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on the second or thij-tl day fever is apt to appear, and increased or diminislied sensibility along the spine posterior to the seat of tlie clot. "When the bladder and rectum are involved in the synqitonis it indicates that the spinal cord is compressed.
Treaimerd. — In the occurrence of injuries to the back of ahorse, whenever there is any evidence of paralysis, it is always advisable to apply bags of ice along the spine to check or prevent hemorrhage or congestion, and 2 drams of the fluid extract of ergot and 20 drops of tincture of digitalis may be given every hour until three doses have been taken. Subsequently tincture of belladonna in half-ounce doses may be given three times a day. If there is much x^ain, 5 grains of sulphate of morphia, injected under the skin, Avill atford relief and lessen the excitability of the animal. In all cases the animal should be kept perfectly quiet.
SPINAL CONCUSSION.
This is rarely observed in the horse, and unless it is sufficiently severe to produce Avell-marked symptoms it would not be suspected. It may occur in saddle-horses from jumping, or it may l>e produced by falling over an embankment, or a violent fall upon the haunches may produce it. Concussion may be followed by partial paralysis or spinal hemorrhage; generally, however, it is confined to a jarring and some disturbance of the nerve elements of the cord, and the paralytic effect which ensues soon passes off. Treatmeut consists in rest nntil the animal has comx>letely recovered from the shock. If secondary effects folloAv from hemorrhage, or comx^ression, they have to be treated as heretofore directed.
SPINAL TUMORS.
AVithin the substance of the chord glioma, or the mixed giiosarco- mata, is found to be the most frequent, tumors may form from the meninges and the vertebrae, being of a fibrous or bony nature, and affect the sx)inal cord indirectly by comx>i'ession. In tlie meninges Ave may find glioma, cancers, x^sammoma, fibromata; and aneurisms of the spinal arteries have been discoA'ered in the spinal canal.
Sympfoms. — Tumors of the spinal canal cause symptoms of spinal irritation, or compression of the cord. The gradual and slow devel- opment of synn)toms of x^aralysis of one or both hind limbs or certain muscles may lead to a susx^iciou of sx^inal tumors. The iiaralj'sis induced is progressive, but not usually marked Avith atrophy of the muscles, or increased sensibility along the spine. When the tumor is Avithin the spinal cord itself all the symptoms of myelitis may be present.
Treafmenf. — General tonics and dram doses of nux vomica may be given; iodide of iron or.iodide of potassa in dram doses, three times a day in feed, may, in a very fcAA^ cases, give some temx^orary benefit. Usually the disease progresses steadily until it proves fatal.
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NEURITIS — INFLAMMATION OF A NERVE.
This is caused by a bruise or wound of a nerve, or to strangulation in a ligature when it is included in the ligation of an artery. The changes in an inflamed nerve are an enlargement, reddening of the nerve sheath, spots of extravasated blood, and sometimes an infiltra- tion of serum mixed with pus.
Sijinptoms. — Acute pain of the parts supplied by the nerve, an absence of swelling or increased heat of the i)art.
Treatment. — Hypodermic injections of from 3 to 5 grains of morphia to i-elieve pain, hot fomentations, and rest. If it is due to an inclusion of a ligature, the nerve should be divided above and l)elow the ligature.
NEUROMA — TUMOR OF A NERVE.
Neuroma may be from enlargement of the end of a divided nerve, or due to fibrous degeneration of a nerve which lias been bruised or wounded. Its most frequent occurrence is found after the operation of neurotomy for foot lameness, and it may appear only after the lapse of months, or even years. Neuroma usually develops within the sheath of the nerve with or without imi^licating the nerve fibers. They are oval, running lengthwise with the direction of the nerve.
Symptoms. — Pain of the affected limb or jiart is manifested, more especially after resting awhile, and when i^ressure is made upon the tumor it causes extreme suffering.
Treatment. — Excision of the tumor, including part of the nerve above and below, and then treat it like any other simi)le wound.
IN.JURY TO NERVES.
These may consist in wounding, bruising, laceration, stretching, compression, etc. The symptoms which are produced Avill dejiend upon the extent, seat, and character of the injury. Recovery may quickly take x>lace, or it may lead to neuritis, neuroma, or spinal or cerebral irritation, which may result in tetanus, paralysis, and other serious derangements. In all diseases, whether x>roduced by some form of external violence or intrinsic causes, the nerves are neces- sarilj' involved, and sometimes it is to a primaiy injury of them that the principal fault in movement or change of nutrition of a part is due. It is often difficult or imj)ossible to discover that an injury to a nerve has been inflicted, but whenever this is possible it may enable us to remedy that which otherwise would result in permanent evil. Treatment should consist in relieving compression, in hot fomenta- tions, the application of anodyne liniments, excision of the injured part, and rest.
CEREBRO-SPINAL MENINGITIS.
I'his may occur sporadically as an encephalitis, with implications of the spinal cord and its meninges. Usually, however, it appears as
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an enzooty in a stable, city, or farming district, not infrequently extending long distances in certain well-defined lines, along rivers, valleys, or along ridges and mountains. For this reason the enzootic cerebro-spinal meningitis has been attributed b}^ some veterinarians to atmosj)heric influences. The first written history we have of this disease was published about thirty years ago by Dr. Isaiah Michener, of Carnersville, Pa., in a x)amphlet entitled "Paralysis of the Par- Vagum." Several years later Prof. A. Large, of Brooklyn, N. Y., gave it the name of " cerebro-spinal meningitis" on account of its simi- larity to that disease in the human family. Dr. J. C. Michener, of Colmar, Pa., in 1882, suggested the name of "Fungosus Toxicum Paralyticus," in view of the exciting cause being found in foods undergoing fermentation. In England a similar disease has been called "grass staggers," due to eating rye grass when it is ripening or when it is cut and eaten while it is heating and undergoing fer- mentation. In eastern Pennsylvania it was formerly known by the name of "putrid sore throat" and "choking distemper." A disease similar in many respects, which is very prevalent in Virginia, espe- cially along the eastern border, is commonly known by the name of "blind staggers," and in many of the Southern States this has been attributed to the consumption of worm-eaten corn. Professor Large attributed the cause of the disease to a lack of sanitary conditions, poisonous gases, or emanations depending upon defective sewerage in cities, defective drainage on lands in the country, and deficient stable ventilation.
These reputed causes, however, are inadequate to account for so- called enzootic or ei)idemic cerebro-spinal meningitis. It frequently proves as fatal on the hills and table-lands of Hunterdon County, N. J., Bucks, Montgomery, Lehigh, and Northampton Counties, Pa., as it does in the dark, damp, illy ventilated stables in New York or Phila- delphia. It attacks animals which have been running at pasture, where drainage has been perfect, as well as animals which have been stabled and kept on dry food, regardless of variation in any appreci- able sanitary condition. It affects horses of all ages and both sexes; temperament or condition does not alter their susceptibility. Mules are attacked as well au horses, and the mortality is equally as great. There is, however, a variable severity of symptoms and degree of fatality in different outbreaks.
That there is some specific cause which induces this disease is cer- tain, for it is neither contagious nor infectious. Personally, I believe the cause is connected with the food, either developed in it through some fermentative process or upon it in the form of one of the many parasitic fungi which grow on plants, grains, and vegetation. That these, when they are consumed at certain stages of their development, make a poisonous impression upon the brain and ultimately induce structural changes is shown, I think, by the history of the outbreaks
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wherever they can be traced. In many instances the outbreak of the disease has been simultaneonsly witnessed where brewers' grains, oats, and hay have been fed, which could be traced from place to place, from one diseased center to another. That they were the carriers, if not the ]3rime factors, can not be denied.
Syinptoms. — The symptoms which typify sporadic or ei)idemic cerebro-spinal meningitis in man are seldom witnessed in equal dis- tinctness among horses, viz: excessive j)ain, high fever, and earl}^ muscular rigidity'. In the recognition of the severity of the attack we may divide the symptoms into three grades. In the most rapidly fatal attacks, the animal may first indicate it by weak, staggering gait, partial or total inability to swallow solids or liquids, impairment of eyesight ; twitching of the uTUScles, and slight cramps may be observed. This is soon followed by a paralysis of the whole body, inability to stand, delirium in which the animal sometimes goes through a series of automatic movements as if trotting or running; the delirium may become very violent and the animal in his unconsciousness bruise his head in his struggles very seriously, but usually a deep coma renders him quiet until he expires. Death in these cases usuall}' takes place in from four to twentj^-four hours from the time the first symptoms became manifest. The pulse is variable during the progress of the disease; it may be almost imperceptible at times, and then again ver}' rapid and irregular; the resj)irations generally are quick and catching. When attacked in this rai)idly fatal form we maj' be able only to distinguish it from encephalitis when other animals in the same stable or neighborhood are similarly affected. In the next form in which it may develop, it first becomes manifest by a difficulty in swallowing and slowness in mastication, and a weakness which may be first noticed in the strength of the tail; the animal will be unable to switch it or to offer resistance when we bend it up over the croup. The pulse is often a little slower than normal. There is no evidence of pain; the respirations are unchanged, and the temperature little less than normal; the bowels may be somewhat constii^ated. These symptoms may remain unchanged for two or three days and then grad- ual improvement take place, or the power to swallow may become entirely lost and the weakness and uncertainty in gait more and more perceijtible; then sleepiness or coma may appear; the pulse becomes depressed, slow and weak, the breathing stertorous, and paroxysms of delirium develop, with inability to stand, and some rigidity of the sijinal muscles or partial cramp of the neck and jaws. In such cases death may occur in from six to ten days from the commencement of the attack. In many cases there is no evidence of i^ain, spasm, or fever at any time during the progress of the disease, and finally profound coma develops and death follows, painless and without a struggle.
In the last or mildest form, the inability of voluntary control of the limbs becomes but slightly marked, the power of swallo^^ing never
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entirely lost, and the animal lias no fever, pain, or nneonscions move- ments. Generally the animal v.ill hegin to improve ahont llie fonrth day and recover.
In a few eases the spinal symptoms, manifested hy pai-aplet;ia, may be the most prominent symptoms; in others the}' may he altogether absent and the main sj'mptonis be difficnlty in mastication and swal- lowing; rarely it maj" affect one limb only. In all cases where coma remains absent for six or seven daj^s the animal is likely to recover. When changes toward recovery take place, the symptoms nsually leave in the reverse order in which they develoi^ed, bnt local paral3'sis may remain for some time, rarelj^ persistent.
One attack does not give immnnity, for it may recur at some later time and prove fatal. Horses have been known to i)ass through three attacks, being aifected for a week or longer each time.
Treaimenf. — In the worst class of cases treatment is very seldom successful, and it is dangerous to attemi^t the administration of medi- cine by the mouth, on account of the inability of the animal to swal- low. Cold shower baths may i)ossibly induce reviilsive action in connection with stimulants per rectum, 4 to G ounces of whiskj^ in 2 pints of milk; the inhalation of ammonia vapor from a sponge saturated with dilute acxua ammonia may arouse consciousness.
In the second class of cases the treatment recommended by Professor Large consists in giving a cathartic composed of 1 ounce of aloes and the administration of 1 to 2 drams of the solid extract of belladonna, alternated eveiy three hours with 30 drops of tincture of aconite root, and the aiDplication of blisters to the neck, spine, and tliroat. When the animal is unable to swallow, one-fourth-grain doses of sulphate of atroj)ia may be injected nnder the skin every four, six, or eight hours, as the case may demand. The atropia is a heart stimulant, increases capillar}^ circulation, and quiets pain and excitability. This treat- ment has been followed by very gratifying results in the hands of Pro- fessor Large and others. When the most prominent symptoms abate give such food as they may be able to eat, keep fresh, cool water con- stantly lief ore them, support them in slings if necessary ; clean stabling and plenty of fresh air are of the utmost importance.
Paihohxjij. — Post mortem examination reveals more or less conges- tion of the blood vessels at the base of the brain, effusion in the ventricles and in the subarachnoid space both in the cranial and the spinal cavities. Plastic exudation is often found adherent to the pia mater of the brain, anterior part of the spinal cord, and in the region of the loins. The brain and cord appear softened in some cases wiiere the greatest evidence of inflammatory action existed.
Hygienic measures neeilfuJ. — Whenever this disease ajipears in a stable all the animals should be removed as soon as possible. They should be provided with clean, well-A^entilated, and well-drained stables, and each animal should receive 1 dram of the extract or half
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an ounce of the tincture of belladonna twice a day for .scxt'iiil days. The abandoned stable should be thoroughly cleansed from all waste matters, receive a coat of whitewash containing 4 ounces of carbolic acid to the gallon, and should have time to drj^ thoroughly before the horses are replaced. A complete change of food is of the very great- est importance, on account of the belief lliat llie cause resides in diseased grain, hay, and grass.
TETANUS — LOCK-JAW.
Tills disease is characterized by si)asms affecting the muscles of the face, neck, body, and limbs, of all the muscles supplied by the cerebro- spinal nerves. The spasms or muscular contractions are rigid and persistent, yet mixed with occasional more intense contractions of convulsive violence.
Causes. — The causes are classified under two heads, traumatic Avhere it is the result of injury, and kliopatliic where it is due to other causes than injuries, such as cold and damp, excessive fright, nervous exhaustion from overwork, chronic irritation caused by worms in the intestines, etc. In the majority of instances the cause of tetanus can be traced to wounds, especially pricks or wounds of the feet or of tendinous structures. It sometimes follows castration, docking, the introduction of setons, inclusion of a nerve in a ligature, etc. It may come on a long time after the wound is healed, three or four months. In some countries where tetanus appears to be enzootic the presump- tion is that it is due to a specific germ. Horses with a nervous, excit- able disposition are more jiredisposed than those of a more sluggish nature. Stallions are more subject to develop tetanus as tlie result of wounds than geldings, and geldings more than mares.
Sijnrptoins. — The attacks may be acute or subacute. In an acute attack the animal usually dies within four daj's. The first symptoms which attract the attention of the owner is difficulty in chcAving and swallowing, an extension of the head and i^rotrusion over the inner part of the ej^e of the membrana nictitans or haw. An examination of the mouth will reveal an inability to open the jaws to their full extent, and the endeavor to do so w ill produce great nervous excita- bility and increased sjDasm of tlie muscles of the jaw and neck. The muscles of the neck and along the spine become rigid and the legs are moved in a stitf manner. The slightest noise or disturbance throws the animal into inci-eased spasm of all the affected muscles. Tlie tail is usually elevated and held immovable; the bowels become constipated early in tlie attack. The temperature and pulse are not much changed. These sjniiptoms in the acute type l)ec()me rapidly aggravated until all the muscles are rigid — in a stale of tonic si^asm — with a continuous tremor running through them ; a cold jDcrspiration breaks out on the body; the breathing l)ecomes painful from the
220
spasm of the muscles used in respiration; the jaws are completely set, ej'e-balls retracted, lij)s drawn tightly over the teeth, nostrils dilated, and the animal presents a picture of the most extreme agony until death relieves him. The pulse, which at first was not much affected, Avill become quick and hard, or small and thready when the spasm affects the muscles of the heart. In the subacute cases the jaws may never become entirely locked ; the nervous excitability and rig- idity of muscles are not so great. There is, however, always some stiffness of the neck or spine manifest in turning; the haw is turned over the eye-ball when the nose is elevated. It is not uncommon for owners to continue such animals at their work for several days after the first symptoms have been observed. All the symptoms may grad- ually increase in severity for a period of ten daj^s, and then gradually diminish under judicious treatment, or they may reach the stage wherein all the characters of acute tetanus become developed. In some cases, however, we find the muscular cramps almost solely con- fined to the head or face, perhaps involving those of the neck. In such cases Ave have complete trismus — lock-jaw — and all the head symptoms are acutely developed. On the contrary, we may find the head almost exempt in some cases, and have the body and limbs perfectly rigid and incapable of movement without falling.
Tetanus may possibly be confounded with spinal meningitis, but the character of the spasm-locked jaw, retraction of the ej^eballs, the difficulty in swallowing due to sjDasms of the muscles of the pharynx, and, above all, the absence of paralysis, should serve to make the distinction.
Treatment. — The animal should be placed in a box-stall without bedding, as far away as possible from other horses. If in a country district, the animal should be put into an outbuilding or shed, where the noise of other animals will not reach him; if the place is moder- ately dark it is all the better; in fly time he should be covered with a light sheet. The attendant must be very careful and quiet about liim, to prevent all unnecessary excitement and increase of spasm.
A cathartic, composed of Barbadoes aloes, G to 8 drams, with which may be mixed 2 drams of the solid extract of belladonna, should be given at once. This is best given in a ball form; if, however, the animal is greatly excited by the attempt or can not swalloAv, the ball may be disolved in 2 ounces of olive oil and thrown on the back of the tongue with a syringe. If the jaw^s are set, or nearly so, an attempt to administer medicine by the mouth should not be made. In such cases one-quarter of a grain of atropia, with 5 grains of sulphate of morjjhia, should be dissolved in 1 dram of pure water and injected under the skin. This should be repeated sufficiently often to keep the animal continually under its effect. This will usually mitigate the severity of the spasmodic contraction of the affected muscles and lessen sensibility to pain. Good results may be obtained
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sometimes b}' the injection per rectum of tlie fluid extract of bella- donna and of cannabis indica, of eacli 1 dram, every four or six hours. This may be diluted "vvitli a quart of milk. "When the animal is unable to swallow liquids, oat-meal gruel and milk should be given by injection per rectum to sustain the strengtli of the animal. A pailful of cool water should be constantly before him, placed high enough for him to reach it without sj)ecial effort; even if he can not drink, the laving of the mouth is refreshing. Excellent success fre- quently may be obtained by clothing the upper i^art of the head, the neck, and greater part of the body in woolen blankets kept saturated with very warm water. This treatment should be continued for six or eight hours at a time. It often relaxes the cramped muscles and gives tliem rest and the animal almost entire freedom from pain; but it should be used every day until the acute spasms have permanently subsided in order to be of any lasting benefit.
If the cause is due to the inclusion of a nerve in a ligature, the division of the nerve becomes necessary. When it is due to a wound all foreign substances should be searched for and be removed; if from a wound which has healed an excision of the cicatrix may be bene- ficial. In all cases it is not uncommon to have a partial recovery fol- lowed by relapse when the animal becomes excited from any cause.
RABIES — HYDROPHOBIA — MADNESS.
This disease does not arise spontaneouslj- among horses, but is tlie result of a bite from a rabid animal — generally a dog or cat. The development of the disease follows the bite in from three weeks to three months — very rarely in twelve or fourteen days.
Symptoms. — The first manifestation of the development of this dis- ease maybe an increased excitability and viciousness; very slight noises or the approach of a person incites the animal to kick, strike, or bite at any object near him. Very often the horse will l)itc his own limbs or sides, lacerating the flesh and tearing the skin. The eyes appear staring, bloodshot ; the ears are on the alert to catch all sounds; tlie head is held erect. In some cases the animal will continually rub and bite the locality of the wound inflicted by the rabid animal. This symptom may precede all others. Generally the bowels become con- stipated and he makes frequent attempts at urination, which is pain- ful and the urine very dark colored. The furious symptoms appear in paroxysms; at other times the animal may eat and drink, altliough swallowing appears to become painful towards the latter stage of the disease, and may cause renewed paroxysms. The muscles of the limbs or back may be subject to intermittent spasms, or spasmodic tremors; finally the hind limbs become paralyzed, breathing very diflicult, and convulsions supervene, followed by death. The pulse and respirations are increased in frequency from the outset of the attack. Rabies may possibly be mistaken for tetanus. In the latter
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disease we fliid tonic spasms of the iinisclesof the jaws, or stiffness of tlie neck or back very early in the attack, and evidence of viciousness is absent.
Treatment. — As soon as the true nature of the disease is ascertained the animal should be killed.
Prevention. — When a horse is known to have been bitten by a rabid animal immediate cauterization of the wound with a red-hot iron may possibly destroy the virus before absorption of it takes place.
PLUMBISM — LEAD-POISONING.
This disease is not of frequent occurrence. It may be due to habitu- ally drinking water which has been standing in leaden conductors or in old i)aint barrels, etc. It has been met with in enzootic form near smelting Avorks, where, by the fumes arising from such works, lead in the form of oxide, carbonate, or sulphate was deposited on the grass and herbage which the horses ate.
SijiniJioms. — Lead-poisoning produces derangement of the functions of digestion and locomotion, or it may affect the lungs principally. In whatever system of organs the lead is deposited mostly there will we have the symptoms of nervous debilit}^ most manifest. If in tlie lungs the breathing becomes difficult and the animal gets out of breath A'cry quickly when he is compelled to run. Roaring also is very fre- quently a symptom of lead-poisoning. When it affects the stomach the animal gradually falls away in flesh, the hair becomes rougli, the skin tight, and colicky symptoms develoj). When the deposit is prin- cipally' in the muscles i^artial or comj)lete paralysis gradually develops. When large quantities of lead have been taken in and absorbed, symp- toms resembling epilepsy may result, or coma and delirium develop and prove fatal. In lead-poisoning there is seldom any increase in temperature. A blue line forms along the gums of the front teeth, and the breath assumes a peculiar offensive odor. Lead can always be detected in the urine b}' chemical tests.
Treatment. — The administration of 2-dram doses of iodide of potassa, three times a day. This will form iodide of lead in the system, which is rapidl}^ excreted by the kidneys. If much muscular weakness or parah'sis is present, sulj)hate of iron in dram doses, and strychnia in 2-grain doses may be given twice a day. In all cases of suspected lead-poisoning all utensils which have entered into the suj)ply of feed or water should be examined for the jjresence of soluble lead. If it occurs near lead works great care must be given to the supply of uncontaminatcd fodder, etc.
UR.EMIA.
Urremic poisoning may affect the brain in nephritis, acute albumi- nuria, or when, from any cause, the functions of the kidnej^s become impaired or suppressed and urea (a natural product) is no longer
w
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eliminated from these organs, causlno- it to aeeumulale in the system and give rise to urajmic poisoning,
SymiJtoms. — Urtemic i^oisoning is usually preeeded by dropsy of the limbs or abdomen; a peculiar fetid breath is often noticed; then drowsiness, attacks of diarrhea, and general debility ensue. Sud- denly extreme stupor or coma develops; the surface of the body becomes cold; the pupils are insensible to light; the pulse slow and intermitting; the breathing labored, and death supervenes. The tem- perature throughout the disease is seldom increased, unless the dis- ease becomes complicated with acute inflammatory disease of the brain or respiratory organs, which often occur as a result of the urea in the circulation. Albumen and tube casts may frequently be found in the urine. The disease almost invariably pioves fatal.
Treatment. — This must be directed to a removal of the cause. (See "Diseases of the Kidney.")
ELECTRIC SHOCK.
Electric shock, from coming in contact with electric wires, is becom- ing a matter of rather frequent occurrence, and has a similar effect upon the animal system to a shock from lightning. Two degrees of electric or lightning shock maybe observed, one producing temporar}^ contraction of muscles and insensibility, from which recovery is pos- sible, the other killing directly, by producing a condition of nervous and general insensibility-. In shocks which are not immediately fatal the animal is usuallj^ insensible, the respiration slow, labored or gasp- ing, the pulse slow, feeble, and irregular, and the pupils dilated and not sensitive, or they may be contracted and sensitive. The temper- ature is lowered. There maybe a tendencj-to convulsions or spasms. The predominating symptoms are extreme cardiac and respiratoiy depression.
Treatment. — Sulphate of atropia should be given hypodermicallyin one-quarter-grain doses every hour or two hours until the heart beats are invigorated, the number and fullness of the respirations increased, and consciousness returns. Stimulating injections per rectum may also be useful in arousing the circulation; for this purpose whisky or ammonia water mav be used.
DISEASES OF THE HEART AND BLOOD-VESSELS.
By M. R. TRUMBOWER, V. S., Sterling, 111.
REMARKS ON THE ANATOMY AND PHYSIOLOGY OF THE HEART AND
BLOOD-VESSELS.
The heart is a hollow, involuntary, muscular organ, situated as nearly as possible in the center of the chest, though its impulse is felt on the left side from the rotary movement of the organ in action. It is cone-shai)ed, with the base upwards; the apex points downwards, backwards, and to the left side. It extends from about the third to the sixth ribs inclusive. The average weight is about Gw pounds. In liorses used for speed the heart is relatively larger, according to the weight of the animal, than in horses used for slow work. It is sus- pended from the spine by the large blood-vessels, and held in position beloAV by the attachment of the pericardium to the sternum. It is inclosed in a sac, the pericardium, wliich is composed of a dense, fibrous membrane, lined by a delicate serous membrane, which is reflected over the heart; the inner layer is firmlj^ adherent to the heart, the outer to the fibrous sac, and there is an intervening space known as the pericardial space, in which a small amount of serum — a thin translucent liquid — is present constantly.
The heart is divided by a shallow fissure into a right and left side; each of tliese is again subdivided by a transverse partition into two compartments, which communicate. Thus there are four cardiac cavities, the superior or upper ones called the auricles, the inferior or lower ones the ventricles. These divisions are marked on the outside by grooves, which contain the cardiac blood-vessels, and are gener- ally filled with fat.
The right side of the heart may be called the venous, the left the arterial side, named from the kind of blood which passes through them. The auricles are thin-walled cavities placed at the base, and are connected with the great veins, the vena cav?e and pulmonary veins, through which they receive blood from all parts of the body. The auricles communicate with the ventricles each by a large aperture, the aitriculo-venfricvlar orifice, which is furnished with a remarkable 59(31 — HOR 8 225
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meehanisiu of Aalves, allowiiig tlie transmission of l)lood from the auricles into the ventricles, l3nt pi-eventing a reverse course. The ventricles are thiek-walled cavities, forming the more massive portion of the heart tov.ards tlie apex. Thej' are separated by a iiartition, and are connected with the great arteries, the pulmonary artery and the aorta, b}' which they send blood to all parts of the body. At the mouth of tlie aorta and at the mouth of the j)iilMionary artery is an arrangement of valves in each case which prevents the reflux of blood into the ventricles. The auriculo-ventricular valves in the left side are comi)osed of two flaps, hence it is called the bicuspid valve.. In the right side this valve has three flaps, and is called the tricuspid valve. The flaps which form these valves are connected with a tendi- nous ring between the auricles and ventricles; and each flap of the auriculo-ventricular valves is supplied with tendinous cords, which are attached to the free margin and under surface, so as to keep the valves tense when closed ; a condition which is produced by the short- ening of muscular pillars with which the cords are connected. The arterial openings, both on the right and on the left side, are i^ro- A'ided with three-flapped semi-lunar shaped valves, to prevent the regurgitation of blood when the ventricles contract. The veins emp- tying into tlie auricles are not capable of closure, liut the iiosterior vena cava has an imperfect valve at its aperture.
The inner surface of the heart is lined by a serous membrane, the endocardium, which is smooth and firmly adherent to the muscular structure of the heart. This membrane is continuous with the lining membrane of the blood vessels, and it enters into the formation of the valves.
The circulation through the heart is as follows: The venous blood is carried into the right auricle by the anterior and posterior ven?B cavpp. It then passes through the right auriculo-ventricular opening into the right ventricle, thence through the iiulmonary artery to the lungs. It returns by the pulmonary veins to the left auricle, then is forced through the auriculo-ventricular opening into the left ventricle, which propels it through the aorta and its b]*anclies into the system, the veins returning it again to the heart. The circulation, therefore, is double, the pulmonary or lesser being performed by the right, and the systemic or greater by the left side.
As the lilood is forced through the heart by forcible contractions of its muscular walls it has the action of a force pump, and gives the impulse at each beat, which we call the pulse — the dilatation of the arteries throughout the system. The contraction of the auricles is quickly followed by that of the ventricles, and then a slight pause occurs; this takes place in regular rythmical order during health.
The action of the heart is governed and maintained by the pneumo- gastric nerve (tenth pair of cranial nerves); it is the inhibitory nerve of the heart, and regulates, slows, and governs its action. When the
227
nerve is cut the lieart-boats increase rapidly, and in fact tlie organ works without control. When the nerve is unduly irritated the hold- back or inhibitory I'orce is increased, and the heart slows nj) in the same measure. The left cavities of the heart, the i)ulmonar3- veins, and the aorta or systemic artery, contain red or florid blood, fit to circulate through the body. The right cavities of the heart, with the vena? cava» or systemic veins and pulmonary arterj-, contain dark blood, which must be transmitted through the lungs for renovation.
The arteries, commencing in two great trunks, the aorta and the pulmonary artery, undergo division as in the l)ranching of a tree. Their branches mostly come off at acute angles, and are commonly of uniform diameter in each case, but successively diminish after and in consequence of division, and in this manner gradually merge into the capillar}- system of blood-vessels. As a general rule, the combined area of the branches is greater than that of the vessels from which they emanate, and hence the collective capacity of the arterial sj's- tem is greatest at the capillary vessels. The same rule applies to the veins. The'effect of the division of the arteries is to make the blood move more slowly along their branches to the capillary vessels, and the effect of the union of the branches of the veins is to accelerate the speed of the blood as it i-et urns from the capillary vessels to the venous trunks.
In the smaller vessels a frequent riuining together or anastomosis occurs. This admits of a free communication between the currents of blood, and must tend to j^romote equability of distribution and of Ijressure, and to obviate the effects of local interruption. The arte- ries are highly elastic, being extensile and retractile both in length and breadth. During life they are also contractile, being jn-ovided with muscular tissue. When cut across they present, although empty, an open orifice; the veins, on the other hand, collapse.
In most parts of the body the arteries are inclosed in a sheath formed of connective tissue, but are connected so loosely that when the vessel is cut across its ends readily- retract some distance within the sheath. Independently of this sheath arteries are usuallj^ de- scribed as being formed of three coats, named, from their i-elative positions, external, middle, and internal. This applies to their struc- ture so far as it is discernible bj-tlie naked eye. The internal, serous or tunica intima is the thinnest, and continuous with the lining mem- brane of the heart. It is made up of two layers, an inner, consisting of a layer of epithelial scales, and an outer, transparent, whitish, highly elastic, and perforated. The middle coat, tunica media, is elastic, dense, and of a yellow color, consisting of non-striated muscuhir and elastic fibers, thickest in the largest arteries and becoming thinner in the smaller. In tlie smallest vessels it is almost entirely muscular. The external coat, tunica adventitia, is composed mainly of fine and closely woven bundles of white connective tissue, which chiefly run
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diagonally or obliquely round the vessel. In this coat the nutrient vessels, the vasa vasorum, form a capillary net-work, from which a few penetrate as far as the muscular coat.
The veins differ from arteries in possessing thinner walls, less elas- tic and muscular tissue, and for the most part a stronger tunica adven- titia. Thej^ collapse when cut across or Avhen they are empty. The majority of A^eins are provided with A^alves; these are folds of the lin- ing membrane, strengthened by fibrous tissue. They favor the course of the blood and jirevent its reflux. The nerves which supply both the arteries and the veins come from the sympathetic system. The smaller arteries terminate in the system of minute vessels, known as the capillaries, which are interjjosed between the termination of the arteries and the commencement of the veins. Their average diame- ter is about one three-thousandth of an inch.
SOUNDS OF THE HEART.
By placing the ear behind the elbow against the left side of the chest two distinct sounds can be heard at each heart-b<*at in health. The first is rather mufiled and prolonged, the second is short and sudden. The first is caused by the contraction of the A^entricles, the closing of the auriculo-ventricular valves, and the forcible propulsion of the blood into the arteries; the second follows immediately, and is due to the reflux of the blood just forced into the arteries, and the sudden closure of the valves Avhich prevent its return to the heart. In disease of the heart or valves these sounds are generally modified, or supplanted by others, which vary so much in character and are so difficult to describe that we can not consider them here; long and extensive experience is required to distinguish them i:>ractically.
CHARACTERS OF THE PULSE.
The circulation of the blood through the heart is constant, and is maintained by the propelling activitj^ of this organ. In the horse the heart beats from thirty-six to forty-six times a minute, varying with the disposition, breed, and temperament of the animal. In the foal the pulse is about three times as rapid as in the adult, from six months to a year about twice as quick, and in the two-year-old about one- quarter faster. The pulse is usually taken at the angle of the jaw, where the artery crosses the bone, and its force or character is often indicative of the nature of the disease from which an animal may be suffering. The jiulse, therefore, is named in accordance with its char- acter as slow, soft, small, full, weak, quick, hard, irregular, intermit- tent, venous, etc.
Slow pulse is one where the number of beats is less than normal, and is often found in certain diseases of the brain.
Soft or cornpressihJe pidse is one Avhere the beat is rather weak, but not abnornuilly rapid. It is often found in debility due to want of
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assimilation or proper nourishment. Wlien accompanied with fever or loss of api>etite it is usually indicative of derangement of the digestive organs.
S)tudl jiidse is one where the sensation conveyed to the finger is one of lessened diameter of the artery; it may be normal in frequency or slightly increased. Generall}" due to exhaustion from work or
disease.
Full or strong 2^ ^(^•'ic is one which imparts a bounding sensation as if from over-distension of the artery at each heart-beat. It is usually increased in frequency. This character may be felt immediately succeeding fast work, or in very plethoric horses when slightly excited. Often it may indicate a general systemic disturbance or disease of the lungs.
TFeaA; ov feehJe pulse is one which is hardly i:>erceptible. This may indicate organic disease of the heart, or denote general weakness from loss of blood, prolonged sickness, starvation, etc.
Quick OY frequent puJse is one where the heart-beats are more rapid than normal, without an}^ special change in its character. It is found in the early stage of nearly all inflammatory diseases.
Hard or wiry pulse is one which is tense, incompressible, or vibrat- ing, and is always increased in frequency. It usually denotes acute disease of serous membranes, such as pleuritic, peritonitis, menin- gitis, etc.
Irregular pulse is one in which several pulsations follow in quick succession and then a pause ensues. This may indicate disease of the heart, or of the nervous system, sometimes observed in lingering, exhausting diseases.
Intermitient pulse is one where a beat is lost at regular intervals. This is almost invariabl}^ an indication of disease of the heart.
Venous xndse may be seen along the side of the neck in the jugular furrow, and has the appearance of blood regurgitating in the vein at each beat of the heart. It usually denotes disease of the heart, or an obstruction to the flow of blood within the chest, from the pres- sure of a tumor, dropsy, etc.
DISEASES OF THE HEART AND BLOOD-VESSELS.
In considering diseases of the heart we meet with many difficulties, depending much upon the position which this organ occupies in the animal. The shoulders cover so much of the anterior portion of the chest, and often in very heavy muscled horses the chest walls are so thick, that a satisfactory examination of the heart cannot be made. Diseases of the heai*t are not uncommon among horses; the heart and its membranes are frequently involved in diseases of the respiratory organs, diseases of the kidnej^s, rheumatism, influenza, etc. Some of the diseases of this organ are never suspected by the ordinary observer during life, and are so difficult to diagnose with any degree
230
of certainty that we Avill liave to confine ourselves to a general out- line, giving attention to such symptoms as may serve to lead to a knowledge of their existence, with directions for treatment, care, etc.
Nervous affections often i^roduce prominent heart sj'mptoms by causing functional disturbance of that organ, Avhich, if removed, will leave the heart restored to perfect vigor and normal action. Organic changes involving the heart or valves, however, usually grow worse and eventually prove fatal. Therefore it is necessary that we arriA-e at an appreciation of the true nature and causes, so that we may be able to form a true estimate of the possibilities for recovery or encouragement for medical treatment.
Disease of the heart may occur at any age, but it is Avitnessed most frequently in young horses, which, when being trained for fast work, are often subjected to excessiA^e hardship and fatigue. NerA'ous or timid animals also suffer from such diseases more frequently than those of a sluggish disposition. Anj^ cause Avliich induces a Aiolent or sudden change in the circulation may result in injury to the heart. Sj-mptoms Avhich may frequently denote disease of the heart are dif- ficult breathing or short-windedness, dropsies of the limbs, habitual coldness of the extremities, giddiness or fainting attacks, inability to stand Avork althougli tlie general appearance Avould indicate strength and ability, etc.
INFLAMMATORY DISEASES OF THE HEART.
This Avill embrace myocarditis, endocarditis, and pericarditis.
MYOCARDITIS — INFLAMMATION OF THE MUSCULAR STRUCTURE OF THE HEART.
This is of rare occurrence Avithout imi)lication of the endocardium or pericardium. That inflammation of the muscular Avails of the heart may frequently exist to some slight degree, induced by excessive action, can not be doubted. Post-moriem examinations occasionally reveal abscess and degeneration within the Avails of this organ, Avhich were not suspected during life. Myocarditis primarily involves the inter- stitial muscular tissue and the blood vessels, and presents itself in a sub-acute or chronic type, AAdiich often leads to induration or hyper- trophy, occasionally to the formation of pus and abscess. It may also lead to a dilatation of the heart and rupture.
Causes. — Over-exertion or heart strain, influenza, rheumatism, pyae- mia, extension of endocarditis or pericarditis, etc. Myocarditis usu- ally involves the endocardial membrane very early in the attack, and develops all the symptoms of endocarditis. Hence Ave Avill con- sider, as most distinctive of inflammation of the heart, endocarditis.
ENDOCARDITIS— INFLAMMATION OF THE LINING BIEMBRANE OF THE HEART, USUALLY INVOLA^NG THE MUSCULAR STRUCTURE,
It is frequently found in gcnei-al rheumatism, iuA^olving the serous membrane, some of the specific or zymotic fevers, septic poisoning, etc.
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Endocarditis is a nineli luoro frequent disease among- horses than we are generally' aware, and often gives rise to sj'mptons which, at first, are obscure and unnoticed. Ihave witnessed two enzoiiticsof influenza in which 20 per cent of the animals attacked develoiied symptoms of either endocarditis or pericarditis. A certain number of these cases subsequently developed the condition knowji as heaves, or gradually failed in strength, with recurrence of attacks of heart failure upon the slightest exertion, rendering main* of them valueless. In the rheumatic type of influenza we may often find the heart becoming involved in the disease, in consequence of the morbid material conveyed through the heart in the blood-stream. In view of the fact that many affec- tions, in even remote portions of the body, may be traced directly to a primary endocardial disease, we shall feel justified in inviting special attention to this disease.
Endocarditis ma}' be acute or assume various degrees of severity. In acute inflammation we find a thickening and a roughened appear- ance of the endocardium througliout the cavities of the heart. This condition is soon followed by a coagulation of fibrine uijon the inflamed surface, which adheres to it, and by attrition soon becomes worked up into shreddy-like granular elevations; this may lead to the formation of librinous clots in the heart and sudden death early in the disease, the second or third day. This acute type of the disease, however, does not always affect the whole interior of the heart, but is often conflned to one ventricle or may be in patches; it may extend through the ven- tricle into the aorta or the i^ulmonary vein; it may affect the valves princii)ally, which are composed of but little else than the endocardium folded U2:»on itself.
In acute endocarditis we invariablj' will find myocarditis develop corresponding to the same space, which in intensity may produce seri- ous results through the destruction of functional ability or lead to weakness, abscess, or rupture. Immediately upon the swelling of this membrane we will find an abnormal action and abnormal sounds of the heart.
Subacute endocarditis, which is the most common form we meet, may not l^eeome ai)preciable for several days after its commencement. It is characterized b}' being confined to one or more anatomical divi- sions of the heart, and all the successive morbid changes follow each other in a comparatively slow process. Often we would not be led to suspect heart affection were it not for the distress in breathing, which it generally occasions when the animal is exercised, especially if the valves are much involved. When the disease extends into the arte- ries, atheromatous dei^osits usuallj' develop; when the inflammation is severe at the origin of the tendinous cords they maj^ become softened and ruptured. AYlien much fibrinous coagula or cellular vegetations form upon the inflamed membi-ane, either in minute shreds or patches, or when formation of fibrinous clots occurs in the cavity affected, some
232
of tliese materials may "be carried from tlie cavity of the heart by the blood-current into remote organs, constituting emboli that are liable to suddenly plug vessels and thereby interrupt important functions. In the great majority of either acute or subacute grades of endocar- ditis, whatever the exciting cause, the most alarming symptoms dis- appear in a week or ten days, often leaving, however, such changes in the interior lining or valvular structures as to cause impairment in the circulation for a much longer period of time. These changes usu- ally consist of thickening or induration of the inflamed structures. But while the eifects of the inflammation in the membrane lining the walls of the ventricles may subside to such a degree as to cause little or no inconvenience, or even wholly disappear, yet after the valvular structures have been involved, causing them to be thicker, less flexible than normal, they usuall}^ remain, obstructing the free passage of the blood through the openings of the heart, thereby inducing secondary changes which take place slowly at first, but ultimately seriously impair the animal's usefulness. AVhat was but a slight obstruction to the circulation during the first few weeks after the subsidence of the cardiac inflammatory attack becomes in process of time so much increased as to induce increased growth in the muscular structure of the heart, constituting hypertrophy of the walls of the ventricles, more particularly of the left, with corresponding fullness of the left auricle and i^ulmonary veins, thereby producing fullness of the capillaries in the lungs, pressure uj)on the air cells, difficult or asthmatic breath- ing— greatly increased in attemjits to work — until in a few months many of these cases become entirely disabled for work. Sometimes, too, droi)sieal effusions in the limbs or into the cavities of the body result from the irregular and deficient circulation. Derangement of the urinary secretion, with passive congestion of the kidneys, may also appear.
Endocardial inflammation is seldom fatal in its early stages, but in many cases the recovery is incomplete, for a large proportion are left with some permanent thickening of the valves, which constitutes the beginning of A^alvular disease.
Symptoms. — As already stated, myocarditis is seldom recognized until pericarditis or endocarditis supervenes. Staggering gait with j)ainful movement of the fore-limbs, a constant irregularity of the heart's action, but equality of strength regardless of the rapidity of the heart-beats, constitutute perhaps the most prominent sj^mptoms which characterize myocarditis. When the disease is associated with rheumatism, influenza, or other zymotic diseases, these symx^tomsmay not be sufficiently well defined to attract the attention they deserve, and medical treatment prescribed for the mitigation of such disease often serves to aggravate the cardiac affection. In chronic myocar- ditis we generally find a persistent i^alpitation with irregularity of beat, which, upon exercise, becomes greatly intensified. Change in
233
the sounds of the heart does not occur unless x)ericarditis, endocarditis, or disease of the valves is associated with myocarditis. When it leads to hypertroj)hy we may find an abnormally increased area of dullness on j)ercussion. In endocarditis, when the attack is sudden and severe, we may find many of the symptoms which characterize pericarditis and pleuritis, but a close examination will reveal notable differences.
Endocarditis may be ushered in by a chill, with sudden and marked rise in temperature. The pulse rapidly decreases in strength or may become irregular, while the heart beats more or less tumultuously. In the early stages soft blowing sounds may be heard Ijy placing the ear over the heart on the left side, which correspond in number and rhythm to the heart's action. Excessive pain, though not so great as in acute pleuritis, is manifested when the animal is compelled to trot; very often difficulty in breathing — shortness of breath — on the slight- est exertion develops early in the attack. AVhen the valves are involved in the inflammatory j)rocess the visible mucous membranes become either very pale or verj^ dark colored, and fainting may occur when the head is suddenly elevated. When the valves of the right side are affected we may have a regurgitant pulsation in the jugular vein. In some cases we find marked lameness of the left shoulder, and when the animal is turned short to the left side he may groan with pain, and the heart's action become violently excited, although pres- sure against the chest-wall will not produce pain unless roughly applied. The animal is not disposed to eat or drink much; the sur- face of the body and legs are cold — rarely excessively hot — and fre- quently the body of the animal is in a subdued tremor. In nearly all cases there is i)artial suj^pression of the urinary secretion. The S3'mp- toms may continue with verj^ little modification for three or four daj's, sometimes seven days, without any marked changes. If fibrinous clots form in the heart the change will be sudden and quickly prove fatal unless iliey become loosened and are carried awaj^ in the circu- lation; then apoplexy may result from the plugging of arteries too small to give further transmission. If the animal manifests symp- toms of improvement, the changes usually are slow and steady until he feels apparentlj^ as well as ever, eats well, and moves freely in his stall or 5'ard. When ho is taken out, however, the seeming strength often proves deceptive, as he may quickly weaken if urged into a fast gait, the breathing become quickened with a double flank movement as in heaves, and all the former symjitoms reappear in a modified degree. An examination at this stage may reveal valvular insufiici- enc}', cardiac hypertrophy, or pulmonary engorgement.
In fatal cases of endocarditis death often occurs about the fourth day, from the formation of heart clot or too great embarrassment of the circulation. Endocarditis may be suspected in all cases where 59G1— HOR 8*
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plain symptoinsof cardiac affection are manifested in animals affected with influenza, rheumatism, or any disease in wliicli the blood may convey septic matter.
Acute endocardial inflammation may be distinguished from i)leuritis by the absence of any friction murmur, absence of pain when the chest wall is percussed, and the absence of effusion in the cavitj^ of the chest. It may be distinguished from pericarditis b}' the absence of the friction sounds and vwant of an enlarged area of dullness on jpercussion.
Treaimeni. — The treatment will be similar in both myocarditis and endocarditis. The objects to be attained Avillbe to remove or mitigate as much as possible the cause inducing the disease; to find a medicine which will lessen the irritability of the heart without weakening it; and last, to maintain a free urinary secretion and prevent exudation and hypertrophy. So long as there is an increase of temperature, with some degree of scautinessof the nrine, it may be safe to believe that there is some degree of inflammatory action existing in the cardiac structures, and, as long as any evidence of inflammatory action remains, however moderate in degree, there is a tendency to increase or hypertrophy of the connective tissue of the heart or valves, thereby rendering it almost certain that the structural changes will become permanent unless counteracted by persistent treatment and complete rest.
The tincture of digitalis, in 20-drop doses, repeated every hour, is perhaps the most reliable agent we know to control the irritability of the heart, and this also has a decided influence upon the urinary secre- tion. After the desired impression ui)on the heart is obtained the dose may be repeated every two or three hours, or as the case may demand. Fluid extract of convaJlaria majalis, in 2-dram doses, will quiet the tumultuous action of the heart in some cases where the digitalis fails. Some veterinarians recommend bleeding, others cold packs around the chest or over the lieart. The former is decidedly objectionable, because of its tendency to favor fibrinous exudation and clot formation; the latter is too risky a proceeding in the majority of cases to warrant its use, for we find this disease in wet and damp sta- bles in the most aggravated and fatal forms. Blistering and stimulat- ing applications to the chest should also be avoided. They serve to irritate tlie animal and can do no possible good. Chlorate of ]3otassa, in 2-dram doses, may be given in the drinking water everj^ four hours for the first five or six days, and then l)e superseded by the nitrate of potassa, in lialf-ounee doses, for the following week, or until the uri- nary secretion becomes abnormally profuse. Where the disease is associated with rheumatism 2-dram doses of salicylate of soda may be substituted for the chlorate of potassa. To guard against chronic induration of the valves the iodide of potassa, in 1 to 2 dram doses, should be given early in the disease, and may be repeated two or three times a day for several weeks. When chronic effects remain after the acute stage has passed this drug becomes indisi)ensable.
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Wlieu dropsy of tlie limbs develoi)s, it is dno to weakened eirculation or f iiiietional impairment of the kidneys. "When there is much weak- ness in the action of the heart, or general debilit}- is marked, the iodide of ii-on, in 1-dram doses, combined with hydrastis, 3 drams, may be given three times a day. Arsenic, in o-grain doses twice a day, will give excellent resnlts in some cases of weak heart associated with diffi- cult breathing. In all cases absojute rest and warm stabling, Avith comfortable clothing, become necessary, and freedom from work should be allowed for a long time after all syjp.ptoms have disappeared.
ABSCESS IX THE HEART.
This is a result of mj'ocarditis, or it may arise from localized pyae- mic infection or embolism of a coronary' vessel, causing disintegra- tion and death of a part. Such abscess may be single and large, or multiple and small. They maj^ weaken the heart sufficiently to cause rupture of its Avails, or may embarrass the circulation by i^ressure upon the orifices or cavities sufficient to produce death.
Abscess of the heart cannot be diagnosed with any degree of certainty.
PERICARDITIS — INFLAMMATION OF THE SAC INCLOSING THE HEART.
Causes. — Pericarditis may be induced by cold and damp stabling, exposure and fatigue, from wounds caused by broken ribs, etc. Gen- erally, however, it is associated with an attack of influenza, rheumatism, pleuritis, etc.
Sijinjjtoiiis. — Usually the disease manifests itself abruptly by a brief stage of chills coincident AAith pain in moving, a short painful cougli, rapid and short breathing, and high temi)erature, AA'ith a rapid and hard pulse. The fever is highest, Avith corresponding jJulse, in the evening and lowest in the morning. In the early stages of the disease the pulse is regular in beat ; later, A\hen there is much exudation pres- ent in the pericardial sac, the heart-beat becomes muffled, and may be of a doubled or rebounding character. By placing the ear against the left side of the chest behind the elboAv a rasx)ing sound may be heard, corresponding to the frequency of the heart-beat. This is known as the to-and-fro friction sound. BetAveen the second and fourth days this sound may disappear, due to a distention of the pericardium by an exu- date or serous effusion. As soon as this effusion i^artly fills the peri- cardium, percussion aaIII reveal an abnormally increased area of dullness over the region of the heart, the heart-beats become less perceptible than in health, and in some cases a splashing or flapping sound ma}' become audible.
If the effusion becomes absorbed, the to-and-fro friction sound usu- ally recurs for a short time; this friction may often be felt by apply- ing the hand to the side of the chest. In a few cases clonic spasms of the muscles of the neck may be present. In acute pericarditis, when
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the effusion is rapid and excessive, the animal may die in a few days, or recovery may begin equally as early. In subacute or in chronic cases the effusion may slowly become augmented until the pressure upon the lungs and interference with the circulation become so great that death will result. Whether the attack is acute, subacute, or chronic, the characteristic symptoms which will guide us to a correct diagnosis are the to-and-fro friction sound, whicli is always synchro- nous with the heart's action, the high temperature with hard, irritable pulse, and in cases of pericardial effusion the increased area of dull- ness over the cardiac region. When the disease is associated with influenza or rheumatism some of the sj'mptoms may be obscure, but a careful examination will reveal sufficient upon which to base a diag- nosis. When pericarditis develoi)s as a result of or in connection with pleuritis, the distinction may not be very clearly definable, neither will manj^ recover. When it results from a wound or broken rib it almost invariabl}' proves fatal.
Pathology. — Pericarditis may at all times be regarded as a very seri- ous affection. At first we will find an intense injection or accumula- tion of blood in the vessels of the pericardium, giving it a red and swollen appearance, during which we have the friction sound. In twentj'-four or forty-eight hours this engorgement is followed b}^ an exudation of sero-fibrinous fluid, the fibrinous jiortion of which may soon form a coating over the internal surface of the pericardial sac, and may ultimately form a union of the opposing surfaces. Generally this adhesion will only be found to occuj)y a i^ortion of the surfaces. As the serous or watery portion of this effusion is absorbed, the dis- tinctness of the friction sound recurs, and may remain perceptible in varied degree for a long time. When the serous effusion is very great, the i^ressure exerted upon the heart Aveakens its action, and may pro- duce death soon; when it is not so great, it may cause dropsies of other portions of the body. When the adhesions of the pericardial sac to the body of the heart are extensive, they generally lead to increased growth or hj'pertrophy of the heart, witli or without dilatation of its cavities; when they are but slight, tliey may not cause any incon- venience.
Treatment. — In acute or subacute pericarditis the tincture of digi- talis and tincture of aconite root may be mixed, taking equal quanti- ties, and give 20 to 30 drop doses every hour until the pulse and temi^crature become reduced. Bandages should be applied to the legs; if they are verj- cold, tincture of capsicum should be first applied; the bodj^ should be warmly clothed in blankets, to xiromote perspiration. When the suffering from pain is very severe, 2 ounces of tincture of opium ma}' bo given once or twice a day; nitrate of potassa, half an ounce, in drinking water, every six hours; after the third day, iodide of potassa, in 2-dram doses, may be substituted. Hot packs to the vhest in the early stages of the disease may give marked relief, or
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smart blisters may be applied to tlie sides of the chest with benefit. If the disease becomes chronic, iodide of iron and gentian to support the strength will be indicated, but the iodide of potassa, in 1 or 2 dram doses, two or three times a day, must not be abandoned so long as there is an evidence of effusion or x^lastic exudate accumulating in the pericardial sac. Where the effusion is great and threatens the life of the patient, tapping, by an expert veterinarian, may save the animal.
VALVULAR DISEASE OF THE HEART.
Acute valvular disease can not be distinguished from endocarditis, and chronic valvular affections are generalh' the result of endocardial inflammation. The valves of the left side are the most subject — the bicuspid or mitral, and the aortic or semilunar. It may consist of mere inflammation and swelling, or the edges of the valves may become agglutinated by the organization of the exudation, thus narrowing the passage. Valvular obstruction and adhesions may occur, or the tendi- nous cords ma}^ be lengthened or shortened, thus obstructing the orifices and i)ermitting the regurgitation of blood. In protracted cases the fibrous tissue of the valves may be transformed into fibro- cartilage or bone, or there may be deposits of salts of lime beneath the serous membrane, which may terminate in ulceration, rupture, or fissures. Sometimes the valves become covered by fibrinous, fleshy, or cartilaginous vegetations or excrescences. In cases of considerable dilatation of the heart there may be atrophy and shrinking of the valves.
Si/mjjtoms. — Valvular disease may be indicated by a venous pulse, jerking pulse, intermittent pulse, irregular pulse; palpitation; con- stant abnormal fullness of the jugular veins; difficulty of breathing when the animal becomes excited, or is urged out of a walk or into a fast trot ; attacks of vertigo ; congestion of the brain ; dropsical swell- ing of the limbs. A blowing, cooing, or bubbling murmur may some- times be heard bj' placing the ear over the heart on the loft side of the chest.
HjTDertrophy, or dilatation, or both, usually follows valvular dis- ease.
Treatment. — When the pulse is irregular, or irritable, tonics, such as preparations of iron, gentian, and ginger, may be given. When the action of the heart is jerking or violent, 20 to 30 drop doses of tincture of digitalis or of veratrum viride may be given until these sjnnptoms abate. As the disease nearlj- alwaj's is the result of endo- carditis, the iodide of potassa and general tonics, sometimes stimu- lants, when general debility suiiervenes, may be of temporary 1)enefit. Very few animals recover, or remain useful for any length of time, after once marked organic changes have taken place in the valvular structure of the heart.
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ADVENTITIOUS GROWTHS IN THE HEART.
Fibrous, (■(.irtihujinous, and honij formations liave been observed in some rare instances in the mnscnlar tissne. Isolated calcareons masses have sometimes been imbedded in the cardiac walls. Fibri- nous coagida and polypous concretions may be foniid in the cavities of the heart. The former consist of coagulated fibrin, separated from the mass of blood, of a whitish or yellowisli white color, translu- cent, of a jellj'-like consistence, and having a nucleus in the center. They may slightly adhere to the surface of the cavity, from Avhich they can easily be separated without altering the structure of the endocardium. They probably i-esult from an excess of coagulability of fibrin, wliich is produced by an organization of the lymph during exudation. They are usually found in the right auricle and ventricle.
Polypous concretions are firmer than the preceding, more opaque, of a fibrous texture, and ma}^ be composed of successive layers. In souie instances they are exceedingly minute, while in others they almost fill one or more of the cavities. Their color is usually white, but occasionally red from the presence of blood. They firmly adhere to the endocardium, and when detached from it give it a torn appear- ance. Occasionall}', a Avascular communication seems to exist between them and the substance of the heart. They may be the result of fibrinous exudation from inflammation of the inner surface of the heart, or the coagulation of a portion of the blood Avhich afterwards contracts adhesion with the heart. These concretions prove a source of great inconvenience, and often danger, no matter how formed. They cause a diminution in the cavity in which they are found, thus narrowing the orifice through which the blood passes, or preventing a proper coaptation of the valves, which may protluee most serious valvular disease.
Si/niptoins. — These are fre<iuently uncertain; they may, however, be suspected when the action of the heart suddenly becomes embar- rassed with irregular and confused pulsations, gTeat difficulty of breathing, and the usual signs dependent upoji the imperfect arteri- alization of the blood.
Treatment. — Stimulauls, Avhisky, or carl)onate of ammonia, may be of service.
FUNCTIONAL AND ORGANIC DISEASES OF THE HEART.
The distinction between f unci ional and organic diseases of the heart is not easily made. We may accept as a guide that the character of organic diseases of the heart is to ijrogress, and that of functional to occur at regular intervals; active exercise almost invariably aggra- vates organic but seldom increases the symptoms of functional dis- ease, and that the physical signs generally are soon developed, and remain permanent in organic, while they seldom exist in functional.
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PALPITATION OF THE HEART.
This is a tumultuous and usually irregular beating of the heart. It may be due to a A'ariety of causes, both functional and organic. ■\Vc will, however, exclude tlio organic causes which lead to irregular action, and give it a more simple specification. It may occur as a result of indigestion, fright, increased nervousness, sudden excite- ment, excessive speeding, etc. (See "Thumps.")
Symptoms. — The heart may act with such violence that each beat may jar the whole body of the animal ; very commonly it may be heard at a short distance away from the animal. It can, usuallj^, be traced A'cry readily to the exciting cause, which we may be able to avoid or overcome in the future and thereby obviate subsequent attacks. Rest, a mild stimulant, or a dose or two of tincture of digitalis or opium ^xi\\ generally give prompt relief. AVlien it is due to organic impairment of tlie heart it must be regarded as a symptom, not as a matter for primarj^ specific treatment.
SYNCOPE — FAINTING.
Actual fainting rarelj' occurs among horses. It may, however, be induced by a raind and great loss of blood, pain of great intensity, a mechanical interference with the circulation of the brain, etc.
Symptoms. — S3'ncoj)e is characterized hy a decrease or temporary suspension of the action of the heart and respiration, with partial or total loss of consciousness. It generally occurs suddenly, though there may be premonitory symptoms, as giddiness or vertigo, dilated pupil, staggering, blanching of the visible mucous membranes, a rapidly sinking jjulse, and dropping to the ground. The pulse is feeble or ceases to beat; the surface of the body turns cold; breath- ing is searcelj^ to be perceived, and the animal may be entirely uncon- scious. This state is uncertain in duration; generally it lasts only a few minutes; the circulation becomes restored, breathing becomes more distinct, and consciousness and muscular strength return. In cases attended with much hemorrhage or organic disease of the heart, the fainting fit may be fatal; otherwise it will prove but a transient occurrence. In j)aralysis of the heart tlie symptoms may be exactlj^ similar to syncope. Syncojie may be distinguished from apoplexy by the absence of stertorous breathing, and lividitj^ of the visible mucous membranes.
Treatment. — Dash cold water on the head; administer a stimulant, 4 ounces of whisky or half an ounce of carbonate of ammonia. Pre- vent the animal from getting up too soon, or the attack may immedi- ately recur. AfterAvards, if the attack was due to weakness from loss of blood, impoverished blood, or associated with debility, general tonics, rest, and nourishing food are indicated.
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HYPERTROPHY OF THE HEART — CARDIAC ENLARGEMENT.
Ilypertroijliy of tlie lieart implies augmentation of bulk in its muscu- lar substance, with or without dilatation or contraction of its cavities. It may exist with or without other cardiac affections. In valvular disease or valvular insufficiency hypertroi^hy frequently results as a consequence of increased demand for propelling jDower. The difficul- ties with which it is most frequently connected are dilatation and ossification of the valves. It may also occur in connection with atro- phied kidneys, weak heart, etc. It may be caused by an increased determination of blood to the organ, or from a latent form of myo- carditis, and it may arise from a long-continued increase of action dependent upon nervous disease. All the cavities of the heart may have their walls hypertrophied or the thickening may involve one or more. AVhile the wall of a ventricle is thickened its cavity ma}^ retain its normal size — simple liypeiiropliy — or be dilated — eccentric hyper- iropliy — or it may be contracted — concentric liypertropliy. Hyper- trophy of both ventricles increases the length and breadth of the heart. Ilypertrophj" of the left ventricle alone increases its length; of the right ventricle alone increases its breadth toward the right side. Hypertrophy with dilatation may affect the chambers of the heart conjointly or separately. This form is by far the most frequent variety of cardiac enlargement. When the entire heart is affected it assumes a globular appearance, the apex being almost obliterated, and situated transversely in the chest. The bulk may become three or four times greater than the average size of heart.
Symptoms. — In hypertroiDhy of the heart, in addition to the Tisual symj^toms manifested in organic diseases of the heart, there is a pow- erful and heaving impulse at each beat, which may be felt on the left side, often also on the right. These i)ulsations are regular, and when full and strong at the jaw there is a tendencj'^ to active congestion of the capillary vessels, which frequently gives rise to local inflamma- tion, active hemorrhage, etc. If the i^ulse is small and feeble at the jaw we may conclude that there is some obstacle to the escape of the blood from the left ventricle into the aorta, which has given rise to the hypertrophy. In case of hypertrophy with dilatation, the impulse is not only powerful and heaving, but it is diffused over the whole region of the heart, and the normal sounds of the lieart are greatly increased in intensity. Percussion reveals an enlarged area of dull- ness, while the impulse is usually much stronger than normal.
Dropsy of the pericardium will give the same wide space of dull- ness, but the imi5ulse and sound are lessened. An animal with a moderate degree of enlargement may possibly live a number of j'ears and be capable of ordinary work ; it depends largely uxDon concomi- tant disease. As a rule, an animal affected with hypertrophy of the heart will soon be incaj)acitated for work, and become useless and incurable.
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Treatment.— 11 the cause can be discovered and is removable it should be done. The iodide of potassa, in cases of valvular thick- ening, may be of some benefit if continued for a sufBcient length of time; it may be given in 2-dram doses, twice a day, for a month or more. Ilj'drocyanic acid, in 30-drox) doses twice a day, may relieve abnormal muscular irritability. General tonics, freedom from excite- ment or fatigue, avoidance of bulky food, good ventilation, etc., are indicated.
DILATATIOX OF THE HEART.
This is an enlargement of the cavities of tlie heart, and may be confined to one or extend to all. Two forms of dilatation may be men- tioned— simple dilatation, where there is normal thickness of the walls, and passive or attenuated dilatation, where the walls are simply dis- tended or stretched out without any addition of substance.
Causes. — Any cause producing constant and excessive exertion of the heart maj" lead to dilatation. Valvular disease is the most fre- quent cause. General anaemia predisposes to it by i^roduciug relaxa- tion of muscular fiber. Changes in the muscular tissue of the heart- walls, serous infiltration from pericarditis, myocarditis, fatty degen- eration and infiltration, atrophy of the muscular fibers, may lead to dilatation.
Symptoms. — The movements of the heart are feeble and prolonged, a disi^osition to staggering or vertigo, dropsy of the limbs, very pale or very dark-colored membranes, and difficult breathing on the slightest excitement.
Treatment. — General tonics, rich food, and rest.
FATTY DEGENERATION OF THE HEART.
Fatty degeneration may involve the whole organ or may be limited to its walls, or even to circumscribed i)atches. The latter is situated at the exterior, and gives it a mottled appearance. When generally involved it is flabby or flaccid, and in extreme cases collapses when emptied or cut. Upon dissection the interior of the ventricles is observed to be covered with buff-colored spots of a singular zigzag- form. This apx)earance maybe noticed beneath the pericardium, and pervading the whole thickness of the ventricular walls, and in extreme cases those of the fleshj^ columns in the interior of the heart. These spots are found to be degenerated muscular fibers and colonies of oil- globules. Fatty degeneration is often associated with other morbid conditions of the heart, as obesity, dilatation, rupture, aneurism, etc. It may be connected with fatty diseases of other organs, as the liver, kidneys, etc. AVhen it exists alone its i^resence is seldom suspected previous to death. It may be secondary to hypertrophy of the heart, to myocarditis, or to pericarditis. It may be due to deteriorated con- ditions of the blood in wasting diseases, excessive hemorrhages, etc., or to poisoning with arsenic and phosphorus.
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Symptoms. — Tlie most prominent sjnnptoms of fatty degeneration are a feeble action of the heart, a remarkably slow pnlse, general debility, and attacks of vertigo. It may exist for a long time, but is apt to suddenly terminate in death upon the occurrence of other dis- eases, surgical operations, etc. It may involve a liabilitj^ to sudden death from rupture of the ventricular walls.
Treatment. — Confinement in feed to oats, wheat or rye bran, and timoth}' hay. Twenty drops of sulphni'ie acid may be given in drink- ing-water three times a day, and hyi^ophosphite of iron in 2-dram doses, mixed with the feed twice a day. (^ther tonics and stimulants as they may be indicated.
ATROPHV OF THE HEART — WASTING.
A diminution of muscular substance of the heart and consiequent accrease in bulk and weight. It is generally due to imperfect nutri- tion from occlusion of the blood-vessels which supplj- it.
Symptoms. — The heart beat is weak and hardly perceptible; the area of dullness over the region of the heart is lessened. Further than this it furnishes no characteristic symptoms which distinguish it from some other diseases of this organ. Treatment is of no avail.
RUPTURE OF THE HEART.
This may occur as the result of some lu'cvious disease, as fatty degeneration, dilatation with weakness of the muscular walls, etc. It may be caused by external violence, a crushing fall, pressure of some great weight, etc. Usually, death follows a rupture verj^ quickly, though an animal may live for some time when the rent is not Aery large.
AVEAKNESS OF THE HEART.
Tills niay arise from general debility, the j-esult of exhausting dis- ease, overwork or heart strain, or loss of blood. It is indicated by a small, feeble, but generally regular j)ulse, coldness of the bod}^, etc.
Treatment. — This should be directed to support and increase the strength of the animal, by tonics, rest, and nutritious food. Carbon- ate of ammonia may be given to stimulate the heart's action and to prevent the formation of heart-clot.
CONGESTION OF THE HEART.
Congestion, or an accumulation of the blood in the cavities of the heai-t, may occur in consequence of fibrinous deposits interfering with the free movements of the valves, usually the product of endocarditis.
Symptoms. — Great difficulty of breathing, paleness of the visible mucous membranes, great anxiet}^ frequently accompanied b}- a gen- eral tremor and cold perspiration, followed by death. It usually results in death very quickly.
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CYANOSIS.
This is a condition sometimes found in foals immediateh* after birth, and is due to non-closure of the foramen ovale, which allows a mix- tuer of the venous with the arterial blood in the left cavities of the heart. It is characterized by a dark purple or bluish color of the visi- ble mucous membranes, shortness of breath, and general feebleness. Foals thus affected generally live only a few hours after birth.
DISEASES OF ARTERIES — ARTERITIS AND ENDARTERITIS.
Inflammation of arteries is rarely observed in the horse as a pri- marj' affection. Direct injuries, such as blows, may produce a con- tusion and subsequent inflammation of the wall of an artery; severe muscular sfjrain may involve an arterial trunk; hypertrophy of the heart, by increasing arterial tension, may result in the iH'oduciJon of a general endarteritis. Septic infection maj' affect the inner coat and ultimately involve all three, or it may be the result of an inflamma- tion in the A'icinity of the vessels, etc. Inflammation of arteries, wliate;,'er the cause may be, often leads to very serious results in the development of secondary changes in their walls. Arteritis may be acute, subacute, or chronic; wlien the inner coat alone is affected it is known as endarteritis.
Symptoms. — Arteritis is characterized by a painful swelling along the inflamed vessel, throbbing pulse, coldness of the parts supplied by the inflamed vessel, sometimes the formation of gangi-enous sloughs, suppuration, abscess, etc. In an inflammation of the iliac arteries we find coldness and excessive lameness or j)aralysis of one or both hind limbs.
Patlwlogy. — In acute arteritis we find swelling along the vessel, loss of elasticity, friabilit}-, and thickening of the walls; a roughness and loss of gloss of the inner coat, with the formation of coagula or pus in the vessel. Subacute or chronic arteritis may affect only the outer coat — periarteritis; both the outer and middle coat, or the inner coat alone — endarteritis; and by weakening the respective coats leads to rupture, aneurism, or to degenerations, such as bony, calcareous, fatty, atheromatous, etc. It may also lead to sclerosis or increase of fibrous tissue, especially in the kidneys, when it may result in the condition known as arterio-capiJlary fibrosis. Chronic endarteritis is fruitful in the production of thrombus and atheroma. Arteritis may be limited to single trunks, or it may affect, more or less, all the arteries of the body. Arteries which are at the seat of chronic endar- teritis are liable to suffer degenerative changes, consisting chiefly of fatty degeneration, calcification, or the breaking down of the degen- erated tissue, and the formation of erosions or ulcer-like openings in the inner coat. These erosions are frequently called atheromatous ulcers, and fragments of tissue from these ulcers mav be carried into
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the circulation, forming emboli. Fibrinous thrombi are apt to form upon the roughened surface of the inner coat, or upon the surface of the erosions.
Fatty degeneration and calcification of the middle and outer coats may occur, and large, hard, calcareous j^lates jDroject inward, upon which thrombi may form or may exist in connection with atheroma of the inner coat. When there is much thickening and increase of new tissue in the wall of the affected artery, it ma}^ encroach upon the capacity of the vessel, and even lead to obliteration. This is often associated with interstitial inflammation of glandular organs.
Treatment. — Carbonate of potassa in dram doses, to be given in 4 ounces liquor acetate of ammonia every six hours. Scalded bran sufficient to produce loosening of the bowels, and complete rest. Externally, applications of hot water or hot hop infusion.
ATHEROMA.
Atheroma is a direct result of an existing chronic endarteritis, the lining membrane of the vessels being invariably involved to a greater or less degree. It is most frequently found in the arteries, altjiough the veins may develop an atheromatous condition when exposed to any source of prolonged irritation. Atheroma may affect arteries in any part of the body; in some instances almost every vessel is diseased, in others only a few, or even parts of one vessel. It is a very common result of endocarditis extending into the aorta, which we find perhaps the most frequent seat of atheroma. As a result of this condition the affected vessel becomes impaired in its contractile power, loses it nat- ural strength, and in consequence of its inabilitj- to sustain its accus- tomed internal pressure, undergoes, in many cases, dilatation at the seat of disease, constituting aneurism. In an atheromatous vessel, calcareous deposits soon occur, which render it rigid, brittle, and sub- ject to ulceration or rupture. In such vessels the contractility is destroyed, the middle coat atrophied and bej'ond repair. Atheroma in the vessels of the brain is a frequent cause of cerebral apoplexy. No symptoms are manifested hy which we can recognize this condition during life.
CONSTRICTION OF AN ARTERY.
This is usually the result of arteritis, and may partly or wholl}^ be impervious to the flow of blood. AVhen this occurs in a large vessel it may be followed by gangrene of the j)arts ; usually, however, collateral circulation will be established to nourish the parts previously supplied by the obliterated vessel. In a few instances constriction of the aorta has produced death.
ANEURISM.
Aneurism is usually described as true and /a/w. True aneurism is a dilatation of the coats of an artery over a larger or smaller part of
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its course. Such dilatations arc usually due to chronic endarteritis and atheroma. False aneurism is formed after a puncture of an artery by a dilatation of the adhesive lymph by which the puncture was united.
Sijinptouis. — If the aneurism is seated along the neck or a limb, it appears as a tumor in the course of an artery, and pulsating with it. The tumor is round, soft, and compressible, and yields a pecul- iar fluctuation upon pressure. By applying the ear over it a peculiar purring or hissing sound may sometimes be heard. Pulsation, syn- chronous with the action of the heart, is the diagnostic symjDtom. It is of a slow, expansive, and heavy character, as if the whole tumor were enlarging under the hand. Aneurisms seated internally may occupj'- the cavity of the cranium, chest, or abdomen. As regards the first, little is known during life, for all the symptoms which they pro- duce may arise from other causes. Aneurism of the anterior aorta may be situated very closely to the heart or in the arch, and it is very seldom that we can distinguish it from disease of the heart. The tumor maj^ encroach upon the wind-pipe and produce difficulty in breathing, or it may produce pressure upon the vente cavfe or the thoracic duct, obstructing the flow of blood and lymph. In fact, whatever parts the aneurism may reach or subject to its pressure may have their functions suspended or disturbed. When the tumor in the chest is large we generally find much irregularity in the action of the heart; the superficial veins of the neck are distended, and there is usually dropsical swelling under the breast and of the limbs. There may be a very trouljjlesome cough "without any evidence of lung affec- tion. Sometimes pulsation of the tumor may be felt at the lower part of the neck where it joins the chest. AVlien the aneurism occurs in the posterior aorta no diagnostic sj^mptoms are appreciable ; when it occurs in the internal iliac arteries an examination per rectum will reveal it.
There is one form of aneurism which is not unfrequently overlooked affecting the anterior mesenteric artery, primarily induced by a worm — the Strongylus armatus. This worm produces an arteritis with athe- roma, degeneration, and dilatation of the mesenteric arteries, associ- ated with thrombus and aneurism. The aneurism gives rise to colic, which appears periodically in a verj^ violent and often i)ersistent type. Ordinary colic remedies have no effect, and after a time the animal succumbs to the disease. In all cases of animals which are habitually subject to colicky attacks i^arasitic aneurism of the anterior mesen- teric artery may be suspected.
Pathology. — Aneurisms may be diffuse or sacculated. The diffuse consists in a uniform dilatation of all the coats of an arter}', so that it assumes the shaj)e of a cylindrical swelling. The Avail of the aneurism is atheromatous or calcified ; the middle coat may be atrophied. The sacculated or circumscribed aneurism consists either in a dilatation of
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the entire circumference of an artery over a short portion of its length, or in a dilatation of only a small portion »f one side of the wall. Aneu- rism may become very large ; as it increases in size it presses uj)on and causes the destruction of neighboring tissues. The cavity of the aneu- rismal sac is filled Avith fluid or clotted blood, or with layers of fibrin which adhere closely to its wall. Death is produced usually by the pressure and interference of the aneurism with adjoining organs, or by rui)ture. In worm aneurism we usually find large thrombi within the aneurismal dilatation of the artery, which sometimes plug the whole vessel or extend into the aorta. Portions of this thrombus or clot may be washed away and produce embolism of a smaller artery. The effect in either case is to produce ana?mia of the intestinal canal, serous or bloodj" exudation in its walls, which leads to paralysis of the intestine and resultant colicky symptoms.
Treatment. — The only treatment advisable is to extirpate or ligate the tumor above and below.
RUPTUKE OF AN ARTERY,
Endarteritis, with its subsequent changes in the walls of arteries, is the primary cause of rupture in the majority of instances. The rup- ture may be partial, involving only one or two coats, and will then form an aneurism. If complete, it may produce death when it involves a large vessel, especially if it is situated in one of the large cavities, permitting an excessive escape of blood. Rupture may be produced by mechanical violence or accident.
Symi^toms. — In fatal rupture associated witl^ profuse bleeding, the animal becomes weak, the visible mucous membranes become blanched, the breathing hurried or gasping, j)upils dilated, staggering in gait, syncope, death. When the hemorrhage is limited, the symp- toms may not become noticeable; if it is near the surface of the body a round or diffuse swelling or tumor may form, constituting a 7i?/^roma. If the rupture is associated with an external wound the bleeding artery should be ligated, or where a bandage is applicable, pressure may be applied by tight bandaging. As a secondary result of rupture of an artery we may have formation of abscess, gangrene of a part, etc.
Treatment. — When rupture of a deep-seated artery is suspected, large doses of fluid extract of ergot may be given to produce contrac- tion of the blood-vessels. Tannin and ii'on are also useful. The animal should be allowed to have as much water as he desires. Afterwards stimulants and nourishing food are indicated.
THROMBUS AND EMBOLISM.
By thrombosis is generally undei'stood the partial or complete clo- sure of a vessel by a morbid product dcAcloped at the site of the obstruction. The coagulum, which is usually fibi-inous, is known as a thrombus. The term embolism designates an obstruction caused
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by auy body detaclied and transported from the interior of the heart, or of some vessel. Thrombi occur as the result of an injury to the wall of the vessel, or may follow its compression or dilatation ; they may result from some alteration of the wall of the vessel by disease, or by the retardation of the circulation. These formations may occur during life, in the heart, arteries, veins, or in the portal sj'stem. When a portion of fibrin coagulates in one of the arteries and is car- ried along by the circulation, it will be arrested, of course, in the capillaries, if not before; when in the veins it may not be stopped until it reaches the lungs; and when in the portal sj-stcm the capilla- ries of the liver will prevent its further progress. The formation of tlirombi may act primarily by causing partial or complete obstruction, and secondarily, either by larger or smaller fragments becoming- detached from their end, and by being carried along by the circula- tion of the blood to remote vessels, embolism; or b}' the coagulum becoming softened and converted into pus, constituting suppurative phlebitis. These substances occur most frequently in those affections characterized by great exhaustion or debility, as j)neumonia, purpura hemorrhagica, endocarditis, phlebitis, puerperal fever, hemorrhages, etc. These concretions may form suddenly and produce instantane- ous death byretai'^ing the blood current, or they may arise gradually, in which case the thrombi maybe organized and attaclied to the walls of the heart, or they may §often, and fragments of them (emboli) may be carried awaj'. The small, wart-like excrescences, occurring some- times in endocarditis, may occasionally form a foundation on which a thrombi may develop.
Sipnptoms. — When heart clot or thrombus exists in the right side the return of blood from the body and the aeration in the lungs are impeded, and if death occurs it is owing to sjTicoiJe rather than to strangulation in pulmonary respiration. There will be hurried and gasping breathing, ijaleness and coldness of the surface of the bod}^ a feeble and intermittent or fluttering pulse, and fainting. When a fibrinous coagulum is carried into the j)ulmonary arterj' from the right side of the heart, the indications are a swelling and infiltration of the lungs and pulmonary apoplexy. When the clot is situated in the left canities of the heart or in the aorta, death, if it occurs, takes place either suddenly or at the end of a few hours from coma.
Pathology. — When a coagulum is observed in the heart it may become a question whether it was formed during life or after death. The loose, dark coagula, so often found after death, are polypi. If the dej)osition has taken i)lacc during the last moments of life, the fibrin viill be isolated and soft, but not adherent to the walls; if it be isohited, dense, and adherent or closely intertwined with the muscles of the paiDillse and tendinous cords, the deposition has occurred more or less remote from the act of dying. Occasionally the fibrin may be seen lining one of the cavities of tlio heart, like a false endocardium,
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or else forming an additional coat to the aorta or other large vessels without producing much obstruction. Thrombi, in some instances, soften in their centers, and are then observed to contain a pus-like substance. If this softening has extended considerably an outer shell or cyst only may remain. The sources of danger exist not only in the interruiDtion of the circulation of the blood, but also in a morbid state of the system, produced by the disturbed nutrition of a limb or organ, as well as the mingling of purulent and gangrenous elements with the blood.
Treatment. — The urgent symjjtoms should be relieved by rest, stim- ulants, and the use of agents which will act as solvents to the fibri- nous clots. Alkalies are si3ecially useful for this i^urpose. Carbonate of ammonia may be administered in all cases of thrombus, and should be continued for a long time in small doses several times a day. In cases of great debility associated Avith a low grade of fever, stimulants and tonics, and nitro-muriatic acid as an antiseptic, may be bene- ficial.
DISEASES OF VEINS — PHLEBITIS.
Inflammation of veins may bo simj)le or diffuse. In simple phle- bitis the disease of the vein is confined to a circumscribed or limited portion of a vein ; in diffuse it involves the vein for a long distance ; it may even extend from a limb or foot to the heart.
Causes. — Phlebitis may be induced hy contusions or direct injuries, an extension of inflammation from surrounding tissue, as in abscess, formation of tumor, or malignant growth. It is often due to embolism of infective material, gangrenous matter, etc. Blood-letting from the jugular vein is occasionally followed by dangerous phlebitis.
Symptoms.— T\\(i symptoms vary according to the extent and severity of the inflammation. In most cases the vein is swollen, thickened, and indurated to such a degree as to resemble an artery. A diffused swelling, with great tenderness, may extend along the affected vessel and the animal manifest all the symptoms connected with acute fever and general functional distiirbance.
Pathology. — The disease is only serious when large veins are affected. The coats undergo the same changes as in arteritis, clots of blood and lymph plug the inflamed vessel, and if the inflammatory process continues these are converted into pus, which ruptures the vessel and produces a deej) abscess; or it may be carried away in the circulation and produce metastatic abcess in the lungs or other remote organs. In mild cases the clots may become absorbed and the vessel restored to health. Phlebitis in the course of the veins of the limbs frequentl}^ leads to numerous abscesses, which maj" be mistaken for farcy ulcerations. A very common result of phlebitis is an oblitera- tion of the affected portion of the vein, but as collateral circulation is readilj^ established this is seldom of any material inconvenience.
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Treatment. — Phlebitis should be treated by the application of a smart blister along the course of the inflamed vessel; early opening of any abscesses which may form; tlie animal should have complete rest, and the bowels be kept loose with bran mashes. When the fever runs high, half-ounce doses of nitrate of potassa may be given in the drinking water, which may be changed in two or three days for dram doses of the iodide of iwtassa. If the animal becomes debilitated, carbonate of ammonia, 1 dram, and powdered gentian, 3 drams, may bo given ever}- six hours.
VARICOSE VEINS — VARIX — DILATION OF VEINS.
This may be a result of weakening of the coats from inflanimatorj^ disease and degeneration. It may also be due to mechanical obstruc- tion from internal or external sources. It is sometimes found in the vein which lies sux)erficial over the inside of the hock- joint, and may be due to the pressure of a spavin. Occasionally it may be observed in stallions, which are more or less subject to varicocele or dilatation of the veins of the testicular cord. Hemorrhoidal veins or piles are occasionally met with, generally in horses which run at pasture. Varicose veins ma}' ulcerate and form an abscess in the surrounding tissues, or they may rujiture from internal blood pressure and the blood form large tumors where the tissues are soft.
Treatment. — Stallions which manifest a tendency' to varicocele should wear suspensory bags when thej' are exercised. Piles may often be reduced by astringent washes — tea made from white oak bark or a saturated solution of alum. The bowels should be kept loose with bran mashes and the animal kept quiet in the stable. When varicose veins exist suijerficially and threaten to produce inconvenience, they may be ligated above and below and thus oblit- erated. Sometimes absorption may be induced by constant bandages.
AIR IN VEINS — AIR EMBOLISM.
It was formerly supposed that the entrance of air into a vein at the time of the infliction of a Avound or in blood-letting was extremely dangerous and very often produced sudden death by interfering with the circulation of the blood through the heart and lungs. Danger from air embolism is exceedingly doubtful, unless great quantities were forced into a large vein by artificial means.
PURPURA HEMORRHAGICA.
Purpura hemorrhagica usually occurs as a sequel to debilitating diseases, such as strangles, influenza, etc. It may, however, arise in the absence of any previous disease in badlj^ ventilated stables, among poorly fed horses, and in animals subject to exhausting work and extreme temperatures. It is apparently due to a primary deteriora- tion of the blood, weakness of the capillary vessels, and general
2o0
debility or exliaustioii of tlie nervous system. Its gravity does not depend so much upon the amount of l)k)od ext ravasated as it does upon the disturbance or diminished action of the vasomotor centers.
Syntpfomt;. — This disease becomes manifested b}' the occurrence of sudden swellings on various parts of the body, on the head or lips, limbs, abdomen, etc. They may l)e diffused or very markedly cir- cumscribed, though in the advanced stages they cover large areas. They pit on jiressure and are but slightly i)ainful to the touch. The limbs may swell to a verj' large size, the nostrils may become almost closed, and the head and throat n\ay swell to the point of suffocation. The swellings not infrequently disappear from one portion of the body and develop on another, or may recede from the surface and invade the intestinal mucous membrane. The mucous lining of the nostrils and mouth is covered with dark red or purple spots, a bloody colored serum ilows from the nostrils, the tongue may be swollen and prevent eating or closing of the jaAvs. In twenty-four or forty-eight hours bloody serum may exude through the skin over the swollen parts, and finally large gangrenous sloughs may form. The temperature is never very high, the pulse is frecxuent and compressible, and becomes feebler as the animal loses strength. A cough is usually i^resent. The urine is scanty and high colored, and when the intestines are much affected a bloody diarrhea may set in, with colicky pains. Some of the internal organs may become implicated in the disease, the lungs may become cedematous, extravasation may occur in the intestinal canal, or effusion of serum into the cavity of the chest or abdomen; occasionally the brain becomes affected. A few cases run a mild course and recovery niixy commence in .three or four days; generalh', however, the outlook is unfavorable. In severe cases septic poison- ing is liable to occur, which soon brings the case to a fatal issue.
PdHioloyy. — (^n section we find the capillaries dilated, the connect- ive tissue filled with a coagulable or coagulated lymph, and frequentlj'^ we may discover gangrenous spots beneath the skin or involving the skin. The lymphatic glands are swollen and inflamed. Extensive extravasations of blood may be found imbedded between the coats of the intestines, or excessive effusion into the substance of the lungs.
Treatment. — Diffusible stimulants and tonics should be given from the very start, regardless of fever or frequency of the pulse. Car- bonate of ammonia, 1 dram; fluid extract of red cinchona bark, 2 drams, and tincture of ginger half an ounce, with half a pint of water; thin gruel or milk should be given every four or six hours. Sulj^hate of iron in drjim doses may be dissolved in water and given every six hours. Chlorate of i^otassa in 2-ounce doses may be given every eight or twelve hours. When the discharges from the mouth and nose become offensive to the smell, 10 drops of carbolic acid in two ounces of water may be given in a drench, or thrown on the root of the tongue with a syi'inge several times a day. Where the swelling is veiy gi-eat,
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incisions half an inch in length penetrating the skin shonld be made with a sharj) knife, to permit drainage. The application of liniments or washes externall}^ is of no nse, and if injudicionsly used may do harm. Complications, when they arise, must be treated with proper circumspection.
DISEASES OF THE I.YMPHATIC SYSTEM.
The lymphatic or absorbent system is connected with tlie blcod vas- cular system, and consists of a series of tubes which absorb and con- vey to the blood certain fluids. These tubes lead to lymphatic glands, through Avhich the fluids pass to reach the right lymphatic vein and thoracic duct, both of which enter the venous system near the heart. Through the excessively thin walls of the capillaries the fluid part of the blood transudes, to nourish the tissues outside the capillaries; at the same time fluid i)asses from the tissues into the blood. The fluid, after it jDasses into the tissues, constitutes the lymph, and acts like a stream irrigating the tissue elements. Much of the surplus of this Ij'miih ijasses into the lymjfli vessels, which in their commencement can hardly be treated as indei^endent structures, since their walls are so closely joined with the tissues through which they pass, being nothing more than spaces in the connective tissue until they reach the larger lymph vessels, which finally empty into lymj)h glands. These lyDiph glands are structures so placed that the lymph flowing towards the larger trunks passes through them, undergoing a sort of filtration. From the fact of this arrangement lymj)h glands are subject to inflam- matory diseases in the vicinity of diseased structures, because infect- ive material being conveyed in the lymph stream lodges in the glands and produces irritation.
LOCAL INFLAMMATION AND ABSCESS OF LYMPHATIC GLANDS.
Acute inflammation of the lymph glands usually occurs in connec- tion with some inflammatory xjrocess in the region from which its lymph is gathered. Several or all of the glands in a cluster may become affected, as in strangles, nasal catarrh, or nasal gleet, diseased or ulcerated teeth, the lymph glands between the branches of the lower jaw almost invariably become affected, which may lead to sup- puration or induration. Similar results obtain in other portions of the body; in pneumonia the bronchial glands become affected; in pharyngitis, the post-pharyngeal glands lying above tlie trachea become affected, etc.
Symptoms. — The glands swell and become painful to the touch, the connective -tissue surrounding them becomes involved, suppuration usually takes place, and one or more abscesses form. If the inflam- nuition is of a milder type, resolution may take place and the swelling recede, the exudative material being absorbed, and the gland restored without the occurrence of suppuration. In the limbs a whole chain
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of the glands along the lymphatic vessels may become affected, as in farcy, phlebitis, or septic poisoning.
Treatment. — Fomentation with hot water, the application of cam- phorated soap liniment, or camphorated oil, may i)roduce a revulsive action and prevent suppuration. If there is any indication of abscess forming, poultices of linseed meal and bran made into a paste with hot water should be applied, or a mild blistering ointment rubbed in over the swollen gland. As soon as fluctuation can be felt a free opening must be made for the escape of the contained pus. The wound may subsequently be washed out with a solution of chloride of zinc, 5 grains to the ounce of water, three times a day.
HYPERTROPHIED LYMPHATICS.
This is characterized by an enlargement and growth of lymi^hatic glands; the causes are obscure, but they sometimes attain an enor- mous size, and seriously interfere with neighboring organs. This con- dition is sometimes found in the region of the throat above the larynx, and produces wheezing or roaring, b}" j)ressing upon the recurrent laryngeal nerve. It may occur in the bronchial glands of the chest, and interfere with the action of the heart and respiration. The SAvelling is not painful or feverish ; it may be very hard or may be rather soft; occasionally they contain a cheesy deposit or even undergo calcification. A condition almost similar to this may be induced by chronic inflammation. In such cases, however, the gland- ular structure may become lessened, as the result of i^ressure by an increase of fibrous or connective tissue, although a large tumor at the site of the gland remains. This may become gradually absorbed; more often, however, recurrence of inflammation takes place and frequentl}- small abscesses form.
Treatment. — Repeated blistering with ointment of cantharides 8 parts, bin-iodide of mercury 1 part, to be thoroughly mixed and applied once in ten days or two weeks. If this fails, extirpation will become necessar3^
LYMPHANGITIS.
Specific inflammation of the lymphatic structures, usually affecting the hind leg, very seldom a fore leg. This disease is very sudden in its attack, exceedingly painful, acconipanied by a high temperature, and great general disturbance.
Causes. — Horses of lymphatic or sluggish tempei'ament are j^redis- posed to this affection. It usually attacks well-fed animals, and in such cases may be due to an excess of nutritive elements in the blood. Sudden changes in work or in the habits of the animal may induce an attack.
Symptoms. — It is usually ushered in b}^ a chill, rise in temperature, and some uneasiness; in a very short time this is followed by lame- ness in one leg and swelling (m the inside of the thigh. The swelling
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gradually surrounds the wliole limb, continues on downward until it reaches the foot. The limb is excessively tender to the touch, the animal perspires, the breathing is accelerated, pulse hard and quick, and the temjDerature may reach 100^ Fah. The bowels early become constipated, and the urine scant}'. The sj'mptoms usually are on the increase for about two days, then they remain stationary for the same length of time; the fever tlien abates; the swelling recedes and becomes less j)ainful. It is very seldom, though, that all the swelling leaves the leg; generally it leaves some permanent enlargement, and the animal becomes subject to recurrent attacks. Occasionally, the inguinal Ij-miahatic glands (in the groin) undergo sui^i^uration, and pyajmia may supervene and prove fatal. In severe cases the limb becomes denuded of hair in i)atches, the skin remains indurated with a fibrous growth, which is known by the name of elephantiasis.
Treatment. — Fomentations with vinegar and water, equal parts, to which add 2 ounces of nitrate of potassa for each gallon. This should be applied every ten or fifteen minutes for six or eight hours, then the leg ma}^ be dried with a woolen cloth and bathed with cami^horated soap liniment. Internall}^, administer tincture of digitalis and aconite root, equal parts of each, 30 drops everj^ hour until the fever and pulse become reduced. Half-ounce doses of nitrate of potassa in the drink- ing-water every six hours, bran mashes, and complete rest. This treatment, if instituted early in the attack, very frequently brings about a remarkable change within twenty-four hours.
DISEASES OF THE EYE.
By Dr. JAMES LAW, F. R. C. V. S.,
Professor of VctcrhHirij Science, etc., Cornell U)n'versift;.
AVg can scareelj^ overestimate the value of sound eyes in the horse, and hence all diseases and injuries which seriously interfere with vision are matters of extreme gravity and apprehension, for should they prove permanent they invariably depreciate the selling price to a considerable extent. A blind liorse is always dangerous in the saddle or in single harness, and he is scarcely less so when, with partially impaired vision, he sees things imperfectly, in a distorted form or in a wrong i^lace, and when he shies or avoids objects which are commonplace or familiar. When we add to this that certain diseases of the eyes, like recurring- inflammation (moon blindness), are habitually transmitted from parent to offspring, we can realize still more fully the importance of these mala- dies. Again, as a mere matter of beauty, a sound, full, clear, intelli- gent eye is something which must always add a high value to our equine friends and servants.
THE EYEBALL.
A full description of the structure of the eye is incompatible Avith our i)rescribed limits, and yet a short description is absolutely essen- tial to the clear understanding of what is to follow.
The horse's eye is a spheroidal body, flattened behind, and with its posterior four- fifths inclosed bj'an opaque, white, strong fibrous mem- brane (the sclerotic), on the inner side of which is laid a more delicate friable membrane, consisting mainly of blood-vessels and pigment cells (the choroid), and that in its turn is lined by the extremely deli- cate and sensitive exi)ansion of the nerve of siglit (the retina). The anterior fifth of the globe of the eye bulges forward from what would have been the direct line of the sclerotic, and thus forms a segment of a much smaller sphere than is inclosed by the sclerotic. Its walls, too, have in health a perfect translucenc}^ from wliich it has derived the name of t rem spar ent cornea . This transparent coat is composed,
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in the main, of iibers witli lymj)ii interspaces, and it is to the condi- tion of these and their condensation and compression that the trans- lucency is largely dne. This may be shown by comjiressing with the fingers the eye of an ox which has just been killed, Avlien the clear transparent cornea will suddenly become clouded over with a whitish blue opacity, and this will remain until the compression is interrupted. The interior of the eye contains three transparent media for the refrac- tion of the rays of light, on their way from the cornea to the visual nerve. Of these media the anterior one (aqueous humor) is liquid, the x^osterior (vitreous humor) is semi-solid, and the intermediate one (crj^stalline lens) is solid. The space occupied bj^the aqueous humor corresponds nearly to the portion of the eye covered by the trans- parent cornea. It is, however, divided into two chambers, anterior and i3osterior, by the iris, a contractile curtain with a hole in the center (the pupil), and which may be looked on as in some sense a projection inward of the vascular and pigmentary cOat from its anterior margin at the point where the sclerotic or opaque outer coat becomes continuous with the cornea or transparent one. This iris, or curtain, besides its abundance of blood-vessels and pigment, possesses two sets of muscular fibers, one set radiating from the margin of the pupil to the outer border of the curtain at its attachment to the sclerotic and choroid, and the other encircling the pupil in the inauner of a ring. The action of the two sets is necessarily antagonistic, the radiating fibers dilating the iiupil and exx^osing the interior of the eye to view, while the circular fibers contract this oj)ening and shut out the rays of light. The form of the pupil in the horse is ovoid, with its longest diameter from side to side, and its ui^x^er border is fringed b}^ several minute black bodies (corjjora nigra) projecting forward and serving to some extent the i)urj)ose of eyebrows in arresting and absorbing the excess of rays of light which fall ui^on the eye from above. These jjigmentary projections in front of the uj)i3er border of the pujiil are often mistaken for the x)roducts of disease or injury, in i)lace of the normal and beneficent protectors of the nerve of sight which they are. They may, like all other parts, become the seat of disease, but so long as they and the iris retain their clear, dark aspect, without any tints of brown or yellow, they may be held to be health}".
The vitreous or semi-solid refracting medium occupies the posterior l^art of the eye — the jaart corresx^onding to the sclerotic, choroid, and retina — and has a consistency corresponding to that of the white of an egg, and a x^o^ver of refraction of the light-rays corresx^ondingly greater than the aqueous humor.
The third or solid refracting medium is a biconvex lens, with its convexity greatest on its posterior surface, Avhich is lodged in a dex)resssion in tlie vitreous humor, while its anterior surface corre- sponds to the ox)ening of the pupil. It is inclosed in a membranous covering (capsule), and is maintained in position by a membrane
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(suspensory ligament) which extends from the margin of the lens outward to the sclerotic at the point of junction of the choroid and iris. This ligament is, in its turn, furnished with radiating muscular fibers, which change the form or position of the lens so as to adapt it to see with equal clearness objects at a distance or close by.
Another point which strikes the observer of the horse's eye is that in the darkness a bright bluish tinge is reflected from the widely- dilated pupil. This is owing to a comparative absence of ijigment in the choroid coat inside the upper part of the eyeball, and enables the animal to see and advance with security in darkness where the human eye would be of little use. The lower part of the cavity of the horse's eye, into which the dazzling rays fall from the sky, is fur- nished with an intensely black lining, by which the rays penetrating the inner nervous layer are instantly absorbed.
MUSCLES OF THE EYE.
These consist of four straight muscles, two oblique and one retractor. The straight muscles pass from the depth of the orbit forward on the inner, outer, upper, and lower sides of the eyeball, and are fixed to the anterior portion of the fibrous (sclerotic) coat, so that in contract- ing singly they respectively turn the eye inward, outward, upward, and downward. When all act together they draw the eyeball deeply into its socket. The retractor muscle also consists of four muscular slips, repeating the straight muscles on a smaller scale, but as they are only attached on the back part of the eyeball they are less adapted to roll the eye than to draw it down into its socket. The two oblique muscles rotate the eye on its own axis, the upper one turning its outer surface upward aiM inward, and the lower one turning it downward and inward.
THE HAW — THE WINKING CARTILAGE — CARTILAGO NICTATANS.
This is a structure, which, like the retractor muscle, is not found in the eye of man, but it serves in the lower animals to assist in removing foreign bodies from the front of the eyeball. It consists, in the horse, of a cartilage of irregular form, thickened inferiorly and posteriorly where it is intimately connected with the muscles of the eyeball, and the fatty material around them; and expanded and' flattened anteriorly where its upper surface is concave, and, as it were, moulded on the lower and inner surface of the eyeball. Exter- nally, it is covered by the mucous membrane which lines the ej'elids and extends over the front of the eye. In the ordinarj^ restful state of the eye the edge of this cartilage should just appear as a thin fold of membrane at the inner angle of the eye, but when the eyeball is drawn deeply into the orbit the cartilage is pushed forward, outward, and upward over it until the entire globe may be hidden from sight. 5961 — HOR 9
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This protrusion of the cartilage, so as to cover the e3'e, maybe induced in the healthy eye by pressing the finger and thumb on the uj^per and lower lids, so as to cause retraction of the eyeball into its socket- AVhen foreign bodies, such as sand, dust, and chaff, or other irritants have fallen on the eyeball or eyelids, it is similarly projected to j)ush them off, their expulsion being further favored by a profuse flow of tears.
This is seen, to a lesser extent, in all painful inflammations of the eye, and to a very marked degree in lockjaw, Avhen the spasm of the muscles of the eyeball draws the latter deeply into the orbit and projects forward the masses of fat and the cartilage. The brutal practice of cutting off this apparatus, whenever it is i^rojected, necessi- tates this explanation which, it is hoped, may save to many a faithful servant a most valuable appendage. That the cartilage and mem- brane may become the seat of disease is undeniable, but so long as its edge is thin and even, and its surface smooth and regular, the mere fact of its projection over a portion or the whole of the eyeball is no evidence of disease in its substance, nor any warrant for its removal. It is usually but the evidence of the presence of some pain in another part of the eye, wdiich the suffering animal endeavors to assuage by the use of this beneficent provision. For the diseases of the cartilage itself see "Encephaloid Cancer."
LACHRYMAL APPARATUS.
This consists, first, of a gland for the secretion of the tears, and, second, of a series of canals for the conveyance of the superfluous tears into the cavity of the nose.
The gland is situated above the outer part of tMfe eyeball, and the tears which have flowed over the eye and reached the inner angle are there directed by a small conical papilla (lachrymal caruncle) into two minute orifleos, and thence by two ducts (lachrymal) to a small pouch (lachrymal, sac) from which a canal leads through the bones of the face into the nose. This opens in the lower jjart of the nose on the floor of the passage, and a little outside the line of union of the skin which lines the false nostril with the mucous membrane of the nose. In the ass and mule this oijeningis situated on the roof instead of the floor of the nose, but still close to the external opening.
EXAMINATION OF THE EYE.
To avoid unnecessary repetition the following general directions are given for the examination of the eye: The eye, and to a certain extent the miu'ous membrane lining the ej^elids, may be exj)Osed to view by gently parting the eyelids with the thumb and forefinger j)ressed on the middle of the respective lids. The pressure, it is true, causes the protrusion of the haw over a portion of the lower and inner part of the eye, but by gentleness and careful graduation of the pressure this
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may be kept within bounds, and oftentimes even the interior of the eye can be seen. As a rule it is best to use the right hand for the left eye, and the left hand for the right, the finger in each case being pressed on the u]3per lid while the thumb depresses the lower one. In cases in which it is desirable to examine the inner side of the eyelid farther than is possible by the above means, the upper lid may be drawn dowTi by the ej^'elashes with the one hand and then everted over the tip of the forefinger of the other hand, or over a probe laid flat against the middle of the lid. AVhere the interior of the eye must be examined it is useless to make the attempt in the open sunshine or under a clear sky. The worst cases, it is true, can be seen under such circumstances, but for the slighter forms the horse should be taken indoors, where all light from above will be shut off, and should be placed so that the light shall fall on the eye from the front and side. Then the observer, placing himself in front of the animal, will receive the reflected rays from the cornea, the front of the lens and the back, and can much more easily detect any cloudiness, opacity, or lack of transparency. The examination can be made much more satisfactory by placing the horse in a dark chamber and illuminating the eye by a lamj) x^laced forward and outward from the eye which is to be exam- ined.- Any cloudiness is thus easily detected, and any doubt may be resolved by moving the lamp so that the image of the flame may be passed in succession over the whole surface of the transparent cornea and of the crystalline lens. Three images of the flame will be seen, the larger one upright, reflected from the anterior surface of the eye; a smaller one upright, reflected from the anterior surface of the lens; and a second small one inverted from the back surface of the lens. So long as these images are reflected from healthy surfaces they will be clear and perfect in outline, but, as soon as one strikes on an area of opacit}^, it will become diifused, cloudy, and indefinite. Thus, if the large upright image becomes hazy and imjierfect over a particular si)ot of the cornea, that will be found to be the seat of disease and opacity. Should the large image remain clear, but the small upright one become diffuse and indefinite over a given point, it indicates opacitj'- on the front of the capsule of the lens. If both upright images remain clear, while the inverted one becomes indistinct at a given point, then the ojjacity is in the substance of the lens itself or in the posterior part of its capsule.
If in a given case the pujiil remains so closely contracted that the deeper parts of the eye can not be seen the ej'elids may be rubbed with extract of belladonna, and in a short time the pupil will be found widelj" dilated.
DISEASES OF THE EYELIDS.
Congenital disorders. — Some faulty conditions of the eyelids are congenital, as division of an eyelid in two, after the manner of harelip,
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abnormally small opening between, the lids, often connected with imper- fect development of the eye, and closure of the lids by adhesioii. The first is to be remedied by paring the edges of the division and then bringing them, together, as in torn lids. The last two, if remediable at all, require seiDaration by the knife, and subsequent treatment with a cooling astringent eye wash.
Nervous disorders. — Spasm of the eyelids maybe owing to constitu- tional susceptibility, or to the presence of local irritants (insects, chemical irritants, sand, etc. ) in the eye, to wounds or inflammation of the mucous membrane, or to disease of the brain. When due to local irritation, it may be temporarily overcome by instilling a few drops of a 4 per cent solution of cocaine into the eye, when the true cause may be ascertained and removed. The nervous or constitutional disease must be treated according to its nature.
Drooping eyelids — Ptosis. — This is usually present in the upper lid, or is at least little noticed in the lower. It is sometimes but a symp- tom of paralysis of one-half of the face, in which case the ear, lips, and nostrils on the same side will be found soft, drooping, and inac- tive, and even the half of the tongue may partake of the palsy. If the same condition exists on both sides there is difficult snuffling breath- ing, from the air drawing in the flaps of the nostrils in inspiration, and all food is taken in by the teeth, as the lips are useless. In both there is a free discharge of saliva from the mouth during mastication. This paralysis is a frequent result of injury, by a poke, to the seventh nerve, as it passes over the back of the lower jaw. In some cases the paralysis is confined to the lid, the injury having been sustained by the muscles which raise it, or by the supra-orbital nerve which emerges from the bone just above the eye. Such injury to the nerve may have resulted from fracture of the orbital process of the frontal bone above the eye ball.
The condition may, however, be due to spasm of the sphincter muscle, which closes the lids, or to inflammation of the upper lid, usually a result of blows on the orbit. In the latter case it may run a slow course with chronic thickening of the lid.
The paralysis due to the poke may be often remedied by, first, the removal of any remaining inflammation by a wet sponge worn beneath the ear and kept in place by a bandage; second, when all inflamma- tion has passed by a blister on the same region, or by rubbing it daily with a mixture in equal proportions of olive oil and strong aqua ammonia. Improvement is usually slow, and it may be months before complete recovery ensues.
In paralysis from blows above the eyes the same treatment may be applied to that part.
Thickening of the lid may be treated by painting with tincture of iodine, and that failing, by cutting out an elliptical strip of the skin from the middle of the upper lid and stitching the edges together
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INFLAMMATION OF THE EYELIDS.
The eyelids suffer more or less in all severe inflammatious of the eye, whether external or internal, but inasmuch as the disease some- times starts in the lids and at other times is exclusivel}^ confined to them, it deserves independent mention.
Among the causes may be named : exposure to draughts of cold air, or to cold rain or snow-storms; the bites or stings of mosquitoes, flies, and other insects; snake-bites, pricks with thorns, blows of whip or club; accidental bruises against the stall or ground, especially during the violent struggles of colic, enteritis, phrenitis (staggers), and when thrown for operations. It is also a result of infecting inoculations, as of erysipelas, anthrax, boil, etc., and is noted by Leblanc as espe- cially prevalent among horses kept on low marshy pastures. Finally, the introduction of sand, dust, chaff, beards of barley and seeds of the finest grasses, and the contact with irritant chemical powders, liquids, and gases (ammonia from manure or factory, chlorine, strong sulphur fumes, smoke, and other products of combustion, etc.), may start the inflammation. The eyelids often undergo extreme inflam- matory and dropsical swelling in urticaria (nettlerash, surfeit), and in the general inflammatory dropsy known as purpura haemorrhagica.
The affection will, therefore, readily divide itself into (1), inflam- mations due to constitutional causes; (2), those due to direct injury, mechanical or chemical; and (3), such as are due to inoculation vnth infecting material.
(1) Inflammations due to constitutional causes are distinguished by the absence of an}^ local wound, and the history of a low damp pas- ture, exposure, indigestion from unwholesome food, or the presence elsewhere on the limbs or body of the general doughy swellings of purpura hsemorrhagica. The lids are swollen and thickened, it may be slightly or it may be so extremely that the eye ball can not be seen. If the lid can be everted to show its mucous membrane, that is seen to be of a deep red color, especially along the branching lines of the blood vessels. The part is hot and painful, and a profuse flow of tears and mucus escapes on the side of the face, causing irritation and loss of the hair. If improvement follows, this discharge becomes more tenacious, and tends to cause adhesion to the edges of the upper and lower lids and to mat together the eyelashes in bundles. This grad- ually decreases to the natural amount, and the redness and congested appearance of the eyes disappears, but swelling, thickening, and stiff- ness of the lids may continue for a length of time. There may be more or less fever according to the violence of the inflammation, but so long as there is no serious disease of the interior of the eye or of other vital organ this is usually moderate.
The local treatment consists in astringent, soothing lotions (sugar of lead 30 gi'ains, laudanum 2 teaspoonfuls, rain water — boiled and cooled — 1 pint), applied with a soft cloth kept wet with the lotion,
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and liiiiig over the eye by tying it to tlie headstall of the bridle on the two sides. If the mucous membrane lining the lids is the seat of little red granular elevations, a drop of a solution of 2 grains of nitrate of silver in an ounce of distilled water should be applied ^yith the soft end of a clean feather to the inside of the lid twice a daj'. The patient should be removed from all such conditions (pasture, faulty food, exi)osure, etc.) as may have caused or aggra Abated the disease, and from dust and irritant fumes and gases. He should be fed from a manger higli enough to favor the return of blood from the head, and should be kept from work, especially in a tight collar, which would prevent the descent of blood by the jugular veins. His diet should be laxa- tive and non-stimulating (grass, bran mashes, carrots, turnips, beets, XDotatoes, or steamed hay), and any costiveness should be corrected by a mild dose of linseed oil (1 to Vr pints). In cold weather warm blanketing may be needful, and even loose flannel bandages to the limbs, and heat should never be sought at the expense of pure air.
(2) In inflammations due to local irritants of a non-infective kind, a careful examination will usually reveal their j)resence, and the first step must be their removal with a pair of blunt f orcex^s or the point of a lead i3encil. Subsequent treatment will be in the main the local treat- ment advised above.
(3) In case of infective inflammation, there will often be found a prick or tear by which the septic matter has entered, and in such case the inflammation will for a time be concentrated at that jjoint. A round or conical swelling round an insect bite is especially charac- teristic. A snake bite is marked by the double prick made by the tv>'0 teeth and by the violent and rapidly spreading inflammation. Erysipelas is attended with much swelling, extending beyond the lids, and causing the mucous membrane to x)rotrude beyond the edge of the eyelid (chemosis). This is characterized by a bright, uniform, rosy red, disappearing on pressure, or later by a dark, livid hue, but with less branching redness than in noninfecting inflammation, and less of the dark, dusky, brownish or yellowish tint of anthrax. Little vesicles may appear on the skin, and pus may be found without any distinct limiting membrane, as in abscess. It is early attended by liigh fever and marked general weakness and inappetence. Anthrax of the lids is marked by a firm swelling, surmounted by a blister, with bloody serous contents, which tends to burst and dry uj) into a slough, while the surrounding parts become involved in the same way. Or it may sliow as a diffuse dropsical swelling, with less of the hard central sloughing nodule, but like that tending to spread quickly. In both cases alike the mucous membrane and the skin, if white, assume a dusky brown or yellowish brown hue, which is largely characteristic. This may i^ass into a black color by reason of extravasation of blood. There apjpears early great constitutional disturbance, with much prostration and weakness and generalized anthrax symptoms.
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The treatment of these will vary according to the severity. Insect Lites may be touched with a solution of equal parts of glycerine and aqua ammonia, or a 1.0 jjer cent solution of carbolic acid in water. Snake bites may be bathed with aqua ammonia, and the same agent given in doses of 2 teaspoonfuls in a quart of water. Or alcohol may be given in pint or quart doses, according to the size of the animal. In erysipelas the skin may be xjainted with tincture or muriate of iron, or with a solution of 20 grains of iodine in an ounce of carbolic acid, and one-half an ounce of tincture of muriate of iron may be given thrice daily in a bottle of water. In anthrax the swelling should be painted with tincture of iodine, or of the mixture of iodine and car- bolic acid, and if very threatening it may have the tincture of iodine injected into the swelling with a hypodermic syringe, or the hard mass may be freely incised to its depth with a sharp lancet and the lotion applied to the exposed tissues. Internally iodide of XJotassium may be given in doses of 2 drams thrice a day, or tincture of the muriate of iron every four hours,
STYE — FURUNCLE (BOIL) OF THE EYELID.
This is an inflammation of limited extent, advancing to the formation of matter and the sloughing out of a small mass of the natural tissue of the eyelid. It forms a firm, rounded swelling, usually near the margin of the lid, which suppurates and bursts in four or five days. Its course may be hastened by a poultice of chamoinile flowers, to which have been added a few drops of carbolic acid, the whole applied in a very thin muslin bag. If the swelling is slow to open after hav- ing become yellowish-white, it may be opened by a lancet, the inci- sion being made at right angles to the margin of the lid.
ENTROPIOX AND ECTROPION — INVERSION AND EVERSION OF THE
EYELID.
These are respectively caused by wounds, sloughs, ulcers, or other causes of loss of substance of the mucous membrane on the inside of the lid and of the skin on the outside; also of tumors, skin diseases, or paralj^sis which leads to displacement of the margin of the eyelid. As a rule they require a surgical operation, with removal of an ellip- tical i)ortion of the mucous membrane or skin, as the case may be, but which requires the skilled and delicate hand of the surgeon.
TRICHIASIS.
This consists in the turning in of the eyelashes so as to irritate the front of the eye. If a single eyelash, it may be snipped off with scis- sors close to the margin of the eyelid, or pulled out by the root with a pair of flat-bladed forceps. If the divergent lashes are more numer- ous the treatment may be as for entropion by excising an elliptical portion of skin opposite the offending lashes, and stitching the edges together, so as to draw outward the margin of the lid at that point.
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WARTS AND OTHER TUMORS OF THE EYELIDS.
The eyelids form a favoi'ite site for tumors, and above all, warts, which consist in a simple diseased overgrowth (hypertrophy) of the surface layers of the skin. If small, these may be snipped off with scissors, or tied around the neck with a stout waxed thread and left to drop off, the destruction being completed, if necessary, by the daily application of a piece of sul^ihate of copper (blue vitriol), until any unhealthy material has been removed. If more widely spread the wart may still be clipped off with curved scissors or knife, and the caustic thoroughly applied day by day.
A bleediilg wart or erectile tumor is more liable to bleed, and is best removed by constricting its neck with the waxed cord or rubber band, or if too broad for this it may be transfixed through its base by a needle armed with a double thread, which is then to be cut in two and tied around the two portions of the neck of the tumor. If still broader the armed needle may be carried through the base of the tumor at regular intervals, so that the whole may be tied in moder- ately sized sections.
In gray and white horses black pigmentary tumors (melanotic) are common on the black portions of skin, such as the eyelids, and are to be removed by scissors or knife, according to their size. In the horse these do not usually tend to recur when thoroughly removed, but at times they prove cancerous (as is the rule in man), and then they tend to reappear in the same site or in internal organs with, it may be, fatal effect.
Encysted, honey-like (melicerous), sebaceous, and fibrous tumors of the lids all require removal with the knife.
TORN EYELIDS — WOUNDS OF EYELIDS.
The eyelids are torn by attacks with horns of cattle, or with the teeth, or by getting caught on nails in stall rack or manger, on the point of stump fences or fence rails, on the barbs of wire-fences and on other pointed bodies. The edges should be brought together as promptly as possible, so as to secure union without the formation of matter, puckering of the skin, and unsightly distortions. Great care is nec- essary to bring the two edges together evenly without twisting or puckering. The simplest mode of holding them together is by a series of sharp j)ins passed through the lips of the wound at intervals of not over a third of an inch, and held together by a thread twisted around each pin in the form of the figure 8, and carried obliquely from pin to pin in two directions, so as to prevent gaping of the wound in the intervals. The points of the pins may then be cut off with scissors, and the wound may be wet twice a day with a weak solution of carbolic acid.
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TUMOR OF THE HAW — CARIES OP THP] CARTILAGE.
Though cruelly excised for alleged "hooks," when itself perfectly- healthy in the various diseases which lead to retraction of the eye into its socket, the haw may, like other bodily structures, be itself the seat of actual disease. The i^igmentary black tumors of white horses and soft (encephaloid) cancer may attack this iDart primarilj^ or extend to it from the eyeball or eyelids; hairs have been found growing from its surface; and the mucous membrane covering it becomes inflamed in common with that covering the front of the eye. These inflamma- tions are but a phase of the inflammation of the external structures of the eye, and demand no particular notice nor specia.1 treatment. The tumors lead to such irregular enlargement and distortion of the haw that the condition is not to be confounded with the simple pro- jection of the healthy structure over the e^^e when the lids are pushed apart with the finger and thumb, and the same remark applies to the ulceration or caries of the cartilage. In the latter case, besides the swelling and distortion of the haw, there is this peculiarity, that in the midst of the red inflamed mass there appears a white line or mass formed by the exposed edge of the ulcerating cartilage. The animal having been thrown and properly fixed, an assistant holds the eyelids apart while the operator seizes the haw with forceps or hook and carefully dissects it out with blunt-pointed scissors. The eye is then covered with a cloth kept wet with an eye wash, aA for external ophthalmia.
OBSTRUCTION OF THE LACHRYMAL APPARATUS — WATERING EYE.
The escape of tears on the side of the cheek is a symptom of exter- nal inflammation of the eye, but it may also occur from any disease of the lachrymal apjDaratus which interferes with the normal j)rogress of the tears to the nose. Hence, in all cases when this symptom is not attended by special redness or swelling of the eyelids, it is well to examine the lachrymal apparatus. In some instances the orifice of the lachrymal duct on the floor of the nasal chamber and close to its anterior outlet will be found blocked bj^ a portion of dry muco purulent matter, on the removal of which tears may begin to escape. This implies an inflammation of the canal, which may be helped by occasional sponging out of the nose with warm water, and the appli- cation of the same on the face. Another remedy is to feed warm mashes of wheat bran from a nose-bag, so that the relaxing effects of the water vapor may be secured.
The two lachrymal openings, situated at the inner angle of the eye, may fail to admit the tears by reason of their deviation outward in connection with eversion of the lower lid, or by reason of their con- striction in inflammation of the mucous membrane. Tlie lachrymal 5901— HOR 9*
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sac, into ^yllicll the laclirymal ducts open, may fail to discharge its contents b}' reason of constriction or closure of the duct leading to the nose, and it then forms a rounded swelling beneath the inner angle of the eye. The duct leading from the sac to the nose may be com- pressed or obliterated by fractures of the bones of the face, and in disease of these bones (osteo-sarcoma, so-called osteoijorosis, diseased teeth, glanders of the nasal sinuses, abscess of the same cavities).
The narrowed or obstructed ducts may be made pervious by a fine silver probe passed down to the lachrymal sac, and anj" existing inflammation of the passages may be counteracted by the use of steaming mashes of wheat bran, by fomentatioiis or wet cloths over the face, and even by the use of astringent eye washes and the injec- tion of similar liquids into the lachrymal canal from its nasal opening. The ordinary eye wash may be used for this purpose, or it jnny be injected after dilution to half its strength. The fractures and dis- eases of the bones and teeth must be treated according to their special demands when, if the canal is still left ijervious, it may be again rendered useful.
EXTERNAL OPHTHALMIA — COX JUNCTIVITIS.
In inflammation of the outer parts of the eye ball the exposed vas- cular and sensitive mucous membrane (conjunctiva) which covers the ball, the eyelids, the haw, and the lachrymal apparatus, is usually the most deeply involved, yet adjacent parts are more or less implicated, and when disease is concentrated on these contiguous iDarts it consti- tutes a phase of external ox)hthalmia which demands a special notice. These have accordingly been alreadj^ treated of.
The causes of external ophthalmia are mainly those that act locally — blovrs with whips, clubs, and twigs, the presence of foreign bodies like hay-seed, chaff, dust, lime, sand, snuff, pollen of plants, flies attracted by the brilliancy of the eye, wounds of the bridle, the migra- tion of the scabies (mange) insect into the eye, smoke, ammonia rising from the excretions, irritant emanations from drying marshes, etc. A very dry air is alleged to act injuriously by drying the eye as well as by favoring the production of irritant dust ; and the undue exposure to bright sunshine through a window in front of the stall, or to the reflection from snow or water, is undoubtedly injurious. The unpro- tected exposure of the eyes to sunshine through the use of a very short overdraw check is to be condemned, and the keeping of the horse in a very dark stall from which it is liabitually led into the glare of full sunlight, intensified by reflection from snow or white limestone dust, must be set down among the locally acting causes. But exposure to cold and wet, to rain and snow storms, to cold draughts and wet lairs must also be accepted as causes of conjuncti- vitis, the general disorder which they produce affecting the eye, if that happens to be the weakest and most susceptible organ of the
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body, or if it lias "been subjected to anysijecial local injury like dust, irritant gases, or excess of light. Again, external oplithalinia is a constant concomitant of inflammation of the contiguous and contin- uous mucous membranes, as those of the nose and throat. Hence the red watery eyes that attend on nasal catarrh, sore throat, influenza, strangles, nasal glanders, and the like. In such cases, however, the affection of the eye is subsidiary and is manifestly overshadowed by the primary and predominating disease.
The symptoms are watering of the ej^e, swollen lids, redness of the mucous membrane exi)osed by the separation of the lids — it may bo a mere pink blush with more or less branching redness, or it may be a deep, dark red, as from effusion of blood — and a bluish opacity of the cornea which is normally clear and translucent. But except when resulting from wounds and actual extravasation of blood, the redness is seen to be superficial, and if the opacity is confined to the edges, and does not involve the entire cornea the aqueous humor behind is seen to be still clear and limx:>id. The fever is always less severe than in internal ophthalmia, and only runs high in the Avorst cases. The eyelids may be kept closed, the eye-ball retracted, and the haw i^ro- truded over one-third or one-half of the ball, but this is due to the pain only and not to any excessive sensibility to light, as shown by the comx3arativel3' widely dilated pupil. In internal ophthalmia, on the contrary, the narrow contracted pupil is the measure of the pain caused by the falling of light on the inflamed and sensitive optic nerve (retina) and choroid.
If the affection has resulted from a wound of the cornea, not only is that the point of greatest opacity, forming a white sj^eck or fleecy cloud, l)ut too often l>lood-vessels begin to extend from the adjacent vascular covering of the eye (sclerotic) to the white spot, and that por- tion of the cornea is rendered permanently oi)aque. Again, if the wound has been severe, though still short of cutting into the anterior layers of the cornea, the injury may lead to ulceration which may 13enetrate more or less deeply and leave a breach in the tissue which, if filled ux? at all, is repaired by oi)aque fibrous tissue in place of the transparent cellular structure. Pus may form, and the cornea assumes a yellowish tinge and bursts, giving rise to a deep sore which is liable to extend as an ulcer, and may be in its turn followed by bulging of the cornea at that point (staphyloma). This inflammation of the con- junctiva may be simply catarrhal, with profuse muco-purulent dis- charge ; it ma}' be granular, the surface being covered with minute reddish elevations, or it maj' become the seat of a false membrane (diphtheria).
In treafmg external ophthalmia the first object is the removal of the cause. Remove any dust, chaff, thorn, or other foreign bod}' from the conjunctiva, purify the stable from all sources of ammoniacal or other irritant gas; keei") the horse from dusty roads, and above all
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from the proximity of a leading wagon and its attendant clond of dust ; remove from pasture and feed from a rack which is neither so high as to drop seeds, etc. , into the eyes nor so low as to favor the accumula- tion of blood in the head ; avoid equally excess of light from a sunny window in front of the stall and excess of darkness from the absence of windows; preserve from cold draughts and rains and wet bedding, and applj^ curative measures for inflammation of the adjacent mucous membranes or skin. If the irritant has been of a caustic nature remove any remnant of it by persistent bathing with tepid water and a soft sponge, or Avith water mixed with white of egg, or a glass filled with the liquid may be inverted over the eye so that its contents may dilute and remove the irritant. If the suffering is very severe a lotion with a few grains of extract of belladonna or of morphia in an ounce of water may be applied, or if it is available a few drops of 4 per cent solution of cocaine may be instilled into the eye.
In strong, vigorous patients benefit will usually be obtained from a laxative, such as 2 tablespoonfuls of Glauber's salts daily, and if the fever runs high from a daily dose of half an ounce of saltpeter. As local applications astringent solutions are usually the best, as 30 grains of borax or of sulphate of zinc in a cjuart of water, to be applied constantly on a cloth, as advised, under inflammation of the eyelids. In the absence of anj^thing better cold water may serve every i)ur- pose. Above all, adhesive and oily agents (molasses, sugar, fats) are to be avoided, as only adding to the irritation. By way of sug- gesting agents that may be used with good effect, salt and sulphate of soda may be named, in solutions double the strength of sulphate of zinc, or 7 grains of nitrate of silver may be added to a quart of dis- tilled water, and will be found especially applicable in granular con- junctivitis, diphtheria, or commencing ulceration. A cantharides blister (1 part of Spanish fly to 4 parts lard) may be rubbed on the side of the face 3 inches below the eye, and washed off next morning with soap-suds and oiled daily till the scabs are dropped.
WHITE SPECKS AND CLOUDINESS OF THE CORNEA.
As a result of external ophthalmia, opaque specks, clouds, or hazi- ness are too often left on the cornea and require for their removal that they be daily touched with a soft feather dipped in a solution of 3 grains nitrate of silver in 1 ounce distilled water. This should be applied until all inflammation has subsided, and until its contact is comparatively i^ainless. It is rarely successful with an old thick scar following an ulcer, nor with an opacity having red blood-vessels run- ning across it.
ULCERS OF THE CORNEA.
These may be treated with nitrate of silver lotion of twice the strength used for opacities. Powdered gentian, one-half ounce, and sulphate of iron, one-fourth ounce daily, may improve the general health and increase the reparatorj^ power.
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INTERNAL OPHTHALMIA — IRITIS— CHOROIDITIS — RETINITIS.
Althoiigli inflammations of the iris, choroid, and retina, the inner, vascular, and nervous coats of the eye, occur to a certain extent inde- l^endently of each otlier, yet one usually supervenes upon the oilier, and as the symptoms are thus made to coincide it will be best for our present purposes to treat the three as one disease.
The causes of internal ophthalmia are largely those of the external form only, acting- Avith greater intensity or on a more susceptible eye. Severe blows, bruises, punctures, etc., of the eye, the penetration of foreign bodies into the eye (thorns, splinters of iron, etc.), sudden transition from a dark stall to bright sunshine, to the glare of snow or water, constant glare from a sunny window, abuse of the overdraw check-rein, vivid lightning flashes, draughts of cold, damp air; above all, when the animal is persi^iring, exposure in cold rain and snow- storms, swimming cold rivers, also certain general diseases like rheu- matism, arthritis, influenza, and disorders of the digestive organs, may become complicated by this affection. From the close relation between the brain and eye — alike in the blood vessels and nerves — disorders of the first lead to affections of the second, and the same remark applies to the persistent irritation to which the jaws are subjected in the course of dentition. So potent is the last agency that we dread a recurrence of ojDhthalmia so long as dentition is incomplete, and hope for immu- nity if the animal completes its dentition without any permanent structural change in the eye.
The sympioms will vary according to the cause. If the attack is due to direct physical injury the inflammation of the eyelids and suijerfi- cial structures may be quite as marked as that of the interior of the eye. If, on the other hand, from general causes, or as a complica- tion of some distant disease, the affection may be largely confined to the deeper structures, and the swelling, redness, and tenderness of the superficial structures will be less marked. When the external coats thus comparatively escape the extreme anterior edge of the white or sclerotic coat where it overlaps the border of the transparent cornea is in a measure free from congestion, and, in the absence of the obscuring dark jjigment, forms a Avhitish ring around the cornea. This is j^artly due to the fact that a series of arteries (ciliary) passing to the inflamed iris j)enetrate the sclerotic coat a short distance behind its anterior border, and there is therefore a marked difference in color between the general sclerotic occupied between these congested vessels and the anterior rim from which they are absent. Unfortunately the pig- ment is often so abundant in the anterior part of the sclerotic as to hide this symptom. In internal ophthalmia the opacity of the cornea may be confined to a zone around the outer margin of the cornea, and even this may be a bluish haze rather than a deep fleecy white. In consequence it becomes possible to see the interior of the chamber
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for the aqueous liumor and the condition of the iris and pupil. The aqueous humor is usually turbid, and has numerous yellowish white flakes floating on its substance or deposited in the lower part of the chamber, so as to cut ofi: the view of the lower x^ortion of the iris. The still visible portion of the iris has lost its natural, clear dark luster, which is replaced by a brownish or yellowish sere-leaf color. This is more marked in jn'oportion as the iris is inflamed, and less so as the inflammation is conflned to the choroid. The amount of flocculent deposit in the chamber of the aqueous humor is also in direct ratio to the inflammation of the iris. Perhaps the most marked feature of internal ophthalmia is the extreme and painful sensitive- ness to light. On this account the lids are usually closed, but when opened the puj)il is seen to be narrowly closed even if the animal has been kept in an obscured stall. Exceptions to this are seen when inflammator}' efllusion has overfilled the globe of the eye, and by pres- sure on the retina has paralyzed it, or when the exudation into the substance of the retina itself has similarly" led to its paralj^sis. Then the puiDil may be dilated, and frequently its margin loses its regular ovoid outline and becomes uneven by reason of the adhesions which it has contracted with the capsule of the lens, through its inflammator}^ exudations. In the case of excessive effusion into the globe of the eye that is found to have become tense and hard so that it can not be indented with the tij) of the finger. With such paralysis of tlie retina, vision is heavily clouded or entirely lost; hence in spite of the open I)upil the finger may be approached to the eye vritliout the animal becoming conscious of it until it touches the surface, and if the nose on the affected side is gently struck and a feint made to repeat the blow the i^atient makes no effort to evade it. Sometimes the edges of the contracted pui)il become adherent to each other by an intervening plastic exudation, and the opening becomes virtuallj' abolished. In severe inflammations pus maj' form in the choroid or iris, and escap- ing into the cavity of the aqueous liumor show as a yellowish white stratum below. In nearly all cases there is resulting exudation into the lens or its capsule, constituting a cloudiness or opacity (cataract), Avhich in severe and old standing cases appears as a white fleecy mass behind a widely dilated pupil. In the slighter cases cataract is to be recognized by examination of the eye in a dark chambe]-, Avith an oblique side light, as described in "the introduction to this article. Cataracts that appear as a simple haze or indefinite fleecy cloud are usually on the caj^sulc (capsular), while those that show a radiating arrangement are in the lens (lenticular), the radiating fibers of which the exudate follows. Black cataracts are formed by the adhesion of the pigment on the back of the iris to the front of the lens, and by the subsequent tearing loose of the iris, leaving a portion of its pigment adherent to the capsule of the lens. If the pupil is so contracted that it is impossible to see the lens, it may be dilated by applying to the
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front of the eye -witli a featlier some drops of a solution of -i grains of atropia in an ounce of water.
The treatment of internal ophthalmia should embrace first the re- moval of all existing causes, or sources of aggravation, of the disease, which need not be here repeated. Special care to protect the patient against cold, wet, strong light, and active exertion, must, however, be specially insisted on. A dark stall, and a cloth hung over the eye, are important, while cleanliness, warmth, drjmess, and rest are equally demanded. If the patient is strong and vigorous a dose of 4 drams of Barbadoes aloes may be given, and, if there is auj^ reason to susx^ect a rheumatic origin, one-half a dram powdered colchicum and one-half ounce salicylate of soda may be given daily. Locally the astringent lotions advised for external ophthalmia may be resorted to, especially when the superficial inflammation is well marked. More important, however, is to instill into the eye, a few drops at a time, a solu- tion of 4 grains of atropia in 1 ounce distilled water. This may be effected with the aid of a soft feather, and may be repeated at inter- vals of ten minutes until the pupil is widely dilated. As the horse is to be kept in a dark stall the consequent admission of light will be harmless, and the dilation of the pui)il i)revents adhesion between the iris and lens, relieves the constant tension of the eye in the effort to adapt the pupil to the light, and solicits the contraction of the blood vessels of the eye and the lessening of congestion, exudation, and intraocular pressure. Sliould atropia not agree with the case, it may be replaced by morphia (same strength) or cocaine in. 4 per cent solu- tion. Another local measure is a blister, which can usually be api^lied to advantage on the side of the nose or beneath the ear. Si^anish flies may be used as for external o^jhthalmia. In very severe cases the parts beneath the eye may be shaved and three or four leeches applied. Setons are sometimes beneficial, and even puncture of the eye-ball, but tliese should be reserved for professional hands.
The diet throughout should be easilj' digestible and moderate in quantity — bran mashes, middlings, grass, steamed hay, etc.
Even after the active inflammation has subsided the atropia lotion should be continued for some weeks to keep the eye in a state of rest in its still weak and irritable condition, and during this i)eriod the patient should be kept in semi-darkness, or taken out only with a dark shade over the eye. For the same reason heavy draughts and rapid paces, which would cause congestion of the head, should l)e carefulh" avoided.
RECURRENT OPHTHALMIA — PERIODIC OPHTHALMIA — MOONBLIND-
NESS.
This is an inflammatorj' affection of the interior of the eye, intimately related to certain soils, climates, and systems, showing a strong tend- ency to recur again and again and usually ending in blindness from cataract or other serious injury.
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Its causes may be fundamentally attributed to soil. On damp clays and marshy grounds, on the frequently overflowed river bottoms and deltas, on the coasts of seas and lakes alternately submerged and ex- posed, this disease prevails extensively, and in many instances in France (Reynal), Belgium, Alsace (Zundel Miltenberger), Germany, and England it has wery largely decreased under land drainage and improved methods of culture. Other influences, more or less asso- ciated with such soil, are potent causative factors. Thus damp air and a cloudy, wet climate, so constantly associated with wet lands, are universally charged with causing the disease. These act on the animal body to produce a lymphatic constitution with an excess of connective tissue, bones, and muscles of coarse oj)en texture, thick skins and gummy legs covered with a profusion of long hair. Hence the heavy horses of Belgium and southwestern France have suffered severel}'^ from the affection, while high dry lands adjacent, like Cata- lonia, in Spain, and Dauphiuy Provence, and Languedoc, in France, have in the main escaped.
The rank aqueous fodders grown on such soils are other causes, but these again are calculated to undermine the characters of the nervous and sanguineous temperament, and to superinduce the lym- phatic. Other foods act by leading to constipation and other disor- ders of the digestive organs, thus impairing the general health ; hence in any animal predisposed to this disease, heating, starchy foods, such as maize, wheat, and buckwheat, are to.be carefully avoided. It has been widely charged that beans, peas, vetches, and other leguminosa are dangerous, but a fuller inquiry contradicts this. If these are well grown they invigorate and fortify the system, while like any other fodder if grown rank, aqueous, and deficient in assimilable principles they tend to lower the health and oi^en the way for the disease.
The period of dentition and training is a fertile exciting cause, for though the malady may appear at any time from birth to old age, yet the great majority of victims are from two to six years old, and if a horse escapes the affection till after six there is a reasonable hope that he will continue to resist it. The irritation about the head dur- ing the eruption of the teeth, and while fretting in the unwonted bridle and collar, the stimulating grain diet, and the close air of the stable all combine to rouse the latent tendency to disease in the eye, while direct injuries by bridle, whip, or hay-seeds are not without their influence.
In the same way local irritants like dust, severe rain and snow storms, smoke, and acrid vapors are contributing causes.
It is evident, however, that no one of these is sufficient of itself to produce the disease, and it has been alleged that the true cause is a microbe, or the irritant products of a microbe, which is harbored in the marshy soil. The prevalence of the disease on the same damp soils which produce ague in man and anthrax in cattle has been
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quoted in support of this doctrine, as also the fact that the malady is always more prevalent center is paribus in basins surrounded b.y hills where the air is still and such products are concentrated, and that a forest or simple belt of trees will, as in ague, at times limit the area of its i3revalence. Another argument for the same view is found in the fact that on certain farms irrigated by town sewage this malady has become extremely prevalent, the sewage being assumed to form a suitable nidus for the growth of the germ. But on these sewage farms a fresh crop may be cut every fortnight, and the product is precisely that aqueous material which contributes to a lymphatic structure and a low tone of health. The presence in the system of a definite germ has not yet been proven, and in the present state of our knowledge we are only warranted in charging the disease on the dele- terious emanations from the marshy soil in which bacterial ferments are constantly producing them.
Heredity is one of the most potent causes. The lymphatic constitu- tion is of course transmitted and with it the proclivity to recurring ophthalmia. This is notorious in the case of both parents, male and female. The tendency appears to be stronger, however, if either par- ent has already suifered. Thus a mare may have borne a number of sound foals, and then fallen a victim to this malady, and all foals sul> sequently borne have likewise suffered. So with the stallion. Rey- nal even quotes the appearance of the disease in alternate generations, the stallion offspring of blind parents remaining sound through life and yet producing foals which furnish numerous victims of recurrent oj)h- tlialmia. On the contrary, the offsijring of diseased parents removed to high, dry regions and furnished with wholesome, nourishing rations, will nearly all escape. Hence the dealers take colts that are still sound or have had but one attack from the affected low Pyrenees (France) to the unaffected Catalonia (Sixain), with confidence that they will escape, and from the Jura Valley to Dauphiny with the same result.
Yet the hereditary taint is so strong and pernicious that intelligent horsemen everywhere refuse to breed from either horse or mare that has once suffered from recurrent oi^hthalmia, and the French Govern- ment studs not only rejept all unsound stallions, but refuse service to any mare which has suffered with her eyes. It is this avoidance of the hereditary predisposition more than anything else that has reduced the formerly wide prevalence of this disease in the Euroi3ean countries generally. A consideration for the future of our horses would demand the disuse of all sires that are unlicensed, and the refusal of a license to any sire which has suffered from this or any other communicable constitutional disease.
Other contributing causes deserve passing mention. Unwholesome food and a faulty method of feeding undoubtedly' j)redisposes to the disease, and in the same district the carefully fed will escape in far larger proportion than the badly fed. But it is so with every other
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condition wliicli undermines the general liealtli. The presence of worms in the intestines, overwork, and debilitating diseases and causes of every kind weaken the vitalitj^ and lay the sj'stem more open to attack. Thierry long ago showed that the imxjrovement of close, low, dark, damj) stables, where the disease had previously prevailed, prac- tically banished this affection. Whatever contributes to strength and vigor is x)rotecti^e — whatever contributes to weakness and poor health is provocative of the disease in the predisposed subject.
The symptoms vary according to the severity of the attack. In some cases there is marked fever, and in some slighter cases this may be almost altogether wanting, but there is alwaj's a lack of vigor and energy, bespeaking general disorder. The local symptoms are in the main those of internal ophthalmia, with, in manj' cases, an increased hardness of the eye-ball from effusion into its cavity. The contracted pupil does not expand much in darkness, nor even under the action of belladonna. Opacity advances from the margin, over a j)art or whole of the cornea, but so long as it is trausx)arent there may be seen the turbid, aqueous humor with or without flocculi, the dingy^ iris robbed of its clear black aspect, the slightly clouded lens and a green- ish yellow reflection from the dei)tli of the eye. From the fifth to the seventh day the flocculi i)recipitates in the lower part of the chamber, exposing more clearly the iris and lens, and absorption commences so that the eye may be cleared u^) in ten or fifteen days.
The characteristic of the disease is, however, its recurrence again and again in the same eye until blindness results. The attacks may follow each other at intervals of a month, more or less, but they show no relation to any particular xjhase of the moon as might be inferred from the familiar name, but are determined rather by the Aveather, the health, the food, or bj' some i)eriodicity of the sj^stem. From five to seven attacks usually result in blindness, and then the second eye is liable to be attacked until it also is ruined.
In the intervals between the attacks some remaining symi)toms betray the condition, and these become more marked after each suc- cessive access of disease. Even after the first attack there is a bluish ring round the margin of the transj)arent cornea. The eye seems smaller than the other, at first because it is retracted in its socket, and often after several attacks because of actual shrinkage (atrophy). The upxDer eyelid, in place of presenting a uniform, continuous arch, has about one-third from its inner angle an abrupt bend, caused by the contraction of the levator muscle. The front of the iris has exchanged some of its dark, clear brilliancy for a lusterless j'ellow, and the depth of the eye presents more or less of the greenish yellow shade. The pupil remains a little contracted, except in advanced and aggravated cases, when, Avith opaque lens, it is widelj- dilated. If one eye only has suffered, as is common, the contrast in these respects with the sound eye is all the more characteristic. Another feature is
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the erect, attentive carriage of the ear, to compensate to some extent for the w aning- \asion.
The attacks vary greatly iu severity in different cases, ])nt the recur- rence is characteristic, and all alike lead to cataract and intraocular effusion, with pressure on the retina and abolition of sight.
The preren/Zo/i of this disease is the great object tobe aimed at, and this demands the. most careful breeding, feeding, housing, and general management as indicated under causes. Much can also be done bj' migration to a high, dry location, but for this and malarious affections the improvement of the land by drainage and good cultivation should be the final aim.
Treatment is not satisfactory, but is largely the same as for common internal ophthalmia. Some cases, like rheumatism, are benefited by scruple doses of powdered colchicum and 2-dram doses of salicylate of soda twice a day. In other cases with marked hardness of the globe of the eye from intraocular effusion, puncture of the eye, or even the excision of a portion of the iris, has helped. During recovery a course of tonics (2 drams oxide of iron, 10 grains nux vomica, and 1 ounce sulphate of soda dailj') is desirable to invigorate the system and help to ward off another attack. The vulgar resort to knocking out the wolf-teeth and cutting out the haw can onl^^ be condemned. The temporary recovery would take place in one or two weeks though no such thing had been done, and the breaking of a small tooth, leaving its fang in the jaw, only increases the irritation.
CATARACT.
The common result of internal ophthalmia, as of the recurrent type, may be recognized as described under the first of these diseases. Its offensive appearance may be obviated by extraction or depression of the lens, but as the rays of light would no longer be projierly refracted, perfect vision would not be restored, and the animal would be liable to prove an inveterate shyer. If perfect blindness continued by reason of pressure on the nerve of sight, no shj'ing would result.
PALSY OF THE NERVE OF SIGHT — AMAUROSIS.
The causes of this affection are tumors or other disease of the brain implicating the roots of the optic nerve; injury to the nerve between the brain and eye; and inflammation of the optic nerve within the eye (retina), or undue pressure on the same from dropsical or inflammatory effusion. It may also occur from overloaded stom- ach, from a i)rofuse bleeding, and even from the pressure of the gravid womb in gestation.
The symptoms are wide dilatation of the jiupils, so a.s to exi:)ose fully the interior of the globe, the expansion remaining the same in light and darkness. Ordinary eyes when brought to the light have
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the pupils suddenly eontraot, and then dilate and contract alternately nntil tliej^ adapt themselves to the amount of light. The horse does not swerve Avhen a feint to strike is made unless the hand causes a current of air. The ears are held erect and turn quickly toward any noise, and the horse steps high to avoid stumbling over objects which it can not see.
Treatment is only useful when the disease is symptomatic of some removable cause, like congested brain, loaded stomach, or gravid womb. When recovery does not follow the termination of these con- ditions, apply a blister behind the ear and give one-half dram doses of nux vomica daily.
TUMORS OF THE EYEBALL.
A variety of tumors attack the eyeball — dermoid, jDapillary, fatty, cystic, and melanotic, but perhaps the most frequent in the horse is encephaloid cancer. This may grow in or on the globe, the haw, the eyelid, or the bones of the orbit, and is only to be remedied if at all by early and thorough excision. It may be distinguished from the less dangerous tumors by its softness, friability, and great vascularity, bleeding on the slightest touch, as well as by its anatomical structure.
STAPHYLOMA.
This consists in a bulging forward of the cornea at a given point by the saccular yielding and distension of its coats, and it maj^ be either transparent or oj^aque and vascular. In the last form the iris has become adherent to the back of the cornea, and the whole struc- ture has become filled with blood-vessels. In the first form the bulg- ing cornea is attenuated ; in the last it may be thickened. The best treatment is by excision of a portion of the iris so as to relieve the intra-ocular pressure.
PARASITES IN THE EYE.
Acari in the eye have been incidentally alluded to under inflam- mation of the lids.
The Filaria lachrymalis is a white worm, one-half to 1 inch long, which inhabits the lachrymal duct and the under side of the eyelids and haw in the horse, producing a verminous conjunctivitis. The first step in treatment in such cases is to remove the worm with for- ceps, then treat as for external inflammation.
The Filaria papiUosa is a delicate, white, silvery-looking worm, which I have repeatedly found 2 inches in length. It invades the aqueous humor, where its constant active movements make it an object of great interest, and it is frequently exhibited as a "snake in the eye." It is found also in other internal cavities of the horse, to which it undoubtedly makes its Avay f rom the food, and especially the
platf: XXX
if jc r fi^
Theoretical Section of the Horse's Eye n .Opdc nerve ; b, SclerotijC ; c,Owroict; d.,Retina. ,■ e.Comefi, f,Jris; g.h, CV/iaj^u circle , CorTijg/ime.nt J a/id^ processes giA'en offbi/ the choroid , t/ioux/h representx£f as isol/iteJ} from it, in ojyier- to indijcate their limits more cieu/i^/y tjizsertion of the nliary processes on ffie cj^i/stnUine Zens, j. Cri/sfaJZine lens, k, Chpstallinr capsule,- Z> Utreov^ l)ody; nv.n.Anierior 'and posierior chambers; o,Theo7vtical indication of the Tne^nbrane of the aqufou^ hiimoiir; p.p.Tar'si; q^q.Fih? ■mis membrane of the eJjeUcJs ; r,Elevntor muscle of the upper ef/elid; s,s,Orlnadaris naiscle of the ei/eUds; t,t, Skirt of the ei7eZi<Ls/ ii,(^jrm/iuictii'a., ^JSjjzdemur lairer of diis mejn7)rane c/n-ering tfte Corneo,y x,T'osteri/fr re-ctiis TJiijscJe ; I/, Sii/jerior rectus nuiscle / z^, Inferior rectus muscle. ,■ xv, Fffn^oiis shent/i of the oilnt (oT'orhitnJ membrnne ) .
"tco Marx. after DArlxA-al p:i71 A Hoen&Co Lith Baliimore
DlAGRAiMATIC N'KimCAL ShXmON THROTTGH K YE .
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water SAvallowecl, and its prevention is therefore to be sought mainly in the supply of pure water from close deep wells. When i)resent in the eye it causes inflammation and has to be removed through an inci- sion made with the lancet in the upper border of the cornea close to the sclerotic, the point of the instrument being directed slightly for-, ward to avoid injury to the iris. Then ajjply cold water or astringent lotions.
The echinococcus, the cystic or larval stage of the echinococcus tapeworm of the dog, has been found in the eye of the horse and a cysticercus {Cysticercus fistidaris ?) is also reported.
The Pentastoma t(Bnioides, which inhabits the nose of horse and dog, has been found by Stitten in the eye of the horse, but the case is unique.
LAMENESS-ITS CAUSES AND TREATMENT.
By Prof. A. LIAUTARD, M. D., V. M., Principal of the American Veterinanj College, Neir York.
The consideration of the usefulness and consequently of the value to their human masters of those of the Inferior animals ^vhich are classed as beasts of burden ultimately and naturally resolves itself into an inquiry into the condition of that special i^ortion of their organ- ism which controls the function of locomotion, for it is onlj^ as living, organized locomotive machines that the horse, the camel, the ox, and their burden-bearing companions are of practical value to man. This is especially true in regard to the members of the equine family, the most numerous and valuable of them all, and it naturally follows that with the horse for a subject of discussion the special topic and leading theme of inquiry will, by an easy lapse, become an inquest into the condition and efficiency of his power for usefulness as a carrier or traveler. There is a large amount of abstract interest in the study of that endowment of the animal economy which enables its possessor to change his ijlace at will and convey himself whithersoever his needs or his moods m.aj incline him; but how much greater the interest that attaches to the subject when it becomes a i)ractical and economic question and includes within its iDurview the various related topics which belong to the domains of x)hysiology, pathology, therapeutics, and the entire round of scientific investigation into which it is finally merged as a subject for medical and surgical consideration, in a word, of actual disease and its treatment. It is not surprising that the intri- cate and complicated apparatus of locomotion, with its symmetry and harmony of movement and the x^erfection and beauty of its details and adjuncts, sliould be admiringly denominated by students of cre- ative design and attentive observers of nature and her marvelous contrivances and adaptations a living macliine.
The horse in a state of domesticity is of all the animal tribe the largest sharer with his master in his liability to the accidents and dan- gers which are among the incidents of civilized life. From his expo- sure to the missiles of war on the battle-field to his chance of picking uj) a nail from the city pavement there is no hour- when he is not in danger of incurring injuries which may demand the best skill of the
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veterinarian j)ractitioner to repair. And this is not alone true of cas- ualties which belong to the class of external and traumatic cases, hut includes as well those of a kind perhaj^s nnore numerous, which may result in lesions of internal parts, frequentl}^ the most serious and obscure of all in their nature and effects.
The horse is too important a factor in the practical details of human life and fills too large a place in the business and i)leasure of the world to justify any indifference to his needs and his physical com- fort or neglect in respect to the preservation of his peculiar powers for usefulness. In this connection it is hardly necessary to allude to sentimental considerations of "humanitj^," so called — a word which too often becomes a wretched misnomer when one recalls the neg- lects, the mistreatment, the overtasking and other cruelties, in many instances tortures, of which he becomes the helpless victim. In enter- ing somewhat largely, therefore, upon a review of the subject, and treating in detail of the causes, the symptoms, the i^rogress, the treat- ment, the results, and the consequences of lameness in the horse, we are performing a duty which needs no word of apology or justi- fication. The subject explains and justifies itself, and is its own vindication and illustration if any are needed.
The function of locomotion is performed by the action of two prin- cipal systems of organs, known in anatomical and physiological terminology as pclssive and active, the muscles performing the active and the bones the passive portion of the movement, the necessary connection between the co-operating organism being effected by means of a vital contact by which the muscle is attached to the bone at cer- tain determinate xwints on the surface of the latter. These points of attachment appear in tlie form of sometimes an eminence, sometimes a depression, sometimes a border or an angle, or again as a mere roughness, but each perfectly fulfilling its purpose, while the necessary motion is provided for by the formation of the ends of the long bones into the requisite articulations, joints, or hinges. Every motion is the product of the contraction of one or more of the muscles, which, as it acts upon the bony levers, gives rise to a movement of extension or flexion, abduction or adduction, rotation or circumduction. The movement of abduction is that which passes from and that of adduc- tion that which passes toward the median line, or the center of the body. The movements of flexion and extension are too well under- stood to need defining. It is the combination and rapid alternations of these movements which produce the different j)ostures and various gaits of the living animal, and it is their interrui^tion and derange- ment, from whatsoever cause, which constitutes the pathological con- dition of lameness.
A concise examination of the general anatomy of these organs, however, must precede the consideration of the j^athologieal ques- tions pertaining to the subject. A statement such as we have just
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given, containing only the briefest hint of matters which, though not necessarily in their ultimate scientific minutiae, must be clearly com- prehended in order to acquire a symmetrical and satisfactory view of the theme as a practical collation of facts to be remembered, analyzed, applied, and utilized.
It was th-e great Bacon who wrote : ' ' The human body may be compared, from its complex and delicate organization, to a musical instrument of the most perfect construction, but exceedingh' liable to derangement." In its degree the remark is equally applicable to the equine body, and if we would keep it in tune and profit by its harmonious action Ave must at least acquaint ourselves with the rela- tions of its parts and the mode of their co-operation.
ANATOMY.
The bones, then, are the hard organs which in their connection and totality constitute the skeleton of an animal. They are of various forms, of which three — the long, the flat, and the small — are recog- nized in tlie extremities. These are more or less regular in their form, but i^reseut upon their surfaces a variety of aspects, exhibiting in turn, according to the requirement of each case, a roughened or smooth surface, variously marked with grooves, crests, eminences, and depressions, for the necessary muscular attachments, and, as before mentioned, are connected by articulations and joints, of which some are immovable and others of a movable kind.
The substance of the bones is composed of a mass of combined earthy and animal matter, surrounded by a fine, fibrous enveloping membrane (the periosteum) which is intimately adherent to the external surface of the bone, and is, in fact, the secreting membrane of the bony structure. The bony tissue proper is of two consistencies, the external portion being hard and " compact," and called by the latter term, while the internal, known as the ' ' spongy tissue " or " areolar," is also of a consistency corresponding with these descrip- tive terms. Those of the bones which possess this latter consistency contain also, in their spongy portion, the medullary substance known as marrow, which is deposited in large quantities in the interior of the long bones, and especially where a central cavity exists, called, for that reason, the medullary cavity. The nourishment of the bones is effected by means of what is known as the nutrient foramen, which is an opening established for the jjassage of the blood vessels which con- vey the necessary nourishment to the interior of the organ. There are other minutiae concerning the nourishment of the skeleton, such as the venous arrangement and the classification of their arterial ves- sels into several orders, which, though of interest as an abstract study, are not of sufficient practical value to refer to here.
The active organs of locomotion, the muscles, form, speaking gen- erally, the fleshy covering of the external part of the skeleton and
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surround the bones of the extremities. They varj' greatly in shape and size, being flat, triangular, long, short, or broad, and are variously and capriciously named, some from their shape, some from their situa- tion, and others from their use, and thus we have abductors and adduc- tors, the pyramidal and orbicular, the digastricus, the vastus, and the rest. Those which are under the control of the will, known as the vol- untary muscles, appear in the form of flesh}^ structures, red in color, and with fibers of various degrees of fineness, and are composed of ^fasciculi,'''' or bundles of fibers, united by connective or cellular tis- sue, each fasciculus being comiDosed of smaller ones, less in size, but united in a similar manner to compose the larger formations, each of which is enveloped by a structure of similar nature known as the sar- colemma. Many of the muscles are united to the bones b}- the direct contact of their fleshy fibers, but, in other instances, the body of the muscle is more or less gradually transformed into a cordy or mem- branous structiire kno^vn as the tendon or sinew, and the attachment is made by ver}^ short fibrous threads through the medium of a long tendinous band, which, passing from a single one to several other of the bones, effects its object at a point far distant from its original attachment. In thus carrying its action from one bone to another, or from one region of a limb to another, these tendons must necessarily have smooth surfaces over which to glide, either upon the bones them- selves or formed at their articulations, and this need is supplied by the secretion of the synovial fluid, a yellowish, unctuous substance, furnished by a jieculiar tendinous synovial sac, designed for the purj)ose.
Illustrations in point of the agency of the synovial fluid in assisting the sliding movements of the tendons may be found under their vari- ous forms at the shoulder joint, at the upper x)art of the bone of the arm, at the posterior part of the knee joint, and also at the fetlocks, on their posterior part.
As the tendons, whether singl}' or in company with others, pass over these natural pulleys they are retained in place by strong fibrous bands or sheaths, which are by no means exempt from danger of injury, as will be readily inferred from a consideration of their impor- tant special use as sujaports and reenforcements of the tendons them- selves, with which they must necessarily share the stress of whatever force or strain is brought to bear upon both or either.
"We have referred to that special formation of the external surface of a bone by which it is adapted to forma joint or articulation, either movable or fixed, and a concise examination of the formation and structure of the movable articulations will liere be in place. These are foi-med generally by the extremities of the long, or they may exist on the surfaces of the short bones; the points or regions where the contact occurs being denominated the articular surface, which assumes from this circumstance a considerable variety of aspect and
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form, being in one case comparatively flat and at another elevated; or as forming a j)rotruding head or knob, with a distinct convexity; and again jiresenting a corresponding depression or cavity, accurately adapted to comi)lete, by their coaptation, the ball and socket joint. The articulation of the arm and shoulder is an examj)le of the first kind, while that of the hip with the thigh bone is a perfect exhibition of the latter.
The structure whose oflice is the retention of the articulation in place, is the ligament. This is a white, inelastic, or yellowish texture, ]x»ssessing in some degree the opposite equality. In some instances it is of a corded or funicular shape, but consists in others of a broad membrane, in the first form serving to bind the bones more firmly together, and in the latter surrounding or inclosing, in whole or in part, the broad articulations, and calculated rather for the i^rotection of tlie cavity from intrusion bj' the air than for other security. These latter are usually found in connection with those of the joints which X>ossess a free and extended movement, but are also found accompa- U3"ing the funicular ligaments either suiTOunding and inclosing the joints or occupjang the interior of their structure, as inter articular, in which situation they secure the union of the several bones more firmly and effectively" than would be possible for the capsular liga- ment unassisted.
The universal need which pertains to all mechanical contrivances of motion has not been forgotten wliile providing for the perfect work- ing of the interesting piece of living machinery which x^erforms the function of locomotion, as we are contemj)lating it, and nature has con- sequently provided for obviating the evils of attrition and friction, and insuring the easy play and smooth movement of its parts, by the establishment of the secretion of the synovia, tlie vital lubricant of which we have before spoken, as a yellow, oily, or rather glairy secre- tion, which performs the indisx>ensable office of facilitating the play of the tendons over the joints and certain given i^oints of the bones. This fluid, which is deposited in a containing sac, the lining (serous) membrane of which forms the secreting organ, is of an excessivelj'' sensitive nature, and while it lines the inner face of the ligaments, both capsular and fascicular, is attached onlj^ upon the edges of the bones without extending upon their length or between the layers of cartilage which lie between the bones and their articular surfaces.
Our object in thus partially and concisely reviewing the structure and condition of the essential organs of locomotion has been rather to outline a sketch which may serve as a reference chart of the gen- eral features of the subject than to offer a minute descri^jtion of the parts referred to. Other j^oints of interest will receive due attention as we proceed with the illustration of our subject and examine the matters which it most concerns us to bring under consideration. The foundation of facts wliich we have thus far prepared will be found suflicientl}^ broad, we trust, to include whatever may be necessary to
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insure a ready comprehension of the essential matters which are to follow as our review is carried forward to completion. What we have said touching these elementary truths will jjrobably be sufficient to facilitate a clear understanding of the requirements essential to the perfection and regularity which characterize the normal j)erform- ance of the various movements which result in the accomplishment of the action of locomotion. So long as the bones, the muscles and their tendons, the joints with their cartilages, their ligaments and their syn- ovial structure; the nerves and the controlling influences which they exercise over all, with the blood vessels which distribute to every part, hoAvever minute, the vitalizing fluid which sustains the whole fab- ric in being and activity — so long as these various constituents and adjuncts of animal life preserve their normal exemption from disease, traumatism, and pathological change, the function of locomotion will continue to be performed with perfection and efficiency.
But on the other hand, let any element of disease become implanted in one or several of the parts destined for combined action, any change or irregularity of form, dimensions, location, or action occur in anj'^ portion of the apparatus — any obstruction or misdirection of vital power take place, any interference with the order of the phenomena of normal nature, any loss of harmony and lack of balance be betrayed, and we have in the result the condition of lameness.
DEFINITION OF LAMENESS.
Physiology. — Comprehensively and universally considered, then, the term lameness signifies any irregularity or derangement of the function of locomotion irrespective of the cause which produced it or the degree of its manifestation. However slightly or severely it may be exhibited, it is all the same. The nicest observation may be demanded for its detection, and it may need the most thoroughly trained i^owers of discernment to identify and locate it, as in cases where the animal is said to be fainting, tender, or to go sore. Or the patient may be so far affected as to refuse utterly to use an injured leg, and under compulsory motion keep it raised from the ground, and prefer to travel on three legs rather than to bear any i3ortion of his weight upon the afflicted member. In these two extremes, and in all the intermediate degrees, the patient is simply lame — pathognomonic minutiae being considered and settled in a place of their own.
These last two classifications of the condition of disabled function, of simple lameness and lameness on three legs, are very easy of detec- tion, but the first or mere tenderness, or soreness, may be very diffi- cult to identify, and at times very serious results have followed from the obscurity which has enveloped the early stages of the malady. For it may easily occur that in the absence of the treatment which an early correct diagnosis would have indicated, an insidious ailment may so take advantage of the lapse of time as to root itself too deeply
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into the economy to be suoverted, and oecome transformed into a dis- abling chronic case, or possibly one that is incurable and fatal. Hence the impolicy of depreciating early symptoms because they are unac- companied by distinct and pronounced characteristics, and from a lack of threatening appearances inferring the absence of danger. The possibilities of an ambush can never be safely ignored. An extra caution cost nothing, even if wasted. The fulfillment of the first duty of a practitioner, when introduced to a case, is not always an easy task, though it is too frequently expected that the diagnosis or " what is the matter " verdict will be reached by the quickest and surest kind of an " instantaneous process," and a sure prognosis, or "how will it end," guessed at instanter.
Usually the discovery that the animal is becoming lame is compar- atively an easy matter to a careful observer. Such a person "«all readily note the changes of movement which will have taken place in the animal he has been accustomed to drive or ride, unless they are indeed slight and limited to the last degree. But what is not always easy is the detection, after discovering the fact of an existing irregularity, of the locality of its point of origin, and whether its seat be in the near or off leg, or in the fore or the hind part of the body. These are questions too often wrongly answered, notwith- standing the fact that with a little careful scrutiny the point may be easily settled. The error, which is too often committed, of pronounc- ing the leg upon which the animal travels soundly as the seat of the lameness, is the result of a misinterpretation of the physiology of locomotion in the crippled animal. Much depends upon the gait with which the animal moves while under examination. The act of walk- ing is unfavorable for accurate observation, though, if the animal walks on three legs, the decision is easy to reach. The action of gal- loping will often, by the rapidity of the muscular movements and their quick succession, interfere with a nice study of their rhythm, and it is only under some peculiar circumstances that the examination can be safely conducted while the animal is moving with that gait. It is while the animal is trotting that the investigation is made with the best chances of an intelligent decision, and it is while moving with that gait, therefore, that the points should be looked for which must form the elements of the diagnosis.
Our first consideration should be the physiology of normal or healthy locomotion, that from thence we may the more easily reach our conclusions touching that which is abnormal, otherwise lameness, and by this process we ought to succeed in obtaining a clew to the solution of the first problem, to wit, in tuhich leg is the seat of the lameness?
A word of definition is here necessary, in order to render that which follows more easily intelligible. In veterinary nomenclature each two of the legs, as referred to in pairs, are denominated a biped. The
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four points occupied by tlie feet of the auinial while standing at rest, forming a square, the two fore legs are known as the anterior biped; the two hinder, the jjo.s/erior; the two on one side, the lateral; and one of either the front or hind biped with the opposite leg of the hind or front biped will form the diagonal hiped.
Considering, as it is proper to do, that in a condition of health each separate biped and each individual leg is required to i^erform an equal and uniform function and to carry an even or equ^l portion of the weight of the body, it will be readily appreciated that the result of this distribution will be a regular, evenly balanced, and smooth displacement of the body thus supported by the four legs, and that therefore, according to the rapidity of the motion in different gaits, each single leg will be required at certain successive moments to bear the weight which had rested upon its congener while it was itself in the air, in the act of moving; or, again, two different legs of a biped maj'- be called upon to bear the weight of the two legs of the opposite biped while also in the air in the act of moving.
To simplify the matter by an illustration, the weight of an animal may be placed at 1,000, of which each leg, in a normal and healthy condition, supports while at rest 250. When one of the fore legs is in action, or in the air, and carrying no weight, its 250 share of the weight will be thrown upon its congener or i)artner to sustain. If the two legs of a biped are both in action and raised from the ground, their congeners still resting in inaction, will carry the total weight of the other two, or 500. And as the succession of movements contin- ues, and the change from one leg to another or from one biped to another, as may be required by the gait, proceeds, there will result a smooth, even, and equal balancing of active movements, shifting the weight from one leg or one biped to another, with symmetrical pre- cision, and we shall be presented with an interesting example of the play of vital mechanics in a healthy organization.
Much jnay be learned from the accurate study of the action of a single leg. Normally, its movements will be without variation or failure. When at rest it will easily sustain the weight assigned to it, without showing hesitancy or betraying pain, and when it is raised from the ground in order to transfer the weight to its mate, it will perform the act in such a manner that when it is again placed upon the ground to rest it will bo with a firm tread, indicative of its ability to receive again the burden to be tlirown back upon it. In planting it upon the ground or raising it up again for the forward movement while in action, and again replanting it upon the earth, each move- ment will be the same for each leg and for each biped, whether the act be that of walking or trotting, or even of galloping. In short, the regular play of every part of the apparatus avIU testify to the existence of that condition of orderly soundness and efficient activity which is eloquently suggestive of the condition of vital integrity,
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which is simph' but comprehensively expressed Ijy the terms lieolth and soundness.
But let some change, though slight and ohscure, occur among the elements of the case, some invisible agenc}^ of evil intrude among the harmonizing processes going forward ; any disorder occur in the rela- tions of cooperating parts; anj'thing appear to neutralize the effi- ciencj^ of vitalizing forces ; any disability' of a limb to accept and to throw back upon its mate the iDortion of the weight which belongs to it to sustain, whether as the effect of traumatic accidents or other- wise; in short, whatever tends to defeat the purpose of nature in organizing the locomotive apparatus may be looked upon as a cause of lameness. And it is not the least of the facts which it is imi^ortant to remember that it is not sufficient to look for the manifestation of an existing discordance in the action of the affected limb alone, but that it is shared by the sound one, and must be searched for in that as well as the halting member, if the hazard of an error is to be avoided. The mode of action of the leg which is the seat of the lameness will vary greatly from that which it exhibited when in a healthy condition, and the sound leg will also offer important modifi. cations in the same three i^articulars before alluded to, to wit, that of resting on the ground, that of its elevation and forward motion, and that of striking the ground again when the full action of stepping is accomplished. Inability in the lame leg to sustain weight will imply excessive exertion by the sound one, and lack of facility or disposi- tion to rest the lame member on the ground will necessitate a longer continuance of that action on the sound side. Changes in the act of elevating the leg, or of carrying it forward, in both, Avill j)resent, however, entirely opposite conditions between the two. The lame member will be elevated rapidly, moved carefully forward, and returned to the ground with caution and hesitancy, and the contact with the earth will be effected as lightly as possible, while the sound liml) will rest longer on the ground, move boldly and rapidl}^ forward, and strike the ground promptly and forcibly. All this is due to the fact that the sound member carries more than its normal, healthy share of the weiglit of the body, a share wliich may be in excess from 1 to 250, and thus bring its burden to a figure varying from 251 to 500, all depending upon the degree of the existing lameness, whether it is simply a slight tenderness or soreness, or whether the trouble has reached a stage which compels the patient to the awkwardness of traveling on three legs.
That all this is not mere theory, but rests on a foundation of fact may l)e established by observing the manifestations attending a single alteration in the balancing of the ])ody. In health, the support and equilibrium of that mass of the body which is borne by the fore legs is equalized, and passes by regular alternations from the right to the left side, and vice versa. But if the left leg, becoming disabled,
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relieves itself by leaning, as it were, on the right, the latter becomes, consequently, i)ractically heavier, and the mass of the body will incline or settle upon that side. Lameness of the left side, therefore, means dropping or settling on the right, and vice versa. We emphasize this statement and insist upon it, the more from the frequency of the instances of error which have come under our notice, in which parties have insisted upon their view that the leg which is the seat of the lameness is that upon which he drops, and which the animal is usually supposed to favor.
HOW TO DETECT THE SEAT OF LAMENESS.
Properl}^ appreciating the remarks which have preceded, and fully comprehending the modus operandi and the true pathology of lame- ness, but little remains to be done in order to reach an answer to the question as to which side of the animal the lameness is seated, except to examine the patient while in action. We have already stated our reasons for preferring the movement of trotting for this i^urpose. In conducting such an examination the animal should be unblanketed, and held by a plain halter in the hands of a man who knows how to manage his paces, and preference should be given to a hard road for the trial. He is to be examined from various positions — from before, from behind, and from each side. Watching him as he approaches, as he recedes, and as he passes by, the observer should carefully study that important action which we have spoken of as the dropping of the body upon one extremity or the other, and this can readily be detected by attending closely to the motions of the head and of the hip. The head droiDS on the same side on which the mass of the body will fall, dropping towards the right when the lameness is in the left fore-leg, and the hip dropping in posterior lameness, also on the sound leg, the reversal of the conditions, of course, producing reversed effects. In other words, when the animal in trotting exhibits signs of irregularity of action,- or lameness, and this irregularity is accompanied by dropping or nodding the head, or depressing the hip on the right side of the body, at the time the feet of the right side strike the ground, the horse is lame on the left side. If the dropping and nodding are on the near side the lameness is on the off side.
But in a majority of cases the answer to the first question relating to the lameness of a horse is, after all, not a very difficult task. There are two other problems in the case more diflficult of solution and which often require the exercise of a closer scrutiny, and draw upon all the resources of the experienced practitioner to settle satis- factorily. That a horse is lame in a given leg may be easily deter- mined, but when it becomes necessary to pronounce upon the query as to what part, what region, what structure, is affected, the easy part of the task is ovei*, and the more difficult and important, because more obscure portion of the investigation has commenced — except, of
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course, in cases of which the features are too distinctlj^ evident to the senses to admit of error. It is true that by carefully noting the man- ner in which a lame leg is performing its functions, and closely scrutinizing the motions of the whole extremity, and especially of the various joints which enter into its structure; by minutely examining every part of the limb; by observing the outlines; by testing the change, if any, in temperature and the state of the sensibility— all these investigations may guide the surgeon to a correct localization of the seat of trouble, but he must carefully refrain from the adoption of a hasty conclusion, and above all, assure himself that he has not failed to make the foot, of all the organs of the horse the most liable to injury and lesion, the subject of the most thorough and minute examination of all the parts which compose the suffering extremity.
The greater liability of the foot than of any other part of the extremities to injury from casualties, natural to its situation and use, should always suggest the beginning of an inquiry, especially in an obscure case of lameness at that point. Indeed the lameness may have an apparent location elsewhere, when that is the true seat of the trouble, and the surgeon who, while examining his lame patient, discovers a ringbone, and satisfying himself that he has encountered the cause of the disordered action suspends his investigation with- out subjecting the foot to a close scrutiny, may deeply regret his neglect and inadvertence at a later day, when regrets willava^il noth- ing towards remedying the irreparable injury which has ensued upon his partial method of exploration. But, as in human pathological experience, there are instances when inscrutable diseases will deliver their fatal messages, while leaving no mark and making no sign by which they might be identified and classified, so it will happen that in the humbler animals the onset and progress of mysterious and unrecognizable ailments will at times baffle the best veterinarian skill, and leave our burden-bearing servants to succumb to the inevitable,' and suffer and perish in unrelieved distress.
DISEASES OF BONES. PERIOSTITIS— OSTITIS— EXOSTOSIS.
From the closeness and intimacy of the connection existing between the two principal elements of the bony structure while in health it frequently becomes exceedingly difficult, when a state of disease has supervened, to discriminate accurately as to the part primarily affected, and to determine positively whether the periosteum or the body of the bone is originally implicated. Yet a knowledge of the fact is often of the first importance, in order to secure a favorable result from the treatment to be instituted. It is, however, quite evident that m a majority of instances the bony growths which so frequently 59G1— HOR 10
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appear on the surface of their structure, to whicli tlie general term of ejcostosis is applied, have had their origin in an inflammation of the periosteum, or enveloping membrane, and known as periostitis. However this may be we have as a frequent result, sometimes on the length of the bone, sometimes at the extremities, and sometimes involving the articulation itself, certain bony growths, or exostoses, known otherwise by the term splint, ringhone, and spainn, all of which, in an important sense, may be finally referred to the j^erios- teum as their nutrient source and support, at least after their forma- tion, if not for their incipient existence. It is certain that inflamma- tion of the x)eriosteum is frequently referable to wounds and bruises caused by external agencies, and it is also true that it may jjossibly result from the s^^reading inflammation of surrounding diseased tis- sues, but in any case the result is uniformly seen in the deposit of a bony growth, more or less diif use, sometimes of irregular outline, and at others projecting distinctly from the surface from which it springs, as so commonly presented in the ringbone and the spavin. This con- dition of periostitis is often diiScult to determine. The signs of inflammation are so obscure, the swelling of the parts so insignificant, any increase of heat so imperceptible, and the soreness so slight, that even the most acute observer may fail to locate the point of its existence, and it is often long after the discovery of the disease itself that its location is x^ositivelj'' revealed by the visible presence of the exostosis. Yet the first question had been resolved, in discovering the fact of the lameness, while the second and third remained unan- swered, and the identification of the affected limb and the i^oint of origin of the trouble remained unknown until their palpable revela- tion to the senses. Wlien, by careful scrutiny, the ailment has been located, a resort to treatment must be had at once, in order to prevent, if possible, any further deposit of the calcareous structure and increase of the exostotic grow^th. With this view the apjjlication of water, either Avarm or cold, rendered astringent by the addition of alum or sugar of lead, will be 1)eneficial. The tendency to the formation of the bony growth, and the increase of its development after its actual formation, may often be checked by the application of a severe blister of Spanish fly. The failure of these means and the establishment of the diseased x^i'ocess in the form of chronic periostitis cause various clianges in the bone covered by the disordered membrane, and the result may be softening, degeneration, or necrosis, but more usually it is follow(Ml by the formation of the bony growths referred to, on the cannon bone, the coronet, the hock, etc. .
We first turn our attention to the si)lint, as certain bony enlarge- ments which are developed on the cannon bone, between the knee or the hock and the fetlock joint, are called. They arc found on the
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iiiside of the leg, from tlie knee, near to wnicli tliey are to he found, downward to about tlie lower third of the principal cannon bone! They are of various dimensions, and are readily perceptible both to the eye and to the touch. They vary considerably in size, ranging from that of a large nut downward to very small proportions. In searching for them tliey may be readily detected by the hand if they have attained sufficient development in their nsual situation, but must be distinguished from a small bony enlargement which may be felt at the lower third of the cannon bone, and is not a splint nor a patho- logical formation of any kind, but merely the normal development of the small cannon bone.
We have said that splints are to be found on the inside of the leg. This is true as a general statement, but it is not invariably so, and they occasionaUy appear on tlie outside. It is also true that they appear most commonly on the fore legs, but this is not exclusively the case, and they may at times be found on both the inside and outside of the hind legs. Usually a splint forms only a true exostosis, or a single bony growth, with a somewhat diffuse base, but neither is this invari- ably the case. In some instances they assume more important dimen- sions, and pass from the inside to the outside of the bone, on its pos- terior face, between that and the suspensory ligament. This form is termed the 2^egged splint, and constitutes a serious and permanent deformity, in consequence of its interference with the play of the fibrous cord which passes behind it, becoming thus a source of con- tinual irritation and consequently of permanent lameness.
A splint may tlius frequently become a cause of lameness though not necessarily in every instance; but it is a lameness possessing f cul- tures peculiar to itself. It is not always continuous, but at times assumes an intermittent character, and is more marked Avhen the ani- mal is warm than when he is cool. If the lameness is near the knee- joint, it is very apt to become aggravated when the animal is put to work, and the gait acquires then a peculiar character, arising from the manner in which the limb is carried outward from the knees down- wards, whicli is done by a kind of abduction of the lower part of the leg. Other symptoms, however, than the lameness and the presence of the splint, which is its cause, may be looked for in the samie connec- tion as those which have been mentioned as pertaining to certain evi- dences of periostitis, in the increase of the temperature of the part, with swelling and probably pain on pressure. This last symptom is of no little importance, since its presence or absence has in many cases formed the determining point in deciding a question of difficult diagnosis.
A splint being one of the results of periostitis, and the latter one of the effects of external hurts, it naturally follows that the parts Avhich are most exposed to blows and collisions will be those on which the splmt will most commonly be found, and it may not be improper.
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therefore, to refer to hurts from without as among the common causes of the lesion. But other causes may also be productive of the evil, and among these may be mentioned the overstraining of an immature organism by the imposition of excessive labor upon a young animal at a too early period of his life. The bones which enter into the for- mation of the cannon are three in number, one large and two smaller, which, during the youth of the animal, are more or less articulated, with a limited amount of mobility, but which become in maturity firmly joined by a rigid union and ossification of their inter-articular surface. If the immature animal is compelled, then, to j)erform exact- ing tasks beyond his strength the inevitable result will follow in the muscular straining, and perhaps tearing asunder of the fibers which unite the bones at their points of juncture, and it is difficult to under- stand how the natural consequences of such a local irritation develop- ing in inflammation or periostitis can be avoided. If the result were deliberately and intelligently designed it could hardly be more eflfect- uall}' accomiDlished.
The splint is an object of the commonest occurrence, so common, indeed, that in large cities a horse which can not exhibit one or more specimens upon some portion of his extremities is one of the rarest of spectacles. Though it is in some instances a, cause of lameness end its discovery and cure are sometimes beyond the abilitj^ of the shrev/dest and most experienced veterinarians, yet as a source of vital danger to the general equine organization, or even of functional dis- turbance, or of practical inconvenience, aside from the rare excep- tional cases which exist as mere samples of possibility, it can not be considered to belong to the category of serious lesions. The worst stigma that attaches to it is that in general estimation it is ranked among eyesores, and continues indefinitely to be that and nothing less or better. Thi inflammation in Avhich they originated, acute at first, either subsid^^s or assumes the chronic form, and the bony growth becomes a permanence, more or less established, it is true, but doing no positive harm, and not hindering the animal from continuing his daily routine of labor. All this, however, requires a proviso against the occurrence of a subsequent acute attack, when, as with other exostoses, a fresh access of acute symptoms may be followed by a new pathological activity which shall again develop as a natural result a reappearance of the lameness.
It is of course the consideration of the comparative harmlessness of splints that suggests and justifies the policy of non-interference, except as they become a positive cause of lameness. And a more positive argument for such non-interference consists in the fact that any active and irritating treatment may so excite the j)arts as to bring about a renewed pathological activity, which may result in a reduplication of the phenomena, with a second edition if not a sec- ond and enlarged volume of the whole story. For our part our faith
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is firm in the impolicy of interference, and this faith is founded on an experience of many years, during which our practice has been that of abstention.
Of course there will be exceptional conditions which will at times indicate a different course. These will become evident when tlie occa- sions present themselves, and extraordinary forms and effects of inflammation and growth in the tumors offer special indications. But our conviction remains unshaken that surgical treatment of the oper- ative kind is usually useless, if not dangerous. We have little faith in the method of extirpation except under very special conditions among which that of diminutive size has been named, which seems in itself to constitute a suflicient negative argument. But even in such a case a resort to the knife or the gouge could scarcely find a justifi- cation, since no operative procedure is ever without a degree of haz- ard, to say nothing of the considerations which are always forcibly negative m any question of the infliction of pain and the unnecessary use of the knife.
If an acute periostitis of the cannon bone has been readily dis- covered, the treatment we have already suggested for that ailment is at once indicated, and the astringent lotions may be relied upon to bring about beneficial results. Sometimes, however, preference may be given to a lotion possessing a somewhat different quality the alter- ative consisting of tincture of iodine applied to the inflamed spot several times daily. If the lameness persists under this mild course of treatment it must of course be attacked by other methods, and we must resort to the cantharidal ointment or Spanish-fly blister, as we have before recommended. Besides this, and producing an analogous effect the compounds of biniodide of mercury are favored bv some It is prepared m the form of an ointment, consisting of l" dram of the bimodide to 1 ounce of either lard or vaseline. It forms an excellent blistering and alterative application, and is of special advantage in newly formed or recently discovered exostosis.
It remains a pertinent query, however, and one which seems to be easily answered, whether a tumor so diminutive in size that it can only be detected by diligent search, and which is neither a disfio-ure- ment nor an obstruction to the motion of the limb, need receive any recognition whatever. Other modes of treatment for splints are rec- ommended and practiced which belong strictly to the domain of operative veterinary surgery. Among these are to be reckoned actual cauterization, or the application of the fire-iron and the operation of periosteotomy. These are frequently indicated in the treatment of splints which have resisted milder means.
The mode of the development of their growth; their intimacv greater or less, with both the large and the small cannon bones; the possibility of their extending to the back of these bones under tlie sus- pensory ligament; the dangerous complications which may follow the
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rouiili lumdling of the parts; with also a possibility, and indeed probability, of their return after removal, these are the considera- tions which have Influenced our judgment in discarding from our practice and our approval the method of removal by the saw or the chisel, as recommended by certain European veterinarians.
RINGBONES.
This peculiar term forms the designation of the exostosis which is found on the coronet, in the digital, and also in the phalangeal region, probably because it extends quite around the coronet, which it encir- cles in the manner of a ring, or perhaps because it often forms upon the back of that bone a regular osseous circlet, through which the back tendons obtain a passage. The dimensions which may be attained by these tumors and the places where they are usually devel- oped have caused their subdivision and classification into three vari- eties with the designations of liigh, middle, and loiv, though much can not be said as to the importance of such distinction. It is true that the ringbone or phalangeal exostosis may be found at various points on the coronet, in one case forming a large bunch on the upper part and quite close to the fetlock joint; then appearing on the very lower portion around the upper border of the foot; seen again on the extreme front of the coronet; or perhaps discovered on the very back of it The shape in which they commonly appear is favorable to their easv discoverr, their form when near the fetlock usually varying too much from the natural outlines of the part when compared with those of the opposite side to admit of error in the matter.
A ringbone when in front of the coronet, even when not very largely developed, assumes the form of a diffused convex swelling If situ- ated on the lower part, it will form a thick ring, encircling the upper portion of the foot; when found on the posterior part, a small sharp osseous growth somewhat projecting, sometimes on the inside and sometimes on the outside of the coronet, may comprise the entire
manifestation. i i •,, ^ovUr
As with splints, ringbones may result from severe labor m eaii} life before the process of ossification has been fully perfected ; or they ma^ be referred to bruises, blows, sprains, or other violence; or inju- ries of tendons, ligaments, or joints may be among the accountable accidents. It is certain that they may commonly be traced to dis- eases and traumatic lesions of the foot, and their appearance may be reasonably anticipated among the sequelae of an abscess of the coronet; or the cause may be a severe contusion resulting from calk^ in- or a deep-punctured wound from picking up a nail or stepping upon any hard object of sufficiently irregular form to penetrate the
'"^Moreover, a ringbone may claim to possess the character of a leg- acv-it maj' originate in heredity. This is a fact of no little impor- tance in its relation to questions connected with the extensive interests
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of the stock breeder and piircnaser. To regard a liability to transmit constitntional idiosyncrasies by. common propagation as a disease or a diathesis would be obviously unphilosophical; but to recognize the fact, in view of existing evidences, in connection with the affection we are considering, is but to render its due to the claims (^f honest conviction, and such a conviction we do not hesitate to own. That it is an active tendency in respect to diseases generally it would be absurd to claim. But we do claim that a disposition to contract this particular form of lesion may be transmitted from parent to offspring though in most cases only with sufficient vigor to impress a predispo- sition on the part of the latter. Yet in a smaller proportion of cases it may, in point of fact, constitute a force sufficient to act as a sec- ondary cause of developed disease, which may in due time become a visible ringbone.
The importance of this point when considered in reference to the policy which should be observed in the selection of breeding stock is obvious, and as the whole matter is within the control of the owners and breeders it will be their OAvn fault if the unchecked transmission of ringbones from one equine generation to another shall be allowed to continue. It is our belief that among the diseases which are known for their tendency to perpetuate and repeat themselves by individual succession, those of the bony structures stand first, and the inference from such a fact which would exclude every animal of doubtful sound- ness m its osseous apparatus from the stud list and the brood farm is too i)lain for argument.
Periostitis of the phalanges is an ailment requiring careful explora- tion and minute inspection for its discovery and is quite likely to result in a ringbone of which lameness is the effect. The mode of its manifestation varies according to the state of development of the diseased growth as affected by the circumstances of its location and dimensions. It is commonly of the kind which, in consequence of its intermittent character, is termed lameness irhen cool, having the pecu- liai^ty of exhibiting itself when the animal starts from the stable and of diminishing if not entirely disappearing after some distance of travel, to return to its original degree, if not indeed a severer one when he has again cooled oflE in his stable. The size of the rino-bone does not indicate the degree to which it cripples the patient, but the position may, especially when it interferes with the free movement of the tendons which pass behind and in front of the coronet YNHiile a large rmgbone will often interfere but little with the motion of the limb, a smaller growth, if situated under the tendon, may become the cause of considerable and continued pain.
A ringbone is doubtless a worse evil than a splint. Its growth its location, Its tendency to increased development, its exposure to 'the influence of causes of renewed danger, all tend to impart an unfavor- able cast to the prognosis of a case and to emphasize the importance
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and the value of an early discovery of its presence and possible growth. Even when the discovery has been accomplished it is often the case that the truth has come to light too late for effectual treatment. Months may have elapsed after the first manifestation of the lame- ness before a discovery has been made of the lesion from which it has originated, and there is no recall for the lapsed time. And by the uncompromising seriousness of the discouraging prognosis must the energy and severity of the treatment and the promptness of its administration be measured. The periostitis has been overlooked; any chance that might have existed for preventing its advance to the chronic stage has been lost; the osseous exudation is established; the ringbone is a fixed fact, and the indications are urgent and pressing. These include severe blistering once or twice repeated ; the application of the red iodide of mercury, and if these fail, firing with the hot iron, and as a last resort, neurotomy, high or low as indicated by the seat of the lesion.
SIDE-BONES.
On each side of the bone of the foot — the coffin-bone — there are normally two supplementary organs which are called the cartilages of the foot. They are soft, and though in a degree elastic, yet somewhat resisting, and are implanted on the lateral wing of the coffin-bone. Evidently their office is to assist in the elastic expansion and contrac- tion of the posterior part of the foot, and their healthy and normal action doubtless contributes in an important degree to the perfect performance of the functions of that part of the leg. These organs are, however, liable to undergo a process of disease which results in an entire change in their properties, if not in their shape, by which they acquire a character of hardness resulting from the deposit of earthy substance in the intimate structure of the cartilage, and it is this change, when its consummation has been affected, that brings to our cognizance the diseased growth which has received the designa- tion of side-bones. They are situated on one or both sides of the leg, bulging above the superior border of the foot in the form of two hard bodies composed of ossified cartilage, irregularly square in shape and unyielding vmder the pressure of the fingers.
The side-bone may be a termination of a low inflammatory condi- tion, or of an acute attack as well, or may be caused by sprains, bruises, or blows; or they may have their rise in certain diseases affecting the foot proper, as corns, quarter cracks, or quittor. The dejjosit of cal- careous matter in the cartilage is not always uniform, the base of that organ near its line of union with the coffin-bone being in some cases its limit, while at other times it is diffused throughout its substance, the size and prominence of the tumors varying much in consequence. It would naturally be inferred that the amount of interference with the proper functions of foot which must result from siich a patholog- ical change would be proportioned to the size of the tumor, and that as
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the dimensions increased, the resulting lameness would be the greater in degree. This, however, is not the fact. A small tumor, while in a condition of acute inflammation during the formative stage, may cripple a patient more severely than a much larger one in a later stage of the disease. In any case the lameness is never Avanting and with its intermittent character may usually be detected when the animal is cooled off after labor or exercise. The class of ani- mals in which this feature of the disease is most frequently witnessed is that of the heavy draft horse, and others similarl}- employed. There is a wide margin of difference in respect to the degrees of severity which may characterize different cases of side-bone. While one may be so slight as to cause no inconvenience, another may develop ele- ments of danger which ma}^ involve the necessity of severe surgical interference.
The curative treatment should be similar to the prophj^lactic, and such, means should be used as would tend to i)revent the deposit of bony matters hy checking the acute inflammation which causes it. The means recommended are the free use of the cold bath; frequent soaking of the feet, and at a later j)eriod treatment with iodine, either by i)ainting the surface with the tincture several times daily, or by applying an ointment made by mixing 1 dram of the crystals with 2 ounces of vaseline, rubbed in once a day for several daj^s. If this proves to be ineffective, a Spanish fly blister, to which a fen^ grains of biniodidc of mercury have been added, will, in a majority of cases, effect the desired result and remove the lameness. If, unally, this treatment is resisted, the case must be relegated to the surgeon for the operation of neurotomj-, or the application of the fire-iron, freely and deeply.
SPAVIN.
This affection, popularly- termed bone spavin, is an exostosis of the hock joint. The general impression is that in a spavined hock the bony growth should be seated on the anterior and internal part of the joint, and this is partially correct, as such a growth will consti- tute a spavin in the most correct sense of the term. But an enlarge- ment may appear on the upper part of the hock also, or possibly a little below the inner side of the lower extremity of the shank bone, forming what is known as a high spavin; or, again, the growth may form just on the outside of the hock and become an outside or external spavin. And, finally, the entire under surface may become the seat of the osseous deposit, and involve the internal face of all the bones of the hock, and this again is a Ijone spavin. There would seem, then, to be but little difiieulty in comprehending the nature of a bone spavin, and there would be none but for the fact that thei-e are similar affections which might confuse a diagnosis if not very carefully and intelligently made.
o9Gl— HOR 10*
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But the hock may be spavined, while to all outward observation it still retains its perfect form. With no enlargement tangible to sight or touch the animal may be disabled by an occult spavin, an anchylosis in fact, which has resulted from a union of several of the bones of the joint, and it is only those who are able to realize the importance of its action to the iierfect fulfillment of the function of propulsion b}' the hind leg, who can comprehend the gravity of the only prognosis which can be justified hy the facts of tlie case — a prognosis which is essen- tially a sentence of serious import in respect to the future usefulness and value of the animal. For no disease, if we except those acute inflammatory attacks upon vital organs to whickthe patient succumbs at once, is more destructive to the usefulness and value of a horse than a confirmed spavin. Serious in its inception, serious in its prog- ress, it is an ailment which, when once established, becomes a fixed condition which there is no known means of dislodging. The peri- ostitis, of which it is nearly always a termination, is usually the efiiect of a traumatic cause operating ui)on the complicated structure of the hock, such as a sprain which has torn a ligamentous insertion and lacerated some of its fibers; or a violent eflEort in jumping, galloping, or trotting, to which the victim has been compelled b}' the torture of whip and spur while in use as a gambling implement by a sporting owner, under the pretext of "improving his breed;" or the extra exertion of starting an inordinately heavy load; or an effort to recover his balance from a misstep; or slipping upon an icy surface; or slid- ing with worn shoes upon a bad pavement, and other kindred causes. And we can repeat liere what we have before said concerning bones, in respect to liereditA' as a cause. As to this, our own experience is an authority' -^we do know of equine families in which this con- dition has been transmitted from generation to generation, and ani- mals otherwise of excellent comformation rendered valueless by the misfortune of a congenital spavin.
The evil is one of the most serious character for other reasons, among which maj^be specified the slowness of its development and the insidiousness of its growth. Certain indefinite x)henomena and alarming changes and incidents furnish usually the only i)ortents of approaching trouble. Among these signs may be mentioned a peculiar posture assumed by the patient while at rest, and becoming at length so habitual that it can not fail to suggest the action of some hidden cause, tending to some undeterminable result. Tlie posture is due to the action of the adductor muscles, the lower part of the leg being carried inward, and the heel of the shoe resting on the toe of the opposite foot. Then an unwillingness may be noticed in the animal to move from one side of the stall to the other. When driven he will travel, but stiffly, and with a sort of sidelong gait between the shafts, and after finishing his task and resting again in his stall, will pose with the toe x>ointing forward, the heel raised, and the hock flexed.
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Some little heat and a considerable amount of inflammation soon appear. The slight lameness Avliich appears when backing out of the stall ceases to be noticeable after a short distance of travel.
A minute examination of the hock will then begin to reveal the existence of the lesion, in a bony enlargement which may be detected just at the junction of the hock and the cannon bone, on the inside and a little in front, and tangible both to sight and touch. This enlargement or hone spavin grows rapidly and persistently and soon acquires dimensions which render it impossible to doubt any longer its existence or its nature. Once established, its development con- tinues under conditions of j)rogress similar to those to which we have before alluded, in speaking of other like affections. The argument obtained by some that because these bony deposits are frequently found on both hocks they are not spavins, is fallacious. If they are discovered on both hocks, it proves merely that they are not confined to a single joint.
The characteristic lameness of bone spavin, as it affects the motion of the hock joint, presents two aspects. In one class of cases it is most pronounced when the horse is cool, in the other when he is at work. The first is characterized by the fact that when the animal travels the toe first touches the ground, and the heel descends more slowly, the motion of flexion at the hock taking place stiffly, and accompanied b}' a dropping of the hip on the opposite side. In the other case the peculiarity is that the lameness increases as the horse travels; that when he stops he seeks to favor the lame leg, and Avhen he resumes his work soon after he steps much on his toe, as in the first variety.
As with sidebones, though for a somewhat different reason, the dimensions of the spavin and the degree of the lameness do not seem to bear an}' determinate relation, the most pronounced symptoms at times accompanying a very diminutive growth. But the distinction between the two varieties of cool and warm may easilj' be determined hy remembering the fact that in a majority of cases the first, or cool, is due to a simple exostosis, wdiile the second is generally connected v>'it]i disease of the articulation, sucli as ulceration of tlie articular surface — a condition which, as we proceed further, will meet our attention when wo reach the subject of springhalt.
Having thus fully considered the historj^ of bone spavin Ave are prepared to give due weight to the reasons which exist for the adverse prognosis which Ave must usually feel compelled to pronounce Avhen encountering it in practice, as Avell as to realize the value of an early discoA'Cry of the symptoms which denote its invasion of the organism. It is but seldom, hoAvever, that the necessary advantage of this early knowledge can be secured, and A\dien the true nature of the trouble has become apparent it is usually too late to resort to the remedial measures Avhich, if duly forcAvarned, a skillful practitioner might have
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eniiiloyed. We are fully persuaded that but foi- the loss of the time wasted in the treatment of purely imaginary ailments very many cases of bone spavin might be arrested in their incipiency and their victims preserved for years of comfort for themselves and valuable labor to their owners.
To consider a hypothetical case: An early discovery of lameness has been made; that is, the existence of an acute inflammation — of periostitis — has been detected. The increased temperature of the parts has been observed, with the stiffened gait and the characteristic pose of the limb, and the question is proposed for solution, "What is to be done?" Even with only these comparatively doubtful symj)- toms — doubtful with the non-expert — we should direct our treatment to the hock in prefei'ence to any other joint, since of all the joints of the hind leg it is this which is most liable to be attacked, a natural result from its peculiarities of structure and function. And in ansAver to the querj^ "What is the first indication?" we should answer res! — emphatically, and as an essential condition, rest. Whether only threatened, susi^ected, or i^ositively diseased, the animal must be wholly released from labor, and it must be no partial or temporary quiet of a few days. In all stages and conditions of the disease, whether the sx)avin is nothing more than a simple exostosis, or v/hether accompanied by the complication of arthritis, there must be a total suspension of effort until the danger is over. Less than" a month's quiet ought not to be thought of — the longer the better.
Good results jway also be expected from local applications. The various lotions which cool the parts, the astringents which lower the tension of the blood vessels, the tejiid fomentations wliicli accelerate tlie circulation in the engorged capillaries, the liniments of various composition, the stimulants, the opiate anodjaies, the sedative prepa- rations of aconite, the alterative frictions of iodine — all these are recommended and prescribed by one or another. We prefer counter- irritants, for the simple reason, among many others, that the}^ tend by the pi^omptness of their action to prevent hy anticipation the for- mation of the bony deposits. The lameness will often yield to the blistering action of cantharides, in the form of ointment or liniment, and to the alterative preparations of iodine or mercury. And if the owner of a spavined horse really succeeds in removing the lameness, he has accomplished all that he is justified in hoping for; beyond this let him be well persuaded that a "cure" is impossible.
For this reason, moreover, he Avill do Avell to be on his guard against the patented "cures" which the traveling horse doctor may urge upon his credulity, and withhold his faith from the circular of the agent who Avill deluge him with references and certificates. It is possible that nostrums may in some exceptional instances prove serviceable, but the greater number of them are capable of producing only injuri- ous effects. The removal of the bony tumor can not be accomplished
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by any siicli means, and if a trial of these unknown compounds should be followed b}' complications no worse than the establishment of one or more ugly, hairless cicatrices, it will be well for both the horse and his owner.
Rest and counter-irritation, with the j^roper medicaments, consti- tute, then, the prominent points in the treatment designed for the relief of bone spavin. Yet there are cases in which all the agencies and methods referred to seem to lack effectiveness and fail to produce sat isf actor}'" results. Either the rest has been prematurelj^ inter- rupted, or the blisters have failed to righth' modif}' the serous infil- tration, or the case in hand has some undiscernible characteristics which seem to have rendered the disease neutral to the agencies emplo3"ed against it. An indication of more energetic means is then presented, and free cauterization with the fire-iron becomes necessary.
At this point a word of explanation in reference to this operation of firing may bs approj)riale for the satisfaction of any among our readers who maj' entertain an exaggerated idea of its severity and possible cruelty.
The operation is one of simplicity, but is nevertheless one which, in order to secure its benefits, must be reserved for times and occa- sions of which only the best knowledge and highest discretion should be allowed to judge. It is not the mere application of a hot iron to a given i^art of the body Avhich constitutes the operation of firing. It is the methodical and scientific introduction of heat into the structure with a view to a given effect upon a diseased organ or tissue bj^ an expert surgeon. The first is one of the degrees of mere burning. The other is scientific cauterization, and is a surgical manipulation Avhich sliould be committed exclusively to the practised hand of the veter- inary surgeon.
Either firing alone or stimulation v\ith blisters is of great efficacy for the I'elief of lameness from bone spavin. Failure to produce relief after a few applications and after allowing a sufficient interval of rest should be followed by a second, or, if needed, a third firing.
In case of further failure there is a reserve of certain special oper- ations which have been tried and recommended, among which those of tarsal tenotom}^ periosteotomy, the division of nervous branches, etc., may be mentioned. These, however, belong to the peculiar domain of the veterinary practitioner, and need not now engage our attention.
FRACTURES.
In technical language a fracture is a " solution of continuity in the structure or substance of a bone," and it ranks among the most seri- ous of the lesions to which the horse — or any animal — can be subject. It is a subject of special interest to veterinarians, and to horse own- ers as well, in view of the vai-iety of forms in which it may occur, as
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well as of the loss of time to wliicli it subjects the patient, and the consequent suspension of his earning capacity. Though of less seri- ous consequence in the horse than in man, it is always a matter of grave import. It is always slow and tedious in healing, aud is fre- quently of doubtful and unsatisfactory result.
This solution of continuity may take place in two x>rincipal ways. In the most numerous instances it includes the total thickness of the bone and is a complete fracture. In other cases it involves a portion only of the thickness of the bone, and for that reason is described as incomplete. If the bone is divided into two separate portions, and the soft parts have received no injury, the fracture is a simple one; or it becomes compoimd if the soft jmrts have suffered laceration, and comminuted if the bones have been crushed or ground into fragments, many or few. The direction of the break also determines its further classification. Broken at a right angle it is transverse; at a different angle it becomes oJjUque, and it may be longitudincd or lengthwise. In a complete fracture, especially of the oblique kind, there is a con- dition of great importance in respect to its effect upon the ultimate result of the treatment in the fact that from various causes, such as muscular contractions or excessive motion, the bony fragments do not maintain their mutual coaptation, but become separated at the ends, and this fact has made it necessary to add another descriptive term in the words ivifli displacement. And this term again suggests its negative, and introduces the fracture without displacement, when the facts justify that description. Again, a fracture may be intraarticu- lar ov extraarticular, as it extends within a joint or otherwise, and once more, intra-periostecd, when the periosteum remains intact. And, finally, there is no absolute limit to the use of descriptive ter- minology in the case.
The condition of displacement is largely influential in determining the question of treatment, and as affecting the finalresult of a case of fracture. This, however, is dependent upon its location or whether its scat be in one or more of the axes of the bone, in its length, its breadth, its thickness, or its circumference. An incomplete fracture may also be either simple or comminuted, the periosteum, in the latter case when it is intact, keeping the fragments together, the fracture in that case belonging to the intra-periosteal class. At times, also, there is only a simple fissure or split in the bone, making a condition of much difficulty of diagnosis.
Two varieties of originating cause may be recognized in cases of fracture. They are the precZ/s^Jos/nr/ and iha occasional. As to the first, different species of animals differ in the degree of their liability. That of the dog is greater than that of the horse, and, in horses, the various questions of age, the mode of labor, the season of the year, tlic portion of the body most exposed, and the existence of ailments, local and general, are all to be taken into account.
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Among horses, those employed in neavy draught work or that are driven over had roads are more exposed than light-draught or saddle horses, and animals of different ages are not eqnall}" liable. Dogs and young horses, with those which have become sufficiently aged for their bones to have acquired an enhanced degree of frangibility, are more liable than those which have not exceeded the time of their adult prime. The season of the year is undoubtedlj^, though in an incidental way, an important factor in the jDroblem of the etiology of these accidents, for though they may be observed at all times, it is during the months Avhen the slippery condition of the ic}' roads renders it difficult for both men and beasts to keep their feet that they occur most frequently. The long bones, those especiallj^ which belong to the extremities, are most frequently the seat of fractures, from the circumstance of their superficial j^osition, their exposure to contact and collision, and the violent muscular efforts involved both in their constant rapid movement and their labor in the shafts or at the pole of heavy and heavily laden carriages.
The relation between sundrj^ idiosyncrasies and diatheses and a lia- bility to fractures is too constant and well established a pathological fact to need more than a x)assing reference. The history of rachitis, of melanosis, and of osteo-porosis, as related to an abnormal frangi- bility of the bones, is a iiart of our common medical knowledge. There are few persons who liave not known of cases among their friends of frequent and almost si)ontaneous fractures, or at least of such as seem to be j)roduced bj^ the slightest and most inadequate vio- lence, and there is no tangible reason for doubting an analogous condition in individuals of the equine constitution. Among local predisposing affections mention must not be omitted of such bony dis- eases as caries, tuberculosis, and others of the same class.
Occasional or "efficient" causes of fracture are inmost instances external traumatisms, as violent contacts, collisions, falls, etc., or sudden muscular contractions. These external accidents are various in their character, and are usually associated with quick muscular exertion. A violent, ineffectual effort to move too heavy a load; a semispasmodic bracing of the frame to avoid a fall or resist a i)res- sure; a quick jump to escape a blow; stojij^ing too suddenly after speeding; struggling to liberate a foot from a rail, i^erhaps to be thrown in the effort — all these are familar and easy examples of acci- dents happening hourlj^ by which our equine servants become suffer- ers. We ma}" add to these the fracture of the bones of the vertebra, occurring when casting a patient for the j^urpose of undergoing a surgical operation, quite as much the result of muscular contraction as of a i)reexisting diseased condition of the bones. A fracture occurring under these circumstances may be called with propriety indirect, while one which has resulted from a blow or a fall differently caused is of the direct kind.
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We now return to the Jirst items in onr classification of tlie varie- ties of lameness, for the purpose of bringing them in turn under an orderly revicAV, and our first examination will include those which belong to the first category, or the complete kind. Irregularity in the performance of the functions of the apparatus to Avhich the fractured bone belongs is a necessary consequence of the existing lesion, and this is lameness. If the broken bone belongs to one of the extremities, the impossibility of the performance of its natural function, in sus- taining the weight of the body and contributing to the act of locomo- tion, is usually complete, though the degree of iDowerlessness avIU vaiy according to the kind of fracture and the bone which i:i injured. •For example, a fracture of the cannon bone without displacement, or of one of the x^halanges which are surrounded and sustained by a complex fibrous structure, is, in a certain degree, not incompatible with some amount of resting of the foot. But on the contrary, if the shank bone, or that of the forearm be the implicated member, it would be verj^ difficult for the leg to exercise any agency whatever in the support of the body. And in a fracture of the lower jaw it would be obviously futile to expect it to contribute materially to the masticji- tion of food.
A fracture seldom occurs which is not accompanied witli a degree of deformity, greater or less, of the region or the leg affected. This is due to the exudation of the blood into the meshes of the surround- ing tissues and to the displacement which occurs between the frag- ments of the bones, with subsequentlj^ the swelling which follows the inflammation of the surrounding tissues. The character of the deformit}^ will mainly depend upon the manner in which the displace- ment occurs.
In a normal state of things the legs perform their movements with the joints as their only centers or bases of action, witli no i^articipa- tion of intermediate points, while with a fracture the flexibility and motion which will be observed at unnatural points are among the most strongly characteristic signs of the lesion. No one need be told that when the shaft of a limb is seen to bend midway between the joints, with the lower portion swinging freel}^, that the leg is broken. But there are still some conditions where the excessive mobilit}^ is not easj' to detect with certainty. Such are the cases where the fracture exists in a short bone, near a movable joint, or in a bone. of a region where several short and small bones are united in a group, or even in a long bone where its situation is such that the muscular covering prevents the visible manifestation of the sj^mptom.
If the situation of a fracture pi'ecludes its discovery by means of this abnormal flexibility, other detective methods remain. And after all there is one decisive sign which, though it may not avail in every case, as it does not, is in cases where its testimony can be secured absolute and positive beyond question. This is crepiirdiou, or the
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X)eculiar effect which is produced by the friction of the fractured sur- faces one against another. Though discerned by the organs of hear- ing it can scarcely be called a so and, for the grating of the parts as the rubbing takes place is more felt than heard, but tliere is no mis- taking its iinijort in cases favorable for the application of the test. The conditions in which it is not available are those of incomplete fracture, in which the mobility of the parts is lacking, and those in which the whole array of phenomena are usually obscure. To obtain the benefit of this pathognomonic sign recxuires deliberate, careful, and gentle manipulation. Sometimes the slightest of movements wiU be sufficient for its development, after much rougher handling has failed to discover it. Perhaps the failure in the latter case is due to a sort of defensive spasmodic rigidity caused by the pain resulting from the rude interference.
]\[ore or less reactive fever is a usual accompaniment of a fracture, and an ecch3nnosis of the parts is but a natural occurrence, more easil}^ discovered in animals iDOSsessing a light colored and delicate skin than in those of the opposite character.
There are difficulties in the way of the diagnosis of an incomplete fracture, even sometimes when there is a degree of impairment in the function of locomotion, with evidences of pain and swelling at the seat of lesion. There should then be a careful examination for evi- dences of a blow or other viol'euce sufficient to account for the fracture, though ver}^ often a suspicion of its existence can only be converted into a certainty by a minute history of the patient if it can be obtained up to the moment of the occurrence of the injury. A diagnosis ought not to'be hastily pronounced, and where good ground for suspicion exists it ought not to be rejected upon any evidence less than the best. Serious and fatal complications are too often recorded of the results following careless conclusions in similar cases, among which we may refer to one instance of a complete fracture manifesting itself in an animal during the act of rising up in his stall after a decision had been IDronounced that he had no fracture at all.
Fractures are of course liable to complications, those especially, from the nature of the case, which are of a traumatic character, such as extensive lacerations, tearing of tissues, i)unctures, contusions, etc. But unless these are in communication with the fracture itself the indication is to treat them sinii)ly as independent lesions upon other parts of the body. A traumatic emphysema will at times cause trouble, and abscesses, more or less deep and diffused, maj^ follow. In some cases small bony fragments from a comminuted fracture, becoming loose and acting as foreign bodies, may give rise to troublesome fistu- lous tracts. A frequent complication is hemorrhage, which often becomes of serious consequence. A fracture in close proximitj^ to a joint may be accompanied hy dangerous inflammations of important organs, and induce an attack of pneumonia, pleurisy, arthritis, etc..
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as well as luxations or dislocations, and the more so if situated near the chest. GcuKjrene, as a consequence of contusions or of hem- orrhage or of an impediment to the circulation, caused by unskillf ully applied apparatus, must not be overlooked fimong the occasional inci- dents; nor must JocVjciw, which is not an uncommon occurrence. Even founder or laminitis has been met with as the result of forced and long continued immobility of the feet in the standing posture, as one of the involvements of unavoidably protracted treatment.
When a simple fracture has been properly treated and the broken ends of the bone have been securely held in coaptation one of two things will occur. Either — and this is the more common event — there will be a union of the two ends by a solid cicatrix, the callus, or the ends will continue separated or become only partially united by an intermediate fibrous structure. In the first instance the fracture is consolidated, or united; in the second there is a false articulation, or pseudarthrosis.
The time required for a firm union or true consolidation of a fracture will vary with the character of the bone affected, the age and consti- tution of the patient, and the general conditions of the case. The union Avill be perfected earlier in a young than in an adult animal, and sooner in the latter than in the aged, and a general healthy con- dition is of course, in every respect, an advantage.
Tlie mode of cicatrization, or method of i-epair in lesions of the bones, has been a subject of much study among investigators in pathology, and has elicited various expressions of opinion from those high in authority. But the weight of evidence and preponderance of oj)inion are about settled in favor of the theory that the law of reparation is the same for both the hard and the soft tissues. In one case a simple exudation of material, with the proper organization of newly formed tissue, will bring about a union by the first intention, and in another the Avork will be accompanied by supjjuration, or the union by the sec- ond intention, a i)rocess so familiar in the repair of the soft structures by granulation.
Considering the process in its simplest form, in a case in which it advances without interruption or complication to a favorable result it may probably be correctly described in this wise :
On the occurrence of the injurj^an effusion of blood takes place be- tween the ends of the bone. The coagulation of the fluid soon fol- lows, and this, after a few days, undergoes absorption. There is then an excess of inflammation in the surrounding structure, which soon spreads to the bony tissue, when a true ostitis is established, and the compact tissue of the bone becomes the seat of a ucav vascular organi- zation, and of a certain exudation of iflastic lymph, appearing between the periosteum and the external surface of the bone, as well as on the inner side of the medullary cavity. After a few days the ends of the l)one thus surrounded by this exudate become involved in it, and
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tlie lymj)h, becoming- vascular, is soon transformed into cartilaginous, and in duo time into bony tissue.
Thus the time required for the consolidation of the fractured seg- ments is divisible into tAvo distinct jieriods. In the first they are sur- rounded by an external bony ring, and the medullary cavitj' is closed by a bony plug or stopper, constituting the period of the provisional callus. This is followed by the period of permanent callus, during which the process is going forward of converting the cartilaginous into the osseous form.
The restorative process is sooner completed in the carnivorous than in the herbivorous tribes. In the former the temporary callus may attain sufficient fineness of consistency' for the careful use of the limb witliin four weeks, but with the latter a period of from six weeks to two months is not too long to allow before removing the supporting apparatus from the limb.
This in general terms represents the fact when the resources of nature have not been thwarted by untoward accidents, such as a want of vigor in the constitution of the patient or a lack of skill on the i)art of the practitioner, and esx)ecially when, from any cause, the bony fragments have not been kept in a state df x^erfect immobility and the constant friction has prevented the osseous union of the two portions. Failures and misfortunes are always more than possible, and instead of a solid and practicable bony union the sequel of the accident is sometimes a /aZse JO /«^, composed of mere flexible cartilage, a poor pseudartlirosis. The explanation of this appears to be that, first, the sharp edges of the ends of tlie bone disappear hj becoming rounded at their extremities by friction and j)olishing against each other. Then follows an exudation of a plastic nature which becomes transformed into a cartilaginous layer of a rough articular aspect. In this bony nuclei soon appear, and the lymph secreted between the segments thus transformed, instead of becoming truly ossified, is changed into a sort of fibro-cartilaginous pouch or capsular sac, in which a somewhat albuminous secretion, or pseudo-synovia, permits the movement to take place. Most commonly, however, in our ani- mals, the union of the bonj- fragments is obtained wholly through the medium of a layer of fibrous tissue, and it is because the union has been accomplished by a ligamentous formation only that motion becomes practicable.
The j)rognosis in a case of fracture in an animal is one of the gravest vital import to the patient, and therefore of serious i)ecuniary concern to his owner. The X)eriod has not long elapsed when to have received siich a hurt was quite equivalent to undergoing a sentence of death for the suffering animal, and j)erhaps to-day a similar verdict is iiro- nounced \i\ many cases in which the exercise of a little mechanical ingenuity, Avith a due amount of careful nursing, might secure a contrary result and insure the return of the patient to his former
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condition of soundness and usefulness. Considered per se, a fracture in an animal is in fact no less amenable to treatment than the same description of injury in any other living being. But the question of the propriet}^ and exi)ediency of treatment is dependent upon certain si^ecific points of collateral consideration.
First. The nature of the lesion itself is a point of paramount imjjor- tance. A simple fracture occurring in a bone where the ends can be firmly secured in coaj^tation presents the most favorable conditions for successful treatment. If it be that of a long bone it will be the less serious if situated at or near the middle of its length than if it were in close proximity to a joint, from the fact that perfect immo- bility can rarely, in the latter case, be secured without incurring the risk of subsequent rigidit}^ of the joint.
A simple is always less serious than a comiDound fracture. A com- minuted is always more dangerous than a simple, and a transverse break is easier to treat than one which is oblique. The most serious are those which are situated on parts of the body in which it is difu- cult to secure perfect immobility, and especially those which are accompanied by severe contusions and lacerations in the soft parts; the protrusion of fragments* through the skin; the division of blood vessels by the broken ends of the bone; the existence of an articula- tion near the point to which inflammation is likely to extend; the luxation of a fragment of the bone; laceration of the i^eriosteum; the presence of a large number of bony particles, the result of the crushing of the bone — all these are circumstances which discourage a favorable i^rognosis, and weigh against the hope of saving the patient for future usefulness.
Fractures which may be accounted curable are those which are not conspicuously visible, as those of the ribs, where displacements are either very limited or do not occur, the jjarts being kept in situhy t\\Q nature of their position, the shape of the bones, the articulations they form with the vertebra, the sternum, or their cartilages of prolonga- tion; those of transverse processes of the lumbar vertebra; those of the bones of the face ; those of the ilium ; and that of the coffin bones. To continue the category, they are evidently curable when their posi- tion an'1 the character of the patient contribute to aid the treatment. Those ol' the cranium, in the absence of cerebral lesions; those of the jaws; of the ribs, wilh displacement; of the hip; and those of the bone of the leg in movab e region ^ but Avhere their vertical position admits of j)erfect coaptation.
On the contrary, a compound, complicated, or comminuted fracture, in whatever region it may be situated, may be counted incurable.
In treating fractures time is an important element and "delays are dangerous." Those of recent occurrence unite more easily and more regularly than older ones.
Second. As a general rule, fractures are less serious in animals of the smaller species than in those of more bulky dimensions. This
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influence of species ^\'i\\ he readily appreciated when we realize that the difficulties involved in the treatment of the latter class have hard!}' any existence in connection with the former. The difference in weight and size, and consequent facility in handling, and making the necessary applications of dressings and other appliances for the \)nv- pose of securing the indispensable immobility of the parts, and nsu- .alh" a less degree of uneasiness in the deportment of the patients are considerations in this connection of great weight.
Third. In respect to the utilization of the animal, the most obvious point in estimating the gravity of the case in a fracture accident is the certainty of the total loss of the services of the patient during treatment — certainly for a considerable period of time, perhaps per- manently. For example, the fracture of the jaw of a steer just fat- tening for the shambles will involve a heavier loss than a similar accident to a horse. Usually the fracture of the bones of the extrem- ities in a horse is a very serious casualty, the more so proportionately as the higher region of the limb is affected. In working animals it is exceedingly difficult to treat a fracture in such a manner as to restore a limb to its original perfection of movement. A fracture of a single bone of an extremity" in a breeding stallion or mare will not necessarily impair their value as breeders. Other specifications under this head, though pertinent, and more or less interesting, may bo omitted.
Foiirih. Age and temper are important factors of cure. A young, growing, robust patient, whose vis vifce is active, is amenable to treat- ment which one with a waning constitution and j)ast mature energies would be unable to endure, and a docile, quiet disposition will act cooperatively with remedial measures which would be neutralized by the fractious opposition of a peevish and intractable sufferer.
The fulfillment of three indications is indispensable in all fractures. The first is the reduction, or the replacement, of the parts as nearly as possible in their normal position. The second is their retention in that position for a period sufficient for the formation of the provisional callus, and the third, which in fact is but an incident of the second, the careful avoidance of any accidents or causes of miscarriage which might disturb the curative process.
In reference to the first consideration, it must be remembered that the accident may befall the patient at a distance from his home, and his removal becomes the first duty to be attended to. Of course this must be done as carefully as possible. If he can be treated on the sj)ot so much the better, though this is seldom practicable, and the method of removal becomes the question calling for settlement. But two ways present themselves — he must either walk or be carried. If the first, it is needless to say that every caution must be observed in order to obviate additional pain for the suffering animal, and to avoid any aggravation of the injury. Led slowly, and with partial support if practicable, the journej^ will not always involve untoward results.
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If he is carried it must be by means of a wagou, a truck, or an ambu- lance; the latter, being designed and adapted to the purpose, Avould of course be the preferable vehicle. As a precaution which should never be overlooked, a tem]3orary dressing should first be applied. This may be so done as for the time to answer all the purpose of the permanent adjustment and bandaging. Without thus securing the patient, a fracture of an inferior degree may be transformed to one of the severest kind, and, indeed, a curable changed to an incurable injury. We recall a case in which a fast trotting iiorse, after run- ning away in a fright caused b}' the whistle of a locomotive, was found on the road limping Avith excessive lameness in the off fore leg, and walked with comparative ease some 2 miles to a stable before being seen by a surgeon. His immediate removal in an ambulance was advised, but before that vehicle could be procured the horse laid down, and upon being made to get upon his feet was found with a well-marked comminuted fracture of the os suffraginis, with consid- erable displacement. The patient, however, after long treatment, made a comparatively good recovery and though with a large bony dei)osit, a ringbone, was able to trot a^nong the forties.
The two obvious indications in cases of fracture are reduction, or replacement, and retention.
In an incomplete fracture, where there is no displacement, the ne- cessity of reduction does not exist. With the bone kept in place by an intact periosteum, and the fragments secured by the uninjured fibrous and ligamentous structure which surrounds them, there is no dislocation to correct. It is also at times rendered impossible by the seat of the fracture itself, by its dimensions alone, or by the resist- ance arising from the muscular contraction excited by the surgical manipulation. Tliis is illustrated even in small animals, as in dogs, by the exceeding difficulty encountered in bringing the ends of a broken femur or humerus together, the muscular contraction being even in these animals sufficiently forcible to renew the displacement.
It is generall}', therefore, onl}' fractures of the long bones, and then at points not in close proximity to the trunk, that may be considered to be amenable to reduction. It is true that some of the more sui^erfi- cial bones, as those of the head, of the pelvis, and of the thoracic walls, may in some cases require special manipulations and appliances for their retention in their normal positions, but the treatment of these and of a fractured leg can not be the same.
The methods of accomplishing reduction vary with the features of each case, the manipulations being necessarilj^ modified to meet changing circumstances. If the displacement is in the thickness of the bone, as in transverse fracture, the manipulation of reduction consists in applying a steady pressure upon one of the fragments, while the other is kept steady in its place, the object of the pressure being the reestablishment of the exact coincidence of the two bony
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siirfa,ces. If the displacemeut has taken plaec at an angle it will be sufficient in order to effect the reduction to x)ress upon the summit or apex of the angle until its disappearance indicates that the parts have been brought into coaptation. This method is often i)racticed in the treatment of a fractured rib. In a longitudinal fracture, or when the fragments are pressed together by the contraction of the muscles to which they give insertion until thej^ so overlap as to correspond by certain i)oints of their circumference, the reduction is to be accom- plished by effecting the movements of extension, counter-extension, and coaptation. Extension is accomplished by making traction upon the lower i^ortion of the limb. Counter-extension consists in firmly holding or confining the upper or bodj' portion in such a manner that it shall not be affected by the traction applied to the lower; in simj)ler language, holding it motionless against the force exercised in the extension. In other words, the operator, grasping the limb below the fracture, draws it down or away from the trunk, while he seeks, not to draw away, but simi)ly to hold still the upper portion until the broken ends of bone are brought to their natural relative positions, when the coaptation, which is thus effected, has only to be made per- manent by the proper dressings to perfect the reduction.
In treating fractures in small animals the strength of the hand is usually' sufficient for the required manipulations. In the fracture of the forearm of a dog, for example, while the upper segment is firmly held by one hand the lower may be grasped by the other and the bone itself made to serve the purpose of a lever to bring about the desired coaptation. In such a case that is sufficient to overcome the muscular contraction and correct the overlapping or other malposition of the bones. If, however, the resistance can not be overcome in this mode, the upper segment may be committed to an assistant for the manage- ment of the counter extension, leaving to the operator the free use of both hands for the further manipulation of the case.
But if the reduction of fractures in small animals is an easy task, it is far from being so when a large animal is the x>atient, whose mus- cular force is largely greater than that of several men combined. In such a case resort must be had not only to superior numbers for the necessary force, but in many cases to mechanical aids. A reference to the mode of proceeding in a case of fracture with displacement of the forearm of a horse will illustrate the matter. The j)atient is first to be carefully cast, on the uninjured side, with ropes, or a broad leather strap about 18 feet long, passed under and around his body and under the axilla of the fractured limb and secured at a point oiDposite to the animal and toward his back. This will form the mechanical means of counter extension. Another rope will then bo placed around the inferior part of the leg below the point of frac- ture, with which to produce extension, and this will sometimes be fur- nished with a block or pulleys, in order to augment the power when
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necessary, and there is, in fact, always an advantage in their nse, on the side of steadiness and uniformity, as well as of increased x^ower. It is secured around the fetlock or the coronet, or, what is better, above the knee and nearer the point of fracture, and is committed to assist- ants. The ti-action on this should be firm, uniform, and slow, with- out relaxing or jerking, while the operator carefully watches the process. If the bone is superficially situated he is able to judge by the eye of any changes that may occur in the form or length of the parts under traction, and discovering at the moment of its happening the restoration of symmetry in the disturbed region, he gently but firmly manipula,tes the place until all appearance of severed conti- nuit}^ have vanished. Sometimes the fact and the instant of restoration are indicated by a peculiar sound or " click," as the ends of the bone slip into contact, to await the next ste]3 of the restorative procedure.
The process is the same Vv^hen the bones are covered v/ith thick muscular masses, excepting that it is attended with greater diflicul- ties, from the fact that the finger must be substituted for the eye, and the taxis must talce the place of the sight, and the result naturallj^ becomes more uncertain.
It frequently happens that perfect coaptation is prevented by the inteiposition between the bony surfaces of substances, such as a small fragment of detached bone or a clot of blood, and sometimes the extreme obliquity of the fracture is the ojiposing cause, b}' permitting the bones to slij) out of place. These aro difdculties which can not always bo overcome, even in small-sized animals, and still it is only when thej^ are mastered that a correct consolidation can be looked for. Yet without it the continuity between the fragments will be by a deformed callus, the union will leave a shortened, crooked or angular limb, and a disabled animal.
If timely assistance can be obtained, and the reduction accom- plished imme'liatelj' after the occurrence of the accident, that is the best time for it. But if it can not be attended to until inflammation has become established and the parts have become swollen and i)ain- ful, time must be allowed for the subsidence of these symptoms before attempting the operation. A spasmodic muscular contraction which sometimes intei'i^oses a difficulty may be easily' overcome by subject- ing the patient to general anesthesia, and need not, therefore, cause any loss of time. A tendency to this may also be overcome by the use of sedatives and antiphlogistic remedies.
The reduction of the fracture having been accomplished, the problem which follows is that of retention. The parts which have been restored to their natural position must be kept there, without disturbance or agitation, until the perfect formation of a callus, and it is here that ample latitude exists for the exercise of ingenuity and skill by the sur- geon in the contrivance of the necessary apparatus. One of the most important of the conditions which are available by the surgeon in
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treating' human patients is denied to the veterinarian in the manage- ment of those which belong to the animal tribes. This is position. The intelligence of the human patient co-operates with the instructions of the surgeon, but with the animal sufferer there is a continual antag- onism between the i^arties, and the forced extension and fatiguing posi- tion which must for a considerable period be maintained as a condition of restoration require special and effective appliances to insure success- ful results. To obtain complete immobility is scarcely jiossible, and the surgeon must be content to reach a point as near as possible to that which is unattainable. For this reason, as will subsequently be seen, the use of slings and the restraint of patients in very narrow stalls is much to be preferred to the practice sometimes recommended, of allowing entire freedom of motion by turning them loose in box stalls. Temporary and movable apparatus are not usually of difiicult use in veterinary practice, but the restlessness of the patients and their unwillingness to submit quietly to the changing of the dressings render it obligatory to have recourse to permanent and immovable bandages, which should be retained without disturbance until the process of consolidation is complete.
The materials composing the retaining apparatus consist of oakum, bandages, and splints, with an agglutinating compound which forms a species of cement by which the different constituents are blended into a consistent mass to be spread ui^on the surface covering the locality of the fracture. Its components are black pitch, rosin, and Venice turpentine, blended by heat. The dressing may be applied directly to the skin, or a covering of thin linen may be interposed. A putty made with powdered chalk and the white of egg is recom- mended for small animals, though a mixture of sugar of lead and burnt alum with the albumen is preferred by others. Another formula is spirits of camphor, Goulard's extract and albumen. Another recom- mendation is to saturate the oakum and bandages with an adhesive solution formed with gum arable, dextrine, flour j)aste, or starch. This is advised particularly for small animals. Dextrine mixed, Avhile warm, with burnt alum and alcohol cools and solidifies into a stony consistency, and is preferable to plaster of Paris, which is less friable and has less solidity, besides being heavier and requiring constant additions as it becomes older. Starch and plaster of Paris form another good compound.
In applying the dressing the leg is usually padded with a cushion of oakum, thick and soft enough to equalize the irregularities of the surface and to form a bedding for the protection of the skin from chafing. Over this the splints are placed. The material for these is, variously, pasteboard, thin wood, bark, laths, gutta percha, strips of thin metal, as tin or perhaps sheet iron. These should be of suffi- cient length not only to cover the region of the fracture, but to extend sufficiently above and below to render the immobility more complete
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tlian in the surrounding joints. The si)lints, again, are covered v/ith cloth bandages, linen jDreferably, soaked in a glutinous moisture. These bandages are to be carefully applied, with a perfect condition of lightness. They are usually made to embrace the entire length of the leg, in order to avoid the possibility of interference with the cir- culation of the extremity, as well as for the prevention of chafing. They should be rolled from the lower part of the leg upwards, and carefully secured against loosening. In some instances suspensory bandages are recommended, but excepting for small animals our experience does not justify a concurrence in the recommendation.
These permanent dressings always need careful watching with ref- erence to their immediate effect upoii the region ih.ey cover, especially during the first daj'S succeeding that of their application. Any mani- festation of ipain, or any appearance of swelling above or below, or any odor suggestive of sui)puration should excite susi)icion, and a thorough investigation should follow without delay. The removal of the dressing should be i^erformed with great care, and especially so if time enough has elapsed since its application to allow of a probability of a commencement of the healing j)rocess or the existence of any points of consolidation. With the original dressing properly applied in its entirety in the first instance, the entire extremity will have lost all chance of mobility, and the repairing process may be permitted to proceed without interference. There will be no necessity and there need be no haste for removal or change except under such sj)ecial conditions as have just been mentioned, or when there is reason to judge that solidification has become perfect, or for the comfort of the animal, or for its readaptation in consequence of the atrophy of the limb from want of use. Owners of animals are often tempted to remove a splint or bandage jirematurely at the risk of producing a second fracture in consequence of the failure of the callus properly to consolidate.
The method of applying the splints which we have described refers to the simx)le varietj^ only. In a comi)Ound case the same rules must be observed, with the modification of leaving oj)enings through the thick- ness of the dressing, opposite the wound, in order to permit the escape of pus and to secure access to the points requiring the application of treatment.
FEACTUEE OF DIFFEEENT BONES.
Of the cranial hones. — Fractures of this varietj^ in large animals are comparatively rare, though the records are not destitute of cases. When they occur, it is as the result of external violence, the sufferers being usually runaways which have come in collision with a wall or a tree, or other obstruction ; or it may occur in those which in pulling upon the halter have broken it with a jerk and been thrown back- wards, as might occur in rearing too violently. Under these condi- tions we have witnessed fractures of the parietal, of the frontal, and
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of the sphenoid bones. These fractures may be of both the complete and the incomplete kind, which indeed is usually the case with those of the flat bones, and they are liable to be complicated with lacera- tions of the skin, in consequence of which they are easily brought under observation. But Avhen the fact is otherAvise and the skin is intact, the diagnosis becomes difficult. The incomplete variety may be unaccompanied by any special symptoms, but in the complete kind one of the bony plates may be so far detached as to press upon the cerebral substance with sufficient force to produce serious nervous complications. When the injury occurs at the base of the cranium hemorrhage may be looked for, with paralytic symptoms, and when these are present the usual termination is death. It may still happen, however, that the symptoms of an apparently very severe concussion may disappear, with the result of an early and complete recovery, and the surgeon will therefore do well to avoid undue x>recipitation in venturing upon a prognosis. In fractures of the orbital or the zygo- matic bones the danger is less i)i'essing than with injuries otherwise located about the head. The treatment of cranial fractures is simple, though involving the best skill of the experienced surgeon, AVhen incomplete, hardly any interference is needed; even plain bandaging may usually be dispensed with. In the complete variety the danger to be combated is compression of the brain, and attention to this indication must not be delayed. Tlie means to be employed are the trephining of the skull over the seat of the fracture and the elevation of the depressed bone or the removal of the portion which is causing the trouble. Fragments of bone in comminuted cases, bony exfolia- tions, collections of fluid, or even i)rotruding portions of the brain substance must be carefully cleansed away, and a simple bandage so applied as to facilitate the application of subsecjuent dressings.
Fractures of ilie hones of the face. — In respect to their origin — usu- ally traumatic— these injuries rank with the preceding, and are com- monly of the incomplete variety. They may easily be overlooked and may even sometimes escape recognition until the reparative i)i'ocess has been well established and the discovery of the wound becomes due to the prominence caused by the presence of the provisional callus which marks its cure. When the fracture is complete it will be marked l)y local deformit}', mobility of the fragments, and crepi- tation. Xasal hemorrhage, roaring, frequent sneezing, loosening or loss of teeth, difficulty of mastication, and inflammation of the cavi- ties of the sinuses are varying complications of these accidents. The ol)ject of tlie treatment should be the restoration of the depressed bones as nearly as possible to their normal position, and their reten- tion in place by protecting splints, which should cover the entire facial region. And 8i:)ecial precautions should be observed to prevent the patient from disturbing the dressing by rubbing his head against surrounding objects, such as the stall, the manger, the rack, etc.
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Clots of blood in the nasal passages must be washed out, collections of pus must be removed from the sinuses, and if the teeth are loos- ened and likelj^ to fall out they should be removed. If roaring is threatened, tracheotomy is indicated.
Fractures of the pre-maxillary hone. — These are mentioned by con- tinental authors. They are usually encountered in connection with fractures of the nasal bone, and may take place either in the width or the length of the bone.
The deformity of the upper lip, which is drawn sidewise in this lesion, renders it easy of diagnosis. The abnormal mobility and the crepitation, with the pain manifested by the patient when undergoing examination, are concurrent symptoms. Looseness of the teeth, abundant salivation, and entire inability to grasp the food complete the symptomatology of these accidents. In the treatment, splints of gutta percha or leather are sometimes used, but they are of difficult application. Our own judgment and practice are in favor of the union of the bones by means of metallic sutures.
The loiver jaw. — A fracture here is not an injurj^ of infrequent occurrence. It involves the body of the bone, at its symphysis, or back of it, and includes one or both of its branches, either more or less forward, or at the posterior i^art, near the temporo-raaxillary articu- lation, at the coronoid process.
Falls, blows, or other external violence, or powerful muscular con- tractions during the use of the speculum, may be mentioned among the causes of this lesion. The fracture of the neck and of the branches in front of the cheeks causes the lower jaw, the true dental arch, to drop, without the ability to raise it again to the upper, and the result is a peculiar and characteristic physiognomy. The pre- hension and mastication of food become impossible; there is an abundant escape of fetid and sometimes bloody saliva, especially if the gums have been wounded ; there is excessive mobility of the lower end of the jawbone; and there is crepitation, and frequently par- alj^sis of the under lip. But although the aspect of an animal suffer- ing with a complete and often compound and comminuted fracture of the submaxilla presents at times a frightful spectacle, the prognosis of the case is comparatively simple, and recovery usually only a ques- tion of time. The severity of the lesion corresponds in degree Avith that of the violence to which it is due, the degree of simplicity or the amount of complication, and with the situation of the Avound. It is simple when at the symphysis, but becomes more serious when it affects one of the branches, to be again aggravated when both are involved. Fracture of the coronoid process becomes important prin- cipall}^ as an evidence of the existence of a morbid diathesis, such as osteoporosis, or the like.
The particular seat of the injury, with its special features, will of course determine the treatment. For a simple fracture without
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displacement, provided there is no laceration of the periosteum, an ordinary sui^porting bandage will usually be sufficient. But when there is displacement the reduction of the fracture must first be accom- plished, and for this special splints are necessary. In a fracture of the symphysis or of the branches the adjustment of the fragments by securing them with metallic sutures is the first step necessary, to be followed by the application of supports, consisting of splints of leather or sheets of metal, the entire front of the head being then covered with bandages prepared mth adhesive mixtures. During the entire course of treatment a special method of feeding becomes necessar}'. The inability of the patient to appreciate the situation of course necessitates a resort to an artificial mode of introducing the necessary food into his stomach, and it is accomplished by forcing between the commissures of the lips, in a liquid form, by means of a sja-inge, the milk or nutritive gruels selected for his sustenance, until the consolidation is sufficiently advanced to permit the ingestion of food of a more solid consistency. The callus will usually be suffi- ciently hardened in two or three weeks to allow of a change of diet to mashes of cut haj^ and scalded grain, until the removal of the dressing restores him to his old habit of mastication.
Fractures of vertehrm. — These are not very common, but when they do occur the bones most frequently injured are those of the back and loins. The ordinary causes of fracture are responsible here as else- where, such as heavy blows on the spinal column, severe falls while convejdng heavy loads, and especially violent efforts in resisting the process of casting. Although occurring more or less frequently under the latter circumstances, the accident is not always attributable to carelessness or error in the management. It may, of course, some- times result from such a cause as a badly prepared bed, or the acci- dental presence of a hard body concealed in the straw, or to a hea\'y fall when the movements of the patient have not been sufficiently control' 3d by an effective apparatus and its skillful adaptation, but it is quite as likely to be caused by the violent resistance and the con- sequent powerful muscular contraction by the frightened patient. The simple fact of the overarching of the vertebral column, with excessive pressure against it from the intestinal mass, owing to the spasmodic action of the abdominal muscles, may account for it, and so also may the struggles of the animal to escape from the restraint of the hobbles while frantic under the pain of an operation without anaesthesia. In these cases the fracture usually occurs in the body or the annular part, or both, of the posterior dorsal or the anterior lumbar vertebra. When the transverse processes of the last-named bones are injured, it is probably in consequence of the heavy concus- sion incident to striking the ground when cast. The diagnosis of a fracture of the body of a vertebra is not always easj'^, especially when quite recent, and more especially when there is no accompanying
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displacement. There are certain peculiar signs accomj)anying the occurrence of the accident while an operation is in progress which should at once excite the suspicion of the surgeon. In the midst of a violent struggle the patient becomes suddenly quiet; the movement of a sharp instrument which at first excited his resistance fails to give rise to any further evidence of sensation; perhaps a general trembling, lasting for a few minutes, will follow, succeeded by a cold, profuse perspiration, particularly between the hind legs, and fre- quently there will be micturition and defecation. Careful examina- tion of the vertebral column may then detect a slight dex)ression or irregularity in the direction of the spine, and there may be a diminu- tion or loss of sensation in the i^osterior part of the trunk while the anterior i)ortion continues to be as sensitive as before. In making an attempt to get upon his feet, however, upon the removal of the hobbles, only the fore part of the bodj' v>-ill respond to the effort, a degree of paraplegia being present, and while the head, neck, and fore j)art of the body will be raised, the hind quarters and hind legs will remain inert. The animal may perhaps succeed in rising and probably may be removed to his stall, but the disiDlacement of the bone will follow, converting the fracture into one of the complete kind, either through the exertion of walking or by a renewed attempt to rise after another fall, before reaching his stall. By this time the paral3'^sis is complete, and the extension of the meningitis which has become established is a consummation soon reached.
To say that the prognosis of fracture of the body of the vertebra is always serious is to speak very mildly. It were better ijerhaps to say that occasionally a ease may recover. Fractures of the transverse processes are less serious.
Instead of stating the indication in this class of cases as if assum- ing them to be medicable, the question naturally becomes rather a query : ' ' Can any treatment be recommended in a fracture of the body of a vertebra? " The only indication in such a case, in our ojiinion, is to reach the true diagnosis in the shortest possible time and to act accardingly. If there is displacement, and the existence of serious lesions may be inferred from the nervous symptoms, the destruction of the suffering animal appears to suggest itself as the one conclusion in which considerations of policy, humanity, and science at once unite.
If, however, it is fairly evident that no disi)lacement exists; that pressure upon the spinal cord is not yet present ; that the animal with a little assistance is able to rise upon his feet and to walk a short dis- tance, it may be well to experiment upon the case to the extent of placing the patient in the most favorable circumstances for recovery, and allow nature to operate without further interference. This may be accomplished by securing immobility of the whole body as much as possible, and especially of the suspected region, by placing the patient in slings, in a stall sufficiently narrow to preclude lateral motion, and
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coverino- the loins with a thick coat of agglutinative mixture, Avatch and wait for developments.
Fracture of ilie ribs. — The different regions of the chest are not equally exposed to the violence to which fractures of the ribs are due, and they are therefore either more common or more easily discovered, during life, at some points than at others. The more exposed regions are the middle and the posterior,*while the front is largely covered and defended by the shoulder. A single rib may be the seat of fracture, or a number maybe involved, and there maybe injuries on both sides of the chest at the same time. It may take place lengthwise, in any part of the bone, though the middle, being the most exposed, is the most freciuentl}' hurt. Incomplete fractures are usually lengthwise, involving a portion only of the thickness or one or other of the sur- faces. The comiDlete kind ma}" be either transverse or oblique, and are most commonly denticulated. The fracture may be comminuted, and a single bone may show one of the comj)lete and one of the incomplete kind at different points. The extent of surface presented b}' thethoracic region, with its complete exposure at all points, ex- plains the liability of the ribs to suffer from all the forms of external violence.
In many instances fractures of these bones continue undiscovered, especiallj' the incomplete variety, without disj)lacement, though the evidences of local iiain, a certain amount of swelling, and a degree of disturbance of the respiration, if noticed during the examination of a patient, may suggest a suspicion of their existence. Abnormal mo- bilitj' and crepitation are difficult of detection, even when present, and they are not always presant. When there is displacement the deformity which it occasions will betray the fact, and when such an injur}' exists the surgeon will of course become vigilant in viev^' of l^ossible and probable complications of thoracic trouble, and prepare himself for an encounter with a case of traumatic pleuritis or pneu- monia. Fatal injuries of the heart are recorded. Subcutaneous emphysema, is a common accompaniment of broken ribs, and we recall the death from this cause of a patient of our own, which had suffered a fracture of two ribs in the region of the withers under the cartilages of the shoulder, and of which the diagnosis vras only made after the fatal ending of the case.
These hurts are not often of a very serious character, though the union is never as solid and complete as in other fractures, the callus being usually imperfect and of a fibrous character, with an amphiar- throsis formation. Still, complications occur which may impart gravity to the prognosis.
Fractures with but a slight or no displacement need no reduction. All that is necessary is a simple application of a blistering nature as a preventive of inflammation or for its subjugation when present, and in order to excite an exudation which will tend to aid in the
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support and immobilization of tlie parts. At times, however, a better etTect is obtained by the application of a bandage placed firmly around the chest, although, while this limits the motion of the ribs, it is apt to render the respiration more labored.
If there is displacement with much accompanying pain and evident irritation of the lungs, the fracture must be reduced without delay. The means of effecting this vary acc^rding to whether the displace- ment is outwards or inwards. In the first case the bone may be straightened by i)ressure from without, while in the second the end of the bone must be raised by a lever, for the introduction of which a small incision through the skin and intercostal spaces will be neces- sar3^ When coaptation has been effected it must be retained by the external application of adhesive mixture, with splints and bandages around the chest.
Fractures of the hones of the pelvis will be considered under their separate denominations, as those of the sacrum and the as innomi- nata, or hip, which includes the subdivisions of the ilium, the pubes, and the ischium.
The sacrum. — Fractures of this bone are rarely met with among solipeds. Among cattle, however, it is of common occurrence, being attributed not only to the usual varieties of violence, as blows and other external hurts, but to the act of coition, and to violent efforts in parturition. It is generall}^ of the transverse kind, and may be recognized by the deformity which it occasions. This is due to the dropping of the bone, with a change in its direction and a lower attachment of the tail, which also becomes more or less paralyzed. The natural and siDOutaneous relief Avhicli usually interposes in these cases has doubtless been observed by the extensive cattle breeders of the West, and their practice and example fully establishes the inutil- ity of interference. Still, cases may occur in which reduction may be indicated, and it then becomes a matter of no difficulty. It is effected by the introduction of a round, smooth piece of wood into the rectum as far as the fragment of bone, and using it as a lever, resting upon another as a fulcrum placed under it outside. The bono having been thus returned may be kept in place by the ordinary external means in use.
The OS innominata. — Fractures of the ilium may be observed either at the angle of the hip or at the neck of the bone; those of the pubes may take place at the symphysis, or in the body of the bone ; those of the ischium on the floor of the bone, or at its posterior external angle. Or, again, the fracture may involve all three of these constituent parts of the hip bone by having its situation in the articular cavity — the acetabulum by which it joins the femur or thigh bone.
Some of these fractures are easily recognized, while others are diffi- cult to identify. The ordinary deformity which characterizes a frac- ture of the external angle of the ilium, its dropping and the diminution
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of that side of the hip iu width, unite in indicating the existence of the condition expressed by the term " hipped." But an incomplete fracture, or one that is comi^lete without displacement, or even one with displacement, often demands the closest scrutin^^ for its dis- covery. The lameness may be well marked, and an animal may show but little ai^pearance of it while walking, but upon being urged into a trot will manifest it more and more, until presently he will cease to use the crippled limb altogether, and perform his traveling entirely on three legs. The acute character of the lameness will vary in degree as the seat of the lesion approximates the acetabulum. In walking, the motion at the hip is very limited, and the leg is dragged, while at rest it is relieved from bearing its share in sustaining the body. An intelligent opinion and correct conclusion will depend largely upon a knowledge of the history of the case, and while in some instances that will be but a report of the common etiology of fractures, siich as blows, hurts, and other external violence, the sim- ple fact of a fall may furnish in a single word a satisfactory solution of the whole matter.
With the exception of the deformity of the ilium in a fracture of its external angle, and unless there have been a serious laceration of tis- sues and infiltration of blood, or excessive disi3lacement, there are no very definite external symptoms in a case of a fracture of the hip bone. There is one, however, which, in a majority of cases, will not fail — it is crepitation. This evidence is attainable by both external and internal examination — by manipulation of the gluteal surface and by rectal taxis. Very often a lateral motion, or balancing of the hinder parts by pressing the body from one side to the other, will be sufficient to render the crepitation more distinct — a slight sensation of grating, which may be jjerceived even through the thick coating of muscle which covers the bone — and the sensation may not onl}^ be felt, but to the ear of the expert may even become audible. This external manifestation is, however, not always sufficient in itself, and should always be associated with the rectal taxis for corroboration. It is true that this may fail to add to the evidence of fracture, but till then the simple testimony afforded by the detection of crepitation from the surface, though a strong confirmatory point, is scarcely sufficiently absolute to establish more than a reasonable probabilitj'^ or strong suspicion in the case.
In addition to the fact that the rectal examination brings the exploring hand of the surgeon into near proximity to the desired point of search, and to an accurate knowledge of the situation of parts, both pro and con as respects his own views, there is another advantage attendant upon it which is well entitled to appreciation. This is the facility with Avhich he can avail himself of the cooperation of an assistant, who can aid him by manipulating the implicated limb 5961— HOR 11
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and placing' il in various positions, so far as the j)atient Avill permit, while the surgeon himself is making explorations and studying the effect from A^ithin. By this method he can hardly fail to ascertain the character of the fracture and the condition of the bony ends. By tlie rectal taxis, as if with eyes in the finger ends, he will " see " what is the extent of the fracture of the ilium or of the neck of that bone; to Avhat ijart of the central portion of the bone (the acetabulum) it reaches; whether this is free from disease ornot, and in what location on the floor of the pelvis the lesion is situated. We have frequently, by this method, been able to detect a fracture at the sj-mphysis which, from its history and s^-mptoms and an external examination, could only have been guessed at.
Yet, with all its advantages, the rectal examination is not always necessary, as, for example, when the fracture is at the posterior and external angle of the ischium, when by friction of the bony ends tlie surgeon may discern the crepitation without it.
Every variety of complication, including muscular lacerations with the formation of deep abscesses and injuries to the organs of the i^elvic cavity, the bladder, the rectum, and the uterus, may be associated with fractures of the hip bone.
The prognosis of these lesions will necessarily vary considerably. A fracture of the most superficial part of the bone of the ilium or of the ischium, especially where there is little displacement, will unite rajiidly, leaving a com];)aratively sound animal often quite free from subsequent lameness. But if there is much dis]3lacement, only a liga- mentous union will take place, with much deformity and more or less irregularity in the gait. Other fractures may be followed by comjilete disability of the patient, as, for example, when the cotyloid cavity is involved, or when the reparatory process has left bony deposits in the pelvic cavity at the seat of the union, which may, with the female, interfere with the steps of parturition, or induce some iocal paralysis by ijressure ui)on the nerves which govern the muscles of the hind legs. This is a condition not infrequently observed when the callus has been formed on the floor of the i^elvis near the obturator foramen, pressing upon the course or involving the obturator nerve.
The treatment of all fractures of the hip bone should, in our esti- mation, be of the simplest kind. Rendered comx^aratively immovable b}^ the thickness of the muscles by which the region is enveloped, one essential indication suggests itself, and that is, to place the animal in a position which, as far as possible, will be fixed and i^ermancnt. For the accomplishment of this purpose the best measure, as we consider it, is to place him in a stall of just sufficient Avidtli to admit him, and to apply a set of slings snugly, but comfortably. This will fulfill the essential conditions of recovery, rest, and immobility. Blistering applications would be injurious, though the adhesive mixture miglit prove in some degree beneficial.
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The iiiiuimiim period allowable for solid union in a fractured hip is, in our judgment, two months, and we have known cases in which that was too short a time.
As we have before said, there may be cases in which the ti-eatment for fracture at the floor of the pelvis has been followed by symptoms of partial paralysis, the animal, when lying down, being unable to regain his feet, but moving freely Avhen placed in an uj)riglit position. This condition is due to the interference of the callus with the func- tions of the obturator nerve, which it presses upon or surrounds. We feel warranted by our experience in similar cases in cautioning own- ers of horses in this condition to exercise due j)atience, and to avoid a premature sentence of condemnation against their invalid servants; they are not all irrecoverably paralytic. With alternations of moder- ate exercise, rest in the slings, and the effect of time while the natural process of absorption is taking effect upon the callus, with other ele- ments of change that may be so operating, the horse may in due time l^ecorae able to once more earn his subsistence and serve his master,
Fracture of ilie scapuJu. — This bone is seldom fractured, its com- parative exemption being due to its free mobility and the protection it receives from the superimiiosed soft tissues. Only direct and pow- erful causes are sufficient to effect the injury, and when it occurs the large rather than the smaller animals are the subjects. The causes are heavy blows or kicks, and violent collisions with unyielding objects. Those wliich are occasioned by falls are generally at the neck of the bone, and of the transverse and comminuted varieties.
The diagnosis is not alwaj^s easy. The symptoms are inability to rest the leg on the ground and to carry weights, and they are present in various degrees from slight to severe. The leg" rests uijon the toe and seems shortened, and locomotion is i:)erformed by jumps. Moving the leg while examining it and raising the foot for inspection seem to produce much pain and cause the animal to rear. Crepitation is readily felt with the hand upon the shoulder when the leg is moved. If the fracture occurs in tlie upper part of the bone, overlapping of the fragments and displacement will be considerable.
Tlie fracture of tliis bone is usually classed among the more serious accidents, though cases may occur which are followed by recovery without very serious ultimate results, especially when the seat of the injurj' is at some of the upper angles of the bone, or about the acromion crest. But if the neck and the joint are the parts involved, comiilications are apt to be present which are likely to disable the animal for life.
If there is no displacement a simple adhesive dressing, to strengthen and immobilize the parts, Avill be sufficient. A coat of black pitch dis- solved with wax and Venice turpentine, and kept in place over the region with oakum or linen bands, will be all tlie treatment required, especially if the animal is kept qui<-1 in 1he slings.
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Displacement cannot be remedied, and reduction is next to impos- sible. Sometimes an iron plate is applied over the parts and retained by bandages, as in the dressing of Bourgelat ; and this may be advan- tageously replaced by a pad of thick leather. In smaller animals the parts are retained by figure-8 bandages, embracing both the normal and the diseased shoulders, crossing each other in the axilla and covered with a coating of adhesive mixture.
Fractures of the humerus. — These are more common in small than in large animals, and are always the result of external traumatism. They are generally very oblique, are often comminuted, and though more usually involving the shaft of the bone will in some cases extend to the upper end and into the articular head. There is ordinarily con- siderable displacement in consequence of the overlapping of the broken ends of the bone, and this, of course, causes more or less shortening of the limb. There will also be swelling, with difiiculty of locomotion, and crepitation will be eas}^ of detection. This fracture is always a serious damage to the patient, leaving him with a permanently short- ened limb and a remediless, lifelong lameness.
If treatment is determined on it will consist in the reduction of the fracture by means of extension and counter extension, and in order to accomplish this the aninuil must be thrown. If successful in the reduc- tion, then follows the application and adjustment of the apparatus of retention, which must needs be of the most perfect and efficient kind. And finally, this, however skillfully contrived and carefully adapted, will often fail to effect any good purpose whatever.
Fracture of the forearm. — A fracture in this region may also involve the radius or the cubitus, the first being broken at times in its upper portion above the radio-cubital arch at the olecranon. If the fracture occurs at any part of the forearm from tlie radio-cubital arch down to the knee, it maj^ involve either the radius alone or the radius and the cubitus, which are there intimately united.
Besides having the same etiology with most of the fractures, those of the forearm are, nevertheless, more commonly due to kicks from other animals, especially when crowded together in large numbers in insufficient space. It is a matter of observation that, under these cir- cumstances, fractures of tlie incomijlete kind are those which occur on the inside of the leg, the bone being in that region almost entirely sub- cutaneous, while those of the complete class are either oblique or ti-ansverse. The least common are the longitudinal, in the long axis of the bone.
This variet}^ of fracture is easily recognized by the appearance of the leg and the different changes it undergoes. There is inability to use the limb; impossibility of locomotion; mobility below the injury; the ready detection of crepitation — in a word, the assemblage of all the signs and symptoms which have been already considered as associated with the history of broken bones.
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The fracture of the cubitus alone, principally above the radio-cubital arch, may be ascertained by the aggravated lameness, the excessive soreness on pressure, and i^erhajis a certain increase of motion, with a very slight crepitation if tested for in the usual waj'. Disi^lacement is not likely to take jDlace except when it is well up towards the ole- cranon or its tuberosity, the upper segment of the bone being in that case likelj' to be drawn upwards. For a simple fracture of this region there exists a fair chance of recovery, but in a case of the compound and comminuted class there is less ground for a favorable prognosis, esijecially if the elbow joint has suffered injur3\ A fracture of the cubitus alone is not of serious importance, excejjt when the same con- ditions prevail. A fracture of the olecranon is less amenable to treatment, and promises little better than a ligamentous union.
Considering all the various conditions involving tlie nature and extent of these lesions, the position and direction of the bones of the forearm are such as to render the chances for recovery from fracture as among the best. The reduction, by extension and counter exten- sion; the maintenance of the coa^Dtation of the segments; the adapta- tion of the dressing by splints, oakum, and agglutinative mixtures; in a word, all the details of treatment may be here fulfilled with a degree of facility and precision not attainable in any other pnvt of the organ- ism. An important if not an essential jDoint, however, must be empha- sized in regard to the sx)lints. Whether these are of metal, wood, or other material, they should reach from the elbow joint to the ground, and should be placed on the posterior face and on both sides of the leg. This is then to be so confined in a i^roperly constructed box as to preclude all i30ssibility of motion, while yet it must sustain a cer- tain portion of the weight of the bod3\ The iron splint (represented in Plate XXYII) recommended by Bourgelet is designed for fractures of the forearm, of the knee, and of the cannon bone, and will prove to be an appliance of great value. For small animals our preference is for an external covering of gutta percha, embracing the entire leg. A sheet of this substance of suitable thickness, according to the size of the animal, softened in lukewarm water, is, when sufficientlj' pli- able, molded on the outside of the leg, and when suddenly hardened by the ai)plication of cold water forms a connjlete casing sufficiently^ rigid to resist all motion. Patients treated in this manner have been able to use the limb freely, without i^ain, immediately after the application of the dressing. The removal of the splint is easily effected by cutting it awaj", either wholly or in sections, after softening it by immersing the leg in a warm bath.
Fracture of tlie Ixuee. — This accident, happily, is of rare occurrence, but when it takes j)lace is of a severe character, being of the commi- nuted kind, and always accompanied by sj^novitis, with disease of the joint, requiring for treatment therefor, besides the indication of perfect immobility of the joint, that of open joints, synovitis, and arthritis.
Fracture of ilie femur. — The protection Avliich this bone receives from the large mass of muscles in which it is enveloped does not suffice to invest it with immunity in regard to fi-actures. It con- tributes its share to the list of accidents of this description, sometimes in consequence of external violence and sometimes as the result of muscular contraction ; sometimes it takes place at the upper extremity of the bone; sometimes at the lower; sometimes at the head, when the condyles become implicated; but it is principally found in the body or diaphysis. The fracture may be of any of the ordinary forms, simple or compound, complete or incomplete, transverse or oblique, etc. A case of the comminuted variety is recorded in which eighty-five frag- ments of bone were counted and removed.
The thickness of the muscular covering sometimes renders the diagnosis difficult by interfering with the manipulation, but the crepi- tation test is readily available even when the swelling is considerable and which is likely to be the case as the result of the interstitial hem- orrhage which naturallj' follows the laceration of the blood-vessels of the region involved. If the fracture is at the neck of the bone the muscles of that region '(the gluteal) are firmly contracted and the leg seems to be shortened in consequence. Locomotion is impossible. Crepitation may in some cases be discerned by rectal examination, with one hand resting over the coxo-femoral (hip) articulation. Frac- tures of the tuberosities of the upper end of the bone, the great trochanter, may be identified by the deformity, the swelling, the impossibility of rotation, and the dragging of the leg in walking. Fracture of the body is always accompanied by displacement, and as a consequence a shortening of the leg, which is carried forward. The lameness is excessive, the foot being moved, both w^hen raising it from the ground and vrhen setting it down, very timidly and cau- tiously. The manipulations for the discovery of crepitation always cause much pain. Lesions of the lower end of the bone are more difficult to diagnosticate with certainty, though the manifestation of pain while making heavy pressure upon the condyles will be so marked that only crepitation will be needed to turn a suspicion into a certainty.
The question as to treatment in fractures of this description resolves itself into tlie query whether any treatment can be suggested that can avail anything practically as a curative measure, whether, upon the liypothesis of reduction as an accomplished fact, any permanent or efficient device as a means of retention is within the scope of human ingenuity. If the i-eduction were successfully x^erformed vrould it be possible to keep the parts in place by any known means at our disposal? At the best the most favorable result that could be antici- pated would be a reunion of the fragments, with a considerable short- ening of the bone, and a helpless, limping, crippled animal to remind us that for human achievement there is a "thus far, and no farther."
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In small animals, howevcM-, attempts at treatment are justifiable, and Ave are convinced that in many cases of dilficulty in the applica- tion of splints and bandages a patient may be iDlaced in a condition of undisturbed quiet and left to the processes of nature for "treat- ment " as safelj" and with as good an assurance of a favorable result as if he had been subjected to the most heroic secundum artem doc- toring known to science. As a case in point, we maj' mention the ease of a pregnant bitch which suffered a fracture of the upper end of the femur by being run over by a light wagon. Her "treatment" consisted in being tied up in a large box and let alone. In due time she Avas delivered of a family of pui^i^ies, and in three weeks she was running in the streets, limping very slightly, and nothing the worse for her accident.
Fracture of tlie pcdella. — This, fortunately, is a rare accident and can only result from direct violence, as a kick or other blow. The lameness which follows it is accompanied with enormous tumefac- tion of the joint and disease of the articulation. The prognosis is unavoidably adverse, destruction being the only termination of an incurable and very painful injury.
Fractures of the tibia are probably more frequently encountered than any others among the class of accidents we are considering. As witii injuries of the forearm of a like character, they may be complete or incomplete; the former when the bone is broken in the middle or at the extremities, and transverse, oblique, or longitudinal. The incomijlete kind are more common in this bone than in any other.
Comijlete fractures are easy to recognize, either with or without dis- j)lacement. The animal is very lame, and the leg is either dragged' or held up clear from the ground b}' flexion at the stifle, while the lower part hangs down. Carrying weight or moving backwards is impossi- ble. There is excessive mobility below the fracture and well-marked crepitation. If there is much displacement, as in an oblique fracture, there will be considerable shortening of the leg.
While incomj)lete fractures can not be recognized in the tibia with anj- greater degree of certainty than in any other bone, there are some facts associated with them by which a diagnosis ma}' be justi- fied. The hypothetical historj' of a ease may serve as an illustration:
An animal has received an injury b}' a blow or a kick on the inside of the bone, perhaps witliout showing any mark. Becoming very lame immediately afterwards, he is allowed a few days' rest. Being then taken out again, he seems to have recovered his soundness, but within a day or two he betrays a little- soreness, and this increasing he becomes very lame again, to be furloughed once more, with the result of a temi^orar}- improvement, and again a return to labor and again a relapse of the lameness; and this alternation seems to be the rule. The leg being now carefully examined, a local periostitis is readily discovered at the point of the injury, the part being warm,
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swollen, and painful. What further proof is necessary? Is it not evident that a fracture has occurred, first sui^erficial — a mere sj)lit in the bony structure which, fortunately, has been discovered before some extra exertion or a casual misstep had developed it into one of the complete kind, j)OSsibly with complications'? What other inference can such a series of symptoms thus repeated establish?
The ijrognosis of fracture of the tibia must, as a rule, oe unfavor- able. The diflficultj'^ of obtaining a union without shortening, and consequently without lameness, is proof of the futility of ordinary" attemjits at treatment. But though this may be ti-ue in respect to fractures of the complete kind, it is not necessarily so with the incom- plete variety, and with this class the simple treatment of the slings is all that is necessary to secure consolidation. A few weeks of this confinement will be sufficient.
With dogs and other small animals there are cases Avhich may be successfully treated. If the necessarj^ dressings can be successfully applied and retained, a cure will follow.
Fractures oftheliock. — Injuries of the astragalus have been recorded which had a fatal termination. Fractures of the os calls have also been observed, but never with a favorable prognosis, and attempts to induce recovery have, as might have been anticipated, ijroved futile.
Fractures of the cannon hones. — Whether these occur in the fore or hind legs they appear either in the body or near their extremities. If in the body, as a rule the three metacarj)al or metatarsal are also affected, and the fracture is generally transverse and oblique, and often compound, one of the segments protruding sharjily through the skin. Having only the skin for a covering the diagnosis is easy. There is no displacement, but excessive mobility, crepitation, inability to sustain Aveight, and the leg is kept off the ground by the flexion of the upper joint.
No region of the body affords better facilities for the application of treatment, and the prognosis is, on this account, usually favorable. We recall a case, however, which proved fatal, though under excep- tional circumstances. The patient Avas a valuable stallion of highly nervous organization, with a compound fracture of one of the cannon bones, and his unconquerable resistance to treatment, excited by the intense pain of the wound, precluded all chance of recovery, and ulti- mateh^ caused his death from nervous fever.
The general form of treatment for these lesions will not differ from that which has been already indicated for other fractures. Reduc- tion, sometimes necessitating the casting of the patient; coaptation, comparatively easy by reason of the subcutaneous situation of the bone; retention, by means of splints and bandages — applied on both sides of the region, and reaching to the ground as in fractures of the forearm — these are always indicated. We have obtained excellent results bv the use of a mold of thick gutta percha, composed of two
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sections and made to surround the entire lower part of the leg as in an inflexible case.
Fracture of the first phalanx. — The hinder extremity is more liable than the fore to this injury. It is usually the result of a violent effort, or of a sudden misstep or twisting of the leg, and may be transverse, or, as has usually been the case in our experience, longitudinal, extend- ing from the upper articular surface down to the center of the bone, and generally oblique and often comminuted. The symptoms are the swelling and tenderness of the region, possibl}^ crepitation; a certain abnormal mobility; an excessive degree of lameness, and in some instances a dropping back of the fetlock, with perhaps a straightened or upright condition of the pastern.
The difficulty of reduction and coaptation in this accident, and the probability of bony deposits, as of ringbones, resulting in lameness, are circumstances which tend to discourage a favorable ijrognosis.
The treatment is that which has been recommended for all frac- tures, as far as it can be applied. The iron sj^lint which has been mentioned gives excellent results in manj?- instances, but if the frac- ture is incomplete and without displacement a form of treatment less energetic and severe should be attempted. One case is within our knowledge in which the owner of an injured horse lost his propertj^ by his refusal to subject the animal to treatment, the j30s^ mortem revealing only a simi3le fracture with very slight displacement.
Fractures of the coronet. — Though these are generally of the com- minuted kind, there are often conditions associated with them which justify the surgeon in attempting their treatment. Though crepita- tion is not always easj^ to detect, the excessive lameness, the soreness on pressure, the inability to carry weight, the difficulty experienced in raising the foot, all these suggest, as the solution of the question of diagnosis, the fracture of the coronet, with the accompanying realization of the fact that there is yet, by reason of the situation of the member, immobilized as it is by its structure and its surround- ings, room left for a not unfavorable prognosis. Only a slight manii^ulation will be needed in the treatment of this lesion. To ren- der the immobility of the region more fixed, to support the bones in their position by bandaging, and to establish forced immobility of the entire body with the slings is usually all that is required. Ringbone, being a common sequela of the reparative process, must receive due attention subsequently. One of the severest complications likely to be encountered is anchylosis.
Fractures of the as pedis. — Though these lesions are not of very rare occurrence their recognition is not easy, and there is more of speculation than of certainty pertaining to their diagnosis. The animal is very lame, and, as much as possible, spares the injured foot, sometimes resting it upon the toe alone and sometimes not at oUGl— HOR 11*
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all. The foot is very tender, and the exploring pincers of the examin- ing surgeon causes much iDain. There is nothing to encourage a favorable i)rognosis, and a not unusual termination is an anchylosis with either the navicular bone or the coronet.
No method of treatment needs to be suggested here, the hoof per- forming the office of retention unaided. Local treatment by baths and fomentations will do the rest. It maj^ be months before there is anj^ mitigation of the lameness.
Fracture of the sesamoid hones. — This lesion has been considered by veterinarians, erroneously, we think, one of rare occurrence. We believe it to be more frequent than has been supposed. Many obser- vations and careful dissections have convinced us that fractures of these little bones have often been mistaken for specific lesions of the numerous ligaments that are implanted upon their suiDerior and infe- rior parts, and which have been described as a "giving way" or "breaking down" of these ligaments. In our 2^ost mortem examina- tions we have always noted the fact that when the attachments of the ligaments were torn from their bony connections minute fragments of bony structure were also separated, though we have failed to detect any diseased process of the fibrous tissue com^DOsing the ligamentous substance.
From whatever cause this lesion maj^ arise, it can hardly be consid- ered as of a traumatic nature, no external violence having anj^ ai^par- ent agency in producing it, and it is our belief that it is due to a peculiar degeneration or softening of the bones themselves, a theory which acquires plausibility from the consideration of the spongy con- sistency of the sesamoids. The disease is a jpeculiar one, and the sud- denness with which different feet are successively attacked, at short intervals and without any obvious cause, seems to prove the existence of some latent morbid cause which has been unsuspectedl}^ incubating. It is not j)eculiar to any particular class of horses, nor to anj^ special season of the year, having fallen under our observation in each of the four seasons. The general fact is reported in the history of a majority of cases that it makes its appearance without premonition in animals which, after enjojing a considerable i)eriod of rest, are first exercised or put to work, though in x^oint of fact it may manifest itself while the horse is still idle in his stable. A hypothetical case, in illustra- tion, will explain our theory:
An animal which has been at rest in his stable is taken out to work and it will be presently noticed that there is something unusual in his movement. His gait is changed, and he travels with short, mincing steps, Avithout any of his accustomed ease and freedom. This may continue until his return to the stable, and then, after being placed in his stall, he will be noticed shifting his weight from side to side and from one leg to another, continuing the movement until rupture of the bony structure takes place. But it may happen that the lameness
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in one or more of the extremities, anterior or posterior, suddenly increases, and it becomes evident tliat tlie rupture has taken j)lace in consequence of a misstep or a stumble while the horse is at work. Then, upon coming to a standstill, he will be found with one or more of his toes turned up — he is unable to place the aifeeted foot flat on the ground. The fetlock has dropped and the leg rests upon this part, the skin of which may have remained intact or may have been more or less extensively lacerated. It seldom happens that more than one toe at a time will turn np, \et still the lesion in one will be followed b}^ its occurrence in another, Commonlj- two feet of a bixjed, the anterior or posterior, are affected, and we recall one case in which the two fore and one of the hind legs Avere included at the same time. The accident, however, is quite as likely to happen while the horse is at rest in his stall, and he may be found in the morning standing on his fetlocks. One of the earliest of the cases occurring in our own experience had been under our care for several weeks for susi3ected disease of the fetlocks, the nature of which had not been made out, when, apparently, imx^roved by the treatment which he had under- gone, the patient was taken out of the stable to be walked a short distance into the country-, but had little more than started when he was called to a halt bj^ the fracture of the sesamoids of both fore legs.
While there are no positive premonitory symptoms known of these fractures we believe that there are signs and symptoms which come but little short of being so, and the appearance of which Avill alwa^'s justify a strong suspicion of the truth of the case. These have been indicated when referring to the soreness in standing, the short "minc- ing" gait, and the tenderness betrayed when pressure is made over the sesamoids on the sides of the fetlock, Avith others less tangible and definable.
These injuries can never be accounted less than serious, and in our judgment will never be other tlian fatal. If our theor^^ of their j^athol- ogy is the correct one, and the cause of the lesions is truly the softening of the sesamoidal bony structure and independent of any changes in the ligamentous fibers, the possibilitj" of a solid osseous union can hardly be considered admissible.
In respect to the treatment to be recommended and instituted it can only be employed with any rational hope of benefit during the incubation, and with the anticipatory purpose of prevention. It must be suggested by a suspicion of the verities of the ease, and applied before any rupture has taken j)lace. To prevent this and to antago- nize the causes which might iDrecipitate the final catastrophe — the elevation of the toes — resort must be had to the slings and to the appli- cation of firm bandages or splints, perhaps of plaster of Paris, Avitli a high shoe, as about tlie only indications which science and nature are able to offer. When the fracture is an occurred event, and the toes, one or more, are turned up, any further resort to treatment will be futile.
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DISEASES OF JOINTS.
Three classes of injury will be considered under this head. These are, affections of the synovial sacs; those of the joint structures, or of the bones and their articular surfaces, and those forms of solution of continuity known as dislocations or luxations.
Diseases of the synovial sacs. — Two forms of affection here present themselves, one being the result of an abnormal secretion which . induces a dropsical condition of the sac without any acute inflamma- tory action, while the other is characterized by excessive inflammatory symptoms, with their modifications, constituting synovitis.
Synovial dropsies. — We have already considered in a general way the presence of these peculiar oil bags in the joints, and in some regions of the legs where the passage of the tendons takes place, and have noticed the similarity of structure and function of both the articular and the tendinous burs*, as well as the etiology of their injuries and their pathological history, and we now propose to treat of the affections of both.
Windy alls. — This name is given to the dilated bursse found at the posterior part of the fetlock joint. They have their origin in a drop- sical condition of the bursse of the joint itself, and also of the tendon which slides behind it, and are therefore further known by the des- ignations of articular and tendinous.
They appear in the form of soft and somewhat symmetrical tumors, of varying dimensions, and generally well defined in their circumfer- ence. They are more or less tense, according to the amount of secre- tion they contain, apparently becoming softer as the foot is raised and the fetlock flexed. Usually they are painless and only cause lameness under certain conditions, as when they began to develop themselves under the stimulus of inflammatory action, or when large enough to interfere with the functions of the tendons, or again when they have undergone certain pathological changes, such as calciflca- tion, Avhich is among their tendencies.
Windgalls may be attributed to external causes, such as severe labor or strains resulting from heavy pulling, fast driving, or jump- ing, or they may be among the sequelse of internal disorders and appear as resultants of a pleuritic or pneumonic attack.
An unnecessary amount of anxiety is sometimes experienced respect- ing these growths, with much questioning touching the expediency of their removal, all of which might be spared, for while they constitute a blemish their uusightliness will not hinder the usefulness of the animal, and in any case they rarely fail to show themselves easily amenable to treatment.
Wlien in their acute stage, and when the dropsical condition is not excessive, pressure by bandages, slight alcoholic frictions, sweating, the use of liniments, or perhaps a stiff blister of the ordinary kind
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will accouiplisli all that will be desired. It will subdue the inflam- mation and abate the soreness, and perhaps if the animal is not too soon returned to labor and exposed to the same causes by which they were before induced, the excess of secretion will be absorbed and the walls of the sac strengthened, and the windgall will disappear.
But if the inflammation has become chronic, and the enlargement has been of considerable duration, the negative course will be the wiser one. If any benefit results from treatment it will be of only a transient kind, the dilatation returning when the patient is again sub- jected to labor, and it will be a fortunate circumstance if inflammation has not supervened.
But notwithstanding the generally benignant nature of the tumor there are exceptional cases, usually when it is probably undergoing certain pathological changes, which may result in lameness and dis- able the animal, in which case surgical treatment will be indicated, especially if repeated blisters have failed to improve the symptoms. Firing is then a preeminent suggestion, and many a useful life has received a new lease as the result of this operation timely performed. The operation, which consists in emptying the sac by means of punc- tures through and through, made with a red-hot needle or wire, and the subsequent injection into the cavity of certain irritating and alter- ative compounds, designed to effect its closure by exciting adhesive inflammation, such as tincture of iodine, may be commended; but they are all too active and energetic in their effects and require too much special attention and intelligent management to be trusted to any hands other than those of an expert veterinarian.
Blood spavin and ilioroughpins. — The complicated arrangement of the hock joint, and the jaowerful tendons which i^ass on the jDOsterior part, are lubricated with the product of secretion from one tendinous synovial and several articular synovial sacs. One large articular sac contributes to the lubrication of the shank bone (the tibia) and the bones of the hock proi^er (the astragalus). The tendinous sac lies back of the articulation itself and extends upwards and downwards in the groove of that joint through which the flexor tendons slide. The dilatation of this articular synovial sac is what is denominated blood spavin, the term thoroughpin being applied to the dilatation of the tendinous capsule.
The blood spavin is situated in front and a little inward of the hock ; the thoroughpin is found at the back and on the top of the hock. The former is round, smooth, well defined, presenting on its outer surface, running from below upwards, a vein which is more or less prominent as the bursa is more or less dilated, and it is from this conspicuous blood vessel that the tumor derives its name. The thoroughpin is also round and smooth, but not so regularly formed, on each side and a little in front of the tendons in that part of the hock known as the "hollows," immediately back of the posterior face of the tibia or shank bone.
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In their general characteristics tliese tumors are similar to wind- galls, and one description of the origin, symptoms, pathological changes, and treatment will serve for all equally, except that it is possible for a blood spavin to cause lameness, and thus to involve a verdict of unsoundness in the patient, a circumstance which will of course justify its classification by itself as a severer form of a single type of disease.
We have alread}^ referred to the subject of treatment and the means employed — rest, of coui'se — with liniments, blisters, etc., and what we esteem as the most active and beneficial of an}-, early, deep, and well- performed cauterization. There are, besides, commendatory reports of a form of treatment by the application of pads and peculiar band- ages upon the hocks, and it is claimed that the removal of the tumors has been effected by their use. But our experience with this appa- ratus has not been accompanied by such favorable results as would justify our indorsement of the flattering representations which have sometimes appeared in its behalf.
Open joints — Broken knees — Sijnovitis — Arihriiis. — The nearness of the relations which exist between these several affections and their apparent connection as perliaps successive develoi^ments of a similar if not an essentially identical origin, with the advantage to be gained by the avoidance of frequent repetition in the details of symptoms, treatment, etc., are our reasons for treating under a single head the ailments we have grouped together in the j^resent chapter.
Tlie great, comprehensive, common cause whose effect is the disa- bility, sometimes permanent and sometimes only of transient duration, of chiefly the horse among our domestic animals, is external trauma- tism. Blows, bruises, hurts by nearly every known form of violence, falls, kicks, lacerations, punctures — we may add compulsory speed in racing and cruel overloading of draught animals — cover the entire ground of the diseases and injuries of the joints, now receiving our consideration.
In one case, a Avorking horse making a misstep stumbles, and falling on his knees receives a hurt, variously severe, from a mere abrasion of the skin to a laceration, a division of the tegument, a slough, mor- tification, and the escape of the synovial fluid with or without exposure of the bones and their articular cartilages.
In another case an animal, from one cause or another, perhaps an impatient temper, has formed the habit of striking or pawing his man- ger with his fore feet until inflammation of the knee-joint is induced, first as a little swelling, diffused, i)ainless; then as a periostitis of the bones of the knee; later as bony deposits, then lameness, and finally the implication of the joint,^ and following all the various conditions of carpitis.
In another case a horse has received a blow with a fork from a care- less hostler, on or near a joint, or has been kicked by a stable com- panio}!, witli llie result of a jjunctured wound, at first mild-looking.
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painless, apparently ^vilhout Inflammation, and not yet causing lame- ness, but which, in a few hours, or it may be not until a few days, becomes excessively painful, grows worse; the entire joint swells, presently discharges, and at last a case of suppurative synovitis is presented, with perhaps disease of the joint proper, and arthritis as a climax. The symptoms of articular injuries vary not only in the degrees of the hurt, but in the nature of the lesion.
Or, the condition of hroken knees, resulting as we have said, may have for its starting point a mere abrasion of the skin — a scratch apparently, which disappears without a resulting scar. The injury may, however, have been more severe, the blow heavier, the fall aggra- vated \>j occurring upon an irregular surface, or sharp or rough object, with tearing or cutting of the skin, and this laceration may remain. A more serious case than the first is now brought to our notice.
Another time, immediate!}' following the accident, or possibly as a sequel of the traumation, the tendinous sacs may be oi^ened, with the escape of the synovia; or worse, the tendons which i^ass in front of the knee are torn, the inflammation has spread, the joint and leg are swollen, the animal is becoming very lame ; synovitis has set in. With this the danger becomes very great, for soon supi)uration will be estab- lished, the external coat of the articulation proper become ulcerated, if it is not alreadj^ in that state, and we find ourselves in the presence of an open joint with suppurative synovitis — that is, with the worst among the conditions of diseased x^rocesses, because of the liability of the suppuration to become infiltrated into every part of the joint, m-acerating the ligaments and irritating the cartilages, soon to be suc- ceeded by their ulceration, with the destruction of the articular sur- face, or the lesion of ulcerative arthritis, one of the gravest among all the disorders known to the animal economy.
But ulcerative arthritis and suppurative synovitis maj' be developed in other connections than that with open joints; the simj^lest and apparently most harmless punctures may prove to be cause sufficient. For example, a horse may be kicked, perhaps, on the inside of the hock; there is a mark and a fcAV droi)s of blood to indicate the spot; he is put to work, apparently free from pain or lameness, and per- forms his task with his usual ease and facility. But on the following morning the hock is found to be a little swollen and there is some stiff- ness. A little later on he betrays a degree of uneasiness in the leg, and shrinks from resting his weight upon it, moving it \\\} and down for relief. The swelling has increased and is increasing, the pain is severe, and, finall}', there is an oozing at the sijot where the kick impinged of an oily liquid mixed with whitish drops of suppuration. The mischief is done and a simple, harmless punctured wound has expanded into a case of ulcerative arthritis and sui^purative SA'novitis.
From ever so brief and succinct description of this traumatism of the articulations, the serious and important character of these lesions,
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irrespective of which iDarticular joint is nffected, will be readily under- stood. Yet there will be modifications in the prognosis in different cases, in accordance with the peculiarities of structure in the joint specially involved, as for examj)le, it is obvious that a better result may be expected from treatment when but a single joint, with only its plain articular surfaces, is the place of injury, than in one which is com- posed of several bones, united in a complex formation, as in the knee or hock. As severe a lesion as suppurative sjmovitis always is, and as frequently fatal as it proves to be, still cases arise in which, the inflam- mation assuming a modified character and at length subsiding, the lesion terminates favorably and leaves the animal with a compara- tively sound and useful joint. There are cases, however, which termi- nate in no more favorable a result than the union of the bones and occlu- sion of the joint, to form an anchylosis, which is scarcely a condition to justify a high degree of satisfaction, since it insures a permanent lameness with very little capacity for usefulness.
Ajjpreciating now the dangers associated with all wounds of articu- lations, however simple and apparently slight, and how serious and troublesome are the complications Avhich are likely to arise during their jirogress and treatment, we are prepared to understand and realize the necessity and the value of early and promiit attention upon their discovery and diagnosis.
For simple bruises, like those which appear in the form of broken knees, or of carpitis, simple remedies, such as warm fomentations or cold water applications and compresses of astringent mixtures, sug- gest themselves at once. Injuries of a more complicated charac- ter, as lacerations of the skin or tearing of soft structures, will also be benefited by simple dressings with antiseptic mixtures, as those of the carbolic acid order. The escape of synovia should suggest the prompt use of collodion dressings to check the flow and jjrevent the further escape of the fluid. But if the discharge is abundant and heavily suppurative, little can be done more than to put in i^ractice the "expectant" method with warm fomentations, repeatedly applied, and soothing mucilaginous poultices. Improvement, if any is possi- ble, will be but slow to manifest itself. The most difficult of all things to do, in view of varying interests and opinions — that is, in a practical sense — is to abstain from "doing" entirelj", and yet we are firmly convinced that non-interference, in the cases we are consider- ing, is the best and wisest policy.
In cases which are carried to a successful result the discharge will by degrees diminish, the extreme i:)ain will gradually subside, and the convalescent will begin timidly to rest his foot upon the ground, and presently to bear weight upon it, and perhaps, after a long and tedi- ous process of recuperation, he may be returned to his former and normal condition of usefulness. When the discharge has wholly ceased and the wounds are entirely healed, a blister covering the whole of the joint for the purj^ose of stimulating the absorj)tion of
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the exudation will be of great service. But if, on the contrary, there is no amelioration of synii^toms and the i^rogress of the disease resists every attempt to check it; if the discharge continues to flow, not only without abatement, but in an increased volume, and not alone by a single oi^ening but by a number of fistulous tracts which have successively formed; if it seems evident that this drainage is rai^idly and painfull}^ sapping the sufiEering animal's vitality, and a deficient vis vitce fails to co6j)erate with the means of cure, all rational hope of recovery may be finally abandoned. An}- fui-ther waiting for chances, or time lost in experimenting, will be mere cruelty and there need be no hesitation concerning the next step. The poor beast is under sentence of death, and every consideration of interest and of humanity demands an anticipation of nature's evident intent in the quick and easy execution of the sentence.
One of the essentials of treatment, and probably an indispensable condition when recover}' is in any wise attainable, is the suspension of the patient in slings. He should be continued in them as long as he can be made to submit quietly to their restraint.
Liuxations. — Strength and solidity are so combined in the formation of the joints of our large animals that dislocations or luxations are injuries which are but rarely encountered. They are met with but seldom in cattle and less so in horses, while dogs and smaller animals are more often the suiferers.
The accident of a luxation or (its synonym) dislocation {displace- ment) is less often encountered in the animal races than in man. This is not because the former are less subject to occasional violence involving powerful muscular contractions, or are less often exposed to casualties similar to those which result in luxations in the human skeleton, but because it requires the cooperation of conditions, ana- tomical, physiological, and perhaps mechanical, i^resent in one of the races and lacking in the other, but which can not in every case be clearly defined. Perhaps the greater relative length of the bony levers in the human formation may constitute a cause of the difference.
Among the predisposing causes in animals, caries of articular sur- faces, articular abscesses, excessive dropsical conditions, degenera- tive softening of the ligaments, and any excessive laxity of the soft structures may be enumerated.
The symptoms of fractures and of dislocations are not always so variant as to preclude the possibility of error in determining a case without a thorough examination, but the essential difference, as it must always exist, must always be discoverable.
In a dislocation there is one very peculiar and characteristic feature in the impossibility of motion associated with an excessive liberty of movement — the impossibility of active or conti-olled motion, and a facility of passive movement (or movableness) at either the affected joint or at another of the same leg near to it. In a dislocation of the scapulo-humeral (or shoulder) joint the animal possesses no power of
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motion over the limb — no muscular contraction can avail to cause it to j)erform its various functions — but in the hands of the surgeon it may be made to describe a series of movements which would be simply- impossible with the joint in a state of integrity. Both fractures and luxations are marked by deformity, but while in a fracture with dis- placement there will usually be a shortening of the leg, a dislocation maj^ be accompanied by either a shortening or a lengthening. Swell- ing of the parts is usuallj^ a well-defined feature of these injuries.
With all this similaritj' in the sj^mptomatology of luxations and fractures, there is one sign which either by its j)resence or its absence will greatly assist in settling a case of differential diagnosis, and this is the existence or lack of crepiiation. It has no place or cause in a mere dislocation; it belongs to a fracture, if it is a complete one. If there is crepitation with a dislocation then it proves that there is a fracture also.
The jDrognosis of a luxation is comparatively less serious than that of a fracture, though at times the indications of treatment may prove to be so difficult to appl}- that complications may arise of a very severe character.
The treatment of luxations must of course be similar to that of frac- tures. Reduction, naturallj", will be the first indication in both cases, and the retention of the replaced parts must follow. The reduction involves the same steps of extension and counter-extension, performed in the same manner, with the patient subdued by anesthetics.
The difference between the reduction of a dislocation and that of a fracture consists in the fact that in the former the object is simply to restore the bones to their true normal position, with each articular surface in exact contact with its companion surface, the apparatus necessary afterwards to keep them in situ being similar to that which is emx)loyed in fracture cases, and which will usually require to be retained for a period of from forty to fifty days, if not longer, before the ruptured retaining ligaments are sufficiently firm to be trusted to perform their office unassisted. A variety of manipulations are to be employed by the surgeon, consisting in pushing, pulling, pressing, rotating, and indeed whatever movement may be necessary, until the bones are forced into such relative positions that the muscular con- traction, operating in just the right directions, imlls the oi)posite matched ends together in true coaptation, a head into a cavity, an articular eminence into a trochlea, as the case may be. The "setting" is accompanied by a peculiar snapping sound, audible and significant, as well as a visible return of the surface to its normal symmetry.
Special dislocations. — While all the articulations of the body are liable to tliis form of injury, there are three in the large animals which may claim a special consideration, viz:
Tlie shoulder joint. — We mention this displacement williout intend- ing to imply the practicability of any ordinary attempt at treatment.
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which is usually unsuccessful, the animal whose mishap it lias been to become a victim to it being disabled for life. The superiov head of the arm bone as it is received into the lower cavity of the shoulder blade is so situated as to be liable to be forced out of x^laee in four directions. It may escape from its socket, according to the manner in Avliich the violence affects it, outwards, inwards, backwards, or forwards, and the deformity Avhich results and the effects which follow will correspondingly differ. We have said that treatment is generally unsuccessful. It may be added that the difficulties which interpose in the way of reduction are nearly insurmountable, and that the api)lication of means for the retention of the parts after reduction would be next to impossible. The prognosis is sufficiently grave from any point of view for the luckless animal with a dislocated shoulder.
The liip joint. — This joint partakes very much of the characteristics of the humero-scapular articulation, but is more strongly built. The head of the thigh bone is more separated, or prominent and rounder in form, and the cup-like cavity or socket into which it fits is much deeper, forming together a deep, true ball-and-socket joint, which is, moreover, reenforced by two strong cords of funicular ligaments, which unite them together. It will be easily comprehended, from this hint of the anatomy of the region, that a luxation of the hip joint must be an accident of comparatively rare occurrence. And yet cases are recorded in which the head of the bone has been affirmed to slip out of its cavity and assume various positions, inwards, outwards, forwards, and backwards.
The indications of treatment are those of all cases of dislocation. When the reduction is accomplished the surgeon will be apprised of the fact by the peculiar snapping sound usually heard on such occasions.
Pseudo luxations of the poiella. — This is not a true dislocation. The stifle bone is so peculiarly articulated with the thigh bone that the means of union are of sufficient strength to resist the causes which usually give rise to luxations. Yet there is sometimes discovered a I)eculiar pathological state in the hind legs of animals, the effect of which is closely to simulate the manifestation of many of the general sj'mptoms of dislocations. This peculiar pathological condition origi- nates in muscular cram^Ds, the action of which is seen in a certain cliange in the coaptation of the articular surfaces of the stifle and thigh bone, resulting in the exhibition of a sudden and alarming series of symptoms which have suggested the phrase of "stifle out" as a descriptive term. The animal so affected stands quietly and firmly in his stall, or perhai)s with one of his hind legs extended backwards, and resists every attemx)t to move him backwards, and if urged to move forwards he will either refuse or eomi)ly witli a jump, with the toe of the disabled leg dragging on the ground and brought forward
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by a second effort. There is no flexion at the lioclc and no motion at the stifle, while the circular motion of the hij) is quite free. The leg appears to be much longer than the other, owing to the straightened position of the thigh bone, which forms almost a straight line with the tibia from the hip joint down. The stifle joint is motionless, and the motions of all the joints below it are more or less interfered with. External examination of the muscles of the hip and thigh discovers a certain amount of rigidity, with perhaps some soreness, and the stifle bone may be seen projecting more or less on the outside and upper part of the joint.
This state of things may continue foi- some length of time and until treatment is applied, or it may spontaneously and suddenly terminate, leaving everything in its normal condition, Init perhaps to return again.
Pseudo dislocation of the patella is likely to occur under many of the conditions which cause actual dislocation, and yet it may often occur in animals which have not been exposed to the ordinary causes, but which have remained at rest in their stables. Sometimes these cases are referred to falls in a slippery stall, or perhaps slipping when endeavoring to rise ; sometimes to weakness in convalescing patients ; sometimes to lack of tonicity of structure and general debility ; some- times to relaxation of tissues from want of exercise or use.
The reduction of these displacements of the patella is not usually attended with difficulty. A sudden jerk or spasmodic action will often be all that is required to spring the patella into place, when the flexion of the leg at the hock ends the trouble for the time. But this is not always suflicient, and a true reduction may still be indicated. To effect this the leg must be drawn well forward by a rope attached to the lower end, and the patella, grasped with the hand, forcibly pushed forwards and inwards and made to slip over the outside border of the trochlea of the femur. The bone suddenly slips into position, the excessive rigor of the leg ceases with a spasmodic jerk, and the animal may walk or trot away without suspicion of lameness. But though this may end the trouble for the time, and the restoration seem to be perfect and permanent, a repetition of the entire transaction may subsequently take place, and perhaps from the loss of some portion of tensile power which would naturally follow the original attack in the muscles involved the lesion might become a habitual weakness.
Warm fomentations and douches with cold water will often promote permanent recovery, and liberty in a box stall or in the field will in many cases insure constant relief. The use of a high-heeled shoe is recommended by European veterinarians. The use of stimulating liniments, with frictions, charges or even severe blisters, may be resorted to in order to prevent the repetition of the difficulty by strengthening and toning up the parts.
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DISEASES OF MUSCLES AND TENDONS.
SjJrains. — This term expresses a more or less complete laceration or jaelcling of the fibers of the muscles, tendons, or the sheaths sur- rounding and supporting them. The usual cause of a sprain is external violence, such as a fall or a powerful exertion of strength, with fol- lowing symptoms of soreness, heat, swelling, and a suspension of function. Their termination varies from simple resolution to sup- puration, and commonly plastic exudation difficult to remove. None of the muscles or tendons of the body are exempt from liability to this lesion, though naturally from their uses and the exposure of their situation the extremities are more liable than other regions to become their seat. The nature of the prognosis will be determined by a con- sideration of the seat of the injury and the complications likely to arise. The treatment will resolve itself into the routine of local applications, including warm fomentations, stimulating liniments, counter irritation by blistering, and in some cases even firing. Rest, in the stable or in a box stall, will be of advantage by promoting the absorption of whatever plastic exudation may have formed, or the absorption may be stimulated by the careful and iDcrsevering applica- tion of iodine in the form of ointments of various degrees of strength.-
There are many conditions in which not only the muscular and tendinous structures proper are affected by a sprain, but, by conti- guity of parts, the periosteum of neighboring bones may become involved, with a comx)lication of periostitis and its sequelse.
Lameness of the shoulder. — The frequency of the occurrence of lame- ness in the shoulder from sprains entitled it to precedence of mention in our present category. For, though so well covered with its mus- cular envelope, it is often the seat of injuries which, from the complex structure of the region, become difficult to diagnosticate with satis- factory precision and facility. The flat bone which forms the skeleton of that region is articulated in a comparatively loose manner with the bone of the arm, but the joint is, notwithstanding, rather solid, and is jDOwerfuUy strengthened bj^ tendons passing outside, inside, and in front of it. Still, shoulder lameness or sprain laay exist, origi- nating in lacerations of the muscles, the tendons or the ligaments of the joint, or perhaps in diseases of the bones themselves. " Slip of the shoulder" is a phrase frequently applied to such lesions.
The identification of the particular structures involved in these lesions is of mucli imj^ortance, in view of its bearing upon the ques- tion of prognosis. For example, while a simple superficial injury of the spinatus muscles, or of the muscles by which the leg is attached to the trunk, may not be of serious import and may readily yield to treatment, or even recover spontaneously and without interference, the condition is quite changed when a case of tearing of the flexor brachii, or of its tendons as they pass in front of the articulation,
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occurs, or, wliat is still more serious, if tlierc is inflammation or ulcer- ation in the groove over whicli this tendon slides, or upon the articular surfaces or their surroundings, or periostitis at any point adjacent.
The frequency of attacks of shoulder lameness is not difficult to account for. The sux)erficial and unprotected position of the part, and the numerous movements of which it is capable, and which in fact it performs, render it both subjectively and objectively preemi- nently liable to accident or injury. It would be difacult, nor would it materially avail, to enumerate all the forms of violence by which the shoulder may be crippled. A fall, accompanied by powerful con- cussion; a violent muscular contraction in starting a heavily loaded vehicle from a standstill; a misstep following a quick muscular effort; a jump accompanied by miscalculated results in alighting; a slip on a smooth, icy road; balling the feet with snow; colliding with another horse or other object — indeed, the list might be indefinitely extended, but it would be without profit or utility. Some of the symptoms of shoulder lameness are peculiar to themselves, and yet the trouble is frequently mistaken for other affections — navicular disease more often than any other. The fact that in both affections there are instances when the external symptoms are but imperfectly defined, and that one of them especially is very similar in both, is sufficient to mislead careless or inexperienced observers and to occasion the error which is sometimes committed of applying to one disease the name of the other, erring both ways in the interchange. The true designation of patho- logical lesions is very far, at times, from being of certain and easy accomplishment, and owing to the massive structure of the parts we are considering this is especially true in the present connection. And still there are many cases in which there is really no reasonable excuse for an error in diagnosis by an average practitioner.
Shoulder lameness will of course manifest itself by signs and appearances more or less distinct and pronounced, according to the nature of the degree and the extent of the originating cause. We summarize some of these signs and appearances:
The lameness is not intermittent but continued, the disturbance of motion gauging the severity of the lesion and its extent. It is more marked when the bones are diseased than when the muscles alone are affected. When in motion the two upper bony levers, the shoul- der blade and the bone of the upper arm, are reduced to nearly complete immobility and the walking is performed by the complete displacement of the entire mass, which is dragged forward without either flexion or extension. The action of the joint below, as a natural consequence, is limited in its flexion. In many instances there is a certain amount of swelling at the point of injury— at the joint, or more commonly in front of it, or on the surface of the spinatus muscle. Again, instead of swelling there will be muscular atrophy, though while this condition of loss of muscular power may interfere with
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perfect locomotion, it is not in itself usually a cause of shoulder lame- ness. . ' ' Sweenied " shoulders are more often diie to disease l^olow the fetlock than to atfections above the elbow.
During- rest the animal often carries his leg forward, somewhat analogous to the "pointing" i)osition of navicular disease, though in some cases the painful member drops at the elbow in a semi-flexed position. The backing is sometimes typical, the animal when per- forming it, instead of flexing his shoulder, dragging the whole leg without motion in the uj^per segment of the extremity. The peculiar manner in which the leg is carried forward in the act of walking or trotting is in some instances cliaracteristic of injuries of the shoulder, the power of extension being limited; the whole leg in the act of locomotion is moved forward with a circumflex, swinging motion, which distinguishes this peculiar affection from others.
With the utmost scrutiny and care the vagueness and uncertainty of the symptoms will contribute tojjerplex and discredit the diagnosis and embarrass the surgeon, and sometimes the expedient is tried of aggravating the symptoms by way of intensifying their significance, and thus rendering them more intelligible. This has been sought by requiring the i)atient to travel on soft plowed ground and compelling him to turn on the affected leg as a pivot, with other motions calculated to betray the locality of the pain.
It is our conviction that lameness of the shoulder mil in manj" cases disappear with no other p»-escription that that of rest. Pro- vided the lesions occasioning it are not too sevei'e time is all that is required. But the negation of Jetting alone is seldom accepted as a means of doing good, in the place of the active and the positive forms of treatment. This is in accordance with a trait of human nature which is universal, and is unlimited in its applications. Hence there must be something done. In mild cases of shoulder lameness, then, the indications are water, either in the cold douche or by showering, or by warm fomentations. Warm wet blankets are of gi-eat service; and in addition, or as alternative, anodyne liniments, camphor, bella- donna, either in the form of tincture or the oils, are of benefit, and at a later period stimulating friction with suitable mixtures, sweating liniments, blistering compounds, etc., will find their place, and, finally, when necessity demands it, the firing iron and the seton.
The duration of the treatment must be determined by its effects and the evidence that may be offered of the results following the action of the reparative process. But the great essential condition of cure, and the one without which the possibility of relapse will always remain as a menace, is, as wo have often reiterated in analogous cases, rest., imperatively rest, irrespective of any other prescriptions with which it may be associated.
Sjyrain of the elboiv muscles. — This injury, whicli fortunately is not very common, is mostly encountered in cities, among heavy draught
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horses or rapidly driven animals Avhicli are obliged to travel, often smooth shod, upon slippery, icy, or greasy pavements, where they are easily liable to lose their foothold. The region of the strain is the posterior part of the shoulder, and the muscles which are afEected are those which occupy the space between the posterior border of the scapula and the posterior face of the arm. It is the muscles of the olecranon which give way.
The symptoms are easily recognized, especially Avhen the animal is in action. While at rest the attitude may be normal, or by close scrutiny a peculiarity may perhaps be detected. The leg may seem to drop ; the elbow may appear to be lower than its fellow, with the knee and lower part of the leg flexed and the foot resting on the toe, with the heel raised. Such an attitude, however, may be occasionally assumed by an animal without having any special significance. But when it becomes more i^ronounced on putting him in motion the fact acquires a symptomatic value, and this is the case in the present instance. A rapid gait becomes quite impossible, and the walk, as in some few other diseases, becomes sufficiently characteristic to Avarrant a diagnosis even when observed from a distance. An entire dropping of the anterior part of the trunk becomes manifest, and no weight is carried on the disabled side, in consequence of the loss of action in the suspensory muscles. There are often heat, pain, and swelling in the muscular mass at the elbow, though at times a hollow or depression may be observed near the posterior border of the scapula, which is probably the seat of injury.
These hurts are of various degrees of imi3ortance, varying from mere minor casualties of quick recovery to lesions which are of sufficient severity to render an animal useless and valueless for life.
The prime elements of treatment, which should be strictly observed, are rest and quiet. Prescriptions of all kinds, however, of course, have their advocates. Among them are ether, chloroform, camphor, alcoholic frictions, warm fomentations, blisters, setons, etc. But, unless the conclusions of experience are to be ignored, our own judg- ment is decisive in favor of rest, judiciously applied; and our view of what constitutes a judicious application of rest has been more than once presented in these pages. There are degrees of this rest. One contemplates simple immobility in a narrow stall. Another means the enforced mobility of the slings and a narrow stall as well. Another a box stall, with ample latitude as to posture and space, and option to stand up or lie down. As wide as this range may appear to be, radical recovery has occurred under all of these modified forms of letting our patients alone.
Hip lameness. — The etiology of injuries and diseases of the hip is one and the same with that of the shoulder. The same causes operate and the same results follow. The only essential change, with an important exception, which would be necessary in passing from one
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region to the otlier in a descrii^tion of its anatoiny, its pliysiology, and its pathology, wonld be a snbstitntion of anatomical names in refer- ring to certain bones, articnlations, muscles, ligaments, and mem- l>ranes concerned in the injuries and diseases described. It would be only a useless repetition to cover again the ground over which we have so recently passed in recital of the manner in which certain forms of external violence (falls, blows, kicks, etc.) result in other certain forms of lesion (luxation, fracture, periostitis, ostitis, etc.), and to recapitulate the items of treatment and the names of the med- icaments proi)er to use. The same rules of diagnosis and the same indications and prognosis are ajiplicable equally to every portion of the organism, with only such modifications in ai^plying dressings and apparatus as may be required b}' diffei'ences of conformation and other minor circumstances, which must suggest themselves to the judgment of every experienced observer when the occasion arri\'es for its exercise.
There is an excei)tion to be made, while considering the subject in connection with the region now under advisement, in respect to the formidable affection known as morbus coxarius, or hip-joiiit disease; and leaving the detail of other lesions to take their place under otlier heads, that relating to the shoulder, for instance, we turn to the hip joint and its ailments as the chief subject of our present consideration.
In investigating for morbus coxarius, let the observer first examine the lame animal by scanning critically the outlines of the joint and the region adjacent for any difference of size or disturbance of sym- metry in the parts, any prominence or rotundity, and on both sides. The lame side will probably be warmer, more developed and fuller, both to the touch and to the eye. Let him then grasp the lower part of the leg (as he would in examining a case of shoulder lameness) and endeavor to produce excessive passive motion. This will prob- ably cause pain when the leg is made to assume a given position. Let him push the thigh forcibly against the hip bone, and the contact will again probably cause a manifestation of pain. If the horse is trotted, the limited action of the hip joint proper and the excessive dropping and rising of the hip of the opposite side will be easil}^ recog- nized. The abductive or circumflex motion observed in shoulder lameness is also present in hii) lameness, but under special conditions, and the test of the difficulty, either by traveling on soft ground or making the lame leg a pivot in turning the horse in a circle, may here also contribute to the diagonosis as in testing for lameness in the anterior extremity.
The prognosis of hip lameness is at times quite serious, not only on account of the long duration of treatment required to effect good results, and because of the characters which may be assumed by the disease, but of the permanence of the disability resulting from it. Exostosis and ulcerative arthritis are sequelae which often resist every form of treatment.
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As before intimated, tliis is little more than a repetition of our remarks upon the lameness of the shoulder, with slight modifications occasioned by the inuseular structure of the hip, and we are limited to the same recommendations of treatment. The advantages of rest must be reaffirmed, Avith local apiilications, of which, however, it may be said that they are more distinctly indicated and likely to be more effective in their results than in shoulder lameness, and may be more freely emjiloyed, whether in the form of liniments, blisters (singly or repeated), firing, or setoning.
Sprains of suspensory ligaments and of ilie flexor tendons or their sheatJi. — The fibrous structure situated behind the cannon bones, both in the fore and hind legs, is often the seat of lacerations or sprains resulting from violent efforts or sudden jerks. The injurj^ is readily recognized by the changed aspect of the region and the accompany- ing local symptoms. The parts, which in health are Avell defined, with the outlines of the tendons and ligaments well marked, become the seat of a swelling, more or less developed, from a small sjjot of the middle of the back of the tendon to a tumefaction reaching from the knee down to and even involving the fetlock itself. It is alwaj^s characterized by heat, and it is variousl}^ sensitive, ranging from a mere tenderness to a degree of soreness which shrinks from the lightest touch. The degrees of the lameness varj- , and it has a corresponding range with the soreness, sometimes showing only a slight halting and at others the extreme of lameness on three legs. Avith intermediate degrees.
It has for its cause, like all the other forms, external traumatism by falls, blows, etc. , and may be considered serious or trifling, accord- ing to the circumstances of each case as judged by its own history. It may be safely assumed on general principles that a leg which has received such injuries very seldom returns to a perfect condition of efficiency and soundness, and that as a fact a certain absolute amount of thickening and deformity will remain in permanency, even when the lameness has entirely disappeared.
For this reason the injured member should receive the earliest attention possible, not only when the inflammatory condition is pres- ent, but when it is subsiding and there is only the thickening of the ligaments, the tendons, or tlie sheath. Cold bathing, cold-water band- ages, either simple or with astringent solutions, do well in some cases, while in others hot applications have the preference, with com- plete rest; also, moderate exercise; frictions with alcohol ; tincture of soap; spirits of camphor; mild liniments; strong sweating liniments; blisters; the cauterj'^ — these are the means bj^ which the absorption of tlie exudate must be promoted and the work of restoration effected. The preparations of iodine are often of benefit in mild cases, but there are others in which the thickening of the tendons refuses to yield ;uid Ihe changed tissues remain firmly organized, leaving them
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iu the form of a thick mass resting on the back part of the cannon bone. As a consequence the deformity remains and a new condition presents itself in the articular disposition, constituting the deformity known as the knuclding fetloclc.
By this is meant a deformity of the fetloclc joint by which the nat- ural angle is changed from that which pertains to tlie healthy articu- lation. The first pastern or suffraginis loses its oblique direction and assumes another which varies from the upright to the oblique, from befoi-e backwards, and from above downwards; in other words, forming an angle with its point in front.
This condition, as we have seen, may be the result of chronic dis- ease pi-oducing structural changes in the tendons, and it may also occur as the result of other affections or some i^eculiarity independent of this and situated below the fetlock, such as ringbones, sidebones^ or traumatic disease of the foot proper. Animals are sometimes pre- disposed to knuckling, such, for example, as are naturally straight in their pasterns or animals which are compelled to labor when too young. The hind legs are more predisposed than the fore to this deformity, in consequence of the greater amount of labor they are required to perform as the propelling levers of the body.
The symptoms of knuckling are easilj" recognized. The changes in the direction of the bones vary more or less with the degree of the lesion, sometimes assuming such a direction that it almost becomes a true dislocation of the pastern.
The effect of knuckling upon the gait also varies aecoixling to the degree of the deformity. As the different degrees of the shortening of the leg aifect the motion of the fetlock the lameness may be very slight or quite extreme. Another consequence of this shortening is such a change in the position of the foot that the heels cease to come in contact with the ground and assume a greater elevation, and the final result of this is soon witnessed in the development of a clubfoot.
To whatever cause the knuckling may be ascribed it is always a severe infirmity, and there is but little room for hoping to overcome it unless it be during the very first stages of the trouble, and the hope dwindles to still smaller dimensions when it is secondary' to other diseases below the fetlock. If it is caused by overworking the animal, the first indication will of course be rest. The animal must be turned loose and left unemi)loyed and careful attention given to the condi- tion of his feet and to the manner of shoeing, while time is allowed for the tendons to become restored to their normal state and the irritation caused by excessive stretching has subsided. A shoe with a thick heel will contribute to this. But if no improvement can be obtained and the tendons though retracted have yet been relieved of much of their thickening, the case is not a desperate one and may yet be benefited by tlie operation of tenotomy, single or double — an oi)erative expedient which must be committed to the experienced surgeon for its performance.
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SpriDHj l:)iee.s. — Tliougli not positively the result of diseases of the tendous acting upon the knees, we venture to consider this deformity in connection with that which we have just described. It consists in such an alteration in the direction and articulation of the bones which form the various carpal joints that instead of forming- a vertical line from the lower end of the forearm to the cannon bone they are so united that the knee is more or less bent forward, presenting a condi- tion due to the retraction of two of the j^rincipal muscles by which the cannon bone is flexed.
Tliis flexion of the knee may also be a congenital deformity and have continued from the foaling of the animal. Or, like clubfoot, it may be the result of heavy labor which the animal has been com- pelled to j)erform at too early an age. It may also be due to other diseases existing in parts below the knee joint.
This change of direction largely influences the movement of the animal by detracting from its flrniness and practically weakening the entire frame, even to the extent of rendering him insecure on his feet, and liable to fall. This condition of weakness is sometimes so pronounced that he is exposed to fall even when standing at rest and unmolested, the knees being unable even to bear the jjortion of the mere weight of the frame Avhicli belongs to them. This results in another trouble, that of being unable to keep x)ermanently upright. He is apt to fall on his knees, and by this act becomes presently a sufferer from the lesion known by the term of broken knees.
Whatever may be the originating cause of this imperfection it detracts very largely from the usefulness and ^■alue of a horse, dis- qualifying him for ordinary labor and wholly unfitting him for serv- ice under the saddle without jeopardizing the safety of his rider. If, however, the trouble is known from the start, and is not the result of congenital deformity or weakness of the knee joint, or secondary to other diseases, rest, with fortifying frictions, may sometimes aid in strengthening the joints; and the application of blisters on the pos- terior part of the knee, from a short distance above to a point a little below the joint, may be followed by some satisfactory results. But with this trouble, as with knuckling fetlocks, the danger of relapse must not be ignored, but kept in mind as a contingency always liable to occur.
Curl). — This lesion is the bulging backwards of the jjosterior part of the hock, where in the normal state there should be a straight line, extending from the uj)per end of the point of the hock down to the fetlock. The cause may be a sprain of the tendon which passes on the posterior part of the hock, or of one of its sheaths, or of the strong ligament situated on the posterior border of the os calcis. This con- dition, if not commonly the result of malformation, is often seen in hocks vdiich present the peculiar condition of being curby. It often occurs, also, as the result of violent efforts, of heav}' pulling, of high
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jumpiug or of slipi^ing'; in a word, it iiiay result from any of tlie causes heretofore considered as instrumental in producing lacerations of muscular, tendinous, or ligamentous structure.
A hock affected Avith curb will, at the outset, present a swelling more or less diffuse on its posterior portion, with varying degrees of heat and soreness, and these will he accompanied by lameness of a permanent character. At a later period, however, the swelling will become better defined, the deformity more characteristic, the promi- nent curved line readity detected, and the thickness of the infiltrated tissue easily determined by the fingers. At this time, also, there may be a condition of lameness, varjdng in degree; while at others, again, the irregularity of action at the hock will be so slight as to escape attention, the animal betrajang no appearance of its existence.
A curb constitutes, by a strict construction of the term, an " unsound- ness," since the hock thus affected is less able to endure severe labor, and is more liable to give way with the slightest effort. And yet the prognosis of a curb can not be considered to be serious, since it gen- erally yields to treatment, or at least the lameness it may occasion is generally easily relieved, though the loss of contour caused by the bulging will always constitute a blemish to the eye.
On the first appearance of a curb, when it exhibits the signs of an acute inflammation, the first indication is to subdue this by the use of warm fomentations or other topical applications. But when these have exhausted their effect and the swelling has assumed better defined boundaries, and the infiltration of the tendons or of the liga- ments is all that remains of a morbid state, then every effort must be directed to the object of effecting its absorption and reducing its dimensions by pressure and other methods. The medicaments most to be trusted are blisters of cantharides and frictions with ointments of iodine, or, preferably, biniodide of mercury. Mercurial agents alone, by their therapeutic properties, or by means of the artificial bandages which they f urnisli by their incrustations when their vesi- catory effects are exhausted, will give good results in some instances by a single application, and often by rexjeated applications. The use of the firing iron must, however, be frequently resorted to, either to remove the lameness or to stimulate the exudation. We believe that its early application ought to be resorted to in preference to waiting until the exudation is firmly organized. Deep and fine needle firing will prove as beneficial in curb as in any other disease of a similar nature.
Lacerated tendons. — This form of injurj^, whether of a simple or of a compound character, may become a lesion of a very serious nature, and will usually require long and careful treatment, which may yet prove unavailing in consequence either of the intrinsically fatal char- acter of the wound itself or the complications which have rendered it incurable.
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Like all similar injuries, tlies^are the result of traumatic violence, such as contact with objects botli blunt and shari?; a curbstone in the city; in the country a tree stump or a fence, especially one of wire. It may easily occur to a runaway horse when he is "whipped" with fragments of harness or "flogged" by fragments of splintered shafts "thrashing" his legs, or by the contact of his legs with the Avagon he has overturned and shattered with his heels while disengaging himself fi-om its wreck.
It is not always necessary that the skin should be involved in this form of injury. On the contrary the tegument is frequently left entirely intact, or exhibits only some slight and superficial abrasions. Yet, again, the skin maj^be cut through and the tendons nearly severed. A point a little above the fetlock is usually the seat of the injury. But irrespective of this, and whether the skin is or is not implicated, the symptoms very much resemble those of a fracture. There is excessive mobility, at least more than in a normal state, with more or less ina- bility to carry weight; there may be swelling of the parts, and on passing the hands carefully along the tendon to the point of division the stumps of the divided structure will be felt more or less separated, I)erhaps wholly divided. The position of the animal while at rest and standing is x^eculiar and characteristic. While the heels are well placed on the ground, the toe is correspondingly elevated with a dis- sion to turn up — a form of breaking down which we have described when speaking of the fracture of the sesamoids. Carrying weight is done only with considerable difficulty, but with comx)aratively little pain, and the animal will unconsciously continue to move the leg as if in great suffering, notwithstanding the fact that his general condi- tion maj" be very good and his appetite unimpaired.
The effect upon the general organism of compound lacerated wounds of tendinous structures, or those which are associated with injuries of the skin, are different. The wound becomes, in a short time, the seat of a high degree of inflammation with abundant suppuration, filling it from the bottom; and the tendon, Avhether as the result of the bruise or of the laceration, or of maceration in the accumulated pus, under- going a process of softening, and necrosis and sloughing ensue. This complicates the case, and probably some form of tendinous synovitis follows, running into suppurative arthritis, to end, if close to a joint, with a fatal result.
The prognosis of lacerated tendons should be very cautiously attemi)ted. Under the most favorable circumstances a period of from six weeks to two months will be necessary for the treatment, before the formation of the cicatricial callus and the establishment of a firm union between the tendinous stumps.
As with fractures, and even in a greater degree, the necessity is im- perative, in the treatment of lacerated tendons, to secure as perfect a state of immobility as can bo obtained compatibly with the disposition
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of the patient; the natural opposition of the animal, sometimes ill- tempered and fractious at best, under the necessary restraint, causing at times much embarrassment to the practitioner in applying the necessary treatment. Without the necessary immobility no close connection of the ends of the tendons can be secured. To fulfill this necessary condition the j)osterior part of the foot and the fetlock must 1)0 suppo' ted and the traction j^erformed bj' them relieved, an object which can be attained by the use of the high-heeled and bar shoo, or possibly better accomplished with a shoe of the same kind extending about 2 or 2^ inches back of the heels. The i^erfect immobilitj' of the legs is obtained in the same way as in the treatment of fracture, with splints, bandages, iron apparatus, plasters of adhesive mixtures, and similar means. So long as the dressings remain in place undisturbed, and no chafing or other evidence of pain is present, the dressings may be continued without changing, the patient being kept in the slings for a period sufficient to insure the perfect union of the tendons. But for a compound lesion, when there is laceration of the skin, some special care is necessary. The wound must bo carefully watched and the dressings removed at intei'vals of a few days, or as often as may be needful, all of which additional manipulation and extra nursing, however indisi^onsablo, still adds to the gravity of the case and ren- ders the prognosis more and more serious. When the tendons have sloughed in threads of various dimensions, or if in the absence of this process of mortification healthy granulations should form and fill uj) the Avound, still very careful attention will 1)0 required, the gran- ulating ends of the tendons having a tendencj^ to bulge between the edges of the skin and to assume large dimensions, forming bulky excrescences or growths of a Avartj' or cauliflower appearance, the removal of which becomes a troublesome matter.
Tlie union of the tendons will at times leave a thickening of varj'^- iug degree near the point of cicatrization,, the absorption of which becomes an object of difficult and doubtful accomplishment, but which may be promoted l)y moderate Ijlistering and the use of altera- tive and absorbent mixtures or perhaps the fire iron, A shoe with heels somewhat higher than usual will prove a comfort to the animal and aid in moderating and relieving the tension of the tendons.
Rupture of the flexor metatarsi. — This is a muscle of the anterior part of the shank. It is situated in front of the tibia, and is of pecul- iar formation, being composed of a muscular portion with a very powerful tendon, which are at first distinct and separate, to bo inti- mately united lower down, and terminating at the lower end by a di%ision into four tendinous bands. It is a powerful muscle of the hinder shank bone, and also acts as a strong means of support for the stifle joint, that is, of the articulation of the thigh and shank bone, in front and outside of which it passes. Its situation and its use cause it to be liable to severe stretcliiug and straining, and a rupture of some of its fibers is sometimes the consequence.
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Tliis uiay be the result of a violent eifort of the animal in leaping over a high obstacle; in missing his foothold and suddenly slipping backwards while powerfully grasping the ground with the feet in striving to start a heavily loaded vehicle; or in making a violent effort to prevent a j)robable fall.
The accident is immediately followed by disability which will vary both as to the true seat of the injury and the period of its duration. This rupture will not i^revent the horse from standing perfectly and firmly on his feet when kept at rest, and while no muscular efforts are required from him there is no appearance of any lesion or unsound- ness. An attempt to move him backwards, however, will cause him to throw all his weight upon his hind quarters, and he will refuse to raise his foot from the ground. If compelled to do so, or required to move forward, the hock being no longer capable of flexion, the muscle which effects that movement being the injured one, the opposite muscles, the extensors, acting freely, the entire lower part of the leg, from the hock down, will be suddenly, with a jerk, extended over the tibia or shank bone, and simultaneously with this the tendo-achilles, the cord of the hock, the tendons of the extensors of the hock will be put in an excessively relaxed condition. Examination of the fore part of the shank from the stifle down to the hock may reveal soreness, and possibly some swelliiig and heat at the seat of the lesion.
Our experience with injuries of this form satisfies us that, gener- ally speaking, they are amenable to treatment. Very few instances have come to our knowledge in which radical recovery has not been obtained, provided a sufficient time has been allowed for cicatrization to take place.
In these cases, as in those alread}^ considered of simple laceration of tendons, the indications resemble those which apply in the treat- ment of fractures; as near a coaptation of the lacerated ends as pos- sible, with immobility, being the necessarj^ objects to secure. The first is a matter of very difficult accomplishment, by bandaging alone, and some have recommended instead the application of charges or blisters. To these we strongly object from their liability to cause irritation and to allow of excessive movement, both circumstances being unfavorable in their influence and hindering the action of the reparative powers.
To secure the necessary immobility the animal should be placed in slings snugly applied, and kept in a narrow stall. lie should also be tied short, and restrained from s,ny backward movement by ropes or boards, and he should moreover be kept in as quiet a temper as pos- sible by the exclusion of all causes of irritation or excitement. Weeks must then elapse, not less, but frequently more than six, often eight, before he can be considered out of danger and able to return to his labor, which should for a time be light and easy, and gradually, if ever, increased to the measure of a thoroughlj^ sound and strong animal.
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SUNDRY ADDITIONAL AFFECTIONS OF THE EXTREMITIES.
Among these there are tliiee wliich will principally occui)y our attention, and these may be considered as forming a single group. In some parts of the legs may be found certain peculiar little struc- tures, of a sac-like formation, containing an oily substance designed for the lubrication of the parts uj)on which they are placed for the purpose of facilitating the movements of the tendons which pass over them. These little sacs or muco synovial capsules are liable under peculiar conditions of traumatism to become subject to a diseased process, which consists principally in a hyper-secretion of their con- tents and an increase in dimensions, and the}'^ may undergo peculiar pathological changes of a character to disable an animal, and in many instances to cause serious blemishes which can not but depreciate his value. These growths, which are known as hygromata, may result from external violence, as blows or bruises, and may appear in the form of small, soft tumors, painless and not inflammatorj- in charac- ter, but, by a repetition of the cause or renewal of violence, likely to acquire a new severity. Severe inflammation may supervene, with suppuration, which, filling up the cavity, the walls will become thick- ened and hai'd, and the formation of a tumor follow, which, resisting all forms of treatment, can only be made to disappear by subjecting tliem to the edge of the bistour3^
The elbow, the knee, and the hock are the principal i3arts of the body where these lesions are ordinarily found, and on account of their peculiar shape and the position they occupy they have received the denomination of being capped. We shall consider them in their peculiar aspect.
Capped elboiv. — The shoe boil, commonly so called, is almost too well known to require a definition from us. An enlargement at the point of the elbow is the lesion, so called, which is simi)ly the result of pressure of the heels of the shoe upon that part. There are, of course, some conditions necessary for the development of the shoe boil, and for the pressure of the heels uj)ou the spot where it occurs. Excessive length in the shoe and a formation of the animal with a cannon bone so long that the flexure of the knee brings the heel in contact with the elbow may be termed the predisposing causes, but to these must be added another necessary condition in the peculiar mode of resting adopted by the affected animal, as exhibited in his manner of lying down, which is that of the cow, b}^ resting upon the breastbone with the legs flexed under the body — a most eligible and natural posture for effecting the result which follows.
The heel just pressing against the elbow, the hard iron of the shoe in contact with the soft skin, with the weight of the body added, forms a combination of causes which can not well fail to produce the 59(31— HOR 12
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bruise wliicli in fact does follow, and ^yllicll soon afterwards l3ecomes characterized by a variety of symptoms — for a capped elbow does not always exhibit the same aspect. In one case there is simply a bruise, with symx3toms of inflammation more or less marked or severe. The parts will be swollen, sometimes enormously, with heat and pain, the swelling- not onl}^ covering the point of the elbow, but sometimes reaching the axilla, and assuming such proportions that there is great difficulty in using the leg, the animal showing signs of lameness even to the extent of the circumflex step, as in shoulder lameness. This cBdematous condition, liowever, does not x-emain stationary. It may b}^ degrees subside or perhajis disappear. In the first instance it will become more distinctly defined, v/ith better marked boundaries, until it is reduced to a soft, round, fluctuating tumor, with or without heat or pain. There is- then either a bloody or serous tumor or a purulent collection, and following the puncture of its walls with the knife there will be an escape of blood, of serum, or of pus, as the case may be, in variable quantities. In either case, but principally in that of the cj'stic form, the tumor will be found to be subdivided by septums or bands running in various directions.
Various changes will follow the opening of the tumor and the escape of its contents. In a majority of cases, the process of cica- trization will take place, and the cavity fill up by granulation, the discharge, at first abundant, gradually diminishing and the wound closing, usually without leaving any mark. At times, however, and especially if the disease has several times repeated its course, there may remain a x)endulous sac, partly obliterated, which a sufficient amount of excitement or irritation may soon restore to its ijrevious dimensions and condition.
In other cases an entirely different process takes place. The walls of the cavity, cyst, or abscess become ulcerated and thickened, the granulations of the sac become fibrous in their structure and fill up the cavit}^, and it assumes the character of a hard tumor on the back of the elbow, sometimes partly and sometimes entirely covered by the skin. It is fibrous in its nature, painless to the touch, well defined in its contour, and may vary in size from that of a small lady api)le to that of a child's head.
This last form of capped elbow is the most serious of any, resisting all known forms of mild treatment, and removable by the knife only. The other forms, even that with the inflammatory aspect and its large oedematous swelling which interferes Avith the work of the animal, maj'- justify a much milder i^rognosis, and aside from their liability to recur may be ranked with the comi^aratively harmless affections.
So long as the danger of recurrence is the principal bad feature of capped elbow the most important consideration is that of devising a means of its prevention by curing the animal of his habit of resting in the cow-like posture of sternal decubitus. To prevent the animal
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from lying down is evidently the simplest method of keeping the heels and the elbow apart. But the impracticability of this i)rescrip- tion is apioarent, since a majority of animals are obliged to lie down when they sleep, though it is true that a few take their sleep on their feet. The question of shoeing here enters into the discussion. The shortening of the inside branch of the shoe, Avhich is the one with which the pressure is made, may be of advantage, and especially if the truncated end of the shoe is smooth and filed over to remove all IJossibility of pressure and contusion upon the skin. The protection of the skin of the elbow }jy interposing soft tissues between that and the shoe, or bj' bandaging the heel with bags, or covering it with boots, is considered by many the best of the preventive methods, and the advantage to be secured by resorting to it can not be overlooked when the number of horses which develop shoe boil whenever the use of the boot is intermitted, is considered. In order to prevent the ani- mal from assuming the sternal decubitus, many give preference to the plan of fastening a piece of wood across the stall at some distance from the front wall or manger. It is a simx^le exxDcdient, primitive perhaps, but nevertheless practical and followed by good results.
The therapeut ic treatment is also important. The oedematous swell- ing, indicative by its external apx)earance and the existing inflamma- tion of the diseased condition, requires the use without delay of all the means attainable for its abatement, with the accomf)anying pain and the heat, Avitli whatever may tend to accelerate the absorption of the exudate. Warm fomentations, repeated several times dailj^, are then indicated, the degree of warmth being as high as can be com- fortabl}- borne. They are of easy application, and often yield impor- tant relief in a few hours. In some cases, however, astringents are used in preference, in the form of poultices or pastes, which are made to cover the entire swelling and allowed to remain, drying after a short time, it is true, and perhaps falling off, but easily renewed and reapi)lied. We have often recommended for these cases (and we renew our indorsement) a putty made of common chalk, powdered, and vinegar (acetate of lime — an excellent astringent), and covering the Avhole swelling with a thick coating of soft clay, made into a softish mass with water. It has proved very beneficial in our experience.
These simple remedies are often all that is required. Under their use the SAvelling i^asses off by degrees and after a short interval the animal is remanded to his work again. But not uncommonly, instead of this a tumor or lump develops itself, putf}-, not painful, and per- haps giving a sensation of crepitation when j)ressure is made on it. It is soft and evidently contains a liquid, and when freely opened, with a good-sized incision, discharges a certain amount of blood, partly liquid and partly coagulated, and perhaps a little hemorrhage will follow. The cavity should then be Avell washed out and a tent of oakum introduced, leaving a small portion protruding llirough the
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cut to prevent it from closing pl•enlatul'el5^ It may be taken off the next day, and a daily cleansing will then be all that is necessary. In another case the tumor becomes very soft in its whole extent, with evi- dent fluctuation and a well-defined form. The discharge of the fluid is then indicated, and a free incision will be followed by the escape of a quantity of thin, j^ellowish liquid from a single sac. The irritation of tlie lining membrane with the finger nails, and the introduction of a tent of oakum, as before, but which should be changed every two or three days, during which time the parts should be kept free from suppuration, will inaugurate a speedy change and recovery will soon follow. But if the cavity is found to be subdivided in its interior by numerous bands, and the cyst proves to be multilocular, the j)ai'titioning sacules should be torn out Avith the fingers, and the cavity then treated in the same manner as the single or unilocular sac. Another condition is that when the tumor is warm and has been painful, and has been soft and fluctuating indistinctly^ or only at a given point, the evidence is of an abscess again indicating the use of the knife for a free incision for the exit of the contents, tlie general and first indication in all suppurative collections.
But cases occur when all the treatment that has been detailed has failed to effect a full recovery, and, instead of closing properly, the cavity has become the seat of granulations other than those of a healthful and benign character, having assumed a new and peculiar form, and appearing in that of a fibrous tumor, quite apt, if not evicted, to constitute a mere eyesore, profitable and pleasing to no one. A change of treatment is of course then in order. The inflam- mation, having a disposition to become chronic, will require stiinulat- ing treatment in order to counteract that tendency by the quickened activity of the process of absorption, and we must again draw upon the resoui'ces of experience in the form of the blisters, the fomenta- tions, the iodine, and the mercurial helps as heretofore mentioned. Good results may always be insured from their judicious and timely administration while combating the aberrations of nature, but little, from them or from any of the allies of the curative art, by their unin- telligent and misdirected emijloyment. In applying the jDowerful mineral inunctions much patience and wisdom are demanded. It should be done by carefully and perseveringly rulibing in small quan- tities daily; it should be done softly and gently, not with force of arms, nor with the expectation of producing an astonishing effect by heavy dosing and main strength in a few hours; it should be after the manner of a siege rather than that of a charge. The object must be to induce the drugs to permeate the affected part until the entire mass is penetrated. Of course cases will be encountered which resist every form of treatment but the last of all (in dealing with external and excessive growths). The tumor remains as a fixed fact; it cor tinues to grow; it is large and pendulous at the elbow; its weight is
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estimated in i)ounds; it is not an eyesore merely, but an uncomfort- able, burdensome mass, excoriating all the surrounding parts and being itself excoriated in turn; mild treatment has failed and is no longer to be relied on. There is no longer an alternative between the abandonment of the patient and the amputation of the tumor. But there is a choice of modes and instrumentalities, a question of pref- erence between the ligature, the electric cautery, and the bistoury. Each has its advocates among practitioners. In a case like the pres- ent, one of the practical embarrassments aiises in connection with the application and retention of bandages ajid other dressings after the amputation has been f)erformed. It is a somewhat difficult prob- lem, owing to the conformation and proi)ortions of the body of the patient, and involves the exercise of a considerable amount of prac- tical ingenuity to adjust and retain the appliances necessary to insure a good final result in obtaining a proper cicatrix.
In our long description of the treatment of the varieties of capi)ed elbow we have thus far omitted any mention of one method which has to some extent received the sanction of experience, and which is practiced and commended by not a few. We refer to the use of setons, introduced through and through the tumor. We mention it to say that our experience is adverse to this mode. We are led to this opinion not only by our observation of many failures, but from the fact that in many cases the use of the seton has been followed by the formation of large fibrous tumors, which in our opinion have resulted from it.
Capped knee. — The passage of the tendons of the extensor muscle of the cannon, as it glides in front of the knee joint, is assisted by one of the little bursse we have before mentioned, and when this becomes the seat of a dropsical collection a hygroma is formed and the knee is "capped." Though somewhat analogous in its history to the capped elbow, there are points of diiference between them. Their develop- ment may j)rove a source of great annoyance from the fact of the blemish which they constitute.
The capped knee presents itself under various conditions. It is sometimes the result of a cause nearly unique, as when it follows a bruise or contusion, often repeated, inflicted upon himself by a horse addicted to the habit of pawing while in the stable and striking the front of the stall with his knees. Another class of patients is formed of those weak-kneed animals which are subject to falling and bruising the front of the joint against the ground, the results not being always of the same character.
The lesion may be a simple bruise, or it may be a severe contusion with swelling, oedematous, hot, painful, and interfering with locomo- tion, the joint becoming stiff and sometimes so rigid that the animal is unable to flex it, and still, under simple treatment, the trouble may subside almost by spontaneous action.
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Or, again, instead of altogether x^assing off, the oedema may diminish in extent, becoming more defined in form and remain as a tnmor more or less developed on the front part of the knee. Resulting from the crushing of small blood vessels, this is essentially a bloody tumor. It is somewhat soft, not painful, surrounded by a little swelling, round, more or less fluctuating, and after a few days becomes cripitant under the pressure of the hand.
But instead of possessing all the characteristics of a bloody tumor it may also assume those of a serous growtli, as often occurs when the violence (the bruise), though perhaps slight, has been frequently repeated. In that case the tumor becomes better defined, generally painless, without any surrounding swelling, is niucli softer, is fluctu- ating, and more or less pendulous.
In other cases, however, this serous tumor becomes the seat of an acute inflammation, perhaps from repetition of the original violence; or it may set in as the immediate result of the bruise, and a phleg- monous inflammation may thus be established. The' tumor is now surrounded with oedema, more or less diffused, and becomes hot and painful. The flexion of the knee can no longer take place; walking is much interfered with — a large acute abscess has been formed, and it is this that constitutes the capped Ixiiee.
Whatever may be the nature of the tumors, whether shown Avhen opened to be bloody, cystic, or i^urulent, or when tliey ulcerate as they sometimes do, though the cavity of the abscess may fill up in a short time, the x)robability is that there will always remain in front of the knee a i^lastic deposit, develoi^ed in varying degrees, which will resist all treatment and continue unabsorbed for life.
Though simple bruises of the knee without extensive lesions are usually of trifling account, a different i)rognosis must be pronounced when the lesion assumes more important dimensions; and though a capped knee may be comparatively an affair of little importance we have seen cases where not only extensive blemishes were left to disfigure the patient, but where the animals had become worthlesss in consequence of the extension of the diseased process to the various elements of structure composing the joint, and giving rise to the most complicated cases of carpitis.
We have seen that usually the first symptom which is observed is the oedematous swelling on the fore part of the knee, the first lesion, in fact, and therefore requiring immediate attention. The prevention of the inflamuiation, and consequently of the abscess, is the prime object in view, and it maj^ be realized by the use of warm water fomentations or compresses applied over the swelling, which may be used either in a simple form or combined with astringents, such as Goulard's extract, alum, or sulphate of zinc. The application of warm poultices of oil meal or ground flaxseed, enveloping the whole joint and kept in place hy bandages, is often followed by absorption of the swelling, or, if the
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ab.seess is in i^rocess of formation, by tJie active secretion of pus. If the formation of a tumor lias followed this treatment, or if it has develoijcd. from its inception, it becomes an immediate necessity to empty it, and the mode of accomplishing this will vary with different cases. In one it should be done by a careful incision, which will allow the escape of the blood or the serum, or of the pus which is inclosed in the sac; in another it may be by means of a seton, in order that the discharge may be maintained and allowed to escape; and for another the more cautious mode may be adopted of emptying the cavity by means of i)unctures with small trochars or aspirators. The danger attending this last method arises from the possible sloughing of large jjortions of the skin, while that attending the first is the hazard of the possibility of the extension of the inflammation to the capsular liga- ment of tlie knee, with the risk of an open joint in i^rospect.
As we have remarked, the cavitj', after being emptied, may rapidly close and leave in a short time but slight traces of its previous exist- ence. But in man}', if not in a majority, of cases there will remain after the cicatrization is complete a thickening or organized exudation, at one time round and vrell defined, at another spreading by a diffused infiltration, to Avhich it will be necessary to give immediate attention, from the fact of its tendency to form into an organized and permanent bod}'. To stimulate inflammation in this diseased structure blisters are recommended, but chiefly for the purpose of promoting the process of absorption. If this treatment should fail, the use of alteratives proper is recommended, mercury and its compounds and iodine prepa- rations probabh' receiving a majority of suffrages. Plain mercurial or plain iodine ointment, or both in combination as iodide of mei'cury, are commonly used, and may either be applied moderately and by gentle degrees, as we have suggested, or more freely and vigorously with a view to more immediate effects, which, however, will also be more superficial. The use of the firing iron applied deeply with fine points is then to be strongl}^ recommended, to be followed by blisters and various liniments. This course may generally be relied on as quite sure to be followed bj^ satisfactory results.
While the treatment is in i^rogress it will of course be necessary to secure the animal in such a manner .that a recurrence of the injury will be impossible from similar causes to those which were previously responsible.
Capped lioclv. — A bad habit prevails among some horses of rubbing or striking the partitions of their stalls with their hocks, with the result of an injury which shows itself on the upper point of that bone, the summit of the os calcis. From its analog}^ to the condition of capped elbow the designation of caiii:>ed hock has been applied to this condition.
A capped hock is therefore but the development of a bruise at the point of the hock, which if many times repeated may excite an inflam- matory process, with all its usual external symptoms of swelling, heat,
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soreness, and the rest of the now familiar phenomena. The swelling is at first diffused, extending more or less on the exterior part of the hock, and in a few instances running uj) along the tendons and muscles of the back of the shank. Soon, however, unless the irritating causes are continued and repeated, the oedema diminishes, and becoming more defined in its external outlines, leaves the hock capped with a hj^groma. The hygroma, at the very beginning of the trouble, con- tains a bloody serosity which soon becomes strictly serum, but through the influence of an acute inflammatory action is liable to undergo a metamorphosis which converts it into the product of the suppurative jjrocess.
The external appearance ought to be sufficient to determine the diag- nosis, but there are a few signs which may contribute toward a nicer identification of the lesion. The capped hock, whether under the appearance of an acute oedematous swelling, or as a sero-bloody col- lection, or as a simple serous cyst, does not give rise to any remark- able local manifestation other than such as have already passed under our survey in considering similar cases, nor will it be likely to inter- fere with the functions which belong to the member in question, unless it assumes verj^ large dimensions and on each side of the tendons, as well as on the summit of the bone. But if the inflammation is quite high, if suppuration is developing, if there is a true abscess, or — and this is a common complication — especially when the kicking or rubbing of the animal is frequently recurring, then, besides the local trouble of the cyst or of the abscess, the bones become diseased and the periosteum inflamed; perhaps the superior ends of the bone and its fibro-cartilage become affected, and a simple lesion or bruise, whatever it maj'' have been, becomes complicafcf^d with periostitis and ostitis, and is naturally accompanied with lameness, developed in a greater or less degree, which in some cases may be permanent and in others increased b}^ work. But these complications are not conunon or frequent.
Capped hocks are in manj" cases amenable to treatment, and yet they often become the opprobrium of the practitioner by remaining, as the}^ frequently do, an ej^esore on the top of the hock; not inter- fering, it is true, with the work of the horse, but fixing upon him the stigma of what, in human estimation, and especially in that of the tribe of " practical politicians," is a most unreliable and objectionable reputation, to-wit, that of being an habitual "kicker," and, worse than all, one that kicks where he receives his provender.
The maxim that " an ounce of prevention is worth a pound of cure " fits the present case vcrj- neatly. A horse whose hocks have a some- what puffy look and whose skin on the front of the hock is loose and flabby, justly subjects himself to a suspicion of his addictedness to this bad habit. But he may easily be cither convicted or exonerated — a little watching will soon establish the truth. If, then, the verdict
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is one of conviction, precautions sliould be immediately adopted against a continuance of the evil. The padding of the sides of the stall with straM" mats or mattresses and covering the posts Avith simi- lar material in such a manner that no hard surface shall be exposed ^itli which to come in contact, will reduce the evil to its minimum. He may jar his frame when he kicks, but even then there will be less force in the concussion than if it impinged ujjon the solid jslank, and cuts and abrasions can not be inflicted by a properly made cushion. Hobbles are also rightly recommended with a view to the required restraint of motion, so api)lied as to secure the leg with which the kicking is j)erformed, or even both hind legs, in such a manner as shall not interfere with the movements of lying down and rising again and yet allowing that of kicking backwards. Boots similar in pat- tern to those whicli are used for the prevention of shoe boil are also prescribed. These are placed above the hock and retained by straps tightly fastened. But we apprehend that the difficulty of retaining them in the proper place without the danger of chafing from the tightness of the strains might form an objection to their use. Xot- withstanding all precautions, hocks will be capped in the future as in the past, and the study of their treatment will alwaj's be in order.
The mode of dealing with them Avill of course be greatlj" influenced by tlie condition of the parts. AVhen the inflammation is excessive and the swelling large, hot, and painful to the touch, the application of warm water will be verj^ beneficial. The leg should be well fomented several times a daj^, for from fifteen to twenty minutes each time, a strong decoction of marsh-mallow leaves being added to the water, and after each application swathed with flannel bandages soaked in the same warm mixture. A few days of this treatment will usually effect a resolution of the inflammation, if not complete, at least sufficiently so to disclose the correct outlines of the hygroma and exhibit its peculiar and si^ecific s^^mptoms. The expediency of its removal and the method of accomplishing it are then to be considered, with the question of opening it to give exit to its contents. If the fluid is of a purulent character the indication is in favor of its imme- diate discharge — no time should be lost, and it should be by means of a small opening made with a narrow bistoury. If, however, the fluid is a serosity, we prefer to remove it by punctures with a very small trochar. Our reason for special caution in these cases is our fear of the possibility of the existence of diseased conditions of a severe character in the pseudo joint. For the same reason we prefer the treatment of those growths bj' external applications. In the first stages of the disease a severe and stiff blister entirely covering the cyst, ijerhaps not yet comi^letely formed, when tlie inflammation has subsided will be of great benefit by its stimulating effect, the absorp- tion it may excite, and the pressure which when dry it will maintain 51)61— HOR 12*
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tiX^on the tumor. If, however, tlie tliickeniug of the growth fails to diminish it should be treated with some of the iodine preparations in the form of ointments, pure or in combination with X)otassa, mercury, etc., of various strengths and in various proportions. Our opinion of setons is not favorable, but the actual cautery, by deep and fine firing, in jDoints — needle cauterization — we believe to be the best mode of treatment, and especiall}^ when applied earlj-.
Whatever treatment may be adopted for capj)ed hock, patience must be one of the ingredients. In these i)arts absorx^tion is slow and the skin is very thick, and its return to a soft, pliable, natural condi- tion, if effected at all, will only take place after weeks added to other weeks of medical treatment and patient waiting.
Interfering — Speedy cuts. — These designations belong to certain spe- cial injuries of the extremities, i)roduced b}' similar causes, giving I'ise to kindred pathological lesions with allied XJhenomeua, requiring about the same treatment and often followed by the same results, to-wit, a blemish which maj" not only subject the animal to a suspicion of unsoundness, but in some special circumstances interfere with his ability to labor. It is known as ' ' interfering " when the location of the trouble is the inside of the fetlock of either the fore or hind leg. It is called "speed}' cut " when it occurs on the inside of the fore leg, a little below tlie knee, at the point of contact of that joint Avith the cannon.
It is always tlic result of a blow, self-inflicted, of varj'ing severity, and giving rise to various lesions. At times the injury is too slight to be seriously noticed, the hair being scarcely cut and the skin unmarked. At other times the skin will be cut through, partly or wiiolly, and it may for the time cause a sufficient amount of pain to check the motion of the animal and induce him to suspend his labor through his inability to use the wounded limb, traveling meanwhile for a short space on three legs only. Sometimes a single blow will suffice, or again there will be a repetition of lighter strokes. In the latter case the parts will become much swollen, hot and so painful to the touch that the motion of the knee or the fetlock will be sufficiently disturbed to cause lameness of a degree of severity corresponding with that of the lesion. Folio Aving the subsidence of this diffused and oedematous swelling is sometimes the formation of a tumor, either at the knee or the fetlock. This may be soft at first or become so by degrees, with fluctuation, its contents being at first extravasated blood, and later a serositj-; or, if there has been a sufficient degree of inflammation, it may become suppurative. The result of the fault of interfering may thus l)e exhibited, whether at the knee or at the fet- lock, as characterized by all the pathological conditions Avhich have appeared as accompaniments of capped knee or capped hock. If, in consequence of the force of the blow or bloAVs, the inflammation has been Tinusually scA'cre, a mortification of the skin may become one of
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the consequences, a slough takiug place, succeeded b^- a cutaneous ulcer on the inside of the fetlock or where the greater number of the original wounds are inflicted. If the interfering has been often relocated it may be followed by another condition, v%'hich has been con- sidered in our remarks upon other affections. It is a plastic exuda- tion or thickening of the parts, vrhich are commonlj' said to have became " callous," and the effect of it is to destroy the regularity of the outlines of the joint to an extent which constitutes a serious blemish, which will bo permanent, and according to the degree of the aberration from the natural aud symmetrical lines will inevitably depreciate the commercial value of the animal.
An animal in interfering may thus exhibit a range of symptoms which, from the simplest form of a mere "touching, "may successively assume the serious characters of an ugly cicatrix, a hard, plastic swelling, or perhaps, as witnessed at the knee, of periostitis with its sequehe.
If a single and constantly recurring cause — a blow — Ijc the starting point in interfering, Ave may now consider the subject of the iDredisi^o- sition Avliich brings such serious results upon the suffering animal, and the conditions which lead to and accompanj^ it. These are numerous, but the first in frequency and importance is peculiarity of conformation in the animals addicted to it. The first class will include horses whose chests are narrow and whose legs do not stand straight and upright, but ai-e crooked and pigeon-toed in and out. The second class includes those A^hose legs are weak, either from youth or hard labor, or from severe attacks of sickness. Another class is made up of those having abnormallj^ developed feet, or which have been badly shod mtli unnecessarily Avide or heavy shoes. Another class consists of those that are affected with swollen fetlocks or chronic oedematous swelling of the leg. Another is formed of animals with a peculiar action, as those whose knee action is very high, and it is these that furnish most of the cases of speedy cut.
The prognosis of interfering is never a very serious one. However violent the blow may be it is rarelj" that subsequent comjblications of a troublesome nature occur. The principal evil attending it is a lia- bility to be followed by a thickened or callous deposit which is not only an eyesore and a blemish, but constitutes a new and increased predisposition. The remark that "an animal whieli has interfered once is always liable to interfere," is often confirmed and sanctioned bj' a recurrence of the trouble.
Another point in Avhich there is a resemblance between this lesion and others Avliich we have considered is in its responsiveness to the same treatment with them. Indeed, the prescrijition of warm fomen- tations, soothing applications, and astringent and resolvent mixtures, in a majority of eases, is the first that occurs all through tlie list. If the swelling assumes the character of a serous collection, pressure.
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cold water, and bandages will contribute to its removal. If suppuration seems to be established, and the swelling assumes the character of a develojiing abscess, the hot poultices of flaxseed or of boiled vege- tables and the embrocations of supjiurative or sedative ointments, those of basilicon, or propuleum, impregnated with preparations of opium or belladonna — all these recommend themselves by their gen- eral adaptation and the beneficial results which have followed their administration, not less in one case than in another. When an abscess has formed and is fluctuating, it should be carefully but fully opened to evacuate the pus. If it is a serous cyst, some care is necessary in emptying it, and the possibility of the extension of tlie inflammation to the joint must be taken into consideration. \Vlien the cavities have been emptied and have closed by filling up with granulations, or if, not being ojiened, the contents have been reabsorbed, and there remains in either case a plastic exudation and a tendency to the cal- lous organization that may yet exist, blisters under their various forms, including those of cantharides, of mercury, and of iodine are then indicated, principally in the early stages, as it is then that their effects ^^■ill i^rove most satisfactory. The use of the actual cautery, with fine points, penetrating deeply througliout the enlargement, has in our hands, when employed in the very early stages of its formation, nearl}^ always brought on a radical recovery with complete absorj)tion of the thickening.
StringhaU. — The characteristic symptom, if not in fact the sum of the symptomatology of this disease, is the spasmodic flexion, more or less violent, of the hock, sometimes to the extent of striking the abdo- men with the fetlock of the affected leg, and at others only sufiicient to lift it a few inches from the ground, but always with the same sud- den, uncontrollable jerk. The habit is unaffected by the gait of the animal, and whether trotting, walking, or merely turning around, it is all the same. It does not seem to be influenced by the horse's age, young and old being alike affected. Its first manifestations are some- times very slight. It has been noticed as occurring to an animal when backing out of his stable and ceasing immediately after. In some animals it is best seen when the animal is turning around on the affected leg, and is not noticed when he moves straight forward. That this peculiar action interferes with facility of locomotion and detracts from a horse's claim to soundness can not for a moment be denied.
Veterinarians and joathologists are yet in doubt in respect to the cause of this affection, as well as to its essential nature. Whether it results from disease of the hock, of an ulcerative character; whether it springs from a malformation; whether it is purely a muscular or purely a nervous lesion, or a compound of both, it still continues, if an etiologist is bound to possess universal knowledge witliin the scope of his special studies, to be his opprobrium and his puzzle.
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Various experiments in the line of treatment have been instituted, but none have been crowned with satisfactory results. We incline to the opinion that some undesignated disease of the hock is responsible for it, and believe that in tlie present state of knowledge the best i)re- scription that can be devised is the safe and economical one of rest, a long rest in a i^asture, where unmolested nature shall be permitted to bring about any necessary change that may be appropriate to the case. Whatever other treatment it may be considered wise to undertake must be of a widely different character, and must be determined upon by those whose chosen and appropriate sphere is the domain of oj^er- ative surgery.
Embolisms. — There are certain forms of lameness which are very peculiar in their manifestation, and which to the non-professional mind must appear to belong rather to the domain of mystery or theorj" than to be subjects of experimental and definite knowledge. Yet they are none the less susceptible of demonstration and positive knowledge than manj^ facts which, plain and familiar to the general comprehen- sion now, were once ranked among things occult and unsearchable. An embolism, considered as a cause of lameness, may find a i)lace among these understood mysteries.
Under certain peculiar conditions of inflammation of the blood ves- sels, clots of blood are sometimes formed in the arteries and find their way in the general circulation. At first, while very small, or suffi- cientl}' so to pass from one vessel to another, they move from a small vessel to a larger, and from that to one still larger, constantly increas- ing in size until at some given point, from their inability to enter smaller vessels, their movement is finally arrested. The artery is thus effectually dammed, and the clot in a short time cuts off completely the supply of blood from the parts beyond. This is the embolism, and it often gives rise to sudden and excessive lameness of a very painful character.
Embolisms may form in any of the arteries of the bodj', and doubt- less have been the cause of many cases of lameness which could never be accounted for. If they exist in small arteries their diagnosis will probably fail to be made out with certainty, but when situated in the larger trunks a strong suspicion of their presence may be excited. In some cases they may even be recognized with positive accuracy, as when the vessels Avhich supply the posterior extremities are affected by the blocking up of the posterior aorta or its ramifications.
The existence of embolisms of the arteries of the hind leg may always be suspected when the following history is known: The gen- eral health of the animal is good, but symptoms of lameness in one of the legs have been developed, becoming more marked as he is worked, and especially when driven at a fast gait. But the disturb- ance is not permanent, and the lameness disapi^ears. almost imme- diately upon his being permitted to rest. There is an increase of the
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difificulty, however, and, lliough ho ma}' walk uormallj-, he will, when made to trot, very soon begin to slacken his pace and to show signs of the trouble, and if urged to increase his speed will become lamer and lamer; an abundant pers]3iration vdll break out; he will refuse to go, and if forced he shows weakness behind; seems ready to fall, and perhaps does fall. While on his feet the leg is kept in constant motion, u^) and down, and is kejit from the ground as if the contact vras too painful to bear. If undisturbed this series of symptoms will graduall}' subside, sometimes very soon, and occasionally after a few hours lie will return to an apparently x^erfect condition. A return to labor will lead to a renewal of the same incidents.
A history like this suggests a strong suspicion of embolism of an artery of the hind leg, and this suspicion will be confirmed by the external sjnni^toms exhibited by the animal. The total absence of any other disease which might account for the lameness, and a mani- fest diminution of heat over a part or the whole of the extremity, when compared with the opposite side or Avitli any other j^ortion of tlie body; a sensation of cold attendant on the pain, but gradually subsiding as the i)ain subsides, and the circulation, quickened bj^ the rest, has been reestablished throughout the extremity; all these are confirmatory circumstances. Still, it is thus far only a suspicion, and absolute certainty is jet wanting. To establish the truth of the case the rectal taxis must be resorted to. The hands then, well prepared and carefulh" introduced into the rectum, must explore for the truth, first feeling for the large blood vessels which, divided at the aorta, separate to supx)ly the right and left legs. These must be compared in respect to the j)ulsation and other particulars. The artery which is health}^ will of course exhibit all the proper conditions of that state. On the other hand, if the vessel appears to the feel hard, more or less cordy, and jjulseless, or giving a sensation of fluttering, as of a small A'olume of blood with a trickling motion i^assing through a confined space, the difference betAveen the sides will make the case plain. The first will be the full flow of the circulation through an unobstructed channel, the other a forced passage of the fluid between the embolism and the coats of the artery.
In such a case the jirognosis is necessarilj' a grave one. No form of treatment can be advised; and the suffering of a helpless and useless animal can onl}' bo terminated by that Avhicli ends all.
Cases occur, however, where this condition of the blood-vessels exists in a much less degree, and the diseased condition is not suffi- ciently' pronounced for final condemnation. There may oven be a possibilitj^ of tlie absorption of the clot, and that an increase of the circulation maj' be sufficient to supply' the parts with blood. In such cases attempls may be made looking to the possibility of relief, and the pasture, field, oi- the stable, and unmolested nature must be trusted for the rest.
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Sprains of the Joins. — This is an affection whicli suggests to the mind the idea of muscular injury, and is difficult to distinguisli from man}' similar eases. If the animal shrinks from the slightest pres- sure or j)inching of the spine, in the region of the loins, he is by many I)ronounced to be "lame in the loins," or "sprained in the loins," or " weak in the kidneys." This is a grave error, as in fact this simiile and gentle j'ielding to such a i3ressure is not a pathological sign, but is normal and significant of health. Yet there are several conditions to which the definition of " sprains of the loins " may applj' which are not strictly normal. The muscles of the back and those of the loins proi)er, as the psoas, may have been injured, or again there maj' be trouble of a rheumatic nature, perhaps suggestive of lumbago. Diseases of the bones of the vertebral column, or even those of the organs of circulation, may giA'e rise to an exhibition of similar symp- toms. These sj^miDtoms are characteristic of a loss of rigiditj* or firm- ness of the vertebral column, both when the animal is at rest and in action. In the former condition, or when at rest, there is an arched condition of the back and a constrained posture in standing, with the hind legs separated. In the latter there is a lateral, balancing move- ment at the loins, i^rincipall}' noticeable while the animal is in the act of ti'otting — a iDCCuliar motion, sometimes referred to as a "crick in the back," or what the French call a '^tour de hafeau.'" If, while in action, the animal is suddenly made to halt, the act is accompanied with much j^ain, the back suddenly arching or bending laterally, and perhaps the hind legs thrown under the bod 3', as if unable to perform their functions in stopping, and sometimes it is only accomjilished at the cost of a sudden and severe fall. This manifestation is also exhibited when the animal is called upon to back, when a repetition of the same symptoms will also occur.
If a slight i)ressure on the back or the loins is followed by a moder- ate yielding of the animal, it is, as we before remarked, a good sign of health. With a sprain of the loins j)ressure of anj- kind is i^aiuf ul, and will cause the animal to bend or to crouch under it more or less, according to the weight of the pressure. Heavy loads, and even heavj' harnessing will develop this tenderness. In lying down he seems to suffer much discomfort, and often accompanies the act with groaning, and when compelled to rise does so only with great difficulty and seldom succeeds without repeated efforts.
Sprains of muscles proper, when recent, will always be accompanied by this series of symptoms, and the fact of their exhibition, with an excessive sensibility of tlie parts, and possibly with a degree of swell- ing, will always justifj^ a diagnosis of acute muscular lesion; and especially so if accompanied by a history of violent efforts, powerful muscular strains, falls, heavy loading, etc., connected Avith the case. But if the symptoms have been of slow development and gradual increase, it becomes a more difficult task to determine whether the
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diagnosis points to ijathological changes in the structure of the muscles or of the bones, the nervous centers, or the blood-vessels of the region. And yet it is important to decide as to which particular structure is affected in reference to the question of prognosis, since the degree of the gravity of the lesion will depend largely upon whether the disabled condition of the animal is due to an acute or a chronic disease. The prescription which will necessarily first of all suggest itself for sprains of the loins is rest. An animal so affected should be immediately placed in slings and none of his efforts to release himself should be allowed to succeed. Hot compresses, cold- Avater douches, sweating applications, stimulating frictions, strength- ening charges, blistering ointments of cantharides and the actual cautery, all have their advocates; but in no case can the immobility obtained by the slings be dispensed with. In many cases electricity has also yielded good results, where the weakness of the hind quarters was dependent on disease of the nervous centers.
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PLATE xxvrn.
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Haines, d«l after Revnders.
A.Hoen SrCo Lithocaustic.Bahjmore
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DISEASES OF THE FETLOCK, ANKLE, AND FOOT.
By A. A. HOLCOMBE, D. V. S.
ANATOMICAL REVIEW OF THE FOOT.
In a description of the foot of the horse it is customaiy to inclnde only the hoof and its contents, j^et, from a zoological standpoint, the foot includes all the leg from the knee and the hock down.
The foot of the horse is undoubtedly the most important part of the animal, in so far as veterinary surgery is concerned, for the reason that this member is subject to so many injuries and diseases, which, in part or in whole, render the patient unfit for the labor demanded of him. The old aphorism, "no foot no horse," is as true to-day as when first exj)ressed; in fact, domestication, coupled with the multi- plied uses to which the animal is put, and the constant reproduction of hereditary defects and tendencies, have largely transformed the ancient "comj)ani(jn of the wind" into a very common piece of machinery AA^hich is often out of repair, and, at best, is but short-lived in its usefulness.
Since the value of the horse depends largely, or even entirely, upon his abilit}' to labor, it is essential that his organs of locomotion should be kept sound; and to accomplish this end it is necessary not only to know how to cure all diseases to which these organs are liable, but, better still, how to i^revent them.
An important prerequisite to the detection and cure of disease is a knowledge of the construction and function of the parts which may be involved in the diseased process; hence, first of all, the anatomical structures must be understood.
The hones of the fetlock and foot constitute, the skeleton on which the other structures are built, and comprise the lower end of the can- non bone (the metacari^us in the fore leg, the metatarsus in the hind leg), the two sesamoids, the large pastern or suffraginis, the small i^as- tern or coronet, the cofl&n bone or os pedis, and the small sesamoid or
navicular bone. (Plate XXXII, Fig. 3.)
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The cannon hone extends from tlie knee or liock to tlie fetlock is cylindrical in shape, and stands nearly or quite perpendicular.
The sesamoids occur in pairs, are small, shaped like a three-faced pyramid, and are set behind the fetlock joint, at the upper end of the suffraginis, with the base of the pyramid down.
The suffraginis is a very compact bone, set in an oblique direction doAvnward and forward, and extends from the cannon bone to the coronet.
The coronet is a short, cube-shaped bone, set between the suffraginis and cof&n bone, in the same oblique direction.
The coffin, hone forms the end of the foot and is shaped like the horny box in which it is enclosed.
The navicular hone is short, flattened above and below, and is attached to the coffin bone behind.
All of these bones are covered on the surfaces with a cartilage of incrustation which goes to make up the joints, while the portions between are covered with a fibrous membrane called the periosteum.
The joints of the legs are of especial importance, since any inter- ference Avith their function very largely impairs the value of the animal for most purposes. As the joints of the foot and ankle are at the point of greatest concussion they are the ones most subject to injury and disease.
There are three of these joints— the fetlock, pastern, and coflin. They are made by the union of two or more bones, held together by ligaments of fibrous tissue, and are lubricated by a thick viscid fluid, called synovia, which is secreted by a special membrane inclos- ing the joints.
The fetlock joint is made by the union of the lower end of the cannon and the upper end of the large pastern bones, supplemented by the two sesamoids, so placed behind the upper end of the pastern that the joint is capable of a very extensive motion. These bones are held together by ligaments, only one of which— the suspensory- demands special mention.
The suspensory ligament of the fetlock starts from the knee, extends down behind the cannon, Ij^ng behind the two splint bones, until near the fetlock, where it divides and sends a branch on either side of the joint, downward and forward, to become attached on the sides of the extensor tendon at the lower end of the pastern bone. As it crosses the sesamoids on the posterior borders of the fetlock it throws out fibers, whieli hold it fast to these bones. (Plate XXXII, Fig. 2.)
Th.^ pastern joint is made by the union of the two pastern bones.
The coffin joint is made by the union of the small pastern, coffin, and small sesamoid or navicular bones, the latter being set behind and beneath the joint surface of the coflin bone in such a way as to largely receive the weight of the small pastern.
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Three tendons serve to move the bones of the foot one on another. Two of these flex or bend the joints, while the other extends or straightens the column of bones. (Plate XXX, Fig. 5.)
The flexor pedis perforans^ or deep flexor of the foot, x)asses down behind the cannon bone, lying against the suspensory ligament in front, crosses the fetlock joint in the groove made by the union of the two sesamoids, and is attached to the bottom of the coffin bone, after covering the navicular, by a wide expansion of its fibers. It is the function of this tendon to flex the coffin bone and with it the horny box.
The flexor pedis perforatus, or superficial flexor of the foot, follows the course of the preceding tendon and is attached to the middle of the ankle. Tlio function of this tendon is to flex the foot at the fetlock.
The extensor pedis runs down in front of the leg, is attached on the most i)rominent i)oint of the coffin bone, and has for function the straightening of the bones of the ankle and foot.
The bones, ligaments, and tendons are covered by a loose connect- ive tissue, which gives a symmetry to the i^arts by filling up and rounding off, and all are protected by the skin and hoof.
The shin of the fetlock and ankle is generally characterized by its thickness and the length of its hairs, especially around the hind j)arts of the fetlock joint in certain breeds of horses. The most important part of this envelope is that known as the coronary band.
The coronarij hand is th^t i^ortion of the skin which secretes the horn by which the wall 9£ the hoof is made. This horn much resem- bles tlie nail wliich grows on the fingers and toes of man. It is com- posed of hollow, cylindrical tubes, extending from the coronary band to the lower border of the hoof, which are held together by a tenacious opaque matter. (Plate XXIX, Fig. 1.)
The hoof is a box of horn, consisting of a wall, sole, and frog, and contains, besides the coffin, navicular and jinvt of the small ]3astern bones, the sensitive lamina?, plantar cushion and the lateral cartilages. (Plate XXX, Fig. 4.)
The sole of the foot incloses the box on the ground surface, is shaped like the cii-cumference of the foot, except that a V-shaped opening is left behind for the reception of the frog, and is concave on the lower surface. The sole is produced by the velvety tissue, a thin mem- brane covering the plantar cushion and other soft tissues beneath the coffin bone. The horn of the sole differs from the horn of the wall, in that its tubes are not straight, and from the fact that it scales off in j)ieces over the whole surface.
The frog is a triangular shajjed body, divided into two equal parts by a deep fissure, extending from its apex in front to the base. It fills the triangular space in the sole to Avhich it is intimately attached by its borders. The horn of the frog is i^roduced in the same manner as the sole, but it differs from both the wall and sole, in that the liorn
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is soft, moist, and elastic to a remarkable degree. It is the function of the frog to destroy shock and to prevent slipping.
The sensitive lamince, are thin plates of soft tissue, covering the entire anterior surface of the coffin bone. They are present in great numbers, and by fitting into corresponding grooves on the inner surface of the horn of the wall the union of the soft and horny tissues is made complete. (Plate XXIX, Fig. 1.)
The planiar cushion is a thick pad of fibrous tissue, placed behind and under the navicular and coffin bones, and resting on tlie sole and frog, for the i^urpose of receiving the downward i^ressure of the column of bones and to destroy shock. (Plate XXIX, Fig. 4.)
The lateral cartilages are attached, one on either side, to the wings of the coffin bone b}' their inferior borders. They are thin plates of fibro-cartilage, and their function is to assist the frog and adjacent structures to regain their proper position after having been displaced by the weight of the body while the foot rested on the ground. (Plate XXIX, Fig. 2.)
FAULTS OF CONFORMATION.
A large percentage of the horses have feet which are not perfect in conformation, and as a consequence of these imperfections they are especially predisposed to certain injuries and diseases.
Flat feet is that condition in which the sole has little or no con- vexity. It is a peculiarity common to some breeds, especially heav^% l3^mi)hatic animals raised on low, marshy soils. It is confined to the forefeet, which are generally broad, low heeled, and with a wall less upright than is seen in the perfect foot.
In flat-foot there can be little or no elasticity in the sole, for the reason that it has no arch, and the weight of the animal is received on the entire plantar surface as it rests upon the ground instead of on the wall. For these reasons such feet are i^articularly liable to bruises of the sole, corns, pumiced sole, and excessive suppuration Avhen the process is once establislied. Horses with flat-foot should be shod with a shoe having a wide web, pressing on the wall only, while the heels and frog are never to be pared. Flat-foot generally has weak walls, and as a consequence the nails of the shoe are readily loosened and the shoe cast.
Clubfoot is a term applied to such feet as have the wall set nearly perpendicular. When this condition is present the heels are high, the fetlock joint is thrown forward, or knuckles, and the weight of the animal is received on the toes. Many mules are clubfooted, especially behind, where it seems to cause little or no inconvenience. Clubfoot may be cured by cutting the tendons in severe cases, but as a rule special shoeing is the only measure of relief that can be adopted. The toe should not be pared, but the heels are to be lowered as much as possible, and a shoe put on with a long projecting toe piece, slightly turned up, wliilc the heels of the shoe are to be made thin.
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Crooked foot is that condition in which one side of the wall is higher than the other. If the inside wall is the higher, the ankle is thrown outward, so that the fetlock joints are abnormally wide apart and the toes close together. Animals with this deformity are "pigeon-toed," and are prone to interfere, the inside toe striking the opposite fetlock. If but one foot is affected, the other being jjerfect, the liability to interfere is still greater, for the reason that the fetlock of the perfect leg is more near the center plane.
When the outside heel is the higher the ankle is thrown in and the toe turns out. Horses with such feet interfere with the heel. If but one foot is so affected, the liability to interfere is less than where both feet are affected, for the reason that the ankle of the perfect leg is not so near to the center line. Such animals are especially liable to stumbling and to lameness from injury to the ligaments of the fetlock joints. The deformity is to be overcome by such shoeing as will equalize the disparity in length of walls, and by proi)er boots to protect the fetlocks from interfering.
INTERFERING.
An animal is said to interfere when one foot strikes the opposite leg, as it passes by, during locomotion. The inner surface of the fetlock joint is the part most subject to this injurj^ although, under certain conditions, it ma}" happen to anj' part of the ankle. It is seen more often in the hind than in the fore legs. Interfering causes a bruise of the skin and deeper tissues, generally accompanied by an abrasion of the surface. It may cause lameness, dangerous tripping, and thickening of the injured parts.
Cmises. — Faulty conformation is the most prolific cause of interfer- ing. When the bones of the leg are so united that the toe of the foot turns in (pigeon-toed), or when the fetlock joints are close together and the toQ turns out, when the leg is so deformed that the whole foot and ankle turn either in or out, interfering is almost sure to folloAv. It may happen, also, when the feet grow too long ; from defective shoe- ing; rough or slippery roads; from the exliaustion of labor or sick- ness; swelling of the leg; high knee action; fast work, and because the chest or hips are too narrow.
Sympfoms. — Generally, the evidences of interfering are easily detected, for the parts are tender, swollen, and the skin broken. But very often, especially in trotters, the flat surface of the hoof strikes the fetlock Avithout evident injury, and attention is directed to these parts onh^ by the occasional trif)ping and unsteady gait. In such cases proof of the cause may be had by walking and trotting the animal, after first painting the inside toe and quarter of the suspected foot with a thin coating of chalk, charcoal, mud, or paint.
Treatment. — When the trouble is due to deformity or faulty confor- mation it may not be possible to overcome the defect.
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In sueli cases, and as well in those due to exhaustion or fatigue, the fetlock or ankle boot must be used. In manj- instances interfering may be prevented by proper shoeing. The outside heel and quarter of the foot on the injured leg should be lowered sufficiently to change the relative i)osition of the fetlock joint, by bringing it further awaj^ from the center plane of the bodj^, therebj' x)ermitting the other foot to pass 1)3' without striking.
A very slight change is often sufficient to effect this result. At the same time the offending foot should be shod, that the shoe may set well nnder the hoof at the point responsible for the injury. The shoe should be reset every three or four weeks.
When the cause has been removed cold water bandages to the injured x^arts will soon remove the soreness and swelling, especially in recent cases. If, however, the fetlock has become calloused from long-continued bruising, a Spanish fly blister over the parts, repeated in two or three weeks' time if necessary, will aid in reducing the leg to its natural condition.
KNUCKLIXG OR COCKED AXKLES.
Knuckling is a partial dislocation of the fetlock joint, in which tlie relatiA'e j)osition of the i^astern bone to the cannon and coronet bones is changed, the pastern becoming more nearly j^erpendicular, with the lower end of the cannon bone resting behind the center line of the suft'raginis, while the lower end of this bone rests behind the center line of the coronet. While knuckling is not always an unsound- ness, it nevertheless predisjjoses to stumbling and to fracture of the pastern.
Causes. — Young foals are quite subject to this condition, but in the great majoritj^ of cases it is onlj^ temporary. It is largely due to the fact that, before birth, the legs were flexed,; and time is required, after birth, for the ligaments, tendons, and muscles to adapt them- selves to the function of sustaining the weight of the body.
Horses vdth erect pasterns are very prone to knuckle as they grow old, especially in the hind legs. All kinds of heavy Avork, particu- larl}' in hillj^ districts, and fast work on hard race-tracks or roads are exciting causes of knuckling. It is also commonly seen as an accom- jianiment to that faulty conformation called club-foot, in which the toe of the wall is perpendicular and short and the heels high, a condi- tion most often seen in the mule, especially the hind feet.
Lastly, knuckling is produced by disease of the suspensory ligament, or of the flexor tendons, wherebj' the}' are shortened, and by disease of the fetlock joints.
Treatment. — In young foals no treatment is necessary, unless there is some deformity present, since the legs straighten up without inter- ference in the course of a few weeks' time. When knuckling has com- menced the indications are to relieve the tendons and ligaments by
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proper shoeing. The foot is to be prepared for tlie shoe by shortening the toe as mucli as jjossible, leaving the heels high; or if the foot is prepared in the usual \vay the shoe should be thin in front, with thick heels or high calks. For the hind feet a long-heeled shoe with calks seems to do best. Of course, >Yhen i^ossible, the causes of knuckling are to be removed, but since this can not always be done, the time ma}^ come when the patient can no longer perform any service, ijarticularlj' in those cases where both forelegs are affected, and it becomes neces- sary either to destroj" the animal or secure relief by surgical inter- ference. In such cases the tendons, between the fetlock and knee, may be divided for the purj)ose of securing temporary relief. Firing and blistering the parts responsible for the knuckling maj^, in some instances effect a cure ; but a consideration of these measures properlj'^ belongs to the treatment of the diseases in which knuckling simply appears as a sequel.
WIXD-GALLS.
Joints and tendons are furnished with sacs containing a lubricating fluid called synovia. When these sacs are overdistended, by reason of an excessive secretion of synovia, thej^are called wind-galls. Thej^ form a soft, puffy tumor about the siz« of a hickorj'^ nut, and are most often found in the foreleg, at the upper part of the fetlock joint, between the tendon and the shin-bone. When they develoj) in the hind leg it is not unusual to see them reach the size of a walnut. Occasionallj^ they appear in front of the fetlock on the border of the tendon. The majority of the horses are not subject to them after colt- hood is passed.
Causes. — Wind-galls are often seen in young, overgrown horses, where the body seems to have outgrown the ability of the joints to sus- tain the weight. In cart and other horses used to hard work, in trot- ters with excessive knee action, in hurdle racers and hunters, and in most cow-ponies there is a predisposition to wind-galls. Street-car horses and others used to start heavy loads on slippery streets are the ones most apt to develop wind-galls in the hind legs.
Symptoms. — The tumor is more or less firm and tense when the foot is on the ground, but is soft and compressible when the foot is off the ground. In old horses wind-galls generallj" develop slowly and cause no inconvenience. If they are caused by excessive tension of the joint the tumor develops rapidly, is tense, hot, and painful, and the animal is exceedingly lame. The patient stands ^^'iththe joint flexed, Avalks with short steps, the toe only being placed on the ground. When the tumor is large and situated upon the inside of the legit may be injured by interfering, causing stumbling and inflammation of the sac. Rest generally causes the tumor to diminish in size, only to All up again after renewed labor. In old cases the tumors arc hardened, and may become converted into bono by a deposit of the lime salts.
376
Treatment — The large, puffy joints of suckling colts, as a rule, require no treatment, for as the animal grows older the parts clean up, and after a time the swelling entirely disappears.
When the trouble is due to an injurj^ entire rest is to be secured by the use of slings and a high-heeled shoe. Cold water douches should be used once or twice a day, followed by cold water bandages, until the fever has subsided and the soreness is largely removed, when a blister is to be applied.
In old wind-galls, which cause more or less stiffness, some relief may be had by the use of cold compress bandages, elastic boots, or the red iodide of mercury blisters. Opening the sacs, as recommended by some authors, is of doubtful utility, and should onlj^ be adopted by the surgeon capable of treating the wound he has made. Enforced rest until complete recovery is effected should alwaj^s be insisted on, as a too early return to work is sure to be followed by a relapse.
SPRAIN OF THE FETLOCK.
Sprain of the fetlock joint is most common in the fore legs, and as a rule affects but one at a time. Horses doing fast work, as trotters, runners, steeple-chasers, hunters, cow-ponies, and those that interfere, are particularly liable to this injury.
Causes. — Horses knuckling at the fetlock, and all those with dis- eases which imi^air the powers of locomotion, such as navicular disease, contracted heels, side bones, chronic laminitis, etc., are pre- disposed to sprains of the fetlock. It generally happens from a mis- stej), stumbling, or slipping, which results in the joint being extended or flexed to excess. The same result may happen where the foot is caught in a rut, hole in a bridge, or in a car track, and the animal falls or struggles violently. Direct blows and punctured wounds may also set up inflamnlation of the joint.
Symptoms. — The symptoms of sprain of the fetlock vary with the severit}'^ of the injury. If slight there may be no lameness, but simply a little soreness, especially when the foot strikes on uneven ground, and the joint is twisted a little. In cases more severe the joint swells, is hot and puffj^, and the lameness may be so intense as to compel the animal to hobble on three legs. While at rest the leg is flexed at the joint affected, and the toe rests on the ground.
Treatment. — If the injury is slight, cold-water bandages and a few days' rest are sufficient to effect recovery. In cases where there is intense lameness, swelling, etc., the leg should be ijlaced under a con- stant stream of cold water, as described in the treatment for quittor. When the inflammation has subsided a blister to the joint should be applied.
In some cases, especially in old horses long accustomed to fast work, the ligaments of the joints are ruptured, in whole or in part, and the lameness may last a long time. In these cases the joint should be
377
kept completely at rest; and tliis condition is best secured by the application of the plaster of Paris bandages, as in cases of fracture. As a rule, patients take kindly to this bandage, and may be given the freedom of a roomy box or yard while wearing it. If they are dis- posed to tear it off, or if sufficient rest can not otherwise be secured, the patient must be kept in slings.
In the majority of instances the jilavSter bandage should remain on from two to four weeks. If the lameness returns when the bandage is removed, a new one should be i)ut on. The swelling, which alwaj^s remains after the other evidences of the disease liave disappeared, may be largely dissipated and the joint strengthened by the use of the firing iron and blisters.
A joint once injured by a severe sj^rain never entire!}^ regains its original strength, and is ever after particularly liable to a repetition of the injury.
RUPTURE OF THE SUSPENSORY LIGAMENT.
Sprain, with or without rupture, of the sii.spensory ligament may happen in both the fore and hind legs, and is occasionally seen in horses of all classes and at all ages. Old animals, however, and especially hunters, runners, and trotters, are the most subject to this injury, and with these classes the seat of the trouble is nearly always in one, or both, the fore legs. Horses used for heavy draught are more liable to have the ligament of the hind legs affected.
AVhen the strain upon the suspensory ligament becomes too great one or both of the branches may be torn from their attachments to the sesamoid bones, one or both of the branches may be torn completely across, or the ligament may ruiJture above the point of division.
Synqjtoms. — The most common injury to the suspensory ligament is sprain of the internal branch in one of the fore legs. The trouble is proclaimed by lameness, heat, swelling and tenderness of the affected branch, beginning just above the sesamoid bone and extend- ing obliquely downward and forward to the front of the ankle. If the whole ligament is involved the swelling comes on gradually, and is found above the fetlock and in front of the flexor tendons. The patient stands or walks upon the toe as much as possible, keeping fetlock joint flexed so as to relieve the ligament of tension.
When both branches are torn from their attachments to the sesa- moids, or both are torn across, the lameness comes on suddenly and is most intense; the fetlock descends, the toe turns up, and, as the aninuil attempts to walk, the leg has the appearance of being broken off at the fetlock. These symptoms, followed by heat, pain, and swelling of the parts at the point of injury, will enable anyone to make a diagnosis.
Treatment. — Sprain of the suspensory ligament, no matter how mild it may be, should always be treated by enforced rest of at least a
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month, and tlie application of cold donclies and cold water bandages, firmly applied nutil the fever has subsided, when a cantharides blis- ter should be put on and repeated in two or three weeks' time, if necessary. When rupture has taken place the patient should be ljut in slings, and a constant stream of cold water allo\ved to trickle over the seat of injur}^ until tlie fever is reduced. In the course of a week or ten days' time a plaster of paris splint, such as is used in frac- tures, is to be applied and left on for a month or six weeks. When this is taken off blisters may be used to remove the remaining sore- ness; but it is useless to expect a removal of all the thickening, for in the process of repair new tissue has been formed which will always remain.
In old cases of sprain tlie firing iron may often be used with good results. As a rule, severe injuries to the suspensory ligament inca- jjacitato tlie subject for anything but slow, light work.
OVERREACH.
An overreach is where the shoe of the hind foot strikes and injures the heel or quarter of the fore foot. It rarely happens except when the animal is going fast, hence is most common in trotting and run- ning horses. In trotters the accident generally happens when the animal breaks from a trot to a run. The outside heels and quarters are most liable to the injur}^
Symptoms. — The coronet at the heel or quarter is bruised or cut, the injuiy in some instances involving the horn as well. Where the hind foot strikes well back on tlie heel of the fore foot — an accident known among horsemen as "grabbing" — the shoe may be torn from the fore foot or the animal may fall to his knees. Horses accustomed to overreaching are often "bad l)reakers," for the reason that the pain of the injury so excites them tliat tliey can not readily be brought back to the trotting gait.
Treatmenf. — If the injury is but a slight bruise cold water bandages applied for a few days will remove all of the soreness. If the parts are deeply cut more or less suppuration will follow, and, as a rule, it is well to poultice the parts for a da}^ or two, after which cold baths may be used, or the Avounds dressed with tincture of aloes, oakum, and a roller bandage.
When an animal is known to be subject to overreaching he should nevfer be driven fast without quarter-boots, which are specially made for the i)rotcction of the heels and quarters.
If tliere is a disposition to "grab "the forward shoes the trouble may be remedied by having the heels of these shoes made as short as possible, while the toe of the hind foot should project well over the hind shoo. When circumstances will permit of their use, the fore feet may be shod witli the tii)S instead of the common shoe, as described in llio treatment for contracted heels.
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CALK AVOUNDS.
Horses wearing shoes with sharp calks are liable to wounds of the coronary region, either from tramping on themselves, or on each other. These injuries are most common in heavy draught horses, especially on rough roads and slippery streets. The fore feet are more liable than the hind ones, and the seat of injury is commonly on the quarters. In the hind feet the wound often results from the ani- mal resting with the heel of one foot set directly over the front of the other. In these cases the injury is generally close to the horn, and often involves the coronary band, the sensitive laminae, the extensor tendon, and even the coffin bone.
Treatment. — Preventive measures would include the use of boots to I)rotect the coronet of the hind foot and the use of a blunt calk on the outside heel of the fore shoe, since this is generally the offending instrument where the fore feet are injured. If the wound is not deep and the soreness slight, cold-water bandages and a light protective dressing, such as carbolized cosmoline, will be all that is needed. Where the injury is deep, followed by inflammation and suppuration of the coronarj" band, lateral cartilages, sensitive lamina?, etc., active measures must be resorted to. In these cases cold, astringent baths, made by adding two ounces of sulphate of iron to a gallon of water, should be used, followed l)y jDoultices if it is necessary to hasten the cleansing of the wound by stimulating the sloughing process. Where the wound is deep between the horn and skin, especiall}^ over the anterior tendon, the horn should be cut away so that the injured tissues may be exposed. The subsecjuent treatment in these cases should follow the directions laid down in the article on toe-cracks.
FROST BITES.
Excepting the ears, the feet and legs are about the only parts of the horse liable to become frost bitten. The cases most commonly seen are found in cities, especially among car horses, where salt is used for the purpose of melting the snow on curves and switches. This mixture of snow and salt is splashed over the feet and legs, rapidly lowering the temperature of the parts to the freezing point. In mountainous districts Avhere the snowfall is heavy and the cold often intense, frost bites are not uncommon even among animals running at large.
Symptoms. — AVhen the frosting is slight the skin becomes pale and bloodless, followed soon after b}' intense redness, heat, pain, and swelling. lu these cases the hair may fall out and the epidermis peel off, but the inflammation soon subsides, the swelling disappears, and only an increased sensitiveness to cold remains. -
In cases more severe, irregular patches of skin are destroyed, and after a few days' time slough away, leaving slow-healing ulcers behind.
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In tlio eases j)rodiieed by low temperatures and deep snoAvthe coronary l)and is the j>art most often affected.
In many instances there is no destruction of the skin, but simply a temporary suspension of the horn-producing function of the coronary band. The fore feet are more often affected than the hind ones, and for some reason the heels and quarters are less often involved than the front part of the foot. The coronarj^ band becomes hot, swollen and painful, and after two or three days' time the horn separates from the band and slight suppuration follows. For a few days the animal is lame, but as the suppuration disappears the lameness subsides; new horn, often of an inferior quality, is produced by the coronary band, and in time the cleft is grown off and complete recover^'' is effected. The frog is occasionally frost bitten and may slough off, exposing the soft tissues beneath and causing severe lameness for a time.
Treatment. — Simple frost bites are best treated by cold fomentations followed by applications of a 5 per cent solution of carbolized oil. When i)ortions of the skin are destroyed their early sejDaration should be hastened by warm fomentations and x)onltices. Ulcers are to be treated by the apx)lication of stimulating dressings such as carbolized oil, a 1 per cent, solution of nitrate of silver or of chloride of zinc, with pads of oakum and flannel bandages. In many of these cases recovery is exceedingly slow. The new tissue hy which the destroyed skin is rei:»laced always shrinks in healing, and as a consequence unsightlj^ scars are unavoidable. Where the coronary band is involved it is generally advisable to blister the coronet over tlie seat of injury as soon as the suppuration ceases, for the purpose of stimulating the growth of nevr horn. Where a crevasse is formed between the old and new horn, no serious trouble is likely to be met with until the cleft is nearly grown out, when the soft tissues may be exposed by a break- ing off of the partly detached horn.
But even where this accident happens final recovery is secured by poulticing the foot until a sufficient growth of horn protects the part from injur}'.
(^UITTOR.
Quittor is a term applied to various affections of the foot wherein the tissues which are involved undergo a j)rocess of degeneration that results in the formation of a slough, followed by the elimination of the diseased structures by means of a more or less extensive suppuration.
For convenience of consideration quittors may be divided into four classes, as suggested by Girard: (1) Cutaneous quittor, which is known also as simple quittor, skin quittor, and carbuncle of the coro- net; (2) tendinous quittor; (;3) subhorny quittor; and (4) cartilagi- nous (piittor.
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CUTANEOUS (^UITTOR.
Simple quittor cousists iu a local inflaiumatiou of the skin and of the subcutaneous connective tissue on some part of the coronet, followed by a slougli and the formation of an ulcer, whi(!li heals by suppuration.
It is an extremely painful disease, owing to the dense character of the tissues involved; for, in all dense structures, the swelling, which accompanies inflammation, always produces intense i)ressure. This pressure not only adds to the patient's suffering, but may, at the same time, endanger the life of the affected parts by strangulating the blood vessels, which alone constitute the means whereby a nutritive supply is constantly maintained. It is held by some writers on the subject that simple quittor is most often met with in the hind feet, but in the author's experience more than two-thirds of the cases have developed in the fore feet. While any part of the coronet may become the seat of attack, the heels and quarters are undoubtedly most liable.
Causes. — Bruises and other wounds of the coronet are often the cause of cutaneous quittor, yet there can be no question but that in the great majority of these cases the disease develops without any known cause. For some reason, not yet satisfactorily explained, most cases happen in the fall of the year. One explanation of this fact has been attempted in the statement that the disease is due to the injurious action of cold and mud. This claim, however, seems to lose force when it is remembered that in many parts of this country the most mud, accompanied by freezing and thawing weather, is seen in the early springtime without a corresponding increase of quittor. Fur- thermore, the serious outbreaks of this disease in the mountainous regions of Colorado, Wyoming, and Montana are seen in the fall and winter seasons, when the weather is the driest. It may be claimed, and perhaps with justice, that during these seasons, when the water is low, animals are compelled to wade through more mud to drink from lakes and pools than is necessar}^ at other seasons of the year, when these lakes and pools are full. Add to these conditions the further fact that much of this mud is impregnated with alkaline salts, which, like the mineral substances always found in the mud of cities, are more or less irritating, and it seems fair to conclude that under certain circumstances mud may become an important factor in the production of quittor.*
*A recent outbreak of quittor near Cheyenne, Wyo., which came under the author's observation, was caused by the mud through which the horses had to wade to reach the watering troughs. These troughs were furnished ^vith water by windmills, and the mud-holes were caused by the waste water. More than fifty cases developed inside of two months' time, or during September and October. Among these fifty cases all forms of the disease and all possible complications were presented. During the rainy season at Leadvilie, Colo. , outbreaks of quittor are common, and the disease is so virulent that it has long been known as the ' ' Leadvilie foot-rot. " The soil being rich in mineral matters is no doubt the cause of the outbreaks. In the city of Montreal quittor is said to be very common in the early springtime, when the streets are muddy from the melting of the snow and ice.
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"While this disease at times attacks an^' and all classes of liorses, it is the large, coinmon breeds, with thick skins, heavy coats, and coarse legs that are most often affected. Horses well groomed and cared for in stables seem to be less liable to the disease than those run- ning at large or than those which are kept and worked under adverse circumstances.
Symptoms. — Lameness, lasting from one to three or four days, nearly always x)recedes the development of the strictly local evidences of quittor. The next sign is the appearance of a small, tense, hot, and painful tumor in the skin of the coronary region. If the skin of the affected foot is white the inflamed portion will present a dark red or even a purplish appearance near the center. Within a few hours' time the ankle, or even the whole leg as high as the knee or hock, becomes much swollen. The lameness is now so great that the patient refuses to use the foot at all, but carries it in the air if comiDelled to move. As a consequence the opposite leg is required to do the work of both, and if the animal persists in standing a greater part of the time it, too, becomes swollen. In many of these cases the suffering is so intense during the first fcAv days as to cause general fever, dull- ness, loss of appetite, and increased thirst. Generally the tumor shows signs of suppuration within from forty-eight to seventy-two hours after its first appearance; the summit softens, a fluctuating fluid is felt beneath the skin, which soon ulcerates completely through, caus- ing the discharge of a thick, yellow, bloody pus, containing shreds of dead tissue which have sloughed away. The sore is now converted into an open Ulcer, generally deep, nearly or quite circular in outline, and with hardened base and edges. In exceptional cases large patclies of skin, varying from 1 to 2^ inches in diameter, slough away at once, leaving an ugly superficial ulcer. These sores, especially when deep, suppurate freely; if there are no complications the}^ tend to heal rapidly as soon as the degenerated, tissue has softened and is entirely removed. When suppuration is fully established the lameness and general symptoms subside. Where but a single tumor and abscess form the disease progresses rapidlj', and recovery, under proper treat- ment, may be effected in from two to three weeks' time; but when two or more tumors are developed at once or where the formation of one tumor is rapidly succeeded by another for an indefinite time the suf- ferings of the patient are greatly increased, the case is more difficult to treat, and recovery is more slow and less certain.
Tliis form of quittor is often complicated with the tendinous and subhorny quittors by an extension of the sloughing process.
Treatment. — The first step in the treatment of an outbreak of quittor should be the removal of all exciting causes. Crowding animals into small corrals and stables, where injuries to the coronet are likely to happen from tramping, especially among unbroken range horses, must be avoided as much as possible.
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Watering places, accessible without having to wade through mud, are to be supplied. In toAvns, where the mud or dust is largely impreg- nated with mineral products, it is not possible to adopt complete pro- phylactic measures. ' Much can be done, however, by careful cleansing of the feet and legs as soon as the animal returns from work. Warm water should be used to remove the mud and dirt, after which the parts are to be thoroughly dried with soft cloths.
The means which are to be adopted for the cure of cutaneous quittor vary with the stage of the disease at the time the case is presented for treatment. If the case is seen early, that is, before any of the signs of suppuration have developed, the affected foot is to be placed under a constant stream of cold Avater, with the object of arresting a further extension of the inflammatory process. To accomplish this put the patient in slings in a narrow stall havinga slat or open floor. Bandage the foot and leg to the knee or hock, as the case may be, with flannel bandages loosely applied. Set a tub or barrel filled with cold water above the patient and by the use of a small rubber hose of sufficient length make a siphon which will carry the water from the bottom of the tub to the leg at the top of the bandages. The stream of water should be quite small, audit is to be continned until the inflammation has entirely subsided or until the presence of pus can be detected in the tumor. When suppuration has commenced the process should be aided by the use of warm baths and poultices of linseed meal or boiled turnips. If the tumor is of rapid growth, accompanied by intense pain, relief is secured and sloughing largely limited by a free incision of the parts. The incision should be vertical and deep into the tumor, care being taken not to entirely divide the coronarj- band. If the tumor is large more than one incision may be necessar3\
The foot should now be placed in a warm bath for half an hour or longer and then poulticed. The hemorrhage produced by the cutting and encouraged by the Avarm bath is generally very copious and soon gives relief to the overtcnsion of the parts.
In other cases it will be found that suppuration is well under way, so that the center of the tumor is soft when the patient is first pre- sented for treatment. It is always good surgery to relieve pus Avhen- ever its presence can be detected; hence in these cases a free incision must be made into the softened parts, the pus evacuated, and the foot poulticed.
By surgical interference the tumor is noAV converted into an oi^en sore or ulcer, which, after it has been well cleaned by v.-arm baths and poultices applied for two or three days, needs to be protected by proper dressings. The best of all protective dressings is made of small balls or pledgets of oakum, carefully packed into the wound and held in place by a roller bandage 4 yards long, from 3 to 4 inches wide, made of common bedticking and skillfully applied. The rem- edies which may be used to stimulate the healing process are many, and as a rule they are applied in the form of solutions or tinctures.
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In my own practice I prefer a .solution of bichloride of mercury 1 part, Avater 500 parts, with a few drops of muriatic acid or a few grains of muriate of ammonia added to cause the mercury to dissolve. The balls of oakum are wet with this solution before they are applied to the wound.
Among the other remedies which may be used, and perhaps with equalh' as good results, will be noted the sulphate of copper, iron, and zinc, 5 grains of either to the ounce of water; chloride of zinc, 5 grains to the ounce; carbolic acid, 20 drops dissolved in an equal amount of glycerine and added to 1 ounce of water, and the nitrate of silver, 10 grains to the ounce of water.
If the wound is slow to heal it will be found of advantage to change the remedies used every few daj^s, for after a time a remedy seems to lose its stimulating effect upon the slow-growing granulations.
If the wound is pale in color, the granulations transparent and glis- tening, the tincture of aloes, tincture of gentian, or the spirits of camphor may do best.
When the sore is red in color and healing rapidly an ointment made of 1 part of carbolic acid to 40 parts of cosmoline or vaseline is all that is needed.
If the granulations continue to grow until a tumor is formed, which projects beyond th(i surrounding skin, it should be cut off with a sharp, clean knife, the foot poulticed for twenty-four hours, after which the wound is to be well cauterized daily with lunar caustic and the bandages applied with great firmness.
The question as to how often the dressings should be renewed must be determined by the condition of the wound, etc. If the sore is sup- purating freely it will be necessary to renew the dressing every twenty- four or forty-eight hours. If the discharge is small in quantity and the patient comfortable the dressing may be left on for several days; in fact, the less often the wound is disturbed the better, in so long as the healing process is healthy. When the sore commences to skin over the edges should be lightly touched with the lunar caustic at each dressing. The patient may now be given a little exercise daily, but the bandages must be kept on until the wound is entirely healed.
TENDINOUS QUITTOR.
This form of quittor differs from the cutaneous in that it not only affects the skin and subcutaneous tissues, but involves, also, the ten- dons of the leg, the ligaments of the joints, and, in many cases, the bones of the foot as well.
Fortunately this form of quittor is less common than the preced- ing; yet any case beginning as simi)le cutaneous quittor may, at any time during its course, become c(nnplicated b}^ the death of some Xiart of the tendons by gangrene of the ligaments, sloughing of the coronarv band, caries of the bones, or inflammation accompanied by
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suppuration of the sj'uovial sacs and joints, thereby converting a simple quittor into one which will, in all probabilit}^, either destroy the patient's life or inaini him for all time.
Causes. — Tendinous quittor is caused by the same injuries and influences that produce the sinqile form. Zundel believes it to be a not infrequent accompaniment of distemper. In my own experience I have seen nothing to verify this belief, but I am satisfied that young animals are more liable to have tendinous quittor than older ones, and that thej^ are much more likely to make a good recovery.
Sumptoms. — When a case of simijle quittor is transformed into the tendinous variety the development of the complications is announced by a sudden increase in the severity' of all of the symptoms. On the other hand, if the attack primarily is one of tendinous quittor, the earliest symj)tom seen is a well-marked lameness in the affected leg. In those cases due to causes other than injuries this lameness is at first very slight, and the animal limps no more in trotting than in walking; but later on, generally during the next forty-eight hours, the lameness increases to such an extent that the patient often refuses to use the leg at all. An examination made during the first two days rarely discloses any cause for this lameness; it may not be possible even to say, with certainty, that the foot is the seat of the trouble. On the third or fourth day, sometimes so late as the fifth, a doughy- feeling tumor will be found forming on the heel or quarter. This tumor grows rapidly, feels hot to the touch, and is extremely painful. As the tumor develops all the other symi)toms increase in intensity; the pulse is rapid and hard, the breathing quick, the temperature elevated three or four degrees, the appetite is gone, thirst is increased, and the lameness is so great that the foot is carried in the air if loco- motion is attempted. At this stage of the disease the patient gener- ally seeks relief by lying upon the broad side, with outstretched legs, the coat bedewed with a clammy sweat, Avhile every respiration is accompanied by a moan. The leg soon swells to the fetlock; later this swelling gradually extends as high as to the knee or hock, and in some cases it even reaches the body. As a rule several days elapse before the disease develoi)s a well defined abscess, for, owing to the dense structure of the bones, ligaments, and tendons, the suppurative pi'ocess is a slow one, and the pus when formed is prevented from readily collecting in a mass.
Recently I made a post mortem examination on a typical case of this disease, Avhere the animal had died on the fourth day after being found on the range slightly lame. The suffering had been intense; yet the only external evidences of the disease consisted in the shed- ding of the hoof from the right fore foot, and a limited swelling of the leg to the knee. The sloughing of the hoof took place two or three hours before death, and was accompanied with but little suppuration 59G1— HOR 13
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and 110 lienioi'i'hage. The skin, tvom the knee to the foot, was thick- ened from Avateiy infiltration (oedema), and on the inside quarter three holes, each about one-half of an inch in diameter, were found. All had ragged edges, while but one had gone deep enougli to per- forate the coronary band. The loose connective tissue, found beneath the skin, was distended with a gelatijious infiltration, over the whole course of the flexor tendons, and to the fetlock joint over the tendon in front. The soft tissues covering the coffin bone were loosened in patches by collections of pus which had formed beneath the sensitive laniin?e. The coffin and pastern joints were both inflamed, as Avero also the coffin, navicular, and coronet bones, while the outside toe of the coffin bono had become softened from suppuration, until it could readily be crumbled between the fingers. The coronary band v/as largely destroyed and completelj' separated from the other tissues of the foot; the inner lateral cartilage was gangrenous, as was also a small spot on the extensor tendon, near its point of attachment on the coffin bone. Several small collections of pus were found deep in the connec- tive tissue of the coronary region; along tlie course of the sesamoid ligaments; in the sheath of the flexor tendons; under the tendon just below the fetlock joint in front, and in the coffin joint.
But all cases of tendinous quitter are by no means so complicated as this one was. In rare instances the swelling is slight, and after a few days' time the lameness and other S3-mptoms subside without an}^ discharge of pus from an external opening. In most cases, however, from one to half a dozen or more soft i^oints arise on the skin of the coronet, open, and discharge slowly a thick, yellow, fetid, and bloody matter. In otlier cases the suppurative process is largely confined to the sensitive laminae and plantar cushion; in these cases the suffering is intense until the pus finds an avenue of escape, which it generally does by separating the hoof from the coronary band, at or near the heels, Avithout causing a loss of the whole horny box. When the flexor tendon is involved deep in the foot, the discharge of pus usually takes place from an opening in the hollow of the heel; if the sesamoid liga- ment, or the sheath of the flexors, are affected, the opening is nearer the fetlock joint; although in most of these cases the suppuration spreads along the course of the tendons until the navicular joint is involved, and extensive sloughing of the deeper parts follows.
Treatment.— ThQ treatment of tendinous quitter is to be directed toward the saving of the foot. First of all, an effort must be made to I)revent suppuration; and if the patient is seen at the beginning, the cold irrigation, recommended in the treatment for cutaneous quittor, is to be resorted to. Later on, when the tumor is forming on the cor- onet, the knife must be used, ;ind a free and deep incision made into the swelling. Whenever openings appear from which the pus escapes they should be carefully probed ; in all instances these fistulous tracts will be found leading down to dead tissue which nature is trying to
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remove by the process of sloughing. If a counter opening can be made, which will enable a more ready escape of the pus, it should be done at once; for instance, if the probe shows that the discharge originates from tlie bottom of the foot the sole must be pared through, over the seat of trovible. AVhenever suppuration has commenced, the process is to be stimulated by the use of warm baths and poultices. The pus which accumulates in the deeper i^arts, especially along the tendons, around the joints, and in the hoof, is to be removed by pres- sure and injections, made with a small syringe and repeated two or three times a day. As soon as the discharge assumes a healthy char- acter and diminishes in quantity, stimulating solutions are to be injected into the open wounds. AVhere the tendons, ligaments, and other deeper i)arts are affected, a strong solution of carbolic acid — 1 to 4 — should be used at first. Or, strong solutions of tincture of iodine, sulphate of iron, sulphate of copper, bichloride of mercury, etc., may be used in j)lace of the carbolic; after which the remedies and dress- ings, directed for use in simple quittor, are to be used. In those cases where the fistulous tracts refuse to heal, it is often necessary to burn them out with a saturated solution of caustic soda, equal parts of muriatic acid, and water, or, better still, with a long, tliin iron, heated white hot.
But no matter what treatment is adopted, a large percentage of the eases of tendinous quittor fail to make good recoveries. Where the entire hoof sloughs away, the growth of a new, but soft and imper- fect, hoof may be secured by carefully jDrotecting the soft and exposed tissues with proper bandages. AVhen the joints are opened by deep sloughing, recovery ma}' eventually take jilace, but the joint remains immovable ever after. If caries of a small part of the coffin bone takes place, it may be removed by an operation ; but if much of the bone is affected, or if the navicular and coronet bones are involved in the carious process, the onh' hojie for a cure is in the amputation of the foot. Of course, this operation would only be advisable where the animal was valuable for breeding purposes. In all other cases where there is no hope for recovery the patient's suffering should be relieved by death. In tendinous quittor much thickening of the coronary region, and sometimes of the ankle and fetlock, remains after supi)uration has ceased and the fistulous tracts have healed. To stimulate the reabsorption of tliis new and unnecessary tissue the parts should be fired with the hot iron; or, in its absence, repeated blistering, with the biniodide of mercury ointment, may largely accomplish the same result.
SUBHORNY QUITTOR.
This is the most common form of the disease. It is generally seen in but one foot at a time, and more often in the fore feet than in the hind ones. It nearly always attacks the inside quarter, but may
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affect the outside quarter, tlie toe or the heel, where it is of but little consequence. It consists in the inflammation of a small part of the coronary band and adjacent skin, followed by sloughing and more or less suppuration, which in most cases extends to the neighboring sensitive laminte.
Causes. — Injuries to the coronet, such as bruises, overreaching, and calk wounds, are considered as the common causes of this dis- ease. Still, cases occur in which there appears to be no exciting cause, just as in the other forms of quittor, and it seems fair to con- clude that subhorny quittor may also be i^roduced by internal causes.
Symptoms. — At the outset the lameness is always severe, and the patient often refuses to use the affected foot. Swelling of the coro- net takes place close to the top of the hoof, causing the quarter to protrude beyond the wall of the foot. This tumor is extremely sensi- tive, and the whole foot is hot and painful. After a few days' time a small spot in the skin, over the most elevated part of the tumor, softens and opens, or else the hoof separates from the coronary band at the quarter or well back toward the heel. From this opening, wherever it may be, a thin, watery, offensive discharge escapes, often dark in color, at times mixed with blood, and always containing a considerable percentage of pus.
Probing will now disclose a fistulous tract leading to the bottom of the diseased tissues. If the opening is small there is a tendency upon the part of the suppurative process to spread downward; the pus gradually separating the hoof from the sensitive laminae until the sole is reached, and even a portion of this may also be undermined.
As a rule, the slough in this form of quittor is not deep, so that if the case receives early and proper treatment complications are generally avoided, but if the case is neglected, and, occasionally, even in spite of the best of treatment, the disease spreads until the tendon in front, the lateral cartilage, or the coffin l)one and joint as well, are involved.
In all cases of subhorny quittor much relief is experienced as soon as the slough has come away, and rapid progress toward recovery is made. If, however, after the lapse of a few days' time, the lameness still remains and the wound continues to discharge a thin unhealthy matter, the probabilities are that the disease is spreading, and that pus is collecting in the deeper parts of the foot. In Zundel's opinion, if the use of the probe now detects a pus cavity below the opening, a cartilaginous quittor is in the course of develoiament.
Treatment.— Wot baths and poultices are to be used until the pres- ence of pus can be determined, when the tumor is to be opened with a knife or sharp-pointed iron heated white hot. The hot baths and poultices are now continued for a few days, or until the entire slough has come away and the discharge is diminished, when the dressings recommended in the treatment for cutaneous quittor are to be used until recovery is completed. In cases where the discharge comes
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from a cleft between the upper border of the hoof and the coronary band, alwaj's pare away the loosened horn, so that the soft tissues beneath are fully exposed, care being taken not to injure the healthy parts. This operation permits of a thorough inspection of the dis- eased parts, the easy removal of all gangrenous tissue, and a better application of the necessary remedies and dressings. The only objec- tion to the oi)eration is that the i^atient is prevented from being early returned to work.
When the probe shows that pus has collected under the coffin bone, the sole must be j)ared through, and if caries of the bone is present, the dead parts must be cut away. After either of these operations the w^ound is to be dressed with the oakum balls saturated in the bichloride of mercury solution, as previously directed, and the band- ages tightly applied. Generally the discharge for the first two or three days is so great that the dressings need to be changed every twenty-four hours; but when the discharge diminishes, the dressing may be left on from one to two weeks. Before the patient is returned to work, a bar shoe should be applied, since the removed quarter or heel can only be made perfect again by a new growth from the coro- nary band.
Tendinous or cartilaginous complications are to be treated as directed under these headings.
CARTILAGINOUS QUITTOR.
This form of quittor may commence as a primary inflammation of the lateral cartilage, but in the great majority of cases it appears as a sequel to cutaneous or sub-horny quittor. It may affect either the fore or hind feet, but is most commonly seen in the former. As a rule, it attacks but one foot at a time, and but one of the cartilages, and that is generally the inner one. It is always a serious affection for the reason that, in many cases, it can only be cured by a surgical operation, requiring a thorough knowledge of the anatomy of the parts involved and much surgical skill.
Causes. — Direct injuries to the coronet, such as trami^ing, pricks, burns, and the blow of some heavy falling object which may puncture, bruise, or crush the cartilage, are the common direct causes of carti- laginous quittor. Besides being a sequel to the other forms of quittor, it sometimes develops as a complication in suppurative corn, canker, grease, laminitis, and punctured wounds of the foot. Animals used for heavy draught, and those with flat feet and low heels, are more liable to the disease than others, for the simple reason that they are more exposed to injury. Rough roads also predispose to the disease by increasing liability to injury.
Symptoms. — When the disease commences as a primaiy inflamma- tion of the cartilage, lameness develops with the formation of a swell- ing on the side of the coronet over the quarter. The severity of this
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lameness depends largely npon the part of the cartilage which is dis- eased; if the disease is situated in that part of the cartilage nearest the heel, where the surrounding tissues are soft and spongy, the lame- ness may be very slight, e'specially if the patient is required to go no faster than a walk; but when the middle and anterior parts of the car- tilage are diseased the ])iihi and consequent lameness are much greater, for the tissues are less elastic and the colFm joint is more likely to become affected.
Except in tlie cases to be noted hereafter, one or more fistulous open- ings finally appear in the tumor on the coronet. These openings are surrounded by a small mass of granulations, which are elevated above the adjacent skin and bleed readily if handled. A probe shows these fistulous tracts to be more or less sinuous, but always leading to one point — tlie gangrenous cartilage. AVhen cartilaginous quittor hap- pens as a comijlication of suppurative corn, or from punctured wounds of the foot, the fistulous tract may open alone at the point of injury on the sole.
The discharge in this form of quittor is generally thin, waterj^ and contains enough pus to give it a pale yellow color; it is offensive to the sense of smell, due to the detachment of small flakes of the cartilage which have become gangrenous and are to be seen in the discharge in the form of small greenish-colored particles. In old cases it is not unusual to find some of the fistulous openings heal at the surface; this is followed by the gradual collection of pus in the deeper parts, form- ing an abscess, which in a short time opens at a new point. The wall of the hoof, over the affected quarter and heel, in very old cases, becomes rough and Avrinkled like the horn of a ram; and generally it is thicker than the corresponding quarter, owing to the stimulating effect which the disease has upon the coronar}^ band.
Complications may arise by an extension of the disease to the lateral ligament of the coffin joint, to the joint itself, to the plantar cushion, and ]\y caries of the coffin bone.
Treatment. — Before recovery can take place in these cases all of the dead cartilage must be removed. In rare instances this is effected b}'' nature without assistance. Usually, however, the disease does not tend to recovery, and active curative measures must be adopted. The best and simplest treatment in a majority of cases is the injection of strong caustic solutions, which are intended to destroy the diseased cartilage, and to cause its removal, along with the other x^roducts of suppura- tion. In favorable cases these injections Avill secure a healing of the wound in from two to three weeks' time. While the saturated solution of the sulphate of copper, or a solution of 10 parts of bi-chloride of me}-cury to 100 parts of water, has given the best results in mj' hands, equally as favorable success lias been secured by others from the use of caustic soda, nitrate of silver, suljjhate of zinc, tincture of iodine, etc. But no matter which one of these remedies maj'^ be selected, it
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must be used at least twice a day for a time. The solution is to be injected into the various openings with enough force to drive it to the bottom of the wound, after which the foot is to be dressed with a pad of oakum, lield in place b}^ a roller bandage tightl}^ applied. "While it is not always necessary, in many cases it is of advantage to relieve the pressure on the parts by rasping away the horn over the seat of the cartilage; the coronary band and the lamin;e sliould not be injured in the operation.
If the caustic injections prove successful, the discharge will become healthy and graduallj' diminish, so that by the end of the second week it will be found that the fistulous tracts are closing up, and that the injections are made with much difficulty.
If, on the other hand, there is but little or no improvement after this treatment has been used for three weeks, it may reasonal^ly be concluded that the operation for the removal of the lateral cartilage must be resorted to for the cure of the trouble. As this operation can be safely undertaken only by an expert surgeon, it will not be described in this connection.
THRUSH.
Thrush is a disease characterized bj* an excessive secretion of un- healthy matter from the cleft of the frog. "While all classes of horses are liable to this affection, it is more often seen in the common draft horse than in any other breed, a fact due to the conditions of servi- tude and not to the fault of the breed. Country horses are much less subject to the disease, except in wet, marshy districts, than are the horses used in cities and towns.
Causes. — The most common cause of thrush is the filth}' condition of the stable in which the animal is kept. Mares are more liable to contract the disease in the hind feet when the cause is due to filth, while the gelding and stallion are more likely to develop it in the fore feet. Hard work, on rough and stony roads, may also induce the dis- ease, as may a change from dryness to excessive moisture. The latter cause is often seen to operate in old track horses, whose feet are con- stantly soaked in the bath-tub for the purpose of relieving soreness. Muddy streets and roads, especially Avhcre mineral substances are plentiful, excite this abnormal condition of the frog. Contracted heels, scratches, and navicular disease predispose to thrush, while by some a constitutional tendency is believed to exist among certain animals which otherwise present a perfect frog.
SyinptoDis. — At first there is simply an increased moisture in the cleft of the frog, accompanied by an offensive smell. After a time a considerable discharge takes place— thin, watery, and highly offen- sive— changing gradually to a thicker puriforni matter, which rapidly desti'03's the horn of the frog. Only in old and severe cases is the patient lame and the foot feverisli— cases in which the whole frog is involved in the diseased process.
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Treatmeni. — Thrushes are to be treated by cleanliness, the removal of all exciting causes, and a return of the frog to its normal condition. As a rule, the diseased and ragged portions of horn are to be pared awaj^, and the foot poulticed for a day or two with boiled turnips, to which maj' be added a few drops of carbolic acid or a handful of pow- dered charcoal to destroy the offensive smell. The cleft of the frog and the grooves on the edges are then to be cleaned and well filled with dry calomel, and the foot dressed with oakum and a roller bandage. If the discharge is profuse the dressing should be changed daily, otherwise it may be left on for two or three days at a time. Where a constitutional taint is supi^osed to exist Avith swelling of the legs, grease, etc., a purgative followed by dram doses of sulphate of iron, repeated daily, may be prescribed. In cases where the growth of horn seems too slow, a Spanish fly blister applied to the heels is often fol- lowed by good results. Feet in which the disease is readily induced may be protected in the stable with a leather boot. If the thrush is but a sequel to other diseases a permanent cure may not be possible.
CANKER.
Canker of the foot is a disease due to the ra^iid reproduction of a vegetable parasite. It not only destroys the sole and frog, but by set- ting up a chronic inflammation in the deeper tissues, prevents the growth of a healthy horn by which the injury might be repaired. Heavy cart horses are more often affected than those of any other class.
Causes. — The essential element in the production of cankers is of course the presence of the parasite; consequently the disease may be called contagious. But, as in all other diseases due to specific causes, the seeds of the disorder must find a suitable soil in which to grow before they are reijroduced. It may be said, then, that the conditions which favor the i)reparation of the tissues for a reception of the seeds of this disease are simply predisposing causes.
The condition most favorable to the development of cankers is dampness — in fact, dampness seems indispensable to the existence and growth of the parasite ; for the disease is rarely, if ever, seen in high, dry districts, and is much more common in vsauy than in dry seasons. Filthy sta])les and muddy roads have been classed among the causes of canker; but it is very doubtful if these conditions can do more than favor a preparation of the foot for the reception of the disease germ.
All injuries to the feet may, by exposing the soft tissues, render the animal susceptible to infection; but neither the injury nor the irrita- tion and inflammation of the tissues which follow, are sufficient to induce the disease.
For some unknown reason horses with lymphatic temperaments, thick skins, flat feet, fleshy frogs, heavy hair, and particularly with white feet and legs, are especially liable to canker.
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Symptoms. — Usually, canker is confined to one foot; but it may attack two, three, or all of the feet at once; or, as is more commonly- seen, the disease attacks first one then another, until all may have been successively affected. When the disease follows an injury which has exposed the soft tissues of the foot the wound shows no tendency to heal, but, instead, there is secreted from the inflamed parts a pro- fuse, thin, fetid, watery discharge, which graduallj^ undermines and destroys the surrounding horn, until eventually a large part of the sole and frog is diseased. The living tissues are swollen, dark-col- ored, and covered at certain i^oints with particles of new, soft, yellow- ish, thready horn, which are constantly undergoing maceration in the abundant liquid secretion l)y which thej^ are immersed. As this secre- tion escapes to the surrounding i^arts it dries and forms small cheesy masses composed of the partly dried horny matter, exceedingly offen- sive to the sense of smell. When the disease originates independ- ently of an injury, the first evidences of the trouble are the offensive odor of the foot, the liquid secretion from the cleft and sides of the frog, and the rotting away of the horn of the frog and sole.
In the earlier stages of the disease there is no interference with locomotion, but later the foot becomes sensitive, particularly if the animal is used on rough roads, and, finally, when the sole and frog are largely destroyed the lameness is severe.
Treatment. — Since canker does not destroy the power of the tissues to produce horn, but rather excites them to an excessive ijroduction of an imperfect horn, the indications for treatment are to restore the parts to a normal condition, when healthy horn may again be secreted. In my experience, limited though it has been, the old practice of strip- ping off the entire sole and deep cauterization, with either the hot iron or strong acids, is not attended with uniformly good results.
I am of the opinion that recovery can generally be effected as surely and as speedil}- with measures which are less heroic and much less painful. True, the treatment of canker is likely to exhaust the patience, and sometimes the resources, of the attendant; but after all success depends more on the persistent application of simple remedies and great cleanliness than on the si^ecial virtues of any particular drug.
First, then, clean the foot with warm baths and, apply a poultice containing j)owdered charcoal or carbolic acid. A handful of the charcoal, or a tablespoonful of the acid, mixed with the poultice serves to destroy much of the offensive odor. The diseased jiortions of horn are now to be carefully removed with sharp instruments, until only healthy horn borders the affected i^arts. The edges of the sound horn are to be i)ared thin, so that the swollen soft tissues may not overlap their borders. With sharp scissors cut off all the promi- nent points on the soft tissues, shorten the walls of the foot, and nail 59(31— HOR 1.3*
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on a broad, plain shoe. The foot is now ready for the dressings, and any of the many stimnlating and drying remedies may be used. Whichever is selected at the outset, it will be necessary to change frequently from one to another, until finallj^ all may be tried.
The list from Avhicli a selection may 1)e made comprises Avood tar, gas tar, i^etroleum, creosote, phenic acid, sulphates of iron, copper and zinc, chloride of zinc, bichloride of mercury, calomel, caustic soda, nitrate of silver, chloride of lime, carbolic, nitric, and sulphuric acids.
In practice I prefer to give the newly shod foot a bath for an hour or two in a solution of the sulphate of iron, made by adding 2 ounces of the liowdered sulphate to a gallon of cold water. When the foot is removed it is dressed with oakum balls, dipped in a mixture made of Barbadoes tar, 1 j)art; oil of turpentine, 8 i^arts, to which are slowly added 2 parts of sulphuric acid, and the mixture well stirred and cooled. The diseased parts being well covered with the balls, a pad of oakum, sufficiently thick to cause considerable pressure, is placed over them, and all are held in place h} pieces of heavy tin fitted to slip under the shoe. The whole foot is now encased in a boot or folded gunny sack, and the patient turned into a loose, dry box. The dressings are to be changed daily, or even twice a day, at first. When they are removed all ijieces of new hornj- matter, Avhicli are now tirmly adherent must be rubbed off with the finger or a tent of oakum. As the secretion diminishes dry powders may prove of most advantage, such as calomel, sulphates of iron, copper, etc. The sulphates should not be used pure, but are to be mixed with powdered animal charcoal in the proportion of one of the former to eight or ten of the latter. When the soft tissues are all horned over the dress- ings should be continued for a time, weak solutions being used to prevent a recurrence of the disease. If the patient is run down in condition, bitter tonics, such as gentian, may be given in 2-dram doses, twice a day, and a liberal diet of grain allowed.
CORNS.
A corn is an injury to the living horn of the foot, involving at the same time the soft tissues beneath, whereb}'' the capillary blood ves- sels are ruptured and a small amount of blood escapes, which, by I)ermeating the horn in the immediate neighborhood, stains it a dark color. If the injury is continuously repeated the horn becomes altered in character, the soft tissues may suppurate, causing the disease to spread, or a hornj" tumor may develop. Corns always appear in that part of the sole included in the angle between the bar and the outside wall of the hoof. In many cases the lamiuse of the bar, of the wall, or of both, are involved at the same time.
Three kinds of corns are commonly recognized — the drj% the moist, and the suppurative, a division based solely on the character of the conditions which follow the i)rimary injury.
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The forefeet are almost exclusively the subjects oL' the disease, for two reasons: First, because they supi)ort a greater part of the bodj'-; secondly, because the heel of the fore foot during progression is first placed ui)on the ground, Avhereby it receives mucli more concussion than the heel of the hind foot, in which the toe first strikes the ground.
Causes. — It maybe said that all feet are exposed to corns, and that even the best feet may suffer from them when the conditions neces- sary to tlie production of the peculiar injury are present. The heavier breeds of horses generally used for heavy work on rough roads and streets seem to be most liable to this trouble. Mules rarely have corns.
Among the causes and conditions which predispose to corns may be named high heels, -which change the natural relative position of the bones of the foot and thereby increase the concussion to which these parts are subject; contracted heels, which in part destroy" the elas- ticity of the foot, increase the pressure upon the soft tissues of the heel, and render lacerations more easy; long feet, which, by removing the frog and heels too far from the ground, deprive them of necessary moisture, which in turn reduces the elastic iDroperties of the horn and diminishes the transverse diameter of the heels; weak feet, or those in which the horn of the wall is too thin to resist the tendenc}' to spread, and as a result the soft tissues are easily lacerated. Wide feet with low heels are always accompanied by a flat sole whose pos- terior wings either rest upon the ground or the shoe, and as a conse- quence are easily bruised ; at the same time the arch of the sole is so broad and flat that it can not support the weight of the bodj^, and in the displacement which happens when the foot is rested upon the ground the soft tissues are liable to become bruised or torn.
It is universallj^ conceded that shoeing of the foot, either as a direct or predisposing cause, is most jDrolific in iiroducing corns. One of the most serious as well as the most common of the errors in shoeing is to be found in the preparation of the foot for the shoe. Instead of seek- ing to maintain the integrity of the arch the first thing done is to Aveaken it bj- freel}' paring away the sole; nor does the mutilation end here, for the frog, which is nature's mainsupi^ort to the branches of the sole and the heels, is also largely cut away. This not only per- mits of an excessive downward movement of tlie contents of the horny box, but it at the same time removes the one great means by which concussion of the foot is destroyed. As adjuncts to the foregoing- errors must be added the faults in the construction of the shoe and in the way it is adjusted to the foot. An excess of concavity in the shoe, by extending it too far back on the heels, high calks, thin heels which permit the shoe to spring, short heels Avith a calk set under the foot, and a shoe too light for the animal wearing it or for the work required of him, are all to be avoided as causes of corns. A shoe so set as to press upon the sole, or one that has been on so long that the
39G
hoof lias overgrown it until the heels rest uj^on the sole and bars, be- comes a direct cause of corns. Indirectly the shoe becomes the cause of corns when small stones, hard dry earth, or other objects collect between the sole and shoe. Lastly, a rapid gait and excessive knee action, especially on hard roads, predispose to this disease of the feet. *S'//7??j5/o?».s'. — Ordinarily a corn induces sufficient pain to cause lame- ness. It may be intense, as seen in sujipui'ative corn, or it may be but a slight soreness, such as that which accompanies dry corn. It is by no means unusual to see old horses having chronic corns appar- ently so accustomed to the slight i)ain which they suffer as not to limp at all; but these animals are generally very restless; they paw their bedding behind them at night, and in many instances they refuse to lie down for any lengthened rest. The lameness of this disease, how- ever, can hardly be said to be characteristic, for the reason that it varies so greatly in intensity; but the position of the leg while the patient is at rest is generally the same in all cases. The foot is so advanced that it is relieved of all weight and the fetlock is flexed until all pressure by the contents of the hoof is removed from the heels. In suppurative corn the lameness subsides or entirely dis- appears as soon as the abscess has opened. AVhen the injured tissues are much inflamed, as may happen in severe and recent cases, the heel of the affected side, or even the whole foot, is hot and tender to pressure. In dry corn, and in most chronic cases, all evidences of local fever are often wanting. It is in these cases that the patient goes w^ell when newly shod, for the smith cuts away the sole over the seat of injury until all i)ressuro b}' the shoe is removed, and lowers the heels so that concussion is reduced to a minimum. If a corn is suspected the foot should be examined for increased sensibility of the inside heel. Tapping the heel of the shoe with a hammer and grasp- ing the wall and bar between the jaws of a pincers, with moderate pressure, will cause more or less flinching if the disease is present. For further evidence the shoe is removed and the heel cut away with the drawing knife. As the horn is pared out not only the sole in the angle is found discolored, but, in many instances, the insensible laminae of the bar and Avail adjacent are also stained with the escaped blood. In moist and suppurative corns this discoloration is less marked than in dry corn and may be even entirely Avanting. In these cases the horn is soft, often Avliite, and stringy or mealy, as seen in pumiced sole resulting from founder. When the whole thickness of the sole is discolored and the horn dry and brittle it is generally evi- dence that the corn is an old one and that the exciting cause has existed continuously. A moist corn differs from the dry corn in that the injury is more severe, the parts affected are more or less inflamed, and the horn of the sole in the angle is undermined b}^ a citron-colored fluid, which often permeates the injured sole and laminae, causing the horn to become somewhat spongy.
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A suppurative corn differs from the others in that the inflammation accompanying the injury ends in suppuration. The pus collects at the point of injury and finally escapes by working a passage way between the sensitive and insensible laminae to the top of the hoof, where an opening is made by separation of the wall from the coronary band at or near the heels. This is the most serious form of corns, for the reason that it may induce gangrene of the plantar cushion, carti- laginous quittor, or caries of the coffin bone.
Treafmenf. — Since a diversity of opinion exists as to what measures must be adopted for the radical cure of corns, the author will advise the use of those which have proven most efficient in his hands.
As in all other troubles, the cause must be discovered, if possible, and removed. In the great majority of cases the shoeing wiU be at fault. AVhile sudden changes in the method of shoeing are not advisable, it may be said that all errors, either in the i^reparation of the foot, in the construction of the shoe, or in its application, may very properly be corrected at any time. Circumstances may, at times, make it imperative that shoes shall be worn which are not free from objections, as, for instance, the shoe with a high calk; but in such cases it is considered that the injuries liable to result from the use of calks are less serious than those which are sure to happen for the want of them.
For a sound foot, perfectly formed, a flat shoe, with heels less thick than the toe, and which rests evenly on the wall proper, is the best. In flat feet it is often necessary to concave the shoe as much as possi- ble on the upper surface, so that the sole may not be pressed upon If the heels are very low the heels of the shoe may be made thicker. If the foot is very broad and the wall light toward the heels, a bar shoe, resting uj)on the frog, will aid to i^revent excessive tension upon the soft tissues when the foot receives the weight of the body. A piece of leather placed betAveen the foot and the shoe serves to largely destroy concussion, and its use is absolutely necessary on some animals in that they may be kept at work.
Lastly, among the jireventive measures may be mentioned those which serve to maintain the suppleness of the hoof. The dead horn upon the surface of the sole not only retains moisture for a long time, but protects the living horn beneath from the effects of evaporation, and for this reason the sole should be pared as little as possible. Stuffing the feet with flaxseed meal, wet clay, or other like sub- stances; damp dirt floors or damp bedding of tan-bark, greasy hoof ointments, etc., are all means which may be used to keej) the feet from becoming too dry and hard.
As to the curative measures which are to be adopted much will depend upon the extent of the injury. If the case is one of chronic dry corn, with but slight lameness, the foot should be poulticed for a day or two and the discolored horn pared out, care being taken not to
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injure the soft tissues. The heel oii the affected side is to be low- ered until all pressure is removed, and, if the i)atient's labor is required, the foot must be shod with a bar shoe or with one having stiff heels. Care must be t^ken to reset the shoe before the foot has grown too long, else the shoe will no longer rest on the wall but on the sole and bar.
In moist corns we believe in cutting them out. If there is inflam- mation present, cold baths and poultices should be used; when the' horn is well softened and the fever allayed, pare ont all of the dis- eased horn, lightly cauterize the soft tissues beneath, and poultice the foot for two or three days. When the granulations look red dress the wound with oakum balls saturated in a weak solution of tincture of aloes or spirits of camphor, and apply a roller bandage. Change the dressing every two or three days until a firm, healthy layer of new horn covers the wound, wlien the shoe may be put on, as in dry corn, and the patient returned to work.
In suppurative corns the loosened horn must be removed so that the i^us may freelj^ escape. If the pus has worked a passage to the coronarj" band, and escapes from an opening between the band and hoof, an opening must be made on the sole, and cold baths, made astringent with a little sulphate of iron or copper^ are to be used for a day or two. When the discharge becomes health)^ the fistulous tracts may be injected daily with a weak solution of bichloride of mercury, nitrate of silver, etc., and the foot dressed as after the operation for moist corns. When complications arise the treatment must be varied to meet the indications; if gangrene of the lateral cartilage takes place it must be treated as directed under the liead of cartilaginous quittor; if the velvety tissue is gangrenous it must be cut away, and if the coffin bone is necrosed it must be scraped, and the resulting wounds are to be treated on general principles. After any of the operations for corns have been performed, in which the soft tissues have been laid l3are, it is best to protect the foot by a sole of soft leather, set beneath the shoe, when the animal is returned to work. Onl}^ in rare instances are the complications of corn so seri- ous as to destroy the life or usefulness of the patient. It is the wide, flat foot, Avith low heels and a thin wall, which is most liable to resist all efforts toward effecting a comj^lete cure.
BRUISE OF THE FROG.
When the frog is severely bruised the injury is followed by suppu- ration beneath the horn, and at times by partial gangrene of the plantar cushion.
Causes. — A bruise of the frog generally happens from the animal stepping on a rough stone or otlier hard object. It is more apt to take place when the animal is trotting, running, or jumping than when he is at a slower pace. A stone wedged between the branches of the shoe in the cleft of the frog, or between tlie sides of the frog and the shoe,
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and remainiug for a time, produces the same results. A cut through the horny frog with some sharp instrument or a punctured ^vound with ablunt-i^ointed insti'ument may also cause suppuration and gangrene of the plantar cushion. Broad, flat feet, with low heels and a fleshy frog, are most liable to these injuries.
Sijni2:)/oins. — Lameness, severe in x^i'oportion to the extent of the bruise and the consequent suppuration, is always an earlj^ sN-mptom. When the animal moves the toe only is placed to the ground, or the foot is carried in the air and the patient hobbles along on three legs. When he is at rest the foot is set forward with the toe resting on the ground and the leg flexed at the fetlock joint. As soon as the pus finds its way to the surface the lameness improves. If the frog is examined early the injured spot may usually be found, and if nooj)en- ing exists the collection of piis maybe detected working its wa}' toward the heels. The horn is felt to be loosened from the deeper tissues, and if it is pared through, a thin, yellow, watery and offensive pus escapes. In other cases a ragged oj^ening is found in the frog, lead- ing down to a mass of dead, sloughing tissues, which are pale green in color if gangrene of the jDlantar cushion has set in. In rare cases the coflin bone may be involved in the injury and a small portion of it become carious.
Treatment. — If the injury is seen at once the foot should be i)hicfKi in a bath of cold water with the object of preventing suppuration. If suppuration has already set in the horn of the frog, and of the bars and l)ranches of the sole if necessary, is to be pared thin, so that all possible pressure may be removed and the foot poulticed. As soon as the lius has loosened the horn, all the detached portions are to be cut away. If the pus is discharging from an opening near the hair the whole frog, or one-half of it, will generally be found separated from the plantar cushion, and is to be removed with the knife. After a few days' time the gangrenous portion of the cushion will slough off under the stimulating effects of the poultice, and under rare circum- stances only should the dead parts be removed by surgical inter- ference. Where the slough is all detached the remaining wound is to be treated with simple stimulating dressings, such as tincture of aloes oi- tui-pentine, oakum balls, and bandages as directed in punctured wounds. The lameness having subsided, and a thin layer of new horn having grown on the exposed parts, the foot may be shod, the frog covered with a thick pad of oakum, held in x^lace by pieces of tin fitted to slide under the shoe, and the animal returned to slow work. Where caries of the coffin bone, etc., follow the injur}' the treatment recommended for these complications in i^unctured wounds of the foot must be I'esorted to.
PUNCTURED WOUNDS OF THE FOOT.
Of all the injuries to which the foot of the horse is liable none are more common than i)unctured wounds, and none arc more serious
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than these may be when involving tlie more important organs con- tained within the hoof. A nail is the most common instrument by which the injury is inflicted, yet wounds maj^ happen from sharp pieces of rock, glass, wire, knives, etc.
A wound of the foot is more serious when made bj- a blunt-pointed instrument than when the point is sharp, and the nearer the injury is to the center of the foot the more likely are disastrous results to follow. Wounds in the heel and in the i^osterior parts of the frog are attended with but little danger, unless they are so deep as to injure the lateral cartilages, when cjuittor may follow. Punctured wounds of the anterior parts of the sole are more dangerous for the reason tliat the coffin bone may be injured and the suppuration, even where the wound is not deep, tends to spread and always gives rise to intense suffering. The most serious of the i^unctured wounds are those which happen to the center of the foot, and which involve, in proportion to their depth, the x^lantar cushion, the plantar aponeurosis, the sesamoid sheath, the navicular bone, or the coffin joint.
Punctured wounds are more likely to be deep in flat or convex feet than in well-made feet, and, as a rule, recovery is neither so rapid nor so certain. These wounds are less serious in animals used for heavj^ draught than in those required to do faster work; for the for- mer may be useful, even if complete recovery is not effected. Lastly, punctured wounds of the fore feet are more serious than of the hind feet, for the reason that in the former the instrument is apt to enter the foot in a nearly perpendicular line, and, consequently, is more likely to injure the deejier structures of the foot, while in the hind foot the injury is generall}^ near the heels and the wound oblique and less deep.
Symptoms. — \ nail or other sharp instrument may iienetrate the frog and remain there for several daj^s without causing lameness; in fact, in man}' cases of punctured wound of the frog the fi.rst evidence of the injury is the finding of the nail on cleaning the foot or the appearance of an oj)ening Avhere the skin and frog unite, from Avhich more or less pus escapes. Even when the sole is perforated, if the injury is not too deep, no lameness develops until suppuration is established. In all cases of foot lameness, especially if the cause is obscure, the foot should be examined for evidence of injujy.
The lameness from punctured wounds, accomj)anied by suppuration, is generally severe, the patient often refusing to use the affected mem- ber at all. The pain being lancinating in character, he stands with the injured foot at rest or constantly moves it back and forth. In other cases the patient lies down most of the time with the feet out- stretched; the breathing is raiiid, the iiulse fast, the temperature ele- vated, and the body covered with patches of sweat.
When the plantar aponeurosis is injured the x^ns escapes with diffi- culty and the wound shows no signs of healing; the whole foot is hot
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and very painful. If the puncture involves the sesamoid sheath the synovial fluid escaijes. At first this fluid is pure, like joint-water, but later on it becomes mixed with the products of suiipuration and loses its clear amber color. In these cases the supijuration generally ex- tends up the course of the flexor tendon, an abscess forms in the hol- low of the heel, and finally oj^ens somewhere below the fetlock joint. The whole coronet is more or less swollen, the discharge is profuse and often mixed with blood, yet the suffering is greatly relieved from the moment the abscess opens.
Wlien the wound reaches the navicular bone the lameness is intense from the beginning; but, after all, the only certain way in which to determine the existence of this complication is in the use of the probe, and unless there is a free escai)e of synovia the probe should be used with the greatest of care, else the coffin joint may be oj^ened.
If the coffin joint has been penetrated, either by the offending instru- ment or by the process of suf>pnration, acute inflammation of the joint follows, accompanied by high fever, loss of appetite, etc. The ankle and coronet are now greatly swollen, and in many cases dropsy of the leg to the knee or hock, or even to the body, follows. If the process of suppuration continues small abscesses appear at intervals on dif- ferent parts of the coronet, the j)atient rapidl}- loses flesh, and may die from the effects of the intense suffering and blood poisoning. In other cases the suppuration soon disappears and recovery is effected by the joint becoming stiff (anchylosis).
When the wound is forward, near the toe, and deep enough to injure the coffin bone, caries always results. The presence of the dead pieces of bone can be determined b}- the use of the probe; the bone feels rough and gritt}". Furthermore, there is no disposition upon the part of the wound to heal.
Besides the complications above mentioned others, equally as seri- ous, may be met with. The tendons may soften and rupture, the hoof may slough off, quittors develop, or sidebones and ringbones grow. Finally laminitis of the opposite foot may happen if the patient persists in standing most of the time, or lockjaw may cause early death.
Treatment. — In all cases of jjunctured wound of the foot the horn around the seat of injury should be thinned doAvn, a free opening made for the escape of the products of suppuration, and the foot placed in a poultice. If the injury is not serious recovery takes place in a few days' time. AVhere the wound is deejier it is better to put the foot in a cold bath or under a stream of cold water, as advised in the treatment for quittor.
If the bone is injured cold baths, containing about 2 ounces each of sulphate of copper and suli:)hate of iron, may be used until the dead bone is Avell softened, when it should be removed b}' an operation. The animal must be cast for this operation, the sole pared away until
402
the diseased bone is exposed, when all the dead particles are to oe removed with a drawing-knife and the wound dressed with a 5 per cent solution of carbolic acid, oakum balls, and a roller bandage.
Wounds of the bone which are made by a blunt-pointed instrument, like the square-pointed cut nail, in which a portion of the surface is driven into the deeper parts of the l)one, always progress slowly, and should be operated upon as soon as the conditions are favorable. Even wounds of the navicular bone, accompanied by caries, may be oper- ated on and the life of the patient saved; but the most skillful sur- gery is required in these cases and only the experienced operator should undertake their treatment.
If there is an escape of pure sjaiovial fluid from a wound of the sole, without injury to the bone, a small pencil of corrosive sublimate should be introduced to the l)ottom of the wound and the foot dressed as directed above.
Tlie other complications are to ])e treated as directed under their
proper lieadings.
After healing of the wounds has been effected, lameness, with more or less swelling of the coronary region, may remain. In these cases the coronet should be blistered, or even fired with the actual cautery, and the patient turned to pasture. If the lameness still persists, and is not due to a stiff joint, unnerving may be resorted to, and in many cases with very good results. If the joint is anchylosed of course no treatment can relieve it, and the patient must eitber be put to very slow work or kept for breeding purposes only.
'' Prich ill shoeing'' is an injury which should be considered under the head of punctured wounds of the foot. The nails by which the shoe is fastened to the hoof may produce an injury followed by infiam- mation and suppuration in two days, either by penetrating the soft tissues directly or by being driven so deep that the inner layers of the horn of the wall are pressed against the soft tissues Avith such force as 1o crush them. In either case the animal generally goes lame soon after shoeing unless the injury is at the toe, when the first evi- dence of the trouble may be the discharge of pus at the coronet. When lameness follows close upon the setting of the shoes, Avith- out other appreciable cause, each nail should be lightly struck with a hammer, when the one at fault will l)e detected by the flinching of the animal.
Tlie treatment consists in drawing the nail, and if the soft tissues have been penetrated, or if suppuration has commenced, the horn must be pared away until the diseased parts are exposed. The foot is now to be poulticed for a day or two, or until the lameness and suppuration have ceased. If the discharge of pus from the coronet is tlie first evidence of the disease the offending nail must be found and removed, the parts pared out, and a weak solution of carbolic acid injected at the cononet until the fistulous tract has healed.
403
CONTRACTED HEELS,
Contificted lieels, or hoof -bound, as it is someMnics called, is a coiunion disease, especially among horses kejDt on liard floors in dry stables, and in such as are subject to much saddle work. It consists in an atrophy or shrinking of the tissues of the foot, whereby the lat- eral diameter of the heels in particular is diminished. It affects the fore feet XJrincipally, but is seen occasionally in the hind feet, where it is of less importance for the reason that the hind foot first strikes the ground vdth the toe, and, consequently, less expansion of the heels is necessary than in the fore feet, where the weight is first received on the heels, and any interference with the expansibility of this part of the foot interferes with locomotion and ultimatel}' gives rise to lame- ness. Usually but one foot is affected at a time, but when both are diseased the change is greater in one than in the other. Occasionally but one heel, and that the inner one, is contracted; in these cases there is less likely to be lameness and x)ermanent impairment of the animal's usefulness. According to the opinion of some of the French veterinarians, hoof -bound should be divided into two classes — total con- traction, in which the Avhole foot is shrunken in size, and contraction of the heels, when the trouble extends only from the quarters backward. (Plate XXXIV, Figs. 4 and 7.)
Causes. — Animals raised in Avet or marsh}' districts, when taken to towns and kept on dry floors, are liable to have contracted heels, not alone because the horn becomes diy but because fever of the feet and wasting away of the soft tissues result from the change. Another com- mon cause of contracted heels is to be found in faulty shoeing, such as rasping the wall, cutting away the frog, heels, and bars; high calks and the use of nails too near the heels. Contracted heels may happen also as one of the results of other diseases of the foot; for instance, it often accompanies thrush, side-bones, ringbones, canker, navicular disease, corns, sprains of the flexor t-endons, of the sesamoid and sus- pensory ligaments, and from excessive knuckling of the fetlock joints.
Sympioras. — In contraction of the heels the foot has lost its circular shape, and the walls from the quarters backward api)roacli to a straight line. The ground surface of the foot is now smaller than the coronary circumference; the frog is pinched between the inclosing heels, is much shrunken, and at times is alfected with thrush. The sole is more concave than natural, the heels are higher, and the bars are long and nearly perpendicular. Tlie whole hoof is dry, and so hard that it can scarcely be cut; the parts toward the heels are scaly and often rigid like the horns of a ram, while fissures, more or less deep, may be seen at the quarters and heels following the direction of the horn fibei^.- (Plate XXXIII, Fig. 10.) When the disease is well advanced lameness is present; in the earlier stages there is only an uneasiness evinced by frequent shifting of the affected foot or feet.
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Stiiiubling is common, especially on hard or rougli roads. In most cases the animal comes out of the stable stiff and inclined to walk on the toe, but after exercise he may go free again. lie wears his shoes off at the toe in a short time, no matter whether he works or remains in the stable. If the shoe is removed and the foot jjared, in old cases a dry, meal}^ horn will be found where the sole and wall unite, extend- ing upward in a narrow line toward the quarters.
Treatment. — First of all, the preventive measures must be consid- ered. The feet must be kept moist and the horn be prevented from drying out by the use of moist sawdust or other damp bedding; by occasional i3oultices of boiled turnips, linseed meal, etc., and the use of greasy hoof ointments to botli the sole and walls of the feet. The wall of the foot should be si)ared from the abuse of the rasp ; the frog, heels, and bars are not to be mutilated Avith the knife, nor should calks be used on the shoe except when absolutelj^ necessary. The shoes should be reset at least once a month, to prevent the feet from becoming too long, and daily exercise must be insisted on.
As to curative measures a diversity of opinion exists. A number of kinds of special shoes have been invented, having for an object the spreading of the heels, and perhaps any of these, if properly used, would eventually effect the desired result. But a serious objection to most of these shoes is that they are expensive and often difficult of make and application. The method of treatment which I have adopted in these cases is not only attended with good results, but is inexpen- sive, if the loss of the patient's services for a time is not considered a part of the question. It consists, first, in the use of poultices or baths of cold water for a few days until the horn is thoroughly softened. The foot is now prepared for the shoe in the usual way, except that the heels are lowered a little, the frog remaining untouched. A shoe called a "tip" is made by cutting off both branches at the center of the foot and drawing the ends down to an edge. The tapering of the branches should begin at the toe, and the shoe should be of the usual width, with both the upper and lower surfaces flat. This tip is to be fastened on with six or eight small nails, all set well forward, two being in the toe. With a common foot rasp begin at the heels, close to the coronet, and cut away the horn of the wall until only a thin layer covers the soft tissues beneath. Cut forward until the new sur- face meets the same 2^ or 3 inches from the heel. The same slox3ing shape is to be observed in cutting downward toward the bottom of the foot, at which point the wall is to retain its normal thickness. The foot is now blistered all around the coronet with Spanish fly oint- ment, and when this is well set the patient is to be turned to pasture in a damp field or meadow. The blister should be repeated in three or four weeks, and, as a rule, the patient can be returned to work in two or three months' time. The object of the tip is to throw the weight on 1 lie frog and heels, which are readily spread after the horn has
405
been cut away on the sides of the wall. The internal structures of the foot at the heels, being relieved of excessive pressure, regain their normal condition if the disease is not of too long standing. The blis- ter not onl}^ tends to relieve any inflammation which may be present, but it also stimulates a rapid growth of healthy horn, which, in most cases, ultimately forms a wide and normal heel. In old chronic cases, with a shrunken frog and increased concavity of the sole, accompanied by excessive wasting of all the internal tissues of the foot, of course satisfactory results can not be expected and are rarel}^ secured. Still mnch relief, if not an entire cure, maj' be effected by these measures. When thrush is present as a complication its cure must be sought by such measures as are directed in a consideration of this disease under its proper heading. If sidebones, ringbones, navicular disease, contracted tendons, or other diseases have been the cause of con- tracted heels, of course treatment of the result will be useless until the cause is removed.
SAND-CRACKS.
A sand-crack is a solution of continuity or fissure in tlie horn of the wall of the foot. These fissures are quite narrow, and as a general rule they follow the direction of the liornj^ fibers. They may happen on any part of the wall, but ordinarilj^ they are only seen directly in front, when they are called foe-cracks; and on the lateral parts of the walls, when thej^ are known as quarter-cracks. (Plate XXXIII.)
Toe-cracks are most common in the hind feet, while quarter-cracks nearly alwaj'S affect the fore feet. The inside quarter is more liable to the injury than the outside one, for the reason that this quarter is not only the thinner, but during locomotion receives a greater part of the weight of the body. A sand-crack may be superficial, involving only the outer parts of the wall, or it may be deep, involving the whole thickness of the wall and the soft tissues beneath.
Tlie toe-crack is most likely to be complete — that is extending from the coronary band to the sole — while the quarter-crack is nearly always incomplete, at least when of comparatively recent origin. Sand-cracks are most serious Avhen they involve the coronary band in the injury. They may be complicated at any time by hemorrhage, inflammation of the lamina^, suiipuration, gangrene of the lateral cartilage and of the extensor tendon, caries of the coffin bone, or the growth of a horny tumor known as a keraphyllocele.
Causes. — Relative dryness of the horn is the principal i)redisposing cause of sand-cracks. Excessive dryness is perhaps not a more pro- lific cause of cracks in the horn than alternate changes from damp to dry. It is even claimed that these injuries are more common in ani- mals working on wet roads than in those working on roads that are rough and dry; at least these injuries are not common in mountain- ous countries. Animals used to running at i)asture Avhen ti-ansferred
406
to stables with hard, dry floors are more liable, especially to quarter- cracks, than those accustomed to stables. Small feet, with tliick, hard hoofs, and feet which are excessively large, are more susceptible to sand-cracks than those of better in-oportion. A ijredisposition to quarter-crack exists in contracted feet, and in those where the toe turns out or the inside quarter turns under.
HeaAy shoes, large nails, and nails set too far back toward the heels, together with such diseases as canker, quittor, grease, and suppura- tive corns, must be included as occasional predisposing causes of sand- cracks.
Fast work on hard roads, jumping, and blov.s on the coronet, together with calk wounds of the feet, are accidental causes of quar- ter-cracks in particular. Toe-cracks are more likely to be caused bj' heavy jJuUing on slippery roads and pavements or on steep hills.
Si/nqdoms. — The fissure in the horn is ofttimes the onl3' evidence of the disease; and even this may be accidentally or purposely hidden from casual view by mud, ointments, tar, wax, jiutty, gutta-percha, or by the long hairs of the coronet.
Sand-cracks sometimes commence on the internal face of the wall, involving its whole thickness, excepting a thin layer on the outer surface. In these cases the existence of the injury maj' be suspected from a slight depression, which begins near the coronary band and follows the direction of the horny fillers, but the trouble can only be positively diagnosed by paring away the outside laj'Crs of horn until the fissure is exposed. In toe-cracks the walls of the fissure are in close apposition when the foot receives the weight of the body, but when the foot is raised from the ground the fissure opens. In quar- ter-crack the opposite is true, and the fissure closes when the weight is removed from the foot. As a rule sand-ci-acks begin at the coro- nary band, and as they become older they not only extend downward, but they also grow deeper. In old cases, particularly in toe-crack, the horn on the borders of the fissure loses its vitalitj-^ and scales off, sometimes through the greater part of its thickness, leaving behind a rough and irregular channel exteaiding from the coronet to tlie end of the toe.
In many cases of quarter-crack, and in some cases of toe-crack as Avell, if the edges remain close together, with but little motion, the fissure is dry, but in other cases a thin, offensive discharge issues from the crack and the ulcerated soft tissues, or a fungus-like growth protrudes from the narrow oi^ening.
Wlion the cracks are deep and the ])iotion of their edges consider- able, so that the soft tissues are bruised and pinched with every move- ment, a constant inflammation of the parts is maintained and the lameness is s(^vere.
Ordinarilj^, the lameness of sand crack is slight Avhen the patient walks; but it is greatly aggravated Avhen he is made to trot, and the
407
harder the road the worse lie limps. Furthermore, the lameness is greater going down hill than up, for the reason that these conditions are favorable to an increased motion in the edges of the fissure. Lastly, more or less hemorrhage accompanies the inception of a sand crack wlien the whole thickness of the wall is involved. Sub- sequent hemorrhages may also take place from fast work, jumping, or a misstep.
Treatment. — In so far as preventive measures are concerned l)ut little can be done. The suppleness of the horn is, of course, to be maintained by the use of ointments, damp floor, bedding, etc. The shoe is to be proportioned to the weight and work of the animal; the nails holding it in place are to be of proper size and not driven too near the heels; sufficient calks and toe-pieces must be added to the shoes of horses Avorking on slipperj^ roads, and the evils of jumping, fast driving, etc., are to be avoided.
AVhen a fissure has made its appearance, means are to l)e adopted which will prevent it from growing longer or deeper; and this can only be done by arresting all motion in the edges. The best and simplest artificial appliance for holding the borders of a toe crack together is the Vachette clasp. These clasps, and the instruments necessary for their application, can be had of any of the more i^rom- inent makers of veterinary instruments. These instruments com- prise a cautery iron with which two notches are burned in the wall, one on each side of the crack, and forceps Avith which the clasps are closed into place in the bottom of the notches and the edges of the fissure brought close together. The clasps being made of stitf steel wire are strong enough to prevent all motion in the borders of the crack. Before these clasps are applied the fissure should be thoroughly cleansed and dried, and, if the injury is of recent origin, the crack may be filled with a putt}' ma-de of 2 parts of gutta percha and 1 part of gum ammoniac. The number of clasps to be used is to be determined by the length of the crack, the amount of motion to be arrested, etc. Generally the clasps are from one-half to three-quarters of an inch apart. The clasps answer equally as well in quarter crack if the wall is sufficiently thick and not too dry and brittle to withstand the strain.
In the absence of these instruments and clasps a hole may be drilled through the horn across the fissure, and the crack closed with a thin nail made of tough iron, neatly clinched at both ends. A plate of steel or brass is sometimes fitted to the parts and fastened on with short screws; Avhile this appliance may prevent much gaping of the fissure it does not entirely arrest motion of the edges for the simple reason that the plate and screw can not be rendered immobile.
If, for any reason, the above measures fail or can not be used recourse must be had to an operation. The horn is softened by the use of warm baths and poultices, the patient cast and the walls of
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the fissure are entirely removed with the knife. Tlie horn removed is in the shape of the letter V with the base at the coronet. Care must be taken not to injure the coronary baud and the laminse. The wound is to be treated with mild stimulant dressings, such as a weak solution of carbolic acid, tincture of aloes, etc., oakum balls, and a roller bandage. After a few daj'S the wound will become covered with a new, white horn, and the oakum and bandages only will be needed. As the new quarter grows out the lameness disappears, and the patient may be shod with a bar shoe and returned to Avork.
In all cases of sand crack the growth of horn should be stimulated by cauterizing tlie coronary band, or by the use of blisters. In sim- ple quarter crack recovery will often take place if the coronet is blis- tered, the foot shod with a "tip," and the patient turned to pasture.
The shoe, in toe crack, should have a clip on each side of the fis- sure and should be thicker at the toe than at the heels. The foot should be lowered at the heels by f>aring, and spared at the toe, except directly under the fissure, where it is to be pared away until it sets free from the shoe.
When any of the complications referred to above arise, special measures must of course be resorted to. For the x^rojier treatment of gangrene of the lateral cartilage and extensor tendon and caries of the coffin bone, reference maj^ be had to the articles on quittors. If the horny tumor known as keraphyllocele should develop it is to be removed by the use of the knife. Since this tumor develops on the inside of the horny box and may involve other important organs of the foot in disease, its removal should only be undertaken by a skillful surgeon.
NAVICULAR DISEASE.
Navicular disease, often called "navicular arthritis" by the English, is an inflammation of the sesamoid sheath, induced by repeated bruis- ing or laceration, and comi)licated in many cases by inflammation and caries of the navicular bone. In some instances the disease undoubt- edly begins in the bone, and the sesamoid sheath becomes involved subsequently by an extension of the inflammatory process. (Plate XXXII, Fig. 5.)
The thoroughbred horse is more commonly affected with the disease than any other, yet no class or breed of horses is entirely exempt. The mule, however, seems rarely, if ever, to suffer from it. For reasons which will appear when considering the causes of the disease the hind feet are not liable to be affected. As a general rule but one fore foot suffers from the disease, but if both should be attacked the trouble has become chronic in the first before the second shows signs of the disease.
Causes. — To comprehend fully how navicular disease may be caused b}' conditions and usages common to nearly all animals it is necessary
409
to recall the peciilifii" anatomy of the parts involved in the jirocess and the functions which they perform in locomotion. It mnst he remem- bered that the fore legs largely support the weight of the body when the animal is at rest, and that the faster he moves the greater is the shock which the fore feet mnst sustain as the bodj^ is thrown forward upon them by the i^ropelling force of the hind legs. This shock could not be withstood by the tissues of the fore feet and legs were it not that it is largely dissipated by the elastic muscles which bind the shoulder to the body, tlie ease with which the arm closes on the shoul- der blade, and the spring of the fetlock joint. But even these means are not sufficient within themselves to protect the foot from injury, and so nature has furtlier supplemented them b}' placing the coffin joint on the hind i)art of the coffin bone instead of directly on top of it, whereby a large part of the shock of locomotion is dispersed before it can reach the vertical column, represented in the cannon, knee, and arm bones. A still further jirovision is made by j)lacing a soft, elastic pad — the frog and plantar cushion — at the heels to receive the sesamoid expansion of the flexor tendon as it is forced downward by the pressure of the coronet bone against the navicular. Extraordi- nary as these means may appear for the destruction of shock, and ample as they are when the animal is at a slow pace or unweighted by rider or load, they fail to completely relieve the parts from concussion and excessive pressure whenever the opposite conditions are present. The result, then, is that the coronet bone forces the navicular hard against the flexor tendon, which, in turn, presses firmly against the navicular as the force of the contracting muscles lifts the tendon into place. It is self-evident, then, that the more rapid the pace and the greater the load, the greater must these contending forces be, and the greater the liability to injury. For the same reason horses with excessive knee action are more likely to suffer from this disease than others, concussion of the foot and intense pressure on the tendon being common attendants upon their usage. Besides these exciting causes must be considered those which predispose to the disease. Most prominent among these is heredity. It maybe claimed, however, that an inherited in-edisposition to navicular disease consists not so much in a special susceptibility of the tissues which are involved in the proc- . ess as in a vice of conformation which, as is well known, is likely to be transmitted from parent to offspring. The faults of conformation most likely to be followed by the development of navicular disease are an insufficient plantar cushion, a small frog, high heels, excessive knee action, and contracted heels. Finalh", the environments of domestication and use, such as dry stables, heavy pulling, bad shoe- ing, punctured wounds, etc., all have their influence in developing this disease.
Symjifoms. — In the earlj- stages of navicular disease the sjmiptoms are generally very obscure. When the disease begins in inflammation
410
of the navicular "bone the animal points the affected foot while at rest, a time before any lameness is seen. While at work he ai^pareutly travels as well as ever, but when placed in the stable one foot is set out in front of tlie other, resting on the toe, with fetlock and knee flexed. After a time, if the case is closelj^ watched, the animal takes a few lame steps while at work, but the lameness disappears as sud- dcnl}'' as it came and the driver doubts if the animal was really lame at all. Later on the patient has a lame spell Avhich may last during a greater part of the day, but the next morning it is gone; he leaves the stable all right, but goes lame again during the daj'. In time he has a severe attack of lameness, which may last for a weelc or more, when a remission takes j^lace and it may be weeks or months before another attack supervenes. Finally, he becomes constantly lame, and the more lie is iised the greater the lameness.
In the lameness from navicular disease the affected leg always takes a short step, and the toe of the foot first strikes the ground, so that the shoe is most worn at this point. If the iiatient is made to move backwards the foot is set down with exceeding great care, and the weight rests upon the affected leg but a moment. When exercised he often stumbles, and if the road is rough he may fall on his knees. If he is lame in both feet the gait is stilty, the shoulders seem stiff, and if the patient is made to Avork he sweats profusely from the intense pain. Early in the develoi)ment of the disease a careful examination will reveal some increased heat in the heels and frog, particularly after work; as the disease progresses this becomes more marked until the whole foot is hot to the touch. . At the same time there is .an increased sensibility of the foot, for the jiatient flinches from the per- cussion of a hammer lightly applied to the frog and heels, or from the pressure of the smith's pincers. The frog is generally shrunken, often of a pale reddish color, and at times it is affected with thrush. If the heels are pared awaj^ so that all the weight is received on the frog, or if the same result is attained by the application of a bar shoe, the animal is excessively lame. The muscles of the leg and shoulder shrink away, and often tremble as the animal stands at rest. After months of lameness the foot is found to be shrunken in its diameter and apparently lengthened; the horn is dry and brittle and has lost its natural gloss, while circular ridges, developed most tOAvard the heels, cover the upper part of the hoof. When both feet are affected the animal points first one foot then the other, and stands with the hind feet well forward beneath the bodj' so as to relieve the fore feet as much as possible from bearing weight. In old cases the wasting of the muscles and the knuckling at the fetlock become so great that the leg can not be straightened, and locomotion can scarcely be per- formed. The disease generall}'^ makes a steady progress without inclining to recovery — the remission of symptoms in the earlier stages should not be interpreted as evidence that the i^rocess has terminated.
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The complications iisuallj' seen are ringbones, sidebones, thrush, con- tracted heels, quarter cracks, and fractures of the navicular, coronet, and j)astern bones.
Treatment. — But few cases of navicular disease recover. In the early stages the wall of the heels should be rasped awaj'' as directed in the treatment for contracted heels, until the horn is quite thin; the coronet should be well blistered Avith Spanish-lly ointment, and the patient turned to grass in a damp field or meadow. After three or four weeks' time the blister sliould be repeated. This treatment is to be continued for two or three months. Plane shoes are to be put on when the patient is returned to work. In chronic cases the animal should be put to slow, easy work. To relieve the pain, neurotomy may be performed — an operation in which the sense of feeling is destroyed in the foot by cutting out pieces of the nerve at the fetlock. This operation in nowise cures the disease, and since it may be attended with serious results can ow\j be advised in certain favorable cases, to be determined b}' the veterinarian.
SIDEBOXES.
A sidebone -consists in a transformation of the lateral cartilages found on the wings of the coffin bone into bonj'- matter by the deposi- tion of lime salts. The disease is a common one, especially in heavy horses used for draft, in cavalry horses, cow-ponies, and other saddle horses, and in runners and trotters.
Sidebones are peculiar to the fore feet, yet thej* occasionally develop in the hind feet, where they are of little importance, since thej' cause no lameness. In manj^ instances sidebones are of slow growth, and being unaccompanied by acute inflammation, they cause no lameness until such time as, b}' reason of their size, they interfere with the action of the joint. (Plate XXXII, Fig. 4.)
Causes. — Sidebones often grow in heavy horses without any appar- ent injury, and their development has been attributed to the over- expansion of the cartilages caused bj^ the great weight of the animal. Blows, and other injuries to the cartilages, may set up an inflamma- tory process which ends in the formation of these bony growths. Iligh-heeled shoes, high calks, and long feet are always classed among the conditions which may excite the growth of sidebones. They are often seen in connection with contracted heels, ringbones, navicular diseases, punctured wounds of the foot, quarter crack, and occasion- ally as a sequel to founder.
Symjitoms. — In the earlier stages of the disease, if inflammation is present, the only evidence of the trouble to be detected is a little fever over the seat of the affected cartilage and a slight lameness. In the lameness of sidebones the toe of the foot first strikes the ground and tlie step is shorter than natural. The subject comes out of the stable stiff and sore, but the gait is more free after exercise.
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Since the deposit of the bony matter often begins in that part of the cartilage Avliere it is attached to the coffin bone, the diseased process may exist for some time before the bony growtli can be seen or felt. Later on, however, the cartilage can be felt to have lost its soft elastic character, and by standing in front of the animal a prominence of the coronary region at the quarters can be seen. Occasionally these bones become so large as to bulge the hoof outward, and by pressing on the joint they so interfere Avith locomotion that the animal becomes entirely useless.
Treatment. — So soon as the disease can be diagnosed active treat- ment should be adopted. Cold water bandages are to be used for a few days to relieve the fever and soreness.
The imjjrovement consequent on the use of these simx3le measures of ten leads to the belief that the disease has recovered; but with a return to work the lameness, fever, etc., reappears. For this reason the use of blisters, or better still the firing iron, should follow on the discontinuance of the cold bandages.
But in many instances no treatment will arrest the growth of these bony tumors, and as a palliative measure neurotomy must be resorted to. Generally this operation will so relieve the pain of locomotion that the patient nnay be used for slow work; but in animals used for faster driving or for saddle purjioses the operation is ijractically use- less. Some years ago I unnerved a number of cavalry horses at Fort Leavenworth that were suffering from sidebones, and the records show that in less than seven months' time all were more lame than ever. Since a predisposition todeveloj) sidebones maybe inherited, animals suffering from this disease should not be used for breeding ijurposes unless the trouble is known to have originated from an accident.
RINGBONE.
A ringbone is the growth of a bony tumor on the ankle. This tumor is in fact not the disease, but simply the result effected by an inflam- matory action set up in the periosteum and bone tissue proper of! the large and small pastern bones. (Plate XXXII, Fig. 1.)
Causes. — Injuries, such as blows, sprains, overwork in young unde- veloped animals, fast work on hard roads, jumiiing, etc., are among the principal exciting causes of ringbones. Horses most disposed to this disease are those with short upright pasterns, for the reason that the shock of locomotion is but imperfectly dissipated in the fore legs of these animals. Imi^roper shoeing, such as the use of high calks, a too great shortening of the toe and correspondingly high heels, predispose to this disease by increasing the concussion to the feet.
Symptoiris. — The first symptom of an actively developed ringbone is the appearance of a lameness more or less acute. If the bony tumor forms on the side or upper parts of the large pastern its growth is generally unattended with acute inflammatory action, and, conse- quently, produces no lameness or evident fcA-er. These are called
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false ringbones. But when the tumors form on tlie whole circumfer- ence of the ankle, or simply in front nnder the extensor tendon, or behind under the flexor tendons; or if they involve the joints between the two pastern bones, or between the small pastern and the coffin bone, the lameness is always severe. These constitute the true ring- bone. Besides the lameness the ankle of the affected limb presents more or less heat, and in many instances a rather firm, though limited, swelling of the deeper tissues over the seat of the inflammatory proc- ess. The lameness of ringbone is characteristic in that the heel is first placed on tlie ground when tlie disease is in a fore leg, and the ankle is kept as rigid as possible. In the hind leg, however, the toe strikes the ground first when the ringbone is high on the ankle, just as in health; but the ankle is maintained in a rigid position. If the bony growth is under the front tendon of the hind leg, or if it involves the coffin joint, the heel is brought to the ground first. In the early stages of the disease it is not always easy to diagnose ringbone; but when the deposits have reached some size they can be felt and seen as well.
The importance of a ringbone of course depends on its seat, and often on its size. If it interferes with the joints, or with the tendons, it maj^ cause an incurable lameness even though small. If it is on the sides of the large pastern, the lameness generallj^ disappears as soon as the tumor has reached its growth and the inflammation sub- sides. Even where the pastern joint is involved, if comj)lete anchy- losis results, the patient may recover from the lameness with simply an imjierfect action of the foot remaining, due to the stiff joint.
Treatment. — Before the bony growth has commenced the inflam- matory process may be cut short by the use of cold baths and wet bandages, followed by one or more blisters. If the bony deposits have begun, the firing iron should always be used. Even where the tumors are large and the pastern joint involved, firing often hastens the process of anchylosis, and should always be tried.
Where the lower joint is involved, or Avhere the tumor interferes with the action of the tendons, of course recovery is not to be expected. In many of these latter cases, however, the animal may be made serv- iceable by proper shoeing. If the patient walks with the toe on the ground the foot should be sliod with a high-heeled shoe and a short toe. On the other hand, if he walks on the heel a thick-toed and thin-heeled shoe must be worn.
Since ringbone is considered to be one of the hereditary diseases no animal suffering from this trouble should ever be used for breeding purposes.
LAMINITIS.
By what term this disease was first known to man is a question unanswerable. During many years in the recent past, and before an
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approximate knowledge of its lesions was had, it vras usually desig- nated as "founder."
In country districts and amongst the great majority of the laity this name is yet almost exclusively used; and undoubtedly it was first so employed because it best expressed the physical inability or disinclination upon the part of the patient to proceed in his gait, resembling thereby a ship similarly disabled. That it could have been adopted upon any other ground hardly seems possible, for the etymology of the term does not indicate that it was so used because it contained even the most remote intimation either as to the seat of the disease, its nature or its cause.
Of the nature of laminitis but little is to be said, it being a simple inflammation of the senstive laminae of the feet, characterized b}^ the general phenomena attending inflammation of the skin and mucous membranes, producing no constitutional disturbances except those dependent upon the local disease, and having a strong tendency, in severe cases, to destructive disorganization of the tissues affected.
Causes. — The causes of laminitis ai^e as wide and variable as in any of the local inflammations, and may be divided into two classes — tlie predisposing and exciting.
Predisposing causes. — From personal observations I do not know that any particular construction of foot or any special breed of horses is thereby predisposed to tliis disease, neither can I find anything to warrant the assumption that it is in any way hereditary; so that while we may easily cultivate a predisposition of the disease upon the part of the tissues subject to become affected, the disease itself does not originate Avithout an exciting cause. Like most other tissues, a pre- disposition to inflammation may be induced in the sensitive lamime by any cause which lessens their power of withstjinding the work imposed on them. It exists to an extent in those animals unaccus- to]i\ed to work, particularly if they are plethoric, and in all those tjiat have been previous subjects of the disease, for the same rule hdlds good here .that we find in so many diseases — /. e., that one attack impairs the functional activity of the affected tissues and thus renders them more easy of a subsequent inflammation.
Unusual excitement by determining an excessive blood supply, bad shoeing, careless paring of the feet by removing the sole support, as well as high calkings without corresponding toe pieces, must be included under this head.
Exciting causes.— The exciting causes of laminitis are many and varied, the most common being concussion, overexertion, exhaustion, rapid changes of temperature, ingestion of various foods, purgatives, and the oft-mentioned metastasis.
(1) Concussion acts as a producer of this disease by the local over- stimulation which it occasions, the excessive excitement being fol- lowed by an almost complete exhaustion of the functional activity of
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the laminated tissues, the exliaustioii by congestion, and eventually by inflammation. But congestion here, as in all other tissues, is not necessarily followed by inflammation ; lor although the principal symp- toms belonging to true laminitis are present, the congestion ma}' be relieved before the processes of inflammation are fully established. This is the condition that obtains in the many so-called cases of lam- initis, Avhich recover in fi'om twenty-four to forty-eight hours' time. These are the cases which should be called congestion of the laminsc. Laminitis from concussion is common in track horses trotting races when not in condition, especially if they are carrying the obnoxious toe Aveights, and in green horses put to work on city pavements to which they are unaccustomed. Concussion from long drives on dirt roads is at times productive of the same results, notably when the weather is extremely warm, or at least when the relative change of temperature is great. But undoubtedly the exhaustion so apt to be produced under these circumstances must be considered as exerting almost as great an influence as an exciting cause as does the long-con- tinued concussion. This same combination of causes must also be admitted as determining the disease when seen at times in hunters, for the imi)osed weight of the rider increases the demands made upon the function of these tissues, and their powers of resisting congestion and its consequences are the sooner exhausted.
(2) Overexertion, as heavy pulling or rapid work, even where there is no chance for immoderate concussion, occasionally results in this disease, although in the majorit}' of instances exhaustion is a con- junctive cause, for overexertion can not be long continued without inducing exhaustion.
(3) Exhaustion, in whatever manner produced, is nearly as prolific a source of laminitis as is concussion, for when the physical strength has been greatly impaired, even though but temporarily, some part of the economy is rendered more vulnerable to disease than others, and it is not strange that in nian}"" instances it should be those parts still called ujion to perform their function of maintaining the weight of the body after their activity has been exhausted. It is to this cause Ave must ascribe those many cases Avhich we see folloAving a hard day's AA'ork, Avhere at no tijne has there been OA^erexertion or immoderate concussion.
In the same manner a strong teiidency to laminitis is induced in horses on sea A^oyages, the exhaustion of the laminje resulting from the continual constrained position Avhich the animal is compelled to maintain on account of the rocking motion of the A^essel,
The same cause exists Avhere one foot has been blistei-ed, or AA^here one limb is incapacitated from any other reason; for the opposite member being called on to do double duty, soon becomes exhausted, and congestion, folloAved T)y inflammation, results as a matter of course. Where one foot only becomes laminitic, it is customary to
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find the other or corresponding menil)er participating at a later date, not always because of sympathy, but because the transfer of all the functional performance to the one foot proves within itself a sufiacient exciting cause.
(4) Rapid changes of temperature act as an exciting cause of lami- nitis in precisely the same way as they act to produce disease in other tissues, the result of these variations of temperature showing itself upon those parts rendered particularly susceptible to pathological changes from some impairment of their natural disease-resisting powers.
This change of temperature may be induced by drinking large quan- tities of cold water while in an overheated condition. Here the inter- nal heat is rapidly reduced, the neighboring tissues and blood-vessels constrained, and the blood supply to these organs greatly diminished, while the quantity sent to the surface is correspondingly increased. True, in many of the cases which result from this cause there has not been sufficient labor performed to impair the powers of the lamiufe, and I am inclined to the opinion that laminitis is the more readily induced than congestion or inflammation of the skin or other surface organs because of the impossibility upon the part of the lamina3 to reUeve themselves of the threatened congestion by the general safety- valve of perspiration. A cold wind or relatively cold air allowed to play upon the body when heated and wet with sweat has virtually the same result, for it arrests evaporation and rapidly cools the external surface, thereby determining an excess of blood to such organs and tissues as are protected from this outside i nfluence. In many instances this happens to be some of the internal organs, as the lungs, where the previous work has been rapid and their functional activity impaired; but in numerous other instances the determination is toward the feet, and that it is so depends upon two very palpable facts; first, that these tissues have been greatly excited and are already receiving as much blood as they can accommodate consistently with health; sec- ondly, even though these tissues are classed with those of the surfac4, their protection from atmospheric influences by means of the thick box of horn incasing them renders them in this respect equivalent to internal organs.
Again, a still more limited local action of cold excites this disease, as seen from driving through water or washing the feet or legs while the animal is warm or just in from work. Here a very marked reac- tion takes place in the surface tissues of the limbs, and passive con- gestion of the foot results from an interference with the return flow of blood, which is being sent to these organs in excess. These are more apt to be simple cases of congestion, soon to recover, yet they may become true cases of laminitis. Youatt says: "The danger is not confined to the change from heat to cold; a sudden transition from cold to heat is as injurious, and therefore it is that so many
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horses after having been ridden far in frost and snow and placed immediately in a hot stable and littered up to the knees are attacked by this complaint." I have never seen the disease occnr nnder exactly similar circnmstances, bnt am inclined to believe that in these cases the disease was attributed to the wrong cause — the excitement, exhaus- tion, and concussion of the long ride being apparently entirelj' over- looked. Furthermore, if we consider the physical conditions which must necessarily be present under the circumstances, it seems incon- sistent Avith our knowledge of the effects of heat and cold to believe tliat the verj' moderate temperature of stables and the lieat-T)roducing ijroperties of bedding "up to the knees" could' be productive of 1am- initis. Rather should we say that such favorable circumstances would be conducive to opposite results.
(5) AVhj^ it is that certain kinds of grain v>-ill cause laminitis does not seem to be clearly understood. Certainly they possess no specific action upon the laminsG, for all animals are not alike affected, neither do thej^ always produce these results in the same animal. In the case of some of these ailments, where their ingestion causes a strong tendency to indigestion, the consequent irritation of the alimentary canal may be so great as to warrant the belief that the lamina3 are affected through sympathy. In other instances there is no apparent interference with digestion, nor evidence of any irritation of the mucous membranes, yet the disease is in some manner dependent upon the food in question for its inception. Barley, wheat, and sometimes corn are the grains most prolific in the production of this disease. With some horses there appears to be a particular susceptibility to this influence of corn. In such instances the feeding of this grain for a few days will be followed by inflammation of the feet, lasting from a few days to two weeks time. In these animals, to all appearances healthy, the corn neither induces colic, indigestion, nor i^urging, and apparently no irritation whatever of tlie alimentary canal.
(()) Fortunately i^urgative medicines but rarely become the exciting cause of inflammation of the lamina?. That it is then the result of a sympathetic action upon the part of the tissues affected is no doubt more than hypothetical, for when there is no derangement of the ali- mentary canal existing a dose of cathartic medicine will at times bring on severe laminitis, and that, too, before purgation commences.
(7) Most if not all the older authorities were agreed that metastatic laminitis is a reality. That such a condition ever does exist outside the imagination certainly awaits the proving. That laminitis may and ofttimes does exist as a concurrent disease with numerous others is unquestionably true, but to believe an inflammation can be almost momentarily transferred from one organ to another, no mat- ter how remote, is to destroy all belief in our knowledge of the pathol- ogy of this complicated process. We do not pretend to deny that 5961— HOR 1-4
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the induction of laminitis, during the course of some other disease, may servo to arrest the further invasion of healthy tissue by the primary process, or that it may exert a remedial influence upon the first dis- ease, but it can not and does not at once remove that inflammation and obliterate its lesions, for the products of any inflammation, be it never so simple, require a certain time for their removal, and it is impossible that, for instance, the products of inflamed lung tissue can be immediately removed and the inflammation in whole trans- ferred to the laminae. Metastatic laminitis, then, is nothing more nor less than concurrent laminitis, and as such presents little in jiny way peculiar outside the imperfectly understood exciting cause, and the practitioner who allows the acute symptoms of the laminitis to mislead liim, simply because their severity has overshadowed those of the primary disease, may lose his case through unguarded subse- quent treatment. This form of laminitis is by no means commonly met with, but when seen will usually be found in conjunction with pneumonia, according to Youatt with inflammation of the bowels and eyes, and according to Law and Williams sometimes with bronchitis. ^ Sym]jtoms.— Laminitis is characterized by a congregation of symp- toms so well marked as scarcely to be misinterpreted by the most cas. ual observer. They are nearly constant in their manifestations, modi- fied by the number of feet affected, the cause which has induced the disease, the previous condition of the patient, and the various other influences which operate in all diseases to some extent. They may be divided into general symptoms, which are concomitants of all cases of the disease, subject to variations in degree only and special symptoms, or those whieli serve to determine the feet affected and the coinplica- tions which may arise.
General si/mj^toms.—Vsuallj the first symptoms that would indicate any definite obstruction to functional performance is the interference with locomotion produced by congestion of the sensitive membrane. Occasionally the other symptoms are presented first. With the devel- opment of the lameness the pulse will be found accelerated, full, hiird, and striking the finger strongly; the temperature soon rises several degrees above the normal, reaching sometimes 106° Fahr., although it generally ranges between 102^° and 105° Fahr. The respirations are rapid and panting in character^ the nostrils being widely dilated, and the mucous membranes highly injected. The facial expression is anx- ious and indicative of the most acute suffering, while the body is more or less bedewed with sweat. At first there may be tendency to diar- rhea, or it may appear later, particularly as the result of the medicines used. The urine is high colored, scant in quantity, and of increased specific gravity, owing to the water from the system being eliminated by the skin instead of the kidneys. The appetite is impaired and sometimes entirely lost, while the thirst is greatly increased. The affected feet arc hot and dry to the touch. They are relieved as much
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as i^ossible from bearing weight. Rapping them with a hammer or compelling tlie animal to stand uj)on one atfected member causes intense pain, while the artery at the fetlock throbs beneath the finger.
Special symptoms. — Liabilitj* to affection varies in the different feet according to the exciting cause. Any one or more of the feet may become the subject of this disease, although it appears more often in the fore feet than in the hind ones, a fact owing to the difference of function, /. e., that the fore feet are the basis of the columns of sup- port, receiving nearly all the body weight during progression and con- sequently most of the concussion, while the hind feet at such times become simply the fulcra of the levers of progression, and arc almost exempt from concussion.
One foot. — Injuries and excessive functional performance are the causes of the disease in only one foot; here the general symptoms as a rule are not severe, there often being no loss of appetite and no unusual thirst, while the pulse, temperature, and respiration remain about normal. In these instances the weight of the body is early thrown upon the opposite foot and the affected one is extended, repeatedly raised from the floor and then carefully replaced. When made to move forward the lame foot is either carried in the air while progression is accomplished by hopping with the health}^ one, or else the heel of the first is placed upon the ground and receives the little weight thrown upon it while the sound limb is quickly advanced. Progression in a straight line is much more easily accomi^lished than in turning toward the lame side.
Both fore feet. — When both fore feet are affected the symptoms are well marked. Tlie lameness is excessive and the animal almost immovable. When standing the head hangs low down, or rests upon the manger as a means of supix>rt and to relieve the feet; the fore feet are well extended so that the weight is thrown upon the heels, where the tissues are least sensitive, least inflamed, and most capable of relief from free effusion. The hind feet are brought forward beneath the body to receive as much weight as possible, thereby relieving the diseased ones. If progression is attempted, Avhich rarely happens voluntarily during the first three or four days, it is accom- plished with very great pain and lameness at the starting, which usually subsides to an extent after a few minutes' exercise. During this exercise, if the animal hai^pens to step upon a small stone or other hard sul)stance, he stumbles painfully on the other foot and is excessively lame in the offended member for a number of steps, owing to the acute pain which pressure upon the sole causes in the tissues beneath. The manner of the progression is pathognomonic of the comj)laint. Sometimes the affected feet are simultaneously raised from the ground (the hind ones sustaining the weight), then advanced a short distance and carefully replaced, while at almost the same moment the hind ones are quickly shuffled forward near to the center of gravitation.
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111 other instances one foot at a time is advanced and placed with the heel upon the ground in the same careful manner, all causes of concussion being carefully avoided. In attempting to back the ani- mal he is found to be almost stationary, sim^jly swaying the body back on the haunches and elevating the toes of the diseased feet as they rest upon their heels. In attempting to turn either to the right or left he allows his head to be drawn to the one side to its full extent before moving, then makes his hind feet the axis around which the forward ones describe a shuffling circle.
In a majority' of cases of laminitis in the fore feet the animal per- sists in standing until he is nearlj^ recovered. In other cases he as persistently lies, standing only when necessity seems to compel it, and then for as short a time as possible. If the recumbent position is once assumed the relief experienced from a removal of the weight of the bod}'- off the inflamed tissues tempts the patient to seek it again, and so we often find him down a greater part of the time. But this is not true of all cases, for sometimes he will make the experi- ment, then cautiously guard against a rejietition. Even in those cases of enforced recumbency, he ofttimes takes advantage of the first opportunity and gets upon his feet, doggedly remaining there until again laid upon his side by his attendants. How to explain this diversity of action I do not know, for theoretically the recumbent jjosition is the only appro i:)riate one, except when complications exist, and the one which should give the most comfort, yet it is rejected by very many x)atients and no doubt for some good reason. It has been suggested as an exjilanation that when the animal gets upon his feet after lying for a time the suffering is so greatly augmented that the memory of this experience deters him from an attempted repetition. If this were true, the horse with the first attack of this disease must necessaril}^ make the exi3eriiiieiit before knowing the after effects of lying down, yet many remain standing without even an attempt at gaining this experimental knowledge.
The most favored jiosition of the animal when down is on the broad- side, with the feet and legs extending. While in this jiosition the general sj'mptoms greatly subside; the respirations and pulse become almost normal; the temperature falls and the persjiiration dries. It is mostly with difficulty that he is made to rise, and when he attempts it gets up rapidl}- and "all in a heap," as it were, shifting quickly from one to the other foot until they become accustomed again to the weight thrown wpon them. Occasionall}^ a i)atient will get up like a cow, rising upon the hind feet first. Although enforced exercise relieves to some extent the soreness, it is but temporary, for after a few minutes' rest it returns again with all its former severity.
BoiJi hind feet. — AYhen only both hind feet are affected, thej^ are, while standing, maintained in the same position as when only the fore ones are the subjects of the disease, but with an entirely different
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object in view. Instead of being liere to receive weight, they are so advanced in that the heels may receive whatever weight is, from neees-^ sity, imposed on them, the fore feet being at the same time placed well back beneath the bodj^, Avhere they become the main supports, the animal standing, as AVilliams describes it, "all of a heaj)."
Progression is even more difficult now than when the disease is confined to the anterior extremities. The fore feet are dubiously advanced a short distance and the hind ones are then brought forward with a kind of a kangaroo hop, which results in an apparent loss of equilibrium which the animal is a few moments in regaining. The general symptoms, or in other words the degree of suffering, seem more severe in these cases than where the disease affects the fore feet alone. The standing position is not often maintained, the patient seeking relief in recumbency. This fact is easilj^ understood when we con- sider how cramped and unnatural is the position he assumes while standing, and if it were maintained for any considerable length of time would no doubt excite the disease in the fore f^et, as explained by D'Arboval.
^4// four feet. — Laminitis of all four feet is but uncommonly met with. The author has seen but three such cases. In all these the position assumed was nearly normal, all the feet being slightly ad- vanced, and first one and then another momentarily raised from the ground and carefully replaced, this [iction being kept up almost con- tinually during the time the animal remained standing. The suffer- ing in these cases is most acute, the appetite is lost, and although the patient lies most of the time the temperature remains too high; the pulse and respirations are greatly accelerated, the body covered with sweat, and bed sores are unpleasant accompaniments.
Course.— The course which laminitis takes varies greatly in different cases, being influenced more or less by the exciting cause, the animal's previous condition, the acuteness of the attack, and the subsequent treatment. The first symptoms rarely exhibit themselves while the animal is at his work, although we will occasionally see the gait impaired by stumbling, the body covered with a profuse sweat, and the respiration become blowing in character as premonitions of the oncoming disease, but as a rule nothing is noted amiss with the animal until lie has stood for some time after coming in from work, wheii, in attempting to move him, he is found very stiff. Like all congestions the early symptoms usually develop rapidly, yet this is not always the case, for in some instances there appears to be no well-defined period of congestion, the disease seemingly commencing at a point and gradu- ally spreading until a large territory is involved in the morbid process.
Simple congest io)}.— Those cases of simj^le congestion of the lamina3 which Ave erroneously call laminitis are rapidly developed, the symp toms being but moderately severe and from one to three days required for recovery. There are no structural changes here and but a moderate
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exudate, wliich is rapidly reabsorbed, leaving the parts precisely in tlie same condition as they were previous to the attack. If the con- gestion has been excessive a rupture of some of the capillaries will bo found, a condition more apt to obtain where the animal is made to continue work after a development of symptoms has begun.
True, the majority of these last-described cases prove to be the lami- nitis in fact, yet at times the congestion will pass away and the extravasated blood be absorbed without inflammation supervening to an extent sufficient to warrant us calling it laminitis. The seat of o-reatest congestion will always be found in the neighborhood of tlie toe, because of the increased vascularity of that part, and although at times it is limited to the podophyllous tissue alone, any or all parts of the keratogenous membrane may be affected by the congestion and followed finally by inflammation.
Acute.— In t\ie acute form of laminitis the symptoms may all develop rapidly, or it may commence by the appearance of a little soreness of the feet during progression, which in twenty-four or forty-eight hours' time has passed into a well-marked case. This peculiarity of develop- ment is due to one of two causes. Either the congestion is general, but takes place slowly, or else it begins in one or more points and Gradually spreads throughout the laminse. These acute cases gener- ally run their course in from a few days to two weeks or more time. Usually a culmination of the symptoms is reached if the patient is properly treated in from three to five days ; then evidences of recovery are discernible in favorable cases. The lameness improves, the other symptoms gradually subside, and eventually health is regained. It is in these acute cases that a strong tendency to disorganization of a destructive character exists, and hence it is we see so many recover imperfectly with marked structural changes permanently remaining. Subacute.— ^nhacnte laminitis is most often seen as a termination of the acute form, although at times it exists independent of or prb- cedes an acute attack. It is characterized by the mildness of its symj}- toms, slow course, and moderate tissue changes. It may be present for a long time before any pathological lesions result other than those found in the acute form, and when these changes do take place they should rather be viewed as complications.
Chronic— Chronic laminitis is a term used by many to designate any of the sequela? of the acute and subacute forms of this disease. Pure chronic inflammation of the lamina; is not very commonly met with, but is most frequent in horses that have long done fast track work. They have " fever in the feet " at all times and are continually sore, both conditions being aggravated by work. Like chronic inflamma- tion of other parts, there is a strong tendency lie.e to tlie development of new connective tissues, which, by its pressure upon the blood ves- sels, interferes with nutrition. Wasting of the coffin bone and mflam- mat'ion of its covering with caries is not unusual. The continued
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fever and impaired function of secretion result in the production of horn deficient in elasticity-, somewhat spongy in character, and inclined to crumble. In others of these cases of " soreness" in horses used to hard work, there is evident weakness of the coats of the A'esscls brought on b}' repeated functional exhaustion. Here slight work acts as an exciting cause of congestion, which results in serious effusion and temix)rary symptoms similar to those of chronic laminitis.
CompUcatiouh;. — Complications concurrent with or supervening upon laminitis are frequent and varied, and are often dependent upon causes not fully understood.
Excessive purgation is one of the simplest of these, and not usually attended with dangerous consequences. It rarely occurs unless induced by the exhibition of a ijurgative, and the excessive action of the medicine is probably to be explained upon the theory that the mucous membrane sympathizes with the diseased laminae, is irritable, and readily becomes overexcited. The discharges are thin and watery, sometimes offensively odorous, and occasionally persist in spite of treatment. It may prove disastrous to the welfare of the patient by the rapid exhaustion which it causes, preventing resolution of the laminitis, and may even cause death.
Sepiiccamia andpyccm /a.— Septicaemia and pyaemia are unusual com- plications and are seen only in the most severe cases, where bed-sores are present or suppuration of the laminae results. They die, as a rule, within three days after showing signs of the complication.
Pneumonia— ihe so-called metastatic— needs no special considera- tion, for in its lesions and symptoms it does not differ from ordinary pneumonia, although it may be overlooked entirely by the practitioner. Examinations of the chest in .laminitis should be made every day, so as to detect the disease at its onset and render proper aid.
Sidebones.—A rapid development of sidebones is one of the compli- cations, or perhaps better, a sequel of laminitis not often met ^vith in practice. Here the inflammatory process extends to the lateral carti- lages, with a strong tendency to calcification. The deposition of the lime salts is sometimes most rapid, so that the "bones" are developed in a few weeks' time; in other instances they are deposited slowly and their growth is not noted until long after the subsidence of the lami- nitis, so that the exciting cause is not suspected. This change in the cartilages may commence as early as the first week of the laminitis, and although the trouble in the lamina' is removed in the course of a fortnight the symptoms do not entirely subside, the animal still retain- ing the shuffling gait, wliile the sidebones continue to grow and the patient usually remains quite lame. This alteration of the cartilages generally prevents the patient recovering liis natural gait, because of tlie permanent impairment of function induced, and tlie practitioner receives unjust censure for a condition of affairs he could neither foresee nor prevent.
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Tlie laininitic j)rocess also occasionally extends to the covering of the coronet bone, or at least concurrent with and subsequent to lauii- nitis the development of "low ringbone" is seen, and it is apparently dependent upon the disease of the laminae for its exciting cause. The impairment of function and consequent symptoms are much less marked here than in sidebones. The coronet remains hot and sensi- tive and somewhat thickened after the laminitis subsides, and a little lameness is present. This lameness persists and the deposits of new bone may readily be detected.
Suppuration of the sensitive membrane is a somewhat common complication, and even when present in its most limited form is always a serious matter; but when it becomes extensive, and especially where the suppurative process extends to the lieriosteum, the results are apt to be fatal. When sux5i)uration occurs the exudation does not appear to be excessive, but is rich in leucocj^tes and seems to have caused a detachment of the sensitive tissues from the horn prior to the forma- tion of pus in some instances, while in others the tissues are still attached to the horn and the suppuration takes place in the deeper tissues.
Limited suppuration may take place in any part of the sensitive tissues of the foot during laminitis, and may ultimately be reabsorbed instead of being discharged upon the surface, but generally the proc- ess begins in the neighborhood of the toe and spreads backward and upward towards the coronet, Avhere it is seen sei^arating the horn from the coronarj^ band at the quarters. At the same time it is spreading over the sole and eventually the entire hoof is loosened and finally sloughs awa3% leaving the tissues beneath entirely unprotected.
In other instances, and these are generally the cases not considered unusually severe, the suppuration begins at the coronary band. The suppuration extends but a short distance in the tissue, yet serves to destroy the patient by separating tlie hoof from the coronary band upon which it depends for su^iport and growth. In this form of the suppurative iirocess it is usually seen beginning in front, for it is this part of the coronary band that is alwaj'-s most actively affected with inflammation, and consequently it is here that imi)airments first occur. Suppuration of the sensitive sole is more common than of the sensitive lamina? and coronary band. It is iDresent in the majority of cases where there is a dropping of the coffin bone, and in other instances where the effusion at this point is so great as to arrest the X)roduction of horn and uncover the sensitive tissues. Except when the result of injury it begins at the toe and spreads backward, and if not relieved by opening the sole escapes at the heel. Suppuration of the sole is much less serious than where present in other parts of the foot.
If the acute constitutional symptoms developed from this slough- ing of the foot do not result in death, a new hoof of very imperfect horn may be dcvcloi^cd after a time, but unless the animal is to be
425
kept for breeding piirjioses alone the foot will ever be useless for work and death should relieve the suffering. When only the sole sloughs recovery takes jilace with x?i"oper treatment.
Peditis. — This is the term which "Williams applies to that serious complication of laminitis where not only the laminse but the perios- teum and the coffin bone are also the subjects of the inflammatory process. Neither is this all, for in some of these cases of peditis acute inflammation of the "coffin joint" is present, and occasionally suppuration of the joint. A mild form of x^eriostitis, in which the exudation is in the outer or looser layer of the lieriosteum only, is a more common condition than is recognized by practitioners gener- ally^, and the intimate contiguity of structures is the predisposing cause, the disease either si)reading from the original seat, or the com- plication occurs as one of the primary results of the exciting cause. In the severer cases where the exudate separates the x)eriosteum from the bone, supiDuration, gangrene, and superficial caries are common results; where infiltration of the bone tissues is rapid the blood sup- ply is cut off by the pressure uj^on the vessels and death of the coffin bone ensues. Grave constitutional symptoms mark these changes and soon prove fatal.
In the mild cases of periostitis it is by no means easy to determine its presence positively, for there are no special symptoms by which it may be distinguished from jDuro laminitis. In the majority of the acute cases, though, which show no signs of inix^rovement by the fifth to seventh day, it is safe to suspect periostitis is present, particularly if the coronets are very hot, the pulse remaining full and hard, and the lameness acute. In the fortunately rare cases where the bone is affected with inflammation and supijuration, the agony of the patient is intense; he occupies the recumbent position almost continually, never standing for more than a few minutes at a time, suffers from the most careful handling of the affected feet; maintains a rapid pulse and respiration, high temperature, loss of appetite, and great thirst. It is in these cases the patient continually grows worse, and the ai)i3earance of suppuration at the top of the hoof in about two weeks after the incei^tion of the disease jiroves the inefficiency of any treat- ment that may have been adopted and the hopelessness of the ease. These patients die usually between the tenth and twentieth days, either from exhaustion or pytemic infections.
Gangrene occurs in the periosteum as the result of excessive detach- ment from the bone, combined with compression from an overprofuse exudate. Other parts of the sensitive tissues are subject to the same fate occasionally, from this last-named cause, and at times large territories will be found dead.
Pumiced sole is that condition in which the horny sole in the neigh- borhood of the toe readily crumbles away and leaves the sensitive 5001— HOR 14*
426
tissues more or less exposed. It is not confined to being a complica- tion of laminitis, but may be seen whenever the necessary conditions for inducing it are present. Williams has described the horn 3' tissue under these circumstances as being "weak, cheesy, or sijongy, like macerated horn, or even grumous," and this certainly conveys a good idea of its appearance and general characteristics. This crumbling- horn when critically examined shows almost an entii-e absence of the cohesive matter which unites the healthy fibers, Avhile the fibers themselves are irregular and granular in appearance. Pumiced sole depends upon an impairment of the horn-secreting i)OAvers of the sen- sitive sole, or upon a separation occurring between the horu}'^ and soft tissues which maintain its vitality. The normal sole phj'siologically maintains a proper thinness by crumbling off in scales as it passes be\-ond the life-maintaining influence of the producing tissues, and anj'thing which i)revents, suspends, or destroys this influence causes the crumbling process to become excessive.
Punctured wounds of the feet, where accomi^anied b}" any consider- able destruction of the soft or horn-secreting tissues, present the same peculiarities in this respect in the immediate neighborhood of the injury. Bruises of the sole are occasionally followed by this change in the horn where the exudation has been excessive and has separated it from the living tissues. True, in these cases we rarely see the soft tissues laid bare, for the reason that new horn is constantly secreted and replaces that undergoing the process of disintegration.
Laminitis presents three diiferent conditions under which pumiced sole may appear : First, where free exudation separates the horn from the other tissues, or where the process of inflammation arrests the pro- duction of horn bj' impairing or desti'oying the horn-secreting mem- brane; secondly, where depression of the coffin bone causes pressure upon and arrests the formation of horn ; and, thirdly, where the eleva- tion of the sole compresses the soft tissues against the pedal bone and induces the same condition. Pumiced sole, as it results from simple exudation and separation of tissues, is of no imi)ortance, for the reason given above in connection Avith bruises; but where suppuration occurs in restricted portions of the foot in conjunction with laminitis it always lays bare the tissues beneath and impairs the animaVs value tempora- rily. In these cases recovery takes iilace after a few weeks' time by the tissues horning over, as in injuries which have been attended with the same process. Depression of the coffin bone is not a sufficient cause within itself to cause pumiced sole, for if the relative change in the bone takes place slowly, or if the horn is thin, the sole becomes convex from the gradual pressure and the soft tissues adapt them- selves to the change vrithout having their function materially impaired. But when the dro])ping is sudden and the soft tissues entirely destroyed, the horn rapidly crumbles away and the toe of the bone comes through. In many of these cases the soft tissues remain uncov- ered for months, and when they eventually become covered it is with
427
a thin, slightly adherent horn that bears but little or no wear. The sole being now convex, the diseased, tissues are compelled to })ear unusual weight by coming in contact with the ground, and hence it is these animals are generally incurable cripples. In the majority of cases wliere the sole is raised to meet the pedal l)one and pumiced sole occurs, it is due not to pressure of the bone from within (for the tis- sues are capable of adapting themselves to the gradual change), but to impaired vitalitj' of the sensitive tissues from the inflammation and tlie constant concussion and pressure a|)j)lied from without during pro- gression. Added to this is to bo considered the paring away of the horn by the smith wh<Mi applying the shoe, thereby keeping the sole at this i)oint too thin.
Tifiintuj up of the toe. — In man}' cases of laniinitis which have become chronic it is found that the toe of the foot turns up, and that the heels are longer than natural, while the whole hoof next to the coronary band is circled with ridges like the horn of a ram. Even in other cases where recovery has taken place, and in other diseases than laminitis, these may be found in the wall of the foot, but in these cases the ridges are equally distant from each )ther all around the foot, while in turning up of the toe the ridges are wide apart at the Iieels and close together in front, as seen in the figure (Plate XXXI, Fig. 4). These ridges are produced by ijeriods of interference with the growth of horn alternating with periods during which a nor- mal or nearly normal growth takes place. When the toe turns up it does so because the coronary band in front produces horn very slowly, while at the heels it grows much faster.
Animals affected with pumiced foot and turning up of the toe dur- ing progression always place the abnormally long heel first upon the ground, not because the heel is too long, nor as in acute or subacute laminitis to relieve the i)ain, but for the simple reason that the animal carries the leg forward \vith the column of bones in the normal posi- tion, and attempting to keep them so the heel first comes in contact with the ground, and lie then knuckles over at the fetlock in propor- tion to the amount of foot deformity present as he brings the toe to tlu^ surface.
Tlie pain and impairment of function in these cases always result in marked atrophy of the muscles of the forearm and shoulder, and to some extent of the pectorals, while the position of the fore feet advances the scapula joints so far forward as to cause a somewhat sunken appearance of the chest in front, which the laity recognize as a peculiar form of the disease popularly designated as "chest founder."
Regarding the presence of inflammation during this process, tliere is no doubt a chronic form exists a long time after these lesions com- mence, yet it may in time subside and leave the feet free from fever while the other changes still cro on.
428
The lesions of turning up of the toe are permanent, and are withal the most interesting pathologically of all the complications of 1am- initis.
Treatment. — The treatment of laminitis is i^robably more varied than in other disease, and yet in spite of it a large number of cases recover for even the poorest practitioner. Since there are two objects to be attained in treatment — xjrevention and remedy — the matter will be considered under the liead of ijrevention and curative measures.
Prevention. — To guard against and prevent disease, or to render an nnpreventable attack less serious than it otherwise would be, is the highest practice of the healing art. In a disease so prone to result from the simplest causes as seen in laminitis, and especially when the soundest judgment may not be able to determine the extent of the disease-resisting powers of the tissues which are liable to be affected, or of what shall in every instance constitute an over-excite- ment, it is not strange that horse owners find themselves in trouble from unintentional transgression. If the disease was dependent upon specific causes, or if the stability of the tissues w^ere of a fixed or more nearly determinate quality, some measures might be instituted that would prove generally i^reventive. But when we recall the fact that predisposing causes are so prevalent and often can not be remedied, that what is but gentle work in one instance may incite disease in another, that what is food to-da}^ inay to-morrow prove disastrous to health, and that necessary medical interference, no matter how judicious, may cause a more serious complaint than that which Avas being treated, the obstacles to contend with become plain. Notwithstanding these difficulties there are some general rules to be observed that will in part serve to prevent the development of an unusual number of cases. In the first place all the predisposing causes named must be removed where j)ossible, and when this is impossible unusual care must be taken not to bring into operation an exciting cause. Fat animals should, under no circumstances, have hard work, and if the weather is warm or the variation of temi^era- ture great they should have but slow, gentle labor until they become inured to it, the tissues hardened and their excitability reduced to a minimum. Green horses should always have moderate Avork for the same reason, and particularly when changed from the farm and dirt roads to city pavements. The increased concussion, changed hj^gienic conditions, and artificial living readily become active causes of the disease under these circumstances. Armj" horses just out of winter quarters, track horses with insufficient preparation, and farmers' horses put to work in the spring, are among the most susceptible classes, and must be i^roteeted by work that is easy and gradual. If long marches or drives are imi^erative, then the incumbrances must be light as possible and the journey interspersed with frequent rests, for this allows the lamina? to regain their impaired functional activity
429
and thereby to withstand much more work without danger. And, furthermore, it permits an early detection of an oncoming attack; in any case prevents working after the disease begins and renders subse- quent medication much more effective b}' cutting the process short at the stage of congestion.
All animals when resting immediately after work should be pro- tected from cold air or draughts. If placed in a stable that is warm and without draught no covering is necessary; under opposite con- ditions blankets should be used until the excitement and exhaustion of the labor performed have entirely passed away. It is still better that all animals coming in warm from work be ' ' cooled out " by slow walking until the perspiration has dried and the circulation and respiration returned to the normal. Animals stoiDped on the road even for a few moments' time should always be i)rotected from rapid change of temperature by appropriate clothing. If it can be avoided horses that are working should never be driven or ridden through a stream or jdooI of water. "Where necessary they should be cooled off before passing through, aud then kept exercising until completely dried. The same rule is to be observed with regard to washing the legs in cold water when the animal is just in from work, for, although it is practiced extensively and usually with imx)unity, occasionally it proves the cause of a most acute attack of this disease. Regarding shoeing as a predisposing cause, unusual changes in the manner of applying the shoe should not be hastily made.
If a jjlane shoe has been worn, high heels or toes must not be sub- stituted at once, but the change, if necessary, should gradually be made, so that the different tissues may adapt themselves to the change of functional performance they are called upon to bear. If, on the other hand, such changes are imperative, as is sometimes the case, then the work must be so reduced in quantity and qualitj^ that it can not prove excitant of the disease. Laminitis from the effects of pur- gative medicines is a condition which can scarcely be guarded against unless we discard entirely this useful class of medicines. I can not determine from the few cases in which I have seen this unhappy result of a purgative that there are any conditions of the system present that would warn us of danger in this direction. The disease does not seem to have any dependence for inception in such cases upon the size of the purgative, the length of time before i^urgation begins, or the activity aud severity v>ath which the remedy acts. Moderate doses of medicines known to have unusual irritating effects on the alimentary canal should be used only M'hen necessity demands it.
Experience alone will determine what animals are liable to suffer from this disease through the influence of the different foods. When an attack can with any certainty be ascribed to any iiarticular food it should ever be withheld unless in the smallest quantities. Horses that have never been fed uj)on Indian corn should receive but a little at a
430
time at first, and alwaj-.s mixed with bran, oats, oi' other food, nntil it lias been determined tliat no danger exists. Corn is much more liable to cause laminitis in warm than in cold weather, and for this reason it should alwaj^s be fed with care during spring and summer months.
AVhen an animal is excessively lame in one foot the other or oppo- site member should have the shoe esu'ly removed and cold water fre- quently applied. At the same time the slings should be used if the subject remains standing. Horses should under no circumstances be overworked; to guard against this, previous work, nature of roads, state of weather, and various other influences must be carefull3=^ noted. Watering while warm is a pernicious habit, and unless the animal is accustomed to it is apt to result in some disorder, ofttimes in laminitis.
Curative measures. — In cases of simple passive congestion of the lamin?e the body should be warmly clothed and warm drinks given to draw the blood in increased quantity" to these parts so as to direct it from the feet ; at the same time the feet should be placed in warm water so as to increase the return flow of blood. In the course of half an hour the feet may be changed to cold water, which .serves as a tonic to all the tissues, and kept there until recovery is completed. If the constitutional symi)toms demand it, diuretics should be given. Half- ounce doses of saltpeter, three times a day in the water, answers the l)urpose. In cases of active congestion the warm foot baths should be omitted and cold ones substituted from the commencement. Subacute laminitis demands the same treatment with laxatives if there is con- stipation, and the addition of low-heeled shoes. The diuretics may need to be continued for some time and their frequency increased. Regarding acute laminitis, what has been called the ' 'American treat- ment " is so simj^le and withal so efficient that it is to be remarked other countries have never adopted it. Since the disease is a local one, unquestionably the remedies used should be ap]3lied in the imme- diate neighborhood of the alfeeted parts, or if drugs are administered internally, they should have some specific localized action. And such are the claims made for the above-named method of treatment. It consists solely in the exhibition of large doses of nitrate of potash and the continued application to the feet and ankles of cold water.
Three to 4 ounces of saltiDeter in a pint of water, repeated every six hours, is the proper dose, and the laminitis frequently subsides inside of a week's time. These large doses may be continued for a week without danger; never under an}' circumstances have I seen the kid- neys irritated to excess or other unfavorable effects prpduced.
The feet should either be kept in a tub of water at a temperature of 45? to 50° Fahr. (it maj' be lowered if desired), or if the animal is lying down swabs should be used and wet every half hour with the cold water. The water not only keeps the horn soft and moist, but acts directly upon the inflamed tissues by reducing their temperature.
431
thereby increasing their vitality and disease-resisting <|nalities, and at the same time hy toning np the coats of the blood vessels dimin- ishes the snpph' of blood and limits the exndation. Fui'thermore, cold has also an anesthetic effect upon the diseased tissues and relieves the i^ain.
Aconite may be given in conjunction with niter where the lieart is greatly excited and beating strong!}'. Ten-drop doses repeated every two hours for twenty-four hours is sufficient. The practice of giving cathartics is dangerous, for it may excite suj^erpurgation. Usually the niter has sufficient effect upon the constipation to relieve it, yet if it should prove obstinate laxatives may be carefully given. Bleed- ing, both general and local, should be guarded against. Tlie shoes should alwaj's be earh^ rem.oved and the soles left unpared.
Paring of the soles presents two objections. First, while it may temporarily relieve the pain hy relieving pressure, it at the same time allows of greater exudation, which may more than counterbalance the good effects. Secondly, it makes the feet tender and subject to bruises when the animal again goes to work. The shoes should be replaced when convalescence sets in and the animal is ready to take exercise. Exercise shoidd never l)e enforced until the inflammation has subsided, for although.it temporarih' relieves the pain and soreness, it serves to maintain continued irritation, increases tlie exudation, and prolongs the recovery.
If at the end of tlie fifth or sixth day prominent sj'mptoms of recov- ery are not apparent ajjply a stiff blister of cantharides around the coronet and omit the niter for about forty-eight hours. As soon as the blister has drawn well the feet may again receive wet swabs. If one blister does not suffice to remove the soreness, as is the case sometimes, especially wliere periostitis is present, it maybe repeated, or the actual cautery ai^plied. The same treatment should be adopted where side bones form or inflammation of the coronet bone ensues. When the sole breaks through and exposes the coffin bone and soft tissues, the feet must be carefully shod with thin heels and thick toes where there is any tendency to walking on the heels, and the sole well protected witli appropriate dressing and iDressure over the exposed parts. AVlien there is a turning up of the toe, blistering of the coronet in front, carefully avoiding the quarters and heels, sometimes stimu- lates the growth of horn, but as a rule judicious shoeing is the only treatment that will keep the animal in a condition to do light, slow work.
Where suppuration of the laminae is profuse it is better to destroy your patient at once and relieve his suffering, but if the suppuration is limited to a small extent of tissue, especially of the sole, treatuu^nt as in acute cases may induce recovery and should always be tried. If from bed-sores or other causes septicaemia or pyremia is feared, the bisulpliite of soda in half -ounce doses ma}' be given in conjunction
432
with tonics and other treatment indicated m these diseases. Regard- ing enforced recumbency I doubt the propriety of insisting on it in the majority of cases, for I think as a rule the animal assumes what- ever position gives comfort. There can be no doubt that recumbency diminishes the amount of blood sent to the feet, and that the suffer- ing is greatly relieved while in this position, so that the experiment of forcing the x^atient to lie down may be tried, j^et should not be renewed if it thereafter j^ersists in standing.
Where the animal stands, or where constant lying indicates it, to prevent extensive sores the patient should be i^laced in slings, and the weight supported in this manner to the relief of the feet. When all four feet are affected it may be impossible to use slings, for the reason that the i^atient refuses to suj)port any of his weight on his feet and simply hangs in them. Lastly, convalescent cases must not be returned to work too early, else permanent recovery may never be effected.
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SOUND AND CONTRACTED FEET.
DISEASES OF THE SKIN.
By JAMES LAW, F. R. C. S. V. S.,
Profcscor of Veterinary Science, etc., Cornell University.
As we find them described in systematic works, tlie diseases of the skin are very numerous and complex, whicii may be largely accounted for by the fact that the cutaneous covering is exposed to view at all points, so that shades of difference in inflammatory and other dis- eased processes are easily seen and distinguished from each other. In the horse the hairy covering serves to some extent to mask the symptoms, and hence the nonprofessional man is tempted to apply the term "mange " to all alike, and it is only a step further to apply the same treatment to all these widely different disorders. Yet even in the hairy quadruped the distinction can be made in a way which can not be done in disorders of that counterpart and prolongation of tiie skin— tlie mucous membrane, which lines the air passages, the digestive organs, the urinary and generative apparatus. Diseased processes, therefore, which in these organs it might be difficult or impossible to distinguish from each otlier, can usually be separated and recognized when appearing in the skin.
Nor is this differentiation unimportant. The cutaneous covering presents such an extensive surface for the secretion of cuticula? scales, hairs, horn, sebaceous matter, sweat, and other excretory mat- ters, that any extensive disorder in its functions may lead to serious internal disease and death. Again, the intimate nervous sympathy of different points of the skin with particular internal organs renders certain skin disorders causative of internal disease and certain inter- nal diseases causative of affections of the skin. The mere painting of the skin with an impermeable coating of glue is speedily fatal; a cold draught striking on the chest causes inflammation of the lungs or pleura; a skin eruption speedily follows certain disorders of the stomach, the liver, the kidneys, or even the lungs; simple burns of the skin cause inflammations of internal organs, and inflammations of such organs cause in their turn eruptions on the skin. The rela- tions—nervous, secretory, and absorptive— between the skin and internal organs are most extensive and varied, and therefore a visible
433
434
disorder in llio skin may point at once and specifically to a particular fanlt in diet, to an injudicions use of cold water when the system is heated, to a fault in drainage, ventilation or lighting of the stables, to indigestion, to liver disease, to urinary disorder, etc.
STRUCTURE OF THE SKIN.
The skin consists primarily of two parts: (1), the superficial non- vascular (without blood vessels) layer, the cuticle or epidermis; and (2), the deep vascular (with blood vessels) layer, the corium, dermis
""'Thl^^/Z/c/c' is made up of cells placed side by side and more or less modified in shape by their mutual compression and "^y/^'^^'^^'T^'. ration and drving. The superficial stratum consists of the cells dued in the form of scales, which fall off continually and form dandruff The deep stratum (the mucous layer) is formed of somewhat rounded cells with large central nuclei, and in colored skin containing numer- ous' pigment ^granules. These cells have prolongations or branches bv which the^' communicate with each other and with the superficial layer of cells hi the true skin beneath. Through these they receive nutrient liquids for their growth and increase, and through these limiids absorbed by the skin, may be passed on into the vessels of the true skin beneath. The living matter in the cells exercises an equally selective power on what they shall take up for their own nourishment and on what they shall admit into the circulation fi^m without. Thus, certain agents Uke iodine and belladonna are readily admitted, whereas others, like arsenic, are excluded by the sound unbroken epidermis. Between the deep and superficial layers of the epidermis there is a thin translucent layer (septum ucidum , con- sistino- of a double stratum of cells, and forming a medium of transi- tion from the deep spheroidal to the superficial scaly cuticle.
The true skin or dermis has a framework of interlacing bundles of white and vellow fibers, large and coarse in the deeper layers, and fine in the superficial where they approach the cuticle. Between the fibrous bundles are left interspaces which, like the bundles, become finer as they approach the surface, and inclose cells, vessels, nerves, o-lands, gland ducts, hairs, and in the deeper layers fat. " The superficial layer of the dermis is formed into a series of mmu e conical elevations or papUla, projecting into the deep ^fl^fj^" cuticle, from which they are separated by a very fine traispaient membi^ne. This papHUwu layer is very richly supplied with capil- lary blood vessels and nerves, and is at once the seat of acute sens^a- tion and the point from which the nutrient liquid is supplied to the cdls of the cuticle above. It is also at this point that the active changes of inflammation are especially concentrated; it is the immedi- atel/superposed cell layers (mucous), that become morbid y increased in the early stages of inflammation; it is on the surface of the papilla.y
435
layer that tlie liquid is thrown out which raises tlie cuticle in the form of a blister, and it is at tliis point mainly that pus forms in the ordinary ])ustule.
The fibrous bundles of the true skin contain plain muscular fil,ers which are not controlled by the will, but contract under the iniiuence of cold and under certain nervous influences, as in some skin dis- eases and in the chill of a fever, and lead to contraction, tightening or corrugation of the skin, contributing to produce the "hidebound"'' of the horseman. Other minute muscular filaments are extended from the surface of the dermis to the hair follicle on the side to which the hair is inclined, and under the same stimulating influences pro- duce that erection of the hair which is familiarly known as "starino- coat. *' Besides these, the horse's skin is furnished with an expansion of red voluntary muscle, firmly attached to the fibrous bundles, and by which the animal can not only dislodge insects and other irritants but even shake off the harness. This fleshy envelope covers the sides of the trunk and the lower portions of the neck and head, the parts unprotected by the mane and tail, and serves to throw the skin of these parts into puckers or ridges in certain irritating skin diseases.
The Imirs are cuticular products growing from an enlarged papilla lodged in the depth of a follicle or sack, hollowed out in the skin and extending to its deepest layers. The hair follicle is lined by cells of epidermis, Avhich at the bottom are reflected on the papilla and become the root of the hair. The hair itself is formed of the same kind of cells firmly adherent to each other by a tough intercellular substance, and overlapping each other like slates on a roof in a direc- tion towards the free end.
The sehaceous glands are branching tubes ending in follicles or sacks and opening into the hair follicles, lined by a very vascular fibrous network representing the dermis, and an internal layer of cells representing the mucous layer of the cuticle. Their oily secretion gives gloss to the hair and prevents its becoming drv and brittle and keeps the skin soft and supple, protecting it at once against undue exhalation of water and undue absorption when immersed in that medium. Jk'sides those connected with the hair follicles there are numerous isolated sebaceous glands, opening directly on the surface of the skin, producing a somewhat thicker and more odorous secre- tion. These are found in large numbers in the folds of the skin where chafing would be likely if the surface were dry, as on the sheath, scro- tum, mammary glands and inner side of the thigh, around the anus and vulva, m the liollow of the heel, beneath the fine horn of the fro- on the inner side of the elbow, on the lips, nostrils, and evelids! AV hen closed by dried secretion or otherwise these glands mav become distended so as to form various sized swellings on the skin, and when mfla ined they may throw out offensive liquid discharges as in " grease " or produce red tender fungus growths ("grapes"). '
436
The sweat glands of the horse, like those of man, are composed of simple tubes, which extend down through the cuticle and dermis in a spiral manner, and are coiled into balls in the deeper layer of the true skin In addition to their importance in throwing offensive waste products out of the system, these glands tend to cool the skin and the entire economy of the animal through the evaporation of their watery secretion Their activity is therefore a matter of no small moment, as beside regulating the animal heat and excreting impurities, it influ- ences largely the internal organs through the intimate sympathy main- tained between them and the skin. ^ ,. •
Diseases of the skin may be conveniently divided, according to their most marked features, into:
(1) Those in which congestion and inflammation are the most markea features, varying according to the grade or form into (o), congestion with simple redness, dryness, and heat, but no eruption {erythema); (h) iniiammation with red pointed elevations but no blisters {jpapules) ; ic) iniiammation with fine conical elevations, each surmounted by a minute blister (resic/e); (^), inflammation with a similar eruption but with larger blisters, like half a pea and upwards {huUc^)', {e) inflammation with a similar eruption but with a small sack of white creamy pus on the summit of each elevation {pustides); (/), the for- mation of pustules implicating the superficial layer of the true skin, a small portion of which dies and is thrown off as a slough or core ihoils)- (a), the formation of round, nodular, transient swellings in the true skin {tnUrcles), and (7^), the excessive production of scales or dandruff (scaly or squamous afl^ections). _
(2) Diseases in which there is only deranged sensations, of itching, heat, tenderness, etc. {neurosis).
(.3) Diseased growths, as warts, callosities, horny growths, cancer,
(4) Diseases due to parasites, animal and vegetable.
(5) Diseases connected with a specific poison-horsepox, erysipelas, anthrax, farcy or cutaneous glanders, etc.
(6) Physical injuries like wounds, burns, scalds, etc.
CONGESTION— RED EFFLORESCENCE— ERYTHEMA.
This is a congested or slightly inflamed condition of the skin, unat- tended by any eruption. The part is slightly swollen, hot tender or tchy and dry, and if the skin is white there is redness. The redness is effaced by pressure, but reappears instantly when the pressure is removed. Unless in transient cases the hairs are liable to be shed. It may be looked on as the first stage of inflammation, and therefore when it becomes aggravated it may merge in part or m whole into a papular, vesicular, or pustular eruption.
Erythema may arise from a variety of c«...s, and ^^f'^J^^ in accordance witli its most prominent cause. Thus the clulling or
437
partial freeziuy of a part will give rise to a severe reaction and con- gestion. Where snowy or icy streets have been salted this may extend to severe inflammation with vesicles, pustules, or even sloughs of circumscribed portions of the skin of the pastern (chiU-blain, frost- bite). Heat and burning has a similar effect, and this often 'comes from exposure to the direct rays of the sun. The skin that does not perspire is the most subject, and hence the white face or ivJiite limb of a horse becoming dried by the intensity of the sun's rays often suffers to the exclusion of the rest of the body {wJiite face and foot disease). The febrile state of the general system is also a potent cause, hence the white-skinned horse is rendered the more liable if kept on a heating ration of huckiclieat, or even of iclieat or maize. Contact of the skin with oil of turpentine or other essential oils, wTth trrdant liquids, vegetable or mineral, with rancid fats, with the acrid secretions of certain animals like the irritcded toad, with pus, sweat, tears, urine or liquid fceces, will produce congestion or even 'inflam- mation. Chafing is a common cause, and is especially liable to affect the fat horse between the thighs, by the side of the sheath or scrotum, on the inner side of the elbow, or where the harness chafes on the poll, shoulder, back, breastbone, and under the tail. The accumula- tion of sweat and dust between the folds of the skin and on the sur- face of the harness, and the specially acrid character of the sweat in certain horses contribute to chafing or ' ' intertrigo. " The heels often become congested, owing to the irritation caused by the short bristly hairs in clipped heels. Again, congestion may occur from friction by halter, harness, or other foreign body under the pastern, or inside the thigh or arm, or by reason of blows from another foot (cuttino- interfering, overreach). Finally, erythema is especially liable to occur in spring when the coat is being shed, and the hair follicles and general surface are exposed and irritable in connection with the dropping of the hairs.
If due only to a local irritant congestion will usually disappear when such cause has been removed, but when the feeding or system IS at fault these conditions must be first corrected. While the coat is being shed the susceptibility will continue, and the aim should be to prevent the disease developing and advancing so as to weaken the skm, render the susceptibility permanent, and lay the foundation of persistent or frequently recurring skin disease. Hence at such times the diet should be nonstimulating; any excess of grain and above all of buckwheat, Indian corn, or wheat being avoided A laro-e gram ration should not be given at once on return from hard work when the general system and stomach are unable to cope with it; the animal should not be given more than a swallow or two of cold water when perspiring and fatigued; nor should he be allowed a full sup- ply of Avater just after his grain ration; he should not be overheated nor exhausted by work, nor should dried sweat and dust be allowed
438
to aoeiiraulate on the skin nor on the narness pressing on it. The exposure of the affected heels to damp, mud, and.snow, and above all to melting snow, should be guarded against; light, smooth, well-fitting harness must be secured, and where the saddle or collar irritates an incision should be made above and one below the part that chafes, and the padding between having been removed, the lining should be beaten so as to make a hollow. A zinc shield in the npper angle of the collar vdll often prevent chafing in front of the withers.
Wash the chafed skin and apply salt water (one-half ounce to the quart), extract of witch-hazel, a weak solution of oak bark or cam- phorated spirit. If the surface is raw nse bland powders, as oxide of zinc, lycopodinm, starch, or smear the surface ^vith vaseline, or with 1 ounce vaseline intimately mixed with one-half dram each of su-ar of lead and opium. In cases of chafing rest must be strictly enjoined Where there is constitutional disorder or acrid sweat 1 ounce cream of tartar or a teaspoonf ul of bicarbonate of soda may be given twice daily.
CONGESTION, Vs^ITH SMALL PIMPLES— PAPULES.
Ill this affection there is the general blush, heat, etc., of erythema, to-ether with a crop of elevations from the size of a poppy-seed to a coffee-bean, visible when the hair is reversed or to be felt with the finger where the hair is scanty. In white skins they vary fi-om the palest to the darkest red. All do not retain the papular type, but some o-o on to form blisters (eczema, bullae), or pustules, or dry up into scales, or break out into open sores, or extend into larger swellings (tubercles). The majority, however, remaining as pimples, charac- terize the disease. Whenveryitchytherubbingbreaksthemopen,and the resulting sores and scales hide the true nature of the eruption.
The general and local cau.^es may be the same as for erythema, and in tlie same subject one porti(m of the skin may have simple conges- tion and another adjacent papules. As the inflammatory action is more pronounced, so the irritation and itching are usually greater, the animal rubbing and biting himself severely. This itching is especially severe in the forms which attack the roots of the mane and tail, and there the disease is often so persistent and troublesome that the horse is rendered virtually useless.
The bites of insects often produce a papular eruption, but in many such cases the swelling extends wider into a button-like elevation, one- half to an inch in. diameter. The same remarks apply to the effects of the poison ivy and poison sumac.
In papular eruption first remove the cause, then apply the same gen- eral remedies as for simple congestion. In the more inveterate cases use a lotion of one-half ounce sulphide of potassium in 2 quarts water, to which a little castile soap has been added.. Or use a wash with one- liaU- ounce oil of tar, 2 ounces castile soap, and 20 ounces water.
439
INFLAMMATION WITH BLISTERS — ECZEMA.
In this the skin is congested, th'ckened, warm (white skins are red- dened), and shows a thick croi> of little blisters formed by effnsions of a straw-colored fluid between the true skin and the cuticle. The blisters may be of an}^ size from a millet seed to a pea, and often crack open and allow the escape of the fluid which concretes as a slightly yellowish scab or crust around the roots of the hairs. This exudation and incrustation are especially common where the hairs arc long, thick, and numerous, as in the region of the pastern of heavy draught horses. Eczema maj' appear on any part of the body, but in horses it is especially common on the heels and the lower parts of the limbs, and less frequently on the neck, shoulder, and abdomen. The limbs appear to be especially liable because of their dependent Ijosition, all blood having to return from them against the action of gravity, and congestions and swellings being common, because of the abundance of blood vessels in this i)art of the skin, and l>ecause of the frequent contact with the irritant dung and urine and their ammonical emanations. The legs further suffer from contact with wet and mud when at work, from snow and ice, from draughts of cold air on the wet limbs, from washing with caustic soaps, or from the relaxing effects of a too deep and abundant litter. Among other causes may be iiamed indigestions and the i)resence of irritant matters in the blood and sweat, the result of patent medicated foods and con- dition powders (aromatics, stimulants), green food, new hay, new oats, buckwheat, wheat, maize, diseased potatoes, smut or ergot in grains, decomposing green food, brewer's grains, or kitchen garbage. The excitement in the skin, caused by shedding the coat, lack of grooming, hot weather, hot boiled or steamed food, conduces to tlie eruption. Lastly, any sudden change of food may induce it.
The blisters may in part go on to suppuration so that vesicles and pustules often appear on the same patch, and when raw from rubbing the true nature of the eruption may be comijletely masked. In high- fed horses, kept in close stables with little Avork, eczema of the limbs may last for months and years. It is a very troublesome affection in draught stallions.
Treatment. — This disease is so often the result of indigestion that a laxative of 1 pound Glauber's salts in 3 or 4 quarts Avater, or 1^ innts, olive oil is often demanded to clear away irritants from the alimen- tai-y canal. Following this, in recent and acute cases, give 2 drams of acetate or bicarbonate of potash twice a day in the drinking water. If the bowels still become costive give daily 1 ounce sulphate of soda and 20 grains powdered nux vomica. In debilitated horses combine the niLx vomica with one-half ounce powdered gentian root. As a ^vash for the skin use 1 dram bicarbonate of soda and 1 dram carbolic acid in a quart of water, after having cleansed the surface with tepid
440
water. Employ the same precautions as regards feeding, stabling, and care of harness as in simple congestion of the skin.
In the more inveterate forms of eczema more active treatment is re<iuired. Soak the scabs in fresh sweet oil, and in a few hours remove these with tepid water and castile soap; then apply an ointment of sulphur or iodide of sulphur day by day. If this seems to be losing its effect after a week, change for mercurial ointment or a solution of sulphide of potassium, or of hyposulphite of soda, 3 drams to the quart of water. In these cases the animal may take a course of sul- phur (1 ounce daily), bisulphite of soda (i ounce daily), or of arsenic (5 grains daily) mixed with 1 dram bicarbonate of soda.
INFLAMMATION WITH PUSTULES.
In tliis affection the individual elevations on the inflamed skin show in the center a small sack of white, creamy pus, in place of the clear liquid of a blister. They vary in size from a millet seed to a hazel nut The pustules of glanders (farcy buds) are to be distinguished by the watery contents and the cord-like swelling, extending from the pustules along the line of the veins, and those of boils by the inflam- mation and sloughing out of a core of the true skin. The hair on the pustule stands erect, and is often shed with the scab which results. AVhen itching is severe the parts become excoriated by rubbing, and, as in the other forms of skin disease, the character of the eruption may become indistinct. Old horses suffer mainly at the root of the mane and tail and about the heels, and suckling foals around the mouth, on the face, inside the thighs, and under the tail.
Pustules like eczema are especially liable to result from unwholesome food and indigestion, from a sudden change of food, above all from dry to green food. In foals it may result from overheating of the mare and allowing the first milk after she returns, or by milk ren- dered unwholesome by faulty feeding of the dam. If a foal is brought up by hand the souring and other decompositions in the milk derange the digestion and cause such eruption. Vetches and other plants affected with honeydew and buckwheat have been the cause of these eruptions on white portions of the skin. Disorders of the kidneys or liver are common causes of this affection.
Treatment— A^yply soothing ointments, such as benzoated oxide of zinc or vaseline with 1 dram oxide of zinc in each ounce. Or a wash of 1 dram sugar of lead or 2 drams hyposulphite of soda m a quart of water may be freely applied. If the skin is already abraded and scabby smear thickly with vaseline for some hours, then wash with soapsuds and apply the above dressings. When the excoriations are indolent they may be painted with a solution of lunar caustic, 2 grains to 1 ounce of distilled water. Internally counteract costiveness and remove intestinal irritants by the same means as in eczema, and fol- low this with one-half ounce doses daily of hyposulphite of soda, and
441
one-half ounce doses of gentian. Inveterate cases may often be bene- fited by a course of svilpliur, bisulijliite of soda, or arsenic. In all the greatest care must be taken with regard to food, feeding, watering, cleanliness, and work. In wet and cold seasons i^redisposed animals should, as far as possible, be protected from Avet, mud, snow, and melted snow, above all from that Avhich has been melted by salt.
BOILS — FUKUNCLES.
These may appear on any part of the skin, but are especially com- mon on the lower x^arts of the limbs, and on the shoulders and back where the skin is irritated by accumulated secretion and chafing with the harness. In other cases the cause is constitutional, or attended by unwholesome diet and overwork with loss of general health and condition. They also follow on weakening diseases, notably strangles, in which irritants are retained in the system from overproduction of effete matters during fever, and imperfect elimination. There is also the presence of a pyogenic bacterium, by which the disease may be maintained and proj)agated.
While boils are pus i)roducing, they differ from simple x^ustule in affecting the deepest layers of the true skin, and even the superficial layers of the connective tissues beneath, and in the death and slough- ing out of the central x)art of the inflamed mass (core). The depth of the hard, indurated, painful swelling, and the formation of this central mass or core, which is bathed in x)us and slowly sei)arated from surrounding parts, serve to distinguish the boil alike from the I)ustule, from the farcy bud, and from a superficial abscess.
To freed very painful boils a free incision with a lancet in two directions, followed by a dressing with one-half an ounce carbolic acid in a pint of water, bound on with cotton avooI or lint, may cut them short. The more common course is to aj^ply a warm poultice of linseed meal or wheat bran, and renew daily until the center of the boil softens, when it should be lanced and the core pressed out.
If the boil is smeared with a blistering ointment of Slianish flies and a poultice put over it, the formation of matter and separation of the core is often hastened. A mixture of sugar and soai) laid on the boil is equally good. Cleanliness of the skin and the avoidance of all causes of irritation are imx)ortant items, and a teaspoonful of bicarbonate of soda once or twice a day will sometimes assist in ward- ing off a new crop.
NETTLERASH— SURFEIT — URTICARIA.
This is an eruption in the form of cutaneous nodules, in size from a hazel nut to a hickory nut, transient, with little disposition to the for- mation of either blister or j^ustule, and usuall}' connected with shed- ding of the coat, sudden changes of weather, and unwholesomeness or
442
sudden clian^e in the food. It is most frequent in the spring and in young andVigorous animals (good feeders). The swelling embraces the entire thickness of the skin and terminates hy an abrupt margin in place of shading oif into surrounding parts. When the individual swellings run together there are formed extensive patches of thickened integument. These may appear on any part of the body, and may be o-eneral; the eyelids may be closed, the lips rendered immovable, or the nostrils so thickened that breathing becomes difficult and snuffling. It may be attended by constipation or diarrhea, or by colicky pams. The eruption is sudden, the whole skin being sometimes covered ma few hours, and it may disappear with equal rapidity or persist for six
or eight days. ^
Treatment.— Thin consists in clearing out the bowels by o drams Barbadoes aloes, or 1 pound Glauber's salts, and follow tlie opera- tion of these by daily doses of one-half ounce powdered gentian and 1 ounce Glauber's salts. A weak solution of alum maybe applied to the swellings.
SCALY SKIN DISEASE— PITYRIASIS.
This affection is characterized by an excessive production and detachment of dry scales from the surface of the skin (dandruff). It is usually dependent on some fault in digestion, and an imperfect secretion from the sebaceous glands, and is most common in old horses witli spare habit of body. Williams attributes it to food rich m sac- charine matter (carrots, turnips), and the excretion by the skm of oxalic acid. He has found it in horses irregularly worked and well fed and advises the administration of pitch for a length of time, and the' avoidance of saccharine food. Otherwise the horse may take a laxative followed by dram doses of carbonate of potash, and the affected parts niav be bathed with soft tepid water and smeared with an ointment made with vaseline and sulphur. In obstinate cases sulpliur may be given daily in the food.
NERVOUS IRRITATION OF THE SKIN— PRURITUS.
Tills is seen in horses fed to excess on grain and hay, kept in close stables, and worked irregularly. Though most common in summer it is often severe in hot, close stables in winter. Pimples, vesicles, and abrasions may result, but as the itching is quite as severe on other parts of the skin, these may be the result of scratching merely. It is especially common and inveterate about the roots of the mane
and tail.
Treatment consists in a purgative (Glauber's salts, 1 pound), re- stricted, laxative diet, and a wash of water slightly soured with oil of vitriol and rendered sweet by carbolic acid. If obstinate, give daily 1 ounce of sulphur and 20 grains nux vomica. If the acid lotion fails,
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2 drams carbonate of potash and 2 grains of cyanide of potassium in a quart of water Avill sometimes Ijenelit. If due to pin worms in the rectum, tlie itching- of the tail may be remedied bj" an occasional injection of a quart of water in which chips of quassia wood have been steeped for twelve hours.
HERPES.
This name has been apj)lied to a disease in whicli there is an erup- tion of minute vesicles in circular groups or clusters, with little tend- ency' to burst but ratlier to dry up into fine scabs. If the vesicles break they exude a sliglit, gummy discharge which concretes into a small, hard scab. It is apparentlj- noncontagious and not appreciably connected with an}" disorder of internal organs. It sometimes accom- panies or follows specific fevers, and is on the whole most frequent at the seasons of changing the coat — spring and autumn. It is seen on the lips and pastern, but may appear on any part of the body. The duration of the eruption is two weeks or even more, the tendency being to spontaneous recovery. The affected part is very irritable, causing a sensitiveness and a disposition to rub out of proportion to the extent of the eruption.
It may be treated hy oxide of zinc ointment, and to relieve the irri- tation a solution of opium or belladonna in water, or of sugar of lead or oil of peppermint. A course of bitters (one-half an ounce Peru- vian bark dailj* for a week) may be servicable in bracing the system and i^roducing an indisposition to the eruption.
BLEEDING SKIN ERUPTIONS — DERMATORRHA(iIA PARASITICA.
In China, Hungary, Spain, and other countries horses frequently suffer from the presence of a thread worm {Filar ia hceuiorrhagira, Railliet: F. muUipapnllosa, Condamine, Drouilly) in the subcuta- neous connective tissue, causing effusions of blood under the scurf skin and incrustations of dried blood on the surface. The erup- tions, which appear mainly on the sides of the trunk, but maj' cover an}' ijart of the body, are rounded elevations about the size of a small pea, containing blood which bursts through the scurf skin and con- cretes like a reddish scab around tlie erect, rigid hairs. These swell- ings appear in groui^s, which remain out for several da^'S, graduallj- diminishing in size; new groups appear after an interval of three or four Aveeks, the manifestation being confined to three or four months of spring and disappearing in winter. A horse will suffer for several years in succession, and then permanently recover. A fatal issue is not unknown. To find the worm the hair is shaved from the part where the elevations are felt, and as vSoon as a bleeding ijoint is shown the superficial layer is laid open with the knife, when the parasite will be seen drawing itself back into the i^arts beneath. The worm is
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about 2 inches long and like a stout thread, thicker towards the head than towards the tail, and with numerous little conical elevations (papilla^) around the head. The young worms are numerous in the body of the adult female Avorm. -, t^- i t.oT.Ux
The Avorm has become common m given localities, and probably enters tlie system with food or water. Treatment is not satisfactory, but the affected surface should be kept clean by sponging, and the pressure of harness on any affected part must be avoided. Thus rest may become essential. The part may be frequently washed with a strong solution of sulphide of potassium.
SUMMER SORES FROM FILARIA IRRITANS.
The summer sores of horses {dermatitis granulosa, boils) have been traced to the presence in the skin of another parasite, 3 millimeters "in length and extremely attenuated {Filaria irritans, Railliet). The sores may be seen as small as a millet seed, but more frequently the size of a pea, and may become an inch in diameter. They may appear on any point, but are especially obnoxious where the harness presses or on the lower part of the limbs. They cause intense and insupportable itching, and the victim rubs and bites the part until extensive raw surfaces are produced. Aside from such friction the sore is covered by a brownish-red, soft, pulpy material with cracks or furrows filled with serous pus. In the midst of the softened mass are small, firm, rounded granulations, fibrinous, and even caseated, and when the soft pultaceous material has been scraped off the sur- face bears a resemblance to the fine yellow points of miliary tuber- culosis in the lung. The worm or its debris is found in the center of such masses. These sores are very obstinate, resisting treatment for months in summer, and even after apparent recovery during the cold season they may appear anew the following summer. In bad cases the rubbing and biting may cause exposure of synovial sacs and ten- dons, and cause irremediable injury. Even in winter, however, when the diseased process seems arrested, there remains the hard, firm, resistant patches of the skin with points in which the diseased prod- uct has become softened like cheese.
The apparent subsidence of the'disease in winter is attributed to the coldness and comparative bloodlessness of tlie skin, whereas in sum- mer, with high temperature, active circulation, and rapid cell-growth, inflammation is increased, itching follows, and from the animal rub- bing the part the irritation is persistently increased. The hotter the climate the more troublesome the disease.
The life history of the parasite is unknown, but it probably enters the system with the food or water.
Treatment consists, first, in placing the animal in a cool place and showering the surface with cold water. The parasite may be destroyed by rubbing the surface of the wound witli iodoform and covering it
445
with a layer of collodion, and repeating the applications every twenty- fonr hours for fifteen days, or until the sores heal up. Ether or chlo- roform may be used in place of iodoform, being poured on cotton wool and applied to the sore for two minutes before painting it Avith collodion.
CRACKED HEELS— SCRATCHES— CHAPS ON KNEE AND HOCK.
This usually sets in with swelling, heat, and tenderness of the hollow of the heel, Avith erections of the hairs and redness (in white skins), with stiffness and lameness, Avhich may be extreme in irritable horses! Soon slight cracks appear transversely, and may gain in depth and width, and may even suppurate. More frequently tliey become cov- ered at the edges or throughout by firm incrustations resulting from the drying of the liquids thrown out, and the skin becomes increas- ingly thick and rigid. A similar condition occurs behind the knee and in front of the hock (malanders and salanders), and may extend from these points to the hoof, virtually incasing that side of the limb in a permanent incrusting sheath. Besides a heavy Ij-mphatic con- stitution, which predisposes to this affection, the causes are overfeed- ing on grain, unwholesome fodder, close, hot, dirty stables, constant contact Avith dung and urine and their emanations, AA-orking in deep, irritant mud; above all, in limestone districts, irritation by dry lime- stone or sandy dust in dry Aveather on dirt road, also cold draughts, snoAv and freezing mud, Avashing the legs Avith caustic soap, Avrapping the wet legs in thick Avoolen bandages Avhieh soak the skin and render it sensitiA-e Avhen exposed next day, clipping the heels, Aveak heart and circulation, natural or superA'ening on overwork, imperfect nourish- ment, impure air, lack of sunshine, chronic, exhausting, or debilitating diseases, or functional or structural diseases of the heart, liA^er, or kidneys. These last induce dropsical sAvelling of the limbs (stocking) , Aveaken the parts, and induce cracking. Finally the cicatrix of' a preexisting crack, weak, rigid, and unyielding, is liable to reopen under any severe exertion, hence rapid paces and heavy draft are acti\'e causes.
In treatment the first step is to ascertain and remove the cause Avhen- ever possible. If there is much local heat and inflammation a laxative (5 drams aloes, or 1 pound Glauber salts) may be given, and for the pampered animal the grain should be reduced or replaced altogether by bran mashes, flaxseed, and other laxative, nonstimulating food. In the debilitated, on the other liand, nutritious food and bitter tonics may be given, and even a course of arsenic (5 grains arsenic Avith 1 di-am bicarbonate of soda daily) . When the legs swell exercise on dry roads, hand-rubbing, and evenly applied bandages are good, and mild astringents, like extract of Avitch-hazel, may be applied and the part subsequently rubbed dry and bandaged. If there is much heat but unbroken skin, a lotion of 2 drams sugar of lead to 1 quart of Avater
446
may be applied on a tliin bandage, covered in cold weather witli a dry one The same may be nsed after the cracks appear, or a solntion of sulpliurous acid 1 part, glycerine 1 part, and water 1 part, applied on cotton and well covered by a bandage. In case these should prove unsuitable to the particular case, the part may be smeared with vaseline 1 ounce, sugar of lead 1 dram, and carbolic acid 10 drops.
INFLAMMATION OF THE HEELS FROM A FUNGUS-GREASE-CANKER.
This is a specific affection of the heels of horses, associated with the oTowth of a parasitic fungus {Oldiiim laimcosis, dennajjhyfon), an offensive discharge from the numerous sebaceous glands and m bad cases the formation of red, raw excrescences {grcqyes) from the sur- face It is to be distinguished (1) iromsim2>Je inflammation, m which the special fetid discharge and the tendency to the formation of "o-rapes" are absent; (2) from horsepox, in which the abundant exu- date forms a firm yellow incrustation around the roots of the hair, and is embedded at intervals in the pits formed by the individual pocks, and in which there is no vascular excrescence; (3) from foot scabies (man-e) in which the presence of an acarus is distinctive; (4) from lymphan-itis, in which the swelling appears suddenly extending around the entire limb as high as the hock, and on the inner side of the thigh along the line of the vein to the groin, and m which there is active fever, and (5) from erysipelas, in which there is active fever (wanting in grease), the implication of the deeper layers of the skin and of the parts beneath giving a boggy feeling to the parts, the absence of the fetid, greasy discharge, and finally a tendency to form pus loosely in the tissues without any limiting membrane as in -ibscess Another distinctive feature of grease is its tendency to implicate the skin Avhich secretes the bulbs or heels of the horny frog and in the cleft of the frog, constituting the disease known as canker. The predisposing causes of grease are essentially the same as those of simple inflammation of the heel, so tliat the reader may consult the preceding article, and though the specific fungus {Oidnnn hatracosis) is essential to the disease, yet it usually remains inoperative unless the field has been prepared by the coexistent predisposing factors. Local irritants may cause simple inflammation, and may be essential to the growth of the implanted germ, but without that germ it will
not produce grease.
The sumptoms vary according to whether the disease comes on sud- denly or more tardily. In the first case there is a sudden swelling of the skin in the heel, with heat, tenderness, itching, and stiffness, which is lessened during exercise. In the slower forms there is only seen a slight swelling after rest, and with little heat or inflammation for a week or more. Even at this early stage a slight serous oozing may be detected As the swelling increases, extending up toward the hock or laiees the haii-s stand erect, and are bedewed by moisture no longer
447
clear aucl odorless, but grayish, milky, and fetid. Tlio fetor of the discharge draws attention to the part whenever one enters the stable, and the swollen pastern and Avet, matted hairs on the heel draw atten- tion to the precise seat of the malady. If actively treated the disease may not advance farther, but if neglected the tense tender skin cracks open, leaving open sores from which vascular bleeding growths grow up, constituting the " grapes. '' The hair is shed, and the heel may appear but as one mass of rounded, red, angry excrescences which bleed on handling and are covered with the now repulsively fetid decom- posing discharge. During this time there is little or no fever, the ani- mal feeds well, and but for its local trouble it might continue at work. When the malady extends to the frog there is a fetid discharge fronl its cleft, or from the depressions at its sides, and this gradually extends to its whole surface and upon the adjacent parts of the sole. The horn meanwhile becomes soft, whitish, and fleshy in aspect, its con- stituent tubes being greatly enlarged and losing their natural cohesion ; it grows rapidly above the level of the surrounding horn, and when pared is found to be penetrated to an unusual depth by the secretino- papilla?, and that at intervals these have bulged out into a vascular fungus mass comparable to the "grapes."
In ireatment hygienic measures occupy a front rank, but are in themselves insufBcient to establish a cure. AU local and general con- ditions which favor the production and pei-sistence of the disease must be guarded against. Above all, cleanliness and purity of tlie stable and air must be secured; also, nourishing diet, regular exercise, and the avoidance of local irritants— septic, muddy, chilling, etc. At the outset benzoated oxide of zinc ointment may be used with advantage. A still better dressing is made with 1 ounce vaseline, 2 di-ams oxide'^of zinc, and 20 drops iodized phenol. If the surface is much swollen and tender, a flaxseed poultice may be applied over the surface of which has been poured some of the following lotion: Sugar of lead, one- half ounce ; carbolic acid, 1 dram ; water, 1 quart. All the astringents of the pharmacopeia have been employed with more or less achan- tage, and some particular one seems to suit particular cases or patients To destroy the grapes, they may be rubbed daily with strong caustics (copperas, bluestone, lunar caustic), or each may be tied round its neck by a stout waxed thread, or finally and more speedily they may be cut off by a blacksmith's sliovel heated to redness, and applied with its sharp edge toward the neck of the excrescence, over a cold shovel held between it and the skin to protect it from the heat. The latter must be frequently dipped in water to cool it down. After the removal of the grapes the astringent dressing must be persistently applied to the surface. When the frog is affected it must be pared to the quick and dressed with dry caustic powders (quicklime, copperas, bluestone), or carbolic acid and subjected to pressure, the dressing being renewed every day at least. '^
448
ERYSIPELAS.
This is a si3ecific contagious disease, characterized by spreading dropsical inflammation of the skin and subcutaneous tissues, attended by general fever. It differs from most specific diseases in the absence of a definite period of incubation, a regular course and duration, and a conferring of immunity on the subject after recovery. On the con- trary, one attack of erysipelas predisposes to another, partly, doubt- less, by the loss of tone and vitality in the affected tissues, but also, perhaps, because of the survival of the inf ecti ng germ. It is no longer to be doubted that the microbes found in the inflammatory product are the true cause of erysipelas, as the disease can be successfully transferred from man to animals and from one animal to another by their means. This transition may be direct or through the medium of infected l)uildings or other articles. Yet from the varying severity of erysipelas in different outbreaks and localities it has been surmised that various different microbes are operative in this disease, and a perfect knowledge of these might perhaps enable us to divide erysipe- las into two or more distinct affections. At present we must recog- nize it as a specific inflammation due to a bacterial poison and closely allied to septicaemia. Erysipelas was formerly known as surgical when it spread from a wound (through which the germ liad gained access) and medical ov idiopathic when it started independently of any recognizable lesion. Depending as it does, however, upon a germ distinct from the body the disease must be looked upon as one no mat- ter by what channel the germ found an entrance. Erysipelas Avhich follows a wound is usually much more violent than the other form, the difference being doubtless partly due to the lowered vitality of the wounded tissues and to the oxidation and septic changes which are invited on the raw, exposed surface. As apparently idiopathic cases may be due to infection through bites of insects, the small amount of poison inserted may serve to moderate the violence.
This affection may attack a wound of any part of the horse's body, ' while apart from wounds it is most frequent about the head and the hind limbs. It is to be distinguished from ordinary imflammations by its gradual extension from the point first attacked, by the abun- dant liquid exudation into the affected part, by the tension of the skin over the affected part, by its soft boggy feeling, allowing it to be deeply indented by the finger, by the abrupt line of limitation between the diseased and healthy skin, the former descending suddenly to the healthy level instead of shading off slowly towards it, by the tendency of tlie inflammation to extend deeply into the subjacent tissues between and into the muscles and other structures, by the great tendency to death and sloughing of portions of skin and of the structures beneath, by the formation of pus at various different points throughout the diseased parts without any surrounding sack to protect the surround- ing structures from its destructive action, and without the usual
449
disposition of pus to advance harmlessly toward the surface and escape; and, finally, by a low prostrating type of fever, with ele- vated temperature of the body, coated tongue, excited breathing and loss of appetite. The pus Avhen escaping through a lancet wound is grayish, brownish, or reddish, with a heavy or fetid odor, and inter- mixed with shreds of broken-down tissues. The most destructive form, however, is that in which pus is deficient, and gangrene and sloughing more speedy and extensive.
Treatment resolves itself mainly into the elimination from the svs- tem of the poisonous products of the bacteria by laxatives and diu-
abo^ e all those of the nature of antiferments, and the local application of astringent and antiseptic agents. Internal treatment may consist m 4 drams tincture of muriate of iron, and one-half dram muriate of ammonia or chlorate of potash, given in a pint of water every two houi-s. lo this may be added, liberally, whisky or brandy when the pro.stration is very marked. Locally a strong solution of iron, alum or of sulphate of iron and laudanum may be used. Or the affected part may be painted with tincture of muriate of iron or with iodized phenol. In mild cases a lotion of 4 drams sugar of lead and 2 ounces audanum m a quart of water may be applied. It is desirable to avoid the formation of wounds and the consequent septic action, yet when pus has formed, and is felt by fluctuation under the finger to be approaching the surface, it should be freely opened with a clean sharp lancet, and the wound thereafter disinfected daily with carbolic acid 1 part to water 10 parts, with a saturated solution of hvposul- phite of soda, or with powders of iodoform or salol
IIORSE-POX, ANTHRAX, AND CUTANEOUS GLANDERS (faRCY) will
come more properly under contagious diseases.
CALLOSITIES.
These are simple thickening and induration of the cuticle by rea- son of continued pressure, notably in lying down on a hard surface I>eing devoid of hair, they cause blemishes, hence smooth floods and good bedding should be secured as preventives.
HORNY SLOUGHS— SITFASTS— SLOUGHING CALLOSITIES.
iZ'^lZT f "•^^^^^^"^f «l«^gli« Of limited portions of the skin,
the lesult of pressure by badly-fitting harness, or by irritatinj^
masses of dirt, sweat, and hairs under the harne s. They a^ mos^
common under the saddle, but may be found under collar oiWch-
ng as well The sitfast is a piece of dead tissue which would be
hrown oif but that it has formed firm connections with the fibrous
skm beneath, or even deeper with the fibrous layers (fascia) of the
5961— HOR 15
450
mnseles, or with the bones, and is thus bound in its phace as a per- sistent source of irritation. The horn-like slough may thus involve the superficial part of the skin only, or the ^vhole thickness of the skin, and even of some of the structures beneath. The first object is to'remove the dead irritant by dissecting it off with a sharp knife, after which the sore may be treated with simple wet cloths or a weak carbolic acid lotion, like a common wound. If the outline of the dead mass is too indefinite, a linseed-meal poultice will make its out- hne more e\ident to the operator. If the fascia or bone has become gangrenous the dead portion must be removed with the horn-like skin. During and after treatment the horse must be kept at rest or the harness must be so adjusted that no pressure can come near the affected parts.
WARTS.
These are essentially a morbid overgrowth of the superficial papil- lary layer of the skin and of the investing cuticular layer. They are mostly seen in young horses, about the lips, eyelids, cheeks, ears, beneath the bellv, and on the sheath, but may develop anywhere. Thesmallerones may be clipped off with scissors and the raw surface cauterized with bluestone. The larger may be sliced off with a sharp knife or if with a narrow neck they maybe twisted off and then cau- terized. If very vascular they may be strangled by a wax thread or cord tied around the neck, at least three turns being made round and the ends being fixed bypassing them beneath the last preceding turn of the cord, so that they can be tightened day by day as they slacken by shrinkage of the tissues. If the neck is too broad it may be trans- fixed several times with a double-threaded needle and then be tied in sections Very broad warts that can not be treated m this way may be burned down to beneath the surface of the skin with a soldering bolt at a red heat and any subsequent tendency to overgrowth kept down by bluestone.
BLACK PIGMENT TUMORS— MELANOSIS.
These are common in gray and white horses on the naturally black parts of the skin at the root of the tail, around the anus, vulva, udder, sheath, eyelids and lips. They are readily recognized by their inky-black collar, which extends throughout the whole mass. Ihey may appear as simple pea-like masses, or as multiple tumors aggre- gating many pounds, especially around the tail. In the horse these are usually simple tumors, and may be removed with the knife. In exceptional cases they prove cancerous, as they usually are in man.
EPITHELIAL CANCER— EPITHELIOMA.
This sometimes occurs on the lips at the angle of the mouth, and elsewhere in the horse. It begins as a small wart-like tumor, which grows slowlv at first, but finally bursts open, ulcerates and extends
451
laterally and deeply in the skin and other tissnes, destroying them as it advances (rodent nicer). It is made nj) of a fibrous framework and numerous round, ovoid, or cylindrical cavities, lined with masses of epithelial cells, which may be squeezed out as a fetid caseous material. The most successful treatment is early and thorough removal with the knife.
VEGETABLE PARASITES OF THE SKIN.
Parasite: Tricliophyf on tonsurans. Malady: Tinea tonsurans — Cirvinate ringworm. — This is esx^ecially common in j-oung horses com- ing into training and work, in low-conditioned colts in winter and spring after confinement indoors and during moulting, in lymphatic rather than nervous subjects, and at the same time in several animals that have herded together. The disease is common to man, and among the domestic animals to horse, ox, goat, dog, cat, and in rare instances to sheep and swine. Hence it is common to find animals of different species and tl\eir attendants suffering at once, the diseases having been propagated from one to the other.
In the horse the symptoms are the formation of a circular scruffy patch where the fungus has established itself, the hairs of the affected si)ot being erect, bristly, twisted, broken, or split iip and droi^xjing off. Later the spot first affected has become entirely bald, and a circular row of hairs around this are erect, bristlj', broken, and split. These in turn are shed and a new row outside passes through the same proc- ess, so that the extension is made in more or less circular outline. The central bald spot, covered with a grayish scruff and surrounded by a circle of broken and split hairs, is characteristic. If the scj'uff and diseased hairs are treated with caustic potash solution and put under the microscope the natural cells of the cuticle and hair Avill be seen to have become transparent, while the groups of spherical cells and branching filaments of the fungus vStand out prominently in the substance of both, dark and unchanged. The eruption usually appears on the back, loins, croup, chest, and head. It tends to spontaneous recovery in a month or two, leaving for a time a dappled coat from the spots of short, liglit-colored hair of the new growth.
The most effective way of reaching the parasite in the hair follicles is to extract the hairs individually, but in the horse the mere shaving of the affected x^art is usually enough. It may then be x^ainted with tincture of iodine t>vice a day for two weeks. Germs about the stable may be covered up or destro^-ed by a whitewash of freshl}' burned quicklime, the harness, brushes, etc., may be Avashed with caustic soda, and then smeared with a solution of corrosive sublimate one-half drachm and water 1 x^int. The clothing may be boiled and dried.
Parasite: Trichophyton sporuloides. Malady: Plica Polonica. — Ptica Polonica, vi-luch mats together the mane and tail of the horse as well as the hair of men, is associated with numerous sx^ores of a
452
trichophyton, and is rationally treated by cutting off the hair and applying tincture of iodine or a solution of corrosive sublimate (4 parts to 1,000 of water).
Parasite: Aclwrwn ScMrdeini. Malady: Favus, Honeycomb ringworm.— ^iegnin and Goyau, who describe this in the horse, say that it loses its characteristic honeycomb or cup-shaped appearance, and forms only a series of closely aggregated, dry, yellowish crusts the size of hemp seed on the trunk, shoulders, flanks, or thighs. They are accompanied by severe itching, especially at night. The cryptogam, formed of spherical cells with a few filaments only, grows m the hair follicles and on the cuticle, and thus a crust often forms around the root of a hair. Like the other cryptogams, their color, as seen under the microscope, is unaffected by acetic acid, alcohol, ether, or oil of turpentine, while the cells are turned bluish by iodine. For treat- ment, remove the hair and apply tincture of iodine or corrosive subli- mate lotion, as advised under the last paragraph.
Parasite: Microsporon Furfur. Malady: Parasitic pityriasis.— This attacks the horse's head where the harness presses, and leads to dropping of the hair, leaving bald patches covered with a branlike scruff, without any eruption, heat, tenderness, swelling, or rigidity of the skin. A lotion of carbolic acid, 1 dram, and water 2i ounces, is usually applied to effect a cure.
animal parasites of the skin.
Acariasis: Jfcmr/e.— This affection is due to the irritation of the skin,
caused by the presence of a nearly microscopic acarus or mite. The
disease varies, however, according to the species of acarus which
infests the skin, so that we must treat of several different kinds of
acariasis. . . . m • •
Parasite: Sarcoptes equi. Malady: Sarcoptic acariasis.— i His is
the special sarcoptes of the horse, but under favorable conditions it
can be transmitted to ass and mule, and even to man, and may live
indefinitely on the human skin. The mite is nearly microscopical,
but may be detected with a magnifying lens among moving scruff
taken from the infected skin. Like all sarcoptes, it burrows little
o-alleries in and beneath the scruff skin, where it hides and lays its
eggs and where its young are hatched. It is therefore often difficult
to find the parasite on the surface, unless the skin has been heated
by a temporary exposure to the sun or in a warm room. Even then
it may be needful to tie the scab on the human arm till a pricking is
felt when the acarus will be found in the center of a minute papule
caused by its bite. Like other acari, this is wonderfully prolific, a
new o-eneration of fifteen individuals being possible every fifteen days,
so thlt in three months the offspring of a single pair may produce a
generation of 1,500,000 young. The sarcoptes have less vitality than
the nonburrowing acari, as they die in an hour when kept in dry air
453
apart from the skin at a heat of 145° F. They live tweb^e to fourteen days apart from the skin in the damj) air of a stable. On a piece of damp hide thej^ lived till the twenty-fourtli day, but were dead on the twenty-eighth.
The symptoms are an incessant, intolerable, and increasing itching of some part of the skin (head, mane, tail, back, etc.), the horse inclining himself toward the hand that scratches him, and moving his lips as if liimself scratching. The hairs may be broken and rubbed off, but the part is never entirelj^ bald as in ringworm, and there may be papules or any kind of eruption or open sores from the energj^ of the scratching. Scabs of any thickness may form, but the special features are the intense itching and the discovery of the acarus.
Treatment consists in the removal of the scabs by soaj)suds, and, if necessarj^, a brush, and the thorough application of tobacco 1^ ounces and water 2 pints, prepared by boiling. This may be applied more than once, and should always be repeated after fifteen days, to destroy the new brood that mjiy have been hatched in the interval. All har- ness and stable utensils should be similarly treated; blankets and rubbers may be boiled, and the stalls should be covered with a white- wash of quicklime, containing one-fourth pound of chloride of lime to the gallon.
Parasite: Sarcoptes mutans. Malady: Sarcopfic acariasis from fowls. — This parasite belongs to chickens, but can live on the skin of the fox and horse as well. A troublesome mange may therefore at times be traceable to the i)roximity of a chicken roost. The general symptoms and treatment are essentially the same as for sarcoptis equi.
Parasite: Psoroptis equi {Dermatocoptis equi, Dermatodectis equi). Malady : Psor optic acariasis. — Thi s produces the most frequent mange in horses, and as the parasite only bites the surface and lives among the crusts under the shelter of the hair, it is very easily discovered. It reproduces itself with equal rapidity, and causes similar symptoms to those produced by the sarcoptes. The same treatment will suffice and is more promptly effectual. The purifying of the stable must be more thorough, as the psoroptis will survive twenty to thirty days in the moist atmosi)here of a stable, and may even revive after six or eight weeks when subjected to moist warmth. Infested pastures will therefore prove dangerous to horses for that length of time, and with rubbing posts, etc , should be secluded.
Parasite: Symbiotis equi, DermatopJiagus equi, Cliorioptes spaiMf- erous. Malady: Foot mange. — This acarus attacks the heels and lower parts of the legs, especially the hind ones, and may be present for years without extending upon the body. Like the psoroptis, it lives on the s urf ace, on the hairs, and among the scabs. It gives rise to great itching, stamj)ing, rubbing of the one leg with the other, and the formation of papules, wounds, ulcerous sores, and scabs. The intense itching will always suggest this parasite, and the discovery
454
of the acarus will identifj^ tlie disease. Treatment is the same as for the sarcoptes, but may be confined to the legs and the parts with which they come in contact.
Parasite.— 2)erwa?i2/ssi<s gaUinecB — Chiclcen Acari. Malady: Poultry acariasis.— This is a large-sized acarus, though usually mis- called " hen louse," and the disease " poultry -lousiness." The mite lives in the hen manure and adjacent woodwork, but temporarily passes on to the skin of man, and of the horse and other quadrupeds, when occasion serves. It causes much irritation, with the eruption of papules or vesicles and the formation of sores and scabs. The examination of the skin is usually fruitless, as the attacks are mostly made at night and the effects only may be seen during the day. The proximity of hen manure swarming with the acari explains the trouble, and the removal of this and a whitewashing with quicklime with or Avithout chloride of lime will prevent future attacks. The skin may still require bland ointments or lotions, as for congestion.
Parasite: Larva of a TromUdium—Leptus Americanus— Harvest Bug, misnamed Jigger {Chigoe). Malady: Aidumn mange.— This parasite is a brick-red acarus, visible to the naked eye on a dark ground, and living on green vegetation in many localities. It attacks man, and the horse, oi, dog, etc., burrowing under the skin and giv- ing rise to small papules and intolerable irritation. This continues for two or three days only if no fresh acari are received, but will last until cold weather sets in if a fresh colony is received every day. Horses at pasture suffer mainly on tlie lower part of the face. If kept indoors the disease will disappear, or if left at pasture a weak tar water or solution of tobacco may be applied to the face.
Parasites: aamarus Pteropioides and Chegletaes live in musty fodders and are found on the horse.
TICKS.
The wood tick is familiar to inhabitants of uncultivated lands, and proves a troublesome parasite to man and beast alike. It lives on bushes, and only attaches itself to the mammal to secure a feast of blood, for when gorged it drops off to sleep off its debauch on the soil. The tick produces great irritation by boring into the skin with its armed proboscis. If pulled out the head and thorax are often left in the skin. They may be covered with oil to shut out the air from their breathing pores, or by touching them with a hot penknife they will be impelled to let go. If extracted by the liand they should be turned to. the left like a screw. It is needless to particularize the several species, as all can be treated alike.
GRUBS IN SKIN.
Parasite: Hypoderma Silenns. IMalady: Larva {Gruhs) under the shin.— This fly deposits its embryo on or in the skin of the horse,
455
as its congener {Hypoclerma horis) does in the ox, and the resulting larva? pass the winter in little rounded sacks beneath tlie integument, furnished with a central opening, through which the mature larva escapes in early summer and develops into a &y. In districts where they exist the grubs should be pressed out of the skin and destroyed in tlie course of the winter.
LARVA (grubs) OX THE SKIX — FLY-BLOW.
The following flies, among others, deposit their eggs on open sores or on wet filthy parts of the skin, where their larvae or grubs give rise to serious trouble: Lucilia Ccesar (blue bottle), Lucilialiominivorax (screw- worm fly), Musca romiforia (meat fly), and Sorcopliaga car- naria (flesh-fly). To xjrevent their attacks wet, filthy hair should be removed and wounds kept clean, and rendered antiseptic by a lotion of carbolic acid 1 part, water 50 parts; by a mixture of 1 ounce oil of tar in 20 ounces sweet oil, or some other antiseptic. If the grubs are already present they should be picked off and one of these dressings freely applied.
FLIES.
A number of flies attack horses and suck their blood, producing great annoyance, and in some Instances death. These insects not onlj^ suck the blood, but also often instil an acid poison into the skin, and in exceptional cases transfer infectious germs from animal to animal by inoculation.
Various devices are resorted to to prevent the attacks, as to sponge the skin with a decoction of walnut or elder leaves, of tobacco, to dust with Persian insect j)owder, to keep a light blanket or fly-net on the horse, to close doors and windows with fine screens and destroy by pyrethrum anj^ flies that have gained admission, to remove all manure heaps that would prove breeding places for flies, to keep the stalls clean, deodorize hj gypsum and to spread in them trays of dry chlo- ride of lime. For the poisoned bites apply ammonia, or a solution of 1 part of carbolic acid in 20 parts of sweet oil or glycerine, or one- fourth ounce bicarbonate of soda and 1 dram of carbolic acid in a quart of water may be used.
STINGS OF BEES, WASPS, AND HORNETS.
These are much more irritating than the bites of flies, partly because the barbed sting is left in the wound, and i^artly because of the amount and quality of the venom. When a swarm attacks an animal the result may prove fatal.
Treatment consists in the application of wet clay, or of a lotion of soda or ammonia, or of carbolic acid, or of sugar of lead 2 drams, laudanum 1 ounce, and water 1 pint. The embedded stings should be extracted with fine forceps or even with the finger nails.
456
FLEA — PULEX.
The flea of man and those of the dog and cat, when nnmerons, will bite the horse and give rise to rounded swellings on the skin. To dispose of them it is needful to clear the surroundings of the grub- like larvje as well as to treat the victim. The soil may be sprinkled with quicklime, carbolic acid, coal tar, or petroleum; the stalls may be deluged with boiling water and afterward painted with oil of tur- pentine and littered with fresh pine sawdust, and all blankets should be boiled. The skin may be sponged with a solution of 1 part car- bolic acid in 50 parts of water. Dogs, cats, and pigs should be dressed with the same lotion, or, better, removed from the ^acinity
of the stable.
The chigoe [Pulex penetrans) of the Gulf Coast is still more injuri- ous, because it burrows under the surface and deposits its eggs to be hatched out slowly with much irritation. The tumor formed by it should be laid open and the parasite extracted. If it bursts so that its eggs escape into the wound, they may be destroyed by introducing a wire at a red heat.
LICE — PEDICULI.
Two kinds of lice attack the horse, one of which is furnished with narrow head and a proboscis for perforating the skin and sucking the blood, and the other— the broad-headed kind— with strong mandibles, by which it bites the skin only. Of the bloodsuckers, one is common to horse and ass and another to horse and ox, while of the nonsucking lice one species attacks horse and ox and a second ox and ass. The poor condition, itching, and loss of hair should lead to suspicion, and a close examination will detect the lice. They may be destroyed by rubbing the victim with sulphur ointment, or with sulphuretof potas- sium 4 ounces, water 1 gallon, or with tar water, or the skin may be sponged with benzine. The application should be repeated a week later to destroy all lice hatched from the nits in the interval. Build- ings, clothes, etc., should be treated as for fleas.
TARANTULA AND SCORPION.
The bite of the first and the sting of the second are poisonous, and may be treated like other insect venom, by carbolated glycerine or a strong solution of ammonia.
SNAKE BITES.
These are marked by the double i'ncision caused by the two fangs, by the excessive doughy (dark red) swelling around the wounds, and in ])ad cases by the general symptoms of giddiness, weakness, and prostration. They are best treated by enormous doses of alcohol, whisky, or brandy, or by aqua ammonia very largely diluted in water,
457
the object being to sustain life until the poison snail have spent its power. As local treatment, if the wound is in a limb, the latter may have a handkerchief or cord tied around it, above the injury, and drawn tight l>y a stick twisted into it. In this way absorption may be checked until the poison can be destroyed b}' the application of a hot iron or a piece of nitrate of silver or other caustic. A poultice of tobacco leaves is a favorite remedy, and may be used to soothe the sore after cauterization.
BURNS AND SCALDS.
For scalds the surface may be bathed with a solution of bicarbon- ate of soda, sweetened or not by carbolic acid, or a weak solution of sugar of lead may be used ; or the surface may be dusted thickly with starch or flour and covered with the cotton wool, or oil of turpentine may be ai^plied over the scalded skin. Burns are well treated by lini- ment made of equal parts of lime water and linseed oil (Carron oil). For both kinds of injuries, cosmoline ten parts, and carbolic acid, one part, proves an excellent dressing. Blisters should be pricked with a needle and emptied to prevent their rupture and the exposure of the raw surface.
Severe burns, leading to destruction of very extensive patches of skin, usually render a horse useless by reason of the contraction of the resulting scar, hence the treatment of such is rarely advisable, unless followed by a skillful plastic operation. In otlier cases a skillful transi)lanting of epidermis, shaved from a healthy surface with a sharp razor, will secure the healing of a granulating wound which has proved obstinate to all other measures. In cases of burns with min- eral acids (sulphuric, nitric or h^xlrochloric) avoid water, as that will develop heat, and cover the surface with dry whiting or chalk, and only when effervescence has ceased wash off with water. "When the caustic has been a salt (cojiperas, bluestoue, chloride of zinc, etc.) apply lime water or white of egg. If the irritant has been caustic potash, soda or ammonia, \anegar should be the first application. If sores result they may be treated like ordinary wounds.
WOUNDS OF THE SKIN.
These are divided into incised {clean cut) wounds, lacerated {torn) wounds, and contused {bruised) and jjuncture'd wounds.
Incised wounds are the simplest, and the sharper the instrument and the cleaner the cut the greater the hope of speedy healing. Some- thing, however, depends on the seat and direction of the wound; thus one running from before backward on the body, or from above down- ward in the limb, will not tend to be drawn open and gape as would one running transversely on the body or limb. Again a wound on a joint and running across the limb will gape when the joint is bent. 59G1— HOR 15*
458
Again, a clean-cut wound wliicli lias not been exposed to the air, and which'lodges no foreign body and no septic nor infecting germ, will heal readily by simple adhesion, whereas those that have been exposed and contain matter foreign to the tissues will have healing delayed or prevented by the disturbing action of such bodies.
Healing in wounds may be said to take place by these modes:
(1) By primary adhesion, in which case the spherical {enibryonic) cells, and the stellate connective tissue cells (placoids) thrown out on the surface of the wound, rapidly multiply and form a bond of union between the divided lips. Union by this means may be affected within twenty-four hours after the wound has been inflicted. Of all domestic animals, however, the horse is the least prone to such union, being more disposed to the formation of pus.
(2) By granulation, which is the common form of healing in raw, exposed\sores, in those containing foreign bodies and septic and infect- ing ferments; also in torn and contused wounds. In this form the wound becomes covered with a layer of embryonic and placoid cells, of which the superficial ones degenerate into pus cells, and thus the surface is kept moist by a layer of whitish, creamy pus. In the deeper layer of cells minute loops of capillary blood vessels start up, causing the small rounded elevations known as granulations. In this way the deeper layer of cells receiving a blood supply is transformed into con- nective tissue, and from its surface new loops of blood vessels start into the layer above, and thus layer after layer of new tissue is formed, and the breach caused by the wound is gradually filled up. The new tissue as formed undergoes a steady contraction, drawing in the adjacent skin over the wound, and hence large wounds healed in this way have the skin more or less puckered around them.
(3) By secondary adhesion, in which two granulating lips of a wound having been brought together and kept in apposition, union takes place through the medium of the cells, as in primary adhesion.
(4) By scabbing, in which the exudation on the surface of the wound dries up into a firm scab, under Avhich the process of repair goes on by the development of tissue from the deeper cells, as in adhesion.
In treating clean, incised wounds, attempts should be made to secure healing by primary adhesion, even in the horse. Bleeding should first be arrested, or nearly so, by applying a cold or hot sponge, or by tying bleeding vessels, and the lips of the wound should then be closed accurately, without any twisting or overlapping. ^ In small wounds pieces of sticking plaster may be used, the lips of the wound having fii-st been smootlily shaved, so that they may adhere firmly. In larger wounds the wound may be sewed with a curved surgical needle\nd a silk thread dipped in a solution of carbolic acid. The stitches may be continued from end to end of the wound and the thread prevented from slipping and loosening by a knot at each end; or the stitches may bo independent, the two ends being tied together across the wound. In such cases they may be one-quarter to one- third inch apart; or the lips of the wound may be pinned together, the
PI.ATE XXXV
I'ertijcaL s&tion. through sTdn^
after Chaiiveau .
Hatr^ cUseaseA hy Tiichoplvi/ton Tonsurans.
after Me^nin.
Hair' disrobed 1)1/ Achnrixjn Srfidnleirn
after Me^nin ■
^°^^r^"fc»^
^^^crosporoTv^daninia frmn. Parasitic J^yriaMs in the horse
after Tkteijnin.
Haines.del
A Hoon&Co Lith, Baltimore.
DISEASES OF THE SKIN
PLATE XXX Vi
.Sfircnpfcs scnbmi , inr.Eqni
Chorijoptes spathiferns.
^_^.
1>
/ 1 ] '-<^ms^ -s$^
^ ')
/'sarnptr.s /ofi</irn.sf7i.s , i •m: h'qiti
Dprmum'saiis ytt/linae.
Hhjiu;s del rffler Megnin
A Hoen &Co Lith. Baltimore
mitf:s that infest thk hohsp:
459
pins in a simple skin wound bein^ inserted one-eighth inch from the edge, and when both lips have been transfixed in this way a thread (or liair) carried snccessivelj' around the tAvo ends of the pin and made to describe a figure S will hold the wound close. When the stitching is not continuous from end to end of the wound the apposition of the edges will be rendered more perfect by the application of strips of sticking plaster in the intervals.
When efforts at primary union have failed and pus has formed, or fermentative changes have occurred on the raw surfaces and the lips gape more or less, some antiseptic dressing will be required, as in the case of lacerated and contused wounds.
In cases where an incised wound has had foreign bodies or septic ferments introduced into it, these should first be removed. A current of water that has been boiled and cooled is one of the best methods of cleansing a wound, and there is no objection to the addition of one- twentieth of its amount of carbolic acid, as this will tend to destroy any germ life that might otherwise prove fatal to the healing process. Then the wound may be stitched up as if it had been clean, and a daily dressing, of carbolic acid 1 part and sweet oil 10 parts, may be applied.
For a wound on the convex surface of a joint, where stitches are not sufficient to keep the lips accurately applied to each other, the movement of the joint may be temporarily abolished by the applica- tion of a splint and bandage, and in any such case the bandage should be applied uniformly from the hoof upward, as othervrise the limb below the bandage is liable to swell or even die.
The treatment of contused, punctured, and lacerated wounds demands cleansing and antiseptic applications as for an incised wound, but as primary adhesion is next to impossible, the same accurate apposition of the lips by stitching is not so essential. If portions of skin or other tissue are so detached or crushed that they can not possibly live, they may be cut off, but if there is any doubt on this matter the injured portion should be left and every attempt should be made to preserve it. Such portions of the wound as are free from such fatally injured parts may be disinfected by the carbolic lotion referred to above, and stitched up like a clean wound. The severely injured parts may be left open to discharge, and the whole may be dressed daily with the carbolized oil, or with a solution of one part of mercuric chloride in one thousand i)arts water.
GranuJatiny wounds may be irrigated with the mercuric chloride solution and if the granulations become inflamed (soft, flabby, exu- berant, rising above the edges of the wound) they may be touched lightly with a stick of lunar caustic so as to leave them covered with a white film.
In all wounds that fail to heal by primary union an elaborate anti- septic treatment is desirable, but the difficulty of applying this suc- cessfully to the hoi-se in an ordinary stable would seem to forbid a lengthy description in a book of this kind.
WOUNDS AND THEIR TREATMENT.
By CH. B. MICHENER, V. S., Professor of Cattle Pathology and Obstetrics at the Xeir York College of Veter- inary Surgeons, Inspector of the Bureau of Animal Industry, etc.
Wounds are of different kinds, and are classified as incised, lacer- afbd, contused, punctured, and gunshot.
An incised wound, or cut, is made with some sharp body. The edges of the wound are smooth, as though cut with a knife. These wounds are the simplest we are called upon to treat. If they occur in fleshy parts, if blood-vessels, tendons, or joints are not injured, they soon recover and often without any treatment whatever. When bleeding to any considerable extent follows, and this is more likely to occur from incised than lacerated or contused wounds, we must first of all stop the flow of blood before attempting to close the wound itself or apply any other treatment. Hemorrhage may take place from either arteries or veins. If from arteries, the blood is bright red or scarlet in color, and flows in jerks or jets; if from veins, it is darker in color and the flow is regular. Bleeding from large vessels may be stopped by compress bandages, torsion, hot iron, and ligatures.
Bu bandages.— It the blood is from an artery, the pressure should be applied between the wound and the center of circulation, i. e., toward the body; if from a vein, toward the extremities. Torsion is to be applied by the artery forceps grasping the divided vessel and twisting it the proper number of times. The liot iron (budding iron) may also be used to sear the end of a blood vessel and thus stopbleed- ing. Of all means, however, employed to stop the flow of blood from a large vessel a ligature is the best. The divided end of the artery or vein is to be caught up and firmly tied about one-half incli from its division. Should profuse bleeding occur from the incision of a great number of small vessels, it is best stopped by compresses moistened with the tincture of the chloride of iron or other astringents. Any moderately tight bandage of oakum, tow, cob-Avebs, etc., will stop the hemorrhage, often without the medicaments referred to.
When we have controlled the bleeding our next step is to cleanse the wound. This is to be accomplished by allowing warm water to
461
462
flov.- or trickle over the wound. Never nib an incised wound with any coarse substance. When the incision is parallel to the muscular fibers the wound does not gape to any extent. Stitches placed about an inch apart are here advisable, or we may keep the edges of the wound together by means of a bandage. If the incision be across the direction of the muscular fibers gaping ensues and a "pocket" forms at the bottom of the wound in which lodge blood and pus. In my experience stitches do more harm than good in such cases. They irritate the parts and soon cause sloughing of the skin. A bandage, so applied as to bring the edges of the wound as close together as possible, is here preferable. It should be applied from below upwards, as this encourages union from the bottom, and serves to prevent the accumulation of pus in the wound. But little is to be done after this. By means of a sponge apply some simple antiseptic wash, carbolic acid 1 part, glvcerine 10 to 15 parts. If the parts become very much soiled they are to be gently washed with castile or carbolic soap and hot water. Should proud flesh appear it is to be treated with burnt alum, powdered bluestone, etc. Ofacious meddling and frequent "dressing" of such wounds do more harm than good.
Incised wounds of tendons, or of any vital part of the body, require professional attendance, and can not be separately treated of here.
Lacerated and contused wounds may be described together, although there is of course this difference, that in contused wounds there is no break or laceration of the skin. Lacerated wounds, however, are as a rule also contused— the surrounding tissues are bruised to a greater or lesser extent. While such wounds may not appear at first sight to be as serious as incised wounds they are commonly very much more so. Lacerations and contusions, when extensive, are always to be regarded as dangerous. Many horses die from septic infection or mortification as a result of these injuries. We find in severe con- tusions an infiltration of blood into the surrounding tissues; dis- organization and mortification follow, and involve often the deeper seated structures. Abscesses, single or multiple, may also result and call for specal treatment.
In wounds that are lacerated the amount of hemorrhage is mostly inconsiderable ; even very large blood vessels are thus torn apart with- out inducing a fatal result. The edges of the wound are ragged and uneven. These wounds are produced by some blunt object, as where a horse runs against fences, board piles, the corners of buildings, or where he is struck by the pole or shafts of another team, falling on rough, irregular stones, etc.
Trecdment.— In lacerated wounds great care must at first be exer- cised in examining or probing to the very bottom of the rent or tear to see if any foreign body be present. Very often splinters of wood or bits of stone or dirt are thus lodged, and unless removed prevent the wound from healing; or if it should heal the wound soon opens again,
463
discliargiiig a tliin, gluey matter that is characteristic of the iiresence of some ol3Ject in the j^arts. After a thorough exploration these wounds are to be carefully and patiently fomented with warm water, to which has been added carbolic acid in the i^roportion of 1 part to 100 of water. Rarely, if ever, are stitches to be inserted in lacerated wounds. The surrounding tissues and skin are so weakened in vitality and structure by the contusion that stitches will not hold; they only irritate the parts. It is better to endeavor to secure coadaptation by means of bandages, plasters, or collodion. One essential in the treat- ment of lacerated wounds is to secure a free exit for the pus. If the orifice of tlic wound is too high, or if i)us is found to be burrowing in the tissues beneath the opening, we must then make a counter open- ing as low as i)ossible. This will admit of the wound being thoroughly washed out, at first with warm water, and afterward injected with some mild astringent and antiseptic wash, as chloride of zinc, 1 dram to a pint of water. A depending opening must be maintained until the wound ceases to discharge. Repeated hot fomentations over the region of lacerated Avounds afford much relief and should be per- sisted in.
Bruises are nothing but contused wounds, where the skin has not been ruptured. There is often considerable solution of continuitj'" of the parts under the skin, subcutaneous hemorrhage, etc. , which VLyay result in local death — mortification — and slough of the bruised j)art. If the bruise or contusion is not so severe, very many cases are quickly cured by constant fomentation with hot water for from two to four hours. The water should be allowed, about this time, to gradually become cool and then cold. Cold fomentation must then be kei)t up for another liour or two. Dry the parts thoroughly and quickly, and bathe them freely with camphor 1 ounce, sweet oil 8 ounces. A (Xvy^ light bandage should then be applied, the horse allowed rest, and, if necessarj^, the camphorated oil may be repeated for two or three days. If, however, the wound is so severe that sloughing must ensue, we must encourage this by poultices made of linseed meal, wheat bran, turnij^s, onions, bread and milk, or hops. Charcoal is to be sprinkled over the surface of the poultice when the wound is bad smelling. After the slough has fallen off the wound is to be dressed with antiseptic washes of carbolic acid, chloride of ^inc, permanganate of potash, etc. If granulating (filling up) too fast, use burnt alum, or air-slaked lime. Besides this local treatment we find that the con- stitutional symptoms of fever and inflammation call for measures to prevent or control them. This is best done by i)lacing the injured animal on soft or green food. A physic of Barbadoes aloes, 1 ounce, should be given as soon as possible after the accident. Sedatives, as tincture of aconite root, 15 drops every two or three hours, and ounce doses of saltpeter twice or three times a day, are also to be adminis- tered. When the symptoms of fever are abated, and if the discharges
464
from the wound are abundant, the strength of our patient must be sui^ported by good food and tonics. One of the best tonics is as fol- lows: Powdered sulphate of iron, powdered gentian, and powdered ginger, of each 4 ounces. Mix thoroughly and give a heaping table- spoonful twice a day on the feed, or as a drench.
Punctured luounds are produced by the penetration of a sharp or blunt pointed substance, as a thorn, fork, nail, etc., and the orifice of these wounds is always small in proportion to their depth. In veteri- nary practice punctured wounds are much more common than the others. They involve the feet most frequently, next the legs, and often the head and face from nails protruding through the stalls and trough. They are not only the most frequent but they are also the most serious. One circumstance rendering them so is the lack of attention that they at first receive. The external wound is so small that but little or no importance is attached to it, yet in a short time swelling, pain, and acute inflammation, often of a serious character, are manifested. Con- sidering the most common of the punctured wounds we must give precedence to those of the feet. Horses worked in cities, about iron works, around building places, etc., are most likely to receive "nails in the feet." The animal treads upon nails, pieces of iron or screws, and forces them into the soles of the feet. If the nail, or whatever it is that has punctured the foot, is fast in some large or heavy body, and is withdrawn as the horse lifts his foot, lameness may last for only a few steps; but unless properly attended to at once he will be found in a day or two to be excrutiatingly lame in the injured member. If the foreign body remains in the foot he gradually grows worse from the time of puncture until the cause is discovered and removed. If, when shoeing, a nail is driven into the "quick" (sensitive laminae) and allowed to remain, the horse gradually evinces more pain from day to day; but if the nail has at once been removed by the smith lameness does not, as a rule, show itself for some days; or, if the nail is simply driven "too close," not actually pricking the horse, he may not show any lameness for a week or even much longer. At this point it is due the blacksmith to say that, considering how thin the walls of some feet are, the uneasiness of many horses while shoeing, the ease with which a nail is diverted from its course by striking an old piece of nail left in the wall, or froi#the nail itself splitting, the wonder is not tliat so many horses are pricked or nails driven ''too close," but rather that many more are not so injured. It is not always carelessness or igno- rance on the part of the smith, by any means, that is to account for this accident. Bad and careless shoers we do meet with, but let us be honest and say that the rarity of these accidents points rather to the general care and attention given by these much-abused mechanics. " From the construction of the horse's foot (being encased in an impermeable horny box), and from the elasticity of the horn closing the orifice, punctured wounds of the feet are almost always productive
465
of lameness. Inflammation results, and as there is no relief afforded by swelling and no escape for the product of inflammation, this mat- ter must and does burrow between the sole or wall and the sensitive parts within it until it generally opens ' ' between hair and hoof. " We can thus see why pain is so much more severe, why tetanus (lock- jaw) more frequently follows wounds of the feet, and why, from the extensive, or at times complete, separation and " casting" of the hoof, these wounds must always be regarded with grave apprehension.
Symptoms and treatment. — A j^ractice Avhich, if never deviated from — that of picking up each foot, cleaning the sole, and thoroughly examining the foot each and every time the horse comes into the stable — will enable us to reduce the serious consequences of punctured wounds of the feet to the minimum. If the wound has resulted from pricking, lameness follows soon after shoeing; if from the nails being- driven too close, it usually appears from four to five days or a week after receiving the shoe. We should alwaj^s inquire as to the time of shoeing, examine the shoe carefully and see whether it has been par- tially pulled and the horse stepped back upon some of the nails or the clip. The i)ain from these wounds is lancinating; the horse is seen to raise and lower the limb or hold it from the ground altogether; often he points the foot, flexes the leg, and knuckles at the fetlock. Swell- ing of the fetlock and back tendons is also frequently seen and is aj)t to mislead us. The foot must he carefully examined, and this can not he properly done without removing the shoe. The nails should be drawn separately and carefully examined. If there is no escape of matter from the nail-holes, or if the nails themselves are not moist, we must continue our examination of the foot by carefully pinching or tapping it at all parts. With a little practice we can detect the spot where pain is the greatest or discover the delicate line or scar left at the point of entrance of the foreign body. The entire sole is then to be thinned, after which we are to carefully cut down u^jon the point where pain is greatest upon pressure, and, finally, through the sole at this spot. When the matter has escaped, the sole, so far as it was undermined by pus, is to be removed. The foot must now be poulticed for one or two days and afterAvard dressed Avith a compress of oakum saturated with carbolic-acid solution or other antiseptic dressing.
If we discover a nail or other object in the foot the principal direc- tion, after havdng removed the oftending body, is to cut away the sole, in a funnel shape, doAvn to the sensitive parts beneath. This is imperative, and if a good free oj^ening has been made and is main- tained for a few days, hot fomentations and antiseptic dressings applied, the cure is mostly easy, simple, quick, and permanent. The horse should be shod with a leather sole under the shoe, first of all applying tar and oakum to prevent any dirt from entering the wound. In some instances nails may puncture the flexor tendons, the coffin bone, or enter the coffin joint. Such injuries are always serious, their
466
recoverj'^ slow and tedious, and the treatment so varied and difficult that the services of a veterinarian will be necessary.
Punctured wounds of joints — Open joints. — These wounds are more or less frequent. They are always serious, and often result in anchy- losis (stiff ening) of the joint or death of the animal. The joints mostly punctured are the hock, fetlock, or knee, though other joints may of course suffer this injury. As the symptoms and treatment are much the same for all, I will only describe this accident as it occurs in the hock joint. Probably the most common mode of injury is from the stab of a fork, but it may result from the kick of another horse that is newl}'' shod, or in many other ways. At first the horse evinces but slight pain or lameness. The owner discovers a small wound scarcely larger than a i)ea, and iiays but little attention to it. In a few days, however, the pain and lameness become excessive ; the horse can no longer bear any weight ujion the injured leg; the joint is very much swollen and painful ui)on i)ressure; there are well-marked s^'m^jtoms of constitutional disturbance — c^uick i)ulse, hurried breathing, liigh temi^erature, 103° to 106° Fahr., the apiDetite is lost, thirst is present, the horse reeks with sweat, and shows by an anxious countenance the pain he suffers. He may lie down, though mostly he persists in stand- ing, and the opposite limb becomes greatly swollen from bearing the entire weiglit and strain for so long a time. The wound, which at first appeared so insignificant, is now constantly discharging a thin whitish or yellowish fluid — joint-oil or water, which becomes coagu- lated about the mouth of the wound and adheres to the part in clots like jelly, or resembling somewhat the white of an egg. Not infre- quently the joint oj)ens at different places, discharging at first a thin bloody fluid that soon assumes the character above described.
Treatment of these wounds is most difficult and unsatisfactory. In my own exx)erience we can do much to j)revent this arraj' of symptoms if the case is seen early — within the first twenty-four or forty-eight hours after the injury; but when inflammation of the joint is once fairl}' established the case becomes one of grave tendencies. When- ever a punctured Avound of a joint is noticed, even though apparently of but small moment, we should without the least delay apply a strong cantharides blister over the entire joint, being even careful to fill the orifice of the wound Avith the blistering ointment. This treatment is almost always effectual. It operates to x^erf orm a cure in two ways — first, the swelling of the skin and tissues underneath it completely closes the wound and j)re vents the ingress of air; second, by the super- ficial inflammation established it acts to check and abate all deep- seated inflammation. In the great majority of instances, if i)ursued soon after the accident, this treatment performs a cure in about one week, but should the changes described as occurring later in the joint have already taken place, we must then treat by cooling lotions and the application to the wound of chloride of zinc, 10 grains to the ounce
467
of water, or a paste made u\) of flour and alum. A bandage is toliold these apj)lications in place, which is only to be removed when swelling of the leg or increasing febrile sj^mptoms demand it. In the treat- ment of open joints our chief aim must be to close the orifice as soon as possible. For this reason rex)eated x)robing or even injections are contra-indicated. The onlj^ i)i'ohing of an open joint that is to be sanctioned is on our first visit, when we should carefully examine the wound for foreign bodies or dirt, and after removing them the probe must not again be used. The medicines used to coagulate the synovial discharge are best simply applied to the surface of the wound, on pledgets of tow, and held in place by bandages. Internal "treatment is also indicated in those cases of open joints where the suffering is great. At first we should administer a light i)hysic, and follow this up with sedatives and anodynes, as directed for contused wounds. Later, however, we should give quinine, or salicylic acid in one-dram doses two or three times a day.
JFounds of tendons are similar to open joints in that there is an escape of synovial fluid, "sinew water." Where the tendons are simjoly punctured bj^ a thorn, nail, or fork, we must, after a thorough exploration of the wound for any remaining foreign substance, treat with the flour and alum paste, bandages, etc., as for oi)en joint. Should the skin and tendons be divided the case is even more serious and often incurable. There is always a large bed of granulations (proud flesh) at the seat of injury, and a thickening more or less i)ro- nounced remains. When the back tendons of the leg are severed we should apply at once a high-heel shoe (which is to be gradualhj low- ered as healing advances) and bandage firmly with a comj)ress mois- tened with a 10-grain chloride of zinc solution. When i^roud flesh appears this is best kept under control by repeated applications of a red-hot iron. Mares that are valuable as brood animals and stock horses sliould always be treated for this injury, as, even though blemished, their value is not seriously impaired. The length of time required and the exj^ense of treatment will cause us to hesitate in attemi)ting a cure if the subject is old and comjiaratively valueless.
Gunshot wounds. — These wounds are so seldom met with in our ani- mals that an extended reference to them seems unnecessary. If a wound has been made by a bullet a careful examination should be made to ascertain if the ball has passed through or out of the body. If it has not we must then probe for the ball, and if it can be located it is to be cut out when practicable to do so. Oftentimes a ball may be so lodged that it can not be removed, and it then wmy become encj'sted and remain for years without giving rise to any inconven- ience. It is often difficult to locate a bullet, as it is very readily deflected by resistances met with after entering the body. Should bones be struck by a baU they are frequently shattered and splintered to such an extent as to warrant us in having the animal destroved.
468
A gunshot wound, when irreparable injury has not been done, is to be treated the same as punctured wounds, i. e., remove the foreign body if possible, and apply hot fomentations or poultices to the wound until suppuration is fairly established. Antiseptic and disinfectant injections may then be used. Should pus accumulate in the tissues openings must be made at the most depending parts for its escape. Wounds from shotguns if fired close to the animal are serious. They are virtually lacerated and contused wounds. Remove all the shot possible from the wound, and treat as directed for contusions. When small shot strike the horse from a distance they stick in the skin or only go through it. The shot grains must be picked out, but as a rule this "peppering" of the skin amounts to but little.
Cliajing hij the harness— saddle or collar galls.— ^Vonnds or abra- sions of this description are very commonly met with during the spring plowing, particularly in "new ground," or from ill-fitting saddles or collars at any time of the year. Collars too large or too small are equally productive of this trouble. In the spring of the year, when the horse has been unused to steady work for some months, the skin is tender and easily abraded. The horse, from being wintered on a scanty allowance of grain, is soft, sweats easily, and if the collar and shoulders are not properly attended to chafing of the skin is almost sure to follow. The harness should be repaired, cleaned, and oiled before using, and the collar in particular should be thoroughly cleansed after every day's use. The shoulders are to be frequently washed with cold water, and afterward bathed with white-oak bark tea, alcohol, or other astringents. Should ill-fitting or badly made harness or saddles gall a horse, they must be refitted at once, or laid aside for other and better ones.
The treatment of such abrasions is simple and effective if the cause be removed without delay. The parts must be thoroughly bathed in soapy water, allowing the lather to remain on the abraded surface. There are many remedies for harness galls. Among them may be mentioned alcohol, 1 pint, in which are well shaken the whites of two eggs; a solution of nitrate of silver, 10 grains to the ounce of water; sugar of lead or sulphate of zinc, 20 grains to an ounce of water; car- bolic acid, 1 part in 15 parts of glycerine, and so on almost without end. Any simple astringent wash or powder will effect a cure pro- vided the sores are not irritated by friction. If the animal must continue his work the harness must be padded or chambered.
Burns and scalds.— Wounds from burning or scalding are rare in the domestic animals, but when extensive they prove very trouble- some and are often fatal. According to the severity of the burn we find the skin simply reddened, vesicles (blisters) may be produced, or the part may be literally roasted or boiled, causing complete destruc- tion of the tissues and sloughing. When a large surface of the skin is burned or scalded the animal (if he does not die at once from shock)
469
will soon show symptoms of fever — shivering, coldness of the extremi- ties, weakness, restlessness, quick, feeble pulse, sighing breathing, etc. The treatment in such cases must be jarompt and energetic. Stimu- lants, such as whisky with milk and eggs, are to be frequently given. Quinine and salicylic acid, of each 1 dram, should also be administered twice a day. The burned surface must be immediately bathed with equal parts of lime-water and linseed oil, and afterwards dredged with as much flour as can be made to adhere. If these can not be obtained cover the i^arts with flour paste, layers of cotton, or any- thing to exclude the air. Nitrate of silver, 5 grains to the ounce of water, or carbolic acid, 1 part to 50 of water, afford great relief if frequently applied. When the slough takes place we must supi)ort the animal's strength with good food and tonics, and treat the raw surface the same as other granulating wounds.
ABSCESSES.
These consist of accumulations of pus within circumscribed walls, at different parts of the body, and may be classed as acute, and cold or chronic abscesses.
Acute abscesses follow as the result of local inflammation in glands, muscular tissue, or even bones. They are Very common in the two former. The abscesses most commonly met with in the horse (and the ones which will be here described) are those of the salivarj^ glands, occurring during the existence of " strangles " or "colt distemper." The glands behind or under the jaw are seen to slowly increase in size, becoming firm, hard, hot, and painful. At first the swelling is uniformly hard and resisting over its entire surface, but in a little while becomes soft — fluctuating — at some portion, mostly in the center. From this time on the abscess is said to be ' ' pointing " or ' ' coming to a head," which is shown by a small elevated or projecting promi- nence, which at first is dry, but soon becomes moist with transuded serum. The hairs over this part loosen and fall off, and in a short time the abscess opens, the contents escape, and the cavity gradually fills up — heals by granulations.
Abscesses in muscular tissue are usually the result of bruises or injuries. In all cases where abscesses are forming we should hurry the ripening procees by frequent hot fomentations and poultices. When they are very tardy in their development a blister over their surface is advisable. It is a common rule with surgeons to open an abscess as soon as j)us can be plainly felt, but this i>ractice can scarcely be recommended to owners of stock indiscriminatelj^ since this little operation frequently requires an exact knowledge of anat- omy. It \^ill usually be found the better plan to encourage the full ripening of an abscess and allow it to open of itself. This is imj)era- tive if the abscess is in the region of joints, etc. When open, we must not squeeze the walls of the abscess to any extent. They may
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be veiy gently pressed witli the fingers at first to remove the clots — inspissated x)us — but after this the orifice is simply- to be kept open by the introduction of a whalebone probe, should it be disposed to heal too soon. If the opening is at too high a level another should be made into the lowest portion of the abscess. Hot fomentations or poultices are sometimes required for a day or two after an abscess has opened, and are i)articularly indicated when the base of the ab- scess is hard and indurated. As a rule, injections into the cavity of abscesses are not indicatedj though in cases of serous abscesses (if one may be allowed such latitude of terms), as cysts of the elbow, knee, etc., astringent injections — sulphate of zinc, 15 grains to the ounce of water — are required to cause adhesions of the walls of the cavity and i)revent it from refilling. If abscesses are foul and bad-smelling their cavities must be syringed with a weak solution of carbolic acid or other antiseptics.
CoJd abscess is the term applied to those large, indolent swellings that are the result of a low or chronic form of inflammation, in the center of which there is a small collection of i>us. These are mostly met with at the base of the neck and in front of the shoulder joint. The swelling is diffuse and of enormous extent, but slightly hotter than surrounding j)arts, and not very x^ainful ux)on x)ressure. There is a i^ronounced stiffness, rather than pain, evinced upon moving the animal. Such abscesses have the appearance of a hard tumor, sur- rounded b}' a softer oedematous swelling, involving the tissues to the extent of a foot or more in all directions from the tumor. This dif- fused swelling gradually' subsides and leaves the large, hardened mass somewhat well defined. One of the characteristics of cold abscesses is their tendency to remain in the same condition for a great length of time. There is neither heat nor soreness; no increase nor les- sening in the size of the tumor; it remains statu quo. If, however, the animal should be put to work for a short time the irritation of the collar causes the surrounding tissues to again assume an oedematous condition, which, after a few daj's' rest, disapi)ear, leaving the tumor as before or but slightly larger. UiDon careful manipulation we may discover what appears to be a fluid deep seated in the center of the mass. The quantity of matter so contained is very small — often not more than a tablespoonf ul — and for this reason it can not, In all cases, be detected.
Cold abscesses are mostlj^ if not always, caused by the long-con- tinued irritation of a loose and badly fitting collar. There is a slow inflammatory action going on, which results in the formation of a small quantity of matter, inclosed in very thick and but partially organized walls, that are not as well defined as is the circumference of fibrous tumors, which they most resemble.
Treatment. — The means recommended to bring the acute abscess "to a head" are but rarely effectual with this variety; or, if successful,
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too mucli time lias been occupied in tlie cure. AVe uiust look for other and more rapid metliods of treatment. These consist in, first of all, carefully exploring the tumor for the presence of pus. The inci- sions must be made over the softest i)art, and carried deep into the tumor (to its verj^ bottom if necessary), and the matter allowed to escape. After this, and whether we have found matter or not, we must induce an active i7} flammed ion of the tumor in order to j)romote solution of the thick walls of the abscess. This may be done by insert- ing well into the incision a piece of oakum or cotton saturated with turpentine, carbolic acid, tincture of iodine, etc., or we may pack the incision with jiowdered sulphate of zinc and keep the orifice plugged for twenty-four hours. These agents set ux3 a destructive inflamma- tion of the walls. Suj)puration follows, and this should now be en- couraged by hot fomentations and poultices. The orifice must be kei)t open, and should it be disposed to heal we must again introduce some of the agents above described. A favored treatment with many, and it is x)robabl3^ the best, is to plunge a red-hot iron to the bottom of the incision, and thoroughly sear all parts of the walls of the abscess. This is to be repeated after the first slough has taken place, if the walls remain thickened and indurated.
It is useless to waste time with fomentations, j)oultices, or blisters in the treatment of cold abscesses, since, though apjiarently removed by such methods, they almost invariably return again when the horse is put to work. Extiri)ation by the knife is not i)racticable, as the walls of the tumor are not sufiicientlj^ defined. If treated as above directed, and i^roperh- fitted with a good collar after healing, there will not remain any track, trace, or remembrance of the large, unsightly mass.
FISTULtE.
The word fistula is properly applied to sinuous pipes or ducts lead- ing from cavities to the surface of the body, through which a discharge is constantly taking i^lace. Thej' are lined by a false or adventitious membrane, and show no disposition to heal. Fistula) may then exist at any part, but the name has come to be commonly accepted as applicable onh^ to such discharges taking place from the withers, and we shall refer to this location when using the term.
Poll evil is a fistula upon the poll, and in no sense differs from fistu- lous Avithers except as to location. The description of fistula will apply then, in the main, to ijoll evil as well. Fistula) are particularly liable to occur at either of these locations from the disx)ositiou of the muscles and tendinous expansions, which favor the burrowing of pus and its retention. Fistulse follow as a result of abscesses, bruises, wounds, or long continued irritation by the harness. Among the more common causes of fistula of the poll — poll evil — are chafing by the halter or heavy bridle; blows from the butt end of the whip; the
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horse striking his head against the hayrack, heams of the ceiling, low doors, etc. Fistulous withers are seen mostly in those horses that have 'thick necks as well as those that are very high in the withel^s; or among saddle horses, those that are very low on the withers, the saddle here riding forward and bruising the parts. They are often caused by bad-fitting collars or saddles, by direct injuries from blows, and from the horse rolling upon rough or sharp stones. In either of these locations, ulcers of the skin, or simple abscesses, if not prop- erly and punctually treated, may become fistuhe. The pus burrows and finds lodgment deep down between the muscles, and only escapes when the sinus becomes surcharged or during motion of the parts, when the matter is squeezed out.
>%mpto?ns.— These of course will vary according to the progress made by the fistula. Following an injury we may often notice sore- ness or stiffness of the front legs, and upon careful examination of the withers we will see small tortuous lines running from the point of irritation downward and backward over the region of the shoulder. These are superficial lymphatics, and are swollen and painful to the touch In a day or two a swelling is noticed on one or both sides of the dorsal vertebra3, which is hot and painful and rapidly enlarging. The pain may at this time subside somewhat, the stiffness disappear, but the swelling continues and increases in size. It fluctuates upon pressure, and either opens or its contents become inspissated, dry up, leaving a tumor that gradually develops the common characteristics of a fibrous tumor. AVhen the enlargement has opened we should carefully examine its cavity, as on its condition will wholly depend
our treatment.
In the earliest stage, when there is soreness, enlarged lymphatics, but no well-marked swelling, the trouble may be frequently aborted. To do this requires both general and local treatment. A physic should be o-iven and the horse receive 1 ounce of powdered saltpeter three times a day in his water or feed. If the fever runs high, 20-drop doses of tincture of aconite root every two hours may be administered. Locally we will find much relief by pouring cold water from a height upon the inflamed spot for an hour at a time three or four times a day Cooling lotions, muriate of ammonia, or saltpeter and water, sedative washes, as tincture of opium and aconite, chloroform lini- ment, or camphorated oil are also to be frequently applied. I have seen a number of cases presenting these initial symptoms of fistula thus aborted that required no other treatment than the avoidance of the original cause. AVhen, however, the formation of pus is inevita- ble this must be hurried as much as possible. Hot fomentations and poultices are to be constantly used, and as soon as fluctuation can be plainly felt the abscess wall is to be opened at its loivest point. In this procedure lies our hope of a speedy cure. If the parts are so laid open by the knife that the pus must escape as fast as it is formed, and
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where there is left no possibility of its burrowing between the muscles, forming pockets or sinuses, the parts rapidly and permanently heal without any mediation whatever, as though we had been dealing Avith a simple abscess of the withers, and not a true fistula at all.
Attention is again called to the directions given above as to the necessit}'^ of probing the cavity when opened. If upon a careful exam- ination with the probe we find that there are no pockets, no sinuses, but a simple, regular abscess wall, the indication for treatment is to make an opening from below so that the matter must all escape. Rarel}' is anything more needed than to keep the orifice open and to bathe or inject the parts with some simple antiseptic wash that is not irritant or caustic. A low opening and cleanliness constitute the essential and rational treatment. If caustics are inserted, tlie}^ cause sloughing of healthy tissues and favor the formation of sinuses by producing ' sloughs below the point of incision. If the abscess has existed for some time and has not opened, its walls become thickened, the pus granular or inspissated, then, after an opening has been made bj" the knife and the contents washed and squeezed out as thoroughl}^ as possible, the plan of treatment is materially different. There is enormous thickening of the walls, which must be destroj^ed and sloughed out by caustics. The best plan here is to make the first incision in the highest point of the swelling, introduce a piece of caustic potash (fused) 1 to 2 inches in length, carefully plug the opening with oakum or cotton, and secure the horse so that he can not disturb the parts by rubbing or biting them. The skin of the shoulder and entire leg must be thoroughly greased with lard or oil in order to prevent the caustic (should it escai)e) from excoriating the skin over which it flows. Twenty-four hours after the introduction of the caustic the plug is to be removed and hot fomentations applied. As soon as the dis- charge is again established we must make another opening with the knife or seton needle as low as possible, and keep this open with a seton. The object of making the first incision on top is to insure the retention of the caustic until it has a'ttacked the entire inner sur- face of the cavity. If this is done the caustic causes sloughing of every portion of the diseased parts, leaving a health}' granulating surface underneath, which only requires that the depending orifice be kept open and the cavity washed out with a weak antiseptic solution once or twice a week to effect a cure. In manj^ cases of fistula there is more than one sinus or pipe that must be explored, laid open with the knife if possible, or opened through its bottom by means of a sharp seton needle, passing a tape through the openings, and retaining it in this position for some time. If the pipes are directed straight downward between the shoulder blade and the spine it is difficult or impossible to make a counter oijening, and the case become serious or intract- able. Caustic solutions must now be injected carefull}' into the sinuses with the hope of reaching every diseased part. Probably the best is
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graniilar cliloride of zinc, 1 ounce to a half pint of water. This should be injected three times during one week, after which a weak solution of the same, or sulphate of zinc, is to be occasionally injected. Pres- sure must be applied /roni helow, and endeavors made in this manner to heal the different pipes /ro?7i the bottom. Should the bones of the withers or the shoulder blade be diseased the complication is again serious, and these must be scraped or portions of them removed, requiring the aid of the veterinary surgeon.
In those cases of fistula where the tumor is large and hard, yet not sufficiently defined to admit of extirpation with the knife, Ave may often effect a cure by making a shallow incision under the skin, over the center of the tumor, and inserting from 20 to 30 grains of arse- nious acid— powdered arsenic— wrapped in a single layer of tissue paper, and retaining in the same manner as before directed for the caustic potassa. No further treatment is necessary for some time. In about ten days or two weeks there will have taken place a large, deep slough, leaving a very ugly looking granulating wound, which, however, gradually contracts during the healing process and results in the entire disappearance of the tumor.
It is to be inferred from the foregoing that, even though fully estab- lished, fistula? of the withers or poll are, in the majority of cases, cur- able. They often require much time and patient attention. The sinuses must be opened at their inferior extremity and kept open. At first caustic injections or applications must be thoroughly applied once or twice, after which mild astringent antiseptic washes and cleanliness complete the cure. In those cases where the sinuses or pipes are so directed that counter openings can not be made, wliere there are diseased conditions of the bones, articulations, etc., that can not l)e reached, the horse had often best be destroyed at once.
It is not at all unusual for fistula? to break out again after having healed. This should not discourage us of a complete cure, as there is mostly only some small particle of diseased tissue remaining, caught, probably, in the healing of ttie orifice. A small abscess forms, points, and open's. This abscess should be injected with a solution of sul- phate of zinc, 20 grains to the ounce of water, every second or third day until entirely healed.
Fistula? of the foot— quittor— should 1)0 ti-eated on the same prin- ciple as those already described.
AVhen fistulous tracts are found at unusual points we must care- fully examine the character and time of the discharges, and diligently probe the sinus to ascertain if the duct of some gland lias not been opened, or if some foreign body, as a splinter of wood, etc., is not retained in the wound. In the first case— fistula of a gland duct— a competent veterinarian must be called. In the second instance the foreign body is to be carefully cut down upon and removed, after which healing progresses rapidly and satisfactorily.
GENERAL DISEASES.
BY RUSH SHIPPEN HUIDEKOPER, M. D., Vet. Editor Journal of Comparative Medicine and Veterinary Archives, Philadelphia.
INFLAMMATION.
Synonyms : Inflam medio, Latin, from Inflammare, to flame, to burn ; Phlegmasia 6\eyjj.affia, Greek; Inflammation, French; Inflamma- zione, Italian; Inflaviacion, Spanish; Entzundung, German.
Definition. — Inflammation is a process of excessive nutrition — hypernutrition— of a living tissue, by wliicli the latter may be altered in its functions while retaining for an indefinite time a morbid life; may be destroyed, as in abscesses, ulcers, necrosis, etc. ; or may be transformed into a new tissue, as in the healing of a previousl^^ injured i)art, the normal tissue in this case being replaced by a scar (cicatricial tissue), or by masses of calcareous deposits (lime salts).
ANIMAL TISSUES.
The non-professional reader may regard tlie animal tissues, which are subject to inflammation, as excessively simple structures, as sim- ilar, simple, and fixed in their organization as the joists and boards which frame a liouse, the bricks and iron coils of pipe whicli build a furnace, or the stones and mortar which make the support of a great railroad bridge. Yet while the principles of structure are thus simple, for the general understanding by the student who begins their study the complete appreciation of the shades of variation, which differentiate one tissue from another, which define a sound ten- don or ligament from a fibrous band, the result of disease filling in an old lesion and tying one organ with another, is as complicated as the nicest jointing of Chinese woodwork, the building of a furnace for the most difficult chemical analj^sis, or tlie construction of a bridge which will stand for ages and resist vtuj force or weight.
All tissues are composed of certain fundamental and similar ele- ments which are governed by the same rules of life, though they may
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appear at first glance to be widely different. These are: (a) amor- phous substances; (b) fibers; (c) cells.
(a) Amorphous substances may be in liquid form, as in the fluid of the blood, which holds a vast amount of salts and nutritive matter in solution, or they may be in a semi-liquid condition, as the plasma which infiltrates the loose meshes of connective tissue and lubricates the surface of some membranes, or they may be in the form of a glue or cement, fastening one structure to another, as a tendon or muscle end to a bone, or again they hold similar elements firmly together as in bone, where they form a stiff matrix which becomes impregnated with lime salts. Amorphous substances again form the protoplasm or nutritive element of cells or the elements of life.
(&) Fibers are formed of elements of organic matter which have only a passive function. They can be assiuiilated to little strings or cords tangled one with another like a mass of waste yarn, woven regu- larly like a cloth or bound together like a rope. They are of two kinds, white connective tissue fibers, only slightly extensible, pliable, and very strong, and yellow elastic fibers, elastic, curly, ramified, and very dense. These fibers once created require the constant presence of fluids around them in order to retain their functional condition, as a piece of harness leather demands continual oiling to keep its strength, but they undergo no change or alteration in their form until destroyed by death.
(c) Cells, which may even be regarded as low forms of life, are masses of protoplasm or amorphous living matter with a nucleus and frequently a nucleolus or living germs, which are capable of assimi- lating nutriment or food, propagating themselves either into others of the same form or into fixed cells of another outward appearance and different function, but of the same constitution. It is simply in the mode of grouping of these elements that we have the variation in tis- sues, as: (1) loose connective tissue ; (2) aponeurosis and tendons; (3) muscles; (4) cartilage; (5) bones; (6) epithelia and endothelia; (7)
nerves. «. i v
(1) Loose connective tissue forms the great framework or scaffolding of the body, and is found under the skin, between the muscles sur- rounding the bones and blood vessels, and entering into the structures of almost all of the organs. In this the fibers are loosely meshed together like a sponge, leaving spaces in which the nutrient fiuid and cells are irregularly distributed. This tissue we find in the skm, m the spaces between the organs of the body where fat accumulates, and as the framework of all glands.
(2) AiJoneuTOsis and tendons are structures which serve for the ter- mination of muscles and for their contention and for the attachment of bones together. In these the fibers are more frequent and dense and are arranged with regularity, either crossing each other or lying parallel, and here the cells are found in minimum quantity.
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(3) Jfiisdes.— In these the cells lie end to eud, forming long fibers which have the power of contraction, and the connective tissue is in small quantity, serving the passive purpose of a band around the contractile elements.
(4) In cartilacje a mass of firm amorphous substance, with no vas- cularity and little vitality, forms the bed for the chondroplasts or cells of this tissue.
(5) Bone differs from the above in having the amorphous matter impregnated with lime salts, which gives it its rigidity and firmness.
(6) Epithelia and endotheUa, or the membranes which cover the body and line all of its cavities and glands, are made up of single or stratified and multiple layers of cells bound together by a glue^'of amorphous substance, and resting on a layer composed of m^ore or less fibers. AVlien the membrane serves for secreting or excreting purposes, as in the salivary glands or the kidneys, it is usually sin> pie when it serves the mechanical purpose of protecting a part, as over the tongue or skin it is invariably multiple and stratified, the surface wearing away while new cells replace it from beneath.
(7) In nerves, stellate cells are connected by their rays to each other, or to fibers which conduct the nerve impressions, or they act as receptacles and storehouses for them, just as the switch board of a telephone system serves to connect the various Avires.
All of these tissues are supplied with blood in greater or less ouan- tity. The vascularity depends upon the function which the tissue is called upon to perform. If this is great, as in the tongue, the luno-s or the sensitive part of the foot, a large amount of blood is require'd' if the labor is a passive one, as in cartilage, the membrane over the withers, or the tendons of the legs, the vessels only reach the periph- ery, and nutrition is furnished by imbibition of the fluids brought to their surface by the blood vessels.
Blood is brought to the tissues by arterioles, or the small termina- tions of the arteries, and is carried off from them by the veinlets or the commencement of the veins. Between these two systems are small delicate networks of vessels called capillaries, which subdivide into a veritable lace-work so as to reach the neighborhood of everv element. ^
In health the blood passes through these capillaries with a reo-ular current, the red cells or corpuscles floating rapidly in the fluid in the center of the channel, while the white or amoeboid cells are attracted to the walls of the vessels and move very slowly. The supplv of blood IS regulated by the condition of repose or activity of the tfssue and under normal conditions the outflow compensates exactly the supply The caliber of the blood vessels, and consequently the amount of blood which they carry, is governed by nerves of the sympathetic system m a healthy body with unerring regularity, but in a diseased organ the flow may cease or be greatly augmented. In health a tissue
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or organ receives its proper quantity of blood; tlie nutritive elements are extracted for the support of the tissue and for the product, which the function of the organ forms. The force required in the achieve- ment of this is furnished by combustion of the hydro-earbons and oxygen brought by the arterial blood, then by the veins this same fluid passes off, less its oxygen, loaded with the waste products, which are the result of the worn out and disintegrated tissues, and of those which have undergone combustion. The above brief outline indicates the I)rocess of nutrition of the tissues.
Hyper-nutrition or excessive nutrition of a tissue maybe normal or morbid. If the latter the tissue becomes congested or inflamed.
CONGESTION.
Congestion is an unnatural accumulation of blood in a part. Excess- ive accumulation of blood may be normal, as in blushing or in the red face which temporarily foUovv^s a violent muscular effort, or, as in the stomach or liver during digestion, or in the lungs after severe work, from which, in the latter case, it is shortly relieved by a little rapid breathing. The term congestion, however, usually indicates a morbid condition, with more or less lasting effects. Congestion is acUve or X>assive. The former is produced by an increased supply of blood to the part, the latter by an obstacle preventing the escape of blood from the tissue. In either case there is an increased supply of blood, and as a result increased combustion and augmented nutrition.
Active congestion is caused by:
(1) Functional activity.— Any organ which is constantly or exces- sively used is habituated to hold an unusual quantity of blood; the vessels become dilated; if overstrained the walls become weakened, lose their elasticity, and any sudden additional amount of blood engorges the tissues so that they can not contract and congestion results. Example: The lungs of a race horse, after an unusual burst of speed or severe work, in damp weather.
(2) Irritants.— Heat, cold, chemical or mechanical. Any of these, by threatening the vitality of a tissue, induce immediately an aug- mented flow of blood to the part to furnish the means of repair— a hot iron, frostbites, acids, or a blow.
(3) Nerve influence.— This may produce congestion either by acting on the partreflexly, or as the result of some central nerve disturbance affecting the branch which supplies a given organ.
(4) Plethora and sanguinary temperament.— 'F\\\\-h\oo(iQ(i animals are much more predisposed to congestive diseases than those of a lymphatic character, or those in an ansemic condition. The circula- tion in them is forced to all parts with much greater force and in larger quantities. A well-bred, full-blooded horse is much more subject to congestive diseases than a common, coarse, or old worn-out animal.
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(5) Fevers. — In fever the heart works more actively and forces the current of blood more rapidly; the tissues are weakened, and it requires but a slight local cause at any part to congest the structures alreadj^ overloaded with blood. Again, in certain fevers, we find alteration of the blood itself, rendering it less or more fluid, which interferes with its free passage through the vessels and induces a local predisposition to congestion.
(G) Warm climate and summer heat. — Warmth of the atmosphere relaxes the tissues; it demands of the animals less blood to keep up their own body temperature, and the extra quantity accumulates in the blood-vessel system. It causes sluggishness in the performance of the organic functions, and in this way it induces congestion, especially of tlie internal organs. So we find founders, congestive colics, and staggers more frequent in summer than in winter.
(7) Previous congestion. — Whether the previous congestion of any organ has been a continuous normal one, that is, a repeated functional activity, or has been a morbid temporary overloading, it always leaves the walls of the vessels weakened and more predisposed to recurrent attacks from accidental causes than i)erfectly healthy tissues are. Thus a horse Avhich has had a congestion of the lungs from a severe drive is apt to have another attack from even a lesser cause.
The alterations of congestion are distention of the blood vessels, accumulation of the cellular elements of the blood in them, and effu- sion of a portion of the liquid of the blood into the fibrous tissues which surround the vessels. Where the changes produced by conges- tion are visible, as in the eye, the nostril, the mouth, the genital organs, and on the surface of the body in white or unpigmented ani- mals, the part appears red from the increase of blood; it becomes swollen from the effusion of liquid into the sponge-like connective tis- sues; it is at times more or less hot from the increased combustion; the part is frequently painful to the animal from pressure of the effusion on the nerves, and the function of the tissue is interfered with. The secretion or excretion of glands may be augmented or diminished. Muscles may be affected with spasms or may be unable to contract. The eyes and ears may be affected Avith imaginary sights and sounds.
PASSIVE COXGESTION.
Passive congestion is caused by interference with the return of the current of blood from a part.
Old age and del) Hit y weaken the tissues and the force of the circula- tion, especially in the veins, and retard the movement of the blood. We then see horses of this class with stocked legs, swelling of the sheath of the penis or of the milk glands, and of the under surface of the belly. We find them also Avith effusions of the liquid parts of the blood into the lymph spaces of the posterior extremities and organs of the pelvic cavity.
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Tumors or other mechanical obstruction, by pressing on the veins, retard the flow of blood and cause it to back up in distal parts of the body, causing passive congestion.
The alterations of passive congestion, as in active congestion, consist of an increased quantity of blood in the vessels and an exudation of its fluid into the tissues surrounding them, but in passive congestion we have a dark thick blood which has lost it oxygen, instead of the rich combustible blood rich in oxygen which is found in active con- gestion.
The termination of congestion is by resolution or inflammation. In the first case, the choked-up blood vessels find an outlet for the exces- sive amount of blood and are relieved; the transuded serum or fluid of the blood is reabsorbed, and the part returns almost to its normal condition, with, however, a tendency to weakness predisposing to future trouble of the same kind. In the other case further alterations take place, and we have inflammation.
INFLAMMATION.
Inflmnniatimi is a hypernutrition of a tissue. It is described by Dr. Agnew, the surgeon, as "a double-edged sword, cutting either way for good or for evil." The increased nutrition may be moderate and cause a growth of new tissue, a simple increase of quantity at first; or it may produce a new growth differing in quality, as a cancer; or it may be so great that, like luxuriant, overgrown weeds, the ele- ments die from their very haste of growth, and we have immediate destruction of the part. According to the rapidity and intensity of the process of structural changes which take place in an inflamed tis- sue, inflammation is described as acute or chronic, with a vast number of intermediate forms. When the phenomena are marked it is termed sthenic; when less distinct, as the result of a broken down and feeble constitution in the animal, it is called asthenic. Certain inflamma- tions are specific, as in strangles, the horsepox, glanders, etc., where a characteristic or specific cause or condition is added to the origin, char- acter of phenomena, or alterations which result from an ordinary inflammation. An inflammation may be circumscribed or limited, as in the abscess on the neck caused by the pressure of a collar, in pneu- monias, in glanders, in the small tumors of a splint or a jack; or it may be diffuse, as in severe fistulas of the withers, in an extensive lung fever, in the legs in a case of grease, or in the spavins which affect horses with poorly nourished bones. The causes of inflamma- tion are practically the same as those of congestion, which is the initial step of all inflammation.
Tlie temperament of a horse predisposes the animal to inflammation of certain organs. A full-blooded animal, whose veins show on the surface of the body, and which has a strong, bounding heart pumping large quantities of blood into the vascular organs like the lungs, the
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intestines, and the laminae of the feet, is more apt to have pneumonia congestive colics, and founder, while lymphatic, cold-blooded animals have pleurisies, inflammation of the bones, spavins, ring bones, etc., inflammation of the glands of the less vascular skin of the extremities,' greasy heels, thrush, etc.
Young horses have inflammation of the membranes lining the air passages and digestive tract, while older animals are more subject to troubles in the closed serous sacks and in the bones.
The work to which a horse is put (saddle or harness, speed or draft) will influence the predisposition of an animal to inflammatory diseases. Like in congestion, the functional activity of a part is an important factor in localizing this fonn of disease. Given a group of horses exposed to the same draft of cold air or other exciting cause of inflammation, the one which has just been eating will be attacked with an inflammation of the bowels; the one that has just been work- ing so as to increase its respiration will have an inflammation of the throat, bronchi, or lungs; the one that has just been using its feet excessively will have a founder or inflammation of the laminae of the feet.
The direct cause of inflammation is usually an irritant of some form. This may be mechanical or chemical, external or internal. Cuts, bruises, injuries of any kind, parasites, acids, blisters, heat, cold, secretions, as an excess of tears over the cheek or urine on the legs, all cause inflammation by direct injury to the part. Strains or wrenches of joints, ligaments, and tendons cause trouble by lacera- tion of the tissue.
Inflammations of the internal organs are caused by irritants as above, and by sudden cooling of the surface of the animal, which drives the blood to that organ which at the moment is most actively supplied with blood. This is called repercussion. A horse which has been worked at speed and is breathing rapidly if suddenly chilled is liable to have pneumonia, while an animal which has just been fed if exposed to the same influence is more apt to have a congestive colic, the blood in this case being driven from the exterior to the intes- tines, while in the former it was driven to the lungs.
Symptoms.— The symptoms of inflammation are, as in congestion, change of color, due to an increased supply of blood ; su-elliny, from the same cause, with the addition of an effusion into the surrounding tis- sues; heat, owing to the increased combustion in the part; j^in"^ due to pressure on the nerves and altered function. This latter may be augmented or diminished, or first one and then the other. In addition to the local symptoms, inflammation always produces more or less constitutional disturbance or fever. A splint or small spavin will cause so little fever that it is not appreciable, while a severe spavin, an inflamed joint, or a pneumonia may give rise to a marked fever. 5061 — HOR 10
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Tlie altercdwns in an inflamed tissue are first those of congestion, distension of tlie blood vessels, and exudation of the fluid of the blood into the surrounding fibers, with, however, a iuore complete stagna- tion of the blood; fibrin or lymph, a glue-like substance, is thrown out as well, and the cells, which we have seen to be living organ- isms in themselves, no longer carried in the current of the blood, migrate from the vessels and finding proper nutriment proliferate or multiply with greater or less rapidity. The cells which lie dormant in tlie meshes of the surrounding fibers are awakened into activity by the nutritious lymph Avhich surrounds them and they also multiply. Whether the cell in an inflamed part is the white amoeboid cell of the blood or the fixed connective tissue cell embedded in the fibei-s, it multiplies in the same way. The germ in the center (nucleus) is divided into two, and then each again into two ad infinitum. If the process is slow, each new cell may assimilate nourishment and become, like its ancestor, an aid in the formation of new tissues; if, however, the changing takes place rapidly the brood of young cells have not time to grow or use up the surrounding nourishment, and but half- developed they die, and we then have destruction of tissue, and pus or matter is formed, a material made up of the imperfect dead ele- ments and the broken down tissue. Between the two there is an inter- mediate form, where we have imperfectly formed tissues, as in " proud flesh," cancer, large and soft splints, fungus growths, greasy heels, and thrush.
Whether the inflamed tissue is one like the skin, lungs, or intes- tines, very loose in their texture, or a tendon or bone, dense in struc- ture, and comparatively poor in blood-vessels, the principle of the process is the same. The effects, however, and the appearance may be widely different. After a cut on the face or an exudation into the lungs, the loose tissues and multiple vessels allow the proliferating cells to obtain rich nourishment; absorption- can take plaee readily, and the part regains its normal condition entirely, while a bruise at the heel or at the withers finds a dense, inextensible tissue where the multiplying elements and exuded fluids choke up aU communication, and the*^ parts die (ulcerate) from want of blood and cause a serious quittor or fistula.
This effect of structure of a part on the same process shows the importance of a i^erfect knowledge in the study of a local trouble, and the indispensable part Avhich such knowledge plays in judging of the gravity of an inflammatory disease, and in formulating- a prognosis or opmion of the final termination of it. It is this which allows the veterinarian, through his knowledge of the intimate structure of a part and the relations of its elements, to judge of the severity of a disease, and to prescribe different modes of treatment in two animals for troubles which appear to the less experienced observer to be abso- lutely identical.
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Termination of inflammation.— L\\^e congestion, inflammation may terminate by resolution. In this case the exuded lym^ih undergoes chemical alteration by oxidization, and the products are absorbed and carried off by the blood vessels and lymphatics, to be thro^vn out of the body by the liver, the glands of the skin, and the other excre- tory organs. The eellB, which have wandered into the neighboring tissues from the blood vessels, find their way back again or become transformed into fixed cells. Those which are the result of the tissue cells, wakened into active life, follow the same course. The vessels tliemselves contract, and liaving resumed their normal caliber, the pai't apparently reassumes its normal condition; but it is always weakened, and a new inflammation is more liable to reapi^ear in a previously inflamed part than in a sound one. The alternate termi- nation is mortification. If the mortification, or death of a part, is by molecules, each losing its vitality after the other in more or less rapid succession, it takes the name of ulceration. If it occurs in a consid- erable part at once, it is called gangrene. If this death of the tissues occurs deep in the organism, and the destroj-ed elements and prolifer- ated and dead cells are enclosed in a cavity, the result of the process is called an abscess. When it occurs on a surface, it is an utcer, and an abscess by breaking on the exterior becomes then also an ulcer. Proliferating and dying cells, and the fluid which exudes from an ulcerating surface, and the debris of broken down tissue, is known as pus, and the process by which this is formed is known as suppuration. A mass of dead tissue in a soft part is termed a slough, while the same in bone is called a sequestrum.
Treatment of inflammaiion.—The study of the cause and patholog- ical alterations of inflammation has shown the process to be one of hypernutrition, attended by excessive l)lood supplv, so this study will indicate the primary factor to be employed in the treatment of it Any agent which will reduce the blood supply and prevent the exces- sive nutrition of the elements of the part will serve as a remedy The means employed may l>e used locaUy to the part,*or thev may be constitutional remedies, which act indirectly. Local treatment consists of:
{a) Rertvoval of the cause, as a stone in the frog, causing a traumatic thrush; a badly fitting harness or saddle, causing ulcers of the skin- decomposing manui-e and urine in a stable, which, by their vapors,' irritate the air tubes and lungs and cause a cough. These causes if removed, will frequently allow the part to heal at once.
{h) i?e6/.— Motion stimulates the action of the blood, and thus feeds an inflamed tissue. This is alike applicable to a diseased point irri- tated by movement, to an inflamed pair of lungs surcharged with blood by the use demanded of them in a working animal, or to an inflamed eye exposed to light, or an inflamed stomach and intestines stiUfurther fatigued by food. Absolute quiet, a dark stable, and small
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quantities of easily digested food will often cure serious inflammatory troubles without further treatment.
(r) Cold.— The application of ice bags or cold water by bandages, douching with a hose, or irrigation with dripping water, contracts the blood vessels, acts as a sedative to the nerves and lessens the vitality of a part; it consequently prevents the tissue change which inflammation produces.
{(]) Heat. — Either dry or moist heat acts as a derivative. It quickens the circulation and renders the chemical changes more active in the surrounding parts; it softens the tissues and attracts the current of blood from the inflamed organ; it also promotes the absorption of the effusion and hastens the elimination of the waste products in the part. Heat maybe applied by hand rubbing or active friction and the appli- cation of warm coverings (bandages), or by cloths wrung out of warm water, or steaming with warm moist vapor, medicated or not, Avill answer the same purpose. The latter is especially applicable to inflammatory troubles in the air passages.
(t) Local hleedmg. — This treatment frequently affords immedicite relief by carrying off the excessive blood and draining the effusion which has already occurred. It affords direct mechanical relief, and, by a stimulation of the part, promotes the chemical changes necessary for bringing the diseased tissues to a healthy condition. Local blood- letting can be done by scarifying, or making small punctures into the inflamed part, as in the eyelid of an inflamed eye, or into the sheath of the penis, or into the skin of the latter organ when congested, or the leg when acutely swelled. This treatment, however, is frequently very advantageous in the toe of the foot in acute founder; leeches, cups, etc., are rarely applicable in veterinary practice.
Counter irritants are used for deep inflammations. They act by bringing the blood to the surface and consequently lessening the blood pressure within. The derivation of the blood to the exterior dimin- ishes the amount in the internal organs and is often almost mirac- ulous in its action in relieving a congested lung or liver. The most common counter irritant is mustard flour. It is applied as a soft paste mixed with warm water to the under surface of the belly and to the sides where the skin is comparatively soft and vascular. Colds in the throat or inflammations at any point demand the treatment applied in the same manner to the belly and sides and not to the throat or on the legs, as so often used. Blisters, iodine, and many other irritants are used in the same way.
Constitutional treatment in inflammation is designed to reduce the current of blood, which is the fuel for the inflammation in the dis- eased part, to quiet the patient and to combat the fever or general effects of the trouble in the system. It consists of :
Reduction of bZoocZ.— This is obtained in various ways. The diminu- tion of the quantity of blood lessens the amount of pressure on the
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vessels, and, as a sequel, the volume of it which is carried to the point of inflammation; it diminishes the body temperature or fever; it numbs the nervous system, which plays an important part as a con- ductor of irritation in diseases.
Blood-letting is the most rapid means, and frequently acts like a charm in relieving a commencing inflammatory trouble. The class of horses and cattle in which this mode of treatment is indicated usually tolerates the loss of a considerable quanity of blood without inconven- ience and recuperates from the loss rapidly.
Ccdliartics act by drawing off a large quantity of fluid from the blood through the intestines, and have the advantage over the last remedy • of removing only the watery and not the formed elements from the cir- culation. The blood cells remain, leaving the blood as rich as it was before. Again, the glands of the intestines are stimulated to excrete much waste matter and other deleterious material which may be acting as a poison in the blood.
Diuretics operate through the kidneys in the same way.
Diaphoretics aid depletion of the blood by pouring water in the form of sweat from the surface of the skin and stimulating the discharge of waste material out of its glands, which has the same effect on the blood pressure.
Depressants are drugs which act on the heart. They slow or weaken the action of this organ and reduce the quantity and force of the cur- rent of the blood which is carried to the point of local disease; they lessen the natality of the animal; so they act in two ways: first, as in the previous classes, by reduction of the force of the blood; and, sec- ondly, as in the next class, by putting to rest the animal system' _ Anodynes quiet the nervous system. Pain in the horse, as in man IS one of the important factors in the production of fever, and the dulling of the former often prevents, or at least reduces, the latter They produce sleep, so as to rest the patient and allow recuperation for the succeeding struggle of the vitality of the animal against the exhausting drain of the disease.
The diet of an animal suffering from acute inflammation is a factor of the greatest importance. An overloaded circulation can be starved to a reduced quantity and to a less rich quality of blood by reducino- the quantity of food given to the patient. Matters of easy digestion do not tire the already fatigued organs of an animal with a torpid digestive system. Nourishment will be taken by a suffering brute in the form of slops and cooling drinks where it would be totally refused If offered in its ordinary form, as hard oats or dry hay, requiring the labor of grinding between the teeth and swallowing by the weakened muscles of the jaws and throat.
Tonics and stimulants are remedies which enter rather into the after treatment of inflammatory trouble than into the acute stages of them, rhey brace up weakened and torpid glands ; they stimulate the
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secretion of the necessary fluids of tlie body, and hasten the excretion of the waste material produced bj^the inflammatory process; they reg- ulate the action of a weakened heart; they promote healthy vitality of diseased parts, arid aid the chemical changes needed for returning the altered tissues to their normal condition.
FEVER.
Synonyms: Fehris, -Latin; Fyrexia, Greek; Flevre,¥veneh; Fieher, German; Fehbre, Italian; Calentura, Spanish.
The etymology of the word fever from the Latin /ere re, to boil or to burn, and otpyre-xia, from the Greek word -S«, fire, defines in a gen- eral way the meaning of the term.
Fever is a general condition of the animal body in which there is an elevation of the animal body temperature, which may be only a degree or two or may be 10° Fahrenheit. The elevation of the body temperature, which represents tissue change or combustion, is accom- panied bv an acceleration of the heart's action, a quickening of the respiration, and an aberration in the functional activity of the various organs of the body. These organs may be stimulated to the perform- ance of excessive work, or they may be incapacitated from carrying out their allotted tasks, or in the course of a fever the two conditions may both exist, the one succeeding the other. To fever as a disease is usually added chills as an essential symptom.
Fevers are divided into essential fevers and symptomatic fevers. In symptomatic fever some local disease, usually of an inflammatory character, develops first, and the constitutional febrile phenomena are the result of the primary point of combustion, irritating the whole body, either through the nervous system or directly by means of the waste material which is carried into the circulation and through the blood- vessels, and is distributed to distal parts. Essential fevers are those in which there is from the outset a general disturbance of the whole economy. This may consist of an elementary alteration in the blood, or a general change in the constitution of the tissues.
Essential fevers are subdivided into ephemeral fevers, which last but a short time and terminate by critical phenomena; intermittent fevers, in which there are alternations of exacerbations of the febrile symptoms and remissions, in which the body returns to its normal condition or sometimes to a depressed condition, in which the func- tions of life are but badly performed; and continued fevers, which include the contagious diseases, as glanders, influenza, etc., the sep- tic diseases, as pyaemia, sopticsemia, etc., and the eruptive fevers, as
variola, etc.
Whether the cause of the fever has been an injury to the tissues, as a severe bruise, a broken bone, an inflamed lung, or excessive work Avhich has surcharged the blood with the waste products of the com- bustion of the tissues, which were destroyed to produce force; or the
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pulliilation of the ferments of influenza in the blood whieli destroy the red blood corpuscles; or the presence of irritating material, either in the form of living organisms or of their products, as in glanders or tuberculosis, the general train of symptoms are the same, only vary- ing as the amount of the irritant differs in quantity, or when some special quality in them has a specific action on one or another tissue. There is in fever at first a relaxation of the small blood vessels, which may have been preceded by a contraction of the same if there was a chill, and as a consequence there is an acceleration of the cur- rent of the blood. There is then an elevation of the peripheral tem- perature, foUowed by a lowering of tension in the arteries and an acceleration in the movement of the heart. These conditions may be produced by a primary irritation of the nerve centers, or the brain from the effects of heat, as is seen in thermic fever or sunstroke, in which trouble the extremes of symptoius may sometimes be seen alter- nating with a very short period, to be counted scarcely by hours.
There are times when it is difficult to distinguish between the exist- ence of fever as a disease and a temporary feverish condition which is the result of excessive work. Like the condition of congestion of the lungs, Avhich is normal up to a certain degree in the lungs of a race horse after a severe race, and morbid when it produces inore than temporary phenomena or when it causes distinct lesions, fever, or as It IS better termed a feverish condition, may follow any work or other employment of enei-gy in which excessive tissue change has taken place, but if the consequences are ephemeral, and no recognizable lesion is apparent, it is not considered morbid. This condition, how- ever, may predispose to severe organic disturbance and local inflam- mations which will cause disease, as an animal in this condition is liable to take cold, develop a lung fever or a severe enteritis, if chilled or otherwise exx^osed.
Fever in all animals is characterized by the same general phenom- ena, but we find the intensity of the symptoms modified bv the species of animals affected, by the races which subdivide tlie species, by the families which form groups of the races, and by certain conditions in individuals themselves. For example, a pricked foot in a thorough- bred may cause intense fever, while the same injury in the foot of a Clydesdale may scarcely cause a visible general svmptom. In tlie horse, fever produces the following symptoms :
The normal body temperatu];e, which varies from 98° to 100° F the latter being usually the result of some temporary cause, is elevated from 1 to 9 degrees. At emperature of 102° or 103° F. is moderate 104° to 105° F. is high, and 10G° F. ^nd over is excessive.
This elevation of temperature can readily be felt bv tlie hand placed m the mouth of tlie animal, or in the rectum, and in the folds between the hind legs; it is usually appreciable at any point over the surface ot the body and in the expired air emitted from the nostrils. The ears
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and cannons are often as hot as tlie rest of the body, but are some- times cokl, which denotes a debility in the circuhition. The pulse, which in a healthy horse is felt beating about 42 to 48 times in the minute, is increased to 60, 70, 90, or even 100. The respirations are increased from 14 or IG to 24, 30, 36, or even more. With the com- mencement of a fever the horse usually has its appetite diminished, or it may have total loss of appetite, if the fever is excessive. There is, however, a vast difference among horses in this regard. With the same amount of elevation of temperature one horse may lose its aj^pe- tite entirely, while others, usually of the more common sort, will eat at hay throughout the course of the fever and will even continue to eat oats or other grains. Thirst is usually increased, but the animal desires only a small quantity of w^ater at a time, and in most cases of fever a bucket of water with the chill taken off should be kept stand- ing before the patient, who maj^ be allowed it ad libitum. The skin becomes dry and the hairs stand on end. Sweating is almost unknown in the early stage of fevers, but f requentl}' occurs later in their course, when an outbreak of warm sweat is often a most favorable symj)tom. The mucous membranes, which are most easily examined in the con- junctiva of the eyes and inside of the mouth, change color if the fever is an acute one ; without alteration of blood the mucous membranes become of a rosy or deep red color at the outset; if the fever is attended with distinct alteration of the blood, as in influenza, and at the end of two or three days in severe cases of pneumonia or other extensive inflammatory troubles, the mucous membranes are tinged with yellow, which may even become a deep ochre in color, the result of the decomposition of the blood corpuscles and the freeing of their coloring matter, which acts as a stain. At the outset of a fever the various glands are checked in their secretions, the salivary glands fail to secrete the saliva, and we find the surface of the tongue and inside of the cheeks dry and covered with a brownish, bad-smelling deposit. The excretion from the liver and intestinal glands is dimin- ished and produces an inactivity of the digestive organs which causes a constipation. If this is not remedied at an early period the undi- gested material acts as an irritant, and later we maj' have it followed by an inflammatory process, producing a severe diarrhea.
The excretion from the kidneys is sometimes at first entirely sup- pressed. It is always considerably diminished, and what urine is passed is dark in color, undergoes ajnmoniacal change rapidly, and deposits quantities of salts. At a later period the diminished excre- tion may be replaced by an excessive excretion, which aids in carry- ing off waste products and usually indicates an amelioration of the fever.
While the ears, cannons, and hoofs of a horse suffering from fever are usually found hot, they may frequently alternate from hot to cold in their temperature, or be much cooler than they normally are. This
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latter condition usuall}' indicates great weakness on the part of the circulatory sj'stem. It is of the greatest importance as an aid in diagnosing the gravity of an attack of fever and as an indication in the selection of its mode of treatment, to recognize the exact cause of a febrile condition in the horse. In certain cases, in very ner^'ous animals in which fever is the result of nerve influence, a simple ano- djnie, or even only quiet with continued care and nursing, will some- times be sufficient to diminish it. When fever is the result of local injury the cure of the cause produces a cessation in the constitutional symptoms; when fever is the result of a pneumonia or other severe parenchymatous inflammation, it usually lasts for a definite time, and subsides Avith the first improvement of the local trouble, but in these cases Ave constantly have exaccerbations of fever due to secondary infiammatory processes, such as the formation of small abscesses, the development of secondary bronchitis, or the death of a limited amount of tissue (gangrene).
In specific cases, such as influenza, strangles, and septicaemia, there is a definite poison contained in the blood-vessel system, and carried to the heart and to the nervous system, which produces a peculiar irritation, usually lasting for a specific period, during which the temperature can be but slightly diminished by any remedy. . In cases attended with complications, the diagnosis becomes at times still more difficult, as' at the end of a case of influenza which becomes complicated AAith pneumonia. The high temperature of the simple inflammatory disease may be grafted on that of the specific trouble, and the line of causation of the fever between the two, frequently a narrow is yet an important one, as upon it depends the mode of treatment.
Any animal suffering from fever, from any cause, is much more sus- ceptible to attacks of local inflammation, which become complications of the original disease, than are animals in sound health. In fever we have the tissues and the walls of the blood vessels weakened, we have an increased current of more or less altered blood, flowing through the vessels and stagnating in the capillaries, which need but an excit- ing cause to transform the passive congestion of fever into an active congestion and acute inflammation. These conditions become still more distinct when the fever is accompanied by a decided deteriora- tion in the blood itself, as is seen in influenza, septicaemia, and at the termination of severe pneumonias.
Fever, with its symptoms of increased temperature, acceleratioh of ' the pulse, acceleration of respiraticm, dry skin, diminished secretions, etc. , must be considered as a symptom of organic disturbance.
This organic disturbance may be the result of local inflammation or other irritants acting through the nerves on nerve centers; altercdions of the blood, in which a poison is carried to the nerve centers, or direct 5961— HOR- 10*
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irritants to the nerve centers themselves, as in cases of heat stroke, injur}- to the brain, etc.
The treatment of fever depends upon its cause. As nerve irrita- tion enters into the etiology of fever in all cases, one of the important factors in treatment is absolute quiet. This maj' be obtained by placing a sick horse in a box stall, awaj' from other animals and extraneous noises, and sheltered from excessive light and draughts of air. Anodjmes, belladonna, hyoscyamus, and opium, act as anti- I)yretics simply by quieting the nervous system. As an irritant exists in the blood in most cases of fever, any remedj' which will favor the excretion of foreign elements from it will diminish this cause. We therefore employ diaphoretics to stimulate the sweat and. excretions from the skin; diuretics to favor the elimination of matter by the kidneys ; cholagogues and laxatives to increase the action of the liver and intestines, and to drain from these important organs all the waste material which is aiding to choke up and congest their rich plexuses of blood vessels. As the heart becomes stimulated to increased action at the outset of a fever, and increases it by iDumj)- ing an augmented quantitj- of blood through the whole body, we emi^loy cardiac depressants to diminish tlie force of this organ. Among these antimony, aconite, veratrum viridQ, and iodide of pot- ash are the most important. The increased blood pressure througli- out the body may also be diminished by lessefting the fjuantity of blood. This is obtained in many cases with advantage by direct abstraction of blood, as in bleeding from the jugular or other veins, or by derivatives, such as mustard, turioentine, or blisters applied to the skin; or setons, which draw to the surface the fluid of the blood, thereby lessening its volume, Avithout having the disadvantage found in bleeding, of imi)Overishing the elements of the blood.
When the irritation which is the cause of fever is a specific one, either in the form of a bacterium (living organism), as in glanders, tuberculosis, influenza, septicaemia, etc., or in the form of a foreign chemical element, as in rheumatism, gout, ha3maglobinuria, and other so-called diseases of nutrition, we employ remedies which have been found to have a direct specific action on them. Among the specific remedies for various diseases are counted quinine, carbolic acid, sali- cylic acid, antipyrine, mercury, iodine, the empyreumatic oils, tars, resins, aromatics, sulphur, and a host of other drugs, some of Avhich are ad hoc and other of Avhickare theoretical in action. Certain reme- • dies, like simple aromatic teas, vegetable acids, as vinegar, lemon juice, etc., alkalies in the form of salts, sweet spirits of niter, etc., which are household remedies, are alwaj^s useful, because they act on the excreting organs and ameliorate the effects of fever. Other reme- dies, which are to be used to influence tlie canse of fever, must be selected with judgment and from a tliorough knowledge of the nature of the disease.
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INFLUENZA.
Synonyms: Pin'k-Eije, Typhoid Fever, Epizodty, Epiliippic Fever, Fievre Typhoide, Freucli; Grippe, French; Pferdestauhe, German; Gastro-enteriUs of Yatel and d'Arboval; Fehris Erysipelatodes, Zim- del; r//2)7??7.s of Delafond; Hepatic Fever, Bilious Fever, etc.
Definition. — Influenza is a contagious and infectious specific fever of tlie horse, ass, and mule, with alterations of the blood, stui)efaction of the brain and nervous s^'stem, great depression of the xHrX forces and frequent inflammatory- complications of the imxx)rtant vascular organs, especially of the lungs, intestines, brain, and lamina of the feet. One attack usualh- protects the animal from future ones of the same disease, but not always. An apparent complete recovery is sometimes followed by serious sequela? of the nervous and blood-vessel systems. The disease is very apt, under certain conditions of the atmosphere or from unknown causes, to assume an epizootic form, with tendency to complications of especial organs, as, at one period the lungs, at another the intestines, etc.
The first description of influenza is given by Laurentius Rusius, in 1301, A. D., when it spread over a considerable portion of Italy, causing great loss amongst the war-horses of Rome and its sur- roundings. In 1648, A. D., an epizootic of this disease visited Ger- many and spread to other parts of Europe. la 1711, A. D., under the name of "epidemica equorum,'' it followed the tracks of the great armies all over Europe, causing unmense losses among the horses, while the ''rinderpest was scourging the cattle of the same regions. The two diseases were confounded v\-ith each other, and were, by the scientists of the day, allied to the typhus, which was a plague to the human race at the same time. AVe find the first advent of this disease to the British Islands in an epizootic among the horses of Lon- don and the southern counties of England, in 1732, which is described by Gibson. In 1758, Robert Whytt recounts the devastation of the horses of the north of Scotland from the same trouble. Throughout the eighteenth centur}- a number of epizootics occurred in Hanover and other portions of Germany and in France, which were renewed early in the present century, with complications of the intestinal tract, which obtained for it its name of gastro-enteritis. In 17GG it first attacked the horses in Xorth America, but is not described as again occurring in a severe form until 1870-1872, when it spread over the entire country, fi-om Canada south to Ohio, and then east- ward to the Atlantic and westward to California. It is noAv a per- manent disease in our large cities, selecting for the continuance of its virulence young or especially susceptible horses which pass through the large and iU-ventilated and uncleaned dealers' stables and assumes, from time to time, an enzootic form, as from some reason its virulence increases, or as from reasons of rural economy
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and commerce large numbers of young and more susceptible animals are exposed to its contagion.
Etiology. — As one attack is self-protective, numbers of old horses, having had an earlier attack, are not cajjable of contracting it again; but, aside from this, young horses, especially those about four or five years of age, are much more predisposed to be attacked, while the older ones, even if they have not had the disease, are less liable to it. Again, the former age is that in which the horse is brought from the farm, where it has been free from the risk of contamination, and is sold to pass through the stables of the country taverns, the dirty, infected railway cars, and the foul stockyards and damp dealers' sta- bles of our large cities. Want of training is a predisposing cause. Overfed, fat, young horses, which have just come through the sales stables, are much more suscex:)tible to contagion than the same horses are after a few months of steady work.
Pilger, in 1805, w^as the first to recognize infection as the direct cause of the disease. Roll and others studied the contagiousness of influenza, and finding it so much more virulent and permanent in old stables than elsewhere classed it as a " stall miasm." The atmos- phere is the most common carrier of the infection from sick animals to healthy ones, and through it it may be carried for a considerable distance. The contagion will remain in the straw bedding and drop- pings of the animar, and in the feed in an infected stable, for a con- siderable time, and if these are removed to other localities it may be carried in them. It maybe carried in the clothing of those who have been in attendance on horses suffering from the disease. The drink- ing water in troughs and even running water may hold the virus and be a means of its communication to other animals even at a distance. The studies of Dieckerhoff, in 1881, in regard to the contagion of influenza were especially interesting. He found that during a local enzootic, produced by the introduction of horses suffering from influenza into an extensive stable otherwise perfectly healthy, the infection took place in what at first seemed to be a most irregular manner, but which was shown later to be dependent on the ventila- tion and currents of air through the various buildings. His experi- ments showed that the virus of influenza is excessively diffusible, and that it will spread rapidly to the roof of a building and pass by the apertures of ventilation to others in the neighborhood. The writer has seen cases spread through a brick wall and attack animals on the opposite side before others even in the same stable were affected. Brick walls, old woodwork, and the dirt which is too frequently left about the feed boxes of a horse stall, will all hold the contagion for some days, if not weeks, and communicate it to susceptible animals when placed in the same locality. A four-year-old colt, belonging to the writer, stood at the open door of a stable where two cases of influ- enza had developed the day before, fully 40 feet from the stall, for
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about ten miuutes on two successive mornings, and in six days devel- oped the disease. On the morning- when the trouble in the colt was recognized it stood in an infirmary with a dozen horses being treated for various diseases, but was imDiediately isolated; within one week two-thirds of the other horses had contracted the pink-eye.
Sij}n2:)toms.—Aiter the exposure of a susceptible horse to infection a period of incubation of from five to seven days elapses, during which the animal seems in perfect health, before any symptom is vis- ible. When the symptoms of influenza develop they may be intense or they may be so moderate as to occasion but little alarm, but the latter condition frequently exposes the animal to use and to the dan- ger of the exciting causes of complications which would not have hap- pened had the animal been left quietly in its stall in place of being Avorked or driven out to show to prospective purchasers. The disease may run its simple course as a specific fever, with alterations only of the blood, or it may become at any period complicated by local inflam- matory troubles, the gravity of which is augmented by developing in an animal with an impoverished blood and already irritated and rapid circulation and defective nutritive and reparative functions.
The first symptoms are those of a rapidly developing fever, which becomes intense within a very short period. The animal becomes dejected and inattentive to surrounding objects; stands with its head down, and not back on the halter as in serious lung diseases. It has chills of the flanks, the muscles of the croup, and the muscles of the shoulders, or of the entire body, lasting from fifteen to thirty minutes, and frequently a grinding of the teeth, which warns one that a severe attack may be expected. The hairs become dry and rough and stand on end. The body temperature increases to 104°, 104^°, and 105° F., or even in severe cases to 107° F., within the first twelve or eighteen hours. The horse becomes stupid, stands immobile with its head hanging, the ears listless, and it pays but little attention to the sur- rounding attendants or the crack of a whip. The stupor becomes rapidly more marked, the eyes become puffy and swollen with excessive lachrymation, so that the tears run from the internal eanthus of the eye over the cheeks and may blister the skin in its course. The respi- ration becomes accelerated to twenty-five or thirty in a minute, and the pulse is quickened to seventy, eighty, or even one hundred, moderate in volume and in force. There is great depression of muscular force; the animal stands limp as if excessively fatigued. There is diminu- tion, or in some cases total loss, of sensibility of the skin, so that it may be pricked or handled without attracting the attention of the animal. On movement, the horse staggers and shows a want of coordination of all the muscles of its limbs. The senses of hearing, sight, and taste are diminished, if not entirely abolished. The visi- ble mucous membranes (as the conjunctiva), from which it is known as the "pink-eye," and the mouth and the natural openings become
494
of a cleej) saffron, oclier, or violet-red color. This -latter is esi^ecially noticeable on tlie rim of the gums and is a condition not found in any- other disease, so that it is an almost diagnostic symptom. If the ani- mal is bled at this iDcriod tlie blood is found more coagulable tlian normal, but at a later period it becomes of a dark color and less coagulable. There is great diminution or total loss of appetite, witli an excessive thirst, but in manj' cases in cold-blooded liorses the ani- mal may retain a certain amount of appetite, eating slowly at its haj^, oats, or other feed.
"We have, following the fever, a tumefaction or oedema of the sub- cutaneous tissues at the fetlocks, of the under surface of the belly, and of the sheath of the penis, Avhich may be excessive. This infiltra- tion is uon-inflammatory in character and produces an insensibility of the skin like the excessive stocking which we see in debilitated animals after exposure to cold. In ordinary' cases the temperature has reached its maximum of 105° or lOG" F. in from twenty-four to forty-eight hours from the origin of the fever. It remains stationary for a period of from three to four days without the variation between morning and evening temperature which we have in pneumonia or other serious diseases of the lungs. At the termination of the specific course of the disease, which is generally close to eightj'-six hours, the fevej.' abates almost as rapidly as it commenced, the swelling of legs and under surface of bell}^ diminishes, the appetite returns, the strength is rapidly regained, the mucous membranes lose their jellow- ish color, which they attain so rapidly at the commencement of the disease, and the animal convalesces promjitly to its ordinary good condition and health, and rapidl}" regains the large amount of weight which it lost in the early part of the disease, a loss which frequentlj^ reaches 30, 50, or even 75 pounds each twenty-four hours. For the first three days of the high temperature there is a great tendency to constiiDation, which should be avoided if possible, for, if it has been marked, it may be followed bj' a troublesome diarrhea.
Terminations. — The termination of simple influenza may be death by extreme fever, with failure of the heart's action; from excessive coma, due generally to a rapid congestion of the brain; to the poison- ous effects of the debris of the disintegrated blood corpuscles; to an asphyxia, following congestion of the lungs; or the disease terminates by subsidence of the fever, return of the api^etite and nutritive func- tions of the organs, and rapid convalescence; or, in an unfortunately large number of cases, the course of the disease is complicated by local inflammatory troubles,, whose gravity is greater in iufluen2;a than it is when, they occur as sporadic diseases.
Complications. — The complications are congestions, followed by inflammatory phenomena in the various organs of the body, but they are most commonly located in the lungs, intestines, brain, or vascu- lar laminai of the feet. Atmospheric influence or other surrounding
495
influences of unknuwn <|uality seem to be an important factor in tlie determination of tlie local lesions. At certain seasons of the year, and in certain epizootics, vre find 40 and 50 j^er cent or even a greater I)ercentage of the cases rendered more serious by complication of the intestines ; at other seasons of the j'ear, or in other epizootics, we find the same per cent of cases complicated by inflammation of the lungs, ■while at the same time a small percentage of them are comi)licated by troubles of the other organs; inflammatory changes of the brain, of the laminfB, more rarely commence in epizootic form, but are to be found in a certain small i^ercentage of cases in all epizootics.
Exciting causes are important factors in comjplicating individual cases of influenza, or in localizing special lesions either during enzo- otics or ej)izootics. These exciting or determining causes act much as they would in si)oradic inflammatory diseases, but in this case we find the animal much more suscei^tible and predisposed to be acted upon than ordinary healthy animals. AVith a temperature already elevated, with the heart's action driving the blood in increased quantity into the distended blood-vessels, whicli become dilated and lose their contractility, with a congestion of all of the vascular organs already established, it takes but little additional irritation to carry the con- gestion one step further and x)roduce inflammation.
Complication of the intestines. — When any cause acts as an irritant to the intestinal tract during the course of this siDecific fever it may produce inflammation of the organs belonging to it. This cause may be constipation, which can only find relief in a congestion which offers to increase the function of the glands and relieve the inertia caused by a temporary cessation of activity; or irritant medicines, especially any increased use of antimony, turpentine, or the more active remedies; the taking of indigestible food, or of food in too great quantities, or food altered in any way by fungus or other injurious alterations; the swallowing of too cold water; or any other irritant may cause conges- tion. This complication is ushered in by colics. The animal paws with the fore feet and evinces a great sensibility of the belly; it looks with the head from side to side, and may lie down and get up, not with \aolenee, but.with care for itself, perfectly protecting the surface of the belly from any violence. At first we find a decided constipation; the droppings if passed are small and hard, coated Avith a A-iscous var- nish or even consisting of false membranes. In from 30 to 40 hours the constipation is followed by diarrhea. The alimentary discharge becomes mixed with sero-mucous exudation, Avhich is followed by a certain amount of suppurative matter. The animal becomes rapidly exhausted and unstable, staggers on movement, losing the little appe- tite which may have remained, and has exacerbations of fever. The I)ulse becomes softer and weaker, the respiration becomes slowly more rapid, the temperature is about 1° to U° F. higher. If a fatal result is not produced by the extensive diarrhea the discharge becomes
496
arrested in from five to ten days and a rapid recovery takes place. While the diarrhea complication is a serious one, and may greatly weaken the animal, it rarely becomes so intense as to assume the name of dysentery, and it rarely becomes hemorrhagic; it is rather a diar- rhea of anaemia. An enteritis takes place in an animal weakened by the previous action of the disease, and there is not sufficient vitality of the organ itself to resist the inflammation, but this is a superficial inflammation, with destruction only of the tissue of the surface of the intestines, which allows a rapid healing. Rapid recovery takes place, and the promptitude with which the intestines can commence to digest and assimilate food when the diarrhea is checked is frequently surprising.
Complication of the Jungs. — If at any time during the course of the fever the animal is exposed to cold or draughts of air, or in any other way to the causes of repercussion, the lungs may be affected. In the majority of cases, however, after three, four, or five days of the fever, the congestion of the lungs commences without any exposure or appar- ent exciting cause. This is due to the alteration of the blood, which allows a more easy osmosis of the blood into the surrounding tissues and to the checking of the capillary blood vessels, produced by the increased rapidity and force of the circulation. Unless this conges- tion of the lungs is relieved at once it is followed by an inflammatory product, a fibrinous pneumonia. This pneumonia, while it is in its essence the same, differs from an ordinary pneumonia at the com- mencement by an insidious course. The animal commences to breathe heavily, which becomes distinctly visible in the heaving of the flanks, the dilation of the nostrils, and frequently in the swaying movement of the unsteady body. The respirations increase in number, wiiat little appetite remains is lost, the temperature increases one to two degrees, the pulse becomes more rapid, and at times, for a short period, more tense and full, but the previous poisoning of the specific disease has so weakened the tissues that it never becomes the characteristic full, tense pulse of a simple pneumonia.
On percussion of the chest dullness is found over the inflamed areas; on auscultation at the base of the neck over the trachea a tubular murmur is heard. The crepitant rales and tubular murmurs of pneu- monia are heard on the sides of the chest if the pneumonia is periph- eral, but in pneumonia complicating influenza the inflamed iwrtions are frequently disseminated in islands of variable size and are some- times deep seated, in which case the characteristic auscultory symptoms are sometimes wanting. From this time on the symptoms of the ani- mal are those of an ordinary grave pneumonia, rendered more severe by occurring in a debilitated animal. After resolution, however, and absorption into the lungs convalescence is rapid, and recovery takes place perhaps more quickly than it does in the simple form of the dis- ease. There is a cough, at first hacky and aborted, later more full
497
and moist, Trlien we have a discharge from the nostrils which is muco- purulent, purulent, or hemorrhagic. As in simple pneumonia, in the outset this discharge may be "rusty," due to capillary hemorrhages. We find that the blood is thoroughly mixed with the matter, staining it evenly instead of being mixed with it in the form of clots. At the commencement of the complication the animal may be subject to chills, which may again occur in the course of the disease, in which case, if severe, an unfavorable termination by gangrene may be looked for. If gangrene occurs, ushered in by severe chills, a rapid eleva- tion of temj)erature, a tumultuous heart, a flaky discharge from the nostrils, and a fetid breath, the symptoms are identical with those which occur in gangrene complicating other diseases.
Complication of tJie brain. — At any time during the course of the disease, at an early period if the fever has been intense from the out- set, but more frequently after three or four days in ordinary cases, a congestion of the brain may occur. The animal, which has been stupid and immobile, becomes suddenly restless, walks forward in the stall until it fastens its head in the corner. If in a box stall and it becomes displaced from its position, it follows the wall with the nose and eyes, rubbing against it until it reaches the corner and again fastens itself. It may become more violent and rear and plunge. If disturbed by the entrance of the attendant or any loud noise or bright light, it will stamp with its fore feet and strike with its hind feet, but is not definite in fixing the object which it is resisting, which is a diagnostic point between meningitis and rabies, and which ren- ders the animal with the former disease less dangerous to handle. If fastened by a rope to a stake or post the animal will wander in a circle at the end of the roi3e. It wanders almost invariably in one direction, either from the right to left or from left to right, in different cases, which is dei)endent upon a greater congestion of one side of the brain than the other. The pupils may be dilated or contracted, or we nvdY find one condition in one eye and the opposite in the other.
The period of excitement is followed by one of profound coma, in which the animal is immobile, the head hanging and placed against the corner of the stall, the body limp, and the motion, if demanded of the animal, unsteady. Little or no attention will be jiaid to the surrounding noises, the crack of a whip, or even a blow on the surface of the body. The respiration becomes slower, the pulsations are diminished, the coma lasts for variable time, to be followed by excesses of violence, after which the two alternate, but if severe the period of coma becomes longer and longer until the animal dies of spasms of the lungs or of heart failure. It may die from injuries which occur in the ungovernable attacks of violence.
Complication of the feet. — The feet are the organs which are next in frequency predisposed to congestion. This congestion takes place in the laminse (podojihyllous structures) of the feet. The stupefied
498
animal is aroused from its condition l)y the excessive pain produced in the feet, and assumes the position of a foundered horse; that is, if the fore feet alone are affected the}' are carried forward until they rest on the heels, and if the hind feet are affected all of the feet are carried forward resting on their heels, the hind ones as near the center of gravity as possible. In some cases the stupor of the animal is so great that the i)ain is not felt, and little or no alteration of the posi- tion of the animal is noticeable. The foot is found hot to the touch, and after a given time the depressed convex sole of the typical founder is recognized. Other complications may occur, due to the action of exciting causes, and we may have a severe corysa, laryngitis, pharyn- gitis, or even congestion of the kidneys, followed by nephritis, con- gestion of the spleen or of any other organ.
Pleurisy. — This is a rare complication, but when it does occur it is ushered in by the usual s^nnptoms of depression, rapid pulse, small respiration, elevation of the temperature, subcutaneous a?dema of the legs and under surface of the belly, and we find a line of dullness on either side of the chest and an absence of respiratory murmur at the lower part. It is usually severe, and we find an effusion filling one- fourth to one-third of the thoracic cavity in from thirty-six to forty- eight hours.
The laryngo-bronchitis is not a frequent complication nor a very serious one. It is ushered in b}" a cough, which is rough and fatty, a purulent discharge from the nostrils and an enlargement of the sur- rounding lymphatic ganglia.
Pericarditis is an occasional complication of influenza, never occur- ring alone or in connection v.ith other organs in the chest cavity. It is ushered in by chills, elevation of tlie temperature ; the pulse becomes rapid, thread}', and imperceptible. The heart murmurs become indis- tinct or can not be heard. A venous pulse is seen on the line of tlie jugular veins along the neck. Respiration becomes more difficult and rapid. If the animal is moved the symptoms become more marked, or it may drop suddenly dead from heart failure.
Peritonitis, or inflammation of the membranes lining the belly and covering the organs contained in it, sometimes takes jjlace, The gen- eral symptoms are similar to those of a commencing pericarditis. The local symptoms are those of pain, especially to pressure on side of the flanks and belly; distension of the latter, and sometimes the formation of flatus or gas, and constipation.
Diagnosis. — The diagnosis of influenza is based upon a continued fever, with great depression and sj'mijtoms of stupor and coma; tlie rapid, dark saffron, ocher, yellowish discoloration of the mucous mem- branes, swelling of the legs and soft tissues of the genitals. When these symptoms have lasted for a greater or less time, the diagnosis of the localization of the fever or complication is based upon the same symptoms that are i^roduced in the more local diseases from other
499
causes, but in influenza the local symptoms are frequently masked or even entirely hidden hy the intense stupor of the animal, which ren- ders it insensible to pain. The evidence of colic and congestion, which is followed by diarrhea, fills the symptoms for the diagnosis of enteritis. The rapid breathing or difiiculty of respiration forms the suspicion at once of complication of the lungs, but as we have seen in the study of the sj-mptoms the local evidences of lung lesions are fre- quently hidden. Again, we have seen that inflammation of the feet or founder complicating influenza is frequently not shown on account of the insensibility to pain on the part of the animal, which indicates the importance of running the hand daily over the hoofs to detect any sudden elevation of temperature on their surface.
The diagnosis of brain trouble is based upon the excessive violence which occurs in the course of the disease, for during the intervening period or coma there is no means of determining that it is due to this complication. Severe cases of influenza may simulate anthrax in the horse. In both we have stupor, the intense coloration of the mucous membranes of the eyes and a certain amount of swelling of the legs and under surface of the belly. The diagnosis here can only be made by microscopic examination of the blood. In strangles, equine variola, and sealma we have an intense red, rosy coloration of the mucous membranes, full, tense pulse, and although in these diseases we may have depression, we do not have the stupor and coma, except in severe cases which have lasted for some days. In influenza we have no evi- dence of the formation of j)us on the mucous membranes as we did in the other diseases, except in the conjunctiva of the eyes, where, however, we have had a profuse serous discharge, producing the conjunctivitis.
In severe x)neumonia (lung fever) Ave may have profound coma, dark yellowish coloration of the mucous membranes, and swelling of the under surface of the belly and legs, but in pneumonia we have the history of the difiicultj^ of breathing and an a<?ute fever of a sthenic tyj)e from the outset, and the other sj'mptoms do not occur for several days; while in influenza we have the history of characteristic symp- toms for several days before the rapid breathing and difficult}- of res- pii-ation indicate the appearance of the complication. Without the history it is frequently difficult to diagnose a case of influenza of scA'eral days' standing complicated by pneumonia from a case of severe pneumonia of five to six days' standing, but from a prognostic point of view it is immaterial, as the treatment of both are identical.
Prognosis. — Influenza Is an excessivelj^ serious disease for many reasons. We find the majority of horses susceptible to this virus when exposed to it. It is fatal to a large number of animals even vvith the best treatment, and is especially fatal to the young and to those ani- mals which are more valuable from their fine breeding, as the disease occurs in a more serious form in well-bred animals than it does in the
500
Ijnnphatic and more common ones. It is more severe than the other epizootic diseases, and its contagiousness is much greater than in the otliers.
The fatal issue of influenza varies in different epizootics ; where the disease is occurring only in scattered cases through a large town or count ly locality, and in some epizootics, the majoritj'^ of the cases run a mild form without complications; at other times, where the disease occurs in enzootic and epizootic form, we find over 50 per cent of the cases complicated by disease of the lungs; in others a large number of cases are complicated by trouble of the intestines.
Alterations. — The alteration of influenza occurs in the blood, and consists of a rajjid destruction of the red blood corpuscles, which are the carriers of oxygen from the lungs to all parts of the body. The animal is always found emaciated. The tissues throughout the body are found stained, and of a more or less yellowish hue, due to the dis- integrated blood corpuscles which Were at first the cause of the char- acterized discoloration of the mucous membranes in the living animal. There is always found a congested condition of all the organs, muscles, and interstitial tissues of the body. The coverings of the brain and spinal cord partake in the congested and discolored condition of the rest of the tissues.
Other alterations are dependent entirely upon the complications. If the lungs have been affected, we find effusions identical in their intimate nature with those of simple pneumonia, but they differ some- what in their general appearance in not being so circumscribed in their area of invasion. Complication of the intestines offers the red, puff}^ swollen, or congested appearance which we have in an ordinary enteritis, with peeling from the surface of the membranes of the intes- tinal tube. The alterations of meningitis and laminitis are identical with those of sporadic cases of founder and inflammation of the brain.
Treatment. — While the appetite remains the patient should have a moderate quantity of sound hay, good oats, and bran ; or even a little fresh clover, if obtainable, can be given in small quantities. With the first decided symptoms of fever the antipyretics are indicated, of which we have a variable choice. Bleeding in this disease is a ques- tionable treatment, and is only to be employed at the very outset of the disease. In large, strong horses of a sanguinarj^ temperament an abstraction of a few quarts of blood will frequently diminish the stupefaction, lower the temperature, slow the pulse and respiration, and render the course of the disease shorter by twelve or twenty-four hours. In some cases, however, bleeding seems to increase the amount of depression, and it should never be used after the deep ocher color of the mucous membranes shows that an extensive disin- tegration of the blood corpuscles has taken place. Derivatives in the form of essential oils and mustard poultices, baths of alcohol, turi^en- tine, and hot water, after which the animal must be immediately dried
501
aud blanketed, serve to waken the animal up from stupor and relieve the congestion of the internal organs. This treatment is especially indicated when complication by congestion of the lungs, intestines, or of the brain is threatened. Quinine and salicylic acid in dram doses will lower the temperature, but too continuous use of quinine in some cases increases the after depression. Aconite is especially indicated, as in addition to its action on the circulation it seems to be almost a specific in certain cases in relieving the congestion of the brain and the nervous symptoms produced by the latter. Iodide of potash reduces the excessive nutrition of the congested organs and thereby reduces the temperature; again, this drug in moderate quantities is a stimulant to the 'digestive tract and acts as a diuretic, causing the elimination of waste matter by the kidneys. Antimony, in guarded doses of one-half dram to 1 dram, repeated not more than two or three times, will reduce excessive fever, and can be used with special advan- tage at the first appearance of complications, but it must be used with care, as it is an irritant to the digestive tract and may produce intesti- nal complication, causing a severe diarrhea. Small doses of Glauber's salts and bicarbonate of soda, used from the outset, stimulate the digestive tract and prevent constipation and its evil results.
In cases of severe depression and weakness of the heart, digitalis can be used with advantage. At the end of the fever, and when con- valescence is established, alcohol in one-half pint doses and good ale in pint doses may be given as stimulants; to these maybe added dram doses of turpentine.
In complication of the intestines camphor and asafetida are most frequently used to relieve the pain causing the colics; diarrhea is also relieved by the use of bicarbonate of soda, nitrate of potash, and drinks made from boiled rice or starch, to which may be added small doses of laudanum.
In complication of the lungs iodide of potash and digitalis are most frequently indicated, in addition to the remedies used for the disease itself.
Founder occurring as a complication of fever is difficult to treat. It is, unfortunately, frequently not recognized until inflammatory changes have gone on for some days. If recognized at once, local bleeding and the use of hot or cold water, as the condition of the ani- mal will permit, are most useful, but in the majority of cases the stu- pefied animal is unable to be moved satisfactorily or to have one foot lifted for local treatment, and the only treatment consists in local bleeding above the coronary bands and the application of poultices.
For congestion of the brain large doses of aconite and small repeated doses of mercury form the ordinary mode of treatment. During con- valescence small doses of alkalies may be kept up for some little time, but the greatest care must be used, while furnishing the animal with plenty of nutritious, easily digested food, not to overload the
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intestinal tract, causing constipation and consecutive diarrhea. Spe- cial care must be taken for some weeks not to expose the animal to
cold.
SEQUELAE OF INFLUENZA. ■
Anasarca. — A previous attack of influenza is the most common pre- disposing cause of a serious disease of the nervous system; paralysis of the vaso-motor nerves which govern the circulation in the smaller blood vessels and capillaries. This trouble, which is also known as pur- j)ura hemorrhagcia and as scarlatina, appears most frequently a few weeks after convalescence is established. It occurs more frequentl}^ in those animals which have made a rapid convalescence and are apparently perfectlj^ well, and in those vdiich have evidently perfectly regained their health, than it does in those which have made a sloAver recovery. The exciting cause of this trouble is usually exposure to cold; and again, exposure to cold draughts of air on the heated but not necessarily^ sweating animal is more aj)t to cause the trouble than exposure to rain or wet. This latter will more f requentlj' cause com- plication of the internal organs, such as pneumonia, pleurisj', etc.
Anasarca commences by sj'mptoms which are excessively variable. The local lesions may be confined to a small portion of the animal's body and the constitutional phenomena be nul. The appearance and gravity of the local lesions may be so unlike, from difference of loca- tion, that they seem to belong to a separate disease, and complications may completely mask the original trouble.
In the simplest form the first symptom noticed is a swelling, or several swellings, occurring on the surface of the body, on the forearm, the leg, the under surface of the belly, or on the side of the head. The tumefaction is at first the size of a hen's egg; not hot, little sensi- tive, and distincl}^ circumscribed by a marked line from the surround- ing healthy tissue. These tumors gradually extend until they coalesce, and in a few hours we have swelling up of the legs, legs and belly, or the head, to an enormous size; they have alwaj^s the characteristic constricted border, which looks as if it had been tied with a cord. In the nostrils are found small reddish spots or petechia, which gradu- ally assume a brownish and frequentl}^ a black color. Examination of the mouth will frequently reveal similar lesions on the surface of the tongue, along the lingual gutter and on the frsenum. If the external swelling lias been on the head the petechia of the mucous membranes are apt to be more numerous and to coalesce into patches of larger size than when the dropsy is confined to the legs. Tlie ani- mals may be rendered stiff by the swelling of the legs, or be annoyed by the awkward swollen head, which at times ma}^ be so enormous as to resemble that of a hippopotamus rather than that of a horse. Dur- ing this period the temperature remains normal; the pulse, if altered at all, is only a little weaker; the respiration is only hurried if the swelling of the head infringes on the caliber of the nostrils. The
503
appetite remains normal. The animal is attentive to all that is going on, and, except for the swelling, apparently in XDerfect health.
In from two to four days the tissues can no longer resist the pressure of the exuded fluid. Over the surface of the skin which covers the dropsy we find a slight serous sweating, which loosens the epiderjnis and dries so as to simulate the eruption of some cutaneous disease. If this is excessive we may see irritated spots which are suppurating. In the nasal fossae the hemorrhagic spots have acted as irritants, and, inviting an increased amount of blood to the Schneiderian membrane, produce a cor3^za or even a catarrh. We maj' now find some enlarge- ment and peripheral oedema of the lymi3hatic glands which are fed from the affected part. The thermometer indicates a slight rise in the body temxjerature, while the pulse and respiration are somewhat accelerated. The appetite usually remains good. In the course of a few daj^s the temperature may have reached 102°, 103°, or 104° F.
Fever is established, not an essential or specific fever in any way, but a simple secondary fever produced by the dead material from the surface or superficial suppuration, and by the oxidization and absorp- tion of the colloid mass contained in the tissues — just such a fever as would be produced by an excoriation of a considerable surface of the skin in an animal otherwise sound, or by the absorption of the oedema resulting from a. blow.
Suppuration may become excessive from the great distension and loss of vitality of the skin. Here the lesion is visible and the consti- tutional phenomena are marked.
Lympliangitis may be established from the large amount of irritat- ing material which the ducts and glands of the lymjjhatie system are forced to carry from the affected part.
Gangrene may be developed in spots from the size of a pea to tliat of a hen's egg,. The great distension of the subcutaneous layer of con- nective tissue or the excessive hemorrhage in the submucous laj^er may completely destroy the vitality of the iDart, and brown and then black masses of slough appear, to be eliminated and leave a deep rosy ulcer in their place. This is more Common in the nose and under the tongue.
Excessive swelling of ihe head. — The swelling of the head may increase and extend outside to the throat or to the nostrils until the latter are closed, or to the larynx, which is so pressed upon as to render respiration difficult or impossible. The same complication renders mastication and deglutition equall}' difficult.
Metastasis. — This is a frequently' dreaded complication. If the trouble lias originallj^ been in the legs and belly it may suddenly commence to api)ear in the head, and disappear from the i^art first affected, or the oj^posite more favorable change sometimes occurs, the dangerous swelling of the head disappearing to attack the belly or legs.
604
Enteric oedema. — The effusion on the exterior may take another course and pass to the intestine, causing symptoms of colic, which either ends fatally or more rarely terminates b}^ a profuse diarrhea, which is sometimes hemorrhagic in character.
P.ulmonary (Edema. — Marked dyspnoea, without swelling of the head, is indicative of metastasis into the parenchyma of the lungs, which will rapidly show dullness on percussion and tubular murmurs on auscultation. The tumefaction leaves the exterior and attacks the lungs, and the animal dies of asphyxia.
SepticcEmia. — There is certainly no disease in veterinary practice which offers a more favorable field for the development of septicreniia. The large mass of colloid matter held at the temj^erature of the animal body could not be surpassed in the gelatine tube of bacteriological laboratory as a nutriment for the putrefactive ferments. Septicaemia is ushered in by general rigor, sudden elevation of temperature, and marked symptoms of coma.
TERMINATIONS.
Resolution. — The simple form of the disease most frequently termi- nates favorably on the eighth or tenth day by absorption of the effusion, with usually a profuse diuresis, and with or Avithout diarrhea. The appetite remains good or is at times capricious. The surface of the body is dirty from desquamated eiiithelium, and at times there is a complete loss of hair, giving the appearance of a bad case of sarcoptic mange. At other times the absorption is slow, lasting for some weeks with tendency to relapses. Again there may be left some permanent induration, the result of embryonic growth.
Death. — Death may occur from mechanical asphyxia, produced by closure of the nostrils or closure of the glottis. Metastasis to the lungs is almost invariably fatal, causing death by asphyxia. Metastatis to the intestines may cause death from pain, enteritis, or hemorrhage.
Excessive suppuration, lyrtipliangitis, and gangrene are causes of a fatal termination by exhaustion. Mortal exhaustion is again pro- duced by inability to swallow in cases of excessive swelling of the head.
Peritonitis may rise secondary to the enteric oedema, or by perfora- tion of the stomach or intestines by a gangrenous spot.
Sepjtic(B77i'ia terminates fatally with its usual train of symptoms.
The essential alterations of anasarca are exceedingly simple; the capillaries are dilated, the lymphatic spaces between the fibers of the connective tissue are filled with serum, and the coagulable por- tion of the blood presents a yellowish or citrine mass, jelly-like in consistency, which has stretched out the tissue like the meshes of a sponge. Where the effusion has occurred between the muscles, as in the head, these are found dissected and separated from each other like those of a hog's head by the masses of fat. The surface of the skin is desquamated and frequently denuded of the hair. Frequently
505
there are traces of suppuration and of ulceration. The mucous mem- brane of the nose is found studded M'ith small, hemorrhagic spots, sometimes red, more frequently brown or black, often coalesced with each other in irregular sized patches and surrounded by a reddish zone, the product of irritation. If oedema of the intestines has occurred the membrane is found four or five times its normal thick- ness, reddish in color, with hemorrhages on the free surface. CEdema of the lungs leaves these organs distended. On section a yellowish fluid runs out, like the fluid does from lungs which have been filled with Avater in the dissecting room. The secondary alterations vary according to the comijlications. There are frequently the lesions of asphyxia; externally we find ulcers, abscesses, and gangrenous spots and the deep ulcers resulting from the latter. The lymphatic cords and glands are found with all the lesions of lymphangitis. Again are found the traces of excessive emaciation, or the lesions of septi- caemia. Except from the complications the blood is not altered in anasarca. If previous to the attack the animal had renemia the tis- sue will be infiltrated and the pallor and other appearances of aenemia will be found. If prior to the attack the animal is in moderate health, with unaltered blood, the blood will be found to clot with the typical change of the buffy coat of the horse. In death by asphyxia the blood will be found fluid, black in color, but gradually turns red, and clots on exposure to the air. Dieckerhoff mentions fibrinous Ijneumonia among the alterations. I myself have never seen it occur.
The diagnosis of anasarca must principally be nmde from farcj' or glanders. In anasarca the swelling is nonsensitive, while sensitive in the acute swelling of farcy. The nodes of farcy are distinct and hard and never circumscribed, as in the other disease. The erujjtion of glanders on the mucous membranes is nodular, hard, and pellet- like. The redness disappears on pressure. In case of excessive swelling of the head, in anasarca, there may occur an extensive sero- fibrinous exudation from the mucous membranes of the nose, poured out as a semi-fluid mass or as a cast of the nasal fosste, never having the appearance or tjpical oily character which it has in glanders. The inflammation of the lymphatic cords and glands in anasarca does not produce the hard, indurated character which is found in farcy.
Sejificanuia may have occurred i^rimarily, or as a complication of anasarca. The diagnosis must be from the history, and the prognosis is of little import.
While this is not an excessively fatal disease, the i^rognosis must always be guarded. The majority of cases run a simi^le course and terminate favorably at the end of eight or ten days, or possibly after one to two relapses, requiring several weeks for comi)letc recoverj^ Effusion into the head renders the jirognosis much more grave from the possible danger of mechanical asphyxia. Threatened mechanical
506
asphyxia is especially dangerous on account of the risk of blood- l^oisoning after an oj^eration of tracheotomy.
Metastasis to the viscera, or from the legs to the head, is a most serious complication, while metastasis from the head or otlier ^ov- tions to the holly and legs is favorable, as removing, for a moment at least, all danger of immediate death. The prognosis is otherwise based on the complications, their extent and their individual gravity, existing, as they do here, in an alreadj^ debilitated subject.
Treatment. — The treatment of anasarca may have been as variable as are the lesions. The Indications are at once shown by the altera- tions and mechanism of the disease, which we have just studied. These are:
(1) Regulation of the disordered circulation of the blood and strengthening of the vaso-motor system.
(2) Promotion of absori)tion of the colloid mass, which has infil- trated the tissues. This, of course, is based upon oxidization in order to metamorphose the exudation into absorbable crystalloids.
(3) Prevention of metastasis, which is the most frequent fatal termination of this trouble, if not directly by a?dema of the lung or enteritis, indirectly by further weakening the already debilitated system.
(i) The immediate treatment of the complications, each, p^r se, asphj-xia and gangrene, being the two which most frequently call for active interference.
These indications call for constitutional and local' remedies.
Blood-letting would at first seem totally contra-indicated, but in certain cases it acts like a charm. Debilitated, as an animal usually is when attacked by anasarca, we have yet seen that one of the great predisposing causes is the plethoric habit. The current of blood, like a swollen river after a spring storm, can be thrown from its usual course by the slightest side channel. The use of bleeding requires the acute i:)erception of the practitioner to be put upon the alert to regulate it. Not only the present condition, but the ijrevious state of health, and the probable future hygienic and medical care must be taken into consideration. Given a case that will admit of bleeding, the quantit}' to be taken is always a minimum one, and it is to be regulated by the effect upon the pulse during the bleeding.
With the weakened walls of the vessels but a little lessening of the pressure will ijroduce a vacuum, when compared with the con- dition found in an ordinary blood-vessel system, with normal elas- tic walls. Bleeding is only permissible at the outset of the disease when the tumors are still isolated. When the tumefaction has coal- esced all the blood is required to oxidize the mass of effused colloid matter.
Hygiene now comes into play as the most imj)brtant factor. Oats, oat and hay tea, milk, eggs, anything which the stomach or rectum
507
cau be coaxed to take care of, must be emploj'ed to give the nutriment which is tlie onlj^ thing that will i)ermanently strengthen the tissues, and thej^ must be strengthened in order to keep the capillaries at their proper caliber.
Laxatives, diaphoretics, and diuretics must be used to stimulate the emunctories so that thej' shall carry off the large amount of the prod- ucts of decomposition, which result from the stagnated effusions of anasarca. Of these the sulphate of soda in small repeated doses, and the nitrate of i)otash and bicarbonate of soda in small quantity, and the chlorate of iwtash in single large doses, Avill be found useful. "Williams cites the chlorate of potash as an antiputrid ; it is useful, I believe, because it frees oxj^gen, and oxygen is a chemical purifier.
Stimulants and astringents are directlj^ indicated. The animal wants wakening up, everything in it wants a shock, and a belt to hold it in j)lace. Spirits of turpentine serves the double purpose of a cardiac stimulant and a powerful warm diuretic, for the kidneys in this disease will stand a wonderful amount of work. Camphor can be used with advantage. Coffee and tea are two of the dif- fusible stimulants v.'hich are too much neglected in veterinary medicine; both are valuable adjuncts in treatment in anasarca, as the}' are during convalescence at the end of any grave disease which has tended to render the patient ansemic. Dilute sulphuric acid and hydrochloric acid are perhaps the best examples of a combination of stimulant, astringent, and tonic which can be emj)loyed. The simx)le astringents of mineral origin, suli)hates of iron, copper, etc., are useful as digestive tonics; I doubt if they have any constitutional effect. The vegetable astringents, tannic acid, etc. , have not i)i'Oved efficacious in my liauds. Iodide of potash in small doses serves the triple purpose of digestive tonic, denutritive for inflammation, and diuretic.
Externally. — Sponging the swollen parts, especially the head, when the swelling occurs here, is most useful. The bath should be at an extreme of temijerature — either ice-cold to constrict the tissues, or hot water to act as an emollient and to favor circulation. Vinegar may be added as an astringent. When we have excessively denuded sur- faces, suppuration, or open wounds, disinfectants should be added to the wash.
In cases of excessive swelling, especially of the head, mechanical relief may be required. Punctures of the jmrt should be made with the hot iron even in country practice, as no other disease so predis- poses to septic contamination. When mechanical asphyxia is threat- ened tracheotomy may be demanded. Here, again, the liot iron should be used, and disinfectant applications should be constantly applied. With the first evidence of dyspnwa, not due to closing of the nostrils or glottis, or with the first pawing which gives rise to a suspicion of colic, a mustard plaster should be applied over the whole
508
belly and chest. The sinapism will draw the current of the circula- tion to the exterior, the metastasis to the lungs or intestines is pre- vented, and the enfeebled, nervous system is stimulated to renewed vigor by the perijiheral irritation. The organs are encouraged by it to renewed functional activity ; the local inflammation produced by it favors absorption of the exudation. Tlie objection to the use of blisters is their more severe action and the danger of mortification. Septicaemia, when occurring as a complication, requires the ordinary treatment for the putrid diseases, with little hope of a good result.
After recovery the animal regains its ordinary health, and in mj'^ own experience there has been no predisposition to a return of the disease.
STRANGLES.
Synonyms: Distemper, colt-ill, catarrhal fever, one form of ship- ping fever, _Fe&Ws ^j/zofye/u'ea.
Definition. — Strangles is an infectious disease of the horse, mule, and ass; seen most frequently in young animals, and usually leaving an animal which has had one attack protected from future trouble of the same kind. It appears as a fever, lasting for a few days, with forma- tion of matter or pus in the air tubes and lungs, and frequently the formation of abscesses in various parts of the body, both near the sur- face and in the internal organs. It usually leaves the animal after convalescence perfectly healthy and as good as it was before, but sometimes leaves it a roarer, or is followed by the development of deep-seated abscesses which may prove fatal.
Causes. — The cause of strangles is infection by direct contact with an animal suffering from the disease, or indirectly through contact with the discharges from an infected animal, or by means of the atmosiihere in which an infected animal has been. There are many predisposing causes which render some animals much more subject to contract the disease than others. Early age, which has given it the popular name of colt-ill, offers many more subjects than the later periods of life do, for the animal can contract the disease but once, and the large majority of adult and old animals have derived an immunity from previous attacks. At three, four, or five years of age the colt, which has been at home, safe on a meadow or in a cozy barnj^ard, far from all intercourse with other animals or sources of contagion, is first put to work and driven to the market town or county fairs to be exposed to an atmosphere or to stables contaminated by other horses suffering from disease and serving as infecting agents. If it fails to contract it there, it is sold and shipped in foul, undisinfected rail- way cars, to dealers' stables, equally unclean, where it meets many opportunities of infection. If it escapes so far, it reaches the time for heavier work and daily contact on the streets of towns or large cities, with numerous other horses and mules, some of which are sure to be
609
the bearers of the germs or this or some otner infectious disease, and at last it succumbs.
The period of the erui)tiou of the last permanent teeth, or the end of the period of development from the colt to an adult horse, at which time the animals usually have a tendency to fatten and be excessively full-blooded, also seems to be a predisposing- jDcriod for the contraction of this as well as of the other infectious diseases. Thoroughbred colts are very susceptible, and frequently contract strangles at a some- what earlier age than those of more humble origin. Mules and asses are much less suscei^tible and are but rarely affected. Other* animals are not subject to this disease, but there is a certain analogy between it and distemper in dogs. After exj)osure to infection there is a period of incubation of the disease, lasting from two to four days, during which the animal enjoys its ordinary health.
Symptoms. — The horse at first is a little sluggish if used, or when placed in its stable, is somewhat dejected, paying but moderate atten- tion to the various disturbing surroundings. Its appetite is somewhat diminished in many cases, Avhile in some cases the animal eats well throughout. Thirst is increased, but not a great deal of water is taken at one time. If a bucket of water is placed in the manger, before the patient, it will dip its nose into it and swallow a few mouthfuls, allowing some of it to drip back, and then stop, to return to it in a short time. The coat becomes dry and the hairs stand on end. At times the horse will have chills of one or the other leg, the fore quarters or hind quarters, or in severe cases of the whole body, with trembling of the muscles, dryness of the skin, and its hairs stand- ing on end.
If the eyes and mouth are examined the membranes are found red- dened to a bright rosy color. The pulse is quickened and the breath- ing may be slightly accelerated. At the end of a couple of days a cough is heard and a discharge begins to come from the nostrils. This discharge is at first watery; it then becomes thicker, somewhat bluish in color, and sticky, and finally it assumes the yellowish color of matter and increases greatly in quantity.
At the outset the colt may sneeze occasionally and a cough is heard. The cough is at first repeated and harsh, but soon becomes softer and moist as the discharge increases. Again the cough varies according ■ to the source of the discharge, for in light cases this may be only a catarrh of the nasal canals, or it may be from the throat, the wind- pipe, or the air-tubes of the lungs, or even from the lungs themselves. According to the organ afi'ected the symptoms and character of cough will be similar to those of a laryngitis, bronchitis, or lung fever caused by ordinary cold.
Shortly after the discharge is seen a swelling takes i)lace under the jaw, or in the intermaxillary space. This is at first puffy, swollen, somewhat hot and tender, and finally becomes distinctly so, and an
510
abscess is felt, or having broken itself the discharge is seen dripping from a small opening. When the discharge from the nostrils has fully developed the fever usually disappears and the animal regains its appetite, unless the swelling is sufacient to interfere with the function of the throat, causing pain on any attempt to swallow. At the end of four or six days the discharge lessens, the soreness around the throat diminishes, the horse regains its appetite, and in two weeks has regained its usual condition. Old and strong horses may have the dis- ease in so light a form that the fever is not noticeable; they may con- tinue to'eat and perform their ordinary work as usual and no symptom may be seen beyond a slight discharge from the nose and a rare cough, whicli is not sufficient to worry any but the most particular owner. But, on the other hand, the disease may assume a malignant form or become complicated so as to become a most serious disease, and even prove fatal in many cases. Inflammation of the larynx and bronchi, if excessive, will produce violent, harsh coughing, which may almost asphyxiate the animal. The large amount of discharge may be mixed with air by the difficult breathing, and the nostrils, the front of tlie animal, manger and surrounding objects become covered with a white foam. The inflammation may be in the lung itself (lobular pneumo- nia) and cause the animal to breathe heavily, heave at the flanks, and show great distress. In this condition marked symptoms of fever are seen; the appetite is lost, the coat is dry, the horse stands back in its stall at the end of the halter strap with its neck extended and its legs propped apart to favor its breathing. Tliis condition may end by resolution, leaving the horse for some time with a severe cough, or the animal may die from choking up of the lungs (asphyxia).
The swelling under the jaw may be excessive, and if the abscess is not opened it burrows toward the throat or to the side and causes inflammation of the parotid glands and breaks in annoying fistulas at the sides of the throat and even up as high as the ears. Roaring may occur either during a moderately severe attack from inflammation of the throat (larynx) or at a later period as the result of continued lung trouble. Abscesses may develop in other parts of the body, in the poll, in the withers, or in the spaces of loose tissue under the arms, in the fold of the thigh, and, in entire horses, in the testicles.
During the course of the disease or later, when the animal seems to be on the road to perfect recovery, abscesses may form in the internal ' organs and produce symptoms characteristic of disease of those parts. Delirium.— Uoaiing, plunging, wandering in a circle, or standing with the head wedged in a corner of the stall indicates the collection of matter in the brain. Sudden and severe lung symptoms, without previous discharge, point to an abscess between the lungs, in the mediastinum; colic, which is often continuous for days, is the result of the formation of an abscess in some part of the abdominal cavity, usually in the mesentery.
511
Patliology. — The lesions of strangles are found on the surface of tlie mucous membranes, essentially of the respiratorj- sj'stem and in the loose connective tissue fibers of the internal organs and glands, and consist of acute inflammatory changes, tending to the formation of matter. The blood is unaltered, though it is rich in fibrin, and if the animal has died of asphyxia it is found dark colored and unco- agulated when the body is first opened. If the animal has died while suffering from high fever the ordinary alterations throughout the body which are produced by any fever not attended by alteration of blood are found.
Treatment. — Ordinary light eases require but little treatment beyond diet, warm washes, moistened hay, warm coverings, and protection from exposure to cold. The latter is urgently called for, .as lung complica- tions, severe bronchitis, and larjTigitis are oiten the results of neglect of this precaution. If the fever is excessive the horse may receive small quantities of Glauber salts (handful three times a day), as a laxative, bicarbonate of soda or niter in dram doses every few hours, and small doses of antimony, iodide of potash, aconite, or quinine. Steaming the head with the vapor of warm water poured over a bucket of bran and hay, in whicli belladonna leaves or tar have been placed, will allay the inflammation of the mucous membranes and greatly ease the cough.
The swelling of the glands should be promptly treated by bathing with warm water and flaxseed poultices, and as soon as there is any evidence of the formation of matter it should be opened. Prompt action in this ^vill often save serious complications. Blisters and irri- tating liniments should not be applied to the throat. When lung com- plications show themselves the horse should have mustard applied to the belly and to the sides of the chest. "\Ylien convalescence begins great care must be taken not to expose the animal to cold, w^hich may bring on relapses, and while exercise is of great advantage it must not be turned into work until the animal has entirely regained its strength.
SCALMA.
The differentiation of the various diseases which have popularly been included under the terms of distemper and influenza up to a comparatively recent date has been so slow and so tardily accepted by the majority of practitioners that we have been subjected to con- stantly seeing announced and heralded as news in the daily papers the appearance of some ncAv disease. These new diseases of the popu- lace and of the empii-ic are to us but the epizootic outbreak or the more severely manifested form of some ordinary contagious disease. We treat several cases of different troubles in tlie same stable with- out having the time or seeing the necessity of explaining them to the owner, when suddenly one- of them spreads to the rest of the stable
512
in an epizootic form, and our clients will not nnderstand that all of the animals liave not suffered from the same illness.
There is, however, one of the contagious fevers of the horse which has constantly been confounded with other diseases, and which has not been separated from them in our English text-books. As this disease has received no proper name in English, I shall use for it the name given by Professor Dieckerhoff, of Berlin, who first described it in the Adams Wochenschrift, XXIX, in 1885.
Etymology.— The term "scalma" is derived from the old German word scalmo, scelmo, sclielm, which indicates roguishness or knavish- ness, as great nervous irritability, especially of the temper, is one of the characteristics, almost diagnostic, symptoms of this disease. The term '' Heimtuchische Kranlchtit,'' signifying malicious, treacherous, or mischievous, is also employed in German for the same trouble. I am not aware of any name in English or French which has been applied to it.
As I am opposed to employing in veterinary medicine any of the nomenclature of human medicine, except for identical, simple, and inflammatory diseases, or for intercommunicable contagious diseases, I will not offer the term "whooping cough" as a name, but I will sug- gest a certain similarity between the latter disease in man and scalma in the horse.
Definition. — Scalma is a contagious and infectious febrile disease of the horse, with local lesions of the bronchi, trachea, and larynx, which is evidenced by cough. It is further characterized by great irrita- bility of temper. It occurs as a stable plague ; that is, in enzo5tic form, with, however, great variations in the susceptibility of the ani- mals to contract it. It is rarely fatal except from complications.
Incuhatio}!.— The period of incubation is from six to seven days, but the disease may develop in two days after exposure or it may delay its appearance for ten days. It spreads through a stable slowly, developing at times in a horse placed in a stall where the previously sick one had stood, or it may pass next to an animal several stalls away. One attack is usually protective.
Symptoms.— The symptoms are ushered in by fever, in which the acceleration of the pulse and respiration is in no way in accord with the great elevation of temperature. With the appearance of the fever is developed a diffuse bronchitis, which is, however, subacute both in its character and in its course. At times the trouble of the bronchi may extend to the trachea, larynx, pharynx, or even to the nasal foss?e. In two or three days a trifling grayish, albuminous discharge from the nostrils occurs, which continues, variable in quantity, for eight to fourteen days, or may even last for three weeks. The cough is short, rough, and painful, spasmodic in its occurrence and in char- acter. The slight watery or slimy discharge may become more pro- fuse, purulent, or even "rusty," if the bronchitis has extended to the
513
neighboring- structures. Pharyngeal discharge may take place. Tho respiration is moderate and only affected during an excess of cough- ing, or in complicated cases. The pulse undergoes but little quicken- ing. The temperature rises rapidly to 39°, 40°, and in some cases even to 41. 5° C. (107|° F. ). The latter temperature usually, but not always, indicates complication by pleurisy. In ordinary cases the temperature drops in two or three days after the appearance of the cough. The hide is dry and rough, with the hairs on end, but the horse appears rather as an animal out of condition than a sick one. Emaciation may be rapid. The mucous membranes are moderately reddened. The appetite is diminished, but the animal chews constantly. Deglutition, either of food or water, is frequently the cause of spasms of c*otighing, and these in turn seem to warn the animal against attempts at swal- lowing. On percussion no alteration of resonance is to be detected. On auscultation of the lungs mucous rales are heard, with at times tubular breathing; the latter, however, we will study under the com- plications, as also the friction warning of pleurisy. Throughout the course of the disease we have still one constant and characteristic symptom— nervous irritability. With temperature of 104° to 107° F., the horse still flinches to the touch on the loins; it stands frequently with the head up, and it is on the alert for the entrance of any one to the stall. The previously good-tempered and quiet horse will turn and bite, will strike with the hind legs, or at the first touch to the side, head, or throat will half rear and back into the corner of the box, or breaking the halter turn backAvard out of the stall.
The course of the disease is from five to eight days, but the cough may continue for two or three weeks with variable elevation of tem- perature. As a stable plague the course is from two to three months, as the contagion is much more uncertain than in strangles or influ- enza. The termination is by resolution and recovery, or by compli- cations. In resolution the temperature drops, the cough becomes less frequent and less spasmodic in character, the appetite returns, and lu) sign is left of the disease except the fever mark on the hoof.
The complications are excessive spasms and pleurisy. In the former tlie cough may be so violent as to convulse the whole animal, the legs are spread and fixed, with the hind ones drawn slightly under the body. The head and neck are extended, with the muscles tense. The cough comes out by rapidly succeeding efforts, or with the first sound the larynx seems to close for a moment before the rest can follow. In two cases of my own the spasm has been so great that the animal has fallen to the ground. During these accesses the respiration becomes accelerated, and on ausculation of the trachea and lungs the tubular murmur of an apparent pneumonia can be heard. This false mur- mur, however, disappears at the end of the attack. In the case which fell to the ground the horse would lie for a moment or two absolutely 5061 — HOR 17
514
motionless. (In the first I believed that he had broken his neck. ) The rapid respiration was then followed by a long inspiration, the animal reo-ained his feet, the respiration became almost normal, andthetnbu- lar murmur had disappeared. I have seen no fatal termination from this spasm of the pneumo-gastric, but can readily believe that trau- matisms resulting from such attacks might prove fatal, or that the' spasm might continue long enough to produce asphyxia. The fatal complication is pleurisy. This occurs when the horse has been kept at work after the development of the disease while suffering from a high fever, and is probably in no way specific, but the result of work on an animal with high temperature. The additional symptoms are those of an ordinary pleurisy.
Diagnosis. — The diagnosis is based upon the elevation of the tem- perature without corresponding acceleration of the pulse and of the respirations; upon the retention of appetite and spinal reflex, with the great irritability of temper in the presence of a high temperature, and upon the spasmodic cough and auscultatory sounds of bronchitis with but trifling discharge.
The diagnosis is made from oidematous pneumonia l)y the absence of the yellow colorations, the absence of pneumonia, and the less con- tinuous high temperature; from influenza by the absence of (edema, of the ocher coloration, and of the typhoid symptoms; from strangles by want of enlargement of the lymphatics, absence of purulent dis- charge and abscesses; from variola by the nonappearance of pustules and enlarged lymphatics; from simple bronchitis, as the latter is spo- radic, and in it great fever is accompanied by profuse discharge; from rheumatic pleurisy and pleurodynia by the history in these of repeated attacks and great temporary pain; from surgical fever by
the absence of cause.
Pro(/Ho.s/.s.— The prognosis is usually favorable. This disease entails
only the loss of ten days' to three weeks' use of the animal, and leaves the subject with no complicating sequelae. In some cases I have seen the irritable disposition remain for a length of time, but in every case it has finally disappeared. As I have suggested, violent spasms might prove fatal. Pleurisy would render the prognosis serious, as the same disease would when occurring from simple causes.
Treatment— The treatment of a stable should be at once prophylac- tic. The infected animal should be removed, and complete disinfec- tion of the stalls and area should be made. The individual treatment is simple. The hygienic measures of cleanliness, fresh air without drafts, frequent rubbing and tempting food should be thorough. The digestive tract is to be regulated by small doses of bicarbonate of soda, sulphate of soda, gentian, and tannic acid. The appetite is to be stimulated by drinks of cold l)reakfast tea and cow's milk. Anti- spasmodics are "to be used when the cough is excessive. The best of these are camphor, belladonna, stramonium, and steaming Avith
• 515
turpentine. (Tuqx-ntino 1 ounee, vajter half bucket.) External fric- tions of alcohol and turpentine, Avith hot packs to the loins, v.ill also affoi-d relief. Quinine and salicylic acid may bo used during the ele- vation of temperature. Professor Dieckerhotf recommends tracheal injections in ounce doses of the following solution: Acetate of alumi- nium, 1 per cent; alum, one-half to 1 per cent; bromide of potash, 1 to 2 per cent; water, 100.
CEDEMATOUS PNEUMONIA.
Syxoxyms: Adj-namic pneumonia; hospital or stable pneumonia; influenza; Pectoralis equorum; pleuro-pneumonia; Contagiosa equo- rum; Brustseuche, German.
Definition.— Thin disease is the adynamic pneumonia of the older . veterinarians wlio did not recognize any essential difference in its nature from an ordinary inflammation of the lungs, excejit in the profound sedation of the force of the animal affected with it, which is a prominent symptom from the outset of the disease. Again, this same prostration of the vital force of the animal, combined vrith the staggering movement and want of coordination of the muscles of the animal, caused it for a long time to bo confounded with influenza, with which at certain periods it certainly has a strong analogy of symptoms, but from which, as from sporadic pneumonia, it can be separated very readily if a case can be followed throughout its wliole course.
(Edematous pneumonia is a specific inflammation of the lungs, pro- ducing an interstitial oedema and inflammation of the tissues of these organs, and a constitutional disturbance or fever of a low or adynamic f 3-pe. It causes a profound sedation of the nervous system which may be so great as to cause death. It is sometimes attended by pleurisy, inflammation of the heart, or septic complications which also nrove fatal.
EtioJogp. —While, as an infectious disease, its original cause is due to a specific virus, there are many predisposing causes which act as important factors in aiding in its development. Old horses, espe- cially those which have been rendered antemic or debilitated by hard use or by diminished quantities of food, and those which are obliged to work constantly in Avater or are exposed to continual cold and wet, as in the ease of canal horses, old hack horses and their congeners' and those younger animals which liave a sudden weakened vitality produced by being put too rapidly to work, or to too hard work before their muscles arc hardened and their organs have been accustomed loathe unusual demands placed upon them by want of training, are much more susceptible to the contagion than adult animals in a good condition of health. Lymplmtic, narrow-chested, thick-hided, and big-hoofed animals will contract the disease much more easily than the finer-skinned, richer-muscled animal of a sanguinary tempera- ment and robust constitution.
516
Old, cold, damp, foul, unclean, and badly drained and ventilated stable's aUow rapid dissemination of the disease to other horses in the same stable, and act as rich reservoirs for preserving the contagion which, in one of these cases, the writer knew to be retained for over a year. Every few weeks during this time, in the corner of a large livery stable, one or more cases of oedematous pneumonia broke out, usually in one of two stalls, but sometimes several stables away. When the stable was remodeled and new woodwork was placed in for mangers and floors the disease disappeared. The virus is but moderately volatile, and in a stable seems rather to follow the lines of the walls and irregular courses than the direct currents of air and the tracts of ventilation. Professor Dieckerhoff found that the con- tagion of influenza was readily diffusible throughout an entire stable and through any opening to other buildings, and substantiates the writer's experience that it will pass through solid walls of considera- ble thickness; but he also found that the contagion of (edematous pneumonia is not transmissible at any great distance, nor is it very diifusible in the atmosphere. A brick wall 8 feet in height served to prevent the infection of other animals placed on that side of a horse ill with the disease, while others placed on the opposite side and separated from the focus of contagion only by open bars in the stall were infected and developed the disease in its typical form.
Symptoms.— The symptoms differ slightly from those of a frank, fibrinous pneumonia, but not so much by the introduction of new symptoms as by the want of or absence of the distinct evidences of local lesions which are found in the latter disease. All of the pneu- monias throughout the whole course of the trouble are less marked and less clearly defined.
At first the symptoms are latent; the animal gives a rare cough which resembles that of a heavy horse affected with a slight chronic bronchitis; it becomes somewhat dejected and dull, at times somno- lent, and has a diminished appetite. This condition lasts for several days. No history can be obtained of causes for symptoms of acute trouble, and the absence of organic lesions to account for the general condition leaves the attendant, however expert he may be, in much doubt as to the nature of the trouble unless previous cases in the same stable, or special tact on the part of the veterinarian, aids in foresee- ing the probable termination of the slight local trouble and commenc- ing adynamic changes in the organic functions of the animal. No crepitant rale is heard as in fibrinous pneumonia, as in this disease the local trouble commences in the neighborhood of the large air tubes and not on the periphery of the lungs. During several days these symptoms increase and a fever of a low type gradually develops. The respiration increases to twenty-four, thirty, or thirty-six to the min- ute, and a small, running, soft pulse, indicating great exhaustion ot the capillaries and their surrounding tissues, attains a rhythm ot htty,
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seventy, or even more beats in the sixty seconds. The heart, how- ever, contrary to the debilitated condition of the pulse, is found beat- ing violently and tumultuously, Kke it does in anthrax and septic intoxication. The mucous membranes of the eyes and mouth and of the g-enital organs are found somewhat oedematous, and they rapidly assume a dirty, saffron color, at times approaching an ocher, but dis- tinguishable from the similar coloration in influenza by the want of the luster belonging to the latter and by the muddy, dull tint which is characteristic throughout the disease.
Suddenly, without the preMminary rales which precede grave lesion of the lungs in other diseases, the blowing murmur of pneu- monia is heard over a variable area of the chfest, usually, however much more distinctly over the trachea at the base of the neck and directly behind the shoulder on either side of the chest. In some cases the evidence of lung lesion can only be detected over the trachea. The body temperature has now reached 104°, 105° F., or in extreme cases even a degree higher. The debility of the animal is great without the stupefaction or evidence of cerebral trouble, which is constant with such grave constitutional phenomena in influ- enza or severe pneumonias. The animal is subject to occasional chills, and on movement staggers in its gait. The yellow coloration of the visible mucous membrane is rendered pale by infiltration of the liquid of the blood into the tissues; the pulse may become so soft as to be almost imperceptible, the heart movement and sounds being at the same time exaggerated. The animal loses flesh rapidly, and dropsies of the extremities, of the under surface of the belly, 'or of the internal organs may show themselves. We then have all the general phenomena of a profound ansemia.
Termmatiojis.— These symptoms may gradually subside; with an improved appetite the inanition may cease and the aminal commence to nourish its impoverished blood and tissues; the pulse becomes stronger, the heart more regular and less tumultuous; the mucous membranes assume a brighter and more distinct color; the difficulty of respiration is removed, and the animal may make a recovery but at best the convalescence is a long one, and in many cases it is ques- tionable If it is an economical proceeding to carry the animal through It. More frequently the disease terminates by death. This is usuaUy directly due to heart failure; in some cases it is caused by asphyxia owing to the great amount of exudation into the lung tissue, render- ing Its further function impossible; in most cases the anemia and marasmus debilitate the animal until it dies as it would from the same condition produced by any other cause.
Complications.— The complications of oedematous pneumonia are inflammatory or necrotic changes in the lungs themselves. Suppura- tion at times takes place in the bronchi and may extend to the lung tissue. In this case yve may find the mucous rales of a bronchitis
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appearing- wliere there were only neg-ativc signs of pulmonary trouble, or we may find them grafted upon the tubular murmur of the pneu- monia if the latter has been detected in the earlier stages of the dis- ease. These are mostly distinctly heard over the trachea and on the sides of the chest directly behind the slioulders. With the develop- ment of the mucous rales, to be heard on auscultation, we have a m.ore purulent discharge from the nostrils, similar to that of a chronic or sub-acute bronchitis. If the inflammation has been of some standing, cavernous rales may be heard indicating the destruction of a consid- erable portion of lung tissue and the formation of a cavity. The effects of this more acute inflammatory process are not appreciable in the general condition of the animal, except to still further weaken it and add to its debilitated and emaciated cachexia. Gangrene frequently occurs. A sudden rise of the body temperature one or two degrees, with a more enfeebled pulse and a still more tumultous heart, develop simultaneously with the appearance of a discharge from the nostrils. Tliis discharge -is gray in color, serous or watery in consistency, mixed with the detritus of broken-down lung tissue, and sometimes contains clots of blood, or in more serious cases may be marked by a quantity of fluid blood from a hemorrhage, which proves fatal. The discharge is fetid to the smell. The animal emaciates rapidly. On examination of the lungs m ucous rales are heard in the larger bronchi, cavities may be found at any part of these organs, and points of lobular pneumonia ma}' bo detected.
Diagnosis.— The diagnosis of oBdematous pneumonia at the outset is aided greatly by a rigid examination of the surroundings, and still more so by the history or knowledge of previous cases in the same stable. The cough and commencing fever of the first few days have nothing diagnostic in them, but when combined with repeated chills, a soft pulse, a tumultuous heart, the rapidly stained dull yellow mucous membranes, and the staggering gait of the animal without marked brain trouble, the diagnosis becomes more easy. In pneu- monia the fever is always of a more sthenic character, the fever is con- comitant, or precedes the marked lung trouble; the yellowish discolor- ation is a phenomenon of the later stages of the disease; the debility of the muscles is simple weakness, or, if complicated by want of coordination, it accompanies an evident brain trouble and loss of consciousness. In pneumonia there has always been in the lungs the regular series of absence of vesicular murmur, crepitant rales, and then tubular murmur. While the pulse in a simple pneumonia may in the later stages become very soft and weak, it commences as a tense and full one. The heart only becomes irregular as the result of cardiac com.plieation, and never assumes the tumultuous character of the septic diseases unless gangrene occurs, in which case the animal is only of value as a scientific study to the veterinary attend- ant. In influenza the symptoms of fever develop before any local
519
lesions are noticed. The feebleness of 1 he mnscles and want of coordi- nation are from the ontset the evident result of a poisoned condition of the brain, as shown b}^ the stupor of the animal; the saffron or ocher coloration of the visible mucous merftbrane is of a decided tint, and while these membranes may be o^deinatous, they become so as the result of an increase in the quantity of blood in their capillaries, or by congestion, and not from the a?dematous infiltration of the watery portion of the blood, as in the disease in question.
Prognosis. — CEdematous pneumonia is an excessively fatal disease. "We have seen that it usually attacks animals which are alread}' in more or less of a depraved condition or weakened in their vital forces by the bad hygienic surroundings to which they have been subjected. Rapid increase in the area of infiltration in the lungs, as shown by dullness on percussion and the extent of the tubular murmur, is an unfavorable symptom. Increased prostration in the early part of the disease augurs badly for the chances of future resistance to the effects of the local lesions. Suppuration with the formation of abscesses and gangrene in the lungs are even more serious in this disease than as a complication of other diseases, on account of the debilitating character of the original trouble.
Alterations. — At the time of death from oedematous pneumonia we frequently find septic changes and the evidences of putrefaction. The solidification of the lung tissue is found irregular in shape and high up around the root of the lungs and around the large bronchi, and is generally covered by sound lung tissue. The anterior lobes of the lungs are usually entirely affected. The diseased portion appears of a gray-yellowish' color, somewhat watery, and tears readily. Matter is found in the air tubes which form gutters througli the jelly-like mass of the diseased lung. Abscesses, from the size of a nut to larger masses, may be found disseminated through the lungs. The blood is dark in color, fluid, or only clotted into soft, jelly-like masses. Classes of gangrenous or dead black tissue may be present.
Treatment.~A study of the symptoms Avill indicate at once tliat the antiphlogistics, or those remedies which we employ in such sthenic dis- eases as fibrinous pneumonia, strangles, etc. , are not to be employed in this disease. Bleeding would only still further weaken an already enfeebled animal; antimony or the alterants would increase the depression of a too depraved constitution. There is in this disease no acute congestion of a particular organ to draw off by depletive meas- ures, nor any violent blood current to be retarded, for fear of liyper- nutrition of any special j^art.
Revulsives do good, as they excite the nervous system and awaken the torpor of the weakened blood vessels, which aid in the reestablisli- ment of the functions. Mustard poultices may be applied over the belly and sides of the chest, as in other diseases, but caution must be used in the emploj'ment of blisters, as ugly ulcers may result from
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tneir action ou a tissue of weakened vitality. Setons are dangerous from the great tendency in this disease to septic complications. Repeated friction of the legs l3y hand-rubbing and warmth by band- aging and by rubbing the surface of the body with turpentine and alcohol, which is immediately to be dried by rough towels, will excite the circulation and stimulate the emunctories of the skin.
Stimulants are given internally from the outset of the disease. Tur- pentine in dram doses regulates the heart and excites the kidneys to carry off waste matter, but if repeated too frequently may disturb the already delicate digestive system. Alcohol rectifies the latter danger, and is a useful stimulant to the heart and digestive system, if given with care in small doses. It must be remembered that this remedy is not a food. It is a hydrocarbon which is not burnt, but is eliminated in the urine and in the expired air. If given in too large quantities it becomes a depressant, and lowers the vitality of all of the tissues of the body, as can too frequently be seen in the mental and physical condition of the drunkard. It is an antiputrid, and is especially indi- cated when septic complications and gangrene are present. The aromatics and bitter tonics are useful ; gentian, tannin, and English breakfast tea in warm decoction form a useful menstruum for other remedies. The various preparations of iron are astringents and excit- ants to the digestive system. Carbolic acid is an antiputrid, which is of marked benefit in oedematous pneumonia; it should be given in small doses diluted in alcohol.
Salicylic acid may be given in 1 or 2 dram doses every few hours. It is a specific for troubles of the serous membranes, lowers the tem- perature, and is of value in this disease in preventing the exudation into the tissue of the lungs. The alkalies, as the sulphate and bicar- bonate of soda, the nitrate of potash, and very small doses of the iodide of potash, should be employed to regulate the digestive tract, the kid- neys, and the other excreting glands, and to stimulate absorption of the waste matter.
The diet demands the strictest attention from the outset. In many of the fevers the food has to be diminished in quantity and regulated in the quality of its heat-producing components during the acute part of the disease, so as to lessen the material for combustion in the in- flamed organs. In oedematous pneumonia, on the contrary, all the food that can possibly be digested and assimilated must be given. Choice must be made of the richest material which can be handled by the weakened stomach and intestines without fatiguing them. Good, sound hay should be chopped short and dampened or partly boiled; in the latter case the hay tea can be reserved to use as a drink. Oats may be preferred dry or in other cases will be taken better scalded; in most cases, however, it is better to give slops of oatmeal, to which can be added a little bran, barley flour, or boiled milk and wheat flour. Ture cow's milk, not too rich in fatty matter, can be given
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alone or with beaten eggs; frequently the horse will have to be coaxed with the milk diluted with several parts of water at first, but will soon learn to drink the pure mild. Apples and carrots out up raw or boiled are useful, and fresh clover in small quantities will fre- quently stimulate the appetite. Throughout the course of the disease and during convalescence the greatest attention must be given to cleaning the coat thoroughly so as to keep the glands of the skin in working order, and light, Avarm covering must be used to protect the animal from cold or draughts of air.
HORSEPOX — EQUINE VARIOLA.
Synonyms: Variola equina — Pustular Grease— Phhjdenoid Herpes.
Definition. —The horseiwx is a specific infectious fever of the horse attended by an eruption of pustules or pocks over any part of the skin or on the mucous membranes lining the various cavities in the body. When the eruption takes place on the mucous membrane of the respir- atory tract it produces an irritation and discharge of matter which greatly resembles that of strangles. This disease was for a long time confounded with the latter disease, and there is no doubt that many light cases in which the eruption is not well marked are still mistaken for distemper.
The horsepox was described by the early Roman agricultural writers and by the veterinarians of the last century. It received its first important notice from the great Jenner, who confounded it Avith grease in horses, as animals with this disease are very apt to have the erup- tion of variola appear on the inflamed fetlocks if they are affected with grease at the same time. He saw these cases transmit the dis- ease to cattle in the byres and to the stablemen and milkmaids who attended them, and furnish the latter with immunity from smallpox, which led to the discovery of vaccination. The horsepox is again frequently mistaken for the exanthemata attending some forms of venereal disease in horses.
Variola in the horse, while it is identical in principle, general course, complications, and lesions with variola in other animals, is a disease of the horse itself, and is not transmissible in the form "of variola to any other animal; nor is the variola of any other animal transmissible to the horse. Cattle and men, if inoculated from a case of horsepox, develop vaccinia, but vaccinia from the latter animals is not so readily reinoculated into the horse with success. If it does develop, it pro- duces the original disease.
Etiology.— The direct cause of the horsepox is infection. A large number of predisposing causes favor the development of the disease as in the case of strangles, for this trouble, like almost all contagious diseases, renders the animal which has had one attack immune from future ones. The causes are, young age, for then the animal is still 5961— HOR 17*
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siiseeptible to contract the disease, but old horses which have not been affected are less apt to become infected when exposed than younger ones. The exposure incident to shipment through public stables, cars, etc., again acts as a predisposing cause as in the other infectious dis- eases. The period of final dentition is a moment of the animal's life which renders it peculiarly susceptible.
Dupaul states that the infection is transmissible through the atmos- phere for several hundred yards. The more common means of conta- gion is by direct contact or by means of fomites. Feed boxes and bridles previously used by horses affected with variola are probably the most frequent carriers of the virus, and we find the lesions in the majority of cases developed in the neighborhood of the lips and nostrils. Coition is a frequent cause. A stallion suffering from this disease may be the cause of a considerable epizootic, as he transmits it to a number of brood mares and they in turn return to the farms where they are surrounded by young animals to whom they convey the contagion. The saddle of the harness and croup straps are fre- quent agents of infection. The presence of a wound greatly favors the inoculation of the disease, which is also sometimes carried by sur- gical instruments or sponges. Trasbot recites a case in which a set of hobbles which had been used on an animal suffering from variola were used on a horse for a quittor operation and transmitted the dis- ease, which developed on the edges of the Avound. There is no elective point for the first development of the disease, but it commences most frequently around the natural openings, as these are points whicli are most exposed to inoculation.
Symi^toms.— There is a period of incubation, after an animal has been exposed, of from five to eight days, during which there is no appreciable alteration in the health. This period is shorter in sum- mer and longer in winter. At the end of this time, small nodes develop at the point of inoculation and the animal becomes feverish. The nodes, which feel like small shot under the skin, soften into small pustules and break into little, shallow, superficial ulcers, exuding a creamy, thick matter, which rapidly dries and forms scabs. The horse is dull and dejected, loses its appetite, and has a rough di-y coat with the hairs on end. There is moderate thrist. The respirations are somewhat quickened and the pulse Ijecomes rapid and full. ^The body temperature is elevated, frequently reaching 104° or 105° F., within thirty-six or forty-eight hours from the appearance of the first symptoms.
The visible mucous membranes, especially the conjunetivse, are of a bright rosy red. In the lymphatic, cold-blooded, and more common horses these symptoms of fever are less marked; even with a com- paratively high temperature the animal may retain its appetite and even work comparatively well, but these cases, if worked and over- heated, are apt to develop serious complications.
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At tlie end of from three and a lialf to four days tlie eruption breaks out, the fever abates, and the general symptoms improve. The eruj)- tion in severe cases may be generalized ; it may be confined to the softer skin of the nose and lips, the genital organs, and tlie inside of the thighs, or it maj- be localized in the neighborhood of a wound or in the irritated skin of a pair of greasy heels. It consists of a greater or less number of little nodes which, on a mucous membrane, as in the nostrils or vagina, or on soft unpigmented skin, appear red and feel at first like shot under the epidermis. These nodes soften and show a yellowish spot in the center when they become pustules. The epi- dermis is dissoh^ed and the matter escapes as a viscid fluid at first citrine and later cloudy and purulent, which dries rapidly, forming scabs; if these fall off or are removed they leave a little shallow con- cave ulcer which heals in the course of five or six days. In the softer skin if i^igmented the cicatrices are white and frequentlj' remain so for about a year, when the pigment returns. The lips or genital organs of a colored horse, if covered with a number of small white spots about the size of a pea, will usually indicate that the aninuit has been affected with the horsepox.
At times the pustules may become confluent and x)roduce large superficial serpentine ulcers on the membrane of the nostrils, around the lips or eyelids, or on the borders of wounds and in greasy heels; in this case the part becomes swollen, hot, painful, and is covered with a profuse discharge of matter. In this form -there is frequently a secondary fever lasting for a day or two.
In severe cases there may be a suppurative adenitis or inflamma- tion of the lymphatic glands which are fed from the affected part. If the eruption is around the nostrils and lips, the glands between the jaws (submaxillary) form abscesses, as in a case of strangles; if the eruption is in a pair of greasy heels abscesses may form in the fold of the groin (inguinal). There may be so much tumefaction of the nostrils as to produce difficulty in breathing.
Complication^. — A case of horsepox maybe attended with various complications of greater or less importance. Adenitis or suppuration of the glands has just been mentioned. Confluent eruptions irritate the part and induce the animal to rub the inflamed part against the manger or scratch it in other ways, and produce troublesome ulcers, Avhieh may leave ugly scars. Irritation of the mucous membrane of the nose causes severe corj-za with purulent discharge.
Tlie eruption may occur in the throat or in the air tubes to the lungs, developing an acute laryngitis or bronchitis. These commence with a harsh cough, wliich becomes moister and more fatty as the dis- charge increases, and is followed for several days by a fever, which is often severe. If the larynx is affected it becomes inflamed and swollen, causing the animal to roar and discharge quantities of foamy mucus and matter from tlie nostrils, as in troubles of the same organ from
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other causes. If the animal is exposed to cokl, or worked so as to engorge the lungs with blood at the termination of the specific fever, just when the eruption is about to localize, it may be determined to the lungs. In this case we have a short dry cough, labored breath- ing, the development of a secondary fever of some gravity, and all of the external symptoms of a pneumonia. This pneumonia differs, however, from an ordinary pneumonia in the symptoms furnished by the examination of the lungs themselves. In place of a large mass of the lung tissue being affected the inflammation is disseminated in smaller spots over the entire lung. The total of these areas may be equal, however, to the half or more of the lungs and prove fatal. The crepitant rales and tubular murmur of pneumonia is absent, and is replaced by sibilant and small mucous rales. When the fever has been intense and the animal is unduly exposed or worked, it may be attacked with a congestion of the lungs, which will prove fatal within a few hours, and no localization be developed ; or, if in this case relief is afforded, it may be followed by a lobar pneumonia, showing itself with all the symptoms of this disease when it is produced by ordinary causes.
Diagnosis.— The diagnosis of the horsepox is to be based on the presence of a continuous fever, with rosy mucous membranes, for several days, and the appearance of the characteristic eruption. If the eruption is in the nasal cavities, marked by a considerable dis- charge and attended by submaxillary abscesses, it maybe confounded Avith strangles. If the throat is affected it may be confounded with an angina (laryngitis or pharyngitis), but in the latter the local trouble precedes or is concomitant with the fever, while in the former the fever precedes the local trouble by several days. Variola may be confounded with bronchitis or pneumonia if complicated with these troubles and the eruption is absent from the exterior, but it is of little moment, as the treatment for both will be much the same. When the ei'uption is in the neighborhood of the genital organs this disease lias been mistaken for the dourine. In variola the eruption is a tem- porary one; the nodes and pustules are followed by shallow ulcers and rapid cicatrization, unless continued in the vagina or on the penis by the rubbing of the walls and the filth which accumulates; there are apt to be pustules at other parts of the body. In the venereal disease the local trouble commences as a papule and breaks into an ulcer without having formed a pustule. The ulcer has not the con- vex rosy appearance of that of the less serious discharge; the symp- toms last for a longer period, by which time others aid in differentiat- ing the two. In glanders the tubercle is hard, and, after breaking into an ulcer, the indurated bottom remains, grayish or dirty-white in color, ragged and exuding a viscous, oily discharge. There is no disposition to suppuration of the neighboring glands. In variola tlie rosy shallow ulcer and healthy laudable pus, with the acutely tumified
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glands, should not be mistaken, at least after a day. I have seen acute glanders in mules which required a day's delay to differentiate from strangles; at that time the farcy buds appeared.
Prognosis. — The average case of the horsepox runs a course of dejec- tion, loss of appetite, and more or less fever for about four days, fol- lowed by a rapid convalescence, and leaves the animal as well and as sound as before. If the eruption has been excessive or confluent, the ulcerations may act as irritants and render the animal unfit for use for several weeks. Larj^ngitis, pharyngitis, bronchitis, and pneumo- nia in this disease are not of greater gravity than they are when occurring from other causes. The spots denuded of pigment left by the pustules on the lips and genitals may temporarily depreciate the value of the animal to a slight degree.
Treatment.— As this is a disease unattended by alterations of the blood itself, although a specific fever, and is of a sthenic type, active remedies are admissible and indicated. The horse should be placed on a low diet— little or no oats— bran mashes, a moderate quantity of good sound hay, a few carrots or apples, which will act as laxatives, and slop feed. Barley flour is more cooling for mashes than bran or oat meal. Water may be given as the animal desires it, but it should not be cold; if a half bucketful of water is kept in the manger the horse will take but a few swallows at a time. Dram doses of nitrate of potash, or ounce doses of sweet spirits of niter are useful in the drinking water. If the fever is high the antipyretics are indicated : Tincture of aconite in fifteen to twenty drop doses; sulphate of qui- nine in dram doses; iodide of potash in dram doses; two or three half -dram doses of tartar emetic or Kermes mineral are often useful ; bleeding will often reduce the temperature at once and prevent com- plications, but is sometimes the cause of an ugly inflammation sur- rounded by an eruption in the neighboi-hood of the wound; infusion of pine tops, of juniper leaves, of the aromatic herbs, or of English breakfast tea are useful in the later stages. If complications of the air passages or lungs are threatened a large mustard poultice should be applied to the belly and sides of the chest. Oxide of zinc oint- ment should be used on confluent eruptions, and if the ulceration is excessive it may have to be touched with caustic.
Great care must be taken to keep the animal protected from cold draughts of air or other exposure. Blankets or sheets should be used on the body and bandages on the legs. After convalescence is estab- lished nutritious food of easy digestion and walking exercise are all that is needed, except perhaps a little Glauber's salts, to pi-event constipation.
Prophylactic treatment.— When the horsepox breaks out amongst a large number of horses, especially on a farm where there are a num- ber of colts, it may be assumed that the greater majority will contract the disease, and it is more economical that they should have it and
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be tliroiigli witli it at once. If the weather is moderate all the animals which have not been affected can be inoculated, which will produce the disease in a mild form, with the eruption at a point of election, and render the danger of complication a minimum one. For inocula- tion the discharge from the pustules of a mild case should be selected and inoculated by scarification on the belly or the under surface of the neck.
ANTHRAX.
Synonyms: Sacer ignis, PustuJa maligna, Anthrax, Latin; Char- hon, Sang de Bate, French; Miltzbrand, German; Carhone, Carhon- cli io, Fiioco de St. Antonio, Italian ; Jaswa , Siherskaji Jasiva, Russian ; Carbuncle, Splenic Fever, Splenic Apoplexy, Braxy (in sheep), etc.
Anthrax is a severe and usually fatal contagious disease, charac- terized by chills, great depression and stupor of the animal, and a profound alteration of the blood, due to destruction of the red blood corpuscles. It is caused by the admission into the animal body of bacteria, or low order of living organisms, or their spores, known as the "hacilhis of Davaine'' or ''hacillus anthracis.''
It affects all animals exposed to its contagion. Tlie herbivora are especially susceptible in the following order: the sheep, the ox, and the horse. The Guinea pig, the hog, the rabbit, mice, and other ani- mals die quickly from its effects. Man, the dog, and other omnivora and carnivora may be attacked by it in a constitutional form as fatal as in the herbivora, but fortunately, in some cases, develop from it only local trouble, followed by recovery. Fowls may be inoculated and develop the disease if they are partially immersed in cold water, to reduce their natural body temperature from 104° to about 100° F. Frogs may be inoculated successfully if kept in warm water, which will elevate their body temperature to one approximating that of the warm-blooded animal, 9G°-98° F.
Anthrax has been a scourge of the animals of the civilized world since the first written history we have of any of their diseases. It existed in Asia Minor at the time of the siege of Troy; it was a plague of the cattle of Egypt during the time of Moses. It was a severe pest among the agricultural animals in the early Greek and Roman days, and we have very accurate accounts of its symptoms from the writings of Columella, Varro, Yirgil, and others. r>y the writers of the Middle Ages it was frequently confounded with the rinderpest, but is described with sufficient precision to identify outbreaks of it in epizootic form in 99G A. D. and 1090 A. D. in France; in 1552 at Lucca, Italy; in 1017 at Naples, where numbers of human beings died from eating the flesh of animals which were affected with the disease.
In 1598 the senate of Venice interdicted the sale of meat, butter, or cheese coming from animals affected with anthrax. In 1709-1712 A. D. extensive outbreaks of anthrax occurred iii Germany, Hungary, and Poland. In the first half of the present century it had become an
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extensive!}^ spread disease in Russia, Holland, and England, and for the last century has been gradually spreading in the Americas; more so in South America. In 1804, in the five governments of Petersburg, Novgorod, Olonetz, Twer, and Jaroslaw, in Russia, over ten thousand horses and nearly one thousand persons perished from the disease.
The causes of anthrax were for a long time attributed entirelj' to climatic influence, soil, and atmospheric temperature, and they are still recognized as most important predisposing factors in the develop- ment of the disease, for it is usually found, especially when outbreaks over any number of animals occur, in low, damp, marshy countries during the warm seasons. It is more frequent in districts where marsh}- lands dry out during the heat of summer and are then covered with light rains. Decaying vegetable matter seems most favorable for nourishing and preserving the virus.
The direct cause of anthrax is always contagion or infection of a pre- viously sound animal, either directly from a diseased animal or through various media which contain excretions or the debris from the body of a previously infected animal. The specific virus of anthrax was first discovered by Davaine in 1851. He recognized in the blood of animals suffering from anthrax microscopic bodies in the form of little rods with bright spots at their extremities. It ^vas not, however, till a quarter of a century later that Pasteur defined the exact nature of the bacillus, the mode of its propagation, and its exact relationship to anthrax as the sole cause of the disease. The bacillus of Davaine, or the virus of anthrax, is a low organism, in the form of a rod with a bright spot or spore at either end, which develops in the blood of an animal, or in other favorable media, as chicken broth or meat jellies kept at the temperature of the animal body. In the animal body the bacilli have a tendency to be filtered from the blood by the tissues of the organs through which the fluid passes, and to accumulate in the spleen, liver, and elsewhere, so that these organs are much more viru- lent than the muscles or less vascular tissues. AVhen eliminated from the animal in the excretions, or when exposed to outside influences by the death of the animal and the disintegration of the tissues, the body of the rod is destroyed and the spores only remain. These spores, which are the germs of the ^irus, retain their vitality for a long period; they resist ordinary putrefaction; they are unchanged by moisture, and they are not afleeeted by moderate heat. If scattered with the debris of a dead animal on the surface of the ground, they may remain around the roots of -the grass in a pasture, or may be washed to the nearest low-lying ground or marsh. If buried in the body of an ani- mal dead from anthrax, they may be washed deep in the ground, and in later years (in one proven case seventeen years) be brought to the surface and infect other animals. They are frequently brought to the surface of the earth, having been swallowed by earthworms, in the bodies of which they have been found.
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This accounts for the outbreaks at the time of the first rains after a dry season. During the latter the earthworm goes deep in the ground in^search of moisture; it finds the spore which has been washed there in past years, swallows it, and brings it to the surface when the rain furnishes the moisture which drives the worm itself from its deeper home. The virus is carried with the wool from infected sheep and remains in it through the process of manufacture into cloth. The spores remain in the hides of animals which have died of anthrax and retain their vitality throughout months of soaking in the tanners' pits, the working of the harness-maker or the cobbler and after the oiling of the completed leather. The dried spores in the dust from any of these products nuxy be carried by the atmosphere.
Infection of an animal takes place through inoculation or contact of the bacillus or its spores Avith an abraded surface or mucous mem- brane on a sound animal. In an infected district horses may eat the rich pasturage of spring and early summer with impunity, but when grass becomes low they crop it close to the ground, pull up the roots around which the virus may be lodged, and under these conditions the animals are more apt to have abrasions of the lips or tongue by contact with dried stubble and the dirt on the roots, which favor the introduction of the germs into the system. The virus may be intro- duced with food and enter the blood-vessel system from the stomach and intestines. If contained in the dust, dried hay, or on the parched pasture of late summer, the virus may be inhaled and be absorbed from the lining of the lungs. If contained in harness leather, it needs but an abrasion of the skin, as the harness rubs it, to transfer the spore from the leather to the circulation of the animal.
The writer saw a case of anthrax occur in a groom from the use of a new horse brush. The strap which passes over the back of the hand inoculated an abrasion on the knuckle of the first finger, and in twelve hours a "pustule" had formed and the arm had become affected.
Sijmptoms.— The symptoms of anthrax develop with extreme rapid- ity; they are frequently so sudden that it appears but a few minutes for'the animals to have passed from a condition of perfect health to a dangerouslv diseased one. The horse is dejected and falls into a state of profound stupor, attended by great muscular weakness. The feeble, indolent animal, if forced to move, drags its legs. There are severe chills, agitation of the muscles, symptoms of vertigo, and at times colickv pains. The mucous membranes turn a deep ocher or bluish-red color. The body temperature is rapidly elevated to 104° and 105° F. The breathing is increased to thirty or forty respirations in the minute and the pulse is greatly accelerated, but the arteries are soft and almost imperceptible, while the heart-beats can be felt and heard, violent and tumultuous. In other words, it resembles a very severe case of influenza, except in regard to the heart's action. The symptoms last but two, three, or four days, at most, when the case
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usually terminates fatally. An examination of the blood shows a dark fluid which does not clot, and which remains black after exposure to the air. After death the bodies putrefy rapidly and bloat up; the tissues are filled with gases and a bloody foam exudes from the mouth, nostrils, and anus, and frequently the mucous membranes of the rec- tum protrude from tlie latter. The hairs detach from the skin. Con- gestion of all the organs and tissues is found, with interstitial hemor- rhages. The muscles are friable and are covered with ecchymotic spots. This is specially marked in the heart.
The black, uncoagulated and incoagulable blood shows an iridescent scum on its surface, which is due to the fat of the animal dissolved by the ammonia produced by the decomposed tissues. The serum oozes out of every tissue and contains broken-down blood, which, when examined microscopically, is found to liave the red globules crenated and the leucocytes granular. A high power of the micro- scope also reveals the bacteria in the shape of little rod-like bodies of homogeneous texture with their brilliant spores.
The lymphatic ganglia are increased four, five, six, or ten times their natural size, enlarged by the engorgement of blood. The spleen shows nodulated black spots containing a muddy blood, which is found teeming with the virus. The mucous membi-anes of the intes- tines are congested and brown; the surface of the intestines is in many places denuded of its lining membrane, showing fissures and hemorrhagic spots. The liver has a cooked appearance; the kidnej^s are congested and friable; the urine is red; the pleura, lungs, and the meninges are congested and the bronchi of the lungs contain a bloody foam.
En resume: The symptoms are those which are found in any dis- ease with a rapidly decomposing blood.
The treatment of anthrax was entirely useless and ineffectual until within a comparatively few years. The curative treatment, for wliich almost every drug in the pharmacopoeia has been used, was without avail, except, perhaps, the use of iodine, injected in the circulation in as large quantities as could be tolerated by the system. This treatment gives good results in the human being, but requires too much personal attention to be economical in animals when the disease occurs in epidemic form, although it may be used in the horse when occurring in an animal of great value.
The prophylactic treatment formerly consisted in the avoidance of certain fields and marshes which were recognized as contaminated dur- ing the months of August and September and had been occupied the years in which the outbreaks usually occurred. It underwent, how- ever, a revolution after the discovery by Pasteur of the possibility of a prophylactic inoculation which granted immunity from future attacks of the disease equal to that granted by the recovery of an animal from an ordinary attack of the disease.
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This treatment consists in an artificial cultivation of the virus of anthrax in broths, jellies, or other media, and in the treatment of it by means of continued exposure to the atmosphere or to a high tem- I)erature for a 'certain length of time, which weakens the virus to such an extent that it is onlj^ capable of j)roducing an ephemeral fever in the animal in which it is inoculated, and which yet has retained a suffi- cient amount of its power to protect the animal from inoculation of a stronger virus. The production of this virus, which is carried on in some countries at the expense of the government and is furnished at a small cost to the farmers in regions where the disease prevails, in this country is made only in private laboratories.
GLANDERS.
Synonyms: Glanders, Farcy, One form of Nasal (rZee/, English; Malleus Inimidus, Equina nasalis. Equina apostematos, Latin; Rotz, Botzkrankheif, German; Siwf, Yerroting, Dutch; Moccio, Ciamorro, Italian; Muermo, Spanish; 3forve, Farcin, French.
Definilion. — Let it be understood at the outset that glanders and farcy are one and the same disease, differing onl}'^ in that the first term is applied to the disease when the local lesions i)redominate in the internal organs, especially in the lungs and the air tubes; and that the second term is applied to it when the principal manifestation is an outbreak of the lesions on the exterior or skin of the animal. The term glanders applies to the disease in both forms, while the term farcy is limited to the visible appearance of external trouble only; but in the latter case internal lesions always exist, although they may not be evident.
Glanders is a contagious constitutional disease of the genus equus (the horse, ass, and mule), readilj^ communicable to man, sheep, goats, to dog, the cat, the rabbit, and Guinea pig. It runs a variable course until it produces the death of the animal affected with it. It is characterized b}^ the formation of neoplasms of connective tissue, or tubercles which degenerate into ulcers from which exudes a peculiar discharge. It is accomT)anied by a variable amount of fever accord- ing to the rapidit}' of its course. It is subject to various complications of the lymphatic glands, of the lungs, of the testicles, of the internal organs, and of the subcutaneous connective tissue.
History. — Glanders is one of the oldest diseases of which we have definite knowledge in the history of medicine. Absyrtus, the Greek veterinarian in the army of Constantino the Great, described this dis- ease with considerable accuracy and recognized the contagiousness of its character. Another Greek veterinarian, Yegetius Renatus, who lived in the time of Theodosius (381 A. D.), described under the name of malleus liumidus a disease of the horse characterized by a nasal discharge and accompanied by superficial ulcers. He recognized the contagious properties of the discharge of the external ulcers, and
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recommended that all animals sick with the disease should be sepa- rated at once with the greatest care from the others, and should be pastured in separate fields for fear the other animals should become affected.
In 1682 Solh'sel, the stable master of Louis XIV, published an account of glanders and fare}-, which he considered closelj^ related to each other, although he did not recognize them as identical. He admitted the existence of a virus which communicated the disease from an infected animal to a sound one. He called special attention to the feed-troughs and water-buckets as being the medium of conta- gion. He divided glanders into two forms, one malignant and con- tagious, and the other benign, and he stated that there was always danger of infection.
Garsault, in 174G, said "that as this disease is communicated ver3^ easilj-, and can infect in a very short time a prodigious number of horses by means of the discharges which may be licked up, animals infected with glanders should be destroyed."
Bourgelat, the founder of veterinary schools, in his "Elements of Hippiatary," published in 1755, establishes glanders as a virulent disease. Extensive outbreaks of glanders are described as prevailing in the great armies of continental Europe and England from time to time during the periods of all the wars of the last few centuries.
Glanders was imported into America at the close of the last century, and before the end of the first half of the present century had spread to a considerable degTee among the horses of the Middle and immedi- ately adjoiiiing Southern States. This disease was unknown in Mexico until carried there during the Mexican war by the badly diseased horses of the United States Army. D uring the first half of the present century a large school of A'eterinarians and medical men protested against the contagious character of tliis disease, and prevailed by their opinion to such an extent against the common opinion that several of the governments of Europe undertook a series of experiments to deter- mine the right between the contesting parties.
At the veterinary school at Alfort, and at the farm of Lamirault in France several hundred horses Avhich had i^assed examination as sound had placed among them glandered horses under various condi- tions. The results of these experiments proved conclusively the con- tagious character of the di.sease.
In 1881 Professor Bouchard, of the faculty of medicine in Paris, assisted by Drs. Capilan and Charrin, undertook a series of experi- ments with matter taken from the farcy ulcer of a human being. They afterward continued their experiments with matter taken from animals of the equine genus. In 1883 these gentlemen presented the results of their researches to the Academy, through Prof essors Bouley and Vulpiam, conclusively demonstrating that the disease was caused by a bacterium or low order of parasitic organism, which is capable
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of propagation and reproduction of others of its own kind if placed in the proper media.
When we come to stndy the etiology of glanders, the difference of susceptibility on the part of difiEerent species of animals, or even on the part of individuals of the same species, and when we come to find proof of the slow incubation and latent character of the disease as it exists in certain individuals, we will understand how in a section of country containing a number of glandered animals others can seem to contract and develop the disease without having apparently been exposed to contagion.
Etiologjj.—The contagious nature of glanders, in no matter what form it appears, being to-day definitely demonstrated, we can recog- nize but one cause for all cases, and that is contagion by means of the specific virus of the disease.
In studying the writings of the older authors on glanders, and the works of those authors who contested the contagious nature of the dis- ease, we find a large number of predisposing causes assigned as factors in the development of the malady.
While a virus from a case of glanders if inoculated into an animal of the genus equus vnll inevitably produce the disease, we find a vast difference in the contagious activity of the products of different cases of glanders. We find a great variation in the manner and rapidity of the development of the disease in different individuals, and we find that the contagion is much more apt to be carried to sound ani- mals under certain circumstances than it is under others. Only cer- tain species of animals are susceptible of contracting the disease, and while some of these contract it as a general constitutional malady, in others it only develops as a local sore.
In acute glanders the contagion is found in its most virulent form, as is shown by the inevitable infection of susceptible animals inocu- lated with the disease, while the discharge from chronic semilatent glanders and farcy may at times be inoculated with a negative result; again, in acute glanders, as we have a free discharge, a much greater quantity of virus-containing matter is scattered in the neighborhood of an infected horse to serve as a contagion to others than is found in the small amount of discharge of the chronic cases.
The chances of contagion are much greater when sound horses, asses, or mules are placed in the immediate neighborhood of glandered horses, drink from the same bucket, stand in the next stall or work in the same wagon, or are fed from the same bales of hay or straw which have been impregnated by the saliva and soiled by the discharge of sick animals. The contagion must terminate by direct contact of the discharges of a glandered animal with the tissues of a sound one, either on the exterior or when swallowed mixed with food into the digestive tract.
Glanders is not infectious in the old acceptation of the word. Re- nault made a large number of experiiuents, forcing sound horses to
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breathe the expired air of giandered horses for an hour and a half a day for seven days, by means of a tube of canvas, and was unable to .produce the disease in any case.
The stable attendants serve as one of the most common carriers of the virus. Dried or fresh discharges are collected from the infected animal in cleaning, harnessing, feeding, and by means of the hands, clothing, the teeth of the currycomb, the sponge, the bridle, and halter and are carried to other animals.
An animal affected with chronic glanders in a latent form is moved from one part of the stable to another, or works hitched with one horse and then with another, and may be an active agent in the provocation of the disease without the cause being recognized.
Glanders is found frequently in the most insidious forms, and we recognize that it can exist Avithout being apparent; that is, it may affect a horSe for a long period without showing any symptoms that will allow even the most experienced veterinarian to make a diagno- sis. An old gray mare belonging to a tavern keeper was reserved for family use with good care and light work for a period of eight years, during which time other horses in the tavern stable were from time to time affected with glanders without an apparent cause. The mare, whose only trouble was an apparent attack of heaves, was sold to a huckster, who placed her at hard work. Want of feed and overwork and exposure rapidly developed a case of acute glanders, from which the animal died, and at the autopsy were found the lesions of an acute pneumonia of glanders grafted on chronic lesions, consisting of old tubercles, which had undoubtedly existed for years.
In a recent case under the care of the writer a coach horse was examined for soundness and passed as sound by a prominent veteri- narian, who a few months afterwards treated the horse for a skin erup- tion from which it recovered. Twelve months afterwards it came into the hands of the writer, hidebound, with a slight cough and a slight eruption of the skin, which was attributed to clipping and the rubbing of the harness, but which had nothing suspicious in its charactei\ The horse was placed on tonics and put to regular light driving. In six weeks it developed a bronchitis without having been specially exposed, and in two days this trouble was followed by a lobular pneu- monia and the breaking of an abscess in the right lung. Farcy buds developed on the surface of the body and the animal died!^ The autopsy showed the existence of a number of old tubercles in the lungs which must have existed previous to purchase, more than a year before.
Public watering troughs and the feed boxes of boarding stables and the tavern stables of market towns are among the most common recip- ients for the virus of glanders, which is most dangerous in its fresh state, but cases have been known to be caused by feeding animals in the box or stall in which giandered animals had stocxl more than a
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year before. While the discharge from a case of chronic ghiiiders is much less apt to contain the virus than that from a case of acute glanders, the former, if it infects an animal, will produce the same • disease as the latter. It may assume from the outset an acute or chronic form according to the susceptibility of the animal infected, and this does not depend upon the character of the disease from Avhich the virus was derived.
The genus equus, the horse, the ass, and the mule, are the animals which are the most susceptible to contract glanders, but in these we find a much greater receptivity in the ass and mule than we do in the horse. In the ass and mule in almost all cases the period of incuba- tion is short and the disease develox)s in an acute form. We find that the race of horse infected influences the character of the disease; in full-blooded, fat horses, of a sanguinary temperament, the disease usu- ally develoj)S in an acute form, while in the lymi)hatic, cold-blooded, more common race of horses the disease usuall}^ assumes a chronic form. If the disease develops first in the chronic form in a horse in fair condition, starvation and overwork are apt to bring on an acute attack, but when the disease is inoculated into a debilitated and imi^overished animal it is apt to start in the latent form. Inoculation on the lips or the exterior of the animal is frequently followed by an acute attack, while infection by ingestion of the virus and inoculation by means of the digestive tract is often followed by the trouble in the chronic latent form.
In the dog the inoculation of glanders may develop a constitutional disease with all the sj^miitoms vrhich are found in the horse, but more frequentlj^ the virus pullulates onlj^ at the iDoint of inoculation, remaining for some time as a local sore, which maj^.then heal, leaving a perfectly sound animal; but while the local sore is continuing to ulcerate, and specific virus exists in it, it maj" be the carrier of con- tagion to other animals. In man we find a greater receptivity to glanders than in the dog, and in many unfortunate cases the virus spreads from the i^oint of inoculation to the entire sj^stem and destroys the vrretched mortal by extensive ulcers of the face and hemorrhage, or by destruction of the lung tissue; in other cases, however, most fortunately, glanders mny develop as in the dog, only in local form, not infecting the constitution and terminating in recover}^, while the specific ulcer by proper treatment is turned into a simple one. In the feline species glanders is more destructive than in the dog. The j)oint of inoculation ulcerates rapidly and the entire system becomes infected.
AVhile a student the writer saw a lion in the service of Professor Trasbot, at Alfort, which had contracted the disease by eating glan- dered meat and died with the lung farcied with tubercles. A litter of kittens lapped at the blood from the lungs of a glandered horse on which an autopsy was being made, and in four days almost their
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entire faces, including the nasal bones, were eaten away by rapid ulceration. Tubercles were found in the lungs.
A pack of wolves in the Philadelphia Zoological Garden died in ten days after being fed with the meat of a glandered liorse. The rabbit, Guinea pig, and mice are specially susceptible to the inoculation of glanders, and the recent discoveries in regard to this disease have made these animals most convenient witnesses and proofs of the exist- ence of suspected cases of the glanders in other animals by the results of successful inoculations.
The sheep and the goat are both capable of developing the disease. The goat is more susceptible and frequently develops it by means of the digestive tract, from its habit of eating droppings, i-ags, etc. , which are found in the neighborhood of the stall. The pig is considered not to be susceptible to glanders, and a large number of inoculations, together with the feeding of glandered meat to a pen of pigs at the vet- erinary school at Alfort, failed to give these animals the disease, but Bollinger reports that Gerlach has seen glanders in the pig nine months after inoculation. An experiment of Spinola has also pro- duced positive results, so that we should consider it dangerous to allow a pig the use of glandered meat.
Horned cattle and barnyard fowls are absolutely exempt from attacks of glanders, whether the virus is given to them by the digest- ive tract or inoculated into their tissues.
The previous reference to the existence of glanders under the two forms more commonly differentiated as glanders and as farcy, and our reference to the various conditions in which it may exist as acute, chronic, and latent, show that the disease may assume several differ- ent phases. Without losing sight for a moment of the fact that all of these varied conditions are identical in their origin and in their essence, for convenience of study we may divide glanders into three classes: Chronic farcy, chronic glanders, and acute farcij glanders.
The primary lesions in any form is a local point of eruption in which we have a rapid prolification of the cell elements which make up the animal tissue with formation of new connective tissue, with a crowd- ing together of the elements until their own pressure on each other cuts off the circulation and nutrition, and death takes place in them in the form of idceration or gangrene. Following this primary lesion we have an extension of infection by means of those tissues immedi- ately surrounding the first infected spot, which is most suitable for the development of simple inflammatory phenomena or the specific virus. Tlie primary symptoms are the result of inoculation developed at the point of inoculation, but at a later time the virus is carried by means of the blood vessels and lymphatic vessels to other parts of the body and becomes lodged at different places and develops in them; again, when the disease has existed in the latent form in the lungs of the animal and tho virus is Avakened into action from any cause, we have
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it carried to various parts of the body and developing in tlie most favorable localities. The points of development are most frequently determined by the activity of the circulation and the effects of exterior irritants. For example, if a horse which has been so slightly affected with the virus of glanders that no symptoms are visible is exposed to cold, rain, or sleet, or by the rubbing of the harness on the body and the irritation of mud in the legs, the disease is apt to develop on the exterior in the form of farcy, while a full-blooded horse which is employed at speed and has its lung and respiratory tract gorged with blood from the extreme use of these organs will develop glanders as the local manifestation of the disease in the respiratory tract.
Chronic farcy. — In farcy the symptoms commence by formation of little nodes on the under surface of the skin, which rapidly infringe on the tissues of the skin itself. These nodes, which are known as farcy "buds" and farcy "buttons," are from the size of a bullet to the size of a walnut. They are hot, sensitive to the touch, at first elastic and afterwards become soft; the tissue is destroyed, and infringing on the substance of the skin the disease produces an ulcer, which is known as a chancre. This ulcer is irregular in shape, with ragged edges which overhang the sore ; it has a gray, dirty bottom and the discharge is sometimes thin and sometimes purulent; in either case it is mixed with a viscous, sticky, yellowish material like the white of an egg in consistency, and like olive oil in appearance. The discharge is almost diagnostic ; it resembles somewhat the dis- charge which we have in greasy heels and in certain attacks of lym- phangitis, but to the expert the specific discharge is characteristic. The discharge accumulates on the hair surrounding the ulcer and over its surface and dries, forming scabs which become thicker by successive deposits on the under surface until they fall off, to be replaced by others of the same kind; and the excess of discharge may drop on the hairs below and form similar brownish yellow crusts. The farcy ulcers may retain their specific form for a considerable time— days or even weeks; but eventually the discharge becomes purulent in character and assumes the appearance of healthy matter. The surface of the gangrenous bottom of the ulcer is replaced by rosy granulations, the ragged edges beveled off, and the chancre is turned into a simple ulcer which rapidly heals.
The farcy buttons occur most frequently on the sides of the lips, the sides of the neck, the lower part of the shoulders, the inside of the thighs, or the outside of the legs, but may occur at any part of the body.
We have next an irritation of the lymphatic vessels in the neigh- borhood of the chancres. These become swollen and then indurated and appear like great ridges underneath the skin; they are hot to the touch and sensitive. The cords may remain for a considerable time and then gradually disappear, or they may ulcerate like a farcy bud itself, forming elongated, ii-regular, serpentine ulcers with a
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characteristic, dirty, gray bottom and ragged edges, and pour out a viscons oily discharge like the chancres themselves.
The essential symptoms of farcy are the above; the luiton, the clumcre, tlie cord, and the discharge. ^Ve have in addition to these symptoms a certain number of accessory symptoms, Avhich, while not diagnostic in themselves, are of great service in aiding the diagnosis in cases where the eruption takes place in small quantities, and when the ulcers are not characteristic.
Epistaxis, or bleeding from the nose without previous work or other apparent cause, is one of the frequent concomitant symptoms in glanders, and such a hemorrhage from the nostrils should always be regarded with suspicion. The animal with farcy frequently develops a cough, resembling much that which we find in heaves— a short, dry, aborted, hacking cough, with little or no discharge from the nostrils! AVith this we find an irregular movement of the flanks, and on auscul- tation of the lungs we find sibilant or at times a few mucous rales. Another common symptom is a sudden swelling of one of the hind legs; it is suddenly found swollen in the region of the cannon, the enlargement extending below to the pastern and above as high as the stifle. This swelling is hot and painful to the touch, and renders the animal stiff and lame. On pressure with the finger the swelling can be indented, but the pits so formed soon fill up again on removal of the pressure. In severe cases we may have ulceration of the. skin, and serum pours out from the surface, resembling the oozing which we have after a blister or in a case of grease. This swelling is not to be confounded with the stocking in lymphatic horses, or the oedema which we have in chronic heart or in kidney trouble, as in the last the swelling is cool and not painful and the pitting on pressure remains for some time after the latter is withdrawn. It is not to be confounded with greasy heels. In these the disease commences in the neighborhood of the pastern and gradually extends up the leg, rarely passing beyond the neighborhood of the hock. The swolleli leg in glandei-s almost invariably swells for the entire length in a single night, or within a very short period. When greasy heels are complicated by lymphangitis we ha\e a condition very much resem- bling that of farcy. The swelled leg in farcy is frequently followed by an outbreak of farcy buttons and ulcers over its surface. In the entire horse the testicles are frequently swollen, hot and sensitive to the touch, but they have no tendency to suppuration. The acute inflammation is rapidly followed by the specific induration, which corresponds to the local lesions in other parts of the body.
Chronic farcy in the ass and mule is an excessively rare condition, but som etimes occurs.
Chronic ghmders.—ln chronic glanders we have the same train of inflammatory phenomena, varying in appearance from those of chronic farcy only by the difference of the tissues in which they are
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located. In chronic glanders we have first the tubercle, which is a small node from the size of a shot to that of a small pea, which forms in the mucous membranes of the respiratory tract. This may be just inside of the wings of the nostrils or on the septum which divides the one nasal cavity from the other and can be easily detected, or they may be higher in the nasal cavities on the turbinated bones, or they may form in the larynx itself, or on the surface of the trachea or deep in the lungs.
The tubercles, which are first red and hard and consist of new con- nective tissue, soon soften and become yellow; the yellow spots break and we have a small ulcer the size of the preceding tubercle, which has a gray, dirty bottom and ragged edges and is known as a chancre. This ulcer pours from its surface a viscous, oily discharge similar to that which we have seen in tlie farcy ulcer. The irritation of tlie discharge may ulcerate the lining mucous membrane of the nose, causing serpentine gutters with bottoms resembling those of the chancres themselves. If the tubercles have formed in large numbers we may have them causing an acute inflammation of tlie Schneiderian membrane, with a catarrhal discharge which may mark the specific discharge, or that which comes from the ulcers and resembles the discharge of strangles or simple inflammatory diseases.
The eruption of the ulcers and discharge soon cause an irritation of the neighboring lymphatics; and in the intermaxillary space, deep inside of the jaws, we find an enlargement of the glands, which for the first few days may seem soft and o-dematous, but which rapidly becomes confined to the glands, these being from the size of an almond to that of a small bunch of berries, exceedingly hard and nodulated. This enlargement of the glands is found high up on the inside of the jaws, firmly adherent to the base of the tongue. It is not to be con- founded with the swelling, puffy, oedematous, and not to be separated from the skin and subcutaneous connective tissues, which we find in strangles, in laryngitis, and in other simi^le inflammatory troubles.
These glands bear a great resemblance to the hard, indurated glands vdiich we find in connection with the collection of pus in the sinuses; but in the latter disease the glands have not the nodulated feel which they have in glanders. With the glands we find indurated cords, feel- ing like balls of tangled wire or twine, fastening the glands together. The essential symptoms of glanders are the iuherde, the chancre, the glands, and the discharge. With the development of the tubercles on the respiratory tract, according to their number and the amount of eruption Avhich they cause, we may have a cough which resembles that of a coryza, a laryngitis, a bronchitis, or a broncho-pneumonia, accord- ing to the location of the lesions. In clironic glanders Ave have the same accessory symptoms Avhich we have in chronic farcy, the hemor- rhage of the nose, the swelling of the legs, the chronic cough, and in the entire liorso the swelling of the testicles.
539
On healing, tlie clianeres on the mucous membranes leave small, whitish, star-shaped scars, hard and indurated to the touch, and which remain for almost an indefinite time. The chancres heal and tlie other local symptoms disappear, Avith the exception of the enlarge- ment of the glands, and we find these so diminished in size that they are scarcely perceptible on examination. During the subacute attacks, Avith a minimum quantity of local troubles, in chronic glan- ders and in chronic farcy the animal rarely shows any amount of fever, but does have a general depraved appearance; it loses flesh and becomes hidebound; the skin becomes dry and the hairs stand on end. There is a cachexia, however, which resembles greatly that of any chronic, organic trouble, but is not diagnostic, although it has in it certain appearances and conditions which often render the animal suspicious to the eye of the expert veterinarian, while without the presence of local lesions he would bo unable to state on what he has based his opinion.
Acute glanders. — In the acute form of glanders we luive the symp- toms which we have just studied in chronic farcy and in chronic glanders in a more acute and aggravated form. We have a rapid out- break of tubercles in the respiratory tract which rapidly degenerate into chancres and pour out a considerable discharge from the nostrils. We have a cough of more or less severity according to the amount and site of the local eruption. "We have over the surface of the body swellings which are rapidly followed by farcy buttons, which break into ulcers; we have the indurated cords and enlargement of the lymphatics.
Bleeding from the nose, sudden swelling of one of the hind legs, and the swelling of the testicles are apt to precede an acute eruption of glanders. As the symptoms become more marked the animal has dif- ficulty of respiration, the flanks heave, the respiration becomes rapid, the pulse becomes quickened, and the temperature becomes elevated to 103°, 104°, or 105° F.
With the other symptoms of an acute fever the general appearance an<l station of the animal is that of one suffering from an acute pneu- monia, but upon examination, while we may find sibilant and mucous rales over the side of the chest, and may possibly hear tubular mur- murs at the base of the neck overthe trachea, we fail to find the tubu- lar murmur or the large area of dullness on percussion over the sides of the chest which belongs to simi^le pneumonia.
The post-mortem examination of the lungs shows that the pneu- monia of glanders is a lobular, V-shaped pneumonia scattered Ihrough the lungs and caused by the specific inflammatory process taking place at the divergence of the smaller air tubes of the lungs. In some cases of acute glanders the formation of tubercles may so irri- tate the mucous membrane of the respiratory tract and cause such a profuse discharge of muco-purulent or purulent matter that the ^Decifie character of the original discharsre is entirelv masked. In
540
this case, too, the submaxillary space may for a few days so swell as to resemble the oedematous inflamed glands of strangles, equine vari- ola, or laryngitis. This condition is especially apt to be marked in an acute outbreak of glanders in a drove of mules.
Cases of chronic farcy and glanders, if not destroyed, may live in a depraved condition until the animal dies from general emaciation and anaemia, but in the majoritj^ of cases, from some sudden exposure to cold, it develops an acute pneumonia or other simple inflammatory trouble which starts up the latent disease and the animal has acute glanders.
In the ass, mule, and plethoric horses, acute glanders usually termi- nates by lobular pneumonia. In other cases the general symptoms may subside. The symptoms of pneumonia gradually disappear, the temperature lowers, the pulse becomes slow^er, the ulcers heal, leaving small indurated cicatrices, and the animal may return to apparent health, or may at least be able to do a small amount of work with but a few symptoms of the disease remaining in a chronic form. During the attack of acute glanders the inflammation of the nasal cavities frequently spreads into the sinuses or air cells, which are found in the forehead and in front of the eyes on either side of the face, and cause abscesses of these cavities, which may remain as the only visible symp- tom of the disease. Animals that have recovered from acute glanders, like the animals that are affected by chronic glanders and chronic farcy, are apt to be affected with emphysema of the lungs or the heaves, and to have a chronic cough. In this condition they may continue for a long period, serving as dangerous sources of contagion, the more so because the slight amount of discharge does not serve as a warning to the owner or driver as profuse discharge does in the more acute cases.
AYith good care, good food, and good surroundings and little work, an animal affected with glanders may live for months or even years in an apparent state of perfect health, but with the first deprivation of food, with a few days of severe hard work, with exposure to cold or with the attack of a simple fever or inflammatory trouble from other causes, the latent seeds of the disease break out and develop the trouble again in an acute form.
At the post-mortem examination of an animal which has been destroyed or has died of glanders we find evidences of the various lesions which we have studied in the symptoms. In addition to this, we find tubercles similar to those which we have seen on the exterior throughout the various organs of the body. Tubercles may be found in the liver, in the spleen, and in the kidneys. We may have inflam- niat ion of the periosteum of the bones, and we have excessive altera- tions in the marrow in the interior of the bones themselves. Both of these conditions during the life of the animal may have been the cause of lameness which was difficult to diagnose. •
541
In one case which came nnder the observation of the writer a lame horse was destroj^ed and found to have a large abscess of the bone of the arm, with old tubercles of the lungs. When an animal has died immediately after an attack of a primary acute case of glanders, we find small V-shaped spots of acute pneumonia in the lungs. If the animal has made an apparent recovery from acute glanders, and in cases of chronic farcy and chronic glanders no matter how few the external and visible symptoms may have been, there is a deposit of tubercles — small, hard, indurated nodes of new connective tissue to be found in the lungs. When these have existed for some time we may find a deposit of lime salts in them. These indurated tubercles retain the virus and their power to give out contagion for almost an indefinite time, and predispose to the causes which we have studied as the common factors in developing a chronic case into an acute case; that is, ah inflammatory process wakens up their vitality and produces a reinfection of the entire animal. The blood of an animal suffering from chronic glanders and farcy is not virulent and is unaltered, but during the attack of acute glanders, while the animal has fever, the blood becomes virulent and remains so for a few days.
Treatment. — Fully the entire list of drugs in the pharmacopoeia have been tested in the treatment of glanders. Good hygienic surroundings, good food, with alteratives and tonics, frequently ameliorate the symp- toms and often do so to such an extent that the animal would pass the examination of any expert as a perfectly sound animal. But while in this case the number of tubercles of the lungs, which are invariably there, may be so few as not to cause sufiicient disturbance in the res- piration as to attract the attention of the examiner, they exist, and will remain there almost indefinitely with the constant possibility of a return of acute symptoms.
In several celebrated cases horses which have been affected with glanders have been known to work for years and die from other causes without ever ha%ing had the return of symptoms; but, allowing that these cases may occur, they are so few and far between, and the dan- ger of infection of glanders to other horses and to the stable attend- ants is so great, that no animal which has once been affected with the disease should be allowed to live.
In all civilized countries, with the exception of some of the States in the United States, the laws are most stringent regarding the prompt declaration on the part of the owner and attending veterinarian at the first suspicion of a case of glanders, and they allow a liberal indemnity for the animal. When this is done, in all cases the animal is destroyed and the articles with which it has been in contact are thoroughly dis- infected. When the attendants have attempted to hide the presence of the disease in a community, punishment is meted to the owner, attend- ing veterinarian, or other responsible parties. Several States have passed excellent laws in regard to glanders, but with few exceptions
542
these laws are not carried out witli the rigidity with which they should be. In other States where an indemnity is allowed on declaration on the i)art of the owner, the appraisement of the animal is not fairly made. If the owners of infected animals are to be encouraged to declare the presence of the disease in order to protect their neigh- bors from the danger of contagion thcj" should be paid, not what the animal affected with the disease is considered worth, when it is value- less, but the one-half or two-thirds of what would be its market value without the disease, and the community should share the loss which the owner should make in order to protect others.
RABIES IX THE HORSE.
Synonyms: Hydrophobia, madness, Ij'ssa, rage, Widhlcranlcheit.
Rabies is a contagious disease, which is usually transmitted by a bite and by the introduction of a virus contained in the saliva of an affected animal, but may be transmitted in other ways. It is char- acterized by symi)toms of aberration of the nervous system, and inva- riably terminates fatally. It is a disease essentiall}^ of the dog, but is transmitted to the horse, either from dogs or from any other animal affected with it.
As a disease of the horse it is useless to enter into the etiology fur- ther than to assume that in this animal it is invariably the result of the bite of a rabid animal, usuallj^ a dog.
Perhaps no disease in medicine has been the object of more contro- versy than rabies. Certain medical men of prominence have even doubted the existence of the disease. Many medical men have claimed for it a spontaneous origin. The experience, however, of ages has shown that contagion can be proved in the great majority of cases, and by analogy with other contagious diseases we may only believe that the development of one ease reciuired the preexistence of a previous case from which the virus has been transmitted. M. Pas- teur has further added to our knov\iedge of the disease by showing that a virus capable of cultivation exists in the nervous system, espe- cially in the loAver part of the brain (medulla oblongata), and in the anterior part of the spinal column. M. Pasteur has further shown that that x)ortion of the nervous system which contains the virus, tlie exact nature of which has not yet been demonstrated, will retain it for an indefinite time if kept at a very low temperature, or if left surrounded by carbonic acid; but if the nerve matter, which is viru- lent at first, is exposed to the air and by substances which will absorb the surrounding moisture is kept from putrefaction, it will gradually lose its virulence and become inoffensive in about fifteen days. lie lias further shown that the action of a weak virus on an animal will prevent tlie development of a stronger virus, and from this he has formulated his method of prophylactic treatment. This treatment
543
consists of the successive inoculation of portions of tlie nerve matter containing the virus from a rabid animal, which has been exposed to the atmosphere for thirteen daj^s, ten days, seven da^-s, and four days, until the Airulent matter which w411 produce rabies in any unpi-oteeted animal can be inoculated with impunity. A curious result of the experiments of M. Pasteur is that an animal which has first been inoculated with a Airus of full strength can be protected by subsequent inoculations of attenuated virus repeated in doses of increasing strength.
In the horse rabies is invariably the result of the bite of a rabid dog or other rabid animal. From the moment of inoculation a variable time elapses before the development of any symptoms. This time may be eight days, or it may be several months; it is usually about four weeks. The first symptom is an irritation of the original wound. This wound, which may have healed completely, commences to itch until the horse rubs or bites it into a new sore. The horse then becomes irritable and vicious. It is especially susceptible to sur- rounding media; excessive light, noises, the entrance of an attendant, or any other disturbance will cause the patient to be on the defensive. It apparently sees imaginary objects; the slightest noise is exaggerated into threatening violence; the approach of an attendant or another animal, especially a dog, is interpreted as an assault and the horse will strike and bite. The violence on the part of the rabid horse is not for a moment to be confounded with the fury of the same animal suffering from meningitis or any other trouble of the brain. In rabies there is a volition, a premeditated method, in the attacks which the animal will make, Avhich is not found in the other diseases. Between the attacks of fury the animal may become calm for a variable period. The vrriter attended a case in which, after a violent attack of an hour, the horse was sufficiently calm to be walked 10 miles and only devel- oped violence again an hour after being placed in the new stable. In the period of fury the horse will bite at the reopened original wound; it will rear and attempt to break its halter and fastenings; it will bite at the woodwork and surrounding objects in the stable. If the animal lives long enough it shows paralytic symptoms and falls to the ground, unable to use two or more of its extremities, but in the majcjrity of cases, in its excesses of violence, it does physical injury to itself. It breaks the jav/s in biting at the manger, or fractures other bones in throwing itself on the ground, and dies of hemorrhage or internal injuries. At times throughout the course of the disease there is an excessive sensibility of the skin, which, if irritated by the touch, will l)ring on attacks of violence. The animal may have appetite and desire water throughout the course of the disease, but on attempting to sv.allow has a spasm of the throat, which renders the act impossible. This latter condition, which is common in all rabid animals, has given the disease the name of hydroxiliohia (fear of water).
544
In a case recently under the care of the writer a horse, four weeks after being bitten on the forearm by a rabid dog, developed local irri- tation in the healed wound and tore it with its teeth into a large ulcer. This was healed by local treatment in ten days and the horse was kept under surveillance for over a month. On the advice of another practitioner the horse was taken home and put to work, and within three days it developed violent symptoms and had to be destroyed.
The diagnosis of rabies in the horse is to be made from the various brain troubles to which the animal is subject; first, by the history of a previous bite of a rabid animal or inoculation by other means; sec- ondly, by the evident volition and consciousness on the part of the animal in its attacks, offensive and defensive, on persons, animals, or other disturbing surroundings. The irritation and reopening of the original wound or point of inoculation is a valuable factor in diag- nosis.
Recovery from rabies may be considered as a question of the cor- rectness of the original diagnosis.
No remedial treatment has ever been successful. All of the ano- dynes and anaesthetics, opium, belladonna, bromide of potash, ether, chloroform, etc. , have been used without avail. The prophylactic treat- ment of successive inoculations is being used on human beings, and has experimentally proved efficacious in dogs, but would be impracti- cable in the horse, which must invariably be destroyed or be so guarded as to protect the surrounding attendants and other animals in the same stable, when it ^^dll die in a day or two from self-inflicted trau- matism or paralysis.
PLATE XNXVJl.
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ines, after Agjiew.
A Hoen iCo Lith. Baltimore
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PLATE XXXVm
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'^■^7 .v^^^- ^"^'^f^'^f'^V oft/ie froff, iOO dirmtetprs reduced '? . a blWiuJe f7//ed n'dfi red and w/dfe rorpfi.scle.s ,- the red in dt/> re/itre and die nhite rroH'di/Hj a/orig die wad^f, c,c. aipdJary distertde^i wiih red and white cor pnsrJes,7ii7jrd)ej-ofdif white. nuicA decreased, ddConnective tissue between '■craiJe and rnr/dlari/ tiiled with migrated, i&icoci/te^^. e.e,rnrai£chi'e d^sue n7/h less Jnratration. f Dark-hordje^e^ nerve fibre ■ o.JMimber of nuclei m sTbeMfis increased. .
Haines, fiel. after Agnev
A Hoen&Co Lithi.BaltJmore
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I
SHOEINC;.
By WILLIAM DICKSON, Veterinarian to the State Farmers' Institute of Minnesota.
Although the subject discussed iu tlie present chapter may not, strictly speaking, be entitled to a place in a category of the ailments to which horseflesh is heir, bad and indifferent shoeing are such pro- lific sources of both disability and disease in the noblest of all our dumb animals, that no excuse is necessary in claiming for it equal attention at the hands of those interested.
It has sometimes been asserted that the history of every horse is a record of human endeavor to mar his utility. While the accuracy of such a sweeping assertion may fairly be called in question, there are undoubtedly respects in which the horse in domestication is very often the victim of his owner's ignorance, indifference, or even mistaken kindness, and in no particular is this more strikingly conspicuous than in the ordinary treatment of organs so vitally essential to his useful- ness as his feet. No horseman questions the truth of the aphorism "no foot, no horse," and yet in no portion of that animal's economy has he suffered so many wrongs, or as a natural consequence endured so much uncalled-for suffering, as in his feet, and to shoeing a very larcre proportion of these evils is, beyond all doubt, directly or indirectly referable.
Unfortunately, under certain conditions, shoeing is an almost un- avoidable consequence of the horse's domestication, and, although we may have no wish to uphold the traditional methods, we are driven to the conclusion that an artificial protection of some kind for the horse's foot is very frequently one of the penalties which civilization inexorably exacts. That the ordinary iron shoe is the best and least hurtful means that could be devised, I am reluctant to admit; but, so far, even American ingenuity has failed to develop anvthing better suited to the purpose. That the system of horseshoing as it obtains, even in the most skillful hands, is pregnant with mischief to the foot,' no one who is conversant with the facts will venture to deny. As a matter of physiological fitness the shoe and its mode of attachment are utterly indefensible. Each time a horse is shod — every nail driven—means so much injury to the foot. The better the job the 5961— HOR 18 545
646
less that injury is; but there is no such thing as absolute immunity from an evil which must always exist in inverse ratio to the skill displayed in the execution of the work. We have, however, to deal with facts as Ave find them, and if we have, day after day, to impose upon our horses work of a nature which entails upon their feet more waste of horn than nature can replace during the ordinary interval of rest, we are obliged to adopt a defense of some kind. It would be futile to inveigh against the form of protection in universal use, unless we were prepared vfitli a substitute not open to the same or equally serious objections.
There is, however, at least one very large and important class of horses to which shoes are by no means an habitual necessity, namely, our agricultural horses. The nature of their work, the pace at wliich they are required to perform it, and the character of the ground over which they ordinarily move, all unite to render artificial protection for their feet, save under exceptional circumstances, altogether uncalled for. When this is so, and when it is conceded that shoeing is, even under the most favora,ble circumstances, an evil (albeit in some cases a necessary one), a frequent cause of disease, and there- fore a direct source of loss, it is a matter of deep regret that such a large majority of our farm horses, the very mainspring of our agricul- tural existence, should be needlessly subjected to a mutilation which curtails the period of their natural efficiency and too often renders their life thus shortened one long-continued agony. For it must be borne in mind that our ordinary village blacksmith, of whose dailj" work horseshoeing forms but an insignificant and by no means either an easy or pleasant pai't, is not alwaj'S tlie most competent of workmen.
"Without wishing to do injustice to our rural knights of the anvil, it is nevertheless a lamentable truth that these votaries of the but- tress and drawing-knife are, all the world over, so wedded to a num- ber of traditionary practices, so heinous, so irrational, so prejudicial to the interests alike of the horse and his owner, that one might well be excused for v/ondering whether their mission were not to mar instead of to protect the marvelously perfect handiwork of the Creator. Ignorant alike of the anatomy, jihysiology, and economic relations of the parts, they mutilate, they cut and carve as whim, prejudice, or time-honored custom dictates. Disaster, it may. be slowly, but surely, follows, and too often the poor dumb creature's suffering foots the bill. Let us glance in passing at some of these traditional practices.
Foremost among them is the insane habit of trimming tlie frog and thinning out the sole till it visibly yields to the pressure of the oper- atoi''s thumbs. The frog is nature's cushion and hoof-expander, placed there b}^ an all-wise hand; bj'^ its elasticity it wards off concussion from the less elastic portions of the structure, and by its resilience
547
assists in maintaiuing the natural expansion of its hoi-ny ambit ; that is to say, it does so in its natural state, but the drawing-knife's touch is fatal to it. Once cut and carved and deprived of pressure, those very acts cause it to shrink, dry, and harden, and at once lose those very attributes which constitute its usefulness to the foot. Robbed of its elasticity and resilience, it is incapable of discharging its allot- ted functions — both as a cushion and as an expander it is a dead fail- ure; indeed it is worse, as in its altered character it is now a menace instead of protection, a bane rather than a boon to the foot that wears it.
The destruction of this important factor having been thus provided for, the operator probably next turns his attention to the sole, which, by all traditions of the craft, must be pared down until only a thin film of soft, partially formed horn is left to protect the living struc- tures vv-ithin against injury from the substances with which the foot necessarily comes in contact. Xor does the mischief stop here. The sole itself, or what is left of it, consists now of soft, moist, half-formed horn, which dries and shrinks on exposure to the air, and thereby entails a further and a still more serious injury on the foot.
We have seen in the preceding chapters how the sole is secreted by the velvety tissue dependent from the membrane which invests the pedal bone, the minute, hollow, fibrous processes of which penetrate it and minister to its support. In the mutilated, shrunken sole these delicate fibers are pinched in the lessened caliber of the pores; the source of supply is cut off, and the process of repair retarded if not absolutely arrested. There seems to be a fascination about this work of destruction, and the incompetent workman next addresses himself to the self-imposed task of improving upon nature by removing the bars and what he calls, on the Incus a noii hicendo principle, "open- ing" the heels, a process Avhich, in plain language, means opening a road for them to close over. On this poor, maimed foot a shoe, often many sizes too small, is tacked, and the rasp is most likely called into requisition to reduce the foot to fit the shoe; for although it is appar- ently of little moment w^hether the shoe fits the foot, it is indispen- sably necessary that the foot should, somehow- or other, be got to fit the shoe, and horseshoeing, like other arts, must needs sacrifice on the altar of appearances. It is sad that art and nature should so often be at variance, and that what satisfies the one should outrage the demands of the other.
The foot is now shod and protected from undue wear, to be sure, but at what a sacrifice! Robbed of its cushion, its natural expander; its lateral braces removed; its sole mangled and its natural repair arrested; the hairlike fibers which make up the horny wall crushed, defiected, and their nutritive function impeded by an unnecessary number of nails; robbed by the rasp of its cortical layer of natural varnish, which retains the moisture secreted by the economy, the
548
strong walls become desiccated and weakened, and the foot is in a very sorry plight indeed. To some this picture may seem overdrawn, but it is nevertheless a matter of daily occurrence.
Of course, even among agricultural horses, there are individuals that can not work unshod; but these are exceptional cases. Then, again, in winter, when the usual snowfall is wanting, most horses' feet will require protection ; but nowadays an owner has himself to blame if he submits to having the work done in that wrong-headed and ridiculous manner, which has called into existence such a long and dismal category of disease and misery.
The horse's foot is, after all, a good deal of what we make it, and if our horses, from their colthood up, had their feet more carefully attended to, and especially were they invariablj^ to stand while in con- finement on some material less deleterious to the hoof than dry wooden flooring, from which the foot suffers no attrition whatsoever, and by which it is moreover depleted of its natural moisture, their feet would, in the period of the animals' active usefulness, be found to be better shaped, harder, less brittle, and in every way better suited for the work required of them.
In the East Indies, where pony racing is very popular and the purses exceedingly valuable, many ex]3edients are resorted to to smuggle a pony that is over height under the 13.2 standard (the maximum height for j)onies) among them, of course cutting down the feet as far as can be done with impunity. I frequently observed that those of the hand- some little Arabs and Walers (Australians), which came up oftenest for measurement, and whose feet were in consequence most frequently pared down (albeit by an artist at the business, as these little animals were too valuable for their owners to accept any risk of injury), were those whose feet subsequently stood best the trying ordeal of training and racing on the adamantine going of the tropics. The moral of this is obvious. It might even be possible (I do not mean necessarily in this i)articular way) in the course of generations to develop a horse whose feet should be so improved that he could do all sorts of work on all sorts of going barefoot with impunity; but this would imply an amount of self-sacrifice in the present for the benefit of remote pos- terity which is hardly to be looked for in this practical age, and the contention of enthusiasts that all horses could and should, under all circumstances, go unshod is, I fear, Utopian and imjiractical.
I have endeavored to show that shoeing, as generally, or at all events very frequently, i^racticed is a fruitful source of injury to our horses' feet; but as we can not altogether dispense with the custom, let us turn to a consideration of the means which lie in our power of minimizing the attendant evil as much as possible.
There is one instrument which I should like to see, if possible, omitted from the shoeing outfit of every farrier, and that is the draw- ing-knife. If our blacksmiths would use their knives less and their
549
heads more in the execution of their very important and by no means easy duty, our horses Avould be the better for it, and so won hi tlieir owners. There is no great mystery surrounding the subject, and the application of ordinary common sense, in lieu of the barbarous routine which has been so long handed down from generation to generation nntil it has actually become a portion of the blacksmith's creed, would go a long way towards obviating many, if not most, of the cruel wrongs to which our horses' feet are day by day needlessly subjected.
The outside, or horny wall, and that portion of the sole which is in immediate contact Avith it, on which the shoe should rest, are the only portions of the foot which require to be interfered witli in prepar- ing the foot for the shoe, and all the trimming that is necessary can and ought to be effected by means of the rasp. The frog and sole should on no pretext whatever be meddled with, save to the extent I have indicated. Their presence in their entirety, and in their natural state, is essentially necessary to the well-being of the foot, and neither brooks the touch of the steel.
There may be differences of opinion auiong authorities as to minor details in shoeing, but there is at all events one issue on which it is satisfactory to know that there is absolute unanimity; one practice which all alike utterly condemn; and that is the irrational treatment of the frog and sole, to which I have already alluded. There is, how- ever, no particular in which the thinking horse-owner finds himself more frequently at variance with his blacksmith, for there is no detail in all the latter's misconceived procedure to which he clings with such colossal obstinacy, which is not open to argument, and which sets com- mon sense at defiance.
It is a strange fact, but none tlie less true, that all the world over the farrier is the one among all our artisans who is least amenable to sug- gestions from his employer. Other mechanics permit their patrons at least some discretion as to the size, shape, and structure of the article desired, but when the ordinary horse owner takes his animal to the shoeing forge he has usually to place himself absolutely in the black- smith's hands, and give him carte blanche to cut and carve at his unholy will, or else take his horse elsewhere, and there probably find himself no better off. The result is that his horse's feet are merci- lessly mutilated instead of being left as nearly as possible as nature in her ineffable wisdom made them.
Plate XXXXII, Fig. 1, shows the only parts which should be re- duced when a foot is properly prepared for the shoe. Sufficient care is not always given to shortening the hoof so that its angle should conform exactly to the inclination of the limb. It would be misleading to lay down any arbitrary degree of obliquity. The angle differs in differ- ent cases, and the natural bias of the superimposed structures is the only safe guide to follow. More than one instrument has been devised for ascertaining the correct degree of obliquity, some of them simple
550
and efficacious; but an inspection of the foot in profile is usually the best way of deciding. Too much importance can not possibl}^ be attached by the workman to this and tlie succeeding step, namely, leveling the ground surface of the foot, as the slightest departure from absolute exactitude here renders whatever amount of care he may devote to the completion of his work vforse than useless. The ver}^ smallest deviation from the perpendicular entails disastrous con- sequences not only on the foot but on the entire limb. In the foot itself, when the weight is borne unevenly, the lowest parts receive an undue share; the pressure retards the growth of new horn, and the foot in consequence becomes weakened, distorted, and deformed. In the limb, deflected as it is by an uneven basis, from the ground sur- face to its union with the trunk, the angle of incidence of the weight is imposed unequally, and bone and tendon mutually suffer from the strain.
THE SHOE.
The shoe should be as liglit as the Aveight of the animal and the nature of the work he is expected to perform will admit of. I am not now writing for the trotting horseman, who knows his own business better than I can teach him. In referring to shoeing smiths it is pos- sible that I should have made an exception in favor of the finished artist who arms the feet of the trotter with those masterpieces of skill and ingenuity wdiich balance his gait, level his action and perfect the rhythm of the motion with which'he spurns the flying track behind him, wdien thousands of anxious eyes watch his every footstep, and fortunes depend on the length and tirelessness of his stride. That is a branch of the business which has received an amount of attention and achieved triumphs unrivaled or unapproached in other lands. Yet have I seen that artist (for he is nothing less), after fitting and setting a shoe, perfect in workmanship as a piece of jewelry, reach out for his tool box and rasp the foot from the coronary band to the plantar border, and thus wantonly court disaster, for what reason let him tell us if he can.
Heavy shoes not only burden the animal which is condemned to wear them, for there is truth in the old adage, "an ounce at the toe means a pound at the withers," but they also increase the concussion insepa- rable from progression, and even in the trotter, whose work is meted out to him v.'itli judicious care, although the weight doubtless accom- plishes the work for w^hich it was intended, it is a draft at usury on the horse's futui-e soundness, which that animal is bound to take up at maturit3^
The legitimate mission of the shoe is to prevent undue wear of the walls, and a light shoe will do this quite as well as a heavy one; it is moreover entirel}' erroneous to suppose that a heavy shoe necessarily wears longer than a light one, as experience proves the contrary, in manv instances, to be the ease. Even among our mammoth draft
551
horses, Avliose shoes must of course he made with reference to the weiglit tliey liave to bear and the inordinate strain to whicli they are subjected when the animal wlneli Avears tliem is at work, I am not prepared to admit that it is l)yauy means necessary to add to the con- cussion to wliich his feet are unavoidably subjected, by several i)ounds of unyielding iron on each foot, when shoes weighing half as much would serve the purpose equally well. The lamentably short career of our city draft horse, which is usually determined by foot lameness of one kind or another, is largely attributable to the aggravated amount of battering on hard pavements which his needless weight of armament entails.
The upper su rface of the slioe should l:>e perfectly level. If the plane of the web inclines from outside inward, it greatly adds to the una- voidable tendency to contraction which shoeing invariably entails, and there is a wealth of unwisdom in most of the clumsy attempts at meclianically spreading the heels by making the inclination in the contrary direction. It is true that in cases of malformation, or grave alteration of the contour of the foot, good results are obtainable by this or other mechanical means, but all such heroic remedies should be undertaken only at the instance and under the immediate super- vision of the veterinary practitioner; otherwise they are liable to do harm instead of good.
In France dilatation of the hoof by mechanical means is advocated and practiced more than elsewhere, but the operation is performed with the utmost exactitude, scrupulous care and delicacy, and under the closest professional supervision. Even under these favorable con- ditions the slightest accidental deviation not only defeats the object in vievv^ but occasionally leads to untoward results. When con- tracted feet have to be expanded there is a far more simple, safe and at the same time effective means of attaining that end to be found within the foot itself. By lowering the walls at the heels, so as to restore frog pressure, the latter speedily recovers its lost character- istics, and in a healthy condition gradually and naturally accomplishes one of the very purposes for which the Great Architect placed it there. It would seem to be unnecessary to say that the shoe sliould be so shaped as to conform exactly to the natural tread of the foot, yet a very common practice obtains of using a shoe of a uniform shape, often less in circumference, if such a term is permissible, than the foot on which it is to be nailed, and then rasping down the foot to fit it. It is ol)viously easier to make the foot to fit the shoe than it is to make the shoe to fit the foot; a stroke or two of the rasp effects the former, but it is a far more arduous undertaking to modify the size and shape of the shoe. The outcome of this pernicious practice is disastrous in the last degree, more especially so in a dry climate like ours, as the walls thus robbed of their natural covering permit the moisture of the foot rapidly to evaporate, and the horn fibers, Avhich make up the
552
outside walls, instead of being compactly knit together, readily disin- tegrate, and in tlie course of a shoeing or two those very portions in Avhich the nails should obtain firm hold possess little more adhesion than a bundle of broom corn. If the shoe fitted as it ought to do, a touch of the rasp under each clinch would be all that was necessarj'-, and even this much might advantageously be dispensed with. Plate XX XXIV illustrates correct and incorrect fitting, figure 1 being the right and figure 2 the wrong way.
FITTING.
In many countries what is called hot-fitting — that is to say, after the foot has been trimmed and leveled, momentarilj^ applying the shoe at a red heat to the foot — is generally ijracticed to the almost entire exclu- sion of any other method, and the system is not only found to answer, but receives the indorsement of the most competent authorities. The climatic conditions which render the practice open to objection in this hemisphere fortunately enable us to dispense with a procedure against which there exists in the minds of many horse-owners a not unrea- sonable prejudice, which, however, is directed at the abuse rather than the intelligent application of a proceeding not necessarily^ hurtful in itself. The advantage conferred by hot-fitting consists in the fact that a more accurate accommodation is by this means more readily obtained than by any other method, and the contact between hoof and shoe can thus be made more intimate and enduring. In moist cli- mates it is only by means of hot-fitting that a set of shoes can be got to remain on for a reasonable length of time; but in no ]3art of this country have I found any difficulty of this nature; indeed, on the con- trary, shoes are usually allowed to remain on too long, especially in the agricultural districts. It has frequently occurred to me, wdien in the discharge of my duties as veterinarian to the Farmers' Institute of Minnesota I have remonstrated with some local blacksmith at the number of gigantic nails he employed in affixing a shoe, that I have been assured that did the shoe not remain on for several months his employer would be dissatisfied and would transfer his custom else- where. Nothing could be more short-sighted nor more unreasonable than such conduct.
The hoof of the horse is in shape a truncated cone with the base downwards; as it grows the circumference of the base consequently increases, and the shoe fitted when it was newly put on after a time becomes too small. It would bo just as reasonable for a horse-owner to buy his little boy a i)air of shoes which just fitted him when he was six years old, and then expect him to wear them until he was twelve, as it is for him to require his dumb servant, who can not protest against the infliction, to wear his shoes for months in succession with- out resetting. A badly fitting shoe is to a horse as painful as a tight boot is to his owner, and under no circumstances should shoes be
553
permitted to remain on more than a month or five weeks at the out- side; many animals require to be resliod even more frequently. It is only when an owner lets his parsimony overcome his reason that he subscribes himself to a penny- wise and pound-foolish policy, which can only result, as such policies invariably do, in a loss to their exponent
NAILS.
The fewest nails, and these of the smallest size, that will ensure the shoe remaining on for the proper length of time, is a rule tliat should never be departed from. The nail lioles should not be punched too fine— that is, too near the outside edge of the web of the shoe (this is a very common failing of "keg shoes"); if punched coarser the nails will take a thicker and lower hold of the walls, and in this wav obviate their having to be driven so high up as to approach dangerouslv near the sensitive structures. Two of the commonest errors in shoeing are using too many nails and these of an altogether unnecessary size and then driving them too high up into the walls. If a perfectly level bearing has been obtained-as ought to be the case-it is astoiiishino- how few and how small nails will hold the slioe firmly in its place'^ but let the fitting be carelessly done, then, no matter how the shoe may be nailed on, but a short time elapses ere the clinches open and the shoe works loose. When we bear in mind that the wall of the hoof consists of a number of hair-like tubes cemented together and that each tube is one of an infinite number of minute canals' which diffuse throughout the horn a fluid that nourishes and pre- serves It, It will be readily understood that each nail driven into the wall deflects those little tubules, probably absolutely closing those with which It comes into actual contact and hurtfullv compressino- those lying half way between the nails, thus impairing if not destrov^ ing their utility and cutting oif the supply of a material necessarv to the foot s existence. If we could dispense ^vith nails altogether our horses feet would be immeasurably better off. This, unfortunately we apparently can not do, but we have it in our power to minimize an evil which, at present, at all events, we can not entirely avoid There 1ms recently been patented in England a nailless horseshoe, for which the patentees claim extraordinary excellence. I have not yet been able to see one of these shoes, but if they will enable us to dispense with the use of nails they will confer a priceless boon on horseflesh generally. From the description given by the patentees I fail to see however, how the shoes can be kept sufficiently firmly in place, nor cun 1 glean from the same source that the new method of attachment (by means of a metal band and studs) is equallv efficacious with the old, or less injurious.
There is, however, one shoe, without some allusion to which any essay of this kind would be incomplete, namely, the "Charlier shoe," 5901 — iioR 18*
554
invented some years ago by M. Cliarlier, a well-known veterinary sur- geon of Paris, France, wliicli lias never, in my opinion, received either the attention or trial its merits deserve. Common sense and science alike indorse it, and were the system to become more generally known in this conntrj' I venture to assert that there is an extremel}' large number of cases in Avhich it would be found both approx)riate and beneficial. For this reason I will briefly describe it. The shoes used are about one-third the weight of an ordinary shoe, and less than one- half the width. In preparing the foot for the shoe and sole, frog and bars are left, as they ought to be, absolutel}' untouched, and a groove is cut, by means of a knife speciall}' designed for the purpose, in the wall, not high enough to reach above the sole level, and less than the thickness of the wall in depth. Into this groove a narrow but thick band of iron is sunk and nailed to the foot by means of four to six conical-headed nails, the heads being countersunk in the shoe. The advantage of this method of shoeing is that the frog, bars, and a por- tion of the sole come to the ground exactly as if the foot were unshod, and one and all participate in weight-bearing as it was obviously intended they should, while the wall is protected from wear by the small rim of iron let into its ground surface.
A modification of the system has been suggested by an enthusiast who writes under the name of "Free Lance," which possesses even superior advantages. Under this sj'stem onlj' tii3S or toe-pieces of the Charlier pattern are used, the foot being prepared for their recep- tion, as shoAvn in Plate XXXXIY, Fig. 3. The tips are made with their ground surface broader than their upper face, and the outside edge of the web beveled ofl so as to follow the angle of the profiles of the foot. (Plate XXXXIV, Fig. 4.)
I have used both the Charlier shoe and the tip in this country- as well as in the East Indies, and I am lierfectl}' satisfied that in many respects they are superior to any other model. They are infinitelj' lighter, the nails are smaller and fewer in numljer — all steps in the right direction; but the dominant superiority' of the device consists in the fact that the frog obtains i3ressure to the extent contemplated by nature, and in the case of the Charlier tip particularlj- the exercise of its double function as a buffer and dilator is absolutelj' untrammeled in any v/ay by the shoe.
FINISHING TOUCHES.
When the shoe has been fitted, the nails driven, drawn up, and clinched, there should l)e nothing left to bo done. Very frequently, liowever, it is just at this stage that the incompetent workman, in the most uncalled-for manner, inflicts serious and lasting injury on the foot. If the wall has not been sufficiently reduced in leveling the foot, or if the shoe used is too small, the rasp is required to reduce the projecting parts. (Plate XXXXIV, Fig. 2.) Often, indeed, when there is not
555
even this pretext, tlie whole surface of the foot is subjected to its relent- less touch. No procedure could well be devised vdiicli would bo more luirtf ul to the foot. In its natural state the entire hoof, from the coronet to the sole level, is covered by a fine coating of natural varnish, tliickest at the upper margin and gradually becoming thinner as it descends. Ujider cover of this beneficent curtain the iiew horn is secreted and protected until it has attained maturity. The moisture secreted by the animal economy necessary to the perfection of the horn is retained vdthin it, and the prejudicial influences of alternating drought and moisture are set at defiance. In a very dry atmosphere like ours it is of paramount importance that this beautiful shield should be pre- served and fostered, and no name is bad enough for a senseless cus- tom which, to serve no good purpose, robs the foot of a necessary protection which it is beyond the power of art 1o imitate or replace.
IVINTER SHOEING.
The subject of winter shoeing presents, in many sections of the country, fresh difficulties, for now the shoe is required, in the case of all classes of horses, to discharge a double duty; to afford foothold as well as guard against undue wear. Various patterns of shoes have from time to time been invented to meet this dual requirement, but the commonest of all, fashioned with shoe and heel calks or calkins, is, faulty though it be, probably, all things considered, the one which best suits the requirements of the case. It should, liowever, never be lost sight of that the shorter, the sharper, and the smaller the calkins are, so long as they answer the purpose which called them into exist- ence, so much the better for the foot that wears them. High calkins, while they confer no firmer foothold, are potent means of inflicting injury both on the foot itself and the superincumbent limb at large! It is only from that portion of the catch which enters the ground sur- face that the horse derives any benefit in the shape of foothold, and It must be apparent to the meanest capacity that long calkings, which do not penetrate the hard, uneven ground, are so many leavers put into the animal's possession to enable if not compel him to wring his feet, rack his limbs, and inflict untold tortures on himself. I have laid particular stress on this subject, as I am of opinion that the pres- ence of navicular disease, a dire malady from which horses used for agricultural lal)or should enjoy a practical immunity, is traceable largely to the habitual use, during our long winter months, of need- lessly large calkins, only fractional parts of which find lodgment in the earth or ice during progression. I will explain what' I mean A\ hen a horse is shod with the exaggerated calkins to which I have alluded, the toe and heel calks are, or ought to be, tlie same height to start with, at all events. Very often, hoM^ever, they are not, and even when they are, the toe calk wears down on animals used for draft purposes far more rapidly than its fellows at tlie heel The
55G
result is that the toe is depressed ^vhile the heel is uunaturally raised. The relative position of the bony structures within the foot is altered, and the navicular bone, which is not one of the weight-bearing bones, is brought within the angle of incidence of both weight and concus- sion, influences which it was never contemplated it should withstand, and which its structure precludes its sustaining vrithout injury. The bone becomes first bruised and then diseased; the tendon to which it was intended it should act as a pulley, which passes over and is in constant contact with it, before long also becomes implicated, and what is technically known as navicular arthritis is thus engendered and developed.
SHOEING FOR A SPECIFIC PURPOSE.
Thanks to the amount of attention whicli every detail that could possibly tend to the more perfect development of that paragon of horseflesh, the American trotter, has received at the hands of all classes of men, the matter of shoeing for specific purposes has made greater progress in America than in any other country on the face of the globe, and that is a department of the farrier's art which is justly entitled to the highest eulogium that can be bestowed upon it.
The dift'er.ent styles of shoes which have been devised are marvels of ingenuity, and many of them are admirably effective as remedial agents for faulty gaits and uneven action. Their number is infinite, but as many are applicable only, or in a large measure, to horses used solely for speed purposes, any attempt at classification or detailed description v.ould be out of place in a work of this kind. Wlien intel- ligentl}^ applied a considerable number are, however, potent auxiliaries in mitigating in some cases the results of natural defects of conforma- tion amongst animals whose lot is cast in the humbler if more useful fields of horse enterprise. Among these are the scoop-toed or roller- motion shoe for the fore feet (Plate XXXXII, Fig. 2) and the shoe Plate XXXXII, Fig. 3) for the hind feet, which, while they obviate "forging" or "clicking," a habit hurtful to the horse and singularly annoying to his driver, do not in any way tend to inflict injury on the feet or limbs. The scooped or rolled toe confers a mechanical advan- tage, enabling the animal to get over his toes more promptly and thus remove the front foot from the stroke of the hind extremity, while the lengthening of the branches of the hind shoes, by increasing the ground surface, retards the flexion and extension of the hind limbs.
The common practice of increasing the weight of the outside web of the hind shoes, to open the action (Plate XXXXII, Fig. 4), is equally harmless and efficacious when not carried to extremes.
Plate XXXXIII, Fig. 1, is the most effective model of shoe to square and balance the gate of unmade horses, but the period of its use should be strictly limited and the weight of the toe graduallj^ reduced as the desired gait becomes established. An ingenious shoe to prevent
PLATE XXXXII.
'/'he foot rearh/ foi-the shoeiShmririf/ fi-oc/ /nid bw.f nn thev shou/d fx' lefi
/•'roiif I'tfiv of.scoi>/>ff>(' it)/Jni</iiittfi'nii shoe
/fiiiil f'o/ji .sjiar /o htiliim-e //if ar//<//i
• Side wi-iijfit slini- for h in// f'oo/
Ki'js 2,3 and VCrorn'RusseH's Scientific HorsH shoeing .
A Hoen sCo Lith. Baltimore-
PLATE XXXVIII
Top wf'igfii .shoe
^
A^oii -/)(ii/r//inf/ shnc
KrDni'RiissGll'.sScionlit'ii; Horse; shoeing
A Hoen &Co Litb. Baltimore
PiATE
Foot prepared /w- Charlier I if) .
Foot shod u'iilt. (^Juu-Uej- Up.
RigM fiUmg.
Wrong niiing.
Haines, del.
A Hoen&Co Lith. Baltimore
557
'•dishiug" or "paddling" is shown in Plate XXXXIII, Fig. _', but I can not acknowledge so implicit confidence in its efficacy, as the vice is the result of a j)hysical malformation,- which mechanical means can go but a small waj' to remove or palliate.
There are many other styles of shoe, the product of American inge- nuity, for which probabl}" equal merit might be claimed, but there are others, which, while they ma3" cure or mitigate the special defect against whicli they are directed, only do so at the expense of some other j)ortion of the structure. It has many a time furnished food for thought to the writer, that, in this great commonwealth, while there are such a large number of artificers who make horse-shoeing a pro- fession, who offer such convincing testimony of a vast amount of care- ful thought and patient study of at least some of the principles of their very important i)rofession as many of these devices afford, the bulk of such work should be permitted to fall into the hands of a set of incompetent, ignorant, and ofttimes unprincipled bunglers, who prey upon the credulity of their emploj^ers and inflict upon the most generous of all our dumb servants an amount of injury which curtails the period of his usefulness and results in his premature decadence at an age when he ought still to be in his prime. It is possible, if not probable, that in the future it maj^ become a less invidious task to discuss this much vexed problem. In this age of marvelous ingenuity, is it visionary to hope that it is within the power of chemistry to develop some preparation which, applied to our horses' hoofs in a liquid or pultaceous form, will quickly harden into a substance closely resembling the natural horn, which will enable us to dispense alto- gether with the lieav}', unyielding iron, and while it affords the neces- sary protection to the foot will permit it to retain to the full its won- drous combination of lightness, strength, and elasticity, and enable it to perform its varied functions under the most exacting conditions wiiich advanced civilization can impose, with that marvelous trinity of ai)i)arently incompatible characteristics unhampered as they left the workshop of the Creator, all acting together in perfect harmony and absolute efficiency?
In the meantime it behooves us to make the most of the means within our power. Our horses are national property. Surelj', there- fore, it is time that the possibility of a great national economy was recognized, and some legislation formulated which Avould require an established standard of attaijiment in a class of workmen to whose care propert}^ of such value is habitually intrusted, and uijon whose proficienc}^, or the reverse, so much of its utility or comparative worth- lessness depends, while it, at the same time, provided for some means of practical instruction Avhich contemplated raising the science of horseshoeing above the baneful influences of ignorance and traditional I'outine, to that position to which its impoi-tance to us as a people justly entitles it.
IINTDE X.
Page.
Abdomen, dropsy of — 53
of foal, dropsy of 168
swelling of 146
Abortion 158
Abrasions by collar and saddle 468
Abscesses, acute 469
cold or chronic 470
intercostal 131
of the brain 193
heart 235
pllar^^lx 27
Acariasis 453
Amaurosis - 209, 275
Amnios, dropsy of 155
Antemia. cerebral 201
spinal .- 213
Anasarca 502, 505
Anchylosis from injury of joints 336
Aneurism 244
Ankles, cocked 374
diseases of 369
Anthrax 528
Apoi)lexy, cerebral 198
of the lungs 118
Arsenical poisoning. _ . 34
Arteries, aneurism of 244
constriction of . 244
diseases of 243
inflammation of 243
nature and functions of 227
rupture of 246
throT^bi and embolisms in 246, 305
Arthritis 334
Ascites 55, 168
Asthma : 132
Atheroma _ . 244
Atrophy of the brain 201
heart ....... 243
AiiscultatiOn 110
Azotcemia 08
Azoturia 68
Balls, liow to administer 9
Bee stings _ -Ll.j
559
5(J0
Pase
Beets as feed 21
Belly-ache (.sv^c also Colic) 39
Big leg (lymphangitis) 253
Black jjigment tumoi's . 365, 450
Black- water (azoturia) _ 68
Bladder, diseased growths in 77
eversion of . 78
inflamination of 75
irritable 77
Xjaralysis of . . 75
spasm of neck of 73, 308
stone in 85, ICG
worms 73
Bleeding after castration 146
from Inngs 131
ruptured artery . . 246
womb 180
skin eruption 443
Blind staggers 816
Bloat (tympanites) _ , 31 , 41
Blood spavin 333
vessels, diseases of 235, 329
Bloody flux (dysentery) 48
urine 67
Bog spavin (blood spavin) 333
Boils, nature and treatment of . 441 , 444
on the eyelid 263
Bone spavin , 297
Bones, anatomy of 281
diseases of 289
fractures of 301
Bots 35
Bowels. (.S^ce Intestines.)
Brain, abscess of 193
affections, acute 193
amemia of 201
anatomy and physiology of 187
atrophy of . _ . 201
complication from influenza . 497
comiiression of _ lOv)
concussion of 300
congestion of 195
dropsy of . . _ _ 201
envelopes, inflammation of 191
hemorrhage of 198
inflammation of 1 89
paralysis of 193
softening of 193
substance, inflammation of 192
Bran as feed . . 31
Broken bones. (.SVe Fractures.)
knees 334
wind 133
Bronchitis _. 110
561
Broiicho-plenro-piieumoiiia _ ^^q
Bronclio-pneuinonia '
Bruises .^.^^ ^^^
Burns and scalds,. V-^" ,„'
Bm-sae. {See Syno\-ial sacs. )
Calculi, biliarv .
. : ' w
gastric ^^
intestinal ... ,~
preputial ^o
renal . ^.j
urethral q„
uietral ' „<
urinary, classes of c,^
n ,, ^'^^'^^^ 85,166
L alk wounds _ or.q
Callosities , '^
Cancer, eucephaloid (soft) o/>- o-p
epithelial .-„
spinal 2j^
Canker in foot of>n ~, ,~
„ , „ - - 6\)2, 440
Capped elbow . . . „^^
, , 353
hock ._ 3g^
knee .,_,
?^^T -'-.-. -------"^-^i-;::;::::::::::: 334,336
C arrots as feed ^.
Castration, conditions favorable to . 14-
covered method of . -..n,
of cryptorchids (ridglings) j45
mares \[\. 148
stallions ^ i,
ti-eatment of complications of I45 j4g
Cataract ' ^^_
Catarrh, acute nasal "'[-,
chronic 'S^^
Catarrhal fever . _' "
Cer ebritis
Cerebrospinal meningitis. ^.t
Chaff as feed '^'
Chaiing^by harness ,^0
Chapped hock " ._
knee
Charbon (anthrax) . -,^
Charlier shoe " LI
Chest cough j- ."-.'..._.'"" i^/o
diseases, methods of examination for j„-
percussion... ..^ .,'
pulse , ,^
respiration
secretions _ "-^!!" !!!! ^^l!!]]"'"""" i„9
temperature '
wounds _ _ _^
Chigoe, treatment for 'J'
Choking, causes of '^l
cervical _,
thoracic "'
562
Pago.
Chorea 304
Choroiditis 269
Clubfoot 373
Coma (sleepy staggers) : - 205
Cocked ankles (knuckling) . 374
Cold in the head - - - - 92
Colic, cramp or spasmodic 39
flatulent or wind 41
from aneurism 244
Collar galls 468
Colt-ill 508
Concretions, gastric 44
intestinal 44
Congestion . causes of . 478
of the brain 195
lungs _- 115
skin . 433
passive 479
spinal -• 212
Conjunctivitis 266
Constipation 43
Consumption 133
Corn as feed 21
Cornea, ulcers of 2(}8
Corns.... 394
Costiveness ^'^
Cough, chronic 135
dry and moist 110
Cracked heels 445
Cramp of hind liml) 156, 203
Crami)-colic 39
Cramps 203
during parturition 156
Cranium, tumors in 202
Crick in the back _ _ . 367
Crooked foot . 373
Croup 103
Curb 348
Cuts 461
Cj^anosis - - 243
Dentition 23
Dermatorrhagica parasitica 443
Diabetes insipidus : C4
mellitus (saccharine) 65
Diaphragm, rupture of 138
spasms of ' 137
Diarrhea - . 47
Digestive organs, diseases of ... . 15
Diphtheria 103
Dislocations, indications of 337
of the hip joint 339
patella 339
slioulder joint S33
reduction of 337
563
Distemper . ^^^
Diuresis „ ,
Doxiche, nasal -.^
Donriue ^,1
Drenches, how to administer jq
Dropsv of abdomen ~- i~c
amnios -,—
bram 2^^
f cetus 1 «A
scrotum
sjniovial sacs Avoinb
Ectropion
Eczema
Edema (oedema) Elbow, capped...
Eruptions, bleeding skin
Er}-thema
Erysipelas
Exostosis
Eye, affection of cornea of_.
diseases of
examination of
lachrymal apparatus of
muscles of
parasites in
waterinsr of
tumors of.
Eyelids, boils on
diseases of
droopinc^
inflammation of _ . .
inver.sion and oversion of. spasm of ....
141 332
Dysentery - . o
. 2m
-. 439
. 5Q4
. . ^~\?
sprain of muscles of 3^P
Electric shock Electuaries . . Elephantiasis
Embolisms n < ^ o^-
Embryotomy -,~,^
Emphj'sema of foetus
Encephalitis .
Endarteritis
Endocarditis
Enemas
Enteritis
Entropion
Epilepsy
Epithelioma
Epizooty (see also Influenza) . ^~' 4m
223
10
S53
177
169
190
243
230
12.40
53
263
205
142, 450
443
433
44g
Exhaustion (see aZso Sunstroke) jg-
289 268
253
25S
T 257
: 276
T-, 1 „ 265
Eyeball, anatomy of o--
276 263 259 260 261 263 260
564
Page.
Eyelids, tumors of 264
warts on 264
wounds of 264
Fainting 239
Falling fits 205
Farcy buds 440.535
, chronic (see also Glanders) 535
Favus ^^^
Feeding ^'
Fetlock, diseases of ''""
sprain of _ _ ^""
Fevers, kinds of 486
rheumatic ^^^
splenic ^"^'^
treatment of.-.. ^^^
Fistula} - . - ^'^
of the foot (quittor) 380, 474
Flat foot _ ^'^
Flatulent colic (tjanimnitis) 31,41
Flaxseed as feed 21
Fleas 4f
Flexor metatarsi, rupture of 351
Flies, protection from ^''^'^
Flooding ^^^_
Flux, bloody (dysentery)
Fly-blow
Foaling {see also Parturition) 160, 172
F«jetus. adherent to walls of womb 1*5
constriction of member by navel cord
dissection of ^'^
dropsy of ^"^
emphysema of -^^^
excessive size of 1"'
extra-iiterine development of l-'^-^
prolonged retention of . . . l'"^"
tumors of - •
Foods and feeding
effects of changes of.
preparation of
Foot, anatomy of
complication from influenza •*•'■!
diseases of 'ff
faults of conformation . ^'"^
454 mange
wounds of ^^^
Founder (see also Laminitis)
Fractures, causes of
nature of.- f^^
of bones of face 315
cannon bones
coronet ■
o-i A
cranial bones
326
48 455
108
170 17 19 22
369
329
femur
first phalanx,
329
565
Fractures of forearm of-fj
624:
hip bone, effect in parturition. jgg
hock... goQ
humerus o^ ,
^'i^ee -[[][][ 325
lower jaw pj/>
OS innominata oon
pedis v.///. 829
patella oo'^
pre-maxillary bone oi g
"^^- --- "------------";;-;;:':::::; 319
"^'^^"^ 164,320
scapula goQ
sesamoid bones ooa
tibia .. .j,^
vertebrae „. ^
--- oil
progiiosis 01 .3„^
reduction of o.l
retention of o^j.
Frog, bruise of " ^^^
Frost-bites
Furuncles (sec also Boils) >^63 441
Gall-stones "^ ' '
Galls, collar and saddle
Gangrene
Gastritis
Generative organs, diseases of Gestation, extra uterine
59 468 131,425.504
139
, , --- 153
prolonged -. _ „
Glanders
acute
cause of
chronic
pustules of
treatment of
Gleet, nasal
urethral
Glossitis
Glycosuria
Grains, feeding value of
Grasses, feeding value of _ . .
Gravel
Grease ....
Grubs on and under the skin
Grunting
Gullet, diseases of (see oho (Esophagus) " " _ 2-^
530
539
532
537
440
541
94
79
25
65
20
22
80
446
434
Gunshot wounds Gut- tie
Guttural pouches
Harness galls
Haematuria
Ha?mogiobinuria .
Haemorrhoids
Haw, tumor of . . .
467 47
106
468 67 68 49
265
566
Page.
Hay as feed 19
Heart, adventitious growths in 238
anatomy and iiliysiology of . 225
atrophy of 243
congestion of 2-12
dilatation of . 241
diseases of 225, 229
enlargement of 240
fatty degeneration of 241
functional and organic diseases of . 238
liypertropliy of 240
palpitation of 239
rupture of . 242
sounds of 228
valvular disease of 237
weakness of 242
Heaves 132
Heels, contracted 403
cracked 445
inflamed 446
Hemiplegia 207
Hemorrhage, cerebral 198
Hepatitis 56
Hernia, diphraginatic 54
inguinal 52
kinds of 51
scrotal ._...• 52
umbilical 53
uterine 164
ventral 53
Herpes (shingles) 443
phlyctenoid 521
High blowing -. 105
Hip bones, fractured, effect in parturition 163
joint, dislocation of 339
lameness 344
Hip- joint disease 345
Hock, capped 360
chapped . 445
Hoof, contracted 403
cracked 405
Hoof -bound 403
Horny sloughs 449
Horsepox 521
Hydrocele 141
Hydrocephalus 168, 201
Hydrophobia 221, 542
Hydro-thorax , . . 130
Hypertrophy of the heart 240
Incoordination of movement 208
Icterus 57
Indigestion . . .- 36
Inflammation, character of . _ 475, 480
of the bladder . 75
5G7
Pajo.
Inflammation of the bowels fjO
brain and its membranes 189
eyelids oQl
heart . 030
heart-case _ 335
kidneys _ '_ 70
knee joint 334,335
lymphatic glands. 253
mouth (stomatitis) 05
nerves . __^ oj.j
periosteum 039
skin 439,440
testicles I39
tongue 05
womb and peritoneum. . 18:j
Influfcftza, alterations of 5Q()
complications of 494
definition of 49I
diagnosis of 493
etiology of 493
in-ognosis of 499
sequela? of 503, .506
symptoms of ■ 493
terminations of 494^ 504
treatment of 500
Injections 13 13 4^^
Inosuritv _ (55
Insufflation of medicines H
Interfering 362,373
Intestines, complication from influenza 494
diseases of 39
inflammation of 50
intussusception or invagination of .. . 45
large, impaction of 43
stones (calculi) in 44
twisting of 47
worms in 38
Invagination. (See Intussusception.)
Iritis.
2G9
Itching from mange 453
Jaundice 5^
Jerks (chorea) 394
Joint water (synovia) , escape of _ 334
Joints, di.seases of 333
dislocated 337
open 334
stiffened by injury (anchylosis) _ 330
Kidneys, acute inflammation of 70
chronic inflammation of 73
tumors of _ 73
Knees, broken 331
capped 357
chapped 445
effects of injuries to 334
5G8
Page.
Knees, sprung 348
Knuckling- _ _ 37-4
Labor pains, premature - 163
suppression from bladder disorder _ _ . ....... 1(55
Lameness, causes and treatment of . . . 2T9
definition of . . 284
location of 288
of the hip , 344
shoulder - . 341
Laminitis (founder) 413
complications of. . 421
curative measures for . 428
exciting caiises of 414
following parturition ....... 184
prevention of 426
symptoms of - 418
treatment of 428
Lampas . . 25
Larvfe on and under the skin - . 455
Laryngitis 98
Laryngismus para,lyticus 103, 208
Larynx, spasm of _ _ - - - . 103
Lead x>oisoning. 33, 223
Leucorrhoea . 183
Lice 452, 456
Ligament, suspensory, rupture of 377
Linseed as feed. . . . 21
Liver, diseases of 56
inflammation of - 56
ruijture of 58
stone in ducts of . 59
Lock-jaw 219
Locomotor .ataxia 208
Loins, sprains of 367
Lung fever 118
Lungs, abscess and suppuration in 131
anatomy of 115
apoplexy of 118
bleeding from . . 131
complication from influenza 496
congestion of 116
consumption of .. 132
drop.sy of 133
mortification of 131
Luxations (see also Dislocations) . ... 337
Lymphangitis 252. 504
Lymphatic glands, abscess and inflammation of . 251
hypertrophied _ 252
system, diseases of 251
Mad staggers _ 191
Madness (rabies) . .... .. . 231
Maize as feed 21
Malignant pustule (anthrax) 536
Mai du coit 143
569
M^°g« ---- 419.438
Masturbation __ j^2
Medicines, how to administer 9
inhalation of j j
injection of . - o 13
insufflation of U
Megrims ^q~
Melanosis 2Q4 450
Meningitis, cerebro-spinal 191 215
spinal 219
Metastasis _ 503
Moles . ' . ] r. . 154
Monstrosities 15^ j-q
Moon-blindness . 'o~i
Morbus coxarius g^-
Mortification -.oi
Mouth, diseases of o-
Muscles, anatomy of _ oqi
diseases of -_ _ 011
of foal, contraction of 1(39
Myelitis _ .,-, I
Myocarditis r,oA
Nail pricks .q^
Nails for shoeing ~~Z
Nasal catarrh 90
douche ^ o
gleet_ f^
Navel, discharge of urine by i^g
Navicular disease .go
Nephritis, acute *l^
Nerve, inflammation of o^-
injury to . " " ! 215
tumor of ^.-
Nervous system, diseases of lg.j,
Nettlerash ^.
Neuroma ,,._
Neuritis g/-
Nose, bleeding from ~q~
Nostrils. tumors in _ qo
wounds near 9^
Oats as feed ^^
CEdema, enteric r-n ,
, 5U4
pulmonary... g^^
(Esophagus, diseases of ' o~
saciTlar dilatation of.
30
stricture of 29
Openjoints gg^
Ophthalmia, external 266
internal ^ 269
recurrent or periodic . . 971
Optic nerve, paralysis of '^09 2'^1
Orchitis ' ' ^^^
Ostitis I ."y^\\ .[.["[[ 389
Overreach „^^
570
, , rase.
Palpitation of the heart -.. - 239
Palsy {see also Paralysis) . 206
Papilloma 142
Paralysis (palsy) 206
during pregnancy 156
facial 208
intestinal 209
local --. 208
of bladder . 209
hind extremities 156, 207
muscles of limbs 208
optic nerve 156, 209, 278
penis 142
rectum and tail 209
side of body _-. 207
Paraphymosis 147
Paraplegia 207
Parasites, animal, of the eye 276
kidneys . _ _ . 73
skin 452
vegetable, of the skin .__, 451
Parasitic pityriasis 452
Parrot-month 24
Parturition. difBcult . IGO, 161, 165
natural -.- 160
of twins_. 172
symxstoms of - _ 160
Pastern, injured by knuckling ... 374
Patella, pseudo luxation of 339
Pediculi 456
Peditis 425
Pelvis, tumors in 163
Penis, growths on 142
paralysis of 142
rujjtured blood vessels of 142
swelled 146
warts on 142
Pericarditis -. 235
with influenza. 498
PeriufBum, dropsy of 156
Periostitis 289, 425
Peritonitis .54
Pharyngitis 26
Pharynx, abscesses in 27
inflammation of - - . 08
paralysis of 26
Phlebitis 348
Phymosis 147
Pigeon-toed foot 373
Piles : 49
Pimples with congestion 438
Pink-eye (see also Influenza) 491
Pin- worm 38
Pityriasis 442
571
Pleurisy. ^^^^
sj-mptoms and prognosis j.jr.
treatment of -i .^^^
with influenza ,oq
Pleurodynia ' ^ ^^^
Pleuro-pneumonia . ....^
Plica polonica ,'
Plurabism gg ^,1,^
Pneumonia (lung fever) 'T^o
metastatic aoo
cedematous . -7-
" ol.j
with bronchitis . .. -.o-.
and pleurisy jyo
with pleurisy -. oq
Poisoning, arsenical o -
lead OQ oot)
Poll evil '~:"
Polypus, nasal _ _ _ „„
pharyngeal ' _"_" g~
Polyuria - --- .-
Potatoes as feed *. q.
Powder?, how to administer ~q
Presentations, natural -,,.\
wrong j-.^
Pregnancy, care of mare during . _ ' ^ -o
constipation during -,-1
duration of i -.-,
mdications of ^-r,
ovarian, tubal, and abdominal : 153 ^ -^
paralysis during ' . -^
Proud flesh :-::::."";::;::::::::::"" lit
Pruritus ^ ..,
Psoroptic acariasis ^~^
Ptosis..... -----!-!"i!!---!!"" ';'!]";!;;;"; o^o
Ptyalism .^^
Pulse ---!!!'^!!-"""!!^' 107 oog
Pumiced sole _ * T^-
_ ^2^^
Purpura hemorrhagica ( anasarca) 049 500
Pnstules with inflammation ' ~^''44.0
Pya^-mia ---------.!"!!!"'!!!! 423
Qunrter-cracks .f,.
Quiddmg q^
^"^"•^^ ---,---- ^"--"---"""""^^^V380,474
cartilaginous o^^rj
cutaneous ..y,
subhorny _ oo~
tendinous qo_£
Rabies .. I"-.'!''.! '!"!!!"! 221,542
Rectum, impaction of _ , ' yZ
paralysis of "' ^^^
Respiration ' "!
Respiratory organs, diseases of ...../ 80
Retinitis " ^^^^
Rheumatic fever, remedies for .„ ..,.. 49O
572
Page.
Ringbone _.. 294,412
Ringworm, circinate . . 451
honeycomb _ 452
Roaring 103, 208
Rodent nicer - . - 451
Roots as feed 21
Rnpture (see also Hernia) . . 51
of arteries 246
the diaphragm 138
heart 243
liver 58
shank muscle (flexor metatarsi) 351
stomach . . _ 32
suspensory ligament .-. 377
the womb 164
Rye as feed 21
Saddle galls 468
Saliva, excessive flow of 26
Sand-cracks 405
Sarcocele 140
Sarcoptic acariasis ". 452
Scalds 457,468
Scalma 511
Seal J' skin diseases 442
Scapula, fracture of 323
Scarlatina (anasarca) 502
Scarum 320
Sclerosis, cerebral 193
spinal 211
Scorpion, sting of 456
Scour . 47
Scratches 445
Scrotum, dropsy of 141
Secretions 109
Self-abuse 142
Septicaemia . 423, 504
Sheath, calculi in 88
swelling of 146
Shingles (herpes) 443
Shivering (chorea) 204
Shoe boil 353
Shoeing, article on 545
bad methods of . 546
finishing touches in . . 554
for specific purposes 556
winter 555
nail prick in . _ _ Z... 402
preparing the foot for ... 549
use of nails in 553
Shoes, best form of ..... . 550
Charlier pattern of 553
fitting of - 553
various styles of 556
Shoulder, dislocation of joint of „ . . . 338
573
Shonlder, lameness of _ 3^j
Shoulder-blade (scapula) . fracture of _ 303
Sidebones .'.'"296,411,423
Sitfasts^ ^^9
Skin, bleeding eruptions of 443
disease, scaly ... 442
diseases of ""' 433^436
nervous irritation of _ , 442
structure of 434
thread worms in 443
Sleepy staggers _ oq-
Slobbering (ptyalism) ~o(5
Snake bites 4-g
Softening of the brain j93
Sole, pumiced 4^-
Sore mouth ' ^^
throat- _ Qg
Sores, summer, from thread worm 443
Spasms, causes of
of diaphragm iq-t
glottis '203
intestines. 39
^^^J'^^ .VV/\V" 103
neck of bladder 1^^ oqq
202 203
womb
166
thigh or hind limb . 203
Spavin, blood or bog 003
bo^^ -- -- ---------- --'^^-""^""""^ 297
occult c,Qg
Spaying ...[]].]. I47
Speedy-cuts 3g2 3^3
Spermatic cord, strangulated ' j4g
tumors on. from castration . _ _ 247
Spinal anaemia c,.n
compression 013
concu.ssion oj,
congestion and hyperaemia ojo
cord ^liy~y[" ^89
hemorrhage 213
^^^^«-- — -----------------!!-----"!";■!!:;-■::: m
sclerosis 219
tumors _ 0^ t
Splenic fever " f.^-
Splints .-.--..."....--.." 290
Sprains, causes and treatment of 34j
of the elbow muscles 343
hiP*^ - --"-----^;""^"!!!!;!!" 344
ligaments and tendons 377
loins ^-""-"ll!l!^"!;i"! 367
shoulder 34^
Springhalt (stringhalt) 204 365
Sprung knees ' ~ " p ,g
Staggers, mad or blind jgj !^jg
^^«^py :-------"--"!"";;!-!;-";;;;;;:; "205
574
Page.
Staggers, stoinacli 30
Stallions, castration of , . 144
Staphyloma 276
Sterility 148
Stethoscope, use of - _ 110
Stiffness of joints (anchylosis) from injuries 336
Stifle- bone (patella) , false dislocation of 339
Stings 455
Stocking 475
Stomach, diseases of - 30
gorged 30
inflammation of 33
rupttire of 33
staggers 30
tympanites of (bloat) 31, 41
Stomatitis 25
Stone in the bladder 85, 166
gall bladder 59
intestines 44
kidney 83
sheath 88
stomach 43
ureter _. 84
urethra 87
Strangles . 508
Straw as feed . 20
Stringhalt 204,365
Stye 263
Summer sores -•- - 443
Sunstroke 197
Surfeit 441
Suppuration, excessive 504
Superpurgation 48
Suspensory ligament, rui^ture of 377
Sweeny 843
Syncope 233
Synovial fluid, escape of 334
sacs, diseases of 333
Synovitis 332,334
Tail, paralysis of 209
Tape- worms 38
Tarantula, bite of 456
Tear ducts, inflamed 265
Teats, diseases of 184
Teeth, aching 24
diseases of 23
irregularities of 23
Teething :. 23
Temperatui'o 108
Tendons, diseases of 341
lacerated 349
wounds of 467
Testicles, abnormal number of 141
congestion and inflammation of 139
.075
Testicles, degeneration of j^l j
enlarged and hardened (sarcocele) 140
thickening of cord of ( varicocele) 141
Tetanus Thick wind
--- 219
Thoronghpm g^g
Thread worm
Throat, soreness of
Thrombus and embolism
Thrush
Ticks.
Tinea tonsurans.
475 427 405 25 24 100 263 132
443
gy
:. 246
Thumps 137 203
454
451
Tip (shoe) , form of ^^j^
Tissues, animal
Toe, turning up of
Toe-cracks .
Tongue, inflammation of
Toothache
Tracheotomy, operation of
Trichiasis
Tuberculosis (consumption)
Tumors, black pigment 055 4^0
in vagina and pelvis " 'jgo
of a nerve ^ '_
the cranium ^^q
eyeball 2„g
foetus... T-,-.
^^^
haw . „„_
- ~0o
Kidnej's r-o
nostrils '^"^"!^!! 93
spermatic cord " ^^
spine !!!!!^!!!!!! 214
udder , !j'o:-
Twins, delivery of ^Ji
Tympanites
Typhoid fever {f;ce also Influenza) 40.
Udder, diseases of
tumors of ^„_
Ulcers of cornea. ^„„
Urachus, persistent. ~
Urtemia ^^3
Urethra, inflammation of " ' ""iZ
stone in „„
stricture of.... ^^
Urinary organs, diseases of q.
Urine, bloody
brownish or black go
discharge of , by navel ~o
examination of po
excessive secretion of g.
sweet (glycosuria) . gr
Urticaria ....
^1-1
Uterus. (-S'eeWomb.)
576
Page.
Vachette clasp for toe-crack 407
Vagina, constriction of ... . . 167
effusion of blood in walls of 165
rupture of 167
tumors in 163
Varicocele ... 141
Variola _ 521
Varix 249
Veins, dilated or varicose 249
Veins, diseases of 248
entrance of air into 249
Vertigo (megrims) 195
Volvulus 47
Warts 450
on the penis " 142
teats 185
Water, amount required for drink 15
impurities of 16
time for giving 16
Wheat as feed 21
Whistling 105
Wind colic (tympanites) 31, 41
Wind-broken . 132
Windgalls , 332,375
Windpipe 106
Withers, fistulous 471
Wood ticks 454
Womb, constriction of neck of . 166
cystic disease of walls of. 154
drojjsy of 155
eversion of 180
rupture or laceration of 182
spasm of neck of 166
twisting of neck of 164
Worms, intestinal , 38
Wounds and their treatment 461
by shoe-calks 379
gunshot 467
incised or cut 457, 461
lacerated and contused 457, 462
near the nostrils - 91
of the skin 457
tendons i 467
punctured 457, 464
Yellows 57
Webster Famib' ' ^"^^i of Veterinary Medicine CummlnQs ::: . .. .^.-rinary Medicine at
Tufts Universiiy 200W5StbQrOt..^u North Grafton, MA 01536
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